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Abstract: Bosentan and its analogues were first reported as endothelin (ET) receptor antagonists in US patent No. 5, 292,740 in 1994. Bosentan synthesis has been reported by employing different methods from the reaction between (4,6-dichloro-5-(2-methoxyphenoxy)-2,2'-bipyrimidine and 4- (tert-butyl) benzenesulfonamide and 4-(tert-butyl)-N-(6-chloro-5-(2-methoxyphenoxy)-[2,2'- bipyrimidin]-4-yl) benzenesulfonamide in the form of different salts like potassium salt, ammonium salt, sodium salt, and free, on its reaction with ethylene glycol. Several changes have been observed in the chemistry of the involved intermediate synthesis, particularly coupling chemistry, to produce bosentan derivatives with high purity and yield.

Oil has become an essential commodity in various fields, including cooking. In India, coconuts are produced abundantly, making it the third-largest coconut-producing nation worldwide. Despite the massive demand for coconut oil, there is a shortage of its production, & the majority of the entities producing the oil are large-scale industries, with only a few operating in local shops. The solution to this problem lies in the "Compact & Cost-Effective Coconut Oil Expeller," which has the potential to increase oil production & address the current gaps. The machine can operate with low quantities of copra, allowing customers to produce oil based on their requirements. Furthermore, it is a zero-waste process that enables the sale of the leftover parts after oil extraction. By facilitating chemical-free oil extraction & reducing space & initial purchase costs, the expeller machine offers an opportunity for small-scale industries to set up a profitable business, similar to flour mills in the area. This project addresses the issues with the currently used oil extractors, leading to the design & fabrication of an automatic portable oil extractor that could enhance the life & functionality of the unit for small-scale industries. The project also incorporates a solar panel for multipurpose use, making it functional even in the absence of electricity. Ultimately, this work contributes to reducing the running cost of an industry & prevents sudden breakdowns on the shop floor, making it a valuable addition to the oil extraction industry

The purpose of the present study is to establish a correlation between gonial angle and freeway space using lateral profile photographs in dentulous individuals. The study includes a total of 150 participants within the age range of 20 – 30 years, of which one twenty-five were females and twenty-five were males. No restrictions were imposed with regard to the presence of malocclusion. The participants were informed about the study through participant information sheet and signed consent was obtained. The study showed a mild negative correlation between Freeway space and gonial angle, indicating that when gonial angle increases freeway space decreases in both class I and class II participants. The study also showed that the freeway space was found to be more in Angle’s class II dentate participantsThe study concludes that there was a statistically significant difference between freeway space between Angle’s Class I and Class II malocclusion. The freeway space in individuals with Angle’s class II malocclusion was greater as compared to that with Angle’s class I malocclusion. The gonial angle was observed to be more acute in participants with Angle’s class II malocclusion as compared to that in participants with Angle’s class 1 malocclusion. Lateral profile photographs can be used as a tool to predict freeway space in patients with Angle’s class I malocclusion.

The digitization of manufacturing has transformed the product realization process across many industries, from aerospace and automotive to medicine and healthcare. While this progress has accelerated product development cycles and enabled designers to create products with previously unachievable complexity and precision, it has also opened the door to a broad array of unique security concerns, from theft of intellectual property to supply chain attacks and counterfeiting. To address these concerns, information embedding (e.g., watermarks and fingerprints) has emerged as a promising solution that enhances product security and traceability. Information embedding techniques involve storing unique and secure information within parts, making these parts easier to track and to verify for authenticity. However, a successful information embedding scheme requires information to be transmitted in physical parts both securely and in a way that is accessible to end users. Ensuring these qualities introduces unique computational and engineering challenges. For instance, these qualities require the embedding scheme designer to have an accurate model of the cyber-physical processes needed to embed information during manufacturing and read that information later in the product life cycle, as well as models of the cyber-physical, economic, and/or industrial processes that may degrade that information through natural wear-and-tear, or through intentional attacks by determined adversaries. This paper discusses challenges and research opportunities for the engineering design and manufacturing community in developing methods for efficient information embedding in manufactured products.

Computed Tomography (CT) chest plays a critical role in early identification & stratification of disease burden and prognostication of COVID-19 disease. We compared in-house created CT based scoring system based on ground glass opacities (G-Score), consolidation (C- Score), and atelectasis A-score (i.e. GCA score) with contemporary CT severity scores & validated it against world health organization (WHO) COVID-19 disease severity scale. Patients confirmed with real time polymerase chain reaction confirmed COVID-19 infections that underwent CT chest investigations as a part of standard of care were recruited. A compound GCA score based on the lung involvement was developed and validated. Five-hundred patients of which 249 had mild, 220 with moderate, and 31 with severe COVID-19 disease were recruited.Most involved segments were superior (65%), lateral basal (56%) and posterior basal segments (64%) of right lower lobe and anteromedial (62%) and posterior basal segments (57%) of left lower lobe.Patchy non-confluent peripheral ground-glass opacities with apicobasal gradient is the most common finding (47%) in mild cases. Bilateral lower lobes were most commonly involved (72%).In moderate cases ground-glass opacities with consolidation is the predominant finding (82%).In severe cases ground-glass opacity, consolidation as well as linear platelike atelectasis and reticular opacities may represent with apicobasal gradient (80%).HRCT Chest has certainly come up as a versatile aid for our war against COVID -19. Firstly it helps to diagnose the pulmonary involvement of the disease and when complimented with a good scoring system furthermore it stratifies the disease burden.

Background: Incorporating emerging knowledge into Emergency Medical Service (EMS) competency assessments is critical to reflect current evidence-based out-of-hospital care. However, a standardized approach is needed to incorporate new evidence into EMS competency assessments because of the rapid pace of knowledge generation. Objective: The objective was to develop a framework to evaluate and integrate new source material into EMS competency assessments. Methods: The National Registry of Emergency Medical Technicians (National Registry) and the Prehospital Guidelines Consortium (PGC) convened a panel of experts. A Delphi method, consisting of virtual meetings and electronic surveys, was used to develop a Table of Evidence matrix that defines sources of EMS evidence. In Round One, participants listed all potential sources of evidence available to inform EMS education. In Round Two, participants categorized these sources into: (a) levels of evidence quality; and (b) type of source material. In Round Three, the panel revised a proposed Table of Evidence. Finally, in Round Four, participants provided recommendations on how each source should be incorporated into competency assessments depending on type and quality. Descriptive statistics were calculated with qualitative analyses conducted by two independent reviewers and a third arbitrator. Results: In Round One, 24 sources of evidence were identified. In Round Two, these were classified into high- (n = 4), medium- (n = 15), and low-quality (n = 5) of evidence, followed by categorization by purpose into providing recommendations (n = 10), primary research (n = 7), and educational content (n = 7). In Round Three, the Table of Evidence was revised based on participant feedback. In Round Four, the panel developed a tiered system of evidence integration from immediate incorporation of high-quality sources to more stringent requirements for lower-quality sources. Conclusion: The Table of Evidence provides a framework for the rapid and standardized incorporation of new source material into EMS competency assessments. Future goals are to evaluate the application of the Table of Evidence framework in initial and continued competency assessments.

Sustainable Development is a development that strikes a balance between current needs achieved by the generation on the future generation. It is a concept that has matured and shifted more focus to economic, social, and environmental development for future generations. There are some capacities for sustainable development: measure progress, promote equity, adapt to shocks, transform development pathways, link knowledge with action, and govern cooperatively. In Commerce, it shows which methods of keeping or maintaining accounting in our business are appropriate for the future generation. In this paper, the ratios show their value by the data. Management shows which policies and programs have not affected the future generation. It shows how efficiently we are currently using our resources and managing them for future generations. Through this research, we will get enough ideas about the future situations of Commerce, Management in the context of sustainability and also give solutions to some unknown conditions.

The prehospital phase is a critical component of delivering high-quality acute stroke care. This topical review discusses the current state of prehospital acute stroke screening and transport, as well as new and emerging advances in prehospital diagnosis and treatment of acute stroke. Topics include prehospital stroke screening, stroke severity screening, emerging technologies to aid in the identification and diagnosis of acute stroke in the prehospital setting, prenotification of receiving emergency departments, decision support for destination determination, and the capabilities and opportunities for prehospital stroke treatment in mobile stroke units. Further evidence-based guideline development and implementation of new technologies are critical for ongoing improvements in prehospital stroke care.

This research proposes early prediction of stroke disease using different machine learning approaches such as Logistic Regression Classifier, Decision Tree Classifier, Support Vector Machine and Random Forest Classifier. In this paper we have used different Machine Learning algorithm and by calculating their accuracy we are proposing fair comparisons of different Stoke prediction algorithms by using same dataset with same no of features. The researcher will help to predict the Stroke using best Machine Learning algorithm.

In recent years, the popularity of AI-enabled conversational agents or chatbots has risen as an alternative to traditional online surveys to elicit information from people. However, there is a gap in using single-agent chatbots to converse and gather multi-faceted information across a wide variety of topics. Prior works suggest that single-agent chatbots struggle to understand user intentions and interpret human language during a multi-faceted conversation. In this work, we investigated how multi-agent chatbot systems can be utilized to conduct a multi-faceted conversation across multiple domains. To that end, we conducted a Wizard of Oz study to investigate the design of a multi-agent chatbot for gathering public input across multiple high-level domains and their associated topics. Next, we designed, developed, and evaluated CommunityBots - a multi-agent chatbot platform where each chatbot handles a different domain individually. To manage conversation across multiple topics and chatbots, we proposed a novel Conversation and Topic Management (CTM) mechanism that handles topic-switching and chatbot-switching based on user responses and intentions. We conducted a between-subject study comparing CommunityBots to a single-agent chatbot baseline with 96 crowd workers. The results from our evaluation demonstrate that CommunityBots participants were significantly more engaged, provided higher quality responses, and experienced fewer conversation interruptions while conversing with multiple different chatbots in the same session. We also found that the visual cues integrated with the interface helped the participants better understand the functionalities of the CTM mechanism, which enabled them to perceive changes in textual conversation, leading to better user satisfaction. Based on the empirical insights from our study, we discuss future research avenues for multi-agent chatbot design and its application for rich information elicitation.

Background: Geriatrics is defined as a branch of medicine which deals with the disease, disabilities & care of aged person. Inactivity may lead to overweight and obese in elderly people. With the increasing ageing population and the extension of life expectancy, improving health-related quality of life of older adults is an important public health issue. Health related quality of life is a predictive factor of mortality in older adults. Purpose: The purpose of this study to find the correlation of Body Mass Index with Physical Activity and Health related quality of life in Geriatric population. Methodology: An observational study was conducted by convenience sampling on Geriatric population. The height and weight of participants was measured by measure tape and weighing scale. International Physical Activity Questionnaire for Elderly was used for physical activity, and Older People’s Quality of Life Questionnaire was used for Health-Related Quality of Life of geriatric population. Printed version of questionnaire was given to all elderly participants in the convenient language. Result: Mean Age of Geriatric population is 70.04 ± 6.11 years. Parametric test was applied to find the correlation between body mass index and Quality of Life. And non-parametric were used to find the correlation between body mass index and physical activity. Conclusion: As the body mass index increases, physical activity in geriatric population decreases. As the physical activity increases, quality of life in geriatric population increases. Keywords: Geriatric population, physical activity, quality of life, body mass index.

In the NLP context identification has become a prominent way to overcome syntactic and semantic ambiguities. Ambiguities are unsolved problems but can be reduced to a certain level. This ambiguity reduction helps to improve the quality of several NLP processes, such as text translation, text simplification, text retrieval, word sense disambiguation, etc. Context identification, also known as contextualization, takes place in the preprocessing phase of NLP processes. The essence of this identification is to uniquely represent a word or a phrase to improve the decision-making during the transfer phase of the NLP processes. The improved decision-making helps to improve the quality of the output. This paper tries to provide an overview of different context-capturing mechanisms used in NLP.

Three-dimensional (3D) printed hydrogels fabricated using light processing techniques are poised to replace conventional processing methods used in tissue engineering and organ-on-chip devices. An intrinsic potential problem remains related to structural heterogeneity translated in the degree of cross-linking of the printed layers. Poly(ethylene glycol) diacrylate (PEGDA) hydrogels were used to fabricate both 3D printed multilayer and control monolithic samples, which were then analyzed using atomic force microscopy (AFM) to assess their nanomechanical properties. The fabrication of the hydrogel samples involved layer-by-layer (LbL) projection lithography and bulk cross-linking processes. We evaluated the nanomechanical properties of both hydrogel types in a hydrated environment using the elastic modulus (E) as a measure to gain insight into their mechanical properties. We observed that E increases by 4-fold from 2.8 to 11.9 kPa transitioning from bottom to the top of a single printed layer in a multilayer sample. Such variations could not be seen in control monolithic sample. The variation within the printed layers is ascribed to heterogeneities caused by the photo-cross-linking process. This behavior was rationalized by spatial variation of the polymer cross-link density related to variations of light absorption within the layers attributed to spatial decay of light intensity during the photo-cross-linking process. More importantly, we observed a significant 44% increase in E, from 9.1 to 13.1 kPa, as the indentation advanced from the bottom to the top of the multilayer sample. This finding implies that mechanical heterogeneity is present throughout the entire structure, rather than being limited to each layer individually. These findings are critical for design, fabrication, and application engineers intending to use 3D printed multilayer PEGDA hydrogels for in vitro tissue engineering and organ-on-chip devices.

PurposeOrthopaedics, rheumatology, pain management, specialist radiology and therapy services were brought under one umbrella to form Northwest Surrey integrated musculoskeletal (IMSK) services and introduced advance clinical practice, a multi-disciplinary team triage with a formalised straight to test (STT) process defined in 2018. Historically, prior to these services' integration, there were a primary and second care triage systems within individual specialities. The aim of this service evaluation is to assess the impact of a single IMSK multidisciplinary triage (MDT) system and the efficacy of STT from triage, which allows patients to be sent for diagnostics based on the cluster of symptoms and past medical history in order to achieve early identification of serious pathologies. This is a complex adaptive system with pathways spanning into the core areas of orthopaedics, rheumatology, therapies, pain management services, radiology and some less frequent specialities such as neurology, oncology, vascular and gynaecology. One of the objectives of this study was to identify how many referrals were triaged to consultants, Advance practice and therapies. In addition, the authors wanted to highlight the proportion of referrals that were sent straight to test from triage and the percentage of these that had sinister pathology identified. This information would then be compared against existing red flag literature to identify common themes. This study aims to discuss the aforementioned objectives.Design/methodology/approachData were extracted retrospectively from a hospital database from January to December 2019 for all the adult musculoskeletal service referrals. The data collected were analysed on a Microsoft Excel sheet with information including date of triage, hospital number, ordering clinician, body part, type of diagnostic, indications for scanning, outcome for STT, serious pathology findings (named code 5 within our trust) and outcome of appointment.FindingsA total of 47,039 referrals were received into the IMSK service. Of these referrals 19,967 were directly referred to therapies, with 27,072 referrals received into the IMSK service MDT process. Within triage, 718 patients were directed to STT to rule out serious pathology. A total of 28 patients (3.9%) had sinister pathology identified on their investigation. A total of 46% of patients were discharged from their first consultation following STT. Overall, 50% of the total number of referrals into the IMSK service was seen by advanced practitioners with 16% of patients directed to consultants with pre-consultation diagnostic work up.Originality/valueThis service evaluation highlights that STT allows early access to diagnostics, resulting in quicker access to identification of sinister pathology. A one stop MDT system has been shown to be effective in guiding the referral to the right place with increased referrals into allied health advance practice clinics and access to therapies directly. It has resulted in a reduction of unwarranted referrals to consultant care, duplication of investigations and identified patients on multiple pathways.

Background: Now-a-day, there is the need to explore the concept of green chemistry in every field. Many existing conventional and novel drug delivery systems have problems related to green chemistry. To overcome the existing limitations of the different dosage forms, a newer untouched dosage form pastilles was explored. Objective: The present study aims to optimize the Glipizide (GPZ) matrix pastilles using waxy erodible polymers integrating the concept of quality by design (QbD) and green chemistry. Methods: The pastilles were formulated using the fabricated lab-scale pastillator. GPZ was used as a model drug. The concern related to the drug is low aqueous solubility and short variable half-life. The solubility of the drug was improved by formulating a complex between GPZ and chemically modified ß –cyclodextrin (β-CD) - hydroxypropyl-ß-cyclodextrin (HP- ß -CD). The complex was prepared using the kneading method. The complex was formulated incorporated different stoichiometric ratios of GPZ: complexing agent. Sustained-release pastille formulated using Gelucire 43/01 (GC 43/01) as release retardant polymer. The central composite design had been used to obtain an optimum batch, using the amount of GC 43/01 and temperature as independent variables, while drug release at 2h, 6h, and 10h was chosen as dependent variables. Design batches were evaluated for post-and preformulation parameters. An optimum formulation was evaluated for the influence of hydroalcoholic media on drug release. Results: The complex formulated using HP- ß –CD (1:1) shown better solubility (36.5mg/ml) and dissolution. The complex was incorporated in the pastilles with erodible polymer GC 43/01. The formulation was found robust with optimum pre and post formulation parameters. Optimized batch was chosen from the design space of central composite design. The drug release of the optimized formulation was found 29.13%, 57.29% and 85.70% at 2, 6 and 10 hrs respectively which was similar to the drug release of the marketed formulation. As the amount of alcohol increased from 5 to 40 %, the drug release also increased but did not show a dose dumping effect. It is just due to the altered solubility of GPZ in alcohol. Conclusion: The untouched formulation, Pastilles of GPZ were developed incorporating the waxy erodible polymer. Pastilles were capable to control drug release up to 12 h. The amount of GC 43/01 and temperature had a significant effect on the formulation of GPZ sustained-release pastille. The newer approach of formulating pastilles might apply to the industry as it is an eco-friendly, single-step process and uses fewer excipients.

The MERN Stack is a set of strong and effective technologies for the creation of backend, frontend, and database-rich web applications. Full-stack web development is quick and effective thanks to JavaScript. The MERN Stack, a JavaScript-based platform that integrates MongoDB, Express, React, and Node.js, streamlines and accelerates the development of fullstack online applications. Its main goal is to simplify and make the development process easier.

Background: Laparoscopic cholecystectomy (LC) using surgical electrocautery is considered to be the gold standard procedure for the treatment of uncomplicated cholecystitis and cholelithiasis. The objective of the current study was to evaluate the effectiveness and safety of the Harmonic scalpel, an advanced laparoscopic technique when compared to electrocautery. Methods: From June, 2021 through December 2022, a total of 50 patients were randomly allocated to LC with a harmonic scalpel (group 2, 25 patients) or conventional monopolar electrocautery (group 1, 25 patients). The main outcome measures were gall bladder perforation during surgery (bile leakage), stone spillage, duration of surgery, hospital stay. Results: The 2 groups were comparable with respect to baseline patient characteristics. When compared to conventional monopolar electrocautery, Gall bladder perforation during surgery (bile leakage) 12% vs. 8%, stone spillage 4% vs. 8%, duration of surgery 52.13 min vs. 54.89 min, hospital stay 2.09 days vs. 2.04 days. Conclusions: LC using conventional monopolar electrocautery is as effective and safe as that with the harmonic scalpel, for treating uncomplicated cholecystitis and cholelithiasis.

वर्तमान में नगरीकरण विकास का पर्याय बन गया हैं। भारत जैसे विकासशील देशोंकी अर्थव्यवस्था में कृषि आधार से सेवा उन्मुख रोजगार में भारी बदलाव का अनुभव किया है। नगरीकरण की प्रक्रीया सामाजिक-सांस्कृतिक परिवर्तनों के साथ-साथ आर्थिक परिवर्तन को भी देखती है। भारत में पिछले दशक में ऐसे गैर कृषि आधारित अर्थव्यवस्था संचालित शहरी क्षेत्रों के विकास में भारी वृद्धि देखी हैं, जहां सामाजिक-सांस्कृतिक पहलू अभी भी ग्रामीण है। बडे गाँवो से विकसित होने वाले इन शहरी क्षेत्रों को भारत की जनगणना द्वारा जनगणना कस्बों के रुपमें परिभाषित किया गया है और उसे रुर्बन केन्द्र समझा जाता है। नगरीकरण के परिणाम स्वरूप शहरी फैलाव ग्रामीण इलाकों की ओर बढ रहा है। शहरी और ग्रामीण के बीच भेद की रेखा मिटती जा रही है। शहरी और ग्रामीण गतिविधियों के प्रसार वाले क्षेत्र को रूर्बन कहा जाता है। ये ग्रामीण केन्द्र नए उभरते नगर है, जो ग्रामीण स्थानीय निकायों द्वारा शासित है, इन क्षेत्रों में होने वाली गतिविधियाँ नगरीय प्रकृति की है। ये रूर्बन केन्द्र आर्थिक रूप से मूलभूत आवश्यकताओं और सामाजिक- सांस्कृतिक सुविधाओं के बिना बढते है। भारत में रूर्बन केन्द्र न केवल नगरीकरण में नए चेहरे लाता है, बल्कि मौजूदा शहरी केन्द्रों में उनकी स्वीकार्यता और समावेशन की दिशा में चुनौतियों को बरकरार रखता है, यह इस अभ्यास का मूल तत्व है।

The deteriorated condition of friction liners after prolonged use is one of the primary causes of judder in centrifugal clutches. The friction characteristics can be retained by generating specific textures or grooves on the friction liner. An attempt has been made to study the characteristics of centrifugal clutch using grooved friction liners. A test cycle for centrifugal clutch has been developed using a number of engagements as the basis. A vehicle test bench was used for the experiment where the developed test cycle was automated. The performance characteristics of the centrifugal clutch have been recorded and analyzed with normal friction liners and grooved friction liners for 100 test cycles. For this study, the groove area ratio was retained at 0.15, and the grooves were cut at 90°. After completing 100 test cycles, the clutch with a grooved friction liner exhibited better characteristics. After completing 100 test cycles, the surface roughness reduction at the leading section of the grooved friction liner and normal friction liner has been found to be 6.44% and 8.11%, respectively. The thickness reduction at the leading section of the grooved friction liner and normal friction liner has been reported to be 3.73% and 4.98%, respectively. Throughout the run of 100 test cycles, the higher clutch housing temperature has been witnessed in the case of a clutch with a grooved friction liner. At the 100th test cycle, the clutch torque with a grooved friction liner was 15.22% more than the clutch torque with a normal friction liner. Even after prolonged use, the clutch with grooved friction liner exhibited better judder characteristics and also provided higher fuel economy for vehicles.

Development of an Efficient Alternative Synthesis of the Endothelin Receptor Antagonist Bosentan

We are concerned with the numerical computation of electrostatic forces/torques in only piece-wise homogeneous materials using the boundary element method (BEM). Conventional force formulas based on the Maxwell stress tensor yield functionals that fail to be continuous on natural trace spaces. Thus their use in conjunction with BEM incurs slow convergence and low accuracy. We employ the remedy discovered in [P. Panchal and R. Hiptmair, Electrostatic force computation with boundary element methods, SMAI J. Comput. Math. 8 (2022), 49–74]. Motivated by the virtual work principle which is interpreted using techniques of shape calculus, and using the adjoint method from shape optimization, we derive stable interface-based force functionals suitable for use with BEM. This is done in the framework of single-trace direct boundary integral equations for second-order transmission problems. Numerical tests confirm the fast asymptotic convergence and superior accuracy of the new formulas for the computation of total forces and torques.

Housing not only provides physical shelter but also has significant impact on the lives of the dwellers in terms of skills enhancement, income generation, increased security, health, self- confidence and human dignity. Housing finance development, therefore, plays a role in boosting equitable economic growth and reducing poverty through helping households build assets, improving living conditions, empowering the middle- and lower-income population, and strengthening communities. The House Building Finance Corporation (HBFC), which has traditionally dominated the housing finance sector, is now a declining player, in part because of decreasing government support, and in part because of its history of operational ineffectiveness. In its place, domestic and international commercial banks and a few new specialised institutions have entered the market, and have a significant potential for growth. This paper has examined the financial operations of Housing Finance Company in India from the year 2018 to 2022. Some selected parameters like liquidity, solvency, valuation and profitability ratios has been used for analysing the financial viability of some selected housing finance Companies listed in recognized stock exchanges for the period from 2018 to 2022. Keeping the focus on above points in mind, the researcher has made an effort to study the financial performance of selected housing finance companies and offer suggestions for the improvement of efficiency in the selected Housing Finance Companies.

The intravenous infusion is an important aspect of therapy under both medical and surgical conditions. Physiologic homeostasis with in the body requires the presence of an adequate supply of fluids. The fluids circulating the body are composed of water, electrolytes, minerals and cells. Their imbalances may result from many factors like injury, surgery and different kinds of medical illnesses. These imbalances can be corrected by intravenous therapy. Intravenous therapy has become a life-saving as well as life sustaining therapy and the intravenous therapy is increasingly being performed by nursing staff in hospitals. Nurses spend upto 2/3rd of their time for IV therapy related responsibilities. Therefore, initiating IV infusion is a challenging skill in nursing.

The aim of study was to identify Single Nucleotide Polymorphisms (SNPs) in the exon regions of GnRH-I, GnRH-II/MRPS26 and GnRHR genes and to assess their association with egg production up to 64 weeks of age (EN64) in chicken. Blood samples were collected from 48 Anand Synthetic White Leghorn (ASWLH) and 48 Anand Bantamised White Leghorn (ABWLH) chicken. Custom panel was designed for these genes’ exon regions and amplicon sequencing was performed on Illumina Miseq platform. Total 41 SNPs (19 previously reported and 22 novel SNPs) were identified from 96 samples. Association analysis revealed that rs314996211 (pC (pC of GnRHR can be implemented as selection markers associated with EN64 in chicken.

Prehospital research and evidence-based guidelines (EBGs) have grown in recent decades, yet there is still a paucity of prehospital implementation research. While recent studies have revealed EMS agency leadership perspectives on implementation, the important perspectives and opinions of frontline EMS clinicians regarding implementation have yet to be explored in a systematic approach. The objective of this study was to measure the preferences of EMS clinicians for the process of EBG implementation and whether current agency practices align with those preferences. This study was a cross-sectional survey of National Registry of Emergency Medical Technicians registrants. Eligible participants were certified paramedics who were actively practicing EMS clinicians. The survey contained discrete choice experiments (DCEs) for three EBG implementation scenarios and questions about rank order preferences for various aspects of the implementation process. For the DCEs, we used multinomial logistic regression to analyze the implementation preference choices of EMS clinicians, and latent class analysis to classify respondents into groups by their preferences. A total of 183 respondents completed the survey. Respondents had a median age of 39 years, were 74.9% male, 89.6% White, and 93.4% of non-Hispanic ethnicity. For all three DCE scenarios, respondents were significantly more likely to choose options with hospital feedback and individual-level feedback from EMS agencies. Respondents were significantly less likely to choose options with email/online only education, no feedback from hospitals, and no EMS agency feedback to clinicians. In general, respondents’ preferences favored classroom-based training over in-person simulation. For all DCE questions, most respondents (66.2% - 77.1%) preferred their survey DCE choice to their agency’s current implementation practices. In the rank order preferences, most participants selected “knowledge of the underlying evidence behind the change” as the most important component of the process of implementation. In this study of EMS clinicians’ implementation preferences using DCEs, respondents preferred in-person education, feedback on hospital outcomes, and feedback on their individual performance. However, current practice at EMS agencies rarely matched those expressed EMS clinician preferences. Collectively, these results present opportunities for improving EMS implementation from the EMS clinician perspective.

Background: The establishment of pneumoperitoneum is the inevitable first step in laparoscopic surgery as it increases the distance between the anterior abdominal wall and intra-abdominal viscera, thus creating a working space. Methods: This prospective study was conducted on 50 patients. Patients were randomly divided into two groups, in first group, pneumoperitoneum is created by Veress needle and in second group, pneumoperitoneum is created by open method. Results: The open method takes less time to create pneumoperitoneum while leads to statistically significant more gas leaks as compared to the closed method. Conclusions: The open technique is almost equal to closed technique or Veress technique in terms of the time taken to complete the operation and major and minor complications because there was no statistically significant difference in the frequency of these parameters between the two techniques. The open method takes less time to create pneumoperitoneum while leads to statistically significant more gas leaks as compared to the closed method.

Phosphate (Pi) deficiency leads to the induction of purple acid phosphatases (PAPs) in plants, which dephosphorylate organic phosphorus (P) complexes in the rhizosphere and intracellular compartments to release Pi. In this study, we demonstrate that OsPAP3b belongs to group III low-molecular weight PAP and is low Pi-responsive, preferentially in roots. The expression of OsPAP3b is negatively regulated with Pi resupply. Interestingly, OsPAP3b was found to be dual localized to the nucleus and secretome. Furthermore, OsPAP3b is transcriptionally regulated by OsPHR2 as substantiated by DNA–protein binding assay. Through in vitro biochemical assays, we further demonstrate that OsPAP3b is a functional acid phosphatase (APase) with broad substrate specificity. The overexpression (OE) of OsPAP3b in rice led to increased secreted APase activity and improved mineralization of organic P sources, which resulted in better growth of transgenics compared to the wild type when grown on organic P as an exogenous P substrate. Under Pi deprivation, OsPAP3b knock-down and knock-out lines showed no significant changes in total P content and dry biomass. However, the expression of other phosphate starvation–induced genes and the levels of metabolites were found to be altered in the OE and knock-down lines. In addition, in vitro pull-down assay revealed multiple putative interacting proteins of OsPAP3b. Our data collectively suggest that OsPAP3b can aid in organic P utilization in rice. The APase isoform behavior and nuclear localization indicate its additional role, possibly in stress signaling. Considering its important roles, OsPAP3b could be a potential target for improving low Pi adaptation in rice.

The K2 eclipsing binary candidates EPIC 211982753 (hereinafter called EPIC2753) and EPIC 211915147 (hereinafter called EPIC5147) are characterized with the help of photometric and high-resolution spectroscopic data. The light curve analysis uses the R-band photometric data from the 1.3-m Devasthal Fast Optical Telescope (DFOT, India), ASAS-3 and K2 observations. High-resolution echelle spectra are collected using the HERMES spectrograph at the 1.2-m MERCATOR telescope (La Palma, Spain). The synthetic light and radial velocity curves are generated with the help of the modeling package PHOEBE 1.0. The orbital period analysis based on the ~3.2 years of K2 observations does not show any change in the orbital period of both targets. The component masses M1,2 are estimated as 1.69(0.02) and 1.59(0.02) solar mass for EPIC2753, and 1.48(0.01) and 1.27(0.01) solar mass for EPIC5147. Both systems are high mass-ratio eclipsing binaries with q>0.85. The component radii R1,2 are found to be 1.66(0.02) and 1.53(0.02) solar radius for EPIC2753, and 1.80(0.05) and 1.42(0.05) solar radius for EPIC5147. The distances of EPIC2753 and EPIC5147 are determined as 238(4) and 199(5) pc, respectively. MESA Isochrones and Stellar Tracks are used to understand the evolutionary status of both systems., Accepted for publication in MNRAS