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Pemphigus is an autoimmune blistering disorder characterized by the presence of intraepidermal blisters and erosions, primarily affecting the mucosa and/or skin. There are no established Indian guidelines for the management of pemphigus, and Western guidelines cannot be directly applied due to differences in clinicodemographic profiles, comorbidities, and resource limitations. These guidelines aim to provide Indian dermatologists with evidence-based and consensus-driven recommendations for the management of pemphigus vulgaris (PV) and pemphigus foliaceous (PF), taking into account the unique challenges posed by the Indian healthcare setting. The guidelines focus on the comprehensive management of PV and PF, addressing diagnosis, treatment, monitoring, and follow-up. It is intended for dermatologists working in both outpatient and inpatient settings across India. The first draft of the guidelines was prepared by the writing group and then reviewed by 19 national experts in pemphigus management, including inputs from allied specialties. Areas with limited evidence or anticipated variation in recommendations were subjected to rounds of voting, with responses categorized as “strongly agree,” “agree,” “neutral,” “disagree,” or “strongly disagree.” Suggestions were incorporated, and statements were revised until a mean agreement score of 4 or higher was reached across 16 key areas after four voting rounds. These guidelines offer a structured approach to managing pemphigus in India, addressing the need for region-specific recommendations that account for unique challenges such as resource constraints and specific comorbidities in Indian patients. They serve as a valuable resource for dermatologists treating pemphigus in a range of clinical settings.

Background: To assess the safety and efficacy of iStent inject placement in individuals with glaucoma with open angles in real world clinical settings. Methods: A review was conducted on the medical records of individuals who received iStent inject implants starting from March 2018. The analysis focused on reductions in intraocular pressure (IOP) and glaucoma medication usage. Safety assessments encompassed intraoperative and postoperative issues, additional surgeries, and improvements in best-corrected visual acuity (BCVA). Results: Analysis of 55 eyes of 48 patients that underwent iStent implantation revealed a mean age of 77 years (range: 51–97). The initial average intraocular pressure (IOP) in these eyes was 20.2 ​± ​6.4 ​mm Hg. Following surgery, IOP decreased by ​≥ ​20% compared to preoperative levels in 21 eyes (43.8%) over the 12-month follow-up period. Notably, there was a significant reduction in medication usage by the 12-month mark (P ​

Rice bodies secondary to synovial inflammation, typically occur in the shoulders and knees of individuals affected by either rheumatoid arthritis or tuberculosis. It is uncommon to encounter these in nontubercular mycobacterial tenosynovitis especially in wrist extensor compartment. Understanding this condition and its distinctive imaging features is crucial for both treating clinicians and radiologists. In this case study, we present the imaging findings of a rare occurrence of tenosynovitis of the fourth extensor compartment in the wrist with the formation of rice bodies due to Mycobacterium avium intracellulare. We have chosen to document this case to emphasize its importance in considering the differential diagnosis of extensor tenosynovitis with rice bodies.

In the real world environment, various micro and nano facial expressions are generated according to the mental state of thought, which leads to a change in an emotional state. A generalizable automatic emotion recognition system is needed to catch these micro and nano facial emotions correctly. Unfortunately, the literature lacks a generalizable Automatic Emotion Recognitions (AER) system. There are various AER systems based on learning and non-learning techniques, but they find it difficult to novel unseen facial expressions, which means they lack generalization ability. This study proposes a generalized deep learning classifier, Generalized Zero-Shot Convolutional Neural Network (GZS-ConvNet), to solve the problem of generalization. The objective of the proposed approach is to enhance the classifier’s generalizability by employing sophisticated adaptation methodologies. The newly developed classifier is meticulously calibrated and optimized using facial expression datasets. Six different datasets of facial expressions were employed to test the effectiveness of the proposed method: FER2013, AffectNet, RAF-DB, CK+, KDEF, and JAFEE. Zero-shot classification is performed on different facial expression datasets to justify the generalizability of the proposed model. The results prove that the proposed model is highly generalizable.

The planar compact four port circularly polarized printed MIMO antenna described in this article is small and intended to support Wi-Fi and WiMAX applications. Suggested four E-shaped monopole elements make up the dual circularly polarized (CP) MIMO antenna that has two left hand CP (LHCP) elements and two right hand CP (RHCP) elements. An I shaped strip is used to join separate ground planes of designed E shaped monopole antenna to have same voltage levels. A good diversity performance is achieved with an envelope correlation coefficient (ECC) of less than 0.15. The 60 mm × 60 mm antenna is designed from FR4 material, which is inexpensive and has a 1.6 mm thickness. Using a high-frequency structure simulator (HFSS), the suggested MIMO antenna is designed and optimized. The measured findings demonstrate the circular polarization, 3-dB axial ratio beamwidth, impedance bandwidth of 2.11 GHz −2.42 GHz and 3.40 GHz-3.51 GHz, adequate axial ratio bandwidth (ARBW) of the suggested MIMO antenna along with high isolation of −17 dB, gain of 3.43 and 2.09 dBic at 2.4 GHz and 3.5 GHz respectively, TARC (Total active reflection coefficient) of less than 0 dB, a CCL (Channel capacity loss) of lesser than 0.4 bits/sec/Hz, and an MEG (Mean effective gain) value of less than 3 dB.

Abstract As digital media grows, there is an increasing demand for engaging content that can captivate audiences. Along with that, the monetary conversion of those engaging videos is also increased. This leads to the way for more content-driven videos, which can generate revenue. YouTube is the most popular platform which shared the revenue from advertisement to video publisher. This paper focuses on the work of video popularity prediction of the YouTube data. The idea of mapping the video features into low-dimensional space to get the latent features is presented. This mapping is achieved by a novel multi-branch child-parent Long Short Term Memory (LSTM) network. These latent features train the fused Convolutional Neural Network (CNN) with LSTM to predict the popularity of unseen videos on the trained deep learning network. We compared our results against Linear Regression (LR), Support Vector Regression (SVR) and Fully Convolutional Networks (FCN) with LSTM. A significant improvement with a 50% reduction in MAE and a 0.61% increase in the coefficient of determination (R²) has been observed by the proposed Multi branch LSTM encoded features with a fused deep learning predictor (MLEF-DL predictor) when compared to existing methods.

Abstract Background Cervical cancer is a significant health issue, especially in low- and middle-income countries like India, where it ranks fourth among women. The Human papillomavirus (HPV) vaccination, a vital preventive measure, has suboptimal uptake among nursing students. We aimed to assess the level of knowledge, attitudes, willingness, and reasons for non-uptake of HPV vaccination among nursing students. Methods A descriptive cross-sectional study was conducted from April to June 2023, using a total enumeration method. Data were collected from 313 nursing students using a validated questionnaire covering sociodemographic information, knowledge, attitudes, and reasons for non-uptake of HPV vaccination. Statistical analysis was performed using SPSS version 26.0. Descriptive statistics summarized the data, while binary and multivariable logistic regression analyses identified factors associated with knowledge, attitude, and willingness for HPV vaccination. Results The mean age of the students was 20.98 ± 2.38 years, with the majority being females (81.2%) and unmarried (93.0%). About half of the participants demonstrated moderate knowledge (52.4%) and negative attitudes (50.1%) towards HPV vaccination, with none having received the vaccine. Female students had 4.24 times the odds of having good knowledge (AOR = 4.24, 95% CI = 1.66–10.80), while those pursuing a bachelor’s degree exhibited 2.70 times the odds of good knowledge (AOR = 2.70, 95% CI = 1.40–5.21). In contrast, first-year students had 0.30 times the odds of having good knowledge (AOR = 0.30, 95% CI = 0.11–0.79) but displayed 4.69 times the odds of having a positive attitude (AOR = 4.69, 95% CI = 1.92–11.41). Additionally, Hindu students had 2.44 times the odds of being willing to receive the vaccine (AOR = 2.44, 95% CI = 1.15–5.20). Most participants expressed willingness to receive the vaccine (62.0%), citing reasons such as not being sexually active (35.8%) and needing more information (18.2%) for non-uptake of the vaccine. Conclusions The study highlights gaps in knowledge and negative attitudes towards HPV vaccination among nursing students. Targeted educational interventions and policy initiatives are essential to improve awareness, promote positive attitudes, and increase HPV vaccination uptake among nursing students.

Abstract We proposed the ultrawideband solar absorber using the multisized metal resonator oriented on the top of the multilayered Metal-SiO₂-MXene-MgF₂-Tungsten structure. We have carried out a numerical investigation of this structure for the 100–2500 THz frequency, which covers the infrared, visible, and UV spectra. The proposed solar absorber is numerically investigated for the different physical parameters, such as the height of the layers, unit cell size, and resonator orientation, to identify optimized results for the high absorption capacity. The structure presented in the study shows promise, with an average absorption of 80% over the large frequency spectrum of 100–2500 THz. This structure was also investigated for the variation in oblique incident angle, which showcases the absorption stability up to 60⁰ of the incident angle. We have also reported the comparative analysis for this proposed absorber structure with other designs, demonstrating the absorption efficiency over infrared, visible, and UV spectra. The proposed structure and discrete resonator length can offer a better solution for trapping the different frequency ranges, resulting in high absorption over a wideband frequency. This study can be applied to designing highly efficient parasitic solar absorber structures, which are essential to highly efficient photovoltaic and solar cell design.

Background/Objective: Alpelisib is a phosphatidylinositol 3-kinase inhibitor used to treat certain hormone therapy resistant breast cancers that can cause hyperglycemia through inhibition of the insulin signaling cascade. Diabetic ketoacidosis with the initiation of alpelisib remains a rare complication. The objective of this report is to describe a patient with alpelisib-induced diabetic ketoacidosis and the difficulties of management. Case Report: A 59-year-old woman was admitted to the hospital with a history of noninsulin dependent type 2 diabetes on metformin presented with diabetic ketoacidosis. One month prior to this hospitalization, the patient was started on alpelisib. On presentation, blood glucose level was 612 mg/dL and hemoglobin A1c level was 11.9% (107 mmol/mol), a 4.6% (27 mmol/mol) increase from 2 months prior. The patient was started on intravenous insulin and alpelisib was held resulting in rapid resolution of the patient’s hyperglycemia and ketoacidosis. However, with reinitiation of alpelisib the patient developed worsening hyperglycemia. Relative glycemic control was ultimately obtained with 3 oral agents and high doses of insulin. Discussion: Direct inhibition of insulin signaling by alpelisib leads to insulin-resistant hyperglycemia. Most cases can be controlled with oral agents; however, insulin therapy is required in rare instances. Although more effective for glycemic control, insulin therapy has the potential to decrease the antitumor effects of alpelisib. Conclusion: Diabetic ketoacidosis is a rare complication of alpelisib initiation, which is quickly resolved with cessation of the agent. For patients where cessation is not an option, insulin and insulin sensitizing agents can be used to achieve glycemic control at the potential detriment of tumor treatment.

Conventional trial designs are resource and time-intensive. To accelerate the process of testing new interventions, we now have several novel research trial designs. This article focuses on master protocol trials, which allow several therapies to be tested within a single larger trial.

ABSTRACT: Periparturient dairy cows exhibit intense lipolysis driven by reduced DMI, enhanced energy needs, and the loss of adipose tissue (AT) insulin sensitivity. Extended periods of low insulin sensitivity and negative energy balance induce lipolysis dysregulation, leading to increased disease susceptibility and poor lactation performance. Chromium (Cr) supplementation improves systemic insulin sensitivity, whereas palmitic acid (PA) increases energy availability for milk production. However, the effect of supplementing Cr and PA alone or in combination on insulin sensitivity in AT is unknown. A total of 32 multiparous cows were used in a randomized complete block design experiment and randomly assigned to one of 4 diets fed from 1 to 24 DIM: a control diet with no supplementation (CON, n = 8); the Cr diet (Cr propionate at 0.45 mg/kg Cr/kg DM, n = 8); the PA diet (1.5% DM, n = 8); or Cr+PA (n = 8). Plasma samples were collected at −13 ± 5.1 d prepartum (PreP), and at 14.4 ± 1.9 d (PP1) and 21 ± 1.9 d (PP2) after calving for quantification of albumin, BHB, BUN, calcium, cholesterol, glucose, nonesterified fatty acids (NEFA), total protein, iron, transferrin, triglycerides, and oxylipids. Subcutaneous AT (SCAT) explants were collected at PreP, PP1, and PP2 and incubated in the presence of the lipolytic agent isoproterenol (ISO = 1 µM, BAS = 0 µM) for 3 h. The antilipolytic effect of insulin (1 µL/L) on SCAT explants was evaluated during ISO stimulation (ISO+INS). Lipolysis was quantified by glycerol release in the medium (nmol glycerol/mg AT). Macrophage infiltration and adipocyte size were measured using hematoxylin and eosin-stained AT sections and immunohistochemistry. The Cr diet tended to reduce postpartum NEFA concentrations when compared with CON, PA, and Cr+PA. Likewise, Cr increased the percentage of large adipocytes (>9,000 µm2) postpartum compared with other diets. In line with higher lipid content, Cr-fed cows had higher ex vivo BAS lipolysis at PP2 when compared with PA and Cr+PA. Isoproterenol induced higher lipolysis at PP1 and PP2, but it was not affected by Cr and PA. The ISO+INS treatment reduced lipolysis by 29.91% ± 11% in Cr compared with ISO. In contrast, ISO+INS did not affect ISO lipolysis in CON, PA, and Cr+PA. Plasma transferrin was reduced by Cr. At PP2, PA cows had 3.3-fold higher macrophage infiltration in SCAT when compared with CON and Cr. Plasma 9-hydroxyoctadecadienoic acid (HODE) and 9-oxo-octadecadienoic acid (oxoODE) were increased by Cr+PA. Palmitic acid increased plasma 13-oxoODE and Cr increased the ratio of 13-HODE to 13-oxoODE. Palmitic acid increased 5-iso prostaglandin F2α-VI. Our results demonstrate that supplementing Cr during the immediate postpartum enhances SCAT insulin sensitivity and lipid accumulation. Further studies should determine the effects and mechanisms of action of Cr and PA on AT lipogenesis, adipogenesis, and their impact on lactation performance.

Abstract African easterly waves significantly influence regional hydroclimate, making it crucial to understand how global warming will impact their activity. Here, we investigate future changes in wave activity and assess the underlying mechanisms using an ensemble of Earth system models. We find a robust increase in wave activity over the Sahel–Sahara region by the end of the 21st century under two emission scenarios. This intensification is linked to increased baroclinicity associated with a strengthening of the meridional temperature gradient between the Guinea Coast and the Sahara. Our results also indicate that low-level warming enhances the waves by reinforcing monsoon flow, leading to increased convergence and vertical motion along the intertropical discontinuity. These energetic alterations significantly modify the conditions that currently produce these waves. Overall, our findings suggest that changes in wave activity could impact the transport of Saharan dust and mesoscale convective activity over the Sahel.

Floating Knee Injury (FKI) are associated with significant complications, including deformity and limb shortening. The Ortho-Solomin-Utekhin-Vilensky (SUV) (OSF) system, integrated with computer software for precision correction, offers an effective solution for treating complex cases, particularly those with rotational deformities. Hereby the authors present the case of a 38-year-old male who sustained a floating knee injury following a high-velocity Road Traffic Accident (RTA). Initial management included stabilisation with an external fixator following Damage Control Orthopaedic (DCO) principles. However, the patient was lost to follow-up and presented three months later with a neglected flexion deformity and significant external rotation of the knee. Clinical and radiological findings showed malunion, knee deformity and a limb length discrepancy of 2 cm. The external fixator was removed and deformity correction and limb lengthening were planned using the OSF frame, a hexapod system designed for complex deformity corrections. Intraoperative findings revealed full-thickness quadriceps muscle loss. The OSF system was used to correct rotational deformities and induce limb lengthening through corticotomy and distraction osteogenesis over a three-month period. Radiological assessments confirmed new bone formation, although residual proximal tibia displacement required screw fixation. After six weeks of non weight bearing, the patient achieved full weight-bearing with normal range of motion. The present case highlights the utility of the OSF system in achieving deformity correction and limb lengthening, demonstrating satisfactory functional outcomes in a neglected floating knee injury. The case underscores the importance of timely follow-up and the role of advanced external fixation techniques in managing complicated orthopaedic injuries.

Background: Artificial intelligence (AI) is revolutionizing healthcare by enabling systems to perform tasks traditionally requiring human intelligence. In healthcare, AI encompasses various subfields, including machine learning, deep learning, natural language processing, and expert systems. In the specific domain of onychology, AI presents a promising avenue for diagnosing nail disorders, analyzing intricate patterns, and improving diagnostic accuracy. This review provides a comprehensive overview of the current applications of AI in onychology, focusing on its role in diagnosing onychomycosis, subungual melanoma, nail psoriasis, nail fold capillaroscopy, and nail involvement in systemic diseases. Materials and Methods: A literature review on AI in nail disorders was conducted via PubMed and Google Scholar, yielding relevant studies. AI algorithms, particularly deep convolutional neural networks (CNNs), have demonstrated high sensitivity and specificity in interpreting nail images, aiding differential diagnosis as well as enhancing the efficiency of diagnostic processes in a busy clinical setting. In studies evaluating onychomycosis, AI has shown the ability to distinguish between normal nails, fungal infections, and other differentials, including nail psoriasis, with a high accuracy. AI systems have proven effective in identifying subungual melanoma. For nail psoriasis, AI has been used to automate the scoring of disease severity, reducing the time and effort required. AI applications in nail fold capillaroscopy have aided the analysis of diagnosis and prognosis of connective tissue diseases. AI applications have also been extended to recognize nail manifestations of systemic diseases, by analyzing changes in nail morphology and coloration. AI also facilitates the management of nail disorders by offering tools for personalized treatment planning, remote care, treatment monitoring, and patient education. Conclusion: Despite these advancements, challenges such as data scarcity, image heterogeneity, interpretability issues, regulatory compliance, and poor workflow integration hinder the seamless adoption of AI in onychology practice. Ongoing research and collaboration between AI developers and nail experts is crucial to realize the full potential of AI in improving patient outcomes in onychology.

This study analyzes total electron content (TEC) variations during two solar eclipse events that occurred on October 25, 2022, and October 14, 2023. The solar eclipse of October 25, 2022, was a partial solar eclipse, while the eclipse of October 14, 2023, was an annular solar eclipse. For this study, the data of eight International GNSS Service (IGS) stations from different eclipse coverage zones are used to analyze TEC variations. It is found that the stations located in the maximum eclipse cover zone exhibited notable decreases in TEC values. The minimum variation of about 11.76% in TEC values is observed at the station situating in about 20 percent eclipse cover zone, while it varies from 22% to 38% at the stations falling in about 60 percent eclipse cover zone. The highest variation in TEC values of about 44% is found at the stations in about 80 percent eclipse cover zone. The time of occurrence of maximum depletion in TEC values at each station is in line with their longitudinal sequence. Atmospheric gravity waves (AGWs) are also observed by performing wavelet analysis on TEC data. The global TEC maps visualize and confirm observed TEC variations, providing spatial and temporal insights into the ionospheric response. This analysis highlights the influence of station location and eclipse coverage on the magnitude and spatial distribution of TEC variations.

Abstract Background The leaves of Psidium guajava (PGAE), fruit peel of Punica granatum (PGRPE), and the bark of Careya arborea (CAE) are widely used traditional medicinal plants for treating diarrheal diseases across India. Our previous studies showed that the hydroalcoholic extracts of these plant parts inhibit the cholera toxin activity. Hence, this study is framed to investigate these extracts for anti-Vibrio cholerae activity and their ability to augment antibiotic sensitivity through a combination of in vitro and computational methods. The hydroalcoholic extracts of PGAE, PGRPE, and CAE were tested for antibacterial activity against Vibrio cholerae by minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and virulence gene expression studies by reverse transcriptase-polymerase chain reaction (RT-PCR). Further, antibacterial activity in combination with selected antibiotics was performed by disk diffusion method. The possible mode of action of these extracts was predicted using docking and molecular dynamics studies on selected virulence factors of Vibrio cholerae. Results All three plant extracts depicted antibacterial activity at different degrees. CAE showed MIC and MBC at 1.25 mg/mL and 10 mg/mL, PGAE at 1.25 mg/mL and 5 mg/mL; and PGRPE at 2.5 mg/mL and 10 mg/mL, respectively. RT-PCR confirmed these extracts significantly inhibited the expression of virulence genes like Flagellin A (FlaA), Vibrio polysaccharide synthesis transcription regulator (VpsT), and Lux Operon (LuxO). Further, the computational studies predicted that phytocompounds of these plants pose stable interaction with AphA, AphB, and ToxT playing the key role in inhibiting the expression of virulence factors. Conclusion The results emphasize that these plant extracts potentially inhibit the growth of Vibrio cholerae, decrease the expression of virulence gene, and enhance the sensitivity of certain conventional antibiotics.

Abstract The purpose of this article is to infer patient level outcomes from population level randomized control trials (RCTs). In this pursuit, we utilize the recently proposed synthetic nearest neighbors (SNN) estimator. At its core, SNN leverages information across patients to impute missing data associated with each patient of interest. We focus on two types of missing data: (i) unrecorded outcomes from discontinuing the assigned treatments and (ii) unobserved outcomes associated with unassigned treatments. Data imputation in the former powers and de-biases RCTs, while data imputation in the latter simulates “synthetic RCTs” to predict the outcomes for each patient under every treatment. The SNN estimator is interpretable, transparent, and causally justified under a broad class of missing data scenarios. Relative to several standard methods, we empirically find that SNN performs well for the above two applications using Phase 3 clinical trial data on patients with Alzheimer’s Disease. Our findings directly suggest that SNN can tackle a current pain point within the clinical trial workflow on patient dropouts and serve as a new tool towards the development of precision medicine. Building on our insights, we discuss how SNN can further generalize to real-world applications.

Abstract Background Racial/ethnic disparities in access to total knee arthroplasty (TKA) have been extensively demonstrated. Over the past several years, there has been a rapid increase in the utilization of robot-assisted TKA (RA-TKA). Therefore, this study sought to determine whether previously established racial/ethnic disparities extend to access to RA-TKA relative to conventional TKA. Methods Patients who underwent TKA from 1 January 2022 to 31 December 2022 were identified in the National Surgical Quality Improvement Program database. Patients were stratified by whether they underwent RA-TKA. Multivariable logistic regressions, controlling for demographics and comorbidities significantly different on univariate analysis, were constructed to determine whether race/ethnicity was associated with likelihood of undergoing RA-TKA relative to conventional TKA. Results Of the 47,898 patients who underwent TKA in 2022, 8560 (17.9%) underwent RA-TKA. On multivariable analysis, Black, Hispanic, Asian, and all other races were significantly less likely than white patients to undergo RA-TKA relative to conventional TKA (OR 0.65, 95% CI 0.59–0.70, P

Abstract Background Unicompartmental knee arthroplasty (UKA) is a surgical treatment for knee osteoarthritis associated with lower morbidity compared with total knee arthroplasty (TKA) in patients with isolated unicompartmental knee arthritis. As disparities have been noted broadly in arthroplasty care, it follows that such disparities might be present in the utilization of UKA relative to TKA. This study therefore examined racial/ethnic, socioeconomic, and payer status differences in utilization of UKA. Methods Patients who underwent UKA or TKA between 2016 and 2020 in the National Inpatient Sample were identified. Multivariable Poisson regression models adjusted for hospital geographic region and patient characteristics [age, sex, and Elixhauser Comorbidity Index (ECI)] were used to examine the effect of race/ethnicity, socioeconomic status, and payer status on incidence rate ratio of UKA relative to TKA. Results Of the 8472 UKA patients and 639,937 TKA patients identified between 2016 and 2020, 8027 (94.7%) UKA patients and 606,028 (94.7%) TKA patients met inclusion criteria. Patients who underwent UKA were significantly younger (63.5 ± 10.7 years) than patients who underwent TKA (66.8 ± 9.5 years; p

Abstract Animal translocations provide striking examples of the human footprint on biodiversity. Combining continental-wide genomic and DNA-barcoding analyses, we reconstructed the historical biogeography of the Asian black-spined toad (Duttaphrynus melanostictus), a toxic commensal amphibian that currently threatens two biodiversity hotspots through biological invasions (Wallacea and Madagascar). The results emphasize a complex diversification shaped by speciation and mitochondrial introgression that comprises two distinct species. One species (true D. melanostictus) is distributed in the Indian subcontinent and is invasive in Wallacea. The other species, whose nomenclature remains unsettled, diverged from D. melanostictus in the Miocene era (~7 Mya) and diversified across Southeast Asia, from where it was introduced to Madagascar. Remarkably, the Indonesian population of D. melanostictus was recently established from India, which suggests historical, possibly human-assisted dispersal across the Bay of Bengal, reflecting the centuries-old connection between these regions.

Abstract Current fetal alcohol spectrum disorders (FASD) studies primarily focus on alcohol’s actions on the fetal brain although respiratory infections are a leading cause of morbidity/mortality in newborns. The limited studies examining the pulmonary adaptations in FASD demonstrate decreased surfactant protein A and alveolar macrophage phagocytosis, impaired differentiation, and increased risk of Group B streptococcal pneumonia with no study examining sexual dimorphism in adaptations. We hypothesized that developmental alcohol exposure in pregnancy will lead to sexually dimorphic fetal lung morphological and immune adaptations. Pregnant rats were orogastrically treated once daily with alcohol (4.5 g/kg, gestational day [GD] 4 to 10, peak BAC, 216 mg/dl; 6.0 g/kg, GD 11 to 20, peak BAC, 289 mg/dl) or 50% maltose dextrin (isocalorically matched pair-fed controls) to control for calories derived from ethanol. Male and female fetal lung RNA from a total of 20 dams were assessed using the TapeStation (Agilent) and Qubit RNA broad-range assay. Samples with RNA Integrity Numbers (RINs) > 8 were prepared using the NEBNext Poly(A) mRNA Magnetic Isolation Module (NEB), xGen Broad-range RNA Library Prep (IDT), and xGen Normalase UDI Primer Plate 2 (IDT). Final libraries were checked for quality and quantity by Qubit hsDNA and LabChip. The samples were sequenced on the Illumina NovaSeq S4 Paired-end 150 bp. Fetal lung tissue were analyzed for histopathological assessments. Mean fetal weight, crown-rump length and placental efficiency of the alcohol-administered rats were significantly lower (P 2 (P

Abstract Background Hepatic artery infusion pump (HAIP) chemotherapy is a locoregional treatment for intrahepatic malignancies. HAIPs are surgically implanted, and the catheter tip is typically inserted into a ligated gastroduodenal artery stump. Potential complications at the catheter insertion site include dehiscence, pseudoaneurysm or extravasation, and adjacent hepatic arterial stenosis and thrombosis. Bleeding complications can be treated with stent-graft placement or coil embolization across the injury site, typically with standard antegrade arterial approach into the hepatic arterial system by transfemoral or transradial access. However, in cases where an antegrade approach is not possible, alternative methods are necessary. Case presentation A patient presented with an enlarging hematoma due to bleeding at the gastroduodenal artery HAIP catheter insertion site. Emergent angiography revealed concomitant common hepatic artery occlusion and retrograde perfusion of the GDA via tortuous, diminutive hepatic collaterals which precluded standard antegrade approach. Collateral inflow from the dorsal pancreatic artery was utilized to opacify the right hepatic artery. The segment 5 hepatic artery was percutaneously accessed under fluoroscopic guidance, and microcoils were deployed both proximal and distal to origin of the gastroduodenal artery. The patient remained stable throughout the postoperative period and was discharged after an otherwise uneventful admission. Follow-up computed tomography demonstrated resolution of the hematoma and no bleeding or biliary complication from transhepatic access. Conclusions This report highlights the safety and efficacy of percutaneous transhepatic arterial access for endovascular management of HAIP associated bleeding at the gastroduodenal artery when standard antegrade interventions cannot be performed. Interventional radiologists caring for patients with HAIPs should be familiar with their potential complications and the range of techniques required for management.

Objective The aims of this study are to compare the multiphasic contrast-enhanced computed tomography (CECT) characteristics of infiltrative hepatocellular carcinoma (HCC) with nodular HCC and to assess the conspicuity of infiltrative HCC on different phases of CECT.

Vitiligo presents a challenge not only in its medical management but also in its impact on patients’ psychosocial well-being. While medical therapies can halt disease progression, achieving repigmentation, especially in challenging areas, remains a hurdle. Surgical interventions, including therapeutic wounding, camouflage techniques, excision, and grafting methods, offer viable solutions. However, success hinges on assessing disease stability, with various clinical, dermoscopic, and cellular indicators employed for evaluation. Pre-procedure counselling is crucial to manage patient expectations and inform them about potential outcomes and risks. Surgical techniques range from simple excision to complex cellular grafting methods, each tailored to the individual patient’s needs and disease characteristics. Postoperative care, including appropriate dressing and follow-up, plays a significant role in ensuring successful outcomes. Newer techniques, such as automated blister epidermal micrografting and Meek micrografting, show promise in improving efficiency and outcomes. Combining traditional methods with innovations such as transverse needling and micro skin grafting enhances the repertoire of surgical options available. Overall, surgical approaches offer effective means to achieve repigmentation and alleviate the psychosocial burden of vitiligo, highlighting the importance of a multidisciplinary approach in its management.

Hollow spherical fly ash cenosphere is a by-product of the coal firing process in thermal power plants and nowadays has become a substitute for the other organic fillers in the composite industry. The present study investigates the mechanical and acoustic performance of cenosphere/epoxy-based polymer composites. Void content, Shore Hardness, Tensile, Flexural, Impact, and Acoustic studies were conducted on epoxy specimens containing 0, 3, 5, and 7% of cenosphere by weight. Surface morphology and failure pattern of the tensile failure samples were investigated using the scanning electron microscope technique. Incorporation of cenosphere into epoxy reduced the void content from 4.27 to 2.54 % and increased the Shore hardness from 80.8 ± 1.44 to 85.8 ± 1.78 when the filler content was increased from 3 to 5%. Impact strength, Tensile and Flexural modulus showed an incremental trend with the increase in the weight percentage of the cenosphere. Examination of the tensile failure surface showed the presence of twist hackles and better interlocking of cenosphere with epoxy matrix. The density of the specimens played vital role in sound absorption characteristics. The addition of the cenosphere in epoxy deteriorates the sound absorption behaviour of the material as compared to neat epoxy.

Abstract This review paper provides a comprehensive overview of recent advancements in energy storage applications, focusing on the utilization of fish industry waste as a sustainable resource. The paper is structured into several key sections, each highlighting a different aspect of this emerging field. Firstly, it explores the use of nanoporous carbons for high-density lithium-ion battery (LIB) anodes, discussing their potential to enhance energy storage capabilities. Secondly, it examines the development of advanced LIB anodes from fish waste-derived nanostructures, showcasing novel approaches to material synthesis. Additionally, the paper delves into the utilization of biomass-derived carbons for sodium-ion battery (NIB) anodes, presenting insights into their role in advancing energy storage technology. Furthermore, it discusses the integration of biomass-derived porous carbons to improve the performance of lithium-sulfur batteries, highlighting strategies to overcome existing limitations. Moreover, the paper explores the application of biomass-derived carbon materials in supercapacitors, emphasizing their potential for high-performance energy storage solutions. Lastly, a significant focus is placed on protein batteries, a novel concept that utilizes seafood waste as a sustainable source for energy storage. The paper elaborates on the processes involved in transforming fish waste into suitable materials for battery electrodes and evaluates the performance of these protein batteries in terms of efficiency, stability, and capacity. Through a structured analysis of recent advancements, this review underscores the potential of biomass-derived materials in addressing sustainability challenges while advancing energy storage technology. Graphical abstract

This paper presents an overview of different machine learning (ML) techniques and algorithms implemented in metal casting industries. ML has made significant contributions to the field of metal casting by improving various aspects of the casting process. In this work, referred quality research papers are divided into two categories. Firstly, work reviewed for the automation in foundry and quality control. Secondly, the raw material melting, material designs and defect predictions in the metal casting. The literature is extensively studied for types of ML models implemented from 2010 to 2023 for the sand-casting application area especially in the prediction of material melting compositions, desired material properties and occurrence of defects along with involvement of advanced foundry technologies.

Organizational agility is a prerequisite for ensuring enhanced corporate performance in the face of technological developments. However, the supplementary role of employee relations and empowerment practices in organizational agility has not been widely explored. FinTech introduction in the banking sector has added to its already dynamic work environment. The study aimed to investigate the effect of Employee Relationship Management (ERM) on Organizational Agility (OA) & Employee Empowerment (EE), and Employee Empowerment on Organizational Agility, and evaluate whether EE has a mediating effect on the relationship between ERM and OA. Structural Equation Modelling over the SmartPLS4 software was used for analysis. A structured questionnaire was distributed to 200 employees in back-office operations departments of the top four banks with the highest market capitalization on the National Stock Exchange, India. Employees from branches operating in metropolitan cities were selected. Results underscore the human asset’s prominence in the banking sector’s sustenance, showing a significant positive direct effect of EE on OA (P value: 0.000, Path Coefficient: 0.627), ERM on OA (P value: 0.025, Path Coefficient: 0.718), and on EE (P value: 0.000, Path Coefficient: 0.718). EE also shows a mediating effect in the influence of ERM over OA (P value: 0.000, Path coefficient: 0.45).The results bridge the gap in knowledge about the prominence of the Resource-Based Theory by investigating the role of employees in enhancing the banking sector’s ability to adjust operations in line with technological advancements.

Abstract The present study demonstrates the synthesis of compact ZnO layers using CdS sensitized on ZnO as a photoanode with copper sulfide (Cu2S) and carbon as a counter electrode (CE). In this study, a compact ZnO layer was fabricated using the simple and low-cost successive ionic layer adsorption and reaction (SILAR) method, and Cu2S CE films were synthesized using the chemical bath deposition method. Various characterizations, such as X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS), confirmed the formation of ZnO and CdS sensitizations on the ZnO . UV-visible spectroscopy revealed that the bandgaps of the ZnO and Cu2S films were 3.2 and 1.3 eV, respectively. Furthermore, the morphology of the ZnO films was optimized by varying the number of SILAR cycles. Scanning electron microscopy revealed the formation of a nanorod compact layer (CL) and the porous nature of the ZnO photoanode films. However, the porosity increased with the number of SILAR cycles. Various parameters, such as the current density, voltage, fill factor, and efficiency, were measured using the J-V characteristics. The highest 0.85% efficiency was achieved by using the ZnO compact film with 30 SILAR cycles for the Cu2S CE. Furthermore, the study revealed that the Cu2S counter electrode had a higher electrocatalytic response than the carbon CE.

Abstract Desert locusts, notorious for their ruinous impact on agriculture, threaten over 20% of Earth’s landmass, prompting billions in losses and global food scarcity concerns. With billions of these locusts invading agrarian lands, this is no longer a thing of the past. Recent invasions, such as those in India, where losses reached US$ 3 billion in 2019-20 alone, underscore the urgency of action. By tapping into the existing Doppler Weather Radar (DWR) infrastructure, originally deployed for meteorological applications, the present study demonstrates a systematic approach to distinctly identify and track concentrations of desert locust swarms in near real-time using single and dual-polarization radars. Findings reveal the potential to establish early warning systems with lead times of 5–7 h and spatial coverage of approximately 100 km, empowering timely mitigation efforts. In stark contrast to satellite imagery, often constrained by resolution limitations that impede swarm detection, DWRs offer unparalleled spatial and temporal resolution, rendering them indispensable tools in this endeavour. Harnessing radar capabilities within the current infrastructure, unleashes unparalleled ecological monitoring potential and fundamentally transform practices in managing migratory pest management practices. Embracing these technological advancements becomes imperative to safeguard agricultural landscapes, uphold global food security, and effectively mitigate the ecological threats posed by migratory pests.

Objective: This pilot study was designed to analyze the effect of yoga on cardiometabolic functions in overweight and obese individuals. Methods: A prospective interventional study was carried out at a tertiary care center in India for 8 weeks. A total of 50 participants were enrolled in the study of which only 29 were regular in yoga intervention. Participants between 25 and 60 years of age, overweight and obese individuals with body mass index ≥25 kg/m2, and those willing to adhere with all the instructions including avoidance of caffeine throughout the study period were included in the study. Baseline demographic details, anthropometric measurements, and biochemical measurements were recorded before and after yoga intervention. Results: After 8 weeks of daily yoga intervention, data of 29 regular attendees were analyzed. The mean age was 44.2 ± 12.3 years and females (72.4%) were predominant than males (27.6%). Homeostasis model assessment-estimated insulin resistance (P < 0.001), fasting blood glucose (P < 0.001), fasting insulin (P < 0.006), quantitative insulin sensitivity check index (P < 0.001), and glycosylated hemoglobin (P = 0.001) were statistically significant, before and after yoga intervention. Furthermore, a statistically significant difference was observed in lipid profiles such as total cholesterol (P < 0.001), low-density lipoprotein (LDL) (P < 0.001), very LDL (P < 0.005), and triglycerides (P < 0.001) before and after yoga intervention. Conclusion: Yoga intervention demonstrated an improved lipid profile and glucose intolerance which subsequently advances cardiometabolic health. However, findings are limited by small sample size and pilot study.

Purpose: The purpose of the study was to find out the preferred, accurate, and effective way to identify the new Indian currency note by a blind individual. Methods: A cross-sectional study was conducted in two phases among 30 subjects in a school for the blind. In phase 1, comparison was done in terms of accuracy and the time taken to identify the Indian currency between the old and new currency notes by using the tactile method by the blind individuals. In phase 2, comparison was done same as phase 1, with the addition of two more note identification methods, one was by using Mani note identifier application via smart phone and the other was Notex. The accuracy and time were analyzed and compared for all three used methods for both phases. Results: Thirty blind individuals were included in the study. The mean age of the subjects was 29.43 years (±10.88 years) and the age range was 18–54 years. The total time taken to identify all the currency notes in each category was recorded in seconds. The average time taken with the help of tactile sense was 75.34 s, but the accuracy here was very poor, even many currencies went unidentified. The average time taken with the help of Notex was 136.54 s. The average time taken with the help of Mani mobile note identifier software was 774.07 s. Conclusion: Notex was the most effective method of identifying Indian currency as compared to the other two methods that were used in our study.

BACKGROUND: Hemovigilance has become one of the important quality check systems of blood transfusion process, but under/non-reporting of transfusion-associated adverse reactions despite the presence of reporting systems emphasize the need to understand the challenges being faced in active reporting of adverse transfusion reactions. AIM: To identify and document the possible factors leading to under-reporting and impacting the quality of blood transfusion reactions being submitted under Haemovigilance Programme of India (HvPI). SETTINGS AND DESIGN: This was a cross-sectional, observational type study, carried out in six blood banks, two each of government, private, and stand-alone sectors in Delhi National Capital Region enrolled under HvPI. MATERIALS AND METHODS: The study was carried out for a period of 6 months with a-month residence in each blood bank. During this period, data related to adverse transfusion reactions and their reporting were collected using a designed data collecting form and a validated questionnaire from all the six blood banks. STATISTICAL ANALYSIS USED: MS Excel Ver. 2007 was used for compilation and descriptive analysis of collected data, and SPSS Ver. 25.0 was used for determining the Cronbach’s alpha for the questionnaire which was statistically significant (α > 0.7). RESULTS: In a period of 6 months, a total of 5136 blood products were issued from these blood banks along with 5136 reaction reporting forms, but only 515 transfusion reaction report forms were returned to these blood banks. It was found that each blood bank faces some challenges with respect to identifying and reporting adverse transfusion reactions. CONCLUSION: Addressing the gaps identified during this study will result in robust hemovigilance system in our country and having reliability of data being reported under HvPI.

Emergence of COVID-19 and thereafter intensive research on bioactive natural compounds against SARS-CoV-2, identified a large number of phytochemicals (i.e., plants-derived) and mycochemicals (i.e., fungi-derived) as potential inhibitors with proven antiviral properties against SARS-CoV-2, but there are no comparative study on the reported compounds. A comparative study among the previously identified/reported main protease (Mpro) inhibitors of SARS-CoV-2 can lead to the most potent compound that eventually helps to make an effective drug lead against SARS-CoV-2. Through manual literature curation, we selected 57 potential bioactive compounds and screened them against Mpro protein of SARS-CoV-2. A series of in silico screening such as binding affinity, drug-like properties, pharmacokinetic, physicochemical, and ADMET studies identified top ten compounds as potential Mpro inhibitors. Further, docking studies prioritized the top two compounds namely Norquinadoline A and Quinadoline B, based on their predicted affinity for the target protein. Binding free energy calculations further emphasized them as top candidates for effective Mpro inhibitors that hold promise for drug development against COVID-19. In-depth molecular dynamics studies and MM/PBSA analysis culminated in the recognition of Norquinadoline A as the most potent Mpro inhibitor of SARS-CoV-2. Thus, Norquinadoline A can be used as lead compound in further drug discovery process after in vitro and in vivo experimental studies.

Aims and method There is currently a lack of monitoring and standardisation of diabetes care in the National Health Service (NHS) psychiatric in-patient setting. We surveyed healthcare professionals in psychiatric in-patient units across England to understand current diabetes care. A 13-item questionnaire was piloted via think-aloud interviews. The survey was completed by healthcare professionals across 19 wards in 11 NHS mental health trusts. Results were analysed via descriptive statistics and thematic analysis. Results Of 150 respondents, 98% agreed that addressing physical health needs was an important part of the mental health team's role; 68% agreed that they had adequate skills and knowledge to manage diabetes safely. Thematic analysis identified themes relating to individual, organisational and patient-level factors. Clinical implications Psychiatric admission could be used opportunistically to improve the healthcare disparities for people with comorbid diabetes and severe mental illness. This national survey highlights areas that need to be addressed to optimise diabetes care in this setting.

Background: Cutaneous squamous cell carcinoma (cSCC) is the most common keratinocyte carcinoma in dark-skinned ethnic groups. Available studies are primarily focused on white populations, with fewer data available for black Africans, including Ethiopians. Therefore, less priority may be given to treatment and prevention in this population. Objective: To determine the prevalence and risk factors of cSCC among patients presenting to All Africa Leprosy, Tuberculosis, and Rehabilitation Training Center , Addis Ababa, Ethiopia. Methods: A literature review was performed to determine existing knowledge. A retrospective descriptive cross-sectional study was then conducted based on stored data of confirmed cases of cSCC from 2011 to 2021 at ALERT. Demographics, other parameters related to cSCC (size, anatomic location, degree of differentiation, metastasis, and recurrence), and potential risk factors including scars, burns, HIV status, xeroderma pigmentosum, and leprosy were collected and entered on a prepared data extraction sheet and analyzed using SPSS version 25 manufactured by IBM. Results: Among 15,075 total pathologic samples reviewed, 3.8% (n = 570) were reported histopathologically as invasive cSCC (n = 437), keratoacanthoma, or (squamous cell carcinoma in-situ (Bowen disease). 50.3% (n = 287) occurred in female, and the mean age of affected patients was 50.1 years (SD 17.2). Nearly 70% were reported after >1 year of symptoms, including morphologic change, ulceration, and nonhealing wound. HIV status was not universally screened but was positive in 9.8% (46/437). Cases were commonly found to occur on the lower extremities (X2 = 2.7196, Pr = 0.099) and >4 cm in size (46.3%). Among 274 cases with adequate histologic description, 82.5% (n = 226) were well-differentiated. Loco-regional metastases comprised 6.0% (n = 34) and 46.7% (n = 266) had ulceration. Conclusion: The biologic significance of ulceration in this population is unclear. Ulceration may indicate chronic wounds or Marjolin’s ulcers. High rates of metastasis call for a better understanding of risk factors, preventive measures, and early diagnosis. This model of research may serve as a foundation for future nationwide investigations through the Federal Ministry of Health of Ethiopia’s Disease Prevention and Control Directorate.

Percutaneous Nephrostomy (PCN) is a minimally invasive procedure used in patients with hydronephrosis. Major haemorrhagic complications requiring transfusions occur in 1-4% of PCNs, while major vascular injuries (requiring embolisation or nephrectomy) occur in 0.1-1% of cases. The sources of bleeding are usually from pseudoaneurysms or Arteriovenous (AV) fistulas when the nephrostomy tract passes near the renal hilum. A calyceal-venous or renal pelvi-venous fistula is a rare but significant complication that can arise following PCN, ureteric obstruction, and renal transplantation. Invasive treatment options for managing these fistulae include transvenous embolisation, external drainage to relieve outflow obstruction, and open surgical management, which may involve closure of the fistula, partial nephrectomy, or complete nephrectomy. Hereby, the authors present a case of 74-year-old male patient with carcinoma of the urinary bladder, who had a history of bilateral PCN due to vesico-ureteric junction involvement. He presented post-procedure with continuous haematuria from the left PCN catheter. There was a significant drop in haemoglobin; however, the patient remained vitally stable. A nephrostogram performed by injecting contrast via the PCN catheter revealed a renal pelvis-renal vein (pelvi-venous) fistula. He was managed by placing a pigtail catheter with its tip in the mid-ureter to provide external drainage and a tamponade effect at the fistula site. The haematuria gradually resolved within two days, with clear urine output. Therefore, the authors aimed to draw attention to the rare finding of a renal pelvi-venous fistula on nephrostogram following PCN and its management through the repositioning of the nephrostomy tube.

A process-specific alloy design strategy was employed to achieve exceptional as-deposited strength-ductility synergy in Al–Ce alloys, eliminating the need for post-aging treatments. Al–Ce alloys, known for their excellent creep resistance and thermal stability due to the Al11Ce3 phase, were optimized using CALPHAD simulations to incorporate solid solution and precipitation strengthening in addition to composite strengthening from the Al11Ce3 phase. Additive friction stir deposition (AFSD) was used to fabricate 3D builds from cast material, refining the grain size and microstructure by fragmenting Al11Ce3 lamellae into smaller, uniformly dispersed particles and inducing Al3Sc nanoprecipitates during deposition. Microstructural and mechanical analyses revealed remarkable improvements: while the cast alloy fractured at 230 MPa with no ductility, the AFSD alloy achieved a yield strength of 385 MPa, UTS of 530 MPa, and 12.6% plastic strain. These as-deposited properties surpassed those of cast, extruded, HIPPed, or LPBF/DED Al–Ce alloys, including the previous results obtained after aging. This strategy leverages AFSD-specific process dynamics, such as intense deformation and localized high temperatures, to enable in-situ precipitation and microstructural refinement with exceptional mechanical properties, offering a transformative pathway for designing energy-efficient, high-performance materials.

A haematoma is a collection of blood and blood components under the skin’s subcutaneous layer. An acute wound to the blood vessel wall is a frequent cause of haematomas. Focal swelling, taut skin and soreness are associated with blood expanding and pooling beneath the skin. It can be difficult to diagnose if there is an underlying discolouration. The authors report a case of an eight-year-old female patient with the chief complaint of swelling on the face for two days due to a fall from a height of 10 feet. She reported a history of blood from the mouth and avulsed upper lateral incisors immediately after the fall. Bilateral diffuse swelling was observed in the submandibular region, measuring 7×7 cm extraorally, extending from the inferior border across the midline and from the chin to the hyoid bone, accompanied by facial asymmetry. The final diagnosis was post-traumatic haematoma and a conservative approach was the treatment of choice. The present case highlights the importance of correct diagnosis and early intervention.

Orbital cellulitis is an acute onset, rapidly progressive and potentially sight-threatening disease of the eye. It is more prevalent in developing regions and low socio-economic strata and may be associated with a host of other systemic diseases, such as paranasal sinus or dental infections, diabetes mellitus, urinary tract infections and sepsis. Often, orbital cellulitis is associated with an orbital or periosteal abscess, which can be diagnosed with orbital imaging and may sometimes require drainage to relieve the pressure. A 63-year-old male patient presented with orbital cellulitis of the right eye. The patient did not reveal any focus of infection upon investigation. Orbital imaging revealed a well-defined intraconal tumour with contrast enhancement, abutting but not involving the optic nerve, likely a cavernous haemangioma. The patient was admitted and managed with parenteral antibiotics, showing an excellent response to treatment. Given that the clinical signs did not support a benign tumour, repeat imaging was performed and again favoured a cavernous haemangioma. Presently, the patient is asymptomatic with slight proptosis and is under observation. This is an uncommon and interesting presentation of proptosis with a hyperacute cause superimposed on a more chronic lesion.

Recently, the growth of the recyclability of carbon fiber reinforced polymer (CFRP) composites has been driven by environmental and circular economic aspects. The main aim of this research work is to investigate the strength retention of a bio-based vitrimer composite reinforced with carbon fibers, which offers both recyclability and material reusability. The composite formulation consisted of an epoxy resin composed of diglycidyl ether of bioshpenol A (DGEBA) combined with tricarboxylic acid (citric acid, CA) and cardanol, which was then reinforced with carbon fibers to enhance its performance. Differential scanning calorimetry (DSC) and Fourier transform infrared (FTIR) spectroscopy were performed to analyze the chemical composition and curing behavior of the vitrimer. Mechanical testing under tensile loading at room temperature was carried out on epoxy, vitrimer, and associated carbon fiber reinforced composite materials. The results demonstrated that the DGEBA/CA/cardanol vitrimer exhibited thermomechanical properties comparable to those of an epoxy cured with petroleum-based curing agents. It was observed that the maximum tensile strength of vitrimer is about 50 MPa, which is very close to the range of epoxy resins cured with petroleum-based curing agents. Notably, the ability of the vitrimer composite to be effectively dissolved in a dimethylformamide (DMF) solvent is a significant advantage, as it enables the recovery of the fibers. The recovered carbon fiber retained comparable tensile strength to that of the fresh carbon composites. More than 95% strength was retained after the first recovery, which confirms the use of fibers for primary and secondary applications. These research results open up new avenues for efficient recycling and contribute to the overall sustainability of the composite material at an economic level.

Background and Aims: Open pyeloplasty in children is associated with considerable postoperative pain. The paravertebral block (PVB) is commonly performed to control postoperative pain in such surgeries. Erector spinae plane block (ESPB) has recently been described as effective in providing postoperative analgesia in pediatric abdominal surgeries. This randomized, assessor-blinded study compared postoperative analgesic effects between ESPB and PVB in children undergoing pyeloplasty. Material and Methods: Eighty pediatric patients scheduled for elective pyeloplasty were randomly allocated to receive either ultrasound-guided (USG) ESPB or PVB. Postoperative pain evaluation was done using the face, legs, activity, cry, and consolability (FLACC) scale for children up to 7 years of age and the visual analog scale (VAS) for children in the age group between 7 and 10 years at 0, 2, 4, 8, 12, and 24 h. The time of first rescue analgesia, the number of doses of analgesic, successful first puncture rate, and block-related complications were noted. Results: No significant differences were noted in the FLACC/VAS scores, duration of time to first rescue analgesia (575.90 ± 118.81 vs. 617.05 ± 144.20, P = 0.168), the number of rescue doses once and twice over 24 h was 72.5% versus 67.5% and 27.5% versus 32.5% (P = 0.626) between ESPB vs PVB. The incidence of hematoma at the block site was higher in the PVB group (10%) compared to the ESPB group (0%) (P = 0.04). The incidence of first puncture success in the block was better in ESPB (P = 0.003). Conclusions: Both ESPB and PVB can be effectively used for controlling post-pyeloplasty pain in children. The ease of performing the block and the relatively lower incidence of hematoma at the block site make ESPB more advantageous.

Introduction: Visually impaired children require a specialised form of dental health education that facilitates the learning process for brushing their teeth correctly using effective techniques. The Braille method is a conventional means of education for children with visual impairments. In contrast, the Audio Tactile Performance (ATP) technique is a uniquely developed method for educating these children and has proven to be effective. Aim: To evaluate the oral hygiene status by comparing the Braille and ATP techniques with the Fones method, as well as ATP with the Modified Bass technique of tooth brushing using a conventional dentifrice in visually impaired children, and to assess its impact on the children’s daily routines. Materials and Methods: A prospective interventional study was conducted by the Department of Paediatric and Preventive Dentistry at SGT University, Gurugram, Haryana, India, involving 300 blind school children aged 6-12 years from New Delhi-National Capital Region (NCR), India over a period of 18 months from November 2018 to February 2020. The Oral Hygiene Index-simplified (OHI-S) scores were recorded pre- and post-operatively among three groups: Group 1 (conventional Braille method), group 2 (ATP technique with the Fones method), and group 3 (ATP with the Modified Bass method). The data were analysed statistically using Statistical Package for Social Sciences (SPSS) software version 21.0. Intergroup comparisons of oral hygiene status were performed using the Post-hoc Bonferroni correction. A p-value of less than 0.05 was considered significant. Results: The study participants comprised 283 males and 17 females, with a mean age of 8.58±1.297 years (Mean±SD). When comparing the three groups, the OHI-S scores at baseline and one month post-examination were found to be statistically insignificant (p-value >0.05). However, at the 6, 9, and 12-month marks, the mean differences between group 1 (Braille) and group 3 (ATP + Modified Bass) and between group 2 (ATP + Fones) and group 1 (Braille) were statistically significant (p-value

Abstract Purpose This study aims to investigate the relationship between institutional support, green export strategies, and export performance among small and medium-sized enterprises (SMEs) operating in various sustainability-focused sectors. Design/methodology/approach Utilising a quantitative approach, structural equation modelling (SEM) is employed to analyse data collected from 227 SMEs in sectors including sustainable agriculture, eco-friendly consumer goods, special woven fabrics, organic food and beverages, green fashion and textiles, and health and wellness. Findings The study reveals a significant association between institutional support and key aspects of green export readiness, green export activities, and green innovation. Moreover, mediating roles of green innovation, green export readiness, and green export activities are identified, elucidating their influence on the relationship between institutional support and green export strategy. Importantly, effective green export strategies positively impact export performance, enhancing SMEs’ competitive positioning in global markets. Originality This research contributes novel insights into SMEs’ engagement in green export, shedding light on the critical role of institutional support and the mediating mechanisms that facilitate the adoption of successful green export strategies. Research limitations One limitation of this study is the cross-sectional nature of the data, which restricts the ability to establish causal relationships. Future research could explore longitudinal data to further investigate the dynamics between institutional support, green export strategies, and export performance. Practical implications The findings provide valuable insights for SMEs seeking to enhance their sustainability-driven international business practices. Managers can leverage institutional support and focus on developing green export strategies to improve their export performance and competitiveness in global markets. Social implications By embracing green export strategies, SMEs can contribute to sustainable development goals and promote environmentally responsible practices in the global marketplace, thereby fostering positive social and environmental impacts.

Abstract Energy consumption in the building sector is about 40% of total energy consumed globally and is trending upwards, along with its contribution to greenhouse gas (GHG) emissions. Given the adverse impacts of GHG emissions, it is crucial to integrate energy efficiency into building designs. The most significant opportunities for enhancing energy performance are present during the initial phases of building design, when there is less impact of other design constraints. Various tools exist for simulating different design options and providing feedback in terms of energy consumption and comfort parameters. These simulation outputs must then be analyzed to derive design solutions. This paper presents an innovative approach that utilizes user input parameters, processes them through cloud computing, and outputs easily understandable strategies for energy-efficient building design. The methodology employs Asynchronous Distributed Task Queues (DTQ) - a more scalable and reliable alternative to conventional speedup techniques-for conducting parametric energy simulations in the cloud. The goal of this approach is to assist design teams in identifying, visualizing, and prioritizing energy-saving design strategies from a range of possible solutions for each project. Furthermore, a tool ‘eDOT’ has been developed utilizing the discussed methodology. Unlike existing tools, eDOT leverages artificial intelligence to dynamically generate and provide design strategies during the early phases of design process. By simplifying the simulation process, eDOT enables design teams to make informed, data-driven decisions without needing to interpret complex simulation outputs. A case study simulated for two locations is provided in this paper to demonstrate the effectiveness of eDOT, further underscoring its practical impact on energy-efficient building design.

Aims: While residual fixed flexion deformity (FFD) in unicompartmental knee arthroplasty (UKA) has been associated with worse functional outcomes, limited evidence exists regarding FFD changes. The objective of this study was to quantify FFD changes in patients with medial unicompartmental knee arthritis undergoing UKA, and investigate any correlation with clinical outcomes. Methods: This study included 136 patients undergoing robotic arm-assisted medial UKA between January 2018 and December 2022. The study included 75 males (55.1%) and 61 (44.9%) females, with a mean age of 67.1 years (45 to 90). Patients were divided into three study groups based on the degree of preoperative FFD: ≤ 5°, 5° to ≤ 10°, and > 10°. Intraoperative optical motion capture technology was used to assess pre- and postoperative FFD. Clinical FFD was measured pre- and postoperatively at six weeks and one year following surgery. Preoperative and one-year postoperative Oxford Knee Scores (OKS) were collected. Results: Overall, the median preoperative navigated (NAV) FFD measured 6.0° (IQR 3.1 to 8), while the median postoperative NAV FFD was 3.0° (IQR 1° to 4.4°), representing a mean correction of 49.2%. The median preoperative clinical FFD was 5° (IQR 0° to 9.75°) for the entire cohort, which decreased to 3.0° (IQR 0° to 5°) and 2° (IQR 0° to 3°) at six weeks and one year postoperatively, respectively. A statistically significant improvement in PROMs compared with baseline was evident in all groups (p < 0.001). Regression analyses showed that participants who experienced a larger FFD correction, showed greater improvement in PROMs (β = 0.609, p = 0.049; 95% CI 0.002 to 1.216). Conclusion: This study found that UKA was associated with an approximately 50% improvement in preoperative FFD across all three examined groups. Participants with greater correction of FFD also demonstrated larger OKS gains. These findings could prove a useful augment to clinical decision-making regarding candidacy for UKA and anticipated improvements in FFD.

In the present study, MnO2 nanoparticles were synthesized using Citrus limetta peels extract and functionalized by chitosan polymer. Surface morphology analysis of chitosan functionalized MnO2 nanoparticles was carried out using a scanning electron microscope (SEM) and transmission electron microscope (TEM), which revealed that the synthesized nanoparticles were spherical, with a size range of 14–24 nm. Energy dispersive X-ray analysis and elemental mapping were used to observe Mn, O, C, H, and N. Fourier-transform infrared spectroscopy confirmed the presence of hydroxyl, carboxyl, and amino groups on the surface of the nanoparticles. The kinetics and isotherms were compared and it was found that the pseudo-second-order and Langmuir isotherm were the best fit, with R2 values of 0.99. The thermodynamic study demonstrated that the adsorption was endothermic and spontaneous. These findings indicate that chitosan functionalized nanoparticles have a better Pb(II) removal efficiency (94.40%), making them an eco-friendly and cost-effective alternative for wastewater treatment.HighlightsChitosan functionalized nanoadsorbent was synthesized through green route.Sorption mechanism explored through isotherm, kinetics, and thermodynamic models.Synthesized adsorbent showed high Pb(II) removal capacity.