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Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society.

We report an extremely rare case of mesocardia with double inferior vena cava (IVC) in this case report. The patient’s associated atrial septal defect (ASD) with left to right shunt leading to pulmonary congestion and recurrent episodes of pneumonia was the leading diagnosis for which care was sought at our hospital. The diagnoses of these rare congenital cardiac anomalies were uncovered only after a thorough workup. Mesocardia is extremely rare and accounts for only 0.2% of congenital anomalies. Its association with other cardiac and vascular anomalies, however, warrants a meticulous workup for the identification of such associated conditions—ASD and double IVC being two such anomalies in our patient. The dictum of working up a case of congenital cardiac anomaly for other congenital cardiaovascular anomalies, therefore, found merit in our case.

Medicinal plants are used from prehistoric time to cure various life-threatening bacterial diseases. Acorus calamus is an important medicinal plant widely used to cure gastrointestinal, respiratory, kidney and liver disorders. The objective of the current research was to investigate the interaction of major phytoconstituents of Acorus calamus with bacterial (6VJE) and fungal (1EA1) protein targets. Protein-ligand interactions were estimated using the AutoDock software, drug likeness was predicted by using the molinspiration server and toxicity was predicted with the swissADME and protox II servers. MD simulation of phytocompounds with the best profiles was done on the GROMACS software for 100 ns. Molecular docking results showed among all the selected major phytoconstituents, that β-cadinene showed best binding interaction in complex with bacterial (6VJE) and fungal (1EA1) protein targets with binding energy −7.66 ± 0.1 and −7.73 ± 0.15 kcal mol−1, respectively. Drug likeness and toxicity predictions showed that β-cadinene follows all rules of drug likeness and toxicity. MD simulation study revealed that β-cadinene fit in binding pocket of bacterial and fungal targets and found to be stable throughout the duration of the simulation. Based on the observations from this in-silico study it is being proposed that β-cadinene, a major phytocompound of Acorus calamus, can be considered for the treatment of bacterial and fungal infections since the study shows that it might be one of the compounds that contributes majorly to the plant’s biological activity. This study needs in vitro and in vivo validation. Communicated by Ramaswamy H. Sarma

Background: Bone growth is the vital process that continues throughout the life of living beings. Several pollutants may cause poorer ossification and bone formation. Vertebral ossification is directly correlated to growth, strength and spinal stability therefore the determination of ossification pattern in vertebral column is important to evaluate the bone formation. Bio-accumulation of lead in the body has been known to cause the adverse effects on the bone development through the disruption of mineralization. Methods: The present study was designed to evaluate the impact of lead exposure on the embryonic ossification in mice during development. For this study 28 pregnant female mice were selected and treated with the lead (as lead acetate 0.5 ppm) for 14 and 21 days periods. At the end of the treatment periods pregnant mice were sacrificed and embryos were excised and processed for further analysis. Results: Present study revealed damaged and ruptured spinal ossification center with premature chondrocytes present in lyzed condition in lead treated group compared to control. Conclusions: It is concluded that lead exposure induced bone toxicity that has deteriorated the spinal ossification in the growing mice.

Adults with distal renal tubular acidosis (dRTA) commonly present with hypokalaemia (with/without paralysis), nephrolithiasis/nephrocalcinosis and vague musculoskeletal symptoms. All adults with dRTA should be thoroughly evaluated for systemic diseases, certain medications and toxins. The leading cause of acquired or secondary dRTA in adults is primary Sjögren syndrome (SS); however, other collagen vascular diseases (CVDs) including seronegative spondyloarthropathy (SSpA) may at times give rise to secondary dRTA. Metabolic bone disease is often encountered in adults with dRTA, and the list includes osteomalacia and secondary osteoporosis; sclerotic metabolic bone disease is an extremely rare manifestation of dRTA. Coexistence of dRTA and sclerotic bone disease is seen in primary dRTA due to mutation in CA2 gene and acquired dRTA secondary to systemic fluorosis. Primary SS and SSpA, rarely if ever, may also lead to both secondary dRTA and osteosclerosis. Circulating autoantibodies against carbonic anhydrase II and possibly calcium sensing receptor may explain both these features in patients with CVD.

Background: Controlled drug release and site-specific delivery of drugs make nanocapsules the most approbative drug delivery system for various kinds of drugs, bioactive, protein, and peptide compounds. Nanocapsules (NCs) are spherical shape microscopic shells consisting of a core (solid or liquid) in which the drug is positioned in a cavity enclosed by a distinctive polymeric membrane. Objectives: The main objective of the present study is to elaborate on various formulation techniques and methods of nanocapsules (NCs). The review also spotlights various biomedical applications as well as on the patents of NCs till date. Methods: The review was extracted from the searches performed using various search engines such as PubMed, Google Patents, Medline, and Google Scholars, etc. In order to emphasize the importance of NCs, some published patents of NCs have been also reported in the review. Results: NCs are tiny magical shells having incredible reproducibility. Various techniques can be used to formulate NCs. The pharmaceutical performance of the formulated NCs can be judged by evaluating their shape, size, entrapment efficiency, loading capacity, etc. using different analytical techniques. Their main applications are found in the field of agrochemicals, genetic manipulation, cosmetics, hygiene items, strategic distribution of drugs to tumors, nanocapsule bandages to combat infection, and radiotherapy. Conclusion: In the present review, our team made a deliberate effort to summarize the recent advances in the field of NCs and focus on new patents related to the implementation of NCs delivery systems in the area of some life-threatening disorders like diabetes, cancer, and cardiovascular diseases.

ObjectivesThe aim was to study the red cell distribution width (RDW) and neutrophil-lymphocyte ratio (NLR) as inflammatory markers and their correlation with clinical disease activity parameters in patients with rheumatoid arthritis (RA).Material and methodsThis observational cross-sectional study included 100 randomly selected patients with RA. Disease Activity Score with 28-joint counts and erythrocyte sedimentation rate (DAS28–ESR) was taken as a marker of disease activity. The diagnostic value of NLR and RDW in RA was assessed.ResultsThe majority (51%) of cases showed mild disease activity. The mean NLR in cases was 3.88 ±2.59. Mean RDW was 16.25 ±2.49%. Neutrophil-lymphocyte ratio significantly correlated with ESR (p = 0.026), severity of pain (p = 0.013), osteoporosis (p = 0.014) and radiographic joint erosions (p = 0.048), but not with DAS28–ESR (p > 0.05) and C-reactive protein (CRP) (p > 0.05). Red cell distri-bution width showed a significant correlation only with NLR (p = 0.009). The positive predictive values of NLR and RDW for disease activity were 93.3% and 90% and the negative predictive values were 20% and 16.7% respectively. For NLR, the area under the curve (AUC) was 0.78 (p = 0.001) and at a cut-off value of 1.63, the diagnostic sensitivity was 97.7% and specificity 50%. For RDW, the AUC was 0.43 (p = 0.40) and at a cut-off value of 14.52, the diagnostic sensitivity was 70.5% and specificity 41.7%. The sensitivity and specificity of NLR were higher than those of RDW. A significant difference was seen between the AUC of NLR and RDW (p = 0.02).ConclusionsNeutrophil-lymphocyte ratio is a valuable inflammatory marker in patients with RA, but RDW is not useful in this regard.

Abstract: The majority of drugs taken orally have limited aqueous solubility and dissolution rate. Cyclodextrin (CD) and its derivatives are used as pharmaceutical adjuvants, contributing to the development of safe and high bioavailability formulations. CDs have a unique structure with a variety of physicochemical features that aid pharmaceutical scientists in solving drug delivery issues for poorly water-soluble drugs (PWS). This article covers information about cyclodextrin and its various derivatives, its different manufacturing process, physicochemical properties, advantages, and recent advancements. There are various advantages of CD-based inclusion complexes, such as enhancement of solubility, bioavailability, and stability and reduction of irritation caused by the drug. Moreover, they are used as odor and taste enhancers and also prevent incompatibility by physically isolating the incompatible drug components in drug formulation. CD and its derivatives are extensively employed as solubilizers in the manufacturing of parenteral and oral dosage forms. Inclusion complexes formed by CDs with appropriately sized guest molecules improve drug water solubility, physical-chemical stability, and bioavailability. Simultaneously CDs prevent the drugs from degradation like oxidation, hydrolysis, and photodegradation and extend the shelf life of the drug. The manuscript also highlights patents and exclusive branded formulations of modified CDs. It also discusses the different examples of chemically modified CDs, i.e., captisol, sulfobutyl ether-β-CD, hydroxy propyl betadex, randomly methylated β-CD, methyl β-CD, and hydoxy propyl γ-CD, all are used in the various dosage forms.

Objectives: The aim of the study is to evaluate the antidepressant activity of the ethanolic extract of the leaves of Moringa oleifera L. (EEMO) on albino mice. Methods: The anti-depressant activity was evaluated using forced swimming test (FST) and tail suspension test (TST). Healthy albino mice were individually forced to swim inside a vertical glass cylinder. Climbing, swimming, and immobility were tested and recorded. In TST, mice were suspended on a string held by a metal stand, and immobility time was recorded. Results: In both FST and TST, it was seen that immobility time decreased with increase in the dose of EEMO. Conclusion: Ethanolic extract of M. oleifera possess anti-depressant activity in a dose dependent manner.

Aim: Influenza A virus (IAV) causes serious illness and is responsible for significant morbidity and mortality. To diagnose IAV infection in its early stages, a quick, sensitive, precise detection method is needed for effective clinical management. Materials & methods: In-house hydroxylnaphthol blue (HNB)-based RT-LAMP assay for early detection of IAV using the HA gene was compared with RT-PCR/multiplex-RT-PCR. Results: For the reference strains of IAV, (H1N1 (A/Texas/50/2012) and H3N2 (A/Malaysia/2089302/2009)) RT-LAMP and RT-PCR/M-RT-PCR exhibited a limit of detection of 10 and 100 fg/ml, respectively. Conclusion: HNB-based RT-LAMP is a rapid, sensitive, cost-effective diagnostic tool, and could be a point-of-care test for IAV patients during outbreaks.

The ongoing pandemic caused by the novel coronavirus, SARS-CoV-2, is influencing global health. Moreover, there is a major threat of future coronaviruses affecting the entire world in a similar, or even more dreadful, manner. Therefore, effective and biocompatible therapeutic options against coronaviruses are urgently needed. To address this challenge, medical specialists require a well-informed and safe approach to treating human coronaviruses (HCoVs). Herein, an environmental friendly approach for viral inactivation, based on plasma technology, was considered. A microwave plasma system was employed for the generation of the high amount of gaseous nitric oxide to prepare nitric oxide enriched plasma-activated water (NO-PAW), the effects of which on coronaviruses, have not been reported to date. To determine these effects, alpha-HCoV-229E was used in an experimental model. We found that NO-PAW treatment effectively inhibited coronavirus infection in host lung cells, visualized by evaluating the cytopathic effect and expression level of spike proteins. Interestingly, NO-PAW showed minimal toxicity towards lung host cells, suggesting its potential for therapeutic application. Moreover, this new approach resulted in viral inactivation and greatly improved the gene levels involved in host antiviral responses. Together, our findings provide evidence of an initiation point for further progress toward the clinical development of antiviral treatments, including such coronaviruses.

Outbreaks of airborne viral infections, such as COVID-19, can cause panic regarding other severe respiratory syndrome diseases that may develop and affect public health. It is therefore necessary to develop control methods that offer protection against such viruses.To identify a feasible solution for virus deactivation, we critically reviewed methods of generating reactive oxygen species (ROS), which can attack a wide range of molecular targets to induce antiviral activity, accounting for their flexibility in facilitating host defense mechanisms against a comprehensive range of pathogens. Recently, the role of ROS in microbial decontamination has been critically investigated as a major topic in infectious diseases. ROS can eradicate pathogens directly by inducing oxidative stress or indirectly by promoting pathogen removal through numerous non-oxidative mechanisms, including autophagy, T-cell responses, and pattern recognition receptor signaling.In this article, we reviewed possible methods for the in vitro generation of ROS with antiviral activity. Furthermore, we discuss, in detail, the novel and environmentally friendly cold plasma delivery system in the destruction of viruses. This review highlights the potential of ROS as therapeutic mediators to modernize current techniques and improvement on the efficiency of inactivating SARS-CoV2 and other viruses.

For optimal decision making and collaborative task performance in multispacecraft missions, it is essential for each spacecraft to maintain a state estimate of all the spacecraft in the formation. However, especially in the case of large formation sizes, each spacecraft may not be able to track or communicate with all other spacecraft. Further, for formations deployed in deep space, the unavailability of the Global Navigation Satellite System makes inertial state estimation challenging. We propose the Distributed Absolute and Relative Estimation (DARE) algorithm for autonomous inertial estimation of spacecraft formations. The algorithm enables each spacecraft to maintain an accurate inertial estimate of the entire formation even in the presence of observability and communication constraints. Each spacecraft utilizes measurements of feature points (landmarks) for inertial localization and measurements of neighboring spacecraft for relative localization. The algorithm is distributed and scalable to any number of spacecraft in the formation. A modified version of the algorithm called the Sparse Distributed Absolute and Relative Estimation (SDARE) algorithm is also derived. This algorithm is computationally more efficient at the expense of estimation accuracy, making it suitable for implementation on nanosatellites where resources are limited. Numerical simulation results demonstrating the effectiveness and comparing the performance of both algorithms are provided.

Background: Cancer is a leading cause of death for people worldwide, in addition to the rise in mortality rates attributed to the Covid epidemic. This allows scientists to do additional research. Here, we have selected Integerrimide A, cordy heptapeptide, and Oligotetrapeptide as the three cyclic proteins that will be further studied and investigated in this context. Methods: Docking research was carried out using the protein complexes 1FKB and 1YET, downloaded from the PDB database and used in the docking investigations. Cyclopeptides have been reported to bind molecularly to human HSP90 (Heat shock protein) and FK506. It was possible to locate HSP90 in Protein Data Banks 1YET and 1FKB. HSP90 was retrieved from Protein Data Bank 1YET and 1FKB. Based on these findings, it is possible that the anticancer effects of Int A, Cordy, and Oligo substances could be due to their ability to inhibit the mTOR rapamycin binding domain and the HSP90 Geldanamycin binding domain via the mTOR and mTOR chaperone pathways. During the calculation, there were three stages: system development, energy reduction, and molecular dynamics (also known as molecular dynamics). Each of the three compounds demonstrated a binding affinity for mTOR's Rapamycin binding site that ranged from -6.80 to -9.20 Kcal/mol (FKB12). Results: An inhibition constant Ki of 181.05 nM characterized Cordy A with the highest binding affinity (-9.20 Kcal/mol). Among the three tested compounds, Cordy A was selected for MD simulation. HCT116 and B16F10 cell lines were used to test each compound's anticancer efficacy. Doxorubicin was used as a standard drug. The cytotoxic activity of substances Int A, Cordy A, and Oligo on HCT116 cell lines was found to be 77.65 μM, 145.36 μM, and 175.54 μM when compared to Doxorubicin 48.63 μM, similarly utilizing B16F10 cell lines was found to be 68.63 μM, 127.63 μM, and 139.11 μM to Doxorubicin 45.25 μM. Conclusion: Compound Cordy A was more effective than any other cyclic peptides tested in this investigation.

Comparative analysis is conducted between nano fluid (nf) Al_2O_3+ZnO+H_2O and water (H_2O) as base fluid through experimental and simulation result. The effect of nano fluid and (base) fluid flowing inside rectangular micro channel with or without insert were acknowledge, for analysis the behavior of fluid flow, heat transfer and performance characteristics like Nusselt number (Nu), Friction factor (f), Effectiveness (Ɛ), Coefficient of thermal transfer (h), Heat transfer factor (Q), Nu/Nus, f/fs, thermal-performance factor (TPF), Number of transferring unit (NTU) and Reynolds’s number (Re). During preparation of nano fluid 0.01% volume fraction, 10-20 nm size nano particles were taken with 0.5ml CTAB (cetyl-2 tri-methyl, ammonium-bromide) surfactant. Experimentation was conducted for different operating parameters under counter flow conditions, where nano fluid is flowing inside micro channel of 0.081mm diameter with flow rate 0.0001562 kg/sec (9.37 ml/min) to 0.006255 Kg/sec (375.30 ml/min) and hot water is flowing inside the concentric tube of 3cm diameter with flow rate of 0.000782 Kg/sec (46.92 ml/min). The operating temperature of nano fluid and hot water were 303K and 323K. As per obtained results, the proposed composition of nanofluid showed better performance than base fluid due to better thermal conductivity and extra molecular area gain in nanofluid due to addition of nano particle with base fluid. It improves the results 21% approximately. Better optimum results were observed in case of rectangular micro channel with micro insert compared with other geometry because of rich turbulency gain and extra exposed area due to micro insert. It affects optimum results in terms of better performance up to 9%-18% compared with simple micro channel without inserts.

Desert coolers are important in society, especially in arid regions with hot and dry climates. They provide a costeffective and energy-efficient alternative to air conditioners, which can be expensive to operate and maintain. Desert coolers use natural cooling mechanisms such as evaporation to cool the surrounding air, which makes them more environmentally friendly than air conditioners. In this case, the cooling materials being considered are coconut coir, wood wool, and honeycomb mesh. This involves constructing a desert cooler with a removable cooling pad compartment to allow for the insertion and removal of the different cooling materials. Install each of the cooling materials in the cooler one at a time and record the temperature and humidity of the air passing through the cooler over a set period of time. Compare the results obtained from each of the cooling materials to determine which one provides the most effective cooling. Honeycomb has been found to have excellent water absorption and retention capacity, which helps in maintaining a high level of humidity in the air passing through the cooler, resulting in better cooling. Honeycomb mesh, on the other hand, has a large surface area and a complex structure that enhances the evaporation process and improves the cooling efficiency. While wood wool is also a popular cooling material used in desert coolers, its efficiency may not be as high as coconut coir or honeycomb mesh. However, the choice of the most efficient cooling material can also depend on other factors such as availability, cost, and environmental impact. Overall, the selection of the most efficient cooling material for a desert cooler may require careful consideration of several factors.

Data security is an essential component of an organization in order to keep the information safe from various competitors. Cryptography is a technique used to avoid unauthorized access of data. It has two main components- Encryption algorithm and Key. Sometime, multiple keys can also be used for encryption. A number of cryptographic algorithms are available in market such as DES, AES, TDES and RSA. The strength of these encryption algorithms depends upon their key strength. The long key length takes more computing time to crack the code and it becomes difficult for the hacker to detect the cryptographic model. In this paper we suggest an innovation in the age-old conventional cryptographic technique of HILLCIPHER using the concept of self repetitive matrix. A numerical method has been stated, mathematically proved and later implemented in generating a random matrix of given periodicity. The method of self-repetitive matrix has then been used to simulate a communication channel with proper decompression techniques to facilitate bit saving.

Murraya koenigiiis a multipotential medicinal plant. Almost each and every part of the plant has numerous medical applications. Thus, it can be considered as most suitable candidate for new drug discovery. The present review proposes very useful idea for developing significant amount of both genetic and genomic resource forM. koenigii.The transcript data which can be developed using these approaches can be used for both basic and applied aspects inM. koenigiigenetics and breeding.Further, this will be helpful for the discovery and characterization of genes responsive to various medicinal values of the plants and can be further studied and validated. The present review is an attempt which will help to isolate the active principles, as well as to elucidate the role of various interacting phytocompounds which influence therapeutic potential and efficacyin vivo.

The concept presented in this article revolves around the idea of an economically designed UGV (Unmanned Ground Vehicle) for the demining process. Landmine discovery is a critical area of exploration due to the high number of losses and injuries caused by landmines each time. The developed technology generally requires human assistance nearby for landmine detection. Every so often the military bear loss of their equipment specialists. Also, false detection leads to the wastage of resources invested in the technology. Our prime aim is to develop a sturdy design for UGV which require minimum assembly time i.e., “Ready-to-Assemble” concept. This paper outlines the design of a UGV equipped with IR sensor, and metal detector and controlled using Arduino microcontroller. The Arduino microcontrollers are programmed to control the UGV’s movements and the sensor data processing. The UGV is built on a six-wheel drive controlled by two motor drivers, which is equipped with IR sensor to detect the heat signature of buried landmines and a metal detector to detect metallic landmines. The GPS location of the landmine is sent directly to a mobile device using a GSM Module. The UGV is controlled using Bluetooth remotely. The design of the vehicle was performed on Solidworks, CAD software. The software was used to design the chassis, suspension system, and other components such as the metal detector and IR sensor mounts. Proteus software was used to stimulate the electronic circuitry. The UGV has potential applications in detecting and removing landmines safely, minimizing the risk of human casualties. Future work could involve improving the system's accuracy and efficiency to make it a more effective tool for landmine detection and removal.

Cosmetics and personal care products (PCPs) are a few of the most commonly used products across the globe with a whopping market share of approximately USD 500 billion. These products are used for cleansing purposes and for improving the quality and beauty of the face, hair, and skin. There are many chemical substances involved in the manufacturing of cosmetics and PCPs. These chemical substances incorporated in cosmetics or PCPs are crucial to develop high-quality products with superior appearance, applicability, and stability; however, excessive use of such chemicals in cosmetics and PCPs has become a safety concern as many of these are reported to cause severe health complications. Overuse of cosmetics and PCPs with hazardous material should be minimized, especially by pregnant women and children. Gynecologists advise pregnant women not to use cosmetics and PCPs with hazardous chemicals. The implementation of a lawful framework is crucial to establish the safety of cosmetics and PCPs. Cosmetic companies/industries must be strictly regulated and made compliant to the guidelines in order to protect human health and minimize safety concerns. In this review, hazardous chemicals incorporated in the personal care products/cosmetics and their related risk and health complications have been discussed in detail. Additionally, regulatory status and clinical trials of chemical substances that involve toxicity and causing severe complications have also been discussed.

BACKGROUND: The COVID-19 pandemic and resultant lockdown has increased the burden of unpaid care work. Hence it is essential to evaluate the crisis response in change of women’s work burden and gender norms of their unpaid care work and social status. OBJECTIVE: To investigate change in women’s job roles after second the wave of the COVID-19 pandemic and its effect on physical and psychological burden of work along with identification of common contributors of gendering of care work. METHOD: Using a structured questionnaire and simple random sampling technique, the study was conducted on married women (n = 691) in West Bengal, India after the second wave of the COVID-19 pandemic. RESULTS: Significant job loss (p = 0.014) occurred during COVID-19. Unpaid care work increased (p = 0.04) with reduction in rest hours (p = 0.002). 62.3% women felt increased burden of work. Work burden score increased with age (p = 0.003), reduction of rest (p

An investigation was carried out at the Experimental Farm, Department of Horticulture, A.A.U., Jorhat during 2021-2022 to study the effect of nano-DAP on quality and soil characteristics of cabbage. The experiment was laid out in Randomised Block Design with thirteen treatments and three replications. The quality and soil characters showed significant differences among the treatments. The maximum compact heads (39.84) were obtained in T3 and among nano-DAP treatments (29.88) in T7. Observations recorded at harvesting stage showed highest number of wrapper and non-wrapper leaves at T12 (16.80) and T3 (31.93). Leaf chlorophyll content was maximum in T11 (1.36 mg/g fw), T5 (1.65 mg/g fw) and T7 (1.66 mg/g fw) at 30, 60 DAT & at harvest. N content in leaves was highest in T10 (3.62%), T3 attained the maximum P (0.46%) and K (3.95%). The maximum available NPK in soil was obtained in T9 (291.03 kg/ha), T13 (20.88 kg/ha) and T4 (95.04 kg/ha). Thus nano-DAP can be a good economic and eco-friendly alternative to conventional inorganic fertilizers, reducing the quantity of application while sustaining the quality of the produce.

Introduction: The novel corona virus (COVID-19), which began in Wuhan, China, in December 2019, has been declared pandemic by the World Health Organization (WHO) on 11th March 2021. Till now, even when nations are in race for developing vaccine against COVID-19, diagnosing the cases and isolating them still remain the only way to contain the disease spread. Hence, effective triage of the suspected COVID 19 patients, becomes an effective tool in preventing disease spread, especially in developing nations. Simple hematological parameters like leukocyte counts, platelet counts, hemoglobin and parameters derived from complete blood counts namely NLR, derived NLR, PLR and liver function tests can be studied and analysed to differentiate COVID 19 patients from other non-COVID 19 Severe Acute Respiratory Illness (SARI) patients. These are the investigations at first point of contact with the patient and are relatively cost effective, keeping in mind the population of developing nations. Patients and Methods: Retrospective case control study conducted over a period of one month including 286 consecutive Severe Acute Respiratory Illness(SARI) patients admitted in a tertiary care hospital in Delhi. The patients were divided into COVID-19 positive and COVID-19 negative groups based on their results of reverse transcriptase-polymerase chain reaction (RT-PCR) for COVID-19. The demographic data, and routine hematological and biochemical parameters including derived parameters like Neutrophil lymphocyte ratio (NLR), derived NLR ratio, Platelet lymphocyte ratio (PLR) and Prognostic nutrition index (PNI) were analyzed and compared between the two groups using SPSS version 23.0. A p value of

The present study highlights the Therapeutic Plasma Exchange in treatment of Autoimmune Encephalitis. Due to the similarities in the clinical, imaging, and laboratory findings of many forms of autoimmune and infectious encephalitis, autoimmune encephalitis is frequently a difficult clinical diagnosis. Diagnosis of autoimmune encephalitis is based on the clinical course, serological evidence of autoimmunity, EEG changes, evidence of intrathecal inflammation in the cerebrospinal fluid and neuroimaging by MRI. In view of the suspected diagnosis of Autoimmune Encephalopathy with super refractory Status Epilepticus, Methylprednisolone was later added to the treatment. This case represents an interesting scenario of sero-negative encephalitis in which an early diagnosis could be made and treatment initiated in time.

This paper shows the use of ML algorithms for the prediction of water quality. The model is trained on Water Quality dataset from Kaggle and it consists of key features such as, pH value, hardness, solids etc. Algorithms used were SVM, Random Forest and Decision Tree. Also, hyperparameter tuning was done in SVM for improving the accuracy using Grid Search technique. The Random Forest algorithm out-performed the others with an accuracy of 68%. Hence, it shows that ML can be used for predicting the quality of water.

PURPOSE To characterize racial and ethnic disparities and trends in opioid access and urine drug screening (UDS) among patients dying of cancer, and to explore potential mechanisms. METHODS Among 318,549 non-Hispanic White (White), Black, and Hispanic Medicare decedents older than 65 years with poor-prognosis cancers, we examined 2007-2019 trends in opioid prescription fills and potency (morphine milligram equivalents [MMEs] per day [MMEDs]) near the end of life (EOL), defined as 30 days before death or hospice enrollment. We estimated the effects of race and ethnicity on opioid access, controlling for demographic and clinical factors. Models were further adjusted for socioeconomic factors including dual-eligibility status, community-level deprivation, and rurality. We similarly explored disparities in UDS. RESULTS Between 2007 and 2019, White, Black, and Hispanic decedents experienced steady declines in EOL opioid access and rapid expansion of UDS. Compared with White patients, Black and Hispanic patients were less likely to receive any opioid (Black, –4.3 percentage points, 95% CI, –4.8 to –3.6; Hispanic, –3.6 percentage points, 95% CI, –4.4 to –2.9) and long-acting opioids (Black, –3.1 percentage points, 95% CI, –3.6 to –2.8; Hispanic, –2.2 percentage points, 95% CI, –2.7 to –1.7). They also received lower daily doses (Black, –10.5 MMED, 95% CI, –12.8 to –8.2; Hispanic, –9.1 MMED, 95% CI, –12.1 to –6.1) and lower total doses (Black, –210 MMEs, 95% CI, –293 to –207; Hispanic, –179 MMEs, 95% CI, –217 to –142); Black patients were also more likely to undergo UDS (0.5 percentage points; 95% CI, 0.3 to 0.8). Disparities in EOL opioid access and UDS disproportionately affected Black men. Adjustment for socioeconomic factors did not attenuate the EOL opioid access disparities. CONCLUSION There are substantial and persistent racial and ethnic inequities in opioid access among older patients dying of cancer, which are not mediated by socioeconomic variables.

Ice aprons are defined as very small ice bodies covering steep rock slopes. They have only been the subject of increased scientific interest for a few years, despite the fact that they are a condition for mountaineering and obvious elements in the high-alpine landscapes. However, very little is known about their distribution, evolution and physical characteristics. In this paper, we review the existing knowledge on ice aprons, which have almost exclusively been investigated in the Mont-Blanc massif, Western Alps. We supplement this review with novel results from recent surveys of ice aprons. We used a wide array of methodologies, from remote sensing (multi-source imagery) to in situ (stakes and thermal monitoring) and laboratory (radiocarbon dating and texture analysis) glaciological investigations. In the Mont-Blanc massif, ice aprons occupy 4.2 km2 within the alpine permafrost zone. Temperature measured at the ice–rock interface is indeed largely negative. Thinness of ice aprons coupled with the cold context implies a quasi-stationary shear regime without basal Sliding. Only ice at the surface can possibly melt in warm periods. After a shrinking period from the end of the Little Ice Age to the mid-to-late-1960s, ice aprons experienced a short period of expansion, followed by an accelerated shrinkage since the beginning of the 21st century. This shrinkage now favours rockfall triggering and poses a serious threat to a glaciological heritage since ice aprons host several-thousand-year-old ice. Finally, we synthesize this information to assess the existing definition of ice aprons, and propose some future research directions.

Background: Alcoholism, also known as alcohol use disorder (AUD), is a broad term for any drinking of alcohol that results in mental or physical health problems like anxiety, dependence and depression. The present study was conducted with an aim to determine the association between alcohol dependence and depressive episode before and after treatment for alcohol dependence. Materials and Methods: An observational study was conducted among all diagnosed alcohol dependent and depressed patients aged more than 18 years, attending to Psychiatry OPD of a Medical College in Kolkata for a period of one year. After getting permission from the local ethics body, initial assessment was done on first visit of the patients to the psychiatry OPD with a semi structured questionnaire for socio-demographic profile and using AUDIT, CIWA and HAM-D 17 scale for their mental status. Further assessments were done in between day 14 to day 16, next in between day 30 to day 35 and final assessment was done after 2 months using same scales. Relationship between depression with alcohol dependence were determined by Pearson corelation test and represented in the form of table and scatter plot. Changes in mean score of different scales before and after treatment was assessed by paired t test considering confidence interval (CI) of 95% and p value ≤ 0.05 as significant. Result: Out of 70 patients, almost 90% of them were below the age 45 years with male preponderance (94.3%). Paired t test result showed, association of mean scores of different scales, before and after treatment of dependence was statistically significant (p=0.00). Mean AUDIT score, mean CIWA score and mean HAM score for the patients were found to be decreased with advancement of treatment. Pearson correlation test revealed, moderate relationship between AUDIT score and HAMD17 score (0.522) and strong relationship between AUDIT score and CIWA score (0.789). Conclusion: If alcohol dependence is treated properly there will be automatically decreased prevalence of alcohol withdrawal and alcohol induced depressive episodes.