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Kevin Bray,1 Kaitlin Burge,1 Om Patel,1 Ishant Yadav,1 William Haynes,1 Nicholas Van Wagoner,2 Charles A Khoury3 1Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; 2Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA; 3Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, AL, USACorrespondence: Kevin Bray, Email kevbray@uab.eduBackground: Beginning January 26th, 2022, the National Board of Medical Examiners transitioned scoring of the United States Medical Licensing Examination (USMLE) Step 1 from a 3-digit score to pass/fail. In the past, the Step 1 score has been weighted heavily by program directors (PDs) as one of the most important metrics when assessing medical student’s competitiveness.Objective: The objective of this study was to evaluate the perceptions of emergency medicine (EM) PDs on the transition to a pass/fail USMLE Step 1 exam, and to elicit the opinions of EM PDs on the USMLE examinations’ ability to predict resident performance.Methods: A survey consisting of ranking and multiple-choice questions was sent to EM PDs. The multiple-choice questions were asked to determine EM PDs level of confidence in the ability of Step 1 and Step 2 Clinical Knowledge (CK) to predict a student’s ability to succeed in residency. The ranking questions focused on assessing each program’s current resident selection practices in comparison to expected selection criteria changes following a transition to pass/fail Step 1. R studio and MATLAB were used for statistical analysis, and a P value < 0.05 was considered significant.Results: The survey was completed by 57 (20.21%) EM PDs. When asked if Step 1 and Step 2 CK are accurate predictors of a resident’s ability to perform clinically within EM, only 10.5% of PDs answered ‘yes’ to Step 1 being predictive, compared to 31.6% for Step 2 CK. Regarding selection criteria, the top quartile of attributes (standardized letters of evaluation [1st], away rotations [2nd], clerkship grades [3rd] and Step 2 CK score [4th]) remained the same following the transition.Conclusion: Our results indicate that the top quartile of attributes might remain the same, despite most PDs agreeing that Step 2 CK is a better predictor of a resident’s performance.Keywords: USMLE, NBME, Step 1, Step 2, emergency medicine, residency, program director, medical student

In this study, the effect of ZnO buffer layer on the electrical properties of PbZrTiO3/BiFeO3 (PZT/BFO) multilayers has been reported. For this, PZT/BFO multilayers were spin-coated with and without ZnO buffer layer on platinized silicon wafers. X-ray diffraction results of both the films showed polycrystalline phase pure perovskite structure. Both the films show a dense and homogeneous grain structure. The electric properties of the films were measured. The ZnO buffered multilayer thin film showed ∼3 times improvement in remnant polarization compared to the multilayer thin film with no buffer. The buffered samples were found to have higher dielectric constant (1000 at 100 Hz) compared to that of sample (580 at 100 Hz)) with no buffer. Dielectric constants of both the films were found to be ∼30% tunable at 5 V. The buffered film also showed low leakage current density and higher dielectric breakdown compared to the multilayer thin film without buffer. [ABSTRACT FROM AUTHOR]

A set of fifty genotypes of chickpea (Cicer arietinum L.)were evaluated in three different environments during 2008-09 to determine the stability for seed yield plant height , number of branches per plant, number of pods per plant, number of seeds per pod, biological yield, seed yield per plant, harvest index (%), 100 seed weight . Analysis of variance revealed significant differences among the genotypes for all the characters studied. Stability analysis showed that a major portion of genotype x environment (G x E) interaction was accompanied by linear component for number of branches per plant, number of pods per plant, number of seeds per pod, biological yield, seed yield per plant and 100 seed weight, whereas, non-linear portion predominantly contributed towards plant height, number of branches per plant and harvest index. Environment two (E2) was observed to be best for most of the yield attributing traits. Considering all the parameters, genotypes H06-79, H04-31, HK05-151, HK06-162, HK06-170, HK06-171, HK-2, HK-3, H06-32 having bi> 1 and i = 0 found promising for favourable environment, while genotype HC-3 having bi< 1 and S-2di= 0 found promising for unfavourable environment and genotypes H05-10, HK06-152, HK06-155 having bi= 1 and S-2di = 0 across the environments. [ABSTRACT FROM AUTHOR]

The field of corrole systems, particularly those with functional groups at their peripheral positions, has experienced a surge of interest in recent years, driven by their exceptional optical and electronic properties, which hold significant promise for a range of applications. This timely review article mainly focuses on synthetic strategies of reaction of meso -triarylcorroles having formyl or acroleyl groups at peripheral positions, with specific emphasis on the influence of core-metal insertion, the quantity of reagent and meso -substituents. Corroles bearing formyl and acroleyl substituents have been exploited as synthons for preparing novel compounds with a magnificent bouquet of characteristics. Furthermore, the reactivity of these corroles derivatives with active methylene compounds and substituted pyrroles is highlighted. The detailed exploration of these functionalizations is helping to advance new developments in the field. Additionally, the review addresses the potential applications of corroles in chemosensing, catalysis, photovoltaics, and nonlinear optics. It also examines the systematic advancements in the optical properties of corroles, providing a thorough overview of their photophysical and redox characteristics. This will help researchers working in this area and promote exceptional future investigations.

Injectable polymeric hydrogels delivered via endoscopic catheter have emerged as promising submucosal agents, offering durable, long-lasting cushions to enhance the efficacy of endoscopic submucosal dissection (ESD) for the removal of small, flat polyps from the gastrointestinal tract (GIT). However, polymer-based injections do not meet the easy-injectability criteria via catheter because their high viscosity tends to clog the catheter needle. To the best of knowledge, for the first time, report the fabrication of an amphiphile-based small molecule hydrogel of diglycerol monostearate (DGMS) that self-assembles to form hydrogel (DGMSH) for delivery via an endoscopic catheter. Physicochemical characterization of the hydrogel reveals its fibrous morphology, shear-thinning behaviour, and easy injectability, along with its scalability and long shelf-life (6 months). Ex vivo studies on the goat's stomach and intestine demonstrate the ease of injectability through the catheters and the development of visible submucosal cushion depots with the desired height. Moreover, the hydrogel can encapsulate both hydrophobic and hydrophilic drugs/dyes. In vivo studies in small animals have found that the hydrogel depot is durable, biocompatible, non-immunogenic, and has a hemostatic effect. Endoscopic studies in the porcine model demonstrate a safe injection and endoscopic excision of GI polyps acting as a suitable agent for ESD., (© 2024 Wiley‐VCH GmbH.)

Regulation of protein mobility is a fundamental aspect of cellular processes. In this study, we examined the impact of DNA methylation on the diffusion of nucleoid associated protein Hfq. This protein is one of the most abundant proteins that shapes the bacterial chromosome and is involved in several aspects of nucleic acid metabolism. Fluorescence microscopy was employed to monitor the movement of Hfq along double-stranded DNA, which was stretched due to confinement within a nanofluidic channel. The mobility of Hfq is significantly influenced by DNA methylation. Our results underscore the importance of bacterial epigenetic modifications in governing the movement of nucleoid associated proteins such as Hfq. Increased levels of methylation result in enhanced binding affinity, which in turn slows down the diffusion of Hfq on DNA. The reported control of protein mobility by DNA methylation has potential implications for the mechanisms involved in target DNA search processes and dynamic modelling of the bacterial chromosome.

The use of submucosal injection is crucial for satisfactory submucosal elevation in the early resection of flat polyps originating from the gastrointestinal tract (GIT). Injectable hydrogels derived from natural polypeptides are attractive candidates due to their excellent biocompatibility and easy gelation properties. However, most of the reported hydrogels are not the class of catheter delivery materials due to quick gelation, high inherent viscosity, and injection clogging. This study presents a novel injectable shear-thinning hydrogel platform of small molecules (nonanal) modified gelatin polymer, which offers a promising submucosal injection for effective removal of polyps from GIT. Physicochemical characterizations of hydrogel demonstrate the suitable features as an effective submucosal injection, including shear thinning property, self-assembly, methylene blue dye encapsulation, flow behavior, stability, syringeability (18 G, 21 G, and 24 G needles) and fibrous morphology. Ex vivo investigations of developed submucosal formulation on goat intestines demonstrate the enhanced visibility of cushions and the ability to produce stable, long-lasting cushions of about 8.07 mm up to ∼60 min of submucosal injection. The rapid blood clotting behavior of hydrogel was observed in about 120 s without compromising hemocompatibility with the hemolysis of about 3.77 % only. In vitro biocompatibility of the hydrogel was also verified using the HepG2 and nHDF cells. In vivo study depicts desirable biocompatibility, a non-toxic organ profile, and optimal cushion height in mice models. Studies established the foundation of novel submucosal fluid to improve the therapeutic outcomes of early resection for gastrointestinal polyps., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The effective management of deep skin wounds remains a significant healthcare challenge that often deteriorates with bacterial infection, oxidative stress, tissue necrosis, and excessive production of wound exudate. Current medical approaches, including traditional wound dressing materials, cannot effectively address these issues. There is a great need to engineer advanced and multifunctional wound dressings to address this multifaceted problem effectively. Herein, a rationally designed composite cryogel composed of a Copper Metal-Organic Framework (Cu-MOF), tannic acid (TA), polyvinyl alcohol (PVA), and zein protein has been developed by freeze-thaw technique. Cryogels display a remarkable swelling capacity attributed to their interconnected microporous morphology. Moreover, dynamic mechanical behaviour with the characteristics of potent antimicrobial, antioxidant, and biodegradation makes it a desirable wound dressing material. It was further confirmed that the material is highly biocompatible and can release TA and copper ions in a controlled manner. In-vivo skin irritation in a rat model demonstrated that composite cryogel did not provoke any irritation/inflammation when applied to the skin of a healthy recipient. In a deep wound model, the composite cryogel significantly accelerates the wound healing rate. These findings highlight the multifunctional nature of composite cryogels and their promising potential for clinical applications as advanced wound dressings., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Obesity is associated with dysfunctional electrocardiographic and cardiac autonomic parameters, which may lead to increased cardiovascular morbidity. Novel electrocardiographic repolarization markers such as Tpeak-Tend (Tpe) interval have not yet been deeply studied in obese patients. We aimed to investigate the association between ventricular repolarization parameters and heart rate variability (HRV) and how they are affected by changes occurring in the cardiac autonomic nervous system. Ninety subjects categorized by Southeast Asian BMI (kg/m 2 ) standards - normal (18-22.9), overweight (23-24.9), and obese (> 24.9), underwent assessment of ventricular repolarization parameters and HRV. Linear correlation between different parameters was also conducted. Obese subjects exhibited longer QTc and Tpe intervals compared to normal-weight subjects (p-value < 0.001, 0.026 respectively). The QTc interval showed a significant correlation (p < 0.05) with all HRV parameters by linear correlation, while the Tpe interval did not. Anthropometric parameters (BMI, WC, and WHR) were also correlated to both ventricular repolarization variables and HRV. While changes in the QTc interval may be due to obesity and/or autonomic changes occurring in the obese state, the Tpe interval does not show a relation with autonomic parameters. Thus, implicating that a change in the Tpe interval is primarily due to the direct effect of either cardiac or visceral obesity. The observed associations between ECG parameters, obesity indices, and HRV parameters suggest a role for ECG in screening for cardiovascular morbidity., (© 2024. The Author(s).)

Background: Heart failure affects almost 64 million people, with more than half of it constituting heart failure with reduced ejection fraction (HFrEF). Angiotensin receptor-neprilysin inhibitors (ARNI) and sodium-glucose cotransporter-2 (SGLT2) inhibitors (SGLT2i) are in the first line for HFrEF, but no head-to-head trials are available. Moreover, growth differentiation factor-15 (GDF-15) has been demonstrated as a promising prognostic marker, specifically for HFrEF, but has not been explored much., Methods: This pragmatic randomised controlled trial recruits 100 patients with HFrEF (ejection fraction <40%) of New York Heart Association (NYHA) II-III and allocates them in a 1:1 ratio to the dapagliflozin and sacubitril/valsartan groups. The primary objective is to assess the difference in N-terminal pro-brain natriuretic peptide serum levels at the end of 16 weeks. The secondary efficacy objectives are to assess GDF-15, Kansas City Cardiomyopathy Questionnaire-overall summary score and estimated glomerular filtration rate. Patients will be assessed at baseline, fourth week and 16th week after randomisation. As health technology assessment practices widely differ in countries, cost assessment is a vital factor to consider. The cost needed to treat one cardiovascular event is also compared between both groups. The occurrence of safety events will also be evaluated at each follow-up point., Conclusion: This pragmatic study aims to compare the efficacy, safety and cost-effectiveness of dapagliflozin versus sacubitril/valsartan in patients with HFrEF in real-world settings. The study aims to provide clinicians with data to make informed decisions regarding the preferred drug class. Additionally, examining the impact of ARNI and SGLT2i on GDF-15 levels could offer better insights into prognosis among patients with HFrEF., Ethics and Dissemination: This study involves human participants and was approved by Institutional Ethics Committee at AlIMS Jodhpur with reference number AIIMS/IEC/2023/5842 approved this study. Participants gave informed consent to participate in the study before taking part. The research findings will be disseminated via closed group discussions at the site of study, scientific conferences, peer-reviewed published manuscripts, and social media., Trial Registration Number: CTRI/2023/12/060772., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Kinetoplast DNA is a complex nanoscale network, naturally assembled from thousands of interconnected DNA circles within the mitochondrion of certain parasites. Despite the relevance of this molecule to parasitology and the recent discovery of tuneable mechanics, its topology remains highly contested. Here we present a multiscale analysis into the structure of kDNA using a combination of high-resolution atomic force microscopy and custom-designed image analysis protocols. By capturing a notably large set of high-resolution images, we are able to look beyond individual kDNA variations and quantify population properties throughout several length scales. Within the sample, geometric fluctuations of area and mean curvature are observed, corresponding with previous in vitro measurements. These translate to localised variations in density, with a sample-wide decrease in DNA density from the outer rim of the molecule to the centre and an increase in pore size. Nodes were investigated in a single molecule study, and their estimated connectivity significantly exceeded mean valence, with a high dependence on their position in the network. While node separation was approximately half the minicircle circumference, it followed a strong bimodal distribution, suggesting more complex underlying behaviour. Finally, upon selective digestion of the network, breakdown of the fibril-cap heterogeneity was observed, with molecules expanding less upon immobilisation on the mica surface. Additionally, preferential digestion was seen in localised areas of the network, increasing pore size disproportionately. Overall, the combination of high-resolution AFM and single molecule image analysis provides a promising method to the continued investigation of complex nanoscale structures. These findings support the ongoing characterisation of kDNA topology to aid understanding of its biological and mechanical phenomena.

Purpose To evaluate nnU-Net-based segmentation models for automated delineation of medulloblastoma tumors on multi-institutional MRI scans. Materials and Methods This retrospective study included 78 pediatric patients (52 male, 26 female), with ages ranging from 2 to 18 years, with medulloblastomas, from three different sites (28 from hospital A, 18 from hospital B, and 32 from hospital C), who had data available from three clinical MRI protocols (gadolinium-enhanced T1-weighted, T2-weighted, and fluid-attenuated inversion recovery). The scans were retrospectively collected from the year 2000 until May 2019. Reference standard annotations of the tumor habitat, including enhancing tumor, edema, and cystic core plus nonenhancing tumor subcompartments, were performed by two experienced neuroradiologists. Preprocessing included registration to age-appropriate atlases, skull stripping, bias correction, and intensity matching. The two models were trained as follows: (a) the transfer learning nnU-Net model was pretrained on an adult glioma cohort ( n = 484) and fine-tuned on medulloblastoma studies using Models Genesis and (b) the direct deep learning nnU-Net model was trained directly on the medulloblastoma datasets, across fivefold cross-validation. Model robustness was evaluated on the three datasets when using different combinations of training and test sets, with data from two sites at a time used for training and data from the third site used for testing. Results Analysis on the three test sites yielded Dice scores of 0.81, 0.86, and 0.86 and 0.80, 0.86, and 0.85 for tumor habitat; 0.68, 0.84, and 0.77 and 0.67, 0.83, and 0.76 for enhancing tumor; 0.56, 0.71, and 0.69 and 0.56, 0.71, and 0.70 for edema; and 0.32, 0.48, and 0.43 and 0.29, 0.44, and 0.41 for cystic core plus nonenhancing tumor for the transfer learning and direct nnU-Net models, respectively. The models were largely robust to site-specific variations. Conclusion nnU-Net segmentation models hold promise for accurate, robust automated delineation of medulloblastoma tumor subcompartments, potentially leading to more effective radiation therapy planning in pediatric medulloblastoma. Keywords: Pediatrics, MR Imaging, Segmentation, Transfer Learning, Medulloblastoma, nnU-Net, MRI Supplemental material is available for this article. © RSNA, 2024 See also the commentary by Rudie and Correia de Verdier in this issue.

Objective: To investigate how the shift of the United States Medical Licensing Examination (USMLE) Step 1 to a Pass/Fail (P/F) scoring system impacts the perceptions of Urology Program Directors (PDs) on evaluating urology residency applicants., Methods and Materials: A cross-sectional survey was sent to 117 PDs, including questions about program characteristics, perceptions of shelf scores and medical school rank post-transition, beliefs about the predictive value of Step 1 and Step 2 Clinical Knowledge (CK) scores for board success and residency performance, and changes in applicant parameter ranking., Results: Forty-five PDs (38% response rate) participated. Notably, 49% favored releasing quantitative clerkship grades, and 71% valued medical school rank more. Opinions on Step 1 scores' correlation with board success were split (49% agreed), and 44% endorsed Step 2 CK scores' connection to board performance. As predictors of good residents, only 9% and 22% considered Step 1 and Step 2 CK scores, respectively, indicative. Clerkship grades and Urology rotation recommendation letters maintained significance, while research experience gained importance. Step 2 CK scores' importance rose but did not match Step 1 scores' previous significance., Conclusion: The transition to P/F for USMLE Step 1 adds intricacies to urology residency selection, exposing PDs' uncertainties regarding clerkship grades and the relevance of medical school rank. This research underscores the dynamic nature of urology residency admissions, emphasizing the increasing importance of research in evaluating applicants and a diminishing emphasis on volunteering and leadership., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Abstract: Developmental anomalies of genital tract result from defective fusion and absorption of various parts of Mullerian ducts in fetal life. Rudimentary horn pregnancy (RHP) is a rare occurrence of one in 76,000 and one in 160,000. We present a case of a 24-year-old primigravida with ruptured RHP initially managed in the line of an intrauterine pregnancy with severe anemia. Hemodynamic instability made us suspect ruptured RHP and lifesaving laparotomy was performed for the same. A 1.5-liter hemoperitoneum was encountered with a right RHP. Multiple adhesions were present with necrotic tissue adherent and clumped together as tubo-ovarian mass. Resection of rudimentary horn was performed. We report this case to emphasize the need to consider rare uterine anomalies as a possibility in patients presenting with acute abdomen in early pregnancy. So, Obstetricians can consider these rare entities in differential diagnosis and management.

The strong two-photon induced nonlinear absorption and self-focusing type positive nonlinear refraction are pronounced by the structural engineering in β-functionalized cobalt corroles.

Background: Root canal re-treatment (RCR) cases are considered some of the most challenging cases in the field of endodontics, as they are mostly associated with various iatrogenic errors such as ledge formation, incomplete biomechanical preparation, file separation, and incomplete obturation. These iatrogenic errors lead to defective niches within root canals that may act as reservoirs for various viable microorganisms. Such residual microbial niches may cause postoperative pain even after thorough debridement and reshaping the canals, ultimately leading to a poor prognosis for the tooth. Nowadays, prevention of postoperative pain in re-treatment cases and prognosis are effectively managed by photobiomodulation therapy (PBMT)., Method: Relevant studies in the English language published before November 2022 were identified using electronic databases like PubMed, SCOPUS, and EBSCO to conduct bibliographic research. This systematic review is based on 3 studies that were found eligible as per the inclusion and exclusion criteria. This systematic review is in accordance with PRISMA guidelines., Results: The systematic review indicated a positive impact by significantly decreasing postoperative pain in RCR cases when treated with PBMT. The variation was statistically significant at 24 hours (P = .0002), 48 hours (P = .03), and 72 hours (P = .02). The mean difference at 24 hours was 0.65 (95% CI, 0.32-0.99), at 48 hours was 0.46 (95% CI, 0.05-0.87), and at 72 hours was 0.40 (95% CI, 0.07-0.74). There was no statistical heterogenicity at 24 hours (P > .05), but a medium heterogenicity was observed at 48 hours and 72 hours., Practical Implication: PBMT or low-level laser therapy has shown superior results as compared to the conventional pharmacologic approach in postoperative pain management in RCR cases., Competing Interests: Conflict of interest None disclosed., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Wound healing has been a challenge in the medical field. Tremendous research has been carried out to expedite wound healing by fabricating various formulations, some of which are now commercially available. However, owing to their natural source, people have been attracted to advanced formulations with herbal components. Among various herbs, curcumin has been the center of attraction from ancient times for its healing properties due to its multiple therapeutic effects, including antioxidant, antimicrobial, anti-inflammatory, anticarcinogenic, neuroprotective, and radioprotective properties. However, curcumin has a low water solubility and rapidly degrades into inactive metabolites, which limits its therapeutic efficacy. Henceforth, a carrier system is needed to carry curcumin, guard it against degradation, and keep its bioavailability and effectiveness. Different formulations with curcumin have been synthesized, and exist in the form of various synthetic and natural materials, including nanoparticles, hydrogels, scaffolds, films, fibers, and nanoemulgels, improving its bioavailability dramatically. This review discusses the advances in different types of curcumin-based formulations used in wound healing in recent times, concentrating on its mechanisms of action and discussing the updates on its application at several stages of the wound healing process. Impact statement Curcumin is a herbal compound extracted from turmeric root and has been used since time immemorial for its health benefits including wound healing. In clinical formulations, curcumin shows low bioavailability, which mainly stems from the way it is delivered in the body. Henceforth, a carrier system is needed to carry curcumin, guard it against degradation, while maintaining its bioavailability and therapeutic efficacy. This review offers an overview of the advanced technological interventions through tissue engineering approaches to efficiently utilize curcumin in different types of wound healing applications.

Embedding nanoparticles with different functionalities into soft substrates is a convenient tool to realize technologically significant multifunctional materials. This study focuses on incorporating bimetallic plasmonic nanoparticles into soft crystals made of cetyltrimethylammonium bromide-iodide. We observed the emergence of a novel symmetry-lowered cetrimonium crystal polymorph that enables the realization of strong interparticle plasmonic coupling in these composite materials. The observed crystal polymorph exhibits a triclinic structure with significantly reduced unit cell volume compared to standard CTAB. Solid-state nuclear magnetic resonance studies revealed an enhanced cetrimonium chain rigidity and a commensurate decrease in the mobility of the methyl groups. This is attributed to iodide incorporation. To study the influence of these interactions on solution phase dynamical properties, we employed light scattering measurements using gold nanospheres as markers, where we observed aggregation of these particles. We then develop a two step synthetic scheme that successfully enables high levels (533 particles per μm 2 ) of incorporation of bimetallic plasmonic particles into the emergent crystal polymorph., Competing Interests: There are no conflicts of interest to declare., (This journal is © The Royal Society of Chemistry.)

Cyanobacteria are the prospective biosolar cell factories to produce a range of bioproducts through CO 2 sequestration. Farnesene is a sesquiterpene with an array of applications in biofuels, pest management, cosmetics, flavours and fragrances. This is the first time a codon-optimized farnesene synthase (AFS) gene is engineered into the genomic neutral site of Synechococcus elongatus UTEX 2973 for farnesene synthesis through its endogenous methylerythritol phosphate (MEP) pathway, rendering UTEX AFS strain. Similarly, bottleneck gene(s) of the MEP pathway, 1-deoxy-D-xylulose-5-phosphate synthase (dxs) and/or fusion of isopentenyl diphosphate isomerase and farnesyl diphosphate synthase (idispA) were engineered engendering UTEX AFS::dxs, UTEX AFS::idispA and UTEX AFS::dxs::idispA strains. UTEX AFS::dxs::idispA achieves farnesene productivity of 2.57 mg/L/day, the highest among engineered cyanobacterial strains studied so far. It demonstrates farnesene production, which is 31.3-times higher than the UTEX AFS strain. Moreover, the engineered strains show similar productivity over a three-month period, stipulating the genetic stability of the strains., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Sanjay Kumar reports financial support was provided by SERB, Department of Science and Technology, India. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Introduction: Non-communicable diseases are a significant cause of mortality worldwide, posing a substantial risk to women's health, as stated by the World Health Organization. In Nepal, a survey revealed that 10.5% of the population suffers from hypertension. The primary objective of this study was to determine the prevalence of non-communicable diseases among women of reproductive age visiting the Department of Obstetrics and Gynecology of a tertiary care hospital., Methods: A descriptive cross-sectional study was conducted at the Department of Obstetrics and Gynecology among women of reproductive age presented from 6 November 2023 to 6 January 2024. The data was retrieved from the medical record during 1 November 2023 to 1 December 2023. Ethical approval was taken from the Institutional Review Committee. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval., Results: The prevalence of non-communicable diseases was 608 (39.02%) (36.60-41.45, Confidence Interval). The mean age was 29.26±3.46 years. The most common non-communicable disease reported was hypertension 204 (33.55%) followed by chronic respiratory diseases 200 (32.89%) and diabetes mellitus 154 (25.34%)., Conclusions: The prevalence of non-communicable diseases among women of reproductive age group was higher as compared to other studies done in similar setting. The study underscores the urgency for stakeholders to implement health education, early detection, and preventive strategies, emphasizing the necessity of targeted interventions and broader public health initiatives to address non-communicable diseases., Keywords: chronic disease; non-communicable disease; prevalence; risk factors.

Stroke causes brain damage and is one of the main reasons for death. Most survivors of stroke face long-term physical disabilities and cognitive dysfunctions. In addition, they also have persistent emotional and behavioral changes. The two main treatments that are effective are reperfusion with recombinant tissue plasminogen activator and recanalization of penumbra using mechanical thrombectomy. However, these treatments are suitable only for a few patients due to limitations such as susceptibility to hemorrhage and the requirement for administering tissue plasminogen activators within the short therapeutic window during the early hours following a stroke. The paucity of interventions and treatments could be because of the multiple pathological mechanisms induced in the brain by stroke. The ongoing immune response following stroke has been attributed to the worsening brain injury. Hence, novel compounds with immunomodulatory properties that could improve the outcome of stroke patients are required. Natural compounds and medicinal herbs with anti-inflammatory activities and having minimal or no adverse systemic effect could be beneficial in treating stroke. Ocimum sanctum is a medicinal herb that can be considered an effective therapeutic option for ischemic brain injury. Ocimum sanctum , commonly known as holy basil or "Tulsi," is mentioned as the "Elixir of Life" for its healing powers. Since antiquity, Tulsi has been used in the Ayurvedic and Siddha medical systems to treat several diseases. It possesses immuno-modulatory activity, which can alter cellular and humoral immune responses. Tulsi can be considered a potential option as an immuno-modulator for treating various diseases, including brain stroke. In this review, we will focus on the immunomodulatory properties of Tulsi, specifically its effect on both innate and adaptive immunity, as well as its antioxidant and antiinflammatory properties, which could potentially be effective in treating ongoing immune reactions following ischemic brain injury., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Four new β-functionalized π-extended cobalt corroles with one and two dicyanovinyl (DCV) or dicyanobutadienyl (DCBD) moieties at the 3- and 3,17-positions have been synthesized and characterized by various spectroscopic techniques. Interestingly, the synthesized DCV- and DCBD-appended cobalt corroles displayed panchromatic and near-infrared absorption in the range 300-1100 nm in CH 2 Cl 2 and pyridine solvents. (MN) 2 -(Cor)Co and A 2 MN 2 -(Cor)Co exhibited 8-9 times enhancement in the molar absorptivity of the Q band compared to the parent corrole ( (Cor)Co ). The unique absorption spectral features of these β-functionalized cobalt corroles are splitting, broadening, and red-shifting in the Soret and Q bands. One DCV unit brings a 30-46 nm red shift, whereas one DCBD unit brings a 40-75 nm red shift in the Q band compared to the corresponding precursors. This is rare that the intensity of the longest Q band is greater than or equal to the Soret-like bands. These corrole derivatives exhibit UV-vis spectral features similar to those of chlorophyll a . A 220 mV positive shift per DCV group and 160 mV positive shift per DCBD group were observed in the first oxidation potentials compared to (Cor)Co in the desired direction for the utility of these cobalt complexes in electrocatalysis. DFT studies revealed that HOMO and LUMO were stabilized after appending DCV and DCBD groups on the corrole macrocycle and exhibited a "push-pull" behavior leading to promising material applications in nonlinear optics (NLO) and catalysis.

Background  Beginning January 26, 2022, the U.S. Medical Licensing Exam (USMLE) Step 1 changed from a numerical score to pass/fail (P/F). The purpose of this study was to determine the perspective of ophthalmology program directors regarding this change in evaluating applicants. Methods  After institutional review board approval, a survey was sent out to program directors of all 125 ophthalmology programs accredited by the Accreditation Council for Graduate Medical Education. Survey questions asked for program demographics, the utility of USMLE Step 1 and 2 Clinical Knowledge scores in assessing applicants, and the importance of 16 different applicant metrics before and after Step 1 becomes P/F. The metrics examined were: letters of recommendation; clerkship grades; class ranking; Alpha Omega Alpha Membership; Gold Humanism Honor Society Membership; Dean's Letter; involvement and leadership; personal statement; number of abstracts, presentations, and publications; mean number of research experiences in the specialty; Step 2 Clinical Knowledge score; volunteering; preclinical grades; away rotation in the specialty; the applicant having another graduate degree; and graduation from a top 40 National Institutes of Health-funded program. Data were analyzed using nonoverlapping 95% confidence intervals. Results  The survey was completed by 50 (40%) program directors. Sixty-eight percent of respondents stated a student's ranking would be considered more after USMLE Step 1 scores become P/F, and 60% stated medical schools should share clerkship shelf exam scores with residency programs. There were no significant differences in program directors' rankings of applicant metrics following the transition to P/F Step 1. Conclusion  Based on our data, program directors will likely not place a greater emphasis on Step 2 scores, despite it being the only remaining objective measure for all applicants following the switch to a P/F Step 1. Nevertheless, program directors expressed an interest in receiving other objective measures, such as shelf exam scores and class ranking, as part of the application process. Notably, we found no significant changes in the rankings of various applicant metrics before and after the transition to P/F Step 1, indicating that the metrics that were important to program directors prior to the change remain just as critical in the new era of admissions., Competing Interests: Conflict of Interest None declared., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Biological macromolecules are excellent materials for wound dressing owing to their similar structure to the extracellular matrix and adjustable physicochemical properties. This research focuses on fabricating biological macromolecule-based hydrogel with desirable antibacterial, antioxidant, controlled drug release, cytocompatibility, and wound healing properties. Herein, different concentrations of nanoceria (NC) and flurbiprofen (FLU) drug-loaded gellan gum/gelatin (GG/Ge) based dual crosslinked (Ionic and EDC/NHS coupling) hydrogels were engineered. All fabricated hydrogels were hydrophilic, biodegradable, good strength, porous, antioxidant, hemocompatible and cytocompatible. Among all, hydrogel loaded with 500 μg/ml NC (GG/Ge/NC@FLU) exhibited desirable antioxidant, antibacterial (killed Staphylococcus aureus and Escherichia coli within 12 h), hemocompatible, cytocompatible, supports oxidative-stressed L929 cell growth and acted as a controlled release matrix for FLU, following Fickian diffusion, Peppas Sahlin and Korsmeyer-Peppas drug release models. Furthermore, nanocomposite hydrogel (GG/Ge/NC@FLU)-treated wounds of rats on day 14 demonstrated significantly higher collagen synthesis, nearly 100 % wound contractions, and efficiently decreased the expression of TNF-α and IL-1 while increasing the production of IL-10 and TNF-ß3, indicating antiinflammatory activity, and effectively reduced the expression of VEGF gene indicating effective angiogenesis than all other controls. In conclusion, the fabricated multifunctional GG/Ge/NC@FLU nanocomposite hydrogel shows promising potential for effectively treating full-thickness wound healing in a rat model., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

An engineered Synechococcus elongatus UTEX 2973-IspS.IDI is used to enhance isoprene production through geranyl diphosphate synthase (CrtE) inhibition and process parameters (light intensity, NaHCO 3 and growth temperature) optimization approach. A cumulative isoprene production of 1.21 mg/gDCW was achieved with productivity of 12.6 μg/gDCW/h in culture supplemented with 20 μg/mL alendronate. This inhibition strategy improvises the cumulative isoprene production 5.76-fold in presence of alendronate. The maximum cumulative production of isoprene is observed to be 5.22 and 6.20 mg/gDCW (54.4 and 64.6 μg/gDCW/h) at statistical and artificial neural network genetic algorithm (ANN-GA) optimized conditions, respectively. The overall increase of isoprene production is found to be 29.52-fold using an integrated approach of inhibition and ANN-GA optimization in comparison to unoptimized cultures without alendronate. This study reveals that alendronate use as a potential inhibitor and machine learning based optimization is a better approach in comparison to statistical optimization to enhance the isoprene production., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Soft, biocompatible, and tunable materials offer biomedical engineers and material scientists programmable matrices for a variety of biomedical applications. In this regard, DNA hydrogels have emerged as highly promising biomaterials that offer programmable self-assembly, superior biocompatibility, and the presence of specific molecular identifiable structures. Many types of DNA hydrogels have been developed, yet the programmability of the DNA building blocks has not been fully exploited, and further efforts must be directed toward understanding how to finely tune their properties in a predictable manner. Herein, we develop physically crosslinked all-DNA hydrogels with tunable morphology and controllable biodegradation, based on rolling circle amplification and multiprimed chain amplification products. Through molecular engineering of the DNA sequences and their nano-/microscale architectures, the precursors self-assemble in a controlled manner to produce soft hydrogels in an efficient, cost-effective, and highly tunable manner. Notably, we develop a novel DNA microladder architecture that serves as a framework for modulating the hydrogel properties, including over an order of magnitude change in pore size and up to 50% change in biodegradation rate. Overall, we demonstrate how the properties of this DNA-based biomaterial can be tuned by modulating the amounts of rigid double-stranded DNA chains compared to flexible single-stranded DNA chains, as well as through the precursor architecture. Ultimately, this work opens new avenues for the development of programmable and biodegradable soft materials in which DNA functions not only as a store of genetic information but also as a versatile polymeric biomaterial and molecularly engineered macroscale scaffold., Competing Interests: The authors have no conflicts to disclose., (© 2023 Author(s).)

Aortic dissection type A is a life-threatening condition that frequently necessitates surgical intervention. This review focuses on central aortic cannulation, arch branch vessel (ABV) cannulation, and proximal arch cannulation as key techniques during aortic surgery. It discusses innovative solutions for addressing these challenges. The review synthesizes findings from recent studies and emphasizes the significance of meticulous planning and execution of cannulation in aortic dissection repair. This review aims to contribute to the advancement of surgical practices and the enhancement of patient outcomes in the management of type A aortic dissection (AAD) by addressing these frequently overlooked details., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Yadav et al.)

Introduction: Obstetric cholestasis is one of the most frequent hepatic disorders specific to pregnancy. It occurs commonly during the latter half of pregnancy. The data regarding this issue is rare in our settings. The aim of this study was to find out the prevalence of obstetric cholestasis among pregnant women visiting a tertiary care centre., Methods: A descriptive cross-sectional study was conducted among pregnant women, who attended a tertiary care centre from 24 July 2022 to 24 January 2023. Ethical approval was taken from the Institutional Review Committee of the same institute. Convenience sampling method was used. The point estimate was calculated at a 99% Confidence Interval., Results: The prevalence of obstetric cholestasis was 80 (1.38%) (1-1.80, 99% Confidence Interval). A total of 40 (50%) were in the age group 21-30 years, with a mean age of 28.06±6.39 years. A total of 48 (60%) were multigravida and 73 (91.30%) had singleton pregnancies. Pruritus of the whole body was complained of by 56 (70%) patients. Previous history of obstetric cholestasis was present in 21 (26.30%)., Conclusions: The prevalence of obstetric cholestasis among pregnant women is lower than other studies done in similar settings., Keywords: Nepal; obstetric cholestasis; pregnancy.