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Skin and soft tissue infections are brought on by invasion of microbes on the skin and underlying soft tissues (SSTIs). They appear in a series of shapes, causes the high level of severeness. Differentiating between SSTI situations that require prompt attention and surgical or medical intervention from those that don’t is difficult. SSTIs are most prevalent in emergency rooms and affect 7% to 10% of hospitalised patients. SSTIs are characterised by inflammatory components as well as other symptoms including fever, quickly growing lesions, and bullae. The creation of a severity categorization approach to specify suitable empirical treatment would improve the management of SSTIs. Based on the patient’s status knowledge of potential infections, an antibiotic medicine is chosen. Oral antibiotics are sufficient for simple mild-to-moderate infections; however, intravenous antibiotics are required for complicated severe infections.

Most, if not all, the vaccine candidates designed to counteract COVID-19 due to SARS-CoV-2 infection require parenteral administration. Mucosal immunity established by vaccination could significantly contribute to containing the SARS-CoV-2 pandemic, which is spread by infected respiratory secretions. The world has been impacted on many fronts by the COVID-19 pandemic since early 2020 and has yet to recover entirely from the impact of the crisis. In late 2022 and early 2023, China experienced a new surge of COVID-19 outbreaks, mainly in the country's northeastern region. With the threat of new variants like XBB 1.5 and BF.7, India might experience a similar COVID-19 surge as China and needs to be prepared to avoid destruction again. An intranasal vaccine can elicit multiple immunological responses, including IgG neutralization, mucosal IgA production, and T-cell responses. In order to prevent further infection and the spread of COVID-19, local immune responses in the nasal mucosa are required. iNCOVACC is a recombinant vaccine vectored by an adenovirus that contains a SARS-CoV-2 spike protein that has been pre-fusion stabilized. This vaccine candidate has shown promise in both early and late-stage clinical trials. iNCOVACC has been designed for intranasal administration via nasal drops. The nasal delivery system was created to reduce expenses for those living in poor and moderate-income countries. The newly introduced intranasal COVID vaccine will be beneficial in mass immunizing the public as it does not need any syringe and can be proven to be an effective method to boost immunity against the SARS-CoV-2 virus. This study uses natural language processing (NLP) techniques to analyze the Indian citizen's perceptions of the newly developed iNCOVACC vaccine in social media. For this study, we have used social media posts (tweets) as data. We have analyzed 125,300 tweets to study the general perception of Indian citizens regarding the iNCOVACC vaccine. Our results have indicated 43.19% of social media posts discussing the COVID-19 nasal vaccine in a neutral tone, nearly 34.29% of social media posts are positive, and 22.5% of social media posts discussions are negative. The general positive feeling that the iNCOVACC vaccine will work and the risks in the new vaccine are the two significant aspects Indian citizens voice out in social media posts about the iNCOVACC vaccine.

Goats provide an essential food supply in the form of milk and meat. Goat milk has distinct qualities, but it shares many similarities with human and bovine milk regarding its nutritional and therapeutic benefits. Because of their different compositions, goat and cow milk products could have different tastes, nutrients, and medicinal effects. Modification in composition aid of goat milk determining the viability of goat milk processing methods. Comparatively, goat's milk has higher calcium, magnesium, and phosphorus levels than cow's or human milk but lower vitamin D, B12, and folate levels. Goat milk is safe and healthy for infants, the old, and healing ailments. Capric, caprylic, and capric acid are three fatty acids that have shown promise as potential treatments for various medical issues. Considering the benefits and drawbacks of goat milk over cow milk is essential; goat milk is more digestible, has unique alkalinity, has a better buffering capacity, and has certain medicinal benefits. Acidifying goat milk shrinks fat globules and makes protein friable (with less αs1-casein and more αs2-casein). Goat milk treats malabsorption illnesses because it has more short- and medium-chain triglycerides that give developing children energy. In wealthy countries, goat milk and its products—yoghurt, cheeses, and powdered goods—are popular with connoisseurs and persons with allergies and gastrointestinal issues who need alternative dairy products. A food product category containing fermented goat milk with live probiotic microbes appears promising nutritionally and medicinally. This article presents anecdotal evidence of the therapeutic effects of consuming goat milk for human health and its nutritional value.

Plaque biolms is the primary etiology for periodontitis. Mechanical debridement procedures to treat periodontitis still remain the gold standard but adjunctive antimicrobial therapy is also required in certain cases. However the use of antibiotics has their own disadvantages of creating resistant bacterial forms as well as systemic side effects. Photodynamic therapy (PDT) is a novel non-invasive therapeutic approach which overcomes these problems. Photodynamic therapy (PDT) or photochemotherapy has increased pathogen specicity as well as site specicity and hence no systemic effects. PDTinvolves the use of a photosensitiser which on exposure to light of specic wavelength, gets activated, to form toxic oxygen species which further cause a localised photodamage and cell death. As PDT is with no localised as well as systemic adverse effects, its application in periodontal disease treatment continues to evolve into a mature clinical treatment modality.

The freshwater resources of our country include groundwater as a significant component. It is essential to supplying the country's numerous user-sectors with the water they need. Without first evaluating the water quality, the natural resource cannot be used and maintained in an optimum manner. Using ArcMap 9.3, a base map has been created after the data gathering. In order to create thematic maps that demonstrate the distribution of different water quality criteria, after doing an analysis, the water quality information is used as an attribute database. The water quality index has been calculated using a number of variables, such as pH, turbidity, total hardness (TH), chloride, total dissolved solids (TDS), calcium, nitrate, iron, and fluoride. A map of the Water Quality Index is also created. In order to better comprehend the current water quality situation in the research region, the data are provided as maps. Analysis shows that the area's groundwater has to undergo field-specific treatment before being used.

Large-scale pollution of water resources is one of the principal consequences of industrialization and urban expansion. Like pollution can be classified depending on factors such as pH, specific conductivity, dissolved oxygen (DO), temperature, and so on. The data acquired from the above attributes can aid in estimating the water quality of any body of water, although the prediction accuracy of traditional models is not particularly good due to unpredictability and imprecision. The ensemble modeling technique was used in this study to estimate the performance of the ANN study to predict the water quality of river Kshipra. The Artificial Neural Network (ANN) is a sophisticated data-driven model capable of capturing and representing both linear and non-linear correlations between input and output data. A total of 17 features is considered for determining the water quality. Some of these are: Temperature, pH, DO, COD, and Specific conductivity. After assessing the obtained results, the assembled ANN model was found to be a better classification model with an accuracy of 92.60%.

The vaccine decision-making process of pregnant and lactating women is complex. Regarding COVID-19, pregnant women are at increased risk for severe disease and poor health outcomes. While pregnant and lactating women were excluded from COVID-19 vaccine trials, available evidence suggests that COVID-19 vaccines are safe and protective during pregnancy. In this study, we used a socio-ecological approach to explore factors influencing the decision-making process for COVID-19 vaccines in pregnant and lactating women in Kenya, for the purpose of informing demand generation strategies. As pregnant and lactating women are influenced by many factors, we conducted 84 in-depth interviews with a variety of stakeholders, including 31 pregnant or lactating women, 20 healthcare workers such as nurses, midwives, doctors, and frontline workers, 25 male family members of pregnant or lactating women, and 8 gatekeepers such as community leaders and faith-based leaders. These individuals were recruited from six communities in Kenya: three urban, and three rural. We applied a grounded theory approach to identify emerging themes and organized emerging themes using the SAGE Vaccine Hesitancy model, which includes three categories of determinants of vaccine acceptance, including contextual influences, individual and group influences, and vaccine and vaccination specific issues. Myths, interpersonal norms, and religion emerged as themes related to contextual influences. Safety, risk perception, and the role of the healthcare worker emerged as themes related to individual and group influences. For vaccine and vaccination specific issues, emerging themes included availability, accessibility, and eligibility. While maternal immunization can substantially reduce the effect of infectious diseases in mothers and infants, vaccine acceptance is critical. However, vaccines do not save lives; vaccination does. We hope the results of this study can be used to tailor communication efforts to increase vaccine demand among pregnant and lactating women.

We examined the effect of intermittent hypoxia (IH, a hallmark feature of sleep apnea) on adipose tissue lipolysis and the role of endothelin-1 (ET-1) in this response. We hypothesized that IH can increase ET-1 secretion and plasma free fatty acid (FFA) concentrations. We further hypothesized that inhibition of ET-1 receptor activation with bosentan could prevent any IH-mediated increase in FFA. To test this hypothesis, 16 healthy male participants (32 ± 5 yr, 26 ± 2 kg/m2) were exposed to 30 min of IH in the absence (control) and presence of bosentan (62.5 mg oral twice daily for 3 days prior). Arterial blood samples for ET-1, epinephrine, and FFA concentrations, as well as abdominal subcutaneous adipose tissue biopsies (to assess transcription of cellular receptors/proteins involved in lipolysis), were collected. Additional proof-of-concept studies were conducted in vitro using primary differentiated human white preadipocytes (HWPs). We show that IH increased circulating ET-1, epinephrine, and FFA ( P < 0.05). Bosentan treatment reduced plasma epinephrine concentrations and blunted IH-mediated increases in FFA ( P < 0.01). In adipose tissue, bosentan had no effect on cellular receptors and proteins involved in lipolysis ( P > 0.05). ET-1 treatment did not directly induce lipolysis in differentiated HWP. In conclusion, IH increases plasma ET-1 and FFA concentrations. Inhibition of ET-1 receptors with bosentan attenuates the FFA increase in response to IH. Based on a lack of a direct effect of ET-1 in HWP, we speculate the effect of bosentan on circulating FFA in vivo may be secondary to its ability to reduce sympathoadrenal tone.

Leprosy is a chronic cutaneous infection. It is usually characterized by thickened nerves and maculo-anesthetic patches. Leprosy often has an unusual presentation, which is a diagnostic challenge. In this case report, we present a case of an elderly male who presented with fever and chronic pus-draining axillary, cervical, and inguinal lymph nodes. He also had a weak left foot for the previous 5 months. During his hospital stay, he developed additional papular lesions over his extremities. We performed fine needle aspiration from the lymph nodes and skin biopsy, which were suggestive of lepromatous leprosy. We initiated him on antileprosy medication. On follow-up, he was responsive to therapy. Although skin and nerve involvement in leprosy is common, this case had an atypical presentation of discharging lymph nodes.

Background Bioavailable vitamin D levels is could be a better marker than total 25 hydroxy vitamin D levels to assess vitamin D status in children with nephrotic syndrome. Primary objective To assess the levels of Serum bioavailable vitamin D in children aged 1 to 12 years with idiopathic FENS and in healthy controls. Secondary objective 1. To measure the levels of bioavailable vitamin D in FENS and after 4 weeks of standard steroid therapy induced remission. 2. To compare levels of serum and urine VDBP in FENS and after 4 weeks of standard steroid therapy induced remission. Materials and Methods A longitudinal study was conducted in children between age 1 to 12 years with idiopathic first episode nephrotic syndrome. After diagnosis of nephrotic syndrome as per ISPN guidelines, additional investigations like calcium, phosphorus, ALP, 25 hydroxy vitamin D, PTH, serum Vitamin D binding protein (VDBP) and urinary VDBP. Bioavailable and free vitamin D was calculated using above data. The patients were followed up after 4 weeks of remission and investigations were repeated and bioavailable vitamin D was calculated again, later results were compared and analysed. Appropriate statistical tests were applied for parametric and non-parametric data. P value of less than 0.05 was considered statistically significant. Results: The mean 25 hydroxy vitamin D level was 11.27(6.08) at FENS and at 4 weeks follow-up it was 13.65 (6.24). Hence children with FENS remained deficient in 25 hydroxy vitamin D, both during relapse and remission compared to healthy controls (15.97 ng/ml). The mean serum VDBP level in FENS during relapse was 242.90 (127.75). There was significant correlation of serum VDBP with serum albumin levels (p value 0.04). At 4 weeks of remission the VDBP levels increased to 550.7(219.7), this increase was significant (p value Conclusion Children with FENS are deficient of vitamin D levels. The free and bioavailable vitamin D levels are reduced in children with FENS during proteinuria, as compared to healthy controls. Further studies showing correlation of bioavailable vitamin D and 25 hydroxyvitamin D with bone mineral density are required in children to validate the usage of bioavailable vitamin D in clinical practice.

Hypertension is commonly observed with obstructive sleep apnea (OSA), partly due to dysregulation of sympathetic activity. As OSA is considered male-dominant, potential sex differences in the sympathetic regulation of BP have yet to be explored. Hemodynamic responses to an orthostatic challenge have implications for cardiovascular risk and are sympathetically-modulated. Therefore, we tested the hypothesis that females with OSA have differential BP and HR responses to orthostasis relative to males with OSA. 160 individuals not taking antihypertensive medications completed an overnight polysomnography to identify OSA (apnea-hypopnea index ≥5 events/hr). Orthostatic responses were quantified as the changes (Δ) in BP and HR (assessed via brachial cuff) from rest (10min supine) to 60sec post-standing. Females with (n=17, 42±14yrs, 30.7±6.0kg/m2) and without (n=43, 39±12yrs, 27.6±5.7kg/m2) OSA were compared to males with (n=60, 45±11yrs, 31.4±3.8kg/m2) and without (n=40, 39±13yrs, 27.4±3.1kg/m2) OSA using a one-way ANOVA. There were no between-group differences in age (p>0.05 for post-hoc comparisons) and BMI was lower in both females, and males, without OSA relative to males with OSA (p This work was supported by the National Institutes of Health T32-HL007111 (JMB), HL134808 (NC), HL065176 (PS and VKS), and HL134885 (VKS). This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Groundwater is a vital resource that provides drinking water to over half of the world's population. However, groundwater contamination has become a serious issue due to human activities such as industrialization, agriculture, and improper waste disposal. The impacts of groundwater contamination can be severe, including health risks, environmental damage, and economic losses. In this research work a list of unknown groundwater contamination sources were developed for the Wang-Tien landfill using Groundwater Modeling System (GMS). Further, AI based models have been developed which accurately predicts the contamination from the sources at this site. A serious complication with most previous studies using Artificial Neural Network (ANN) for contamination source identification has been the large size of the neural networks. To simplify this, we have designed the ANN models which use three different ways of presenting inputs that are categorized by hierarchical k-means clustering. Such an implementation reduces the overall complexity of the model along with high accuracy. The predictive capability of developed models was assessed using performance indices and compared with the ANN models. The results show that the Hybrid model of hierarchical K-means Clustering and ANN model (HCA-ANN) is highly accurate model for identifying pollution sources in contaminated water.

Spatially explicit measurement of Above Ground Biomass (AGB) is crucial for the quantification of forest carbon stock and fluxes. To achieve this, an integration of Optical and Synthetic Aperture Radar (SAR) satellite datasets could provide an accurate estimation of forest biomass. This will also help in removing the uncertainties associated with the single sensor-based estimation approaches. Therefore, the present study attempts to integrate Sentinel-2 optical data with Sentinel-1 SAR dataset to estimate AGB in the Shoolpaneshwar Wildlife Sanctuary (SWS), Gujarat, India. In this study, two non-parametric machine learning algorithms viz Support Vector Machines (SVMs) with different kernel functions—linear, sigmoidal, radial and polynomial and Random Forest (RF) were employed for the prediction of AGB using different combinations of VV, VH, Normalized Difference Vegetation Index (NDVI) and Incidence Angle (IA). Ground based AGB was estimated through allometric equation at 35 sampling sites with the help of tree height and Diameter at Breast’s Height (DBH). Standalone collinearity analysis among different parameters resulted in poor correlation of AGB with VH (r = 0.05) and IA (r = 0.015), whereas a significantly good correlation with NDVI (r = 0.80) and VV (r = 0.74) were observed. Inclusion of NDVI with VV and VH together also resulted in a better correlation (r = 0.85) than other combinations. The SVM with linear kernel utilizing parametric the combinations of VV + VH + NDVI and VV + VH + NDVI + IA were found to be best performing on the basis of evaluation metrics. The outcome of this study highlighted the significance of machine learning techniques and synergistic use of different remote sensing data for an improved AGB quantification in tropical forests.

COVID-19 vaccine rollout in Kenya has been challenged by both the supply of and demand for vaccines. With a third of the adult population classifying as vaccine hesitant, reaching vaccination targets requires an understanding of how people make decisions regarding vaccines. Globally, pregnant and lactating women have especially low uptake rates, which could be attributed to the “infodemic,” or constant rush of new information, as this group is vulnerable to misinformation and uncertainty. While presentation of COVID-19 vaccines in the media allows for easy access, these sources are also susceptible to misinformation. Negative and unfounded claims surrounding SARS-CoV-2 infection and COVID-19 vaccines contribute to vaccine hesitancy. Given the influence that the media may have on people's attitudes toward vaccines, this study examines the relationship between the media and the vaccine decision-making process among pregnant and lactating women, healthcare workers, community members (male relatives, male neighbors, and gatekeepers), and policymakers in Kenya. Data were collected through in-depth interviews in urban and rural counties in Kenya to understand how media information was utilized and consumed. While healthcare workers were the most frequently cited information source for pregnant and lactating women, other healthcare workers, and community members, findings also show that the media (traditional, social, and Internet) is an important source for obtaining COVID-19 information for these groups. Policymakers obtained their information most frequently from traditional media. Ensuring that information circulating throughout these media channels is accurate and accessible is vital to reduce vaccine hesitancy and ultimately, meet COVID-19 vaccination goals in Kenya.

Employees have always been a prerequisite part of the institutes. This paper sheds light on how employee welfare Schemes could help to advance Employee Productivity and Effectiveness of Educational Institutes in Gwalior Region. The researchers therefore will try to highlight on the impact of employee welfare schemes on Employee Productivity and Employee Effectiveness of Educational Institutes in Gwalior Region. In the course of the study, a review of related literature will be ascertained. The study is a descriptive and empirical research in nature; the collected data of study was both primary and secondary data. Data was collected by survey method through a questionnaire with 200 as the sample size. Normality Analysis, Reliability Analysis and Regression Analysis have been used as tools of data analysis. The paper reveals that employee welfare schemes have significant impact on Employee Productivity and Effectiveness of Educational Institutes in Gwalior Region. This research paper suggested that Employee Welfare Schemes (remuneration policies; occupational health and training and development) should be adopted by the Educational Institutes to improve on Employee Productivity and Effectiveness of Educational Institutes in Gwalior Region.

As per WHO, the pneumococcus causes one million fatalities each year because of their underdeveloped immune systems, children are the most vulnerable to pneumococcal infections. The rise of S. pneumoniae resistance to antibiotics is causing widespread alarm all across the globe. Since the last couple of years, a recently developed technique is being used to overcome resistant pathogens. One of these is the computational subtractive genomics technique, in which the bacterial pathogen full proteins are effectively decreased to a limited amount of probable therapeutic targets. The procedures employed in this strategy are to locate human non-homologs targets, proteins that are vital to the illness producing agent, and participation of the identified proteins in pathogen metabolic pathways that are required for bacterial survival. In this work, we applied computational subtractive genomics on the proteins of the S. pneumonia strain D39 and came up with three cytoplasmic proteins that can serve as a promising candidate for novel drug to control the pathogenicity caused by S. pneumoniae.

SARS-CoV-2 infection in pregnancy is associated with a greater risk of maternal and newborn morbidity and maternal death. In Kenya, pregnant and lactating women (PLW) were ineligible to receive COVID-19 vaccines until August 2021. How shifts in policy influence vaccine behaviors, such as health worker recommendations and vaccine uptake, is not well documented. We conducted qualitative interviews with PLW, health workers, and policymakers in Kenya to understand how different stakeholders' perceptions of national policy regarding COVID-19 vaccination in pregnancy shaped vaccine behaviors and decision-making. Policymakers and health workers described pervasive uncertainty and lack of communication about the national policy, cited vaccine safety as their primary concern for administering COVID-19 vaccines to PLW, and expressed that PLW were inadequately prioritized in the COVID-19 vaccine program. PLW perceived the restrictive policy as indicative of a safety risk, resulting in vaccine hesitancy and potentially exacerbated inequities in vaccine access. These findings support the need for the development and dissemination of effective vaccine communication guidelines and the prioritization of PLW in COVID-19 vaccination policies and campaigns. To ensure PLW do not face the same inequities in future epidemics, data on infectious disease burdens and vaccine uptake should be collected systematically among pregnant women, and PLW should be included in future vaccine trials.

Chronic sleep deficiency (CSD) poses a threat to physical health, mental well-being, and social functioning. The concept of behaviorally induced CSD has not changed much since it was first introduced four decades ago. Behaviorally induced CSD is currently referred to as insufficient sleep syndrome (ISS). In the latest edition of the International Classification of Sleep Disorders (ICSD-3, 2014), ISS is considered a disorder of central hypersomnolence with diagnostic codes ICD-9-CM 307.44 and ICD-10-CM F51.12. In this review, we will describe the biological importance of sleep, the ramifications of CSD on the individual and society, the nosological status and diagnostic features of ISS, and the apparent lack of attention to ISS in contemporary medical practice and public health programs. The last three decades have seen a global rise in voluntary sleep curtailment such that ISS may already be the leading cause of CSD, not only in adults but also in school-aged children and adolescents. Acknowledging ISS as a public health priority is a necessary first step in our response to the global threat of CSD and CSD-related health consequences. It is only by confronting ISS directly that we can hope to develop and implement effective educational and advocacy programs, along with more responsible public health policies and regulations.

Introduction: Breast cancer is a leading cause of cancer death among women, and its age-standardised incidence rate is one of the highest in Asia. We aimed to review studies on barriers to breast cancer screening to inform future policies in Singapore. Method: This was a literature review of both quantitative and qualitative studies published between 2012 and 2020 using PubMed, Google Scholar and Cochrane databases, which analysed the perceptions and behaviours of women towards breast cancer screening in Singapore. Results: Through a thematic analysis based on the Health Belief Model, significant themes associated with low breast cancer screening uptake in Singapore were identified. The themes are: (1) high perceived barriers versus benefits, including fear of the breast cancer screening procedure and its possible outcomes, (2) personal challenges that impede screening attendance and paying for screening and treatment, and (3) low perceived susceptibility to breast cancer. Conclusion: Perceived costs/barriers vs benefits of screening appear to be the most common barriers to breast cancer screening in Singapore. Based on the barriers identified, increasing convenience to get screened, reducing mammogram and treatment costs, and improving engagement with support groups are recommended to improve the screening uptake rate in Singapore. Keywords: Barriers, breast cancer, mammography, screening programme

Introduction: Obstructive sleep apnea (OSA) is a prevalent sleep disorder with high type 2 diabetes (T2D) risk. OSA therapy includes positive airway pressure (PAP) treatment, which resolves breathing events but modestly improves metabolic health. Metformin is recommended for T2D prevention but is not advocated in patients with OSA. Our pilot study evaluated the effects of metformin on glucose metabolism and mitochondrial function in OSA patients. Methods: Sixteen adults (50.5±1.6 years, BMI: 36.4±0.8 kg/m2) with OSA (apnea hypopnea index: 53.2±21.1 events/hour) were randomized to receive placebo (n=8) or metformin (n=8) treatment along with PAP for 3 months in a double-blind parallel-group design. Whole body and adipose tissue-specific insulin sensitivity (IS) was determined by oral glucose tolerance test (OGTT) . Skeletal muscle mitochondrial function was determined by high-resolution respirometry using biopsies obtained at baseline and after 3 months of treatment. Results: Change in whole body IS (Matsuda index) was not different in metformin or placebo treated groups (p=0.46) . However, improved acute phase responses during OGTT - glucose uptake (p=0.02) , insulin release (p=0.03) , and suppressed lipolysis (p=0.03) were observed with metformin treatment relative to control. Increased skeletal muscle mitochondrial function was evident with metformin relative to control. Specifically, metformin increased complex I phosphorylation and complex IV electron transfer capacity. Conclusion: Metformin treatment improves acute phase IS and insulin suppression of lipolysis in OSA patients. Strikingly, metformin improved skeletal muscle mitochondrial function independent of changes in second phase glucose disposal and BMI, indicating improved tissue metabolic function. These data suggest that in patients with OSA, improvement in tissue level metabolic function may precede changes in whole-body IS and metformin may improve metabolism. Disclosure E.R.M.Zunica: None. E.C.Heintz: None. R.C.Hebert: None. M.C.Tanksley: None. E.C.Mader: None. J.P.Kirwan: None. C.L.Axelrod: None. P.Singh: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (DK123456789) ;National Institute of General Medical Sciences (GM123456789)

Interband information overlapping enhances redundancy in hyperspectral data. This makes identification of application-specific optimal bands essential for obtaining accurate information about folia...

Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder and an established risk factor for cardiovascular diseases, including hypertension. The pathogenesis of elevated blood pressure (BP) in OSA is multifactorial, including sympathetic overdrive, vascular aberrations, oxidative stress, inflammation, and metabolic dysregulation. Among the mechanisms potentially involved in OSA-induced hypertension, the role of the gut microbiome is gaining increasing attention. Perturbations in the diversity, composition, and function of the gut microbiota have been causally linked to numerous disorders, and robust evidence has identified gut dysbiosis as a determinant of BP elevation in various populations. In this brief review, we summarize the current body of literature on the implications of altered gut microbiota for hypertension risk in OSA. Data from both preclinical models of OSA and patient populations are presented, and potential mechanistic pathways are highlighted, along with therapeutic considerations. Available evidence suggests that gut dysbiosis may promote the development of hypertension in OSA and may thus be a target for interventions aimed at attenuating the adverse consequences of OSA in relation to cardiovascular risk.

This prospective, observational study investigated changes in sleep and the effect on energy intake, gestational weight gain, and cardiometabolic health across pregnancy in 52 healthy pregnant women with obesity. Habitual sleep was assessed by wrist-worn actigraphy (time spent in bed; TIB, total sleep time; TST, and sleep efficiency) in early (13(0)-15(6) weeks) and late (35(0)-36(6)) pregnancy. A change to habitual sleep was defined as change of one-half of the standard deviation of TIB and TST across six consecutive nights from early pregnancy. Energy intake and changes in weight, fasting glucose, insulin, and lipids across pregnancy were compared between women who changed sleep. During early pregnancy, TIB was 9:24±0:08h and varied by 1:37±0:07h across the six nights. TST and sleep efficiency significantly declined from early to late pregnancy (7:03±0:08h to 6:28±0:09h, p

Introduction The management of septic shock and refractory septic shock is essential in preventing sepsis-related death. The handheld vital microscope is a new modality of investigation for sepsis for microcirculatory assessment. This study aimed to identify predictors of inotrope requirements among patients with early sepsis and impending septic shock with particular reference to sublingual microcirculation assessment parameters. Methodology We conducted an observational cross-sectional hospital-based study in central India. The formal sample size was calculated to be 52 patients using a convenient sampling technique. The study was initiated with ethics approval (IHEC-LOP/2019/ MD0090) with consent from the patients. We used the MicroScan (MicroVision Medical, Netherlands) Video Microscope System (No.16A00102) to obtain sidestream dark-field imaging along with the AVA 4.3C software (MicroVision Medical). Results Of 51 cases, 60.8% were women, and 39.2% were men, and the study population had a mean age of 41.0 ± 14.9 years. Patients were recruited from medical wards (64.7%) and emergency departments (35.3%). The most common site of infection was gastrointestinal (33.3%), followed by respiratory infections (25.5%) and genitourinary infections (11.8%). The quick sequential organ failure assessment score was 2.0 ± 0.1. Eight patients required inotropes, and six patients died. High respiratory rates and lactate levels were important predictors of inotrope requirements in patients with early sepsis. Sublingual microcirculatory parameters at baseline did not significantly affect the requirement of inotropes consequently. Conclusions Sublingual microscopy is a suggested tool for the management of sepsis. However, without clearly defined cut-off values, handheld vital microscopy could not predict fluid responsiveness among patients with early sepsis. Also, it would be difficult to incorporate this technology into regular practice without equipment upgrades and image acquisition software.

Cultured meat, also known as 'in-vitro meat' or 'clean meat', holds the potential solution to environmental sustainability along with conventional meat alternatives, including plant-based meat, insects, algae, and pulses. A critical step to its widescale acceptance is consumer perception. Both qualitative research and quantitative analysis are being carried out to enhance the acceptability of cultured meat. In this review, consumer behavior towards cultured meat is accessed to understand the current market scenario. Psychological factors that can hinder or improve cultured meat acceptance are discussed. Consumer social factors geared towards consumer behavior on cultured meat are also summarized. As per the research findings, meat lovers are more likely to try cultured meat owing to the attached sustainability claims. The consumers' concerns about the unnaturalness of cultured meat should be addressed in order to encourage them to get more acquainted with the product and modify their attitudes about it. Marketing tactics of labeling it as 'clean meat' rendered better purchasing as compared to other terms. Furthermore, educating the masses likely reduced the unfamiliarity with newly marketed products resulting in improved consumer perception of cultured meat.

Coupling of leaf physiological models with leaf and canopy RT (Radiative Transfer) models allow evaluation and quantification of most influential variables using fluorescence signal emitted by the leaf and canopy. Using RTM output, one of the most successful method i.e. Sobol global sensitivity analysis was used to identify the most influential input variables through matrices such as first-order (Si) and total-Order effect (STi). The present study was conducted using the field-based and hyperspectral datasets in the agricultural site in Northern India. Ground bio-physical (Leaf water content, Leaf area Index) and bio-chemical (Chlorophyll) parameters were collected. RTM spectral outputs were generated for hyperspectral data within the spectral range of 350-2500 nm. To calculate the first order and total order sensitivity result of PROSPECT-4 (leaf) and PROSPECT+SAIL (canopy) RTMs were evaluated. Sobol results for PROSPECT-4 model reveal that the role of biochemical parameter chlorophyll content in the visible region and the influence of the other biophysical parameters such as Leaf structure and dry matter across the whole spectral range. Only Leaf water content reflectance was found around 1200 nm onwards. After coupling the leaf PROSPECT-4 model with SAIL (Scattering by Arbitrary Inclined Leaves) model, reference PROSAIL STi results showed that the LAI variable shows 50% of the total variability, especially in the SWIR region. The present study is not only useful to know wavelength-dependent influential and non-influential RTM input variables but also for driving input variables of fluxes such as photosynthesis of the canopy and for the estimation of FPAR (Fraction of photosynthetically active radiation) values.

Tomato is an important nutritional vegetable crop and its nutrient contents are affected by both biotic and abiotic stresses. The main objective of this study was to determine the effect of seed biopriming with Trichoderma pseudokoningii BHUR2 and vermiwash treatment on nutrient content of tomato and defense response against Sclerotium rolfsii under heat stress condition. The combined application of T. pseudokoningii BHUR2 and vermiwash increased fresh weight of root (4.8-fold) and shoot (5.8-fold), dry weight of root (6.9-fold) and shoot (6.4-fold) and number of fruits per plant (4.2-fold) as compared to control under S. rolfsii inoculated condition. Plants treated with T. pseudokoningii BHUR2 and vermiwash exhibited higher defense response against S. rolfsii, mediated by higher activity of superoxide dismutase (3.57-fold), peroxidase (2.05-fold) and phenylalanine ammonia lyase (2.98-fold) enzymes and accumulation of total phenol content (5.35-fold) as compared to control plants. In addition, combined treatment was found to have a positive impact on nutritional status (N, P, K and Ca and lycopene, total soluble sugar and total protein) in tomato fruit. These results suggest potential of T. pseudokoningii BHUR2 and vermiwash in enhancing tomato immunity against S. rolfsii under heat stress condition, which was due to (1) induction in the antioxidant activity and phenylpropanoid pathway, which minimize oxidative damage and reduce pathogen infection and (2) significant improvement in nutrient content leads to better plant growth. The formulation of Trichoderma BHUR2 can be used for field application to mitigate heat stress in plants.

Background: The most commonly received specimen in any histopathology laboratory is cholecystectomy specimen. The majority of the cholecystectomies are done for Cholelithiasis. Inflammation may be acute, chronic or acute on chronic. It almost always occurs in association with gallstones, which is responsible for carcinoma and if the diagnosed early prognosis of the carcinoma gall bladder is good. Histopathological examination is therefore a must for diagnosis of early carcinomas. Subjects and Methods: 100 cholecystectomy specimens from patients of all ages were included. All specimens were subjected to gross and microscopic assessment. Different histological findings were noted in various layers of the gall bladder. The study includes all radiologically confirmed inflammatory pathologies of including metaplastic changes of the gall bladder epithelium, irrespective of age and sex. The study excludes patients with evident gallbladder malignancy, cases with known secondaries from gall bladder, traumatic rupture of gallbladder. Results: The age of patients varied from 16 to 70 years, with a maximum number of patients (25%) belong to 31 to 40 years. Gall stones were associated with 59% cases of cholecystitis. Pigment stones were most common (74%). Histopathologically the most common diagnosis was chronic cholecystitis (69%). Conclusion: Almost all of the gallbladder lesions are inflammatory in origin, of which the most common disease being chronic cholecystitis. Chronic cholecystitis was found to be most probable diagnosis in a female of 30-40 years. Pigmented gall stones were found to be the most common etiology of chronic cholecystitis. Prompt detailed histopathological analysis will help to confirm the benign nature of the disease or to detect any precursors of malignancy.

Objectives: The objective of this study is to assess clinical characteristics, obstetric and perinatal outcome of pregnant women with H1N1 infection. Methods: A retrospective observational study was conducted at a tertiary care teaching hospital. All clinically suspected, probable as well as confirmed cases of swine flu, in pregnancy were included. We analyzed the presenting complaints, condition on admission, criteria for admission in ICU, abnormalities in laboratory reports, course of illness and perinatal outcome. Results: A total of 52 patients in pregnancy and postpartum period were admitted with fever or acute respiratory illness over the period of two years from March 2017 to February 2019. Mean age of patients was 25.88 years. 32 patients were H1N1 positive. In which, 29 were pregnant and 3 patients were postpartum. Mean gestational age was 31weeks. Out of 32 patients, 11 patients were admitted in intensive care unit. There were 4 deaths due to H1N1 illness and all were in 3rd trimester. Conclusion: Acquiring infection in late trimester, late initiation of antiviral treatment and presence of co-morbid illness were high risk factors for developing critical illness. We emphasize that high index of suspicion, early diagnosis; early antiviral therapy and immunization to pregnant women are to reduce the complications, ICU admissions and mortality in this group.

Background: The post-operative pain in knee arthroscopy procedures can be attributed to irritation of free nerve endings of synovial tissue, anterior fat pad, and joint capsule during surgical excision and resection1. In the recent years, new interest has focused on the cholinergic system that modulates pain perception and transmission. The present study is designed to compare the efficacy of intra- articular Bupivacaine and Neostigmine with Bupivacaine and Fentanyl for pain relief following arthroscopic surgeries.Subjects and Methods:Prospective, Interventional, Randomised study was conducted over 90 patients scheduled for elective arthroscopic knee surgery, who were randomly allocated into three equal groups of 30 patients each. Group I-Bupivacaine with Neostigmine, Group II-Bupivacaine with Fentanyl and Group III-Bupivacaine alone. The study drug combinations were administered Intra-articularly at the conclusion of surgery. Hemodynamic variables and Pain were observed immediately after completion of surgery (Baseline) and thereafter at fixed intervals. The duration of effective analgesia was measured from the “baseline” until the first use of rescue analgesic. The number of rescue analgesics given in 24 hours were also recorded. The statistical analysis was done using SPSS (Statistical Package for Social Sciences) Version 15.0 statistical Analysis Software.Results:Requirement for first analgesia was significantly earlier in Group III (146.00±71.66 minutes) as compared to Group II (236.00±111.34 minutes) and Group I (648.00±228.55 minutes). Majority of patients of Group I (90.0%) required rescue analgesia only once while in was twice in Group II (90.00%) and thrice in Group III (86.67%).Conclusion:Intra-articular administration of Neostigmine in combination with Bupivacaine provided a better post-operative analgesic effect with a lower incidence of side effects and lesser requirement of rescue analgesia.

PURPOSE: This study assessed whether the newly developed PET radioligand [(11)C]PS13, which has shown excellent in vivo selectivity in previous animal studies, could be used to quantify constitutive levels of cyclooxygenase-1 (COX-1) in healthy human brain. METHODS: Brain test-retest scans with concurrent arterial blood samples were obtained in 10 healthy individuals. The one- and unconstrained two-tissue compartment models, as well as the Logan graphical analysis were compared, and test-retest reliability and time-stability of total distribution volume (V(T)) were assessed. Correlation analyses were conducted between brain regional V(T) and COX-1 transcript levels provided in the Allen Human Brain Atlas. RESULTS: In the brain, [(11)C]PS13 showed highest uptake in the hippocampus and occipital cortex. The pericentral cortex also showed relatively higher uptake compared with adjacent neocortices. The two-tissue compartment model showed the best fit in all the brain regions, and the results from the Logan graphical analysis were consistent with those from the two-tissue compartment model. V(T) values showed excellent test-retest variability (range 6.0–8.5%) and good reliability (intraclass correlation coefficient range 0.74–0.87). V(T) values also showed excellent time-stability in all brain regions, confirming that there was no radiometabolite accumulation and that shorter scans were still able to reliably measure V(T). Significant correlation was observed between V(T) and COX-1 transcript levels (r = 0.82, P = 0.007), indicating that [(11)C]PS13 binding reflects actual COX-1 density in the human brain. CONCLUSIONS: These results from the first-in-human evaluation of the ability of [(11)C]PS13 to image COX-1 in the brain justifies extending the study to disease populations with neuroinflammation. CLINICAL TRIAL REGISTRATION: NCT03324646 at https://clinicaltrials.gov/. Registered October 30, 2017. Retrospectively registered.

Introduction: Chronic suppurative otitis media (CSOM) is a common health problem in countries with low socio-economic strata because of poor nutrition, population burden, low hygienic condition, insufficient health care, and repeated upper respiratory tract infection (URTI). Untreated cases of CSOM result in complications ranging from persistent otorrhoea, mastoiditis, labyrinthitis, facial nerve palsy to intracranial abscesses or thromboses. Microbiological profile and their antibiotic sensitivity pattern are essential to enable proper treatment of this disease and preventing the development of complications. Material and Methods: The current study was designed to identify the pathogenic agents causing CSOM and to understand their antimicrobial resistance pattern who attended ENT Department of this hospital between July 2017 to June 2019. Results: Among 496 clinical samples, microbes were seen in 329 (66.3%) cases with predominant male (66.3%) distribution and age group of 11-20 years (31%). Pseudomonas spp. (50.7%) is predominantly isolated. It showed resistance to aminoglycosides and fluoroquinolones but was found sensitive to carbapenems with a resistance rate of 1.2%. ESBL (Extended-spectrum β- lactamase) detection was seen in 30.9% of GNB while MBL (Metallo β- lactamase) was detected in 2.7% of cases. S.aureus was highly resistant to first-line antibiotics with MRSA (Methicillin-resistant S.aureus) rate of 64.1%, however, all were sensitive to glycopeptides. Conclusions: There should be a minimum gap between the onset of symptoms and the treatment provided to prevent complications of CSOM and also the complicated cases should be referred to specialized centers for better management.

Accurate estimation of evapotranspiration is generally constrained due to lack of required hydro-meteorological datasets. This study addresses the performance analysis of Reference Evapotranspiration (ETo) estimated from NASA/POWER, National Center for Environmental Prediction (NCEP) global reanalysis data before and after dynamical downscaling through the Weather Research and Forecasting (WRF) model. The state of the art Hamon’s and Penman-Monteith methods were utilized for the ETo estimation in the Northern India. The performances indices such as Bias, Root Mean Square Error (RMSE) and correlation(r) were calculated, which showed the values 0.242, 0.422 and 0.959 for NCEP data (without downscaling) and 0.230, 0.402,0.969 for the downscaled data respectively. The results indicated that after WRF downscaling, there was some marginal improvement found in the ETo as compared to the without downscaling datasets. However, a better performance was found in the case of NASA/POWER datasets with Bias, RMSE and correlation values of 0.154 0.348 and 0.960 respectively. In overall, the results indicated that the NASA/POWER and WRF downscaled data can be used for ETo estimation, especially in the ungauged areas. However, NASA/POWER is recommended as the ETo calculations are less complicated than those required with NASA/POWER and WRF.