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Abstract well known for its insecticidal, anti-inflammatory, antioxidant, anticancer, anti-rheumatic and antibiotic properties, Turmeric (Curcuma longa L.) Essential oil (EO), is effective in repelling and controlling many different pest species. The present study evaluates in vitro efficacy of turmeric EO against ectoparasitic tick, Rhipicephalus (Boophilus)annulatus collected from their natural host, domesticated cows. Repellency and toxicity of the EO on ectoparasitic ticks was analyzed with petri dish choice bioassay and AIT (Adult immersion test) against adult engorged females and nymphal stages of ticks. The Repellency Concentration (RC50) and Lethal Concentration (LC50) reproductive index, inhibition of oviposition and egg hatchability of treated ticks were estimated. GC-MS analysis identified Ar-turmerone as the major phytochemical, which induces adulticidal and repellant properties of EO. The nymphal stages of the ticks exhibited greater repellency on application of EO than the adult stage. Also, EO induced effective mortality in adult ticks. Further, this lethal concentration is capable of producing a decreased output in reproductive parameters namely, fecundity, % of oviposition and egg hatchability in surviving ticks thereby considerably reducing Rhipicephalus (Boophilus) R(B). annulatus population on its host. This study reveals the potency C. longa EO to be used as an effective pest control agent against R (B). annulatus infestation that can serve as an alternative to synthetic pesticides.

Background: BK virus (BKV) is a member of the polyomavirus family. The determination of anti-BKV immunoglobulin G (IgG) antibody levels in kidney donors and recipients has been reported as a possible predictor of the risk of BK nephropathy. Allograft dysfunction is a significant risk factor. The main objective of this study was to address the high prevalence of renal failure due to BKV nephropathy in kidney transplant recipients. This investigation aims to determine whether donors and recipients of renal transplants had BKV IgG antibodies before transplantation. Methods: Blood samples were collected from 46 kidney transplant recipients and their corresponding 46 donors. An enzyme-linked immunosorbent assay was used to qualitatively analyze human BKV IgG. Results: Ninety-two participants, 46 kidney transplant donors, and 46 kidney transplant recipients, were analyzed. Pretransplantation anti-BKV antibody levels were higher in kidney transplant donors (73%) than in recipients (63%). Donors and recipients included in the study were grouped into seropositive and seronegative recipients, with the highest proportion of seropositive recipient-donor groups (48%) and the lowest percentages in the seronegative donor and seronegative recipient groups. Fifty-one percent of the participants were male and 49% were female. The age distribution of most subjects was >50 years old. Conclusion: BKV can cause kidney transplant rejection. Routine screening of transplant recipients and donors for BKV IgG seropositivity is recommended before renal transplantation. This can improve transplant outcomes and prevent rejection.

BackgroundNational survey data show that age- and sex-standardized weight and length measurements decline early in Indian children. In population-level longitudinal data, early detection of growth trajectories is important for the implementation of interventions. We aimed to identify and characterize distinct growth trajectories of Indian children from birth to 12 months of age residing in urban and rural areas.MethodsPooled data from four interventional and non-interventional longitudinal studies across India were used for the analysis. Latent class mixed modeling (LCMM) was employed to identify groups of children with similar trajectories over age. The trajectories named Classes of Children were created for length-for-age Z scores (LAZ) and weight-for-age Z scores (WAZ) based on place of birth, residential area, and maternal education.ResultsWe identified two latent classes for LAZ in boys and three latent classes for LAZ in girls, and four classes for WAZ were identified in both boys and girls. The first class for LAZ, with the highest proportion of children (>80% of children), did not decline or increase with age; In boys, Class 1 was close to the WHO median, whereas in girls, Class 1 was lower than the WHO median from birth. The LAZ classes of remaining boys and girls declined with age (slope, μdg= − 1.04; 95% CI: −1.09, −0.99 for boys and μdg= − 0.69; 95% CI: −0.76, −0.63 for girls). The first trajectory of WAZ (approximately 50% of children) for boys (μdg=0.13; 95% CI: 0.11, 0.16) and the second trajectory of WAZ for girls (μdg=0.24; 95% CI: 0.18, 0.30) increased with age, while the remaining trajectories of WAZ declined with age.ConclusionThere is heterogeneity in the growth of Indian children in the first year of life, which was identified by distinct types of growth trajectories. The predominant trajectories of both LAZ and WAZ did not decline with age, while most other trajectories demonstrated an initial decline.

Abstract Background The rising demand for food production along with the concerns regarding the injudicious use of chemicals in pest management has paved way for the alternatives that could promise sustainable pest management. Bacillus thuringiensis Berliner (Bt), a soil bacterium, is a potential biopesticide with its ability to produce crystal toxins that are insecticidal in nature. Main body This article provides an insight into the diverse Bt toxins and their applications as biopesticides in pest management. The selective action of Bt towards target organism is based on its specific interactions with the insect gut receptors. The significance of Bt in the management of lepidopteran, coleopteran, hemipteran, dipteran and nematode pests of crops and livestock through its mode of action is extensively reviewed. Conclusion Besides being a promising pest control option, the challenges faced through resistance development, variation in susceptibility across species and non-target effects of Bt are also discussed. Proactive approaches and multiple modes of action can mitigate this issue.

Background: Stainless steel crowns are considered to be a practicable alternative in the restoration of carious primary tooth. This study was done to assess Indian pediatric dentists’ knowledge, attitude, and practice of this technique and related factors with the use of the Hall technique (HT). Methods: A well-structured preused online questionnaire was sent to pedodontists practicing in India through various social media groups and emails. Descriptive statistics were used to characterize survey responses. A Chi-square test was employed to check the distribution of responders using the HT. Statistically P < 0.05 or less was considered statistically significant. Results: A total of 210 pedodontists participated in this survey. 66.20% of the participants have

Background: Collection and compilation of spatial, meteorological, entomological, and virological data are critical in mitigating climate-sensitive emerging infections like dengue. This study was a holistic attempt to understand the dengue situation in the Kasaragod district of Kerala, India. Methods: This cross-sectional study was conducted in 13 health institutions from June to July 2021. Adult patients presenting with fever and testing positive for NS1 ELISA were subjected to Dengue RT-PCR and serotyping. The spatial and clinical features of the RT-PCR-positive patients, the district’s meteorological data, and the vector indices were studied. Results: The pre-epidemic months were marked by intermittent rainfall, peak ambient temperature and high larval indices. Among the 136 dengue RT-PCR patients studied, 41.2% had DENV2 followed by DENV1 (22.8%), DENV3 (5.9%) and DENV4 (4.4%); with 25% mixed infections. DENV1 showed a higher risk of gastrointestinal manifestations (80.6%, p=0.019) and musculoskeletal symptoms (77.4%, p=0.026) compared with other serotypes. Conclusions: In the context of dengue hyperendemicity, the possibility of an emerging serotype’s dominance coupled with the mixing up of strains should warn the health system regarding future outbreaks. Furthermore, the study emphasizes the importance of monitoring larval indices and the window of opportunity to intervene between environmental predictors and dengue outbreaks.

As climate change intensifies, drought stress presents a critical challenge for horticultural crops like okra (Abelmoschus esculentus). The effectiveness of melatonin in reducing drought stress is investigated in this study. The treatments include: Absolute control (fully irrigated), control (drought), drought and seed treatment with 100 µM melatonin, drought and foliar spray of 100 µM melatonin, and drought stress with combined effect of seed treatment and foliar spray of 100 µM melatonin. Physiological parameters such as photosynthetic rate, stomatal conductance, transpiration rate, Fv/Fm ratio, and chlorophyll index were evaluated, alongside biochemical parameters including malondialdehyde, proline content, membrane stability index and antioxidant enzyme activities such as catalase and ascorbate peroxidase were quantified. Melatonin supplemented as seed treatment and foliar spray enhanced both physiological and biochemical parameters including antioxidant activity compared to drought control. Metabolite profiling identified bioactive compounds (mainly carbohydrates and amino acids) contributing to drought tolerance in okra. The results highlight that application of 100 µM melatonin via seed treatment and foliar spray enhances drought tolerance in okra, suggesting its potential to enhance crop resilience under water-deficit conditions.

The role of interleukin-18 (IL-18) and inflammasomes in chronic inflammatory airway diseases, such as asthma and chronic obstructive pulmonary disease (COPD), has garnered significant attention in recent years. This review aims to provide an overview of the current understanding of IL-18 biology, the associated signaling pathways, and the involvement of inflammasome complexes in airway diseases. We explore the multifaceted role of IL-18 in asthma pathophysiology, including its interactions with other cytokines and contributions to both T2 and non-T2 inflammation. Importantly, emerging evidence highlights IL-18 as a critical player in severe asthma, contributing to chronic airway inflammation, airway hyperresponsiveness (AHR), and mucus impaction. Furthermore, we discuss the emerging evidence of IL-18’s involvement in autoimmunity and highlight potential therapeutic targets within the IL-18 and inflammasome pathways in severe asthma patients with evidence of infections and airway autoimmune responses. By synthesizing recent advancements and ongoing research, this review underscores the importance of IL-18 as a potential novel therapeutic target in the treatment of severe asthma and other related conditions.

We use a new method to determine a fuzzy similarity measure using fuzzy implication operators‎. ‎We use this method to determine the fuzzy similarity between the two rankings of countries involving health security and health care‎. ‎We then find a fuzzy similarity of countries involving the two rankings of countries with respect to national disaster‎ ‎and political disaster‎.

The present study is focused on the reduction of hexavalent chromium by using the isolated bacterium Halomonas maridiana EA1. H. maridiana EA1 has shown a > 90 % reduction of 100 ppm hexavalent chromium on day 1 and a > 70 % reduction of 1200 ppm hexavalent chromium on day 4. ICP-OES analysis revealed that H. maridiana EA1 has efficiently reduced hexavalent chromium into trivalent chromium. The occurrence of the chrA gene in H. maridiana EA1, which regulates the ChrA (reductase) enzyme, may be associated with the reduction of hexavalent chromium into trivalent chromium. TEM images depicted the alteration in the morphology of H. maridiana EA1 under hexavalent chromium stress conditions. The LCMS result illustrates the role of metabolites in hexavalent chromium reduction by regulating two main pathways: cell wall strengthening and biofilm formation, which help to maintain the cell integrity. Hence, applications of such dynamic bacteria H. maridiana EA1 can be useful to minimize the burden of hexavalent chromium in the soil for the sustainability of the ecosystem.

The study was conducted to evaluate the individual as well as synergistic growth promoting effects of K. galanga and C. longa in broiler chicken. Total 150 Vencobb 430Y chicks were grouped into four treatments (T1 to T4). The birds of T2 and T3 were supplemented with K. galanga at a level of 25 g/kg of feed and C. longa at 1.9 g/kg of feed respectively, and the birds of T4 were supplemented with a combination of K. galanga (62.5 mg/kg) and longa (0.38 mg/kg). The weekly body weight, cumulative feed intake and feed conversion ratio were evaluated. On forty-second day, three birds from each treatment were humanely slaughtered and the carcass characteristics, serum biochemical values, serum corticosterone level and intestinal histomorphology were studied. Significantly better growth-promoting activities in terms of body weight, FCR and carcass characteristics were exhibited by birds from treatments fed with K. galanga alone and its combination with C. longa. No significant difference could be observed in serum biochemical parameters and corticosterone level, but significantly higher villi-to-crypt ratio was observed in K. galanga fed alone and combination fed groups. All these data are indications of the growth-promoting efficiency of K. galanga alone and its combination with C. longa in broiler chicken. A combination of these two herbs [K. galanga (62.5 mg/kg) and C. longa (0.38 mg/kg)] can thus be recommended for commercial broiler chicken considering the economic feasibility in terms of higher body weight gain and low cost of herbal additives.

Purpose: The aim of the study was to assess safety of phacoemulsification in hard cataract by evaluating the post-operative endothelial cell loss and visual acuity. Materials and Methods: This is a hospital-based, prospective study conducted on 70 eyes of 70 patients with hard cataract. At the time of admission, detailed evaluation of anterior segment using slit lamp bio microscopy was done and cataract graded using LOCS III. Posterior segment was evaluated using indirect ophthalmoscopy under 20D/B-Scan. All patients with hard cataract underwent phacoemulsification procedure. The visual acuity and endothelial cell density assessed using Snellens chart and specular microscopy pre-operatively and post-operatively on Day 1, Day 7, and Day 30, respectively. Descriptive statistics, namely, mean, standard deviation to express continuous variables wherever applicable. Correlation between endothelial cell loss and cataract grading and correlation between final endothelial cell loss and final best-corrected visual acuity (BCVA) is analyzed by using Pearson's Chi-square test and Pearson's correlation coefficient. P value

Inflammation is a physiological condition that when unattended causes serious health concerns over the long term. Several phytocompounds have emerged as promising sources of anti-inflammatory agents. Thottea siliquosa is a traditional medicine for inflammatory and toxicity insults; however, this has not been scientifically confirmed. The purpose of this study is to evaluate the anti-inflammatory properties of T. siliquosa methanol leaf extract in a mouse model. This study investigates the anti-inflammatory activities of a plant extract obtained from leaves of T. siliquosa (TSE) with a focus on carrageenan- and formalin-induced paw oedema in mice. The extract’s efficacy was assessed using well-established inflammation models, and the results showed a considerable reduction in paw edema in both cases. In the case of carrageenan model TSE at 50 mg/kg showed a 53.0 ± 2.5% reduction in edema, while those treated with TSM at 100 mg/kg exhibited a 60.0 ± 1.8% reduction (p < 0.01). In the case of a formalin model when a higher dose of TSE (100 mg/kg) was given, paw thickness decreased by 47.04 ± 1.9% on the fifth day and by 64.72 ± 2.2% on the tenth day. LC-MS analysis reported the presence of gallic acid, quinic acid, quercetin, clitorin, myricitrin, retronecine, batatasin II, gingerol, and coumaric acid in the extract. Overall, this study confirms that T. siliquosa extract exerts anti-inflammatory effects in animals and is possibly mediated through the combined effects of these phytochemicals.

The efficacy of ultra-high-pressure homogenisation (UHPH) in inactivating Bacillus pumilus ATCC 27142 and Bacillus subtilis ATCC 6633 spores suspended in sheep and cow milk was investigated. The UHPH treatment was conducted at 200 and 250 MPa with an inlet temperature of 85 °C, resulting in homogenising valve temperatures of 117 °C and 127 °C, respectively. To isolate the role of temperature and pressure in the inactivation of bacterial spores, the UHPH treatment was repeated at 250 MPa with a lower inlet temperature of 70 °C that resulted in a valve temperature of 117 °C. Increasing the pressure and valve temperature resulted in increased inactivation. At 250 MPa with a valve temperature of 127 °C, greater than 5 log CFU/mL reduction was achieved in B. pumilus and B. subtilis spores in both milk types. Reductions of 0.61 ± 0.03 log CFU/mL and 0.62 ± 0.09 log CFU/mL in B. pumilus spores and 1.18 ± 0.04 log CFU/mL and 1.30 ± 0.07 log CFU/mL in B. subtilis spores were obtained at 250 MPa with a valve temperature of 117 °C in sheep and cow milk, respectively. The spore inactivation was influenced by both the pressure and temperature, suggesting a synergistic effect, with the latter playing a critical role in the lethality of the treatment. No significant differences in the inactivation of either strain was observed between sheep and cow milk.

This paper explores the role that 5G, WiFi 7, and Time-Sensitive Networking (TSN) play in driving smart manufacturing as a fundamental part of the Industry 4.0 vision. It provides an in-depth analysis of each technology’s application in industrial communications, with a focus on TSN and its key elements that enable reliable and secure communication in industrial networks. In addition, this paper includes a comparative study of these technologies, analyzing them based on several industrial use cases, supported secondary applications, industry adoption, and current market trends. This paper concludes by highlighting the challenges and future directions for adopting these technologies in industrial networks and emphasizes their importance in realizing the Industry 4.0 vision within the context of smart manufacturing.

Abstract While studies on ambient fine particulate matter (PM2.5) exposure effect on child health are available, the differential effects, if any, of exposure to PM2.5 species are unexplored in lower and middle-income countries. Using multiple logistic regression, we showed that for every 10 μg m−3 increase in PM2.5 exposure, anaemia, acute respiratory infection, and low birth weight prevalence increase by 10% (95% uncertainty interval, UI: 9–11), 11% (8–13), and 5% (4–6), respectively, among children in India. NO3 -, elemental carbon, and NH4 + were more associated with the three health outcomes than other PM2.5 species. We found that the total PM2.5 mass as a surrogate marker for air pollution exposure could substantially underestimate the true composite impact of different components of PM2.5. Our findings provide key indigenous evidence to prioritize control strategies for reducing exposure to more toxic species for greater child health benefits in India.

Introduction: It is necessary to understand the importance of different energies in Fractionated Stereotactic Radiotherapy (FSRT) plans for better outcome. The study objective is to compare FSRT plans with Flattening Filter (FF) and Flattening Filter Free (FFF) beams.Material and Methods: Twelve patients with primary Brain Metastasis (BM), were selected and given 25 Gy in five fractions for which 6FF beams were angled in double arc. The Planning Target Volume (PTV) and Organs at Risk (OARs) were assessed using dosimetric indices after each plan was replanned with 6 FFF, 10 FF, and 10 FFF energies. Treatment time (TT) and Monitor Units (MUs) were also compared. Additionally, we compared portal dosimetry for dose agreement across all plans using the gamma analysis criterion.Results: PTV parameters of created plans showed better values when compared to 6 FF plans, where the most significant is with FFF plans which include D98%, D80%, D2%, D50% and Dose Gradient Index values of 6FFF plans. Among OARs, the most significant is the V10 value of (Brain-PTV) as (46.77±43.9) and maximum dose values of optic chiasm, brainstem, and left lens in 6FFF plans. Among technical parameters, the 6FFF plan showed significant TT value of (3.06±1.0) with p-value 4.13E-05. Better gamma analysis passing rates were achieved with FFF beams.Conclusion: Linear accelerator-based FSRT delivery of BM using 6 FFF beam results in better dosimetric indices, OAR sparing, fastest treatment delivery, and energy conservation with reduced peripheral and out-of-field dose for higher treatment modalities like Rapid arc.

Background and aim: Asthma is a chronic airway hyperresponsiveness disorder and Obese people have greater rates of asthma incidence and prevalence. Obesity, a complex condition, can cause nutritional metabolic problems that change trace elements and minerals. Trace element and antioxidant levels affect asthma aetiology. In this study, we aim to determine the serum levels of trace elements Zn, Fe, Cu, Mg, Co, Ni, Pb, Cd, and Cr, total antioxidants (TAS), and lifestyle that determine specific clinical conditions in asthma and obesity patients from Vellore City (Tamil Nadu, India). Methods: A case-control study to determine the level of the serum trace elements with 838 subjects (n = 242 asthma patients, n = 140 asthmatic obese, n = 185 obese patients, and n = 271 controls) between the ages of 20 and 60 years was carried out. Asthma was diagnosed based on the clinical examination and pulmonary function tests. Trace element levels were determined by atomic absorption spectrophotometry (AAS) in serum, and a DPPH-free radical scavenging assay was used to determine the total antioxidant capacity level in serum. Result: In asthma male patients, serum levels of Zn, Fe, Cu, Mg, and TAS were significantly lower and Pb, Cd, and Cr significantly higher, whereas in female asthma patients, serum levels of Zn, Fe, Mg, and TAS were significantly lower and Pb significantly higher. In asthmatic obese male patients, Fe, Cu, and TAS were significantly lower, and Pb, Cd, and Co were significantly higher; in asthmatic obese female patients, Zn, Fe, Cu, Mg, and TAS were significantly lower, and Ni was significantly higher. In obese male patients, Zn, Fe, Cu, and TAS were significantly lower and Cd was significantly higher, and in obese female patients, Zn, Fe, Cu, Mg, and TAS were significantly lower. Conclusion: The influence of the level of trace elements, heavy metal, total antioxidant, and the lifestyle patterns, may increase the risk of asthma and obesity.

Metabolic syndrome affects more than one in three adults and is associated with increased risk of diabetes, cardiovascular disease, and all-cause mortality. Muscle insulin resistance is a major contributor to the development of the metabolic syndrome. Studies in mice have linked skeletal muscle sarcoplasmic reticulum (SR) phospholipid composition to sarcoplasmic/endoplasmic reticulum Ca2+-ATPase activity and insulin sensitivity. To determine if the presence of metabolic syndrome alters specific phosphatidylcholine (PC) and phosphatidylethanolamine (PE) species in human SR, we compared SR phospholipid composition in skeletal muscle from sedentary subjects with metabolic syndrome and sedentary control subjects without metabolic syndrome. Both total PC and total PE were significantly decreased in skeletal muscle SR of sedentary metabolic syndrome patients compared with sedentary controls, particularly in female participants, but there was no difference in the PC:PE ratio between groups. Total SR PC levels, but not total SR PE levels or PC:PE ratio, were significantly negatively correlated with BMI, waist circumference, total fat, visceral adipose tissue, triglycerides, fasting insulin, and homeostatic model assessment for insulin resistance. These findings are consistent with the existence of a relationship between skeletal muscle SR PC content and insulin resistance in humans.

Abstract Background In Ireland, the agriculture sector reports the highest number of fatalities even though farmers constitute only 6% of the working population. Tractor-related behaviours are implicated in 55% of all vehicle work-related fatalities and 25% of reported injuries, and many of these occur in farmyards. There is limited research on the feasibility and acceptability of behaviour change interventions to improve tractor safety. Target behaviours that promote safe operation in farmyards, determining and addressing blind spots of tractors, were identified, and an intervention was developed following the Behaviour Change Wheel Approach. The objective of the study is to examine the feasibility, fidelity and acceptability of a behaviour change intervention to enhance the safe operation of tractors in farmyards with a particular focus on tractor blind spots. Method A single group feasibility study will be undertaken. Approximately 16 farmers from four major farm types will be recruited for the study between August and September 2022. The intervention involves an in-person demo session, facilitated discussion and personalised safety training procedure with safety goals. The study will collect data from participants at three time points: baseline (3–10 days prior to the intervention), during the intervention and at the follow-up session (7–30 days post-intervention). Quantitative data will be collected through a pre-intervention interview and feedback surveys. A pre- and post-intervention qualitative interview will also be conducted with the participants and will be supplemented with qualitative data from recruitment logs, observational memos and logs and feedback from recruiters. Evaluation of the feasibility, acceptability and fidelity of the intervention will be guided by a pre-determined feasibility checklist, fidelity framework and theoretical framework of acceptability, respectively. Interviews will be analysed using the content analysis. Discussion The current study can determine the feasibility and fidelity of delivering a systematic, theoretically driven, tailored behaviour change intervention. It will also assess whether the intervention, its ingredients and delivery are acceptable to the farming population. This study will also inform the development of a future larger trial to test the effectiveness of the intervention. Trial registration ISRCTN Identifier: ISRCTN22219089. Date applied 29 July 2022

Secondary hypertension can occur from a variety of renal and endocrine disorders. Pheochromocytoma, a rare catecholamine-secreting neuroendocrine tumor, is associated with adverse maternal and fetal outcomes in the absence of a timely diagnosis and a coordinated multidisciplinary approach. Clues to diagnosis include resistant hypertension or an adrenal mass on imaging.

AbstractBackground: Type 2 diabetes mellitus (T2DM) is a multifaceted disease appropriate to elevated blood glucose levels resulting from decreased insulin and beta-cell activity. Using a case–control methodology, researchers have examined the relationship between polymorphisms in LEPR and T2DM in a population from south India.Materials and Methods: We conducted a genetic analysis of 311 participants, and results were accomplished using a case-control study, a meta-analysis of previous studies on LEPR was conducted, and type 2 diabetes genotype distribution across various geographical regions Malaysians, Chinese Han, Kuwait, Iran, Mongolia, and Han Chinese, Greece, Saudi, India (North India, Punjabi), (South India, Tamilnadu). The study involved 254 prospective investigations, and nine association studies were preferred according to preset criteria. Studies were assessed for quality using the Hardy-Weinberg equilibrium (HWE) and the Newcastle–Ottawa Scale (NOS). An analysis of the genetic models was conducted to determine their relationship, statistical analysis was utilized to calculate odds ratios (ORs) and matching 95% confidence intervals (CIs).Results: The LEPR-rs1137101 polymorphism in the case-control study was associated with a significant increase in the risk of type 2 diabetes. A meta-analysis revealed a connection between LEPR gene polymorphism (rs1137101) and type 2 diabetes risk. Investigators might gain a more profound thought on the significance of the identified genetic variation and its impact on the chance of developing type 2 diabetes by verifying and strengthening previously reported findings. The model of fixed effects was chosen due to the low heterogeneity, and significant associations were observed in the allelic (OR = 0.79, 95% CI [0.70–0.87]), homozygote (OR = 0.58, 95% CI [0.46–0.72]), dominant (OR = 0.66, 95% CI [0.56–0.79]), and recessive (OR = 0.83, 95% CI [0.71–0.96]) genetic models. A Begg’s funnel plot and Egger’s test indicated no publication bias. These findings suggest that the rs1137101 variant in the LEPR gene has been linked to a higher risk of T2DM.Conclusions: A larger sample size, however, is required for further research, and consideration of potential confounding factors is needed to validate these associations. Understanding the implications of LEPR gene polymorphisms in T2DM susceptibility may contribute to personalized treatment strategies for patients with T2DM.

Plastics are non-biodegradable synthetic substances produced by chemical reactions. Except few test resins derived from corn and other organic substances, almost all plastics are made from carbon and petroleum. The invention of plastics alterated our society by introducing a huge spreading of products and has displaced many traditional materials. We use plastic in countless ways in our daily life such as food storage containers, electric wiring, toys, furniture, clothes, injection, syringes water, and milk bottles, packaging and carry bags, pipes, electronic items, frames, and other several thousands of items. A polymer of carbon and hydrogen alone or with nitrogen, chlorine, oxygen, or sulfur is the backbone of the majority of plastics. Plastic is a non- biodegradable material. Plastic pollutes the air, earth, and water as they contain toxic chemicals. Ethylene oxide, benzene, and xylenes are highly toxic and these are the major chemicals that go into the making of plastic and cause a serious threat to living being of all species on earth. These chemicals can cause disorders ranging from birth defects to cancer, damage the nervous system and the immune system and also affect the blood and the kidneys. Also, many toxic gases are emitted during recycling of plastic. More than 100 million tons of plastic are produced worldwide each year. Plastics do not undergo bacterial decomposition and the disposal of plastic through recycling, burning, or landfilling is a fable. Plastic wastes clog the drains and thus hit especially urban sewage systems. The plastic contaminates the water, soil, marine life and also the air we breathe, causing countless problems to living organism.

Abstract Background Rice grain size (GS) is an essential agronomic trait. Though several genes and miRNA modules influencing GS are known and seed development transcriptomes analyzed, a comprehensive compendium connecting all possible players is lacking. This study utilizes two contrasting GS indica rice genotypes (small-grained SN and large-grained LGR). Rice seed development involves five stages (S1–S5). Comparative transcriptome and miRNome atlases, substantiated with morphological and cytological studies, from S1–S5 stages and flag leaf have been analyzed to identify GS proponents. Results Histology shows prolonged endosperm development and cell enlargement in LGR. Stand-alone and comparative RNAseq analyses manifest S3 (5–10 days after pollination) stage as crucial for GS enhancement, coherently with cell cycle, endoreduplication, and programmed cell death participating genes. Seed storage protein and carbohydrate accumulation, cytologically and by RNAseq, is shown to be delayed in LGR. Fourteen transcription factor families influence GS. Pathway genes for four phytohormones display opposite patterns of higher expression. A total of 186 genes generated from the transcriptome analyses are located within GS trait-related QTLs deciphered by a cross between SN and LGR. Fourteen miRNA families express specifically in SN or LGR seeds. Eight miRNA-target modules display contrasting expressions amongst SN and LGR, while 26 (SN) and 43 (LGR) modules are differentially expressed in all stages. Conclusions Integration of all analyses concludes in a “Domino effect” model for GS regulation highlighting chronology and fruition of each event. This study delineates the essence of GS regulation, providing scope for future exploits. The rice grain development database (RGDD) ( www.nipgr.ac.in/RGDD/index.php ; https://doi.org/10.5281/zenodo.7762870 ) has been developed for easy access of data generated in this paper.

The growth and performance of cowpea seedlings are negatively impacted by climate change and the subsequent occurrence of drought stress. Osmotic stress leads to the formation of reactive oxygen species, causing membrane breakdown, and impairs metabolic activities. The harmful effects of osmotic stress can be reduced by using seed priming techniques. Seeds of cowpea var. Anaswara were treated with polyethylene glycol (PEG) and β-amino butyric acid (BABA) as priming agents. The seedlings emerged from the primed seeds have been found to reduce the lipid peroxidation rates and improve plant water status by accumulating osmolytes such as proline, total free aminoacids, and total soluble sugars, and also enhanced the production of non-enzymatic antioxidants such as total phenolics, ascorbate, and glutathione, as well as increased the activities of enzymatic antioxidants such as catalase, peroxidase, and superoxide dismutase, which effectively scavenge ROS and maintain the homeostasis of the cell. PEG priming (cis-priming) and BABA priming (trans-priming) exhibited differential physiochemical responses in cowpea subjected to PEG stress. The current work investigates the extent of stress tolerance acquired through seed priming, and it will help to make a sensitive variety to a more tolerant one. Physiochemical responses of seedlings emerged from BABA-primed seeds towards PEG stress were better regulated to encounter the PEG-induced osmotic stress than the seedlings emerged from PEG-primed seeds.

Dry eye disease (DED) is a chronic ocular surface disorder, associated with inflammation, which can cause severe morbidity, visual compromise, and loss of quality of life, affecting up to 5–50% of the world population. In DED, ocular surface damage and tear film instability due to abnormal tear secretion lead to ocular surface pain, discomfort, and epithelial barrier disruption. Studies have shown the involvement of autophagy regulation in dry eye disease as a pathogenic mechanism along with the inflammatory response. Autophagy is a self-degradation pathway in mammalian cells that reduces the excessive inflammation driven by the secretion of inflammatory factors in tears. Specific autophagy modulators are already available for the management of DED currently. However, growing studies on autophagy regulation in DED might further encourage the development of autophagy modulating drugs that reduce the pathological response at the ocular surface. In this review, we summarize the role of autophagy in the pathogenesis of dry eye disease and explore its therapeutic application.

Introduction: Prolonged COVID-19 pandemic accelerates the emergence and transmissibility of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants through the accumulation of adaptive mutations. Particularly, adaptive mutations in spike (S) protein of SARS-CoV-2 leads to increased viral infectivity, severe morbidity and mortality, and immune evasion. This study focuses on the phylodynamic distribution of SARS-CoV-2 variants during the year 2021 in India besides analyzing the functional significance of mutations in S-protein of SARS-CoV-2 variants. Methods: Whole genome of SARS-CoV-2 sequences (n = 87957) from the various parts of India over the period of January to December 2021 was retrieved from Global Initiative on Sharing All Influenza Data. All the S-protein sequences were subjected to clade analysis, variant calling, protein stability, immune escape potential, structural divergence, Furin cleavage efficiency, and phylogenetic analysis using various in silico tools. Results: Delta variant belonging to 21A, 21I, and 21J clades was found to be predominant throughout the year 2021 though many variants were also present. A total of 4639 amino acid mutations were found in S-protein. D614G was the most predominant mutation in the S-protein followed by P681R, L452R, T19R, T478K, and D950N. The highest number of mutations was found in the N-terminal domain of S-protein. Mutations in the crucial sites of S-protein impacting pathogenicity, immunogenicity, and fusogenicity were identified. Intralineage diversity analysis showed that certain variants of SARS-CoV-2 possess high diversification. Conclusions: The study has disclosed the distribution of various variants including the Delta, the predominant variant, in India throughout the year 2021. The study has identified mutations in S-protein of each SARS-CoV-2 variant that can significantly impact the virulence, immune evasion, increased transmissibility, high morbidity, and mortality. In addition, it is found that mutations acquired during each viral replication cycle introduce new sub-lineages as studied by intralineage diversity analysis.

The study on the evaluation of carcass characteristics of Gramasree hens by feeding fresh black soldier fly larvae (BSFL) as soya bean meal replacer at 0, 25, 50, 75 and 100 per cent levels was carried out at University Poultry and Duck Farm, Mannuthy, Thrissur, Kerala, for a period of 8 weeks. Eighty numbers of 40 week old Gramasree hens were allotted to five treatment groups with four replicates each and with four birds in each replicate. Slaughter parameters like pre-slaughter body weight, dressing percentage and eviscerated percentage were not affected by the inclusion of fresh BSFL. Abdominal fat was significantly (p

A study was conducted to evaluate the effect of Chlorella vulgaris hydro-alcoholic extract on blood biochemistry and immune organs characteristics in broiler chicken. A total of 128 Vencobb 400, day-old broiler chicks were randomly assigned into four treatment groups having four replicates with eight birds per replicate. A basal diet was formulated in accordance with BIS recommendation and hydro-alcoholic extract of Chlorella vulgaris was added at an inclusion level of 0, 0.1, 0.2 and 0.4 per cent respectively to the basal diet to form 4 different treatment diets. After 42 days of experimental feeding trial, one bird from each replicate was sacrificed to study blood biochemical parameters and immune organs status. The results of the present study indicated that the birds fed with 0.4 percent C. vulgaris extract in their diet showed significantly higher WBC (P

The present study was carried out at the Department of Livestock Products Technology, College of Veterinary and Animal Sciences, Pookode and ICAR - Central Institute of Fisheries Technology, Kochi to develop retort processed traditional Kerala chicken curry and to evaluate its microbial quality. Traditional Kerala chicken curry was prepared using boneless chicken breast pieces and with a gravy of roasted coconut, spices and condiments. The product was packed in multilayer laminated pouch, which was then hermetically sealed and processed in an over-pressure retort. Accurate time-temperature standardisation was done to maintain sterility. The pouches were checked for commercial sterility after processing. The product was stored at ambient temperature and microbiological evaluation was conducted on days 0, 30, 60, 90 and 120 of storage. The curry showed no aerobic and anaerobic growth on different days of storage and did not spoil till day 120.

Zinc oxynitride (ZnON) has recently emerged as a highly promising band gap-tunable semiconductor material for optoelectronic applications. In this study, a novel DC reactive sputtering protocol was developed to fabricate ZnON films with varying elemental concentrations, by precisely controlling the working pressure. The working pressure was varied from 0.004 mbar to 0.026 mbar.For working pressure greater than 1.6 × 10 ^−3 mbar, the mean free path of ions decrease, the sputtering rate decreases and the concentration of nitrogen in the films decreases. The band gap of the film obtained from UV Vis Spectroscopy initially decreases and reaches a minimum of 1.6 eV at a flow rate of 20 sccm of nitrogen, after which it drastically increases. The correlation between the micro structure and band gap was investigated. The initial alloy structure of the film was found to exist when the band gap was between 1.66 eV and 2.15 eV, beyond which, a distorted wurtzite structure began to emerge. At a band gap of 2.7 eV, the spectrum peaks indicated the coexistence of both alloy and wurtzite structures. With an increasing band gap, the wurtzite structure became dominant, completely replacing the alloy structure at 3.25 eV. This study revealed the existence of intermediate structures formed during the tuning of the band gap, which can have important implications for future research aimed at developing heterostructures and 2D superlattices for photonics applications.

This paper provides a review of using Interferometric Synthetic Aperture Radar (InSAR), a microwave remote sensing technique, for deformation monitoring of hydroelectric power projects, a critical infrastructure that requires consistent and reliable monitoring. Almost all major dams around the world were built for the generation of hydropower. InSAR can enhance dam safety by providing timely settlement measurements at high spatial-resolution. This paper provides a holistic view of different InSAR deformation monitoring techniques such as Differential Synthetic Aperture Radar Interferometry (DInSAR), Ground-Based Synthetic Aperture Radar (GBInSAR), Persistent Scatterer Interferometric Synthetic Aperture Radar (PSInSAR), Multi-Temporal Interferometric Synthetic Aperture Radar (MTInSAR), Quasi-Persistent Scatterer Interferometric Synthetic Aperture Radar (QPSInSAR) and Small BAseline Subset (SBAS). PSInSAR, GBInSAR, MTInSAR, and DInSAR techniques were quite commonly used for deformation studies. These studies demonstrate the advantage of InSAR-based techniques over other conventional methods, which are laborious, costly, and sometimes unachievable. InSAR technology is also favoured for its capability to provide monitoring data at all times of day or night, in all-weather conditions, and particularly for wide areas with mm-scale precision. However, the method also has some disadvantages, such as the maximum deformation rate that can be monitored, and the location for monitoring cannot be dictated. Through this review, we aim to popularize InSAR technology to monitor the deformation of dams, which can also be used as an early warning method to prevent any unprecedented catastrophe. This study also discusses some case studies from southern India to demonstrate the capabilities of InSAR to indirectly monitor dam health.

Abstract Increased sedimentation is the main problem that affects dam efficiency by reducing storage capacity. Planning for dam construction and maintenance requires design strategies that heavily depend on integrated basin models, properly identifying principal sediment origins within the watershed and qualifying the sediment production rate. In this research work, the physically-based watershed SWAT model, defined as the Soil and Water Assessment Tool, was used to estimate the rate of sediment production for future dams in the Tata basin, located in southeast Morocco. The model was calibrated and tested for uncertainty by the employment of the algorithm Sequential Uncertainty Fitting-2. The outputs were used for assessing critical sediment source areas. Calibration and validation of the model were performed by monthly data. The values for Nash–Sutcliffe efficiency coefficient, Percent bias coefficient and determination coefficient (R2), respectively, during the calibration period 1990–1998 (0.96, −13% and 0.96) and the validation period 1999–2006 (0.77, + 11% and 0.93) indicate the accordance with the results obtained for the measured flow and the simulated flow values. The annual sediment yield of the Tata basin extends from 0 to 11 t/ha/y with a mean of 2.3 t/ha/y. The spatial distribution of these sediments varies from upstream to downstream. The downstream basin generated more sediment to the river per unit area, though it was less than the total amount of the basin for the upstream area. This variation is influenced by the increased downstream surface runoff and also by other characteristics of the basin such as slope and lithology. The low erosion places correspond to areas with lithological formations that are more resistant to erosion.

Social disparity referred to as social differences that continue within each sector of the society. The paper highlights the linkage between disparity in educational attainment and the role of cultural capital towards the aspiration for education. Educational outlook and exposure can be varied depending on certain factors like the location where they reside, education and occupation of parents, socioeconomic status of the family, and amenities provided by schools. The overriding factors which contribute towards educational aspiration are the parental education and occupation. As education is the leading facet for an individual towards their expectations for existence, these factors bring constructive and unconstructive outputs. Pierre Bourdieu (1998) argues that individuals are endowed with durable cognitive structures and a dispositional sense of action that directs them to appropriate responses to given situations, which refers to as cultural capital, i.e., the familiarity of prestigious aesthetic culture, such as high arts, literary culture and linguistic ability which helps the individual to make comfortable in the formal school setting. It was found that in Kerala, the most influential cultural capital which added advantage to the basic education is the parental occupation rather than literary culture, and linguistic ability. It lessens the true picture that, a new emerging society of Kerala lacks the value of literary wealth as part of the commercialization of education. The Higher secondary students (final years of basic education) were the respondents, and the samples are drawn from rural, semi-urban and urban areas of Ernakulam district, Kerala using interview schedule.

Social disparity referred to as social differences that continue within each sector of the society. The paper highlights the linkage between disparity in educational attainment and the role of cultural capital towards the aspiration for education. Educational outlook and exposure can be varied depending on certain factors like the location where they reside, education and occupation of parents, socioeconomic status of the family, and amenities provided by schools. The overriding factors which contribute towards educational aspiration are the parental education and occupation. As education is the leading facet for an individual towards their expectations for existence, these factors bring constructive and unconstructive outputs. Pierre Bourdieu (1998) argues that individuals are endowed with durable cognitive structures and a dispositional sense of action that directs them to appropriate responses to given situations, which refers to as cultural capital, i.e., the familiarity of prestigious aesthetic culture, such as high arts, literary culture and linguistic ability which helps the individual to make comfortable in the formal school setting. It was found that in Kerala, the most influential cultural capital which added advantage to the basic education is the parental occupation rather than literary culture, and linguistic ability. It lessens the true picture that, a new emerging society of Kerala lacks the value of literary wealth as part of the commercialization of education. The Higher secondary students (final years of basic education) were the respondents, and the samples are drawn from rural, semi-urban and urban areas of Ernakulam district, Kerala using interview schedule.

Purpose: To present varied clinical presentations, surveillance reports, and final visual outcomes of a rare outbreak of cluster endophthalmitis caused by gram-negative, opportunistic bacilli, Burkholderia cepacia complex (Bcc). Methods: Details of five patients who developed postoperative cluster endophthalmitis were collected. For each patient, an undiluted vitreous sample was collected during vitreous tap. Bacterial culture from the vitreous sample in each case had grown Bcc. Surveillance investigations for root cause analysis (RCA) were performed in the operating room (OR), admission, and day-care wards to localize the source. Results: Four patients had undergone phacoemulsification surgery, and one patient had undergone penetrating keratoplasty. Each patient received an initial dose of empiric intravitreal ceftazidime and vancomycin. The organism isolated in each case was sensitive to ceftazidime, cotrimoxazole, and meropenem and resistant to other antibiotics. Core vitrectomy was done after 48–60 hours in four patients along with intravitreal imipenem injection. One patient did not provide consent for core vitrectomy and subsequently developed phthisis bulbi. Three patients had subsequent recurrences. Two patients had a final BCVA of 20/60, two had BCVA better than 20/200, while one patient had no perception of light. None of the surveillance samples from the OR complex could isolate Burkholderia. Conclusion: Extensive OR surveillance should be done to identify the potential source of infection. However, the source may not be identifiable in few instances like in our case. Longer follow-up is recommended in cases of Bcc endophthalmitis due to the persistent nature of the infection.

Introduction: The emergence of a novel coronavirus in China has turned into a SARS-CoV-2 pandemic with high fatality. As vaccines are developed through various strategies, their immunogenic potential may drastically vary and thus pose several challenges in offering immune responses against the virus. Methods: In this study, we adopted an immunoinformatics-aided approach for developing a new multi-epitope vaccine construct (MEVC). In silico approach was taken for the identification of B-cell and T-cell epitopes in the Spike protein, for MEVC various cytotoxic T-lymphocyte, helper T-lymphocyte, and B-cell epitopes with the highest affinity for the respective HLA alleles were assembled and joined by linkers. Results: The computational data suggest that the MEVC is nontoxic, nonallergenic and thermostable and elicit both humoral and cell-mediated immune responses. Subsequently, the biological activity of MEVC was assessed by bioinformatic tools using the interaction between the vaccine candidate and the innate immune system receptors TLR3 and TLR4. The epitopes of the construct were analyzed with that of the strains belonging to various clades including the emerging variants having multiple unique mutations in S protein. Conclusions: Due to the advantageous features, the MEVC can be tested in vitro for more practical validation and the study offers immense scope for developing a potential vaccine candidate against SARS-CoV-2 in view of the public health emergency associated with COVID-19 disease caused by SARS-CoV-2.

Mycobacterial diseases are endemic in India but simultaneous occurrence of tuberculosis and leprosy is rarely reported. We report a case of disseminated tuberculosis in an immunocompromised host due long-standing unsupervised corticosteroid intake with erythema nodosum leprosum (type 2 lepra reaction). The patient presented with generalized erythematous papulonodular skin lesions with malaise and body ache for the past 2 years. Later, he developed fever and testicular pain for which he sought medical advice. The diagnosis was based on the various laboratory and imaging studies supported by demonstration of Mycobacterium tuberculosis and Mycobacterium leprae in sputum and skin smears, respectively. The patient developed hepatitis which led to management challenges, however, the institution of antitubercular and antileprosy therapy in titrating doses resulted in improvement of the patient's condition.

Background: Researchers have been perplexed by the diverse clinical symptoms of COVID-19 spikes, and its oral symptoms are not frequently documented. Objectives: To estimate the prevalence of orofacial symptoms associated with confirmed COVID-19 cases and to assess the oral health–related quality of life among these patients. Methods: After audio consent, a pre-tested structured questionnaire was used to gather data from COVID-19-confirmed patients, and cases from a tertiary dental care facility in Thiruvananthapuram were also included. Results: Out of 200 participants, 86 (43%) were females, and 114 (57%) were males. The mean age was 40 years, ranging from 10 to 75 years. It was found that loss of taste (111, 56%), dry mouth (54, 27%), oral ulceration (18, 9%), white discoloration (12, 6%), burning sensation (9, 4.5%), red discoloration (7, 3.5%), tooth mobility (4, 2%), osteomyelitis (3, 2%), mucormycosis (4, 2%) and gingival bleeding (1, 0.5%) were the orofacial symptoms present in the participants. Conclusion: The prevalence of orofacial symptoms was 68% in COVID-19 patients, with loss of taste, dry mouth, and oral ulcerations as predominant symptoms. The mean oral health impact profile (OHIP) value of the COVID patients who showed oral manifestations was 17.44, whereas for those who did not show oral manifestations, it was only 7.46.

The efforts to signify the relevance of tRNA modifications were always within the limits of prokaryotes, humans, and some fewer model plant systems. The story of tRNA modifications in higher plants is still overlooked, especially in non-model spice crops. Stress causes alterations in tRNA modifications to facilitate the downstream functions of tRNAs. The present study was done to identify and better understand the fate of tRNA nucleoside modifications during biotic stress response in a widely used spice crop called Black pepper. We have uncovered the various tRNA nucleoside modifications present in black pepper. Methylations were the predominant nucleoside modifications in black pepper tRNAs.Furthermore, the different methyltransferase gene candidates implicated in catalyzing tRNA nucleoside methylations in black pepper were also identified. The LC-MS profile showed that certain tRNA nucleoside modifications showed varied abundance upon P. capsici infection. The N4-acetylcytidine (ac4C) nucleoside modification has shown a constant hike at 24 and 48 hpi. At the same time, some nucleoside modifications have exhibited a time-dependent abundance. Altogether our study suggests that tRNA modifications and the expression of associated enzymes are altered during biotic stress regulation.

Objective: Functional foods play important roles in the management of health; the haustoria from the Cocos nucifera and Borassus flabellifer are less explored for their nutritional benefits. Therefore, the study evaluated the proximate composition, biological and anti-diabetic effects of the CH and BH. Methods: The total polyphenol content of coconut and palmyra palm haustorium was conducted using the standard Folin-Ciocalteu based assay. The radical scavenging properties of Coconut and Palmyra palm haustorium was analyzed by DPPH radical scavenging assay, Lipid peroxidation inhibition as well as by hydrogen peroxide scavenging assay. Anti-diabetic activity of the coconut and palmyra palm haustorium extracts were analyzed in terms of the inhibition of α-amylase and α-glucosidase activities. Results: The results indicated significantly higher amounts of protein, fiber, and fat content in BH. Similarly, higher polyphenol content was present in BH. Substantiating these results, the anti-DPPH radical and anti-hydrogen peroxide radical was higher in BH (18.66 ± 2.09 and 30.73 ± 2.37 µg/mL); likewise, the BH had higher lipoygenase inhibition and nitric oxide scavenging potential (42.14 ± 3.45 and 72.12 ± 4.02 µg/mL). Both the extracts exhibited anti-diabetic activity (58.61 ± 2.98 and 91.17 ± 3.52 µg/mL), however a higher concentration was required for CH compared to the BH. Conclusion: The Palmyra palm and coconut haustorium are highly nutritional in terms of the various components. By virtue of these compounds, the BH and CH may evolve as possible functional foods over time.

The genera Trichrysis Lichtenstein, 1876 and Chrysidea Bischoff, 1910 from India are reviewed. A new species, Trichrysis poseidonia sp. nov. from India and Nepal is described. Trichrysis bengalensis (Mocsáry, 1889) is revalidated from the previous synonymy with T. lusca (Fabricius, 1804). Trichrysis inops (Gribodo, 1884) is recorded from India for the first time. The lectotype of Chrysis spectrum Wickwar, 1908 is designated. Chrysis mendicalis Cameron, 1897 is transferred from the genus Trichrysis to the genus Chrysidea. Keys and illustrations are provided for the identification of the eleven species of Trichrysis and the four species of Chrysidea so far known in the country, including a Sri Lankan species.

This study presents a novel approach to fabricate silver nanoparticles (AgNPs) using the poisonous plant, Holigarna arnottiana leaf extract. The formation of AgNPs was confirmed by a color change from green to dark brown and validated by UV analysis. FTIR analysis identified functional groups on the AgNPs, while Zeta potential analysis assessed their stability. TEM analysis established an average diameter of 18 nm and a spherical morphology for the nanoparticles. LC MS analysis coupled with database searches revealed the presence of diverse bioactive compounds, including flavonoids, nucleotides, dipeptides, enzymes, and glycosides. These compounds are postulated to act as reducing agents in the leaf extract-mediated synthesis process. Moreover, the bio-fabricated AgNPs exhibited noteworthy anticancer properties against DLA cells. In addition, AgNPs displayed substantial antimitotic effects in an assay involving Allium cepa root cells. These findings underscore the potential of the AgNPs as cytotoxic agents. The biosynthesized AgNPs showed antimicrobial activity against various bacterial pathogens, including Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus. Furthermore, the AgNPs exhibited outstanding radical-scavenging properties in the DPPH assay, suggesting their potential application in antioxidant therapies. The study collectively highlights the successful synthesis of AgNPs through a green, biocompatible approach, and demonstrates their promising potential for anticancer, antimitotic, and radical-scavenging applications.

BackgroundThe American Society of Gastrointestinal Endoscopy (ASGE) has proposed practice guidelines for evaluating patients with suspected choledocholithiasis. This study aims to assess and compare practice patterns for following ASGE guidelines for choledocholithiasis in a large academic vs. community hospital setting.MethodsA total of one thousand ER indicated for choledocholithiasis were randomly selected. Patients’ demographics, total bilirubin, imaging studies including magnetic resonance cholangiopancreatography (MRCP), intraoperative cholangiogram (IOC), endoscopic ultrasound (EUS), and ERCP results were retrospectively collected. Patients with prior sphincterotomy were excluded. We examined the following practice deviations from the current ASGE guidelines; (1) ERCP was potentially delayed in high probability cases while awaiting additional imaging studies, (2) ERCP was performed without additional imaging studies in cases of low/intermediate-risk, or (3) ERCP was performed in low/intermediate-risk cases when additional imaging studies were negative.ResultsA total of 640 patients with native papilla who underwent ERCP were included in the final analysis. Overall, the management of 43% (275) of patients was deviated from the applicable ASGE guidelines. Academic and community provider rates of non-adherence were 32 vs. 45%, respectively (p-value: < 0.01). Of 381 high-risk cases, 54.1% had additional imaging before ERCP. (Academic vs. community; 11.7 vs. 88.3%, p-value: < 0.01). In 26.7% (69/258) of low/intermediate risk cases, ERCP was performed without additional studies; academic (14.5%) vs. community (85.5%) (p-value: < 0.01). Finally, in 11.2% (19/170) of patients, ERCP was performed despite intermediate/low probability and negative imaging; academic (26.3%) vs. community (73.7%) (p-value: 0.02).ConclusionOur study results show that providers do not adhere to ASGE practice guidelines in 43% of suspected choledocholithiasis cases. The rate of non-adherence was significantly higher in community settings. It could be due to various reasons, including lack/delays for alternate studies (i.e., MRCP, EUS), concern regarding the length of stay, patient preference, or lack of awareness/understanding of the guidelines. Increased availability of alternate imaging and educational strategies may be needed to increase the adoption of practice guidelines across academic and community settings to improve patient outcomes and save healthcare dollars.