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Objective: To examine existing literature regarding health literacy levels and their association with multimorbidity and the potential underlying mechanisms behind the said association., Design: Systematic review and meta-analysis., Data Sources: The databases MEDLINE, EMBASE, CINAHL and Science Direct were searched for articles published between 1 January 2000 and 31 October 2023 using a systematic search strategy., Eligibility Criteria: Included were all primary studies conducted in people over 18 years old with data on health literacy levels and the presence of multimorbidity. No language restrictions were used., Data Extraction and Synthesis: Two authors independently extracted data and assessed the bias using the Joanna Briggs Institute critical appraisal tools., Results: We included a total of 39 studies (36 quantitative, two qualitative and one mixed-method), representing 154 337 participants. We found a 32% proportion of limited health literacy among individuals with multimorbidity. Analysis of three articles using the Health Literacy Questionnaire tool (n=31 228) (Pooled OR 2.88 (95% CI 1.92 to 4.31)) and three articles using the Health Literacy Survey Questionnaire-European Union tool (n=35 358) (OR 1.16 (95% CI 1.07 to 1.25)) indicated that people with limited health literacy were likely to have multiple conditions. One of three articles studying underlying mechanisms reported that self-efficacy mediates the association between health literacy and multimorbidity. Additionally, substantial literature identified education and income as the most consistent determinants of health literacy among individuals with multimorbidity. Of the only two articles studying the effectiveness of health literacy-related interventions, both reported an improvement in clinical outcomes after the intervention., Conclusions: Our review demonstrated a consistent association between health literacy and multimorbidity, indicating that people with lower health literacy levels are more likely to have multimorbidity. More evidence is needed regarding the effect of health literacy interventions on multimorbidity., Prospero Registration Number: CRD42022301369., 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.)

Background: The UK's National Health Service (NHS) is grappling with rising demand and limited dermatologists, leading to longer waiting times. This is particularly concerning for conditions like malignant melanoma, where early diagnosis is crucial. Teledermatology is being introduced to address these issues, but its impact on patients' monetary and time costs, especially in deprived areas, is under-researched. This study investigates the impact of a community-based teledermatology model in East Kent, a coastal region with high cross-regional health inequalities., Methods: We analysed the financial costs and time invested by patients undergoing community-based teledermatology versus if they were to attend traditional appointments. Data were gathered from 1368 referrals, from May 2022 to January 2024 at a secondary care provider in the region. We considered the diagnosis method, appointments, travel, monetary cost of time, parking costs and Index of Multiple Deprivation Deciles (IMDD)., Results: Our study showed the community teledermatology model significantly reduced the active patient's time and cost to obtain a diagnosis. Average time was 38.1 min, compared to 96.7 min in traditional clinics, saving 58.4 min (95% CI -62.3 to -54.5, p < 0.001). Patients saved £17.9 per diagnosis with this model (95% CI -£19.2 to -£16.6, p < 0.001). Time savings were more substantial for patients from more deprived regions (IMDD 1-3)., Conclusion: The community-based teledermatology model proves to be cheaper for patients, providing a convenient alternative to traditional clinics, particularly benefiting patients from deprived backgrounds by improving healthcare accessibility and offering flexible consultation options., Competing Interests: Declarations. Ethics approval and consent to participate: This project utilised data collected as part of standard care and optional questionnaires. Data analysis was conducted using anonymised data, as the system allows for anonymous data extraction. The project was reviewed and approved by the East Kent Hospitals University NHS Foundation Trust Clinical Audit and Improvement Team, which deemed it a clinical audit improvement project that did not require further review by an ethics committee (Reference Number: RN903073). This determination was made in accordance with national regulations, including the Data Protection Act 2018, General Data Protection Regulation (GDPR) and applicable Health Research Authority (HRA) guidance. Ethical approval was not required for this study because the data used was fully anonymised and excluded from the definition of personal data under the Data Protection Act 2018. Similarly, Recital 26 of the General Data Protection Regulation (GDPR) states that "the principles of data protection do not apply to anonymous information." As such, anonymised data does not constitute personal data, and its use in this project complies with national regulations. Informed consent for data use was not required because the anonymised data was extracted from the hospital’s electronic database (Pathpoint eDerma) without patient interviews. However, questionnaire responses were provided voluntarily by patients who had given explicit consent. All methods in this project adhered to the ethical principles outlined in the Declaration of Helsinki. Furthermore, per Health Research Authority (HRA) guidelines, ethical approval is required only for research involving identifiable personal data. As the data in this project was anonymised and the study was classified as a clinical audit, ethical approval was not necessary. Consent for publication: Not applicable. Competing interests: Authors NAN, TH and PM declare a competing interest in their employment by Open Medical Ltd., (© 2024. The Author(s).)

Though mitochondria have their own genome and protein synthesis machineries, the majority of the mitochondrial proteins are actually encoded by the nuclear genome. Most of these mitochondrial proteins are imported into specific compartments of the mitochondria due to their mitochondrial target sequence (MTS). Unlike the nuclear target sequence, the MTS of most of the mitochondrial localized proteins remain poorly understood, mainly due to their variability, heterogeneity, unconventional modes of action, mitochondrial potential-dependent transport, and other complexities. Recently, we reported that transient receptor potential vanilloid subtype 4 (TRPV4), a thermosensitive cation channel, is physically located at the mitochondria. Here we characterize a small segment (AA 592-630) located at the TM4-loop4-TM5 segment of TRPV4 that acts as a novel MTS. The same region remains highly conserved in all vertebrates and contains a large number of point mutations each of which causes an diverse spectrum of diseases in human. Using confocal and super-resolution microscopy, we show that this MTS of TRPV4 or its mutants localizes to the mitochondria independently and also induces functional and quantitative changes in the mitochondria. By using conformal microscopy, we could detect the presence of the MTS region within the isolated mitochondria. These findings may be important to understand the complexity of MTS and TRPV4-induced channelopathies better., (© 2024 The Author(s). PROTEINS: Structure, Function, and Bioinformatics published by Wiley Periodicals LLC.)

Enhanced lipid-droplet formation by adipocytes is a complex process and relevant for obesity. Using knock-out animals, involvement of TRPV4, a thermosensitive ion channel in the obesity has been proposed. However, exact role/s of TRPV4 in adipogenesis and obesity remain unclear and contradictory. Here we used in vitro culture of 3T3L-1 preadipocytes and primary murine-mesenchymal stem cells as model systems, and a series of live-cell-imaging to analyse the direct involvement of TRPV4 exclusively at the adipocytes that are free from other complex signalling as expected in in-vivo condition. Functional TRPV4 is endogenously expressed in pre- and in mature-adipocytes. Pharmacological inhibition of TRPV4 enhances differentiation of preadipocytes to mature adipocytes, increases expression of adipogenic and lipogenic genes, enhances cholesterol, promotes bigger lipid-droplet formation and reduces the lipid droplet temperature. On the other hand, TRPV4 activation enhanced the browning of adipocytes with increased UCP-1 levels. TRPV4 regulates mitochondrial-temperature, Ca 2+ -load, ATP, superoxides, cardiolipin, membrane potential (ΔΨm), and lipid-mitochondrial contact sites. TRPV4 also regulates the extent of actin fibres, affecting the cells mechanosensing ability. These findings link TRPV4-mediated mitochondrial changes in the context of lipid-droplet formation involved in adipogenesis and confirm the direct involvement of TRPV4 in adipogenesis. These findings may have broad implication in treating adipogenesis and obesity in future., Competing Interests: Declaration of competing interest All authors declare the existence of no conflict with this work. The funding bodies have no role in experiment design, data analysis, manuscript preparation or decision to publish this work., (Copyright © 2024 Elsevier Inc. All rights reserved.)

In recent years, Internet Addiction Disorder (IAD) has become a major mental health concern among adolescents, with detrimental effects on social relationships, academic performance, and emotional well-being. The focus of mindfulness-based interventions (MBIs) on improving self-awareness, emotional regulation, and cognitive flexibility has drawn interest in MBIs as possible therapeutic approaches for treating IAD. The purpose of this narrative review is to investigate how mindfulness interventions affect teenagers who are experiencing IAD. The review summarizes research findings from multiple studies that look at how well MBIs work to promote healthier online behavior, improve mental health outcomes, and cut down on excessive internet use. According to recent research, adolescents who engage in mindfulness practices are better able to control their compulsive internet usage habits, resist impulsive impulses, and spend less time on the internet. Furthermore, mindfulness practices like breathing exercises, body scanning, and meditation may help reduce stress, anxiety, and depression, which are the common comorbidities linked to IAD. The review ends by emphasizing the necessity of more research on the long-term impacts of MBIs on IAD, the incorporation of mindfulness into school-based initiatives, and the significance of developing interventions that are specific to the developmental needs of teenagers. All things considered, mindfulness intervention seems like a promising strategy for reducing Internet addiction disorder, but more thorough research is needed to determine its effectiveness and suitability for use in a range of adolescent populations., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Samanta et al.)

In this study, the pressing issue of persistent organic pollutants in wastewater was addressed by designing and fabricating a magnetically separable MnFe 2 O 4 /rGO heterostructure catalyst for efficient mineralization of bisphenol A (BPA) and dyes such as alizarin red S (anionic) and malachite green (cationic), which are known for their resistance to biodegradation and carcinogenic properties. Comprehensive structural and surface analyses using XRD, XPS, SEM, and TEM/HRTEM coupled with magnetic and optical property measurements revealed the formation of the MnFe 2 O 4 /rGO heterostructures. Among all, the MnFe 2 O 4 /rGO-10 catalyst with 10% wt% of rGO exhibited 100% efficiency in the mineralization of BPA and both dyes under visible light illumination within 60 min. The stability and recyclability of the catalyst, assessed through XRD and VSM studies, demonstrated its consistent performance over multiple uses. The cost-effectiveness and stability of this catalyst underscore its potential for practical application in wastewater treatment, offering a viable solution to the persistent challenge of removing stubborn organic contaminants., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

While many studies have documented adverse impact of multiple chronic conditions or multimorbidity on COVID-19 outcomes in patients, there is scarcity of report on how physicians managed these patients. We investigated the experiences and challenges of clinicians in managing patients with multimorbidity throughout the COVID-19 pandemic in Odisha state, India. To understand the factors influencing illness management and the adaptive responses of physicians alongside the evolving pandemic, we followed a longitudinal qualitative study design. Twenty-three physicians comprising general practitioners, specialists, and intensivists, were telephonically interviewed in-depth. Saldana's longitudinal qualitative data analysis method was employed for data analysis. COVID-19 pandemic initially diverted the attention of health systems, resulting in reduced care. With time, the physicians overcame fear, anxiety, and feelings of vulnerability to COVID-19 and started prioritising patients with multimorbidity for treatment and vaccination. All physicians recommended teleconsultation and digital health records to benefit chronic illness care during future public health crises. The findings underscore the transformative potential of physician resilience and adaptation during the COVID-19 pandemic, emphasizing the importance of prioritizing patients with multimorbidity, incorporating teleconsultation, and implementing digital health records in healthcare systems to enhance chronic illness care and preparedness for future public health crises., (© 2024. The Author(s).)

Physicians' hold pivotal roles in improving non-communicable diseases (NCDs). Studies conducted in India revealed that physicians' feel unprepared to address NCDs risk reduction and provide counseling. We conducted a gap analysis using desk reviews to identify inclusion of NCD risk reduction in medical curricula, and a scoping review to assess knowledge, attitude, perception, and practice related to NCD risk reduction among the undergraduate medical students in India. We also conducted key-informant interviews to understand perceptions among medical students and physicians. We found a lack of knowledge about NCDs and strong interest and perceived need for NCD risk reduction training among both medical students and their teachers. Our findings suggest promoting NCD prevention by physicians and allied health workers in clinical settings can enable the learning environment for medical students to adopt these practices., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

Objective: To identify literature on health literacy levels and examine its association with tuberculosis treatment adherence and treatment outcomes., Methods: Two authors independently searched Pubmed®, Embase, CINAHL, PsycINFO, Scopus, LILACS, Global Health Medicus and ScienceDirect for articles reporting on health literacy levels and tuberculosis that were published between January 2000 and September 2023. We defined limited health literacy as a person's inability to understand, process, and make decisions from information obtained concerning their own health. Methodological quality and the risk of bias was assessed using the JBI critical appraisal tools. We used a random effects model to assess the pooled proportion of limited health literacy, the association between health literacy and treatment adherence, and the relationship between health literacy and tuberculosis-related knowledge., Findings: Among 5813 records reviewed, 22 studies met the inclusion criteria. The meta-analysis revealed that 51.2% (95% confidence interval, CI: 48.0-54.3) of tuberculosis patients exhibit limited health literacy. Based on four studies, patients with lower health literacy levels were less likely to adhere to tuberculosis treatment regimens (pooled odds ratio: 1.95; 95% CI: 1.37-2.78). Three studies showed a significant relationship between low health literacy and inadequate knowledge about tuberculosis (pooled correlation coefficient: 0.79; 95% CI: 0.32-0.94)., Conclusion: Health literacy is associated with tuberculosis treatment adherence and care quality. Lower health literacy might hamper patients' ability to follow treatment protocols. Improving health literacy is crucial for enhancing treatment outcomes and is a key strategy in the fight against tuberculosis., ((c) 2024 The authors; licensee World Health Organization.)

Introduction: The objectives of this study were: 1) to describe the socio-demographics and classify the chief complaints and reasons to encounter facilities of patients presenting to public healthcare facilities; 2) to explore differences in these complaints and: International Classification of Primary Care-3 (ICPC-3) groups across socio-demographic and health system levels., Methods: This is a cross-sectional study conducted in three districts of Odisha, India. Within each district, the district hospital (DH), one Sub-district hospital (SDH) (if available), two Community health centers (CHCs), and two Primary health care centers (PHCs) were selected. Thus, a total of three DHs, three SDHs, six CHCs, and six PHCs were covered. Two tertiary healthcare facilities were also included. Patients aged 18 years and older, attending the Outpatient Departments (OPD) of sampled health facilities were chosen as study participants through systematic random sampling., Results: A total of 3044 patients were interviewed. In general, 65% of the sample reported symptoms as their chief complaint for reason of encounter, whereas 35% reported disease and diagnosis. The most common reasons to encounter health facilities were fever, hypertension, abdominal pain, chest pain, arthritis, skin disease, cough, diabetes, and injury. Among the symptoms, the highest number of patients reported the general category (29%), followed by the digestive system (16%). In the disease category, the circulatory system has the highest proportion, followed by the musculatory system. In symptom categories, general, digestive, and musculatory systems were the key systems for the reasons of encounter in outpatient departments irrespective of different groups of the population. In terms of different tiers of health systems, the top three reasons to visit OPD were dominated by the circulatory system, respiratory system, and musculatory system., Conclusion: This is the first Indian study using the ICPC-3 classification for all three levels of health care. Irrespective of age, socio-economic variables, and tiers of healthcare, the top three groups to visit public health facilities according to the ICPC-3 classification were consistent i.e., general, digestive, and circulatory. Implementation of standard management and referral guidelines for common diseases under these groups will improve the quality and burden at public health facilities in India., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Gupta et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

In an era defined by an insatiable thirst for sustainable energy solutions, responsible water management, and cutting-edge lab-on-a-chip diagnostics, surface wettability plays a pivotal role in these fields. The seamless integration of fundamental research and the following demonstration of applications on these groundbreaking technologies hinges on manipulating fluid through surface wettability, significantly optimizing performance, enhancing efficiency, and advancing overall sustainability. This Review explores the behavior of liquids when they engage with engineered surfaces, delving into the far-reaching implications of these interactions in various applications. Specifically, we explore surface wetting, dissecting it into three distinctive facets. First, we delve into the fundamental principles that underpin surface wetting. Next, we navigate the intricate liquid-surface interactions, unraveling the complex interplay of various fluid dynamics, as well as heat- and mass-transport mechanisms. Finally, we report on the practical realm, where we scrutinize the myriad applications of these principles in everyday processes and real-world scenarios.

The present article deals with the electrohydrodynamic motion of diffuse porous particles governed by an applied DC electric field. The spatial distribution of monomers as well as the charge distribution across the particle are considered to follow sigmoidal distribution involving decay length. Such a parameter measures the degree of inhomogeneity of the monomer distribution across the particle. The diffuse porous particles resemble several colloidal entities which are often seen in the environment as well as in biological and pharmaceutical industries. Considering the impact of bulk pH and ion steric effects, we modelled the electrohydrodynamics of such porous particulates based on the modified Boltzmann distribution for the spatial distribution of electrolyte ions and the Poisson equation for electric potential as well as the conservation of mass and momentum principles. We adopt regular perturbation analysis with weak field assumption and the perturbed equations are solved numerically to calculate the electrophoretic mobility and neutralization fraction of the particle charge during its motion as well as fluid collection efficiency. We further deduced the closed form relation between the drag force experienced by the charged porous particle and the fluid collection efficiency. In addition to the numerical results, we further derived the closed form analytical results for all the intrinsic parameters indicated above derived within the Debye-Hückel electrostatic framework and homogeneous distribution of monomers within the particle for which the decay length vanishes. The deduced mathematical results as indicated above will be useful to analyze several electrostatic and hydrodynamic features of a wide class of porous particulate and environmental entities.

Monitoring the temperature distribution within a local environment at the micro and nanoscale is vital as many processes are solely thermal. Various thermometric techniques have been explored in the community, and out of these, fluorescent nano/micro particle-based mechanisms are accepted widely (fluorescence intensity ratio (FIR) techniques, where the ratio of populations in two consecutive energy levels is compared with Boltzmann distribution). We describe a new technique to account for the temperature rise near an illuminated upconverting particle (UCP) using wavefront imaging, which is more sensitive than the conventional thermometric techniques on the microscale. We rely on a thermo-optical phase microscopic technique by reconstructing the wavefront of emission from an upconverting particle using a Shack-Hartmann wavefront sensor. The wavefront maps the local phase distribution, which is an indicator of the surroundings' optical parameters, particularly the suspended medium's temperature-induced refractive index in the presence of convection currents. We describe how these extracted phase values can provide information about the optical heating due to the particle and hence its local environment along the direction of the emission. Our findings demonstrate the detection of a minimum temperature rise of 0.23 K, while the FIR methods indicate a minimum of 0.3 K rise. This technique is used to study the temperature increase in the backscattered direction for an upconverting particle illuminated on pump resonance. We also estimate the Soret coefficient for an upconverting particle optically trapped on pump resonance and experiencing anisotropic heating across the body.

Background: Community engagement and involvement (CEI) was crucial for the COVID-19 pandemic response, particularly among the urban poor in low-and middle-income countries (LMICs). However, no evidence synthesis explores how CEI can benefit public health emergencies., Objective: We conducted a systematic scoping review of the CEI with an emphasis on stakeholder identification, accountability mapping, the support system, and the engagement process among urban poor populations in LMICs during the COVID-19 pandemic., Methods: We searched eleven databases, including PubMed, Embase, Web of Science, and CINAHL, following the PRISMA-2020 guidelines to find articles published between November 2019 and August 2021. PROSPERO registration No: CRD42021283599. We performed the quality assessment using a mixed-method appraisal tool. We synthesized the findings using thematic framework analysis., Results: We identified 6490 records. After the title and abstract screening, 133 studies were selected for full-text review, and finally, we included 30 articles. Many stakeholders were involved in COVID-19 support, particularly for health care, livelihoods, and WASH infrastructure, and their accountability mapping by adopting an interest - influence matrix. This review emphasizes the significance of meaningful CEI in designing and implementing public health efforts for pandemic management among urban slum populations. The interest - influence matrix findings revealed that specific community volunteers, community-based organizations, and civil society organizations had high interest but less influence, indicating that it is necessary to recognize and engage them., Conclusion: Motivation is crucial for those with high influence but less interest, such as corporate responsibility/conscience and private food supply agencies, for the health system's preparedness plan among urban populations.

With the decline in HIV mortality, a concomitant increase in morbidity and death not directly related to HIV has been witnessed. Consequently, many countries especially low- and middle-income countries (LMICs) are now facing the dual burden of HIV and non-communicable diseases (NCDs). 2.3 million people living with HIV in India are at a higher risk of developing NCDs due to ageing, which can be attributed to the additional impact of long-standing HIV infection and the side-effects of antiretroviral therapy. This has led to a rise in demand for a combined health system response for managing HIV infection and co-existing NCDs, especially in LMICs such as India. The health and wellness centres (HWCs) envisioned to provide an expanded range of preventive and curative services including that for chronic conditions may act as a window of opportunity for providing egalitarian and accessible primary care services to these individuals. The reasons for integrating HIV and NCD care are epidemiological overlap between these conditions and the similar strategies required for provision of healthcare services.

Menthol is a small bioactive compound able to cause several physiological changes and has multiple molecular targets. Therefore, cellular response against menthol is complex, and still poorly understood. In this work, we used a human osteosarcoma cell line (Saos-2) and analysed the effect of menthol, especially in terms of cellular, subcellular and molecular aspects. We demonstrate that menthol causes increased mitochondrial Ca 2+ in a complex manner, which is mainly contributed by intracellular sources, including ER. Menthol also changes the Ca 2+ -load of individual mitochondrial particles in different conditions. Menthol increases ER-mito contact points, causes mitochondrial morphological changes, and increases mitochondrial ATP, cardiolipin, mitochondrial ROS and reduces mitochondrial membrane potential (ΔΨm). Menthol also prevents the mitochondrial quality damaged by sub-lethal and lethal doses of CCCP. In addition, menthol lowers the mitochondrial temperature within cell and also serves as a cooling agent for the isolated mitochondria in a cell free system too. Notably, menthol-induced reduction of mitochondrial temperature is observed in diverse types of cells, including neuronal, immune and cancer cells. As the higher mitochondrial temperature is a hallmark of several inflammatory, metabolic, disease and age-related disorders, we propose that menthol can serve as an active anti-aging compound against all these disorders. These findings may have relevance in case of several pharmacological and clinical applications of menthol. SIGNIFICANCE STATEMENT: Menthol is a plant-derived bioactive compound that is widely used for several physiological, behavioural, addictive, and medicinal purposes. It is a well-established "cooling and analgesic agent". However, the exact cellular and sub-cellular responses of menthol is poorly understood. In this work, we have characterized the effects of menthol on mitochondrial metabolism. Menthol regulates mitochondrial Ca 2+ , ATP, superoxides, cardiolipin, membrane-potential, and ER-mito contact sites. Moreover, the cooling agent menthol also cools down mitochondria and protects mitochondrial damage by certain toxins. These findings may promote use of menthol as a useful supplementary agent for anti-aging, anti-cancer, anti-inflammatory purposes where higher mitochondrial temperature is prevalent., Competing Interests: Declaration of competing interest All authors declare the existence of no conflict with this work. The funding bodies have no role in experiment design, data analysis, manuscript preparation or decision to publish this work., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Competing Interests: The authors declare no conflict of interest. No funding was received for this work.

Dynamic electrophoresis is the foundation for electroacoustical measurements, in which the electroacoustical signals may be used to analyze the size and electrostatic charge of colloidal entities by means of the results for dynamic electrophoretic mobility. Thus, the electrophoresis under an alternating electric field is the key foundation for electroacoustic theory. In this article, we develop a tractable analytical theory for the dynamic electrophoresis of hydrophobic and dielectric fluid droplets possessing uniform surface charge density. The tiny fluid droplets possess charged mobile surfaces and have found widespread applications in our day-to-day life. For dielectric fluid droplets (e.g., oil-water emulsions), the tangential electric stress at the interface is nonzero, which significantly affects its electrohydrodynamics under an oscillatory electric field, which has, however, a negligible impact on the electrophoretic motion of conducting droplets (e.g., mercury droplets). Besides, the micro/nanoscale fluid droplets often show hydrophobicity when they are immersed in an aqueous medium, and the impact of the electric field on hydrophobic surfaces remains a research frontier in the chemical discipline. Whereas a number of approximate expressions for electrophoretic mobility have been derived for the conducting droplet, none of them are applicable to such generic hydrophobic fluid droplets with dielectric permittivity that is significantly lower than or comparable to that of an aqueous medium. In this work, within the Debye-Hückel electrostatic framework, we elaborate an original analytical expression of dynamic electrophoretic mobility for this generic dielectric fluid droplet with a hydrophobic surface considering that the droplet retains its spherical shape during its oscillatory motion. We further derived a set of simplified expressions for dynamic electrophoretic mobility deduced under several limiting cases. The results are further illustrated, indicating the impact of pertinent parameters.

Introduction: Multimorbidity has emerged as a major healthcare challenge in low/middle-income countries (LMICs) such as India and Brazil. Life course epidemiology suggests that adverse events in early life contribute to an individual's later health in adulthood. However, little is known about the influence of early life health and social factors on the development of multimorbidity in adulthood in LMICs. We aimed to explore the association of adult multimorbidity with childhood health and social disadvantages among two LMICs, India and Brazil., Methods: We conducted a secondary data analysis of older adults aged ≥50 years using nationally representative surveys from Longitudinal Ageing Study in India, 2017-2018 (n=51 481) and 'Estudo Longitudinal da Saude e Bem-Estar dos Idosos Brasileirous', 2015-2016 (n=8730). We estimated the prevalence of multimorbidity along with 95% CI as a measure of uncertainty for all weighted proportions. Log link in generalised linear model was used to assess the association between childhood health and disadvantages with multimorbidity, reported as adjusted prevalence ratio (APR)., Results: The prevalence of multimorbidity was 25.53% and 55.24% in India and Brazil, respectively. Participants who perceived their childhood health as poor and missed school for a month or more due to illness had the highest level of multimorbidity across both countries. After adjusting for age and gender, a significant association between adult multimorbidity and poor self-rated childhood health (APR: (India: 1.38, 1.16 to 1.65) and (Brazil: 1.19, 1.09 to 1.30)); and missed school for a month due to illness (AOR: (India: 1.73, 1.49 to 2.01) and (Brazil: 1.16, 1.08 to 1.25)) was observed., Conclusion: Early life health, educational and economic disadvantages are associated with adult multimorbidity and appear to contribute to the later course of life. A life course approach to the prevention of multimorbidity in adulthood in LMICs may be useful in health programmes and policies., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

Owing to the importance of analytical results for electrokinetics of colloidal entities, we performed a mathematical analysis to determine the closed form analytical results for the diffusiophoretic velocity of a hydrophobic and polarizable fluid droplet. A comprehensive mathematical model is developed for diffusiophoresis, considering the background aqueous medium as general electrolytes (e.g., binary valence-symmetric/asymmetric electrolytes and a mixed solution of binary electrolytes). We performed our analysis under a weak concentration gradient, and the analytical results for diffusiophoretic velocity are calculated within the Debye-Hückel electrostatic framework. The exact form of the diffusiophoretic velocity is further approximated with negligible error, and the approximate form is found to be free from any of the cumbersome exponential integrals and thus very convenient for practical use. The present theory also covers the diffusiophoresis of perfectly dielectric as well as perfectly conducting droplets as its limiting case. In addition, we have further derived a number of closed form expressions for diffusiophoretic velocity pertaining to several particular cases, and we observed that the derived limit correctly recovers the available existing analytical results for diffusiophoretic velocity. Thus, the present analytical theory for diffusiophoresis can be applied to a wide class of fluidic droplets, e.g., hydrophobic and dielectric oil/conducting mercury droplets, air bubbles, nanoemulsions, as well as any polarizable and hydrophobic fluidic droplet suspended in a solution of general electrolytes.

Introduction: There is a dearth of data on common multimorbidity clusters and the healthcare costs for individuals with mental health disorders. This study aimed to identify clinically meaningful physical-mental multimorbidity clusters, frequently occurring clusters of conditions, and healthcare utilization patterns and expenditure among patients attending a psychiatric outpatient clinic., Materials and Methods: Data were collected in the psychiatric outpatient department among patients aged 18 years and above in February-July 2019 ( n = 500); follow-up data on non-communicable disease incidence were collected after 18 months. For analysis, morbidity clusters were defined using two approaches: 1) agglomerative hierarchical clustering method to identify clusters of diseases; and 2) non-hierarchical cluster k mean analysis to identify clusters of patients. Self-reported healthcare costs in these clusters were also calculated., Result: Two disease clusters were identified: using the 1 st approach were; 1) hypertension, diabetes, and mood disorder; 2) Neurotic, stress-related, and somatoform disorders, and acid peptic disease. Three clusters of patients identified using the 2 nd approach were identified: 1) those with mood disorders and cardiometabolic, musculoskeletal, and thyroid diseases; 2) those with neurotic, substance use, and organic mental disorders, cancer, and epilepsy; and 3) those with Schizophrenia. Patients in Cluster 1 were taking more than six medicines and had more hospital visits. Within 18 months, 41 participants developed either one or two chronic conditions, most commonly diabetes, hypertension, or thyroid disease., Conclusion: Cardiometabolic diseases are most commonly clustered with mood disorders. There is a need for blood pressure and sugar measurement in psychiatric clinics and mood disorder screening in cardiac, endocrinology, and primary care clinics., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Journal of Psychiatry.)

Respiratory rate (RR) monitoring is essential in neonatal intensive care units. Despite its importance, RR is still monitored intermittently by manual counting instead of continuous monitoring due to the risk of skin damage with prolonged use of contact electrodes in preterm neonates and false signals due to displacement of electrodes. Thermal imaging has recently gained significance as a non-contact method for RR detection because of its many advantages. However, due to the lack of information in thermal images, the selection and tracking of the region of interest (ROI) in thermal images for neonates are challenging. This paper presents the integration of visible (RGB) and thermal (T) image sequences for the selection and tracking of ROI for breathing rate extraction. The deep-learning based tracking-by-detection approach is employed to detect the ROI in the RGB images, and it is mapped to the thermal images using the RGB-T image registration. The mapped ROI in thermal spectrum sequences gives the respiratory rate. The study was conducted first on healthy adults in different modes, including steady, motion, talking, and variable respiratory order. Subsequently, the method is tested on neonates in a clinical settings. The findings have been validated with a contact-based reference method.The average absolute error between the proposed and belt-based contact method in healthy adults reached 0.1 bpm and for more challenging conditions was approximately 1.5 bpm and 1.8 bpm, respectively. In the case of neonates, the average error is 1.5 bpm, which are promising results. The Bland-Altman analysis showed a good agreement of estimated RR with the reference method RR and this pilot study provided the evidence of using the proposed approach as a contactless method for the respiratory rate detection of neonates in clinical settings., (© 2022. The Author(s).)

Aim: The present study explored the family caregivers' perspectives and elicited their experience while managing dementia care during the COVID-19 pandemic in Odisha, India., Background: The onset of the COVID-19 pandemic has diverted the attention of health systems away from chronic disease management and health services delivery. Psychiatric care particularly for dementia and the elderly is found to be more compromised in such situation., Methods: We adopted an inductive phenomenological approach to garner key insights into the care continuity for people living with dementia in the context of the COVID-19 pandemic. Telephonic in-depth interviews (IDIs) were carried out with 17 immediate caregivers. All IDIs were digitally recorded, transcribed, and analysed using a thematic approach., Findings: Caregivers did not perceive dementia as an overwhelming challenge; instead viewed it as a part of the ageing process. Caring for dementia was being done by family members as a collective responsibility with task-sharing. The caregivers primarily relied on their usual physician for the continuity of dementia care and took utmost precautions to prevent exposure to COVID-19 risk. However, they found it more challenging to ensure adequate care for the multiple illnesses (multimorbidity) coexisting with dementia. Towards this, they adopted all possible measures to keep the chronic conditions under control, lest the vulnerability to COVID-19 infection might heighten. The fear of visiting a hospital, prevailing restrictions in mobility, and diverted attention of health systems to pandemic containment created impediments towards maintaining multimorbidity care. The support of local administration, neighbourhood pharmacy and diagnostic laboratories and teleconsultation with the physicians were vital for care continuity. Caregivers adapted by reducing or deferring physical consultation and seeking treatment via telephonic advice of the treating physicians. Our findings suggest leveraging digitally enabled health care technology and augmenting caregiver activation for home-based dementia care to cruise through any similar catastrophic situations.

Condensing atmospheric water vapor on surfaces is a sustainable approach to addressing the potable water crisis. However, despite extensive research, a key question remains: what is the optimal combination of the mode and mechanism of condensation as well as the surface wettability for the best possible water harvesting efficacy? Here, we show how various modes of condensation fare differently in a humid air environment. During condensation from humid air, it is important to note that the thermal resistance across the condensate is nondominant, and the energy transfer is controlled by vapor diffusion across the boundary layer and condensate drainage from the condenser surface. This implies that, unlike condensation from pure steam, filmwise condensation from humid air would exhibit the highest water collection efficiency on superhydrophilic surfaces. To demonstrate this, we measured the condensation rates on different sets of superhydrophilic and superhydrophobic surfaces that were cooled below the dew points using a Peltier cooler. Experiments were performed over a wide range of degrees of subcooling (10-26 °C) and humidity-ratio differences (5-45 g/kg of dry air). Depending upon the thermodynamic parameters, the condensation rate is found to be 57-333% higher on the superhydrophilic surfaces compared to the superhydrophobic ones. The findings of the study dispel ambiguity about the preferred mode of vapor condensation from humid air on wettability-engineered surfaces and lead to the design of efficient atmospheric water harvesting systems.

Background & Objectives: The National Prevalence Survey of India (2019-2021) estimated 31 per cent tuberculosis infection (TBI) burden among individuals above 15 years of age. However, so far little is known about the TBI burden among the different risk groups in India. Thus, this systematic review and meta-analysis, aimed to estimate the prevalence of TBI in India based on geographies, sociodemographic profile, and risk groups., Methods: To identify the prevalence of TBI in India, data sources such as MEDLINE, EMBASE, CINAHL, and Scopus were searched for articles reporting data between 2013-2022, irrespective of the language and study setting. TBI data were extracted from 77 publications and pooled prevalence was estimated from the 15 community-based cohort studies. Articles were reviewed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and were sourced using a predefined search strategy from different databases., Results: Out of 10,521 records, 77 studies (46 cross-sectional and 31 cohort studies) were included. The pooled TBI prevalence for India based on the community-based cohort studies was estimated as 41 per cent [95% confidence interval (CI) 29.5-52.6%] irrespective of the risk of acquiring it, while the estimation was 36 per cent (95% CI 28-45%) prevalence observed among the general population excluding high-risk groups. Regions with high active TB burden were found to have a high TBI prevalence such as Delhi and Tamil Nadu. An increasing trend of TBI was observed with increasing age in India., Interpretation & Conclusions: This review demonstrated a high prevalence of TBI in India. The burden of TBI was commensurate with active TB prevalence suggesting possible conversion of TBI to active TB. A high burden was recorded among people residing in the northern and southern regions of the country. Such local epidemiologic variation need to be considered to reprioritize and implement-tailored strategies for managing TBI in India.

Particles can be assembled at the air-water interface due to optically induced local heating. This induces convection currents in the water which brings particles to the surface. We improve the technique by employing an upconverting particle (UCP), which, when illuminated with 975 nm light, not only emits visible emission but also generates heat owing to the poor efficiency of the upconversion process. This induces strong convection currents which makes particles dispersed in the suspension assemble at the interface and immediately under the UCP. We show assembly of polystyrene particles of 1 μm diameter and diamonds of 500 nm diameter bearing Nitrogen-Vacancy (NV) centers around the UCP. We also show, for the first time, that the microdiamonds are assembled within about 30 nm at the bottom of the UCP by utilizing non-radiative energy transfer that reduces the lifetime of the 550 nm emission from about 90 μs to about 50 μs.

Background: Digital health technologies (DHTs), such as electronic health records and prescribing systems, are transforming health care delivery around the world. The quality of information in DHTs is key to the quality and safety of care. We developed a novel clinical information quality (CLIQ) framework to assess the quality of clinical information in DHTs., Objective: This study explored clinicians' perspectives on the relevance, definition, and assessment of information quality dimensions in the CLIQ framework., Methods: We used a systematic and iterative eDelphi approach to engage clinicians who had information governance roles or personal interest in information governance; the clinicians were recruited through purposive and snowball sampling techniques. Data were collected using semistructured online questionnaires until consensus was reached on the information quality dimensions in the CLIQ framework. Responses on the relevance of the dimensions were summarized to inform decisions on retention of the dimensions according to prespecified rules. Thematic analysis of the free-text responses was used to revise definitions and the assessment of dimensions., Results: Thirty-five clinicians from 10 countries participated in the study, which was concluded after the second round. Consensus was reached on all dimensions and categories in the CLIQ framework: informativeness (accuracy, completeness, interpretability, plausibility, provenance, and relevance), availability (accessibility, portability, security, and timeliness), and usability (conformance, consistency, and maintainability). A new dimension, searchability, was introduced in the availability category to account for the ease of finding needed information in the DHTs. Certain dimensions were renamed, and some definitions were rephrased to improve clarity., Conclusions: The CLIQ framework reached a high expert consensus and clarity of language relating to the information quality dimensions. The framework can be used by health care managers and institutions as a pragmatic tool for identifying and forestalling information quality problems that could compromise patient safety and quality of care., International Registered Report Identifier (irrid): RR2-10.1136/bmjopen-2021-057430., (©Kayode Philip Fadahunsi, Petra A Wark, Nikolaos Mastellos, Ana Luisa Neves, Joseph Gallagher, Azeem Majeed, Andrew Webster, Anthony Smith, Brian Choo-Kang, Catherine Leon, Christopher Edwards, Conor O'Shea, Elizabeth Heitz, Olamide Valentine Kayode, Makeba Nash, Martin Kowalski, Mateen Jiwani, Michael Edmund O'Callaghan, Nabil Zary, Nicola Henderson, Niels H Chavannes, Rok Čivljak, Olubunmi Abiola Olubiyi, Piyush Mahapatra, Rishi Nannan Panday, Sunday O Oriji, Tatiana Erlikh Fox, Victoria Faint, Josip Car. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 06.12.2022.)

Effective manipulation of liquids on open surfaces without external energy input is indispensable for the advancement of point-of-care diagnostic devices. Open-surface microfluidics has the potential to benefit health care, especially in the developing world. This review highlights the prospects for harnessing capillary forces on surface-microfluidic platforms, chiefly by inducing smooth gradients or sharp steps of wettability on substrates, to elicit passive liquid transport and higher-order fluidic manipulations without off-the-chip energy sources. A broad spectrum of the recent progress in the emerging field of passive surface microfluidics is highlighted, and its promise for developing facile, low-cost, easy-to-operate microfluidic devices is discussed in light of recent applications, not only in the domain of biomedical microfluidics but also in the general areas of energy and water conservation.

Lignocellulosic crop residues (LCCRs) hold a significant share of the terrestrial biomass, estimated at 5 billion Mg per annum globally. A massive amount of these LCCRs are burnt in many countries resulting in immense environmental pollution; hence, its proper disposal in a cost-effective and eco-friendly manner is a significant challenge. Among the different options for management of LCCRs, the use of lignocellulose degrading microorganisms (LCDMOs), like fungi and bacteria, has emerged as an eco-friendly and effective way for its on-site disposal. LCDMOs achieve degradation through various mechanisms, including multiple supportive enzymes, causing oxidative attacks by which recalcitrance of lignocellulose material is reduced, paving the way to further activity by depolymerizing enzymes. This improves the physical properties of soil, recycles plant nutrients, promotes plant growth and thus helps improve productivity. Rapid and proper microbial degradation may be achieved through the correct combination of the LCDMOs, supplementing nutrients and controlling different factors affecting microbial activity in the field. The review is a critical discussion of previous studies revealing the potential of individuals or a set of LCDMOs, factors controlling the rate of degradation and the key researchable areas for better understanding of the role of these decomposers for future use., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objective: Measure the satisfaction level of patients visiting a tertiary level cancer institute in Odisha, identify the factors associated with the satisfaction level and assess the health system challenges related to quality service provision for cancer survival., Material and Methods: Analytical cross-sectional study was carried out using a mixed-methods approach in a tertiary cancer care unit in Odisha among 538 cancer patients using the Patient Satisfaction 32 questionnaire and the Patient Health Questionnaire (PHQ)-9 questionnaire., Results: There were 41% and 43% of outdoor and indoor patients who were below poverty line. Hindu was the predominant religion (>90%), 10% were illiterates and 90% were married in each category. Breast cancer (16%) was predominant among outdoor patients, whereas, it was stomach cancer (15%) among indoor patients. The PHQ median score for females was 1.5 and 1 each for indoor and outdoor patients, respectively. Nearly, 72% and 57% of males and females had mild depression to adjustment disorders statistically significant at P < 0.05. 90% of outdoor and 68% of indoor patients with a greater frequency of visits were significantly more depressed than their counterparts. All those accompanied by people other than their family members also showed higher values of adjustment and mild depressive features (69%) at P < 0.05. About 81% were satisfied with both general services and staff and nearly 40% with treatment and diagnosis., Conclusion: It gave us demographic details of cancer morbidity and its associates besides validating the survivorship framework in the Indian setting. Self-help anonymous and rehabilitation centres for a holistic integrative approach at the primary level of care need to be done., Competing Interests: There are no conflicts of interest., (© 2022 Published by Scientific Scholar on behalf of Indian Journal of Palliative Care.)

The abysmal health of the urban poor or slum dwellers was attributed to structural inequities such as inadequate housing, water, and sanitation. This review aimed to assess housing-related opportunities and challenges during the COVID-19 pandemic among urban poor in low-and middle-income countries. For study identification, a comprehensive search was performed in 11 databases that yielded 22 potential studies. The inadequate housing infrastructure makes the lives of the urban poor more precarious during COVID-19. Typically, the houses lacked lighting, ventilation, and overcrowding. This review reflected that it is crucial to reimagine housing policy for the urban poor with an emphasis on pandemic/epidemic guidelines., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Dubey, Sahoo, Dash, Sahay, Mahapatra, Bhattacharya, Barrio and Pati.)

Inadequate water, sanitation, and hygiene (WASH) among urban poor women is a major urban policy concern in low- and middle-income countries (LMICs). There was a paucity of systematic information on WASH among the urban poor during the pandemic. We reviewed the opportunities and challenges faced by the urban poor in LMICs during the COVID-19 pandemic. We used the PRISMA guidelines to conduct a comprehensive search of 11 databases, including MEDLINE, Embase, Web of Science, and CINAHL, between November 2019 and August 2021. We used thematic analysis to synthesize the qualitative data and meta-analyses to estimate the pooled prevalence. We screened 5008 records, conducted a full-text review of 153 studies, and included 38 studies. The pooled prevalence of shared water points was 0.71 (95% CI 0.37-0.97), non-adherence to hygiene practices was 0.15 (95% CI 0.08-0.24), non-adherence to face masks was 0.27 (95% CI 0.0-0.81), and access to shared community toilets was 0.59 (95% CI 0.11-1.00). Insufficient facilities caused crowding and long waiting times at shared facilities, making physical distancing challenging. Women reported difficulty in maintaining privacy for sanitation, as men were present due to the stay-at-home rule. Due to unaffordability, women reported using cloth instead of sanitary pads and scarves instead of masks.

The present article deals with the theoretical study on electrophoresis of hydrophobic and dielectric spherical fluid droplets possessing uniform surface charge density. Unlike the ideally polarizable liquid droplet bearing constant surface ζ-potential, the tangential component of the Maxwell stress is nonzero for dielectric fluid droplets with uniform surface charge density. We consider the continuity of the tangential component of total stress (sum of the hydrodynamic and Maxwell stresses) and jump in dielectric displacement along the droplet-to-electrolyte interface. The typical situation is considered here for which the interfacial tension of the fluid droplet is sufficiently high so that the droplet retains its spherical shape during its motion. The present theory can be applied to nanoemulsions, hydrophobic oil droplets, gas bubbles, droplets of immiscible liquid suspended in aqueous medium, etc. Based on weak field and low charge assumptions and neglecting the Marangoni effect, the resultant electrokinetic equations are solved using linear perturbation analysis to derive the closed form expression for electrophoretic mobility applicable for the entire range of Debye-Hückel parameter. We further deduced an alternate approximate expression for electrophoretic mobility without involving exponential integrals. Besides, we have derived analytical results for mobility pertaining to various limiting cases. The results are further illustrated to show the impact of pertinent parameters on the overall electrophoretic mobility.

Background: Accurate restoration of joint line height and posterior offset in primary Total Knee Arthroplasty (TKA) have been shown to be important factors in post-operative range of movement and function. The aim of this study was to assess the accuracy of joint line and posterior offset restoration in a group of patients that underwent robotic-assisted TKA (raTKA). A matched cohort of patients that underwent a TKA using a conventional jig-based technique was assessed for comparison. The null hypothesis was that there would be no difference between groups., Methods: This study was a retrospective analysis of a cohort of 120 patients with end-stage knee osteoarthritis that received a TKA using the Navio Surgical System (n = 60), or Conventional manual TKA (n = 60). Procedures were performed between 1 January 2019 and 1 October 2019 at six different centres. Joint line height and posterior offset was measured pre-operatively and post-operatively on calibrated weight bearing plain radiographs of the knee. Two observers performed measurements using validated measuring tools. A BMI and age-matched cohort of patients that underwent TKA using a conventional technique in the same six centres were assessed for comparison. Mean values, standard deviations and confidence intervals are presented for change and absolute change in joint line height and posterior offset. Student's t-test was used to compare the changes between techniques., Results: Patients that underwent robotic-assisted TKA had joint line height and posterior offset restored more accurately than patients undergoing TKA using a conventional technique. Average change from pre-operative measurement in joint line height using raTKA was -0.38mm [95% CI: -0.79 to 0.03] vs 0.91 [0.14 to 1.68] with the conventional technique. Average absolute change in joint line height using raTKA was 1.96mm [1.74 to 2.18] vs 4.00mm [3.68 to 4.32] with the conventional technique. Average change in posterior offset using raTKA was 0.08mm [-0.40 to 0.56] vs 1.64mm [2.47 to 0.81] with the conventional technique. Average absolute change in posterior offset with raTKA was 2.19mm [1.92 to 2.46] vs 4.24mm [3.79 to 4.69] with the conventional technique. There was a significant difference when comparing absolute change in joint line height and posterior offset between groups (p<0.01)., Conclusion: Robotic-assisted primary TKA restores the joint line height and posterior offset more accurately than conventional jig-based techniques., Competing Interests: AA, PB, ME, SJ, JLV & DN are reimbursed for educational activities by Smith & Nephew. This does not alter our adherence to PLOS ONE policies on sharing data and materials

Background & Objectives: Globally, mental disorders are rising with increasing urbanization. India has the world's second-largest tribal population and it is critical to appreciate the mental health problems in this population. However, the extent of mental health issues among tribal populations is unknown. Against this background, we systematically reviewed community-based studies on mental health issues among tribal populations in India., Methods: Online databases PubMed, Embase, ProQuest databases and Google Scholar were searched and articles published between January 1990 and May 2021 including primary community-based quantitative observational studies focused exclusively on tribal population were retrieved. PRISMA guidelines were followed and this review was registered on PROSPERO (CRD42020178099)., Results: A total of 935 articles were identified, of which 63 were selected for full-text review, and finally, 11 studies were included. Seven studies examined alcohol use disorder with a pooled prevalence of 40 per cent. Two studies reported on suicidal attempts. A few studies mentioned anxiety, depression and other mental health conditions., Interpretation & Conclusions: : This systematic review established that a few community-based primary studies were conducted on mental health issues among tribal populations over the last three decades. Among these, fewer studies focused exclusively on tribal communities. The studies differed in their study design and the tools used. The findings of these investigations highlighted a limited range of mental health issues, primarily alcoholism, anxiety, depression and suicide.

Endometriosis is a benign gynecological condition characterized by increased growth, inflammation, invasion, and angiogenesis, partly regulated by a class of enzymes called matrix metalloproteinases (MMPs). The importance of a few MMPs, e.g., MMP-9, -3, and -7 has been studied in endometriosis progression. Although MMP-13 plays an essential role in bone regeneration and cancer, no report has been found on the part of MMP-13 and endometriosis progression. We found the upregulation of MMP-13 expression and activity in patients having endometriosis in the eastern Indian population. In addition, the -77A/G polymorphism of the MMP13 promoter (rs: 2252070) is associated with regulating transcription and subsequent susceptibility to disease. In eastern Indian case-control groups, the effect of the -77A/G single-nucleotide polymorphism on MMP13 promoter activity and its relationship with endometriosis susceptibility was studied. The AG genotype was shown to be more predisposed to endometriosis risk than the GG genotype (p: 0.02; odds ratio [OR]: 1.65, 95% confidence interval [CI]: 1.10-2.49), also AG genotype was more frequent in late-stage patients compared to early-stage (p: 0.03, OR: 2.0, 95% CI: 1.09-3.66). Furthermore, the MMP13 gene levels were greater in AA compared to GG individuals. Additionally, MMP13 promoter-reporter experiments in cultured endometrial epithelial cells and in silico analyses both demonstrated increased transcriptional activity near the G to A transition under basal/IL-1β -induced/c-FOS overexpressed condition. Overall, c-FOS tighter binding to the A allele-carrying promoter enhances MMP13 transcription, which is further amplified by IL-1β due to increased c-FOS phosphorylation, promoting MMP-13 production and endometriosis risk., (© 2022 Wiley Periodicals LLC.)

Background: There is limited evidence on technology addiction among adolescents in low- and middle-income countries where 90% of global adolescents live. We aimed to investigate the prevalence and correlates of technology addiction (Internet, gaming, smartphone, television) among school-going adolescents in India., Methods: A cross-sectional survey covering the entire district (administrative unit for health) of India was conducted among representative sample of school-going adolescents using stratified cluster sampling. A total of 1729 adolescents completed the survey (age M = 12.58; SD = 0.97) by responding to Internet Addiction Test-Adolescents, Game Addiction Scale, Smartphone Addiction Scale and Television Addiction Scale. Associated factors were analyzed using binomial logistic regression analysis., Results: Almost all the participants (99.59%; 95% confidence interval (CI): 99.28-99.91%) were using technology in one or other form. Prevalence of technology addiction among the users was 10.69% (95% CI: 5.26-16.11%). Phone addiction (8.91%; 95% CI: 3.31-14.52%) was the most common type followed by gaming addiction (2.55%; 95% CI: 1.16-3.95%). Technology addiction among adolescents was significantly associated with several risk factors at individual, family and school levels., Conclusion: Technology addiction emerges as an important public health problem among adolescents in India. An integrated socio-ecological framework with multi-level approach that targets risk factors at various levels is required to promote healthy behaviors towards technology., (© The Author(s) 2021. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Problem Considered: Medical students are vulnerable to poor sleep quality which may lead to attention difficulties and poor academic performance. Good quality sleep is needed for optimal neurocognitive and psychomotor functions as well as physical and mental health. This study aimed to assess the prevalence of poor sleep quality among undergraduate medical students during home confinement at the time of Covid-19 pandemic and analyze the relationship between sleep quality and relevant socio-demographic and psychological variables., Methods: A cross-sectional study was conducted among 284 undergraduate medical students of a teaching hospital of Bhubaneswar from October-November 2020. Using a semi-structured questionnaire, relevant information was collected. Sleep quality of the students was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire and mental health status of the students using Depression, Anxiety, and Stress Scale - 21 (DASS-21)., Results: The prevalence of poor sleep quality among undergraduate medical students was 45%. Multivariate logistic regression revealed that students doing exercise for <3 days/week (AOR: 1.81, 95% CI: 1.01-3.23), spending ≥8 h screen time/day (AOR: 2.02, 95%: 1.12-3.66), having anxiety symptoms (AOR: 3.61, 95% CI: 1.72-7.57), and those who were not satisfied with own self (AOR: 2.69, 95% CI: 1.35-5.38) were more likely to report poor sleep quality., Conclusion: Poor sleep quality was prevalent among undergraduate medical students during their home confinement at the time of Covid-19 pandemic. Sleep educational programs, anxiety management, and lifestyle modifications can be recommended to improve sleep quality among medical students., Competing Interests: All the authors hereby declare that they have no conflicts of interest., (© 2022 The Authors.)

Background: The study aims to identify recurrent multimorbidity pattern among individuals in the age-group 15-64 years. Further, the study examines the association of these identified patterns with sociodemographic variables and selected health outcomes., Methods: The study utilized data on 2912 individuals in the age-group 15-64 years collected under the burden of diseases study among patients attending public health care settings of Odisha. A latent class analysis was used to identify commonly occurring disease clusters., Results: The findings suggested that 2.4% of the individuals were multimorbid. Two latent disease clusters were identified, low co-morbidity and Hypertension-Diabetes-Arthritis. Findings highlighted that age, belonging to a non-aboriginal ethnicity and urban area increased the risk of being in the 'Hypertension-Diabetes-Arthritis' group. Furthermore, 50% of the individual in the 'Hypertension-Diabetes-Arthritis' group reported poor quality of life, whereas 30% reported poor self-rated health compared to only 11% by their counterparts. Additionally, the mean health score reported by the individuals in the 'Hypertension-Diabetes-Arthritis' group was 39.9 compared to 46.9 by their counterparts., Conclusions: The study findings hint towards increasing burden of multimorbidity among the working age population, which depicts a shift in causation of diseases as a result of which preventive measures also need to be taken much prior., Competing Interests: Conflict of interest statement The authors declare that they gave no competing interests., (©2022 Pacini Editore SRL, Pisa, Italy.)

Liquid spreading on open surfaces is a widely observed phenomenon. The physics of liquid spreading has become more complex when the surface is porous like paper or fabrics due to the evaporation of the liquid and swelling of the fibers. In this study, we have performed liquid imbibition experiments on paper strips in a controlled environment with and without using hydrophobic boundaries. The experimental results are compared to the existing analytical models that account for each effect separately. The existing models were found to be inaccurate in predicting the experimental results. We developed new analytical models by modifying existing models to predict the capillary rise of the liquid through the paper substrate accurately. Different effects, such as the barrier (hydrophobic boundary), evaporation, and swelling, are considered simultaneously while developing the modified models to mimic the exact practical situation for the first time. We discovered that the modified models predict the experimental results more accurately than the existing models. For cases with and without barriers, the final models considering several effects simultaneously predict the data with a maximum error range of 7 and 10%, respectively. Finally, we conducted capillary rise experiments with volatile (water) and non-volatile (silicon oil) liquids at various temperatures and under various relative humidity conditions to validate the analytical results.

Background: Currently, inequality in life expectancy across gender makes women outlive men. Adult women transit towards menopause around midlife accompanied by a series of natural physiological changes leading to several conditions such as osteoporosis, depression, and urinary incontinence, which puts them at a higher risk of having multimorbidity. Multimorbidity is often associated with poorer quality of life, leading to deteriorated work productivity and associated economic loss in midlife. Hence, this study aimed to determine the magnitude and correlates of early onset of multimorbidity and explore its linkages with health-related quality of life (HRQoL) among middle-aged women in India., Methods: We have utilized data from the first round of the Longitudinal Ageing Study in India, 2017-19. We included women aged 45-65 years (n = 23,951) for analysis. Descriptive data were presented. An ordered logistic regression was conducted and proportional odds were reported to identify the correlates of multimorbidity. To explore the linkages between multimorbidity and selected indicators of HRQoL, an array of regression models were executed., Results: Multimorbidity was reported amongst 29.8% of women in midlife. Chandigarh (PR-54.8 PER 100 women) and Punjab (PR-52.8 per 100 women) reported the highest prevalence of multimorbidity. Women with multimorbidity reported compromised HRQoL indicators such as self-rated health, work-limiting health conditions, mobility, and activities of daily living., Conclusions: Multimorbidity is increasingly prevalent in midlife women associated with inferior quality of life. The reproductive health programs for women should consist of midlife women focusing on multimorbidity and overall well-being., (© 2022. The Author(s).)

Background: Virtual fracture clinics (VFCs) have become widely adopted, aiming to improve efficiency, standardise patient care and reduce clinic appointments for injuries that can be managed conservatively. A variety of means exist to manage VFC referrals and assessment, including paper-based and digital methods. This study assesses VFC referral quality and outcomes before and after implementation of a digital VFC referral and management system., Methods: A retrospective analysis was conducted of all VFC referrals and assessments from July 2017-March 2020 in a large UK district general hospital. All referrals and assessments were analysed for quality and completeness of referral information, grade of assessor, outcome of assessment, referral-to-assessment time, and assessment-to-surgery time (for those requiring operative management)., Results: 3038 paper and 9,228 digital referrals were analysed by 2 separate reviewers. Quality and completeness of referral information showed significant improvement in 11 predetermined key data points with the digital referral system (p < 0.001). Date and mechanism of injury were the most commonly missing data criteria (67.5% and 68.2%, respectively) with paper referrals. Significant improvements were noted in the proportion of Consultant delivered VFC assessments (84.2% vs 71.0%; p < 0.001), VFC discharge rate (20.8% vs 13.1%; p < 0.001) and patients recalled for urgent review (6.2% vs 0.8%; p < 0.001) with digital referrals. Mean referral-to-assessment (31.2 vs 49.9 h; p < 0.001) and assessment-to-surgery (9.2 vs 13.0 days; p = 0.01) times also reduced significantly with referral digitisation., Conclusion: Improvements in virtual referral quality and completeness directly lead to facilitation of more thorough, detailed and appropriate virtual assessments; improving timely decision-making, reducing unnecessary appointments, and permitting better prioritisation of workload and earlier surgery for patients requiring operative treatment. Purpose-built digital solutions are an excellent means of achieving these aims., (© 2021. Crown.)

Oxidative stress that damages cellular components affects various organs including the brain. It is thus believed to play an active role in neurodegenerative diseases, wherein the intrinsic antioxidant enzymes metabolize toxic intermediates. For therapeutic purpose, instead of antioxidant enzymes, small organic compounds as antioxidants may be more effective. Here, reducing power and electrochemical behavior of some flavanols, flavanonols, flavones, flavonols and O-methylated flavonols have been estimated and confirmed by the calculated bond dissociation energy. Compared to other classes, flavonols exhibited increased reducing power that decreased with methylation of the oxygen atom in the B-ring. Gossypetin emerged as the most effective of these flavonols. Generally, compounds with two hydroxyl groups in two consecutive positions of the phenyl ring and an enolic group in the C-ring with more preference for the hydroxyl group in the ortho position with respect to each other in the catechol moiety showed major activity. 5 position of the A-ring showed the least effect on the activity. The present understanding therefore may be applied for identifying compounds to be used as scaffold for designing potent antioxidants., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Depression is a commonly prevailing condition that goes undetected in clinical settings. Both abdominal obesity and periodontal disease have a bearing on mental health and have an impact on the quality of life., Objective: To assess the level of clinical depression in abdominally obese subjects with periodontal disease., Methods: Two hundred and ten subjects with a mean age of 37.45 ± 9.59 years (males = 117; females = 93) were grouped as per their abdominal obesity and periodontal status and assessed for their clinical depression levels (mental health) using the Centre for Epidemiologic Studies-Depression Scale (CES-D). Collected data were analysed., Results: The clinical depression score significantly varied in subjects with different periodontal status in both non-obese (F (2,102) = 113.66, P < 0.0001) and abdominally obese subjects (F (2,102) = 132.04, P < 0.001). Significantly higher depression score was demonstrated in healthy (P < 0.001), gingivitis (P < 0.001), and periodontitis (P < 0.001) groups in abdominally obese subjects., Conclusion: Clinical depression is significantly associated with abdominal obesity and periodontal disease in subjects with abdominal obesity and severe periodontal disease demonstrating higher depression scores., Competing Interests: None

Objectives: Studies that examined the growth during late childhood and early adolescence beyond 8 years of age are very limited. Further, most studies have used dichotomized classification of stunting, thereby limiting the understanding of moderate stunting in childhood growth trajectory. We aimed to examine the course of stunting from childhood to adolescence by undertaking robust analyses of the Young Lives Survey (YLS) longitudinal data from India using multilevel categorization of stunting., Study Design: Retrospective cohort analysis was undertaken from YLS in India among 1827 children from the younger cohort born in 2001-02 with complete follow-up data in all five rounds of YLS collected in 2002, 2006, 2009, 2013, and 2016., Methods: A three-state multistate Markov model (not stunted, moderate, severe) was performed to estimate annual transition probabilities, mean sojourn-time, and transition-specific risk factors., Results: Between Round-one and Round-five, cross-sectional prevalence of severe stunting decreased from 10.4% (95% confidence interval [CI]: 7.8%, 13.7%) to 5.3% (95% CI: 3.8%, 7.3%), while moderate stunting increased from 19.9% (95% CI: 16.3%,23.9%) to 21.7% (95% CI: 18.4%, 24.9%). Mean Sojourn time estimation indicated a relatively concise state for moderate stunting. The stunting trajectory had shown gender differential where more faltering to severe stunting and lower recovery to the normal state was observed among girls between 8 and 12 years and among boys between 12 and 15 years. Compared with boys, girls had 40% excess likelihood (Hazard Ratio: 1.40; 95% CI 1.00 to 1.95) for moderate-to-severe stunting transition and also had 19% excess likelihood (Hazard Ratio: 1.19; 95% CI 1.01 to 1.40) of favorable transition (moderate-to-non-stunted)., Conclusions: The transition trajectory highlights preadolescence, especially among girls, as an additional window of opportunity to ensure better nutrition in adolescent life. With a fifth of adolescents living in India, study findings call for coordinated, multisectoral, age-appropriate, and gender-responsive approach to take India closer to meeting SDG-2., (Copyright © 2021 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Background: The purpose of this study was to compare total blood loss and the risk of receiving a blood transfusion in robotic-assisted total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) against conventional jig-based techniques., Methods: Robotic TKA (n = 50) and UKA (n = 50) patients were matched to contemporary controls for TKA (n = 50) and UKA (n = 50) and retrospectively analysed., Results: Robotic TKA patients experienced 23.7% less blood loss compared to conventional TKA patients (911.0 ml vs 1193.7 ml, p < 0.01), and were associated with an 83% relative risk reduction of receiving a transfusion (2% of patients vs 12%, p = 0.02). Robotic UKA patients did not demonstrate less blood loss compared to corresponding controls (821.7 ml vs 854.7 ml, p = 0.69). Both UKA groups received no transfusions., Conclusions: Robotic surgical systems in TKA reduces blood loss and lowers the risk of requiring a blood transfusion. In UKA, robotic-assisted arthroplasty did not reduce blood loss compared to conventional arthroplasty., (© 2021 John Wiley & Sons Ltd.)

Vapor condensation is a well-known phase-change phenomenon observed in nature as well as in different industrial applications. Superhydrophobic surfaces (SHSs) with low hysteresis can efficiently drain off the condensate and rejuvenate the nucleation sites further. In this work, three distinct SHSs were fabricated by nanocoating three hydrophobic agents, viz., perfluoro-octyl-triethoxy-silane (PFOTS), perfluoro-octanoic-acid (PFOA), and commercial Glaco solution on a hierarchical aluminum surface. The surface morphology of all surfaces was investigated, and its effects on the wetting, droplet departure, and overall heat-transfer coefficient (HTC) during condensation phenomena in the humid air (>95% noncondensable gases) were analyzed. The contact angle hysteresis of all three surfaces was very low (∼5°); however, different wetting behaviors were observed during the condensation, depending on the adhesion of the condensate drop with nanoscale textures in the microcavities. Dropwise condensation (DWC) was observed in silane and Glaco-coated surfaces. A gravity-assisted sweeping mechanism removed the condensate from the silane-coated surface. In contrast, the condensate was ejected out of the plane of the Glaco-coated surface by droplet jumping. The PFOA-coated surface has shown DWC initially and floods in the later stages due to highly pinned condensed droplets. This study reports an enhancement of ∼35 to ∼110% in the HTC for the SHS-exhibiting gravity-assisted sweeping mechanism compared to the droplet-jumping mechanism. The present work will provide substantial insights into the fabrication of efficient hierarchical interfaces for water-energy nexus applications.

Background: There is an increasing need for Mental Health Promotion (MHP) among adolescents, especially in developing countries with limited resources and rapid socio-demographic transition. With the growing burden of mental health problems among adolescents (suicide, depression) and their preferences to seek help from their peers, improving Mental Health Literacy (MHL) and behaviours for First Aid in Mental Health (MH-FA) becomes crucial to promote their mental health., Methods: Schools are ideal settings for reaching the vulnerable adolescents. The proposed study evaluates the effectiveness of a classroom-based teacher-led integrated school mental health intervention called SUMS (MHP + MHL + MH-FA). The study will involve a pragmatic, cluster-randomised waitlist-controlled design to evaluate the effectiveness of SUMS intervention using schools as unit-of-randomisation. The study will be conducted in Srinivaspura taluka (Sub-district) of Kolar district (administrative unit of health) of Karnataka in collaboration with a multi-disciplinary expert team from NIMHANS (National Institute of Mental Health And Neuro Sciences), Bangalore-India and Department of Education, Government of Karnataka, India. A total of 8 schools (400 students studying in 6-8 grade) from Srinivaspura taluka will be randomised into intervention and waitlist control group. The intervention group will receive SUMS intervention through 10-15 h of classroom sessions. The primary outcome is the improvement in positive mental health literacy, as measured by the Mental Health-Promoting Knowledge (MHPK-10) scale. Changes in MH-FA knowledge and intentions, Mental health stigma, help-seeking and resilience are assessed as secondary outcomes. Data will be collected at baseline, 6-weeks, 6-months and 12-months post-intervention. The waitlist-control schools will receive the interventions at the end of the 12-month follow-up assessment in intervention-schools., Discussion: This is the first study to integrate Mental Health Literacy with Mental Health Promotion and behaviours for First Aid in Mental Health to promote mental health well-being among adolescent school children in India. With a need to build a more substantial evidence base on School Mental Health Promotion approaches in developing countries, the study findings will have implications for implementing and operationalising Health and Wellness Ambassador initiative in India., Trial Registration: Clinical Trials Registry - India, CTRI/2019/07/020394. Registered prospectively on 29 July 2019. ( ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=35724&EncHid=&userName=sums )., (© 2021. The Author(s).)