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Background Spinal anesthesia is commonly used in various surgical procedures but is often associated with hypotension, which can lead to significant complications. The Inferior Vena Cava Collapsibility Index (IVCCI) and Caval Aorta Index (CAI) are potential predictors of fluid responsiveness and can help anticipate hypotension after spinal anesthesia. This study aims to evaluate the efficacy of IVCCI and CAI in predicting hypotension following spinal anesthesia. Materials and Methods A total of 100 patients scheduled for elective surgeries under spinal anesthesia were enrolled in this prospective clinical study. Preoperative IVCCI and CAI measurements were obtained using ultrasound. Spinal anesthesia was administered using 0.5% bupivacaine. Blood pressure was monitored every 5 minutes for 30 minutes post-anesthesia. Hypotension was defined as a systolic blood pressure decrease of more than 20% from baseline or below 90 mmHg. Statistical analysis was performed using logistic regression to assess the predictive value of IVCCI and CAI for hypotension. Results Out of 100 patients, 35 developed hypotension after spinal anesthesia. The mean IVCCI for the hypotensive group was 45%, compared to 25% in the non-hypotensive group (p < 0.01). The mean CAI was 0.8 in the hypotensive group and 0.6 in the non-hypotensive group (p < 0.05). Logistic regression analysis revealed that both IVCCI and CAI were significant predictors of hypotension, with IVCCI having a higher predictive accuracy (AUC = 0.85) compared to CAI (AUC = 0.78). Conclusion The Inferior Vena Cava Collapsibility Index and Caval Aorta Index are effective predictors of hypotension following spinal anesthesia. IVCCI, in particular, demonstrates superior predictive accuracy. Incorporating these indices into preoperative assessments may enhance the management and prevention of hypotension, improving patient outcomes. [ABSTRACT FROM AUTHOR]

Pyridoxal hydrochloride, a vitamin B6 vitamer, was synthetically converted to a series of diverse redox‐active benzoyl pyridinium salts. Cyclic voltammetry studies demonstrated redox reversibility under basic conditions, and two of the most promising salts were subjected to laboratory‐scale flow battery tests involving galvanostatic cycling at 10 mM in 0.1 M NaOH. In these tests, the battery was charged completely, corresponding to the transfer of two electrons to the electrolyte, but no discharge was observed. Both CV analysis and electrochemical simulations confirmed that the redox wave observed in the experimental voltammograms corresponds to a two‐electron process. To explain the irreversibility in the battery tests, we conducted bulk electrolysis with the benzoyl pyridinium salts, affording the corresponding benzylic secondary alcohols. Computational studies suggest that the reduction proceeds in three consecutive steps: first electron transfer (ET), then proton‐coupled electron transfer (PCET) and finally proton transfer (PT) to give the secondary alcohol. 1H NMR deuterium exchange studies indicated that the last PT step is not reversible in 0.1 M NaOH, rendering the entire redox process irreversible. The apparent reversibility observed in CV at the basic media likely arises from the slow rate of the PT step at the timescale of the measurement. [ABSTRACT FROM AUTHOR]

This paper investigates the ultimate resistance of aluminum circular hollow sections (C.H.S.) under simple load cases as affected by local buckling and material strain hardening. Following the development of advanced non-linear shell finite element models and their validation against existing test data, extensive non-linear numerical analyses were carried out, varying several key parameters such as alloy types, load case (compression or pure bending) and various section dimensions. The numerical results are used as references to analyze the structural performance of aluminum C.H.S., and to assess the accuracy of design equations based on the Overall Interaction Concept (O.I.C.). The O.I.C.-based proposal is shown to yield more accurate, consistent, and continuous resistance predictions than Eurocode 9 recommendations. [ABSTRACT FROM AUTHOR]

Aluminum appears as a promising structural material as it shows many benefits such as a great strength to weight ratio, low maintenance costs, resistance to corrosion, recyclability, etc. Accordingly, characterizing the behavior and resistance of different aluminum sections under various loading conditions is essential. The current paper presents an experimental investigation on aluminum sections with simple and complex geometries to study the effect of cross-section shape on the buckling response of the aluminum sections. Firstly, eight tensile coupon tests were conducted on coupons of aluminum alloy 6061-T6 to accurately determine its material properties. Geometrical imperfections on the surface of each specimen were then measured using a 3D scanner. Further, eight stub column tests were also performed to study the behavior of I, H and complex cross-sections under pure compression. In addition to this, 12 cross-section tests under combined compression and bending are currently under way to study the buckling behavior of these specimens under eccentric compression. [ABSTRACT FROM AUTHOR]

Aluminum has a bright future as a structural material due to its excellent corrosion resistance, durability, lightweight, and complete recyclability. However, it is necessary to fully understand its mechanical behaviour under various loading conditions to make it competitive with other materials, such as concrete or steel, for civil engineering applications, especially as primary load-bearing structural members. To develop an in-depth knowledge on the behaviour of extruded aluminum sections of various shapes, an extensive experimental study was undertaken with specific emphasis on analyzing the buckling response of rectangular and square hollow sections (RHS and SHS) with 6061-T6 aluminum alloy under compressive loads. In this regard, six stub column tests were performed under axial compression, while eleven short beam-column tests under eccentric compression are currently in progress. Additionally, six tensile coupon tests were performed to obtain the full material stress--strain curve, and initial geometrical imperfections were measured mechanically and using a 3D scanner. Finally, the results of the stub column tests were compared to the resistances calculated using the Canadian standard CSA S157, which were generally conservative compared to the experimental observations. [ABSTRACT FROM AUTHOR]

Purpose: This article initially aims to explore the factors of every quality construct of the 5Qs model of service quality and, second, identify the significant factors affecting the total quality of e-healthcare services and its association with consumer satisfaction using a multidimensional hierarchical 5Qs model of e-healthcare service quality. Design/methodology/approach: Questionnaire-oriented research was performed at three public hospitals of Punjab and Chandigarh. In total, 53 variables were covered in all quality constructs for data collection from the designated public hospitals. The respondents who agreed to have knowledge regarding e-Healthcare services and were availing these services were included in the study. The analysis comprised structural equation modeling technique using AMOS 21. Findings: The outcomes suggest that the 5Qs model is more comprehensive and can be used to evaluate service quality perceptions using e-Healthcare services. The research identified 11 sub-dimensions for the five quality constructs of the 5Qs model, representing total quality, which is primary to consumer satisfaction. "Overall objectivity" and "technical objectivity" defined the quality of object. The quality of process of e-Healthcare services was characterized by "functionality," "timeliness" and "responsiveness." Quality of infrastructure was defined by "technical infrastructure," "physical infrastructure," "manpower skills" and "organizational infrastructure." "Manner of interaction" and "timely interaction" defined the quality of interaction. The atmosphere was represented by only one factor. The results also suggest that quality of infrastructure, quality of interaction and quality of atmosphere play the most significant role in total quality leading to consumer satisfaction. Research limitations/implications: Theoretical implications: The multidimensional hierarchical model will help the researchers study the e-Healthcare service quality in a more organized manner, and the outcomes of this study can be linked with that of future studies for more generalized application in other public hospitals. The sub-dimensions of each quality construct of the 5Qs model can be applied in private hospitals, and the hierarchical model can be tested in different industries to measure service quality perceptions of the consumer Practical implications: The outcomes of the study can be applied in various public sector hospitals to redesign the e-Healthcare services based on consumers' perception for better consumer satisfaction and quality services. This paper identifies the role of each quality construct in e-Healthcare services for improvement in the total quality, which in turn will lead to higher satisfaction for the consumers. Originality/value: In this study, the original 5Qs model has been used for the first time in a new instrument to understand better and design quality e-Healthcare services. The paper explores the sub-factors of each quality construct and its significance in measuring the total quality. [ABSTRACT FROM AUTHOR]

Aim: Elucidation of the antiproliferative efficacy and mechanism of action of a design‐optimized noscapine analog, N‐4‐CN. Methods: Cell viability was studied using an MTT assay. The drug‐tubulin interactions were investigated using spectrofluorometry. The architectural defects, hyper stabilization, and recovery competence of cellular microtubules were studied using immunofluorescence microscopy. DCF‐DH and rhodamine 123 were used as probes to to examine the levels of reactive oxygen species and the loss of mitochondrial membrane potential, respectively. Flow cytometry revealed the cell cycle progression pattern of the drug‐treated cells. Key findings: Among the cell lines tested, N‐4‐CN showed the strongest inhibition of the viability of the triple‐negative breast cancer (TNBC) cell line MDA‐MB‐231(IC50, 2.7 ± 0.1 µmol/L) and weakest inhibition of the noncancerous epithelial cell line, VERO (IC50, 60.2 ± 3 µmol/L). It perturbed tertiary structure of tubulin and stabilized colchicine binding to the protein. In cells, N‐4‐CN hyperstabilized the microtubules, and prevented the recovery of cold‐depolymerized microtubules. Its multitude of effects on tubulin and microtubules facilitated cell cycle arrest and subsequent cell death that were complemented by elevated levels of reactive oxygen species (ROS). Significance: Owing to its ability to perturb a well‐defined cancer drug target, tubulin, and to promote ROS‐facilitated apoptosis, N‐4‐CN could be investigated further as a potential therapeutic against many neoplasms, including TNBC. [ABSTRACT FROM AUTHOR]

Tenosynovitis is an infrequent presentation of Hansen's disease. It may occur during the natural course of disease or treatment as part of type 1 reaction or rarely may be the presenting complaint. We report a case of tenosynovitis of bilateral wrist joints who after being ineffectively treated by an orthopedician as well as rheumatologist for several months and was finally diagnosed as a case of Hansen's disease (borderline lepromatous) in type 1 reaction with excellent response to multidrug therapy and tapering doses of systemic steroids. [ABSTRACT FROM AUTHOR]

Acrodermatitis enteropathica (AE) is a rare genetic autosomal recessive disorder of zinc deficiency which manifests in infancy with triad of peri-orificial skin rash, alopecia, and diarrhea. We report the case of an 8-month-old infant with dermatological features of AE being managed as a case of candidial-intertrigo and diaper dermatitis who showed excellent response to oral zinc. [ABSTRACT FROM AUTHOR]

Since the onset of the present pandemic, effect of the novel corona virus on other infectious conditions continues to be investigated. Although the immunological responses to SARS‐Cov‐2 infection have been elaborated extensively, they fail to explain, variations in its clinical manifestations and its interaction with other diseases. Hansen's disease is known to present as a complex immunological response to the lepra bacilli, resulting in its varied spectral manifestations. An interaction between these two infectious agents, hence, may affect Hansen's disease. We came across six cases of Hansen's disease who developed COVID19 co‐infection. This series presents their clinical course and outcome, during the period of co‐infection. All cases were followed up for a minimum eight‐week period thereafter. In all these cases the active phase of coronavirus infection had no effect on Hansen's disease and those on prednisolone for their lepra reaction had a more favorable outcome, with two cases manifesting exacerbation of their lepra reactions in the follow period. [ABSTRACT FROM AUTHOR]

Objectives: To examine the antiproliferative effect of a rationally designed, novel noscapine analogue, 9‐((perfluorophenyl)methylene) aminonoscapine, '9‐PAN') on MDA‐MB‐231 breast cancer cell line, and to elucidate the underlying mechanism of action. Methods: The rationally designed Schiff base‐containing compound, 9‐PAN, was characterized using IR, NMR and mass spectra analysis. The effect of the compound on cell viability was studied using an MTT assay. Cell cycle and cell death analyses were performed using flow cytometry. Binding interactions of 9‐PAN with tubulin were studied using spectrofluorometry. Reactive oxygen species (ROS) generation and mitochondrial membrane potential (MMP) were investigated using the probes, DCFDA and rhodamine‐123, respectively. Immunofluorescence imaging was used to visualize cellular microtubules. Key findings: 9‐PAN inhibited cell proliferation (IC50 of 20 ± 0.3 µm) and colony formation (IC50, 6.2 ± 0.3 µm) by arresting the cells at G2/M phase of the cell cycle. It bound to tubulin in a concentration‐dependent manner without considerably altering the tertiary conformation of the protein or the polymer mass of the microtubules in vitro. The noscapinoid substantially damaged cellular microtubule network and induced cell death, facilitated by elevated levels of ROS. Conclusions: 9‐PAN exerts its antiproliferative effect by targeting tubulin and elevating ROS level in the cells. [ABSTRACT FROM AUTHOR]

Purpose: Use of technology for quality healthcare services has developed into a new field known as "e-Healthcare services." Healthcare providers often judge their quality of services with consumer satisfaction. With e-Healthcare services, consumer satisfaction is influenced by the quality of healthcare services provided and the demographic characteristics. The purpose of the present case study is to recognize the important predictors of quality, which are significant for consumer satisfaction with e-Healthcare services by using Zineldin's 5Qs model. It also aims to find the strength of association among the predictors of consumer satisfaction and the demographic characteristics of the respondents.Design/methodology/approach: A questionnaire-based study was conducted at a public (PGIMER, Chandigarh) and a private hospital (Fortis Hospital, Mohali) of Punjab, India, from February 2018 to March 2019. The structured, closed-ended questionnaire, to be marked on a 1-5 point Likert scale, was adapted from Zineldin's 5Qs model and was distributed to the respondents sitting in the waiting halls of the selected hospitals. The respondents comprised of both the patients and their attendants who were aware of e-Healthcare services and were using them.Findings: The analysis identified quality of interaction, quality of hospital atmosphere and quality of object to be the key predictors of consumer satisfaction with e-Healthcare services. The results reveal a strong association between different demographic characteristics and overall consumer satisfaction with e-Healthcare services.Practical Implications: The results suggest that improvements in the quality of interaction, quality of hospital atmosphere and quality of object may result in higher consumer satisfaction with e-Healthcare services. Working on the identified dimensions of quality will help the e-Healthcare providers in identifying functional problems of e-Healthcare services and developing improvement strategies, which will also result in better health and quality outcomes. The results of this study will help the e-Healthcare providers in better segmentation of e-Healthcare consumers based on their demographic characteristics and in developing better marketing strategies.Originality/value: This paper focuses on the quality of e-Healthcare services only and attempts to identify the quality dimensions, which leads to the satisfaction of e-Healthcare consumers. The identified quality dimensions will help in designing better e-Healthcare services and framing policies. It also highlights the association of demographic characteristics with important quality dimensions. [ABSTRACT FROM AUTHOR]

Introduction: Cases of female targeted violence often go uncounted in India. To identify the unreported cases of violence, Sukoon was established in 2014 as a hospital-based 'One Stop Crisis Centre' (OSCC). Sukoon provides counselling, police assistance and legal aid to the victims. The aim of the present study was to recognize the role of Sukoon in preventing violence against women (VAW) in the region. Methods: Secondary data was extracted from 430 victims who approached Sukoon from August 2014 through January 2017. Data was collected on different variables: age, marital status, nature of violence, medium through which victims approached Sukoon and type of assistance provided. Significance of association of studied factors with the type of assault was investigated usi ng 2 test. Results: Age of study-victims ranged from 4 to 75 years with a median age of 26 years and mean age of 27.61 years with standard deviation of 10.56 years. Major types of VAW (96.51%) were domestic violence, sexual assault, physical assault and poisoning. The types of violences were significantly associated with victims' age (2 =5.76, d.f.=1, p<0.05) and marital status (2 = 98.23, d.f=4, p<0.001). About 78% of victims were identified from Sukoon through screening and counseling. Around 69% of the cases were resolved directly by Sukoon or through police assistance. Conclusion: The above results indicate a significant role of Sukoon in screening victims of violence and providing them required assistance within the hospital environment in one location. Such centers should be further promoted by the government to address the issues of VAW. [ABSTRACT FROM AUTHOR]

The asymmetric total synthesis of optically pure (-)-gracilamine ( 1) was achieved by employing a bioinspired approach. The strategy involved elaboration of 3 a-arylhexahydroindole 7, a designed precursor, to 3 a-formylarylhexahydroindole 5, which upon heating with l-leucine ethyl ester gave (-)- 1 efficiently. [ABSTRACT FROM AUTHOR]

The aim of the present study is to evaluate the radioprotective effect of low-dose selenium supplementation (multiple administrations) on radiation toxicities and mortality induced by lethal dose of whole-body irradiation (WBI). For this, BALB/c mice received sodium selenite (4 μg/kg body wt) intraperitoneally for five consecutive days and subjected to WBI at an absorbed dose of 8 Gy (Co, 1 Gy/min). Administration of sodium selenite was continued even during the post irradiation days three times a week till the end of the experiment. The radioprotective effect was evaluated in terms of the improvement in 30 days post irradiation survival, protection from DNA damage, and biochemical and histological changes in radiosensitive organs. The results indicated that low-dose sodium selenite administration did not protect the mice from radiation-induced hematopoietic and gastrointestinal injuries and subsequent mortality. However, it significantly prevented the radiation-induced genotoxicity or DNA damage in peripheral leukocytes. Further sodium selenite administration modulated the messenger RNA (mRNA) expression of GPx1, GPx2, and GPx4 in the spleen and intestine differentially and led to a significant increase in GPx activity (∼1.5 to 2-folds) in these organs. In line with this observation, sodium selenite administration reduced the level of lipid peroxidation in the intestine. In conclusion, our study shows that low-dose sodium selenite supplementation can be an effective strategy to prevent WBI-induced genotoxicity but may not have an advantage against mortality sustained during nuclear emergencies. [ABSTRACT FROM AUTHOR]

A series of amphiphilic conjugates of dihydroxy selenolane (DHS) and monoamine selenolane (MAS), which we had previously reported to inhibit lipid peroxidation and assist the oxidative protein folding reaction respectively in cell free systems, were evaluated for cytotoxicity, associated mechanisms and antioxidant effects in cells. Our results indicated that a fatty acid/alkyl group of variable chain lengths (C6–14) as a lipophilic moiety of the DHS/MAS conjugates not only improved their ability to incorporate within the plasma membrane of cells but also modulated their cytotoxicity. In the concentration range of 1–50 μM, C6 conjugates were non-toxic whereas the long chain (≥C8) conjugates showed significant cytotoxicity. The induction of toxicity investigated by the changes in membrane leakage, fluidity, mitochondrial membrane potential and annexin-V–propidium iodide (PI) staining by using flow cytometry revealed plasma membrane disintegration and subsequent induction of necrosis as the major mechanism. Further, the conjugates of DHS and MAS also showed differential as well as nonlinear tendency in cytotoxicity with respect to chain lengths and this effect was attributed to their self-aggregation properties. Compared with the parent compounds, C6 conjugates not only exhibited better antioxidant activity in terms of the induction of selenoproteins such as glutathione peroxidase 1 (GPx1), GPx4 and thioredoxin reductase 1 (TrxR1) but also protected cells from the AAPH induced oxidative stress. In conclusion, the present study suggests the importance of hydrophilic–lipophilic balance (HLB) in fine tuning the toxicity and activity of bioinspired amphiphilic antioxidants. [ABSTRACT FROM AUTHOR]