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ObjectivesIndividuals with spinal cord injury deal with multiple health complications that require them to use many medications. The purpose of this paper was to find the most common potentially harmful drug–drug interactions (DDIs) in therapeutic regimens of persons with spinal cord injury, and the risk factors associated with it. We further highlight the relevance of each of the DDIs specific to spinal cord injury population.DesignObservational design and cross-sectional analysis.SettingCommunity; CanadaParticipantsIndividuals with spinal cord injury (n = 108)Main outcome measures/AnalysisThe main outcome was the presence of one or more potential DDIs that can lead to an adverse outcome. All the reported drugs were classified as per the World Health Organization’s Anatomical Therapeutic Chemical Classification system. Twenty potential DDIs were selected for the analysis based on the most common medications prescribed to people with spinal cord injury and severity of clinical consequences. The medication lists of study participants were analyzed for selected DDIs.ResultsAmong the 20 potential DDIs analyzed in our sample, the top 3 prevalent DDIs were Opioids + Skeletal Muscle Relaxants, Opioids + Gabapentinoids, and Benzodiazepines + ≥ 2 other central nervous system (CNS)-active drugs. Of the total sample of 108 respondents, 31 participants (29%) were identified with having at least one potential DDI. The risk of having a potential DDI was highly associated with polypharmacy, though no associations were found between the presence of a drug interaction and age, sex, level of injury, time since injury, or cause of injury among the study sample.ConclusionAlmost three out of ten individuals with spinal cord injury were at risk of having a potentially harmful drug interaction. Clinical and communication tools are needed that facilitate identification and elimination of harmful drug combinations in the therapeutic regimens of patients with spinal cord injury.

The increased demand for rare earth elements in advanced technological applications and supply shortages call for metal recovery from secondary sources. Permanent magnet (Nd2Fe14B or NdFeB) may serve as a potential secondary source due to its high rare earth (Nd+Pr+Dy: ∼30 %) content and its vast application. The present study utilizes a chloridizing roasting (CaCl2.2 H2O) pre-treatment process followed by water leaching, acid leaching (0.5 M HCl, S/L =1/10 g/ml, 90 °C, 3 h), oxalic acid precipitation and calcination (850 °C, 2 h) to obtain mixed rare earth oxides. The process was optimized based on temperature (400–700 °C), dosage (CaCl2.2H2O: NdFeB=0.5:1–2.5:1), and time (30–120 min) on the rare earth dissolution. The theoretical activation energy for the chloridizing roasting process is estimated as 22.3 (OFW) and 16.7 kJ/mol (KAS), while the experimental activation energy for Nd and Dy dissolution was determined to ∼29.3 and ∼17.7 kJ/mol, respectively depicting product layer diffusion-controlled kinetics. Higher dosages of CaCl2.2H2O (1.5:1 and 2:1) favored NdOCl formation, thereby, higher dissolution; however, further higher dosage (2.5:1) leads to reduced Nd dissolution due to higher CaO formation and acid consumption by Ca during leaching. Incomplete oxidation at lower temperatures (400 °C) and iron dissolution impair the Nd dissolution and selectivity. Excessive oxidation at >700 °C favors the formation of NdFeO3, decreasing Nd dissolution. The maximum dissolution of Nd was ∼89 %, while for Dy, it was ∼88 % at optimum conditions of 600 °C, 90 min, 2:1. Water leaching post-roasting leads to ∼87 % Ca removal and the precipitation efficiency of rare earth oxalates was 99 %. The overall extraction for rare earth elements was ∼89 %, and 1 kg of NdFeB powder can yield ∼285 g of rare earth oxides (∼239 g Nd2O3, ∼14 g Dy2O3) with 96 % purity. Further, this study demonstrates that using CaCl2.2 H2O as a solid chlorinating agent in chlorination roasting enhances recovery rates of mixed rare earth oxides while providing a safer and more environment-friendly alternative for industrial applications.

The use of sanitary napkins during menstruation is inevitable. However, they pose a menace to the environment because of the associated non-biodegradability. Conventional sanitary napkins are composed of around 90% plastic, which goes to landfill and remains there for centuries leading to an increased carbon footprint. A study conducted on major brands of sanitary napkins in India revealed that the presence of various phthalate groups harms neurological, cardiovascular, and reproductive systems in women and volatile organic compounds show harmful neurological effects including paralysis and memory loss. To overcome this environmental mayhem and severe pathological effects, various approaches have been undertaken by researchers and government authorities. Plant-based alternatives aid the dire need to manufacture sanitary napkins which can decompose and leave no threat to biodiversity. The use of organic materials like cotton, jute, bamboo, banana fibers, and neem leaves in making sanitary napkins holds magnanimous potential. The utilization of sansevieria and water hyacinth to produce sanitary napkins served the dual purpose of recreating life in water bodies and providing financial independency to the local women in Africa. Leftovers of many natural products during their processing end up creating an increased amount of waste material. Incorporating the industrial waste in the absorbent layer to generate eco-friendly napkins retains the sustainable tripod and also reduces the cost which will make napkins affordable by women of every class in society. This review sheds light on the grave issue of disposal and non-biodegradability of currently used marketed sanitary napkins, various biodegradable approaches and their importance over conventional sanitary napkins, that can be adopted to overcome this environmental problem.

Hepatoxicity associated with recombinant adeno‐associated virus gene therapy is being increasingly encountered by hepatologists in tertiary and quaternary referral units due to the recent increase of these therapies for neuromuscular and haematological disorders. The challenges in managing the condition stem from a lack of good‐quality evidence on the appropriate protocols for immunosuppressants due to lack of representative animal models. There is a need for protocols for diagnosing and treating hepatotoxicity and this possible with further research to understand the problem and its management. The review also highlights the importance of a multidisciplinary team in managing hepatotoxicity and recommends further research to better identify at‐risk individuals, define the extent of the problem and assess the long‐term effects of liver injury and immunosuppressants. Paediatric hepatologists are increasingly encountering hepatotoxicity related to recombinant adeno‐associated virus gene therapy.The hepatoxicity may result in life‐threatening complications, loss of transgene activity and adverse events related to immunosuppression use. Paediatric hepatologists are increasingly encountering hepatotoxicity related to recombinant adeno‐associated virus gene therapy. The hepatoxicity may result in life‐threatening complications, loss of transgene activity and adverse events related to immunosuppression use. There is a need for research to better understand the problem and its management to guide immunosuppression protocols for treating hepatotoxicity. Long‐term outcomes of hepatotoxicity and immunosuppression also need to be studied.Early and reliable identification of individuals at risk for hepatotoxicity could decrease morbidity and mortality. There is a need for research to better understand the problem and its management to guide immunosuppression protocols for treating hepatotoxicity. Long‐term outcomes of hepatotoxicity and immunosuppression also need to be studied. Early and reliable identification of individuals at risk for hepatotoxicity could decrease morbidity and mortality.

AbstractBackgroundNonvariceal upper gastrointestinal bleeding (NVUGIB) is a complication of dual antiplatelet therapy (DAPT) and direct oral anticoagulant therapy (DOAC). There is a lack of data comparing mechanical therapy (clips) with thermal therapy in this population.MethodsWe conducted a retrospective chart review of patients undergoing urgent/emergent endoscopy for NVUGIB while being on DAPT or DOAC. Patients who had DAPT/DOAC held as per American Society of Gastrointestinal Endoscopy guidelines were excluded from the study.ResultsA total of 122 patients were included in the study. There was no difference in primary hemostasis, rebleeding rate, rescue hemostatic procedure, and 30-day mortality between the mechanical and thermal therapy groups. The mechanical therapy group had a significantly higher rate of prolonged length of stay (61.2% vs 38.9%, P = 0.02), serious clinical outcomes (56% vs 37.5%, P = 0.04), and intensive care unit admissions (50% vs 20.8%, P = 0.001) than the thermal therapy group.ConclusionPatients on DAPT/DOAC presenting with NVUGIB can undergo mechanical or thermal endoscopic intervention without a significant difference in achieving primary hemostasis, rebleeding, requiring a secondary procedure, or mortality outcomes.

Background Blood and blood product transfusion is an essential component of the health care system. Nursing personnel constitute a significant aspect of the transfusion process as they are the last in the chain of the transfusion process to ultimately transfuse the blood and blood products to the recipient. Nurses face many problems/issues in this process. The present study highlights the problems/issues faced by them in the transfusion of blood and blood products.Objective To explore the problems/issues faced by nursing personnel related to blood and blood products transfusion process in a tertiary care hospital in North India.Methods A qualitative design was used. Three focused group discussions were conducted with 8–10 nurses in each group working in the Emergency Neurosurgery Ward of a tertiary care hospital in North India. Tools used were the sociodemographic and job profile of nurses and a focus group discussion (FGD) guide about blood and blood products transfusion. Each FGD session lasted for 15–20 minutes and data saturation was achieved after three FGDs. Colaizzi’s procedural steps were used to analyse the data. Themes and subthemes were generated.Results and Conclusion The problems/issues identified in the FGD were related to a lack of awareness regarding awareness, transportation, storage in the ward, thawing of fresh frozen plasma, problems in a blood bag, wastage of blood in case of children, inadequate nurse patients ratio, taking consent, Judicial request, proper prescription/orders, related to transfusion responsibilities, monitoring and documentation of blood, and blood products transfusion. The above problem/issues should be addressed and overcome to promote safe transfusion. It is recommended that regular In-service education programs should be planned for nursing personnel to update guidelines awareness, and the developed transfusion monitoring sheet should be implemented, to improve documentation and reduce transfusion errors.

Green’s function methods lead to ab initio, systematically improvable simulations of molecules and materials while providing access to multiple experimentally observable properties such as the density of states and the spectral function. The calculation of the exact one-particle Green’s function remains a significant challenge for classical computers and was attempted only on very small systems. Here, we present a hybrid quantum-classical algorithm to calculate the imaginary-time one-particle Green’s function. The proposed algorithm combines the variational quantum eigensolver and the quantum subspace expansion methods to calculate Green’s function in Lehmann’s representation. We demonstrate the validity of this algorithm by simulating H2and H4on quantum simulators and on IBM’s quantum devices.

Breast cancer is a malignant tumor with a high mortality rate among women. Therefore, it is necessary to develop novel therapies to effectively treat this disease. In this study, iron selenide nanorods (FeSe2NRs) were designed for use in magnetic hyperthermic, photothermal, and chemodynamic therapy (MHT/PTT/CDT) for breast cancer. To illustrate their efficacy, FeSe2NRs were modified with the chemotherapeutic agent methotrexate (MTX). MTX-modified FeSe2(FeSe2-MTX) exhibited excellent controlled drug release properties. Fe2+released from FeSe2NRs induced the release of •OH from H2O2via a Fenton/Fenton-like reaction, enhancing the efficacy of CDT. Under alternating magnetic field (AMF) stimulation and 808 nm laser irradiation, FeSe2-MTX exerted potent hyperthermic and photothermal effects by suppressing tumor growth in a breast cancer nude mouse model. In addition, FeSe2NRs can be used for magnetic resonance imaging in vivo by incorporating their superparamagnetic characteristics into a single nanomaterial. Overall, we presented a novel technique for the precise delivery of functional nanosystems to tumors that can enhance the efficacy of breast cancer treatment.

Rhino-oculo-cerebral mucormycosis (ROCM) was on a rise during the second wave of the Covid-19 pandemic. The objective was to study the demographics of covid-19 associated ROCM, utilize radiological imaging as a tool to study the involvement of Paranasal Sinuses and its correlation with the pneumatisation and anatomical variations.

Orthotopic liver transplantation (OLT) is the current standard of care for both chronic and acute terminal liver disease. However, a major limitation of this treatment is the shortage of healthy donor organs and the need for life-long immunosuppression to prevent graft rejection. Hepatocyte transplantation (HTx) has emerged as a promising, alternative therapeutic approach to either replace OLT or to act as a bridge until a donor liver becomes available thus reducing waiting list mortality. HTx involves the infusion and engraftment of human hepatocytes, typically isolated from organs unsuitable for OLT, into recipient liver parenchyma to carry out the missing hepatic function of the native cells. HTx is less invasive than OLT and can be performed repeatedly if required. The safety of clinical HTx has been shown and treatment results are promising, especially in patients with liver-based metabolic disorders. Nevertheless, HTx has failed to become the standard of care treatment for such disorders. This review aims to evaluate the progress that has been made within the field of HTx over the last 30 years and identify potential shortcomings within the approach which may be hindering its routine clinical application.Graphical Abstract

The blocking probability is studied for improving the quality of service of the network. The call blocking model for mode of operation to determine the types of applications suitable for Generalized Multi-Protocol Label Switched (GMPLS) networks is proposed. The performance of optical network depends upon various parameters such as number of channels, number of sources, traffic intensity which directly affect the blocking probability of the network. A mathematical model of an optical network for blocking probability of cleared calls and holding calls is developed. In the proposed model, blocking probability of the network gets reduced with a large number of servers. The proposed models decrease the blocking probability of the network to a level of 10–40. In addition, the blocking performance for held calls is also analyzed to compare the amount of traffic intensity that can be handled and completed properly with that of the cleared calls probability. The blocking probability is less for cleared calls than that for held calls as more traffic intensity can be handled in case of cleared calls but the chances for call completion increases in case of held calls.

AbstractProtein supplements are widely consumed by athletes as well as young adults and teenagers going to the gym and are an excellent source to increase protein intake, build muscle mass, and enhance recovery. They are available in the form of powders, gummies, protein bars, and ready-to-drink shakes and have been shown to have effects on almost every system in the body. Subjects consuming whey protein–based supplements regularly show significantly lower systolic blood pressure, while subjects who consume soy-based protein supplements have been reported to show a significant decrease in their systolic and diastolic blood pressures. Favorable effects of soy protein consumption have been observed on the serum lipid profile, with significant decreases in serum low-density lipoprotein and triglyceride levels. Lower postprandial glucose levels have been observed in diabetic subjects as well, which can be attributed to the lower glycemic index of these supplements. This can lead to an indirect decrease in diabetes-related complications. While these supplements affect the body positively, caution has to be exercised while consuming them in excess, as they have been shown to cause hyperfiltration and increased urinary calcium excretion which can, in turn, lead to chronic kidney disease development. This article focuses on the effects of protein supplementation on the human body, with emphasis on the cardiovascular, endocrine, and renal systems.

Abstract: Lithium-based coin cells are primarily used for portable electronic devices and comprise lithium and manganese in the electrode material as the LiMn2O4phase. Various pre-treatment methods, such as thermal exposure, pyrolysis, and hydrogen reduction, are investigated for the selective recovery of Li and Mn. The effect of pre-treatment on phase dissociation and metal recovery is evaluated. Thermal treatment and pyrolysis result in partial phase dissociation in the 450–750 °C temperature range, causing lower Li extraction. However, hydrogen reduction at 650 °C is suitable for selective Li dissolution (~ 86% using 10% H2and ~ 96% in pure H2atmosphere). The dissociation of the LiMn2O4phase, formation of LiOH, and microstructural features influence the Li extraction. For Mn recovery, reductant-free sulfuric acid leaching of the water-leached residue results in 95.0% and 99.3% extraction using 10% H2and pure H2,respectively. Further, the manganese from the leach solution is recovered as manganese oxide (Mn3O4) nanoparticles (96% purity) by precipitation, which can be used as a precursor for battery and supercapacitor applications. It is calculated that 315 g of the coin cells (100 g of electrode material) will yield 17.8 g of Li2CO3and 67.9 g of Mn3O4nanoparticles. Graphical Abstract:

This article establishes sufficient conditions for the existence of positive solutions to initial value problems associated with the discrete fractional oscillation equation using the well-known conical shell fixed point theorem. Two numerical examples illustrate the applicability of the established results.

This study uses numerical methods and HYSPLIT trajectory cluster analysis to evaluate the influence of wind speed and mixing height on the dispersive potential of PM10. The analysis reveals a correlation of 0.58 and 0.44 between PM10concentrations and wind speed and mixing height, respectively. Wind speed and mixing height are decisive parameters in modulating PM10levels in ambient air. The study highlights that PM10concentrations decreased by 41.28% in February with wind speeds over 2 m/s and mixing heights below 400 m. Conversely, in April, PM10concentrations increase by 52.65% due to wind-induced resuspension with wind speeds over 2 m/s and mixing heights above 450 m. The findings of this study underscore wind speed as a crucial factor in reducing PM10levels during winter, provided the mixing height is sufficiently high, and in increasing PM10levels during summer due to resuspension effects.

The increasing number of electronic transactions on the Internet has given rise to the design of recommendation systems. The main objective of these systems is to give recommendations to the users about the items (i.e., movies, music, books, etc.) they are likely to purchase in near future. These recommendations are on the foundation of the response provided by the other individuals about these products in the terms of ratings, which are in the form of a five-star rating system. Plenty of algorithms have been proposed in the past for building recommender systems. The most popular of these algorithms comprise content-centered and collaborative filtering recommendation methodologies. Recently, matrix factorization has appeared as a technique in recommender systems. Several algorithms centered on matrix factorization have been suggested in the recent past. In this paper, an improved alternating least squares algorithm has been proposed for building more efficient and accurate recommender systems which improves the performance of matrix factorization. The performance of the model has been evaluated using metrics like root-mean-square-error and execution time. However, in general, the time complexity of both algorithms is O(n^3), where n is the number of users or items. This is because both IALS and ALS involve iteratively solving a system of linear equations, and the time complexity of solving a system of linear equations is O(n^3). However, IALS can achieve significant performance improvements over ALS, particularly for large datasets, due to its incorporation of stochastic gradient descent and parallelization techniques.

In the present study, discarded random access memory cards were evaluated as a secondary copper source. Both air and water fluidization process were investigated as the pretreatment steps followed by thermal exposure. A significant reduction of plastic/resin content from ~ 62% in feed to ~ 9% was attained in the underflow fraction of the water fluidization. Formation of the molten mass was observed at a thermal exposure of 1100 °C, whereas at 800 °C, a discrete structure with copper purity of 90.2% was attained. The adopted process provided an alternative pathway to recover metals without using any external additive and minimal gas generation because of the effective removal of epoxy resin. The experimental data revealed that 91% of copper values, i.e., ~ 31 g concentrate, could be recovered from 100 g of the RAM boards. The overflow product comprised of a calorific value of 4.5 × 106J/kg and could be further used.

In this paper, we focus on two distinct types of nabla fractional relaxation equations with periodic boundary conditions. Our first step is to build the related Green’s functions and discover some of their characteristics. Next, using the appropriate fixed point theorems, we derive sufficient conditions for the existence of solutions to the problems under consideration. Further, to illustrate the applicability of our findings, we also offer two examples.

Titanium-based alloys exhibit superior resistance to corrosion and biocompatibility in comparison to other alloys utilized for implant applications, such as stainless steel and cobalt-based alloys. Nonetheless, no completely inert metal is suitable for implantation in the human body, as aseptic loosening of the implant or the release of ions in the vicinity of the implant can result in inflammation and implant failure. Therefore, the primary objective of this study was to employ hydrogenated titanium 6-aluminum-4-vanadium (H–Ti6Al4V) alloy to reduce reactive oxygen species (ROS) and thereby achieve the function of regulating inflammatory signaling when employed as an implant.

Recovery of critical metals such as Li and Co from the spent lithium-ion batteries is necessary to alleviate resource scarcity and mitigate supply risk. The present study emphasizes the carbothermal and hydrogen reduction of lithium cobalt oxide (LCO) and the recovery of Li and Co from spent LCO-based batteries. Carbothermal reduction (CR) and hydrogen reduction (HR) at 500–900 °C followed by water leaching was carried out for Li recovery. Complete reduction with hydrogen was achieved at 500 °C, whereas a significant reduction for CR was achieved at 700 ℃. Characterization analysis of the reduced products affirms the decomposition of the layered LCO structure with the evolution of new phases. CR favored the Li2CO3formation, while the LiOH phase was observed in the HR products. Both reductive treatments yielded metallic Co, but CoO was also found in the CR products. The hydrogen reduction was found better compared to carbothermal reduction for both Li and Co recovery. CR process at 900 °C resulted in 61% Li dissolution and 76.5% Co recovery, while HR at 500 °C yielded much higher Li dissolution (93%) and Co recovery (86.5%).

The current study investigates sericite clay as an alternative source of potash and alumina. The alumina and potash content in the sericite is approximately 35 and 10%, respectively, compared with 50–55% in bauxite ore. Muscovite and illite phases are stable, and direct leaching is found to be ineffective. Here, planetary ball milling was performed, which provided dissociation of stable phases to relatively reactive phases. The milling led to a five-fold increase in the surface area, resulting in enhanced leaching kinetics even at low acid concentration. The statistical design obtained optimal conditions of 8 h of milling followed by leaching in 1.73 M HCl at 75 °C, yielding 82% alumina extraction in precipitate with 85% purity in γ-alumina form and 63% potassium dissolution in sylvinite phase. The yield of the precipitate was ~65–68%, and the acid leach residue contained primarily silica.

Background: Street children are vulnerable to adverse health and risk behaviors and drug use. Substance use among street children has been well documented in several countries. This study reports sociodemographic and peer, family, and stress-related factors associated with substance use and non-use in a representative sample of street children of Delhi.Methods: This cross-sectional survey was conducted through six NGOs working with street children, using Respondent Driven Sampling, in nine districts of Delhi (n = 766, 7–18 years). The multivariable model was developed by applying binary logistic regression analysis.Results: The rate of substance use was 49%. Significant association was found between substance use in the past year and increasing age [Odds Ratio: OR (95% Confidence Interval)] [1.22(1.12,1.33)], male sex [4.34 (2.28,8.26)], lacking psychosocial support from family/relatives [3.27(1.84,5.80)], being engaged in earning from illegal sources, [3.04(1.75,5.29)], family use of substance [2.59(1.38,4.89)], presence of substance-using peers [29.86(14.38,62.01)], lack of non-drug-using peers [2.35(1.46,3.79)], and not possessing basic amenities [2.26(1.31,3.93)].Conclusion: Multiple modifiable factors exist within the family and peer group, including risk and protective factors or a consequence of substance use. Some challenges in the form of difficulty in reaching out to them and poor treatment seeking by those using substances warrant intensification in both primary and secondary prevention initiatives.

The present work aims at studying five Indian coals and their solvent extracted clean coal products using Py-GCMS analysis and correlating the characterization data using theoretical principal component analysis. The pyrolysis products of the original coals and the super clean coals were classified as mono-, di- and tri-aromatics, while other prominent products that were obtained included cycloalkanes, n-alkanes, and alkenes ranging from C10–C29. The principal component analysis is a dimensionality reduction technique that reduced the number of input variables in the characterization dataset and gave inferences on the relative composition of constituent compounds and functional groups and structural insights based on scores and loading plots which were consistent with the experimental observations. ATR-FTIR studies confirmed the reduced concentration of ash in the super clean coals and the presence of aromatics. The Py-GCMS data and the ATR-FTIR spectra led to the conclusion that the super clean coals behaved similarly for both coking and non-coking coals with high aromatic concentrations as compared to the raw coal. Neyveli lignite super clean coal was found to show some structural similarity with the original coals, whereas the other super clean coals showed structural similarity within themselves but not with their original coal samples confirming the selective action of the e,N solvent in solubilizing the polycondensed aromatic structures in the coal samples.