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Background Encapsulated pancreatic fluid collection (PFC) is a requisite for endoscopic drainage procedures. The 4-week threshold for defining walled-off necrosis does not capture the dynamic process of encapsulation. We aim to investigate the changes in the wall characteristics of PFC in acute necrotizing pancreatitis (ANP) by comparing baseline contrast-enhanced computed tomography (CECT) with follow-up CT scans.

Abstract Forest fires are the source of countless fatalities and extreme economic repercussions. The safe evacuation of residents of an area affected by forest fires is the highest priority of local authorities, and finding the most optimal course of action has been a primary research focus for years. Previous studies over several decades have attempted to find an optimal solution using the applications of bug navigation systems, road network reconfiguration, graph traversals, swarm optimization, etc. The author, with the motivation to prevent human casualties at the time of such calamity, presents a novel study which solves the problem in nearly linear time computation, surpassing the performance standards of previous research, and accommodates the unpredictability of the spread of forest fires. This includes a proposal of an algorithm which builds upon the application of Spielman and Teng’s Electrical Circuit Approach to solve for maximum flow in a network and implements this with real-time sensor and Global Positioning System input.

Abstract Background Myopathy, lactic acidosis and inherited sideroblastic anemia (MLASA) are a group of rare intriguing disorders with wider pathophysiological implications. One of the causes of MLASA is the mutation in PUS1 gene that encodes for pseudouridine synthase. This PUS1 mutation results in MLASA in which anemia and myopathy predominate. Severe pulmonary arterial hypertension has not been previously reported in patients with PUS1 gene mutation. Case report A 17 year old girl with congenital sideroblastic anemia presented with worsening of breathlessness. Severe pulmonary artery hypertension was documented on investigations. A homozygous variant in exon 3 of gene PUS1,( chromosome 12:g.131932301 C > T c.430 C > T) was found on sanger sequencing. Conclusion We document severe pulmonary arterial hypertension in a patient of congenital sideroblastic anemia from PUS1 gene. We hypothesis that cross talk with TGFb pathways might occur in PUS1 mutation, and that might cause severe PAH. This observation might have therapeutic implications.

Background The role of dual-modality drainage of walled-off necrosis (WON) in patients with acute pancreatitis (AP) is established. However, there are no data on the association of clinical outcomes with the timing of percutaneous catheter drainage (PCD). We investigated the impact of the timing of PCD following endoscopic drainage of WON on clinical outcomes in AP.

Abstract Age estimation is a crucial component of human identification in forensic science. It has a vital role in forensic anthropology, including examinations of skeletal remains, disaster victim identification, and locating missing individuals. Present communication focuses on the age estimation through the examination of ossification centers of bones and its significance in identifying the age of 18 years old, a recognized age of majority in many countries. The process of ossification is integral to biological development and serves as critical standard for age estimation in forensic identification. This study reviews relevant literature from well-known databases such as PubMed, Scopus, Web of Science, and ScienceDirect. Additionally, the present review elaborates various classification methods used by authors to classify the stages of ossification centers of bones. The objective of this communication is to assess the effectiveness of both imaging and physical methods for age estimation and to provide a critical comparison to determine the superior approach. The findings suggest that imaging methods are more reliable for the estimation of age from ossification centers. Staging methods introduced by Schmeling et al, Kellinghaus et al, Dedouit et al, Vieth et al, and Kvist et al. are found to be the best methods for age estimation.

Abstract Liver abscess is a potentially life-threatening medical emergency. Prompt empirical antimicrobial with or without percutaneous aspiration or drainage is therapeutic. The rational for using empirical intravenous broad-spectrum antimicrobials upfront instead of oral Fluoroquinolone or Cephalosporin is contentious. In this double blind randomized control clinical trial 69 participants received Ciprofloxacin (500 mg q 12 hourly) and 71 participants received Cefixime (200 mg q 12 hourly) orally for 2 weeks. Both the group received oral Metronidazole (800 mg q 8 hourly) for 2 weeks and percutaneous drainage or aspiration of the abscess was done as per indication and followed-up for 8 weeks. Out of 140 participants, 89.3% (N = 125) achieved clinical cure, 59 (85.5%) in Ciprofloxacin group and 66 (93%) in Cefixime group (p = 0.154). Mean duration of antimicrobial therapy was 16.2 ± 4.3 days, 15.1 ± 4.5 days in Ciprofloxacin group and 16.0 ± 4.2 days in Cefixime group (p = 0.223). Total 15 (10.7%) participants had treatment failure, 10 (14.5%) in Ciprofloxacin group and 5 (7.0%) in Cefixime group (p = 0.154). The most common reason for treatment failure was need of prolong (> 4 weeks) antimicrobial therapy due to persistent hepatic collection requiring drainage, which was significantly (p = 0.036) higher in Ciprofloxacin (14.5%, N = 10) group, compared to the Cefixime (4.2%, N = 3) group. In conclusion, both, the Ciprofloxacin or Cefixime plus Metronidazole for duration of 2–3 weeks were efficacious as empirical oral antimicrobial regimen along with prompt percutaneous drainage or aspiration for the treatment of uncomplicated liver abscess with similar efficacy. Oral Cefixime was better than Ciprofloxacin in term of lesser chance of treatment failure due to persistent collection which is required to be investigated further in larger clinical trial. Trial registration: clinicaltrials.gov PRS ID: NCT03969758, 31/05/2019.

Background/Aims Association of sarcopenia with disease severity in ulcerative colitis (UC) is not clearly defined. We planned to estimate the prevalence of sarcopenia in patients with UC as per the revised definition and its relation with the disease severity. Methods A cross-sectional assessment of sarcopenia in patients with UC was performed. Disease activity was graded according to complete Mayo score. Hand grip strength was assessed with Jamar hand dynamometer, muscle mass using a dual energy X-ray absorptiometry scan, and physical performance with 4-m walk test. Sarcopenia was defined as a reduction of both muscle mass and strength. Severe sarcopenia was defined as reduced gait speed in presence of sarcopenia. Results Of 114 patients (62 males, mean age: 36.49±12.41 years), 32 (28%) were in remission, 46 (40.4%) had mild-moderate activity, and 36 (31.6%) had severe UC. Forty-three patients (37.7%) had probable sarcopenia, 25 (21.9%) had sarcopenia, and 14 (12.2%) had severe sarcopenia. Prevalence of sarcopenia was higher in active disease (2 in remission, 6 in active, and 17 in severe, P

Illegal activities associated with deforestation for the lumber and furniture industries pose significant threats to plant and animal biodiversity, as well as natural resources. Accurate identification of wood sources is vital, yet traditional laboratory techniques often fall short in precisely determining the chemical composition of samples for classification. This study aims to leverage ATR-FTIR spectroscopy alongside machine learning algorithms to construct a robust model for discerning the geographical origins of wood samples from India. By systematically comparing various machine learning classifiers, we address the limitations of subjective visual interpretation and evaluate their accuracy using wood spectral data. Logistic regression emerges as the most effective classifier for distinguishing Eucalyptus (75 % accuracy), Dalbergia (68 % accuracy), and Populus (81.5 % accuracy) species. Through a methodology encompassing data pre-processing, classifier selection, and performance evaluation, this research offers promising tools for combating challenges posed by illegal wood trafficking and transportation. The outcomes hold significant potential for enhancing wildlife crime prevention efforts by facilitating the tracing illicit timber sources, apprehension of perpetrators, and implementation of preventive measures.

Although sustainability issues disproportionately affect disenfranchised populations, justice considerations are often left to social scientists in sustainability research. As early-career researchers pursuing doctoral degrees in diverse disciplines focusing on sustainability, we reflect on the unintentional exclusion of justice in sustainability research. Building on our individual and collective research experiences, we propose a critical multifaceted-disciplinary perspective, advocating for the holistic creation of interdisciplinary academic teams involving scholars from diverse racial, social, cultural, and economic contexts. By embracing multifaceted-disciplinarity, we can step toward establishing and nurturing spaces that enrich justice considerations in sustainability science, forming a more comprehensive understanding of sustainability predicaments and building sustainable and humane futures for all.

The measles virus is an RNA virus belonging to the Paramyxoviridae family. It leads to an acute communicable illness that primarily involves the respiratory tract. Vaccination has significantly reduced the overall incidence and mortality worldwide; however, outbreaks still occur globally each year due to several factors. The SARS-CoV-2 pandemic has been a major hurdle since 2020. Despite the World Health Organization's goal to eradicate measles by 2023, there has been an increase in measles incidence in India, with 61,562 cases in 2022. Vaccination is a crucial preventive measure, and coverage needs to be increased through education, advocacy, and outreach to isolated communities.

Small bowel tumors are rare with nonspecific and protean clinical presentation. Early diagnosis of small bowel tumors is desirable as they can be associated with significant morbidity. In malignant small bowel tumors, delayed diagnosis may result in dissemination and metastasis leading to poor clinical outcomes. Imaging evaluation of small bowel can be challenging due to unpredictable luminal distension, peristalsis, and motion. In addition, the lack of distinction between the intraluminal lesions and intraluminal contents can be difficult at times. Computed tomography (CT) and magnetic resonance (MR) enterography are the most common imaging techniques for the evaluation of small bowel tumors. While these techniques may not be able to detect small tumors, they provide comprehensive evaluation of lumen, wall, and extramural structures in tumors more than 2 cm. Acquaintance of imaging appearance of common benign and malignant small bowel tumors may allow improved detection during evaluation of CT and MR enterography studies. In this review, we discuss the imaging appearances, approach, and differential diagnosis of small bowel tumors on cross-sectional imaging studies.

Background: Keeping in view the role of tobacco consumption as a modifiable risk factor in various diseases and gaps in scientific knowledge among the apparently healthy adult male population in India, the researchers chose to undertake this study. Materials and Methods: A cross-sectional study was conducted among apparently healthy adult males employed in various government offices to determine the prevalence of tobacco consumption. The minimum sample size to estimate a 95% confidence interval for the prevalence of tobacco consumption with 5% absolute precision was calculated to be 340. However, 500 subjects were included in the study. The tool used for data collection was the “personal interview technique.” Standard statistical methods were utilized for data analysis. Results: The overall mean age (standard deviation (SD)) of the study subjects was 30.96 yrs (4.32). Overall, the mean (SD) of number of years of tobacco use was 5.64 years (1.98). The mean (SD) of number of cigarettes smoked per day was 6.36 (3.09). The prevalence of current smokers showed a statistically significant increase from the age groups of 20–29 yrs to 50–59 yrs (P < 0.001). All subjects in the study were able to name at least three harmful effects of tobacco consumption. The overall mean amount spent on tobacco consumption per month was Rs 536.97 (1.44% of basic salary). Overall, the most common reason for smoking was peer pressure, where 40 (93.02%) gave this reason. Of forty-three tobacco users, 27 (62.79%) expressed a desire to quit tobacco consumption. The most common reason for expressing a desire to quit tobacco was the ill effects of tobacco consumption, where 23 (85.18%) tobacco users gave this reason. Conclusion: Our study on the prevalence of tobacco consumption among government employees provides an adequately clear picture of this public health epidemic in India. There is an immediate need for target group-specific policies for tobacco control, which should be integrated with the relevant national health programs at all levels.

In the modern world, people are too techno-friendly and dependent on technology using the Internet for every work. The same goes for the news. People are shifting from traditional mass media to digital news platforms and getting news through websites, news portals, social media, etc. If you are dependent on the Internet for every kind of information, then you will face false information on the Internet. False or fake news is defined as any information that does not have any credible and reliable source behind it or any misleading information that is likely to mislead the public. The aim behind fake news transmission is to damage a person's or entity's reputation or advertising revenue. If you want not to fall into the fake news you should know about fake news detection and media literacy. The main purpose of the study is to check the exposure of fake news awareness and fake news detection methods among social media users. In the current scenario, this is much necessary to know that social media users have the advisable knowledge of fake news detection and media literacy because people easily fall into the rumors. Mob lynching is one of the biggest rumors on the Indian Internet. In this research, the survey method and questionnaire for data collection were used. The questionnaire was distributed randomly over different social media platforms and emails to the intended respondents. The findings obtained reveal that most fake or false news in India is transmitted through WhatsApp, but social media users have adequate knowledge of fake news and media literacy.

Cardiorenal syndrome (CRS) is a complex interdependent relationship between the heart and kidneys, prevalent in hospitalized patients with acute decompensated heart failure (ADHF). The main aim of this study is to evaluation of cardiac and renal function, treatment factors, and outcomes in view of mortality and persistent renal dysfunction in acute decompensated heart failure (cardio renal syndrome type 1) patients. We studied 100 patients hospitalised with ADHF and acute kidney injury (AKI). Patients were evaluated clinically, biochemically, ultrasonographically, and echocardiographically to assess demographics, etiologic and risk factors, cardiac and renal function, and outcomes in view of mortality and persistent renal dysfunction. The study monitored the patients until discharge and follow up with three months to one year. Record information about functional improvement, worsening symptoms, and mortality. The majority of the patients were males (72%), with dyspnea being the most common symptom (92%) followed by decreased urinary output (82%). The mean age of the patients was 62.60 years. Low level of Mean arterial pressure (MAP) 18.97 (95% CI 4.59 to 78.37, P 0.0001), estimated glomerular filtration rate (eGFR) 0.92(95% CI 0.87 to 0.99; P 0.02), maximum creatinine 3.08 (95% CI 1.67 to 5.67, P 0.0001), maximum level of urea 1.02(95% CI, P 0.001), lower Left ventricular ejection fraction (LVEF) 1.05 (95% CI 0.15 to 0.84, P 0.04) were independently predictors of in-hospital mortality. CRS-1 is associated with increased risk of mortality (25%), residual renal dysfunction (16%) at one year follow up. Persistent renal dysfunction, renal replacement therapy possibly improves for the treating persistent renal dysfunction, and recurrent HHF (more than 2 admissions) post hospitalisation index within twelve months were predictors of mortality (25%) at one-year.

Dental traumatic injuries in paediatric patients result in a painful experience for both the parents and the child. Although children may exhibit similar fracture patterns as seen in adult traumatic injuries, there are various factors to consider when treating fractures in paediatric patients, which pose challenges for paediatric dentists. There are numerous treatment options available for managing maxillofacial fractures, such as open reduction, closed reduction, immobilisation with open or closed cap splint, with or without circummandibular wiring, and the use of mini plates, among others. In this present case report, a five-year-old child presented with multiple step deformities in the mandible. Since the patient had deciduous dentition, the main concerns were the high possibility of disruption to the periosteal envelope, which could affect the growth of the mandibular processes, and damage to developing permanent tooth buds. These were key considerations when planning the appropriate treatment. Taking into account these potential complications associated with other invasive procedures, a minimally invasive conservative management approach was chosen for the child, which proved to be highly successful and cost-effective. Undisplaced fractures in paediatric patients should always be treated or stabilised using the closed reduction method.

Aims: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus) affects vital organs and causes vascular injury. There are concerns that this injury may have long-term consequences on the cardiovascular system after recovery from COVID-19. We investigated the incidence and predictors of new-onset hypertension at 1-year follow-up post-COVID-19 disease. Methods: In this prospective observational study, 393 patients hospitalised and diagnosed with COVID-19 disease at a tertiary cardiac care hospital during 27th March 2021 to 27th May 2021. Eligible 248 patients whose baseline characteristics, laboratory findings, treatment and outcome data were received systematically. Patients were followed up at 1 year of COVID-19 disease recovery. Results: We found that 32.3% of the population had new onset of hypertension at 1 year follow-up post-COVID-19 disease recovery. More hypertensive patients had severe computed tomography (CT) score severity (28.7 vs 14.9%; P 0.02). More number of patients in the hypertensive group were treated with steroids (73.8% vs 39%; p

Introduction: Head and Neck Squamous Cell Carcinoma (HNSCC) is the sixth most common cancer globally and the seventh most common cause of cancer-related mortality. Tobacco use, alcohol consumption, and Human Papillomavirus (HPV) infection are prominent risk factors for HNSCC. HPVpositive Oral Squamous Cell Carcinoma (OSCC) differs from HPV-negative OSCC in terms of risk factors, preferential site of origin, age, histomorphological features, molecular genetic alterations, and prognosis. The prominent basaloid morphology and lobular growth of OSCCs are associated with p16 positivity and p53 negativity, respectively. Aim: To establish the immunohistochemical expression of p16 (p16INK4a) and p53 in OSCC and to assess their relationship with specific histomorphological features, in the form of solid growth of cells in a lobular configuration, small crowded cells with scant cytoplasm, dark hyperchromatic nuclei without nucleoli. Materials and Methods: The cross-sectional study involved fifty cases of OSCC over a two-year period from January 2017 to January 2019 at Army Hospital (R and R) Delhi Cantt. The intensity of p16 and p53 protein expression was graded as follows: no staining (0), weak staining (1), moderate staining (2), and strong staining (3). The proportion/percentage of staining for p16 and p53 protein expression was calculated as follows: 1-4% (1), 5-19% (2), 20-39% (3), 40-59% (4), 60-79% (5), and 80-100% (6) cells stained. A quick score of 0-1 (negative), 2-3 (weak positive), 4-5 (moderate positive), and >6 (strong positive) was assessed. Cross tables were generated and the Chi-square test was used for testing associations. The Statistical Software for Data Science (STATA)-14 was used for statistical analysis. Results: A total of 50 cases of OSCC were analysed for histomorphological features and immunohistochemical patterns of p16 and p53. The age distribution showed that 8 (16%), 9 (18%), 18 (36%), 13 (26%), and 2 (4%) of the patients were in the age groups of 31-40 years, 41-50 years, 51-60 years, 61-70 years, and above 70 years, respectively. The gender distribution noted 42 (84%) males and 8 (16%) females. Genital and nongenital mucosa are usually involved by HPV subtypes 6, 11, 16, 18, and 16, 18, 11, 13, 2, respectively. HPV-16 has been demonstrated in 90-95% of all HPV-positive HNSCC cases, followed by HPV-18, HPV-31, and HPV-33. p53 is considered the guardian of the genome and controls the expression and activity of proteins involved in cell cycle regulation, DNA repair, cellular senescence, and apoptosis. More than 50% of all primary HNSCC exhibit p53 mutation. Conclusion: A significant correlation was observed between age, dysplasia, keratinisation, basaloid morphology versus p16 expression, and lobular growth, histological grade versus p53. An inverse relationship between p16 and p53 expressions was observed. The immunohistochemical expression of p16 as an immunohistochemical marker of HPV, along with p53, is recommended. Due to the constraint of the study period, the survival of the patients could not be assessed in correlation with p16 and p53 expression.

Abstract Background Ulcerative colitis is a relapsing and remitting disease that may be associated with flares. The causes of flares in the Indian setting are not well recognized. Methods The present prospective case-control study was conducted at a single center in North India. Cases were defined as patients admitted for flare of ulcerative colitis, while controls were patients in remission enrolled from the outpatient department. The basis of the diagnosis of flare was a simple clinical colitis activity index (SCCAI) of ≥ 5 and endoscopic activity, while remission was based on SCCAI

Mycobacterium avium subspecies paratuberculosis (MAP) infection leads to chronic, persistent granulomatous enteritis, causing prolonged diarrhoea and emaciation. The disease is managed using medications such as antibiotics, live vaccines, mycobacteriophage therapies and other treatments; however, a notable proportion of affected animals do not show improvement with this approach. We hypothesise that immunoinhibitory receptors TIM-3 (T cell immunoglobulin mucin protein-3) and PD-1 (Programmed death receptor 1) may be upregulated on Peripheral blood mononuclear cells (PBMCs) of MAP-seropositive bovines, potentially contributing to immune exhaustion. Samples (blood and faeces) were collected from 32 diarrhoeic bovines suspected of MAP infection; eight apparently healthy buffaloes from the dairy farm at Hisar, Haryana and from 14 cows (suffering from chronic diarrhoea, weakness and emaciation) housed in stray cattle shed. MAP infection was estimated using indigenous ELISA (i-ELISA), faecal IS900 PCR, culture and acid-fast staining. TIM-3 and PD-1 gene expression on PBMCs were determined using qRT-PCR. TIM3 expression was relatively higher (~400-fold, 330-fold, 112-fold, 65-fold and 16-fold) in 5 chronically diarrhoeic PBMCs samples (MAP-seropositive), and higher PD-1 expression (around ~7-fold, 1.75-fold, 2.5-fold, 7.6-fold) was recorded in 4 diarrhoeic MAP-seropositive animals, compared to apparently healthy and other MAP-seronegative diarrhoeic animals. High co-expression of TIM-3 and PD-1 levels was also recorded in chronically diarrhoeic, emaciated stray cattle. Understanding immune responses in field conditions might aid in the therapeutic management of paratuberculosis.

Purpose Critically ill patients with acute pancreatitis (AP) require intensive care unit (ICU) admission. The management of pancreatic fluid collections (PFCs) in this group is challenging. We aimed to evaluate the feasibility and safety of bedside percutaneous ultrasound (USG)-guided interventions in necrotic PFC in ICU patients. Methods This retrospective study comprised consecutive patients with AP in the ICU who underwent bedside USG-guided interventions for necrotic PFC. Indications for intervention, technical success, clinical success, and complications were recorded. The site, number, and size of catheters were recorded. Clinical outcomes were assessed. Results Thirty-three patients (mean age, 38.1 years, 15 females) were included. All patients had nonresolving organ failure and were on mechanical ventilation. The mean pain to percutaneous catheter drainage (PCD interval was 42.2 days (range, 7–167 days). All the procedures were technically successful, and none of the patients required shifting to the interventional radiology suite for computed tomography guidance. PCD was clinically successful in 40% of the patients. There were no major complications. The mean length of hospital stay and ICU stay was 35 days (range, 6–69 days) and 13 days (range, 1–63 days), respectively. Six (17.1%) patients underwent necrosectomy. Sixteen (45.7%) patients died in the hospital. Conclusion USG-guided bedside PCD can be performed safely with high technical success in the ICU setting.

Abstract Gastrointestinal Tuberculosis (GITB) and Crohn’s disease (CD) are both chronic granulomatous diseases with a predilection to involve primarily the terminal ileum. GITB is often considered a disease of the developing world, while CD and inflammatory bowel disease are considered a disease of the developed world. But in recent times, the epidemiology of both diseases has changed. Differentiating GITB from CD is of immense clinical importance as the management of both diseases differs. While GITB needs anti-tubercular therapy (ATT), CD needs immunosuppressive therapy. Misdiagnosis or a delay in diagnosis can lead to catastrophic consequences. Most of the clinical features, endoscopic findings, and imaging features are not pathognomonic for either of these two conditions. The definitive diagnosis of GITB can be clinched only in a fraction of cases with microbiological positivity (acid-fast bacilli, mycobacterial culture, or PCR-based tests). In most cases, the diagnosis is often based on consistent clinical, endoscopic, imaging, and histological findings. Similarly, no single finding can conclusively diagnose CD. Multiparametric-based predictive models incorporating clinical, endoscopy findings, histology, radiology, and serology have been used to differentiate GITB from CD with varied results. However, it is limited by the lack of validation studies for most such models. Many patients, especially in TB endemic regions, are initiated on a trial of ATT to see for an objective response to therapy. Early mucosal response assessed at two months is an objective marker of response to ATT. Prolonged ATT in CD is recognized to have a fibrotic effect. Therefore, early discrimination may be vital in preventing the delay in the diagnosis of CD and avoiding a complicated course.

Abstract Citrus species among the most important and widely consumed fruit in the world due to Vitamin C, essential oil glands, and flavonoids. Highly variable simple sequence repeats (SSR) markers are one of the most informative and versatile molecular markers used in perennial tree genetic research. SSR survey of Citrus sinensis and Citrus maxima were identified perfect SSRs spanning nine chromosomes. Furthermore, we categorized all SSR motifs into three major classes based on their tract lengths. We designed and validated a class I SSRs in the C. sinensis and C. maxima genome through electronic polymerase chain reaction (ePCR) and found 83.89% in C. sinensis and 78.52% in C. maxima SSRs producing a single amplicon. Then, we selected extremely variable SSRs (> 40 nt) from the ePCR-verified class I SSRs and in silico validated across seven draft genomes of citrus, which provided us a subset of 84.74% in C. sinensis and 77.53% in C. maxima highly polymorphic SSRs. Out of these, 129 primers were validated on 24 citrus genotypes through wet-lab experiment. We found 127 (98.45%) polymorphic HvSSRs on 24 genotypes. The utility of the developed HvSSRs was demonstrated by analysing genetic diversity of 181 citrus genotypes using 17 HvSSRs spanning nine citrus chromosomes and were divided into 11 main groups through 17 HvSSRs. These chromosome-specific SSRs will serve as a powerful genomic tool used for future QTL mapping, molecular breeding, investigation of population genetic diversity, comparative mapping, and evolutionary studies among citrus and other relative genera/species.

Abstract The gut microbiome influences the pathogenesis and course of metabolic disorders such as diabetes. While it is likely that duodenal mucosa associated microbiota contributes to the genesis and progression of increased blood sugar, including the pre-diabetic stage, it is much less studied than stool. We investigated paired stool and duodenal microbiota in subjects with hyperglycemia (HbA1c ≥ 5.7% and fasting plasma glucose > 100 mg/dl) compared to normoglycemic. We found patients with hyperglycemia (n = 33) had higher duodenal bacterial count (p = 0.008), increased pathobionts and reduction in beneficial flora compared to normoglycemic (n = 21). The microenvironment of duodenum was assessed by measuring oxygen saturation using T-Stat, serum inflammatory markers and zonulin for gut permeability. We observed that bacterial overload was correlated with increased serum zonulin (p = 0.061) and higher TNF-α (p = 0.054). Moreover, reduced oxygen saturation (p = 0.021) and a systemic proinflammatory state [increased total leukocyte count (p = 0.031) and reduced IL-10 (p = 0.015)] characterized the duodenum of hyperglycemic. Unlike stool flora, the variability in duodenal bacterial profile was associated with glycemic status and was predicted by bioinformatic analysis to adversely affect nutrient metabolism. Our findings offer new understanding of the compositional changes in the small intestine bacteria by identifying duodenal dysbiosis and altered local metabolism as potentially early events in hyperglycemia.

The livestock industry faces significant challenges, with disease outbreaks being a particularly devastating issue. These diseases can disrupt the food supply chain and the livelihoods of those involved in the sector. To address this, there is a growing need to enhance the health and well-being of livestock animals, ultimately improving their performance while minimizing their environmental impact. To tackle the considerable challenge posed by disease epidemics, multiomics approaches offer an excellent opportunity for scientists, breeders, and policymakers to gain a comprehensive understanding of animal biology, pathogens, and their genetic makeup. This understanding is crucial for enhancing the health of livestock animals. Multiomic approaches, including phenomics, genomics, epigenomics, metabolomics, proteomics, transcriptomics, microbiomics, and metaproteomics, are widely employed to assess and enhance animal health. High-throughput phenotypic data collection allows for the measurement of various fitness traits, both discrete and continuous, which, when mathematically combined, define the overall health and resilience of animals, including their ability to withstand diseases. Omics methods are routinely used to identify genes involved in host-pathogen interactions, assess fitness traits, and pinpoint animals with disease resistance. Genome-wide association studies (GWAS) help identify the genetic factors associated with health status, heat stress tolerance, disease resistance, and other health-related characteristics, including the estimation of breeding value. Furthermore, the interaction between hosts and pathogens, as observed through the assessment of host gut microbiota, plays a crucial role in shaping animal health and, consequently, their performance. Integrating and analyzing various heterogeneous datasets to gain deeper insights into biological systems is a challenging task that necessitates the use of innovative tools. Initiatives like MiBiOmics, which facilitate the visualization, analysis, integration, and exploration of multiomics data, are expected to improve prediction accuracy and identify robust biomarkers linked to animal health. In this review, we discuss the details of multiomics concerning the health and well-being of livestock animals.

Background: Hepatotoxicity is the foremost issue for clinicians and the primary reason for pharmaceutical product recalls. A biomarker is a measurable and quantifiable attribute used to evaluate the efficacy of a treatment or to diagnose a disease. There are various biomarkers which are used for the detection of liver disease and the intent of liver damage. Objective: This review aims to investigate the current state of hepatotoxicity biomarkers and their utility in clinical settings. Using hepatic biomarkers, the presence of liver injury, its severity, prognosis, causative agent, and type of hepatotoxicity can all be determined. Methods: Relevant published articles up to 2022 were systematically retrieved from MEDLINE/PubMed, SCOPUS, EMBASE, and WOS databases using keywords such as drug toxicity, hepatotoxicity biomarkers, biochemical parameters, and nonalcoholic fatty liver disease. Results: In clinical trials and everyday practice, biomarkers of drug-induced liver injury are essential for spotting the most severe cases of hepatotoxicity. Hence, developing novel biomarker approaches to enhance hepatotoxicity diagnosis will increase specificity and/or identify the person at risk. Importantly, early clinical studies on patients with liver illness have proved that some biomarkers such as aminotransferase, bilirubin, albumin, and bile acids are even therapeutically beneficial. Conclusions: By assessing the unique signs of liver injury, health care professionals can rapidly and accurately detect liver damage and evaluate its severity. These measures contribute to ensuring prompt and effective medical intervention, hence reducing the risk of long-term liver damage and other major health concerns.

Abstract Sarcopenia is a condition marked by progressive loss of skeletal muscle mass and function while frailty is a multidimensional concept characterized by diminished physiological reserve and increased vulnerability to stressors. Both of these were previously considered as related to aging and shown to impact the quality of life and carry prognostic significance. Emerging data show that both sarcopenia and frailty carry similar relevance in chronic illness. Inflammatory bowel disease (IBD) is characterized by chronic inflammation of the gastrointestinal tract and malnourishment, both of which contribute to the development of sarcopenia by increasing protein breakdown and reducing protein synthesis. The coexistence of frailty further compounds the clinical complexity of IBD patients. Published evidence suggests a bidirectional association with IBD contributing to muscle wasting, while the resultant sarcopenia and frailty could further exacerbate the disease course. Sarcopenia and frailty are independently associated with adverse outcomes, including hospitalizations, increased surgical interventions, and surgical complications. As therapeutic strategies for IBD evolve, understanding the nuanced relationship between inflammatory bowel disease, sarcopenia, and frailty is crucial for devising holistic management. Comprehensive care should encompass not only disease‐modifying therapies but also interventions targeting frailty and sarcopenia, as they have been shown to have a significant impact not only on the disease course but also on the quality of life. Future research could focus on further elucidating underlying mechanisms, simple screening strategies, and developing targeted interventions to improve the overall quality of life for individuals grappling with the complex interplay of IBD, sarcopenia, and frailty.

The extraordinary and unique properties of persistent luminescent (PerLum) nanostructures like storage of charge carriers, extended afterglow, and some other fascinating characteristics like no need for in-situ excitation, and rechargeable luminescence make such materials a primary candidate in the fields of bio-imaging and therapeutics. Apart from this, due to their extraordinary properties they have also found their place in the fields of anti-counterfeiting, latent fingerprinting (LPF), luminescent markings, photocatalysis, solid-state lighting devices, glow-in-dark toys, etc. Over the past few years, persistent luminescent nanoparticles (PLNPs) have been extensively used for targeted drug delivery, bio-imaging guided photodynamic and photo-thermal therapy, biosensing for cancer detection and subsequent treatment, latent fingerprinting, and anti-counterfeiting owing to their enhanced charge storage ability, in-vitro excitation, increased duration of time between excitation and emission, low tissue absorption, high signal-to-noise ratio, etc. In this review, we have focused on most of the key aspects related to PLNPs, including the different mechanisms leading to such phenomena, key fabrication techniques, properties of hosts and different activators, emission, and excitation characteristics, and important properties of trap states. This review article focuses on recent advances in cancer theranostics with the help of PLNPs. Recent advances in using PLNPs for anti-counterfeiting and latent fingerprinting are also discussed in this review.

The Regenerative Endodontic Procedure (REP) is one of the latest biological procedures for successfully treating immature non vital teeth. Treating non vital immature teeth in children with associated bone resorption poses a challenge. In the present case, a 10- year-old male patient presented with an immature pulpally involved right permanent first molar, exhibiting a periapical radiolucency measuring 2×3.2×10.5 mm (distal root) and 4.4×5.2×10.5 mm (mesial root). The molar was non-surgically treated using a minimally invasive REP approach, aiming for anatomical healing and root completion. Mineral Trioxide Aggregate (MTA) was applied over a blood clot used as a scaffold. The radiolucency decreased significantly to a size of 0.9×1.3×0.2 mm (distal root) and 1×0.4×0.2 mm (mesial root). Continuous root formation was also observed, resulting in complete resolution of the Apical Bone Defect (ABD). The mesial and distal roots progressed from Nolla stage 8 (2/3rd of root formation) to Nolla stage 9 (root formation complete) over a twelve-month period. Three-dimensional (3D) analysis was employed to explain pathosis and the healing of lesions from every aspect. The present case demonstrates that REP may be the treatment of choice for managing non vital immature permanent posterior teeth with severe ABD in a paediatric patients, particularly when the surgical approach is contraindicated due to the presence of other developing structures. Furthermore, long-term follow-up is required, and the type of healing and root completion may vary depending on the stage of root formation, disinfection, and coronal seal achieved.

Background and Purpose Transabdominal ultrasound (US)-based shear wave elastography (SWE) provides an attractive method of estimating pancreatic stiffness. There is limited data on the SWE values of the healthy pancreas in Indian subjects. The current study aimed to evaluate SWE of the normal pancreas. Methods We performed a study from January 2019 to March 2019. We included adult patients who presented for the US of the upper abdomen for vague abdominal symptoms, unrelated to the pancreas. The SWE values were obtained from the pancreatic head and body. The association of pancreatic SWE with age, gender, fatty liver, chronic liver disease, and cholelithiasis was recorded. Results During the study period, 205 subjects underwent SWE of the pancreas. The mean age of subjects was 41.3 (standard deviation [SD] 15.3) years. There were 93 males and 112 females. The mean SWE value in the head of the pancreas was 8.98 (SD 2.46 kPa), and that in the body region was 8.67 (SD 2.67 kPa). There was a positive correlation of SWE with age. The SWE of the pancreatic body was significantly higher in patients who had a fatty liver on US (p

Abstract Getting access to administrative health data for research purposes is a difficult and time-consuming process due to increasingly demanding privacy regulations. An alternative method for sharing administrative health data would be to share synthetic datasets where the records do not correspond to real individuals, but the patterns and relationships seen in the data are reproduced. This paper assesses the feasibility of generating synthetic administrative health data using a recurrent deep learning model. Our data comes from 120,000 individuals from Alberta Health’s administrative health database. We assess how similar our synthetic data is to the real data using utility assessments that assess the structure and general patterns in the data as well as by recreating a specific analysis in the real data commonly applied to this type of administrative health data. We also assess the privacy risks associated with the use of this synthetic dataset. Generic utility assessments that used Hellinger distance to quantify the difference in distributions between real and synthetic datasets for event types (0.027), attributes (mean 0.0417), Markov transition matrices (order 1 mean absolute difference: 0.0896, sd: 0.159; order 2: mean Hellinger distance 0.2195, sd: 0.2724), the Hellinger distance between the joint distributions was 0.352, and the similarity of random cohorts generated from real and synthetic data had a mean Hellinger distance of 0.3 and mean Euclidean distance of 0.064, indicating small differences between the distributions in the real data and the synthetic data. By applying a realistic analysis to both real and synthetic datasets, Cox regression hazard ratios achieved a mean confidence interval overlap of 68% for adjusted hazard ratios among 5 key outcomes of interest, indicating synthetic data produces similar analytic results to real data. The privacy assessment concluded that the attribution disclosure risk associated with this synthetic dataset was substantially less than the typical 0.09 acceptable risk threshold. Based on these metrics our results show that our synthetic data is suitably similar to the real data and could be shared for research purposes thereby alleviating concerns associated with the sharing of real data in some circumstances.

Abstract The exponential increase in IoT device usage has spawned numerous cyberspace innovations. IoT devices, sensors, and actuators bridge the gap between physical processes and the cyber network in a cyber‐physical system (CPS). Cyber‐physical system is a complex system from a security perspective due to the heterogeneous nature of its components and the fact that IoT devices can serve as an entry point for cyberattacks. Most adversaries design their attack strategies on systems to gain an advantage at a relatively lower cost, whereas abusive adversaries initiate an attack to inflict maximum damage without regard to cost or reward. In this paper, a sensor spoofing attack is modelled as a malicious adversary attempting to cause system failure by interfering with the feedback control mechanism. It is accomplished by feeding spoofed sensor values to the controller and issuing erroneous commands to the actuator. Experiments on a Simulink‐simulated linear CPS support the proof of concept for the proposed abusive ideology, demonstrating three attack strategies. The impact of the evaluations stresses the importance of testing the CPS security against adversaries with abusive settings for preventing cyber‐vandalism. Finally, the research concludes by highlighting the limitations of the proposed work, followed by recommendations for the future.

Undoubtedly, throughout the past half-century, environmental quality has emerged as a significant obstacle to both economic and social endeavors. Recent local and international policy debates have focused on environmental deterioration and global warming, but how governments balance economic growth and environmental sustainability is still enigmatic. For this reason, we have examined the determinants of environmental quality in India from 1972 to 2021. More specifically, we have investigated whether the fiscal deficit is ‘curse’ or ‘haven’ for environmental quality (CO2) in India. Moreover, this study deliberated four other predictors, comprising technological development (TIN), fossil fuel consumption (FFC), urbanization (Ub), and human capital index (HCI). In order to attain this objective, a range of econometric estimation techniques are employed to ensure the validity and reliability of the outcomes. For instance, we have employed a battery of ARDL approaches, such as standard ARDL, nonlinear ARDL, and multiple threshold NARDL approaches. In light of our research findings, we will be focusing directly on the examination of the NARDL and MTNARDL outcomes. This is due to the empirical evidence indicating the existence of asymmetric effects resulting from FD on CO2 emissions in India. The NARDL approach reveals that the consequence of fiscal deterioration is more pronounced, and the influence of fiscal progress is mild in terms of CO2 emission growth. Further, the outcomes of the MTNARDL approach revealed that the size of the extremely low changes in FD is much higher than the extremely high changes in FD in both models. This implies that as the FD rises, CO2 ascends more significantly, and when the FD lowers, CO2 declines progressively. In a nutshell, FD has a long-run positive and asymmetric impact on CO2 in India; thus, we may conclude that FD is considered the ‘curse’ for CO2 in India. Furthermore, TIN, HCI, and Ub have detrimental effects on CO2, whereas FFC stimulates CO2 in India. This research work provides some important policy implications for environmentalists, economists and macroeconomic policymakers to promote a green and healthy environment.

Objective: Takayasu arteritis is a rare, chronic, inflammatory disease that primarily affects the aorta and its major branches. It mainly affects young females, and it can cause significant morbidity and mortality if untreated. The aim of this study was to evaluate the demographic profile, clinical manifestations, diagnostic features, angiographic findings in patients with aortoarteritis (Takayasu arteritis). Methods: We enrolled prospectively 116 patients with Takayasu arteritis who came to Cardiology OPD at tertiary cardiac care hospital. We looked for constitutional symptoms, heart-related symptoms, systemic hypertension, neurological symptoms and upper & lower limb fatigue and claudication. We evaluated our patients using different diagnostic criteria: clinical, ACR criteria and Indian Takayasu Activity score. We also studied the angiographic profile and lesion characteristics in these patients, based on peripheral and coronary angiograms. Results: We studied patients consisted of 14 male patients (12.1%) and 102 female patients (87.9%). Type V Takayasu arteritis was most common type (36.2%). Fatigue (60%) was most common cardinal symptom followed by myalgia (30%) and arthralgia (10%). About 43% of patients had neurological symptoms. Systemic hypertension (67%) was the most common manifestation of renal involvement. 110(95%) of the patients met clinical criteria and 105(91%) patients had American College of Rheumatology (ACR) score ≥3. Angiographic evidence of left renal artery stenosis was more (20%) than right renal artery stenosis (15%). bilateral renal artery involvement was found in 29% of patients. Conclusion: Type V Takayasu arteritis was most common type (36.2%) of total study population. Hypertension and subclavian artery involvement both were seen in 2/3rd of population. Angiographic evidence of right and left renal artery stenosis was seen in 15% and 20% respectively, while bilateral renal artery involvement was found in 29% of patients. Take home message: Takayasu arteritis rarely involves the coronary arteries. Angiographic evidence of right and left renal artery stenosis was observed in 15% and 20% of patients, respectively, with bilateral renal artery involvement found in 29% of patients.

Abstract Background Gastrointestinal strictures impact clinical presentation in abdominal tuberculosis and are associated with significant morbidity. Aim To conduct a systematic review of the prevalence of stricturing disease in abdominal and gastrointestinal tuberculosis and response to antitubercular therapy (ATT). Methods We searched Pubmed and Embase on 13th January 2022, for papers reporting on the frequency and outcomes of stricturing gastrointestinal tuberculosis. The data were extracted, and pooled prevalence of stricturing disease was estimated in abdominal tuberculosis and gastrointestinal (intestinal) tuberculosis. The pooled clinical response and stricture resolution (endoscopic or radiologic) rates were also estimated. Publication bias was assessed using the Funnel plot and Egger test. The risk of bias assessment was done using a modified Newcastle Ottawa Scale. Results Thirty-three studies reporting about 1969 patients were included. The pooled prevalence of intestinal strictures in abdominal tuberculosis and gastrointestinal TB was 0.12 (95%CI 0.07–0.20, I2 = 89%) and 0.27 (95% CI 0.21–0.33, I2 = 85%), respectively. The pooled clinical response of stricturing gastrointestinal tuberculosis to antitubercular therapy was 0.77 (95%CI 0.65–0.86, I2 = 74%). The pooled stricture response rate (endoscopic or radiological) was 0.66 (95%CI 0.40–0.85, I2 = 91%). The pooled rate of need for surgical intervention was 0.21 (95%CI 0.13–0.32, I2 = 70%), while endoscopic dilatation was 0.14 (95%CI 0.09–0.21, I2 = 0%). Conclusion Stricturing gastrointestinal tuberculosis occurs in around a quarter of patients with gastrointestinal tuberculosis, and around two-thirds of patients have a clinical response with antitubercular therapy. A subset of patients may need endoscopic or surgical intervention. The estimates for the pooled prevalence of stricturing disease and response to ATT had significant heterogeneity.

Context: Pulmonary hypertension (PH) is a condition characterized by an increase in pulmonary artery pressure, leading to morbidity and poor survival. In India, the high prevalence of certain diseases contributes to the burden of PH. To address this, this study provides epidemiological data and clinical characteristics of pulmonary artery hypertension. Materials and Methods: A cross-sectional study was conducted at a tertiary cardiac care hospital, recruiting 964 patients with severe pulmonary arterial hypertension (PAH). Patient data were obtained through a detailed history and physical examination, including 12-lead electrocardiogram, two-dimensional echocardiography, coronary angiography, right heart catheterization, and hematological and serological investigations. Results: The majority of patients (28.94%) were in the age group of 31–40 years, with a female preponderance in PAH disease. Idiopathic PAH (IPAH) was the most common type, accounting for 69.78% of all cases. The most common comorbid conditions were hypertension (48.55%) and Type-2 diabetes mellitus (44.81%). Dyspnea on exertion (98.34%) and edema of extremities (91.18%) were the most common symptoms. The mean survival rate was 50.98 months, with Type 1 PAH having the worst survival rate of 47.56 months. The statistical analysis showed a significant association between smoking and PAH. Conclusion: This study provides epidemiological data and clinical characteristics of PAH patients in India, emphasizing the need for early diagnosis, prompt management, and smoking cessation programs. The high prevalence of IPAH and female preponderance was also observed in this study. These findings can help in the development of targeted interventions and management strategies for PH patients in India.

Background: We investigated the pharmacokinetic behavior of pyrazinamide (PZA) and pyrazinoic acid (PA) in the presence of carbon-tetrachloride (CCl4) plus antitubercular treatment (ATT) drug-induced liver injury (DILI) in rats. Methods: Thirty rats utilized in the experiment were separated equally into five groups. Each rat was injected with 0.5 ml/kg CCl4 intra-peritoneal injection on day zero. Group, I rats did receive only CCl4 (single i.p. injection, 0.5 ml/Kg in olive oil in a 1:1 ratio). Groups II, III, IV, and V did receive daily oral PZA, PZA plus isoniazid (INH), rifampicin (RMP) plus pyrazinamide (PZA), and three drugs together, respectively, for 21-days. Pharmacokinetic sampling was performed at 0, 0.5,1,3,6,12 and 24 hours post-dosing on day-20. Liver function test (LFT) was assessed at days 0,1,7, and 21 days after CCl4 and ATT administration, and rats were sacrificed on the last experiment day. Results: ATT treatment maintained the liver function changes initiated by CCl4 administration. An evidential LFT rise was observed in groups administered with pyrazinamide. Co-administration of Isoniazid caused a 2.02 and 1.78 times increase in Area-under-the-curve (AUC) values of PZA and PA, respectively (p < 0.05). Histological and oxidative-stress changes supported the biochemical and pharmacokinetic observations. Conclusion: The enzyme inhibitory capacity of isoniazid is well-preservd in CCl4-induced liver injury.

Background: N-acetyl transferase 2 (NAT2) polymorphism testing could not see the light of success as a biomarker tool in tuberculosis management. Additionally, the antitubercular treatment (ATT) drug's reintroduction regimen variations exist because of the scarcity of robust preclinical evidence on ATT drug metabolism. Objective: The experiment was planned to understand the pharmacokinetic (PK) behavior of isoniazid and acetylisoniazid (AcINH) in a Wistar rat model of acute liver injury induced by carbon tetrachloride (CCl4) and preclinical drug-induced liver injury (DILI) model induced with CCl4 + anti-Tuberculosis (TB) drugs together. Materials and Methods: Thirty rats were used for the experiment and were divided into five groups. All rats were administered a single 0.5 ml/kg CCl4 intraperitoneal injection on day 0 to induce an animal model of DILI. Group I rats received CCl4 alone. Groups II–V were started on additional gavage feedings of isoniazid (H) alone, H plus rifampicin (R), H plus pyrazinamide (Z), and H, R, and Z together, respectively, daily for 21 days subsequently. Isoniazid and AcINH PK assessment was accomplished on day 20 of continuous once-daily dosing. Liver function test (LFT) monitoring was done at baseline on days 1, 7, and 21. On the last day of experiments, all experimental rats were sacrificed. Results: Three-week ATT administration sustained the CCl4-induced LFT changes. Area under the curve (AUC) values for isoniazid and AcINH were found to be 2.24 and 1.69 times higher in the H + R group compared with the CCl4 + H group, respectively (P < 0.05). Isoniazid and AcINH maximum concentration (Cmax) reached the highest, while isoniazid clearance reached the lowest in the H + R group. AcINH AUC increased by double in the CCl4 + Isoniazid+Rifampicin+Pyrazinamide (HRZ) group compared with the CCl4 + H group (P < 0.05). Biochemical, histological, and antioxidant changes were consistent with the new liver injury model's development. Conclusion: Rifampicin almost doubles up the isoniazid and AcINH exposure, in presence if DILI.

Background: Variation in the speech of speakers is a crucial issue for the forensic system. The main reason behind incorrect speaker identification is greater intra-speaker fluctuation. In the forensic state of play, a lot of research has been carried out on speaker identification. However inter variations and intra fluctuations in speakers for the Punjabi language is still a grey area. Aims and Objectives: Our aim is to study acoustic analysis of fluctuations for inter and intra speaker variability in speech sounds. In our study, we will consider Punjabi vowel with consonants. The Statistical methods will be applied to analyze the data; firstly, the Shapiro-Wilk test will be checked for normality and then Levene's Test to assess the equality of variances. Materials and Method: Five vowels were selected with different consonants. They were combined to make meaningful words. Then these meaningful words were embedded in sentences. Ten speakers participated voluntarily. All are students of A.S College at Khanna in Punjab. The individuals were aged between 20-22 years with no hearing or speech disorder. The voice samples were recorded with help of good quality microphone and by Goldwave software in the sound proof lab.Samples were introduced directly into PRAAT software by the use of a Sony microphone and with sampling rate of 44100 Hz frequency. Acoustic Analysis has been done with help of Goldwave software in form of spectrograms. Results and Conclusion: Each formant shows a different value for inter variations and inter speaker fluctuations. F1 and F2 shows lesser speaker variation than the high-frequency region in F3 and F4, so we can say that in comparison with the lower part, high-frequency regions are more valuable. The assumptions for TWO-WAY ANOVA is violated and hence, we have used the non-parametric Friedman Test and performed its Post hoc analysis. From Posthoc analysis, we can say that F1 and F2 (p >0.05) and F2 and F3 (p>0.05) gave the same type of results. Hence, from the results of these statistical tests, we can conclude that F1 is recommended over F2, F3, and F4. As the frequency of F1 is high as well as in line with the results of statistical tests. Because we prefer more variation among frequencies so that we can easily distinguish different speakers and it would be more beneficial for inter variations and intra fluctuations.

Objective: The behavior monitoring of older adults in their own home and enabling daily-life activity analysis to healthcare practitioner is a key challenge. Methods and procedures: Our framework replicates the elderly home in digital space which can provide an unobtrusive way to monitor the resident&ahat;s daily life activities. The learning challenges posed by different performed activities at home are solved by introducing the deep meta-class sequence model. The notion is to group the set of activities into a single meta-class according to the nature of the activities. It helps the learning process, which is based on long short-term memory (LSTM) to learn feature space abstraction. Each meta-class abstraction is further decomposed to an individual activity performed by the elderly at home. Results: The experiments are carried out over the Center for Advanced Studies in Adaptive Systems dataset and proposed model outperforms as compared to baseline models. Clinical impact: Our findings demonstrate a robust framework to digitally monitor the elderly behavior, which is beneficial for healthcare practitioners to understand the level of support the elderly needed to perform the daily tasks or potential risk of an emergency in their own homes.

Abstract We investigated the effect of two dosing regimens of oral iron on iron status and hematological parameters in patients with CKD. In this single center, open label, randomized, active controlled clinical trial, stable adult patients with CKD stage G3–4 with percentage transferrin saturation (%TSAT) ≤ 30% and serum ferritin ≤ 500 ng/ml were eligible. Participants were randomized to receive either 100 mg of ferrous ascorbate once daily (OD group) or 100 mg of ferrous ascorbate twice daily (BD group, total daily dose 200 mg). The primary outcome was change in %TSAT between groups over 12 weeks. The secondary outcomes were changes in other iron status and hematological parameters, serum interleukin-6 (IL-6) and hepcidin. 80 participants were enrolled out of which 76 completed the study. Change in %TSAT was not significantly different between groups (β = − 1.43, 95% CI − 3.99 to 1.12, BD group as reference). The rise in serum ferritin was less in the OD group as compared to BD group (β = − 0.36, 95% CI − 0.61 to − 0.10) whereas MCHC increased in the OD group as compared to decrease in the BD group (β = 0.37, 95% CI 0.067–0.67). These observations need exploration to ascertain the impact of different oral iron dosing strategies in CKD.

Twelve apparently healthy and recently parturiated Murrah buffaloes, vaccinated with Foot-and-mouth disease (FMD) + Haemorrhagic septicaemia (HS) combined vaccine at an organized farm along with their newborn calves were inducted for detection of antibodies in serum and colostrum against FMD virus (FMDV) serotypes O, A and Asia-1, and Pasteurella multocida using enzyme linked immunosorbent assay. The calves born to vaccinated dams showed the presence of protective maternal antibody titre (≥1.8 log10) from birth till the period of study (16th week of age) against FMDV serotypes O, A and Asia-1. The maternal antibody titre against P. multocida were protective (≥1.8 log10) till fifth day of age which became partially protective thereafter till the period of study. It is recommended to avoid vaccination of the calves before 16th week of age with FMD+HS combined vaccine.

Objective To construct a machine-learning (ML) model for health systems with organised falls prevention programmes to identify older adults at risk for fall-related admissions.Design This prognostic study used population-level administrative health data to develop an ML prediction model.Setting This study took place in Alberta, Canada during 2018–2019.Participants Albertans aged 65 and older with at least one prior admission. Those with palliative conditions or emigrated out of Alberta were excluded.Exposure Unit of analysis was the individual person.Main outcomes/measures We identified fall-related admissions. A CatBoost model was developed on 2018 data to predict risk of fall-related emergency department visits or hospitalisations. Temporal validation was done using 2019 data to evaluate model performance. We reported discrimination, calibration and other relevant metrics measured at the end of 2019 on both ranked predictions and predicted probability thresholds. A cost-savings simulation was performed using 2019 data.Results Final number of study participants was 224 445. The validation set had 203 584 participants with 19 389 fall-related events (9.5% pretest probability) and an ML model c-statistic of 0.70. The highest ranked predictions had post-test probabilities ranging from 40% to 50%. Net benefit analysis presented mixed results with some net benefit using the ML model in the 6%–30% range. The top 50 percentile of predicted risks represented nearly $C60 million in health system costs related to falls. Intervening on the top 25 or 50 percentiles of predicted risk could realise substantial (up to $C16 million) savings.Conclusion ML prediction models based on population-level administrative data can assist health systems with fall prevention programmes identify older adults at risk of fall-related admissions and reduce costs. ML predictions based on ranked predictions or probability thresholds could guide subsequent interventions to mitigate fall risks. Increased access to diverse forms of data could improve ML performance and further reduce costs.

The development of sustainable biorefineries and bioeconomy has been the mandate of most of the governments with major focus on restricting the climate change concerns and finding new strategies to maintain the global food supply chain. Xylooligosaccharides (XOS) are short-chain oligomers which due to their excellent prebiotic potential in the nutraceutical sector has attracted intense research focus in the recent years. The agro-industrial crop and food waste can be utilized for the production of XOS which are derived from hemicellulose fraction (xylan) of the lignocellulosic materials. The extraction of xylan, is traditionally achieved by acidic and alkaline pretreatments which, however, have limited industrial applications. The inclusion of cutting-edge and environmentally beneficial pretreatment methods and technologies such as deep eutectic solvents and green catalysts are preferred. Moreover, the extraction of xylans from biomass using combinatorial pretreatment approaches may help in economizing the whole bioprocess. The current review outlines the factors involved in the xylan extraction and depolymerization processes from different lignocellulosic biomass and the subsequent enzymatic hydrolysis for XOS production. The different types of oligosaccharides and their prebiotic potential for the growth of healthy gut bacteria have also been explained. The introduction of modern molecular technologies has also made it possible to identify enzymes and microorganisms with the desired characteristics for usage in XOS industrial production processes.

Objective: Cancer treatment-related cardiac dysfunction (CTRCD) is a significant concern for patients undergoing chemotherapy. The aim of the present study was to study the accuracy and value of longitudinal strain in prediction of left ventricular dysfunction (LVD) in cancer patients undergoing cancer therapy. Methods: This was a prospective observational study conducted among 183 adult patients undergoing chemotherapy between 2018 and 2020. Patients with congenital or acquired valvular disease, prior myocardial infarction, coronary revascularization, or cardiac surgery were excluded. The patients were evaluated using a detailed history, clinical examination and echocardiography at baseline, 1 month, 3 months, and 6 months after chemotherapy. Speckle-tracking strain analysis was used to evaluate left ventricular (LV) global longitudinal strain (GLS), circumferential strain (GCS), and radial strain (GRS). LVD was defined as >15% decrease in GLS, GCS, or GRS from baseline to 6 months. Accuracy of longitudinal strain in prediction of LVD was studied using ROC analysis. Results: Of the 183 patients, 59% were male, and 54.1% were between 46-60 years of age. Breast cancer was the most common malignancy (10.9%). The most common chemotherapy regimen was doxorubicin + paclitaxel (9.9%). At baseline, the mean GLS, GCS, and GRS were -18.6 (1.03)%, -20.4 (1.11)%, and 39.9 (6.09)%, respectively. At the 6-month follow-up, 27 (14.8%) patients had LVD. The incidence of LVD was higher (51.48%) in patients who received doxorubicin-containing regimens compared to non-doxorubicin-containing regimens (P

The ADITYA upgrade (ADITYA-U), a medium-sized $\left( {{R_0} = 75{\text{ cm}},\,\,a = 25{\text{ cm}}} \right)$ conventional tokamak facility in India, has been consistently producing experiments findings by using circular and shaped-plasmas. Recognizing the plasma parameters aligning closely with the design parameters of circular limited plasmas, ADITYA-U shifted its focus toward exploring the operational regime for experimentation on saw-tooth and MHD phenomena. Moreover, ADITYA-U has made consistent advancements toward conducting preliminary plasma shaping experiments through the activation of top and bottom divertor coils utilizing hydrogen as well as deuterium fuels. Confinement is improved by a factor of ∼1.5 in ${D_2}$ plasmas when compared to H _2 plasmas of ADITYA-U. Further, ADITYA-U operations emphasize preventing disruptions and runaway electrons (REs) to ensure safe operations for future fusion devices. Significant suppression of REs has been achieved in ADITYA-U with the application of pulsed localized vertical magnetic field (LVF) perturbation, thereby establishing the technique’s independence from the tokamak device. The successful RE mitigation requires a critical threshold of LVF pulse magnitude, which is approximately 1% of the toroidal magnetic field, and a minimum duration of ∼5 ms. Apart from this, several novel findings have been achieved in the ADITYA-U experiments, including the modification of sawtooth duration through gas-puff, the emergence of MHD-induced geodesic acoustic mode-like oscillations, the propagation of fast heat pulses induced by MHD activity, the control of RE dynamics through Gas-puffs, the propagation of pinch-driven cold-pulses, the transport and core accumulations of argon impurities, the mass dependency of plasma toroidal rotation and the detection of ‘RICE’ scaling, as well as the characterization of edge plasma using wall conditioning methods, such as glow discharge cleaning using a combination of Ar -H _2 mixture, localized wall cleaning by electron cyclotron resonant plasma, and the development of machine learning-based disruption predictions, will be discussed in this paper.

Making a correct diagnosis is the first, and most important, step in the therapeutic journey of a disease [...]

ABSTRACT Background Variceal hemorrhage (VH) is a medical emergency. Prompt endoscopic variceal ligation (EVL) is therapeutic. Terlipressin is used in VH and continued for 2—5 days even after EVL. As hemostasis is primarily achieved by EVL, the benefit of continuing trelipressin after EVL is unknown. Objective To evaluate the efficacy of continuing terlipressin after EVL to prevent re-bleed and mortality. Methods In this pilot study, after EVL 74 patients of VH were randomized into two treatment groups TG2 & TG5, received terlipressin (1 mg IV bolus q 4 hourly) for 2 days and 5 days respectively and one control group (TG0), received 0.9% normal saline (10 mL IV bolus q 4 hourly) and followed up for 8 weeks. Results A total of 9 (12.6%) patients had re-bleed with maximum 4 (5.6%) patients in TG5 group followed by 3 (4.2%) in TG2 and 2 (2.8%) in TG0 groups (P=0.670). The overall mortality was 15 (21.1%) patients, 6 (8.5%) patients in TG0 group, followed by 5 (7.0%) in TG5 and 4 (5.6%) in TG2 group (P=0.691). Adverse drug reactions were significantly higher in treatment groups with maximum 18 (24.32%) patients in TG5, followed by 8 (10.8%) in TG2 and 2 (2.7%) in TG0 groups (P=0.00). Duration of hospital stay was also significantly higher in treatment group, 6.63 (±0.65) days in TG5 followed by 3.64 (±0.57) in TG2 and 2.40 (±0.50) days in TG0 groups (P=0.00). Conclusion The rational for continuing terlipressin after EVL is doubtful as it didn’t have any benefit for the prevention of re-bleed or mortality; rather it increased the risk of adverse drug reactions and duration of hospital stay. Further randomized clinical trials are encouraged to generate more evidence in support or against continuing terlipressin after EVL.