Search

This study utilises mathematical modelling and computations to analyse the magnetohydrodynamic (MHD) effects on non-Newtonian Eyring–Powell fluid flow in an inclined non-uniform channel under long-wavelength, low Reynolds number conditions. The governing equations are solved by applying slip boundary conditions to determine the velocity, temperature, concentration, and streamline profiles. The key findings show that the magnetic parameter dampens the flow rate. The relationship between the variable viscosity, velocity, and temperature is nonlinear. The wall rigidity parameter and axial velocity are directly proportional until a threshold. Increasing inclination angles distorts streamlines. The magnetic field alters concentration contours and thermal transport. MATLAB parametric analysis explores MHD effects. This study enhances the understanding of inclined channel fluid dynamics, offering insights into variable viscosity, magnetic fields, wall properties, and impacts of inclination angles on non-Newtonian flow characteristics. This knowledge can optimise industrial MHD conduit/channel transport applications.

Abstract Background Usually non-pathogenic in immunocompetent individuals, mucormycosis is an aggressive, angio-invasive fungus. It is a rare, opportunistic infection belonging to the zygomycete family. The second wave of COVID-19 saw the emergence of a more dangerous and a potentially deadly invasive fungal sinusitis evolving in rhino-cerebral mucormycosis thus compounding and complicating the pandemic. Alarming and exponential rise in the number of cases of rhino-cerebral mucormycosis in India versus the rest of the world when the treatment protocols essentially remained the same needs to be probed scientifically along with its prompt management. Here an attempt has been made to explore this in the study of 50 cases of rhino-cerebral mucormycosis. This study aims to explore the cause and extension of the disease along with its treatment and outcome in 50 cases of post COVID rhino-cerebral mucormycosis. Results This is a retrospective cohort study conducted on 50 patients with post COVID-19 invasive mucormycosis of the paranasal sinuses with extension to surrounding structure visiting Otorhinolaryngology department at Acharya Vinoba Bhave Rural Hospital, Wardha. Among 50 patients, 86% males in 4th to 7th decade with mean age of 51.08 years. Large majority had mild–moderate severity on high-resolution computed tomography thorax with 84% having uncontrolled diabetes and 18% newly diagnosed diabetic cases. Seventy-two percent had history of steroid intake for COVID-19 management. Maxillary sinus was most commonly involved sinus in 94% cases while 32% had commonest extra nasal spread hard palate. Seventy-eight percent of the post operated mucormycosis cases are alive with no recurrence, 8% are alive and had recurrence of the disease while 14% resulted in death. Conclusion Effective management and control of the infection can be achieved with the use of strong antibiotics, oral or systemic antifungal drugs, extensive surgical excision of diseased tissue, and addressing underlying risk factors can effectively manage and control the infection. This approach results in positive outcomes and reduced morbidity compared to the time prior to the COVID-19 pandemic including cases with extensive disease.

Abstract Background The indoor home environment plays a crucial role in determining the outcome of respiratory diseases, including asthma. Researchers, clinicians, and patients would benefit from self-reported questionnaires to assess indoor home environmental exposures that may impact on respiratory health. Objective To review self-reported instruments for assessing indoor home environmental exposures in asthma patients and to characterise their content, development, and psychometric properties. Design A scoping review was conducted with content assessment. Methods A literature search was conducted in Embase and PubMed using the key words housing quality, questionnaire and asthma and their index terms, covering articles published in English between January 2000 to July 2023. Articles in which questionnaires or single item questions were used to assess indoor home environmental exposures in asthma patients in middle- and high-income countries were included. We excluded articles in which the questionnaire required an interviewer or onsite observations and those conducted in low-income countries. Results We screened 1584 articles to identify 44 studies containing self-reported questionnaires measuring indoor home environmental exposures. 36 studies (82%) were cross sectional, 35 (80%) had a sample size of greater than 1000 participants, and 29 (66%) were conducted in children. Most studies (86%, n = 38) had binary (yes/no) or multiple-choice responses. 25 studies (57%) included a recall period of 12 months. 32 studies (73%) had a response rate of greater than 50%. Dampness, biological exposures (e.g. mould), and second-hand tobacco smoke were the most assessed indoor home environmental exposures. Childhood asthma (54%, n = 24) and asthma symptoms (36%, n = 16) were the most examined asthma related outcomes. The exposure most associated with adverse asthma outcomes was exposure to damp (79%, n = 35). 13 studies (29%) had developed a self-reported instrument by adapting questions from previous studies and almost all instruments (n = 42 studies, 95%) had not been validated. Conclusions The scoping review did not identify a comprehensive, validated self-reported questionnaire for assessing indoor home environmental exposures in patients with asthma. There is need to develop and validate a robust but pragmatic self-reported instrument, incorporating the findings from this review.

In recent years, the tobacco- and/or nicotine-containing product (TNP) portfolio has expanded to include products such as e-vapor products, heated tobacco products, and nicotine pouches. Although scientific papers and regulatory requirements/recommendations related to the assessment of product use behavior and exposure to product use have been published for these novel TNPs, there is great diversity in the terminology used to characterize and assess these types of products. The aim of this paper is to define the terms and methods used for assessing product use behavior and exposure, with the objective to suggest a uniform application of terms used by scientists working in this field of research. This publication is the work product of a cross-industry work item commissioned by the Cooperation Centre for Scientific Research Relative to Tobacco (CORESTA) Product Use Behaviour and Biomarkers Subgroups.

Abstract The study investigated the effect of soilless media (burlap), on the morphological traits and antioxidant activities of microgreens from Brassicaceae, Amaranthaceae, and Linaceae families. The results revealed significant variations were observed in the selected morphological, biochemical composition, and antioxidant capacity of the microgreens. The radish sango and microgreens showed superior morphological characteristics compared to other microgreens. The elemental composition analysis revealed consistent moisture, ash, fat, fiber, and protein content across all families. The results revealed significant variations in the biochemical composition and antioxidant capacity of the microgreens, depending on the growing medium and between microgreens. Notably, microgreens differed in photosynthetic pigment profiles, with flaxseed and cabbage showing the highest chlorophyll content of 26.59 to 27.18 µg/g, FW and carotenoid content in a range of 3.74 to 6.39 µg/g, FW was observed in microgreens. The radish sango and beetroot microgreens exhibited elevated anthocyanin levels of 27.94–28.25 µmol/100 g, FW. Biochemical analysis indicated varying levels of ascorbic acid (177.58 to 256.46 mg/100 g, FW), total glucosinolate content (4.09 to 47.38 µmol/g, FW), phenolic content (131.44 to 298.56 mg GAE/100 g, FW), and flavonoid content (10.94 to 18.14 mg QUE/100 g, FW) were observed in selected microgreens families. Radish sango microgreens demonstrated the highest DPPH (76.82%, FW) and ABTS (88.49%, FW) radical scavenging activities, indicating superior antioxidant potential. The study showed that Brassicaceae microgreens are particularly rich in bioactive and antioxidant properties. Additionally, studies could assess the economic feasibility and scalability of soilless cultivation methods for microgreens to support their inclusion in sustainable agricultural practices and health-promoting diets.

Elisabetta Bugianesi,1 Luca Miele,2,3 Giovanna Donnarumma,4 Katrine Grau,5 Mariarosaria Mancuso,4 Preethy Prasad,5 Andrea Leith,6 Victoria Higgins6 1Division of Gastroenterology, Department of Medical Sciences, University of Torino, AOU Città della Salute e della Scienza, Torino, Italy; 2Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; 3Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy; 4Novo Nordisk SpA, Rome, Italy; 5Novo Nordisk A/S, Søborg, Denmark; 6Adelphi Real World, Bollington, Cheshire, UKCorrespondence: Elisabetta Bugianesi, Email elisabetta.bugianesi@unito.itBackground: Although the estimated prevalence of non-alcoholic steatohepatitis (NASH) in Italy is 4– 6%, little is known about patient characteristics and care pathways.Aim: To describe patient characteristics and management approaches for patients with NASH or suspected NASH in Italy.Methods: Data were drawn from the Adelphi Real World NASH Disease Specific Programme™, a cross-sectional survey of endocrinologists and gastroenterologists in Italy from January to March 2018. Physicians completed questionnaires for their next five consecutively consulting patients with NASH or suspected NASH. Analyses were descriptive.Results: Seventy-six physicians provided data on 380 patients. The mean age was 58.5 ± 11.1 years and the mean body mass index was 31.8 ± 5.5 kg/m2. A total of 231 patients (61%) had no/non-advanced fibrosis as evaluated by liver biopsy or non-invasive tests. Common diagnostic assessments were cholesterol, hemoglobin A1c, absence of viral hepatitis, and alcohol assessment. At diagnosis, 87% (n=322/372) and 45% (n=169/372) of patients received an ultrasound and liver biopsy, respectively. Overall, 88% of patients were referred from primary to secondary care. Obesity (81%) and type 2 diabetes (62%) were the most commonly recorded comorbidities, with 70% of patients having ≥ 3 comorbidities. Vitamin E (13%) and GLP-1 receptor agonists (13%) were the most prescribed guideline-recommended treatments for all patients.Conclusion: Patients with NASH in Italy had high levels of obesity and comorbidities, while diagnosis and treatment frequently were not according to guidelines. Our data show an unmet need for more targeted diagnosis and treatment in Italian patients with NASH, in order to optimize outcomes.Plain language summary: Fat buildup in the liver, known as fatty liver disease, affects around 4-6% of people in Italy, and can lead to complications if left untreated. However, little is known about how doctors manage people with this disease. Fatty liver disease can only be diagnosed by a liver biopsy, but we found this is only performed in 45% of people, making accurate diagnosis difficult. We also found that 28% of people receive a recommended medication. Overall, increasing doctor awareness of fatty liver medical guidelines may help improve the diagnosis and treatment for people living with fatty liver disease in Italy.Keywords: NASH diagnosis, NASH treatment, NASH resource utilization

Purpose: The purpose of the study was to estimate the efficacy of dichoptic amblyopia training (DAT) in patching resistant/patching noncompliant amblyopic subjects on best-corrected distance visual acuity and stereoacuity with 12-month follow-up. Methodology: In this study, 113 participants with anisometropic, isometropic, strabismic, and accommodative esotropia with amblyopia, with a mean age of 8 years (interquartile range [IQR] 7–10), using full-time spectacle correction and not improving with prescribed patching protocol in 2 subsequent visits 3 months apart were included in the study. Subjects with deprivational amblyopia, ocular comorbidity, or neuronal defects were excluded. Subjects were given 30 min of dichoptic gameplay with Bynocs DAT for 5 days a week for at least 6 weeks. Best-corrected distance visual acuity and stereoacuity of subjects were recorded before treatment, immediately after Bynocs DAT, 6 months, and at 12-month follow-up. Results: The age group of the participants was divided into three groups – (1) 18 years (1.8%). The median (IQR) age of 113 participants was 8 years (7–10). The diagnosis of the participants was anisometropic amblyopia in 18 (15.9%), isometropic amblyopia in 72 (63.7%), accommodative esotropia with amblyopia in 18 (15.9%), and strabismic amblyopia in 5 (4.4%). Post dichoptic therapy, the best-corrected distance visual acuity improvement was statistically significant using the McNemar test and remained stable till the 12-month follow-up (P < 0.001). Post Bynocs DAT, stereoacuity improvement was statistically significant using the McNemar test and maintained till the 12-month follow-up (P < 0.001). Conclusion: Best-corrected distance visual acuity and stereoacuity improved after Bynocs DAT and remained stable in patching resistant/patching noncompliant subjects with anisometropic and isometropic amblyopia 12 months after cessation of treatment.

AIM: To investigate clinical outcomes in adults with type 2 diabetes (T2D) after insulin degludec/insulin aspart (IDegAsp) treatment in a real-world setting. Methods: The 26 weeks study involved 1102 adults with T2D who were either initiated with or switched to IDegAsp according to local practice in six countries. It was an open-label, non-interventional study. The primary endpoint was the change in glycosylated haemoglobin (HbA1c) levels from baseline to the end of study (EOS). Results: From India, 185 adults participated in this study with mean age of 58.1 (10.3) years and 14.4 (8.1) years of mean duration of T2D. Mean HbA1c decreased from 9.8% (1.8) at baseline to 8.2% (0.1) at the EOS; change in HbA1c from baseline [95% CI]: -1.6% (0.1) [-1.8; -1.4], P < 0.0001. There was a significant reduction in mean fasting plasma glucose (FPG) level from 190.0 (65.8) mg/dl at baseline to 141.9 (4.3) mg/dl at EOS; change in FPG from baseline [95% CI]: -52.2 (4.3) mg/dl [-60.7; -43.7], P < 0.0001. There was a numerical reduction in resource utilization related to diabetes and its complications and hypoglycaemic episodes. From baseline to EOS, the participants with outpatient visits (72 to 32) and workdays missed (2 to 0) decreased. Additionally, the number of patient-reported non-severe hypoglycaemic (47 to 8) and severe hypoglycaemic (4 to 1) episodes decreased as well. Conclusion: Initiation or switching to IDegAsp led to improvement in glycaemic control in real-world population of Indian adults with T2D. This was accompanied by a numerical reduction in resource utilization and patient-reported hypoglycaemia. Clinical trial registration: NCT04042441

Purpose Nonneurogenic chronic urinary retention is an uncommon problem in young female individuals, and a well characterised causes is Fowler syndrome (primary disorder of urethral sphincter relaxation). Intermittent catheterisation is often challenging, and gold standard treatment sacral neuromodulation is not widely available. Urethral sphincter botulinum toxin injection has been shown to be effective cross-sectionally, however little is known about long-term outcomes. Methods Female individuals presenting with urinary retention due to Fowler syndrome were reviewed retrospectively from a single tertiary referral centre over an 11-year period (2010–2021). One hundred units of onabotulinum toxin A (BoTX-A) was injected into the striated urethral sphincter in a divided dose by the periurethral approach. Efficacy and side effects were assessed 4 weeks after injection. Results Thirty-three female individuals with a mean age of 40.1±14.1 years received 165 unique urethral sphincter BoTX-A injections over 11 years. Nineteen individuals (57.6%) presented in acute urinary retention, and 28 (84.8%) were reliant on catheterisation. Twenty-one individuals (64%) responded to BoTX-A injections and had a significantly raised baseline maximum urethral closure pressure (MUCP), compared to nonresponders (114.6 cm H2O, P=0.012). Side effects were reported following 19 injections (11.5%) however, were mild and transient. Fifteen individuals received more than 1 botulinum toxin injection (median, 3 injections), with a median interval of 112 days (interquartile range) and efficacy persisted following repeat injections and no safety concerns were seen. Conclusions Sphincter botulinum toxin through the periurethral approach is safe and effective following repeat injections, and offers a low-cost, minimally invasive alternative to managing female chronic urinary retention due to Fowler syndrome, particularly when there was a high baseline MUCP.

The developments of nano-roughness surface textures are important to implement enhanced osseointegration, cell adhesion, and proliferation in polymers for biomedical applications such as tissue engineering scaffolds and orthopaedic implants. The hydrophilicity of the polymeric implants is a crucial factor for cell adhesion, which can be improved via adapting the roughness of the surface. This study explores the surface modification of poly (lactic acid) (PLA) polymer through an alkaline wet etching process, varying alkaline concentration and etching time under both room temperature and elevated conditions. The main objective is to refine the PLA surface through wet etching, altering its properties for potential use in biomedical contexts. The assessment of surface roughness is conducted through scanning electron microscopy (SEM), atomic force microscopy (AFM), and fourier-transform infrared spectroscopy (FTIR). These techniques offer a comprehensive analysis of surface topography, nanoscale roughness, and potential chemical changes resulting from the wet etching process. The nano-roughness of treated 3D printed PLA was increased by 1.4 times compared to the control 3D printed PLA. The research contributes to the broader field of biomaterial engineering, laying the groundwork for subsequent investigations that will focus on applying the derived conclusions to enhance PLA’s biocompatibility and functionality in tissue engineering and orthopaedic applications.

Ashwagandha (Withania somnifera L. Dunal) is an Ayurvedic medicinal herb that has been known for its therapeutic properties for millennia. Ashwagandha contains several bioactive compounds, including withanolides, alkaloids, and saponins. They make ashwagandha a potent adaptogen and a versatile herb that can maintain optimal health and overall well-being. Ashwagandha reduces stress and anxiety, as well as boosts the immune system. Its anti-inflammatory properties treat arthritis, asthma, diabetes, and inflammatory bowel disease. Ashwagandha produces an immunomodulatory effect on natural killer cells, lymphocytes, and leukemia cells. It enhances the activity of natural killer cells, increases lymphocyte function, and induces apoptosis in leukemia cells. However, its mechanism of action still remains understudied. Ashwagandha has an impact on COVID-19: phytochemical withanone blocks or weakens the interaction between S-protein and Angiotensin-converting enzyme 2. Withanoside V and somniferine inhibit viral transcription and replication caused by SARSCoV-2 Mpro. This review explores the potential utilization of ashwagandha in the food industry, i.e., its safety and toxicity, as well as the mechanism behind its immunomodulatory effect.

Background: Hypertension is a common complication of type II diabetes. The present research work aimed to develop bilayer tablets that would manage type II diabetes patients with hypertension. The prepared bilayer tablet has an immediate-release layer of anti-hypertensive irbesartan and a sustained-release (SR) layer of anti-diabetic metformin hydrochloride. The purpose of these bilayer tablets was to increase patient compliance by converting two separate monotherapy to single combination therapy. Methodology: Several ratios of polymers, including HPMC K100M, EC, Eudragit, and Guar gum, were employed to prolong the drug release for twelve hours. An immediate-release layer of irbesartan was prepared by spherical agglomeration. The physical properties, drug content, solubility profiles, release kinetics, and stability of prepared bilayer tablets were assessed. Results and Discussion: The examination of SR granules and bilayer tablets revealed outstanding packing qualities and excellent flow properties, with bulk and tapped densities ranging from 0.39-0.46 g/cm³ and 0.42-0.55 g/cm³, respectively. In vitro dissolution tests revealed that the immediate-release layer gave an initial burst of Irbesartan. Still, the sustained-release layer of metformin showed controlled drug release over 12 hours at greater polymer concentrations. According to stability testing, the bilayer tablets' physical properties, drug content, and dissolving profiles did not change significantly. Conclusion: The bilayer tablet combination of Irbesartan and Metformin exhibited desired physical features, controlled drug release, and stability. This formulation represents a viable treatment option for diabetic hypertensive patients, offering effective and consistent management of both disorders while improving patient compliance.

Although testing the Bowersox and Daugherty (B&D) (1987) typology in international markets have provided valuable insights into the model’s relevance in logistics, literature has not re-examined the B&D model’s effectiveness during the post-pandemic business environments. The current research examines the robustness of the B&D logistics strategy framework during the post-COVID-19 Indian market environment. Using a structured questionnaire, the data for this study (n=372) was collected from the executives whose main job responsibility was related to distribution/logistics decisions in micro and small-sized (MSEs) manufacturers in India. Based on the conceptual relationships identified in the B&D typology, we used structural equation modeling to test the study hypotheses. Results show that overall logistics strategy comprised of three strategic priorities positively influences firms’ competitive responsiveness through the logistics coordination effectiveness and customer service commitment route, supporting the robustness of the model in the post COVID-19 environment. Effective logistics strategy does not occur in isolation. Emphasis in coordination and customer service must occur for a well thought out logistics strategy (process, market, and information orientation) to improve organizational competitive responsiveness in the context of Indian MSEs. This study contributes to the literature by providing empirical support for the validity and the robustness of the B&D logistics strategy model during the post COVID-19 environment in an emerging market.

Abstract Background The COVID-19 pandemic—with its first reported case in Sri Lanka in March 2020—had the potential to impact the risk of re-establishing malaria, a disease which was eliminated from Sri Lanka in 2012. Post-elimination, the country remains highly vulnerable to a return of malaria on account of high vector mosquito densities and the inflow of imported malaria cases. Methods Parallels between COVID-19 and malaria after its elimination as health security threats were drawn, and the many ways in which the COVID-19 pandemic impacted the prevention of re-establishment of malaria programmes in the country in 2020 were examined. The implications of this experience for global health security are analysed. Results In 2020, imported malaria cases were fewer than in the previous 3 years, due to restrictions on international travel. Yet, a high level of malaria case and entomological surveillance was sustained through surveillance strategies modified to focus on quarantine centers, in response to the pandemic. As a result, more imported malaria cases were detected by active case detection than by passive surveillance. Some of the operational shifts adopted by the Anti Malaria Campaign were moving rapidly into functioning as an intersectoral player by reinforcing its collaborations with the Ministries of Aviation and Defense, switching to the use of online communication systems, and integrating and synergizing its field activities with the COVID-19 control programme. Conclusions The experience highlights the need for disease control programmes to be agile, flexible and responsive, and underscores the importance of maintaining even a lean focal programme for diseases such as malaria after they have been eliminated. Sustaining public health leadership and robust technological capacities in communication and data management were paramount in preventing the disruption of the malaria prevention programme during the pandemic and sustaining the malaria-free status of the country.

Pain is the feeling of discomfort, most of the time, it refers to physical discomfort. Children often suffer from various kinds of pain, including abdominal pain and pain due to sports injuries. Unrelieved pain may be detrimental psychologically and physically from the start. A child’s quality of life can be significantly impacted by pain if it is not addressed and treated at an early age, affecting their mood, sleep, hunger, attendance at school, academic performance, and extracurricular activities. Pain management in paediatric populations poses unique challenges, necessitating a comprehensive and holistic approach. However, the use of Ayurvedic therapies can be very effective in the management of pain in children, though it is not specifically defined by any authors or researchers. This paper offers a review of the literature with a particular focus on how Ayurveda, an ancient Indian medical system that emphasizes the harmony of the body, mind, and spirit, might be utilised to treat paediatric pain. This study includes the exploration of the historical roots of Ayurveda and its traditional applications for managing pain in children, including dietary guidelines and non pharmacological interventions like Abhyanga (oil massage) and Swedana (sudation therapy).

Abstract The present work deals with developing a method for revalorizing steel residues to create sunlight-active photocatalysts based on iron oxides. Commercial-grade steel leftovers are oxidized under different combinations of pH and temperature (50–90 °C and 3 ≥ pH ≤ 5) in a low energy-intensive setup. The material with the highest production efficiency (yield > 12%) and magnetic susceptibility (χm = 387 × 10−6 m3/kg) was further explored and modified by diffusion of M2+ (Zn and Co) ions within the structure of the oxide using a hydrothermal method to create ZnFe2O4, CoFe2O4 and combined Co–Zn ferrite. (Co–Zn)Fe2O4 displayed a bandgap of 2.02 eV and can be activated under sunlight irradiation. Electron microscopy studies show that (Co–Zn)Fe2O4 consists of particles with diameters between 400 and 700 nm, homogeneous size, even distribution, and good dispersibility. Application of the developed materials in the sunlight catalysis of black liquors from cellulose extraction resulted in a reduction of the Chemical Oxygen Demand (− 15% on average) and an enhancement in biodegradability (> 0.57 BOD/COD) after 180 min of reaction. Since the presented process employs direct solar light, it opens the possibility to large-scale water treatment and chemical upgrading applications.

Introduction: Due to the limitations in finding the right donor, the majority of patients with renal failure (chronic kidney disease stage 5) are treated with hemodialysis. In literature, we have extensive evidence of different hemodialysis prescriptions based on different frequencies per week and duration of each session. We tried to assess the impact of different hemodialysis frequencies on the adequacy of dialysis based on nutritional parameters, electrolyte imbalances and quality of life (QoL) parameters. Material and Methods: It was a single center, prospective, observational study conducted over three consecutive months on patients on hemodialysis and their biochemical, and QoL parameters were recorded. We could enroll 29 patients for this study. The objective was to assess the effect of different hemodialysis frequencies per week on hemodialysis adequacy parameters and QoL indices. Results: The baseline characteristics were uniform with respect to age (p=0.761) and commonly associated co-morbidities like obesity (BMI p=0.971), hypertension (p=0.927), diabetes mellitus (p=0.822). The serum albumin was observed to be similar in patients receiving either thrice weekly or twice weekly hemodialysis (p=0.736). The URR and kt/v were marginally higher in patients receiving thrice weekly dialysis but with no statistical significance (p=0.938 for URR & p=0.615 for kt/v). Discussion and Conclusions: The biochemical indices of nutrition along with electrolyte imbalance and quality of life parameters observed with different frequencies of hemodialysis per week were identical over three consecutive months.

Anomalous origin of the circumflex artery from the pulmonary artery (ACxAPA) is a rare but clinically significant condition in which the circumflex artery arises from either the main pulmonary artery or one of its main branches. Untreated patients with ACxAPA may develop severe heart failure or sudden cardiac death. Diagnosis is established with either catheter or CT angiography. We present a case of an adult male with no prior known cardiac history who was found to have ACxAPA after presenting to our institution in acute decompensated heart failure.

Abstract The draft genome sequence of an agriculturally important actinobacterial species Amycolatopsis sp. BCA-696 was developed and characterized in this study. Amycolatopsis BCA-696 is known for its biocontrol properties against charcoal rot and also for plant growth-promotion (PGP) in several crop species. The next-generation sequencing (NGS)-based draft genome of Amycolatopsis sp. BCA-696 comprised of ~ 9.05 Mb linear chromosome with 68.75% GC content. In total, 8716 protein-coding sequences and 61 RNA-coding sequences were predicted in the genome. This newly developed genome sequence has been also characterized for biosynthetic gene clusters (BGCs) and biosynthetic pathways. Furthermore, we have also reported that the Amycolatopsis sp. BCA-696 produces the glycopeptide antibiotic vancomycin that inhibits the growth of pathogenic gram-positive bacteria. A comparative analysis of the BCA-696 genome with publicly available closely related genomes of 14 strains of Amycolatopsis has also been conducted. The comparative analysis has identified a total of 4733 core and 466 unique orthologous genes present in the BCA-696 genome The unique genes present in BCA-696 was enriched with antibiotic biosynthesis and resistance functions. Genome assembly of the BCA-696 has also provided genes involved in key pathways related to PGP and biocontrol traits such as siderophores, chitinase, and cellulase production.

Abstract Background A woman with a history of GDM has a high risk of developing type two diabetes (T2DM) in her future life. Lifestyle modifications are known to attenuate the progression of GDM to T2DM. Therefore, the aim of this study was to assess the impact of a simple, cost effective, culturally acceptable lifestyle intervention programme on the trajectory towards T2DM in women with a history of GDM. Methods This cluster randomized trial was conducted in 100 postpartum women in three selected districts of Sri Lanka. The subjects were divided into intervention (n = 50) and control groups (n = 50) by cluster randomization method. A culturally adapted protocol (comprised of dietary and physical activity modifications) was administered to the intervention group. The glycemic profile was assessed using fasting and 2-hour post-OGTT plasma glucose and HbA1c, and insulin resistance by HOMA-IR at baseline and after one year of intervention. Results The mean age (SD) of the subjects in the intervention and control groups were 33.0 (5.1) and 34.3 (6.5) years respectively. All glycemic and insulin resistance parameters (i.e. Fasting plasma glucose- FPG, 2-hour post-OGTT plasma glucose, HbA1c and HOMA-ir) were comparable (p > 0.05) between the two groups at baseline. FPG, 2 h post OGTT, HbA1c and HOMA-ir values between intervention vs. control (p) at 12 months were 87.3 vs. 123.2 (

Background: Complex renal calculi, characterized by their size, location, and composition, pose a significant challenge to urologists due to the potential for complications and the difficulty in achieving complete stone clearance. Conventional percutaneous nephrolithotomy (PCNL) and endoscopic combined intrarenal surgery (ECIRS) are two established techniques for managing these complex renal calculi. Aims and Objectives: The aims and objectives are to compare the effectiveness, safety, and outcomes of PCNL versus ECIRS in managing complex renal calculi in a cohort of 60 cases treated at GMKMCH-Salem. Materials and Methods: A retrospective analysis was conducted on 60 patients with complex renal calculi who underwent either conventional PCNL or ECIRS during a specified period at GMKMCH-Salem. Patient demographics, stone characteristics, procedural details, intraoperative and post-operative parameters, and complications were analyzed and compared between the two treatment groups. Results: The study found that both PCNL and ECIRS techniques were effective in treating complex renal calculi. However, significant differences were observed between the two groups in terms of outcomes. The ECIRS technique exhibited superior outcomes with higher stone clearance rates (P

Spine stereotactic body radiation therapy (SBRT) for the treatment of metastatic disease is increasingly utilized owing to improved pain and local control over conventional regimens. Vertebral body collapse (VBC) is an important toxicity following spine SBRT. We investigated our institutional experience with spine SBRT as it relates to VBC and spinal instability neoplastic score (SINS).

Recent decades have witnessed transformative advances in radiation physics and computer technology, revolutionizing the precision of radiation therapy. The adoption of intricate treatment techniques such as three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, volumetric-modulated arc therapy, and image-guided radiotherapy necessitates robust quality assurance (QA) programs. This study introduces the SunCHECK™ Machine (SCM), a web-based QA platform, presenting early results from its integration into a comprehensive QA program. linear accelerators (LINAC) demand QA programs to uphold machine characteristics within accepted tolerances. The increasing treatment complexity underscores the need for streamlined procedures. The selection of QA tools is vital, requiring efficiency, accuracy, and alignment with clinic needs, as per recommendations such as the AAPM task group 142 report. The materials and methods section details SCM implementation in various QA aspects, encompassing daily QA (DQA), imaging QA with Catphan, conventional output assessment with a water phantom, and LINAC isocenter verification through the Winston–Lutz test. Challenges in QA processes, such as manual data transcription and limited device integration, are highlighted. Early results demonstrate SCM’s significant reduction in QA time, ensuring accuracy and efficiency. Its automation eliminates interobserver variation and human errors, contributing to time savings and near-immediate result publication. SCM’s role in consolidating and storing DQA data within a single platform is emphasized, offering potential in resource optimization, especially in resource-limited settings. In conclusion, SCM shows promise for efficient and accurate mechanical and dosimetric QA in radiation therapy. The study underscores SCM’s potential to address contemporary QA challenges, contributing to improved resource utilization without compromising quality and safety standards.

The study examined the emission of electromagnetic radiation (EMR) from cement/Ba0.06Bi0.47Na0.47TiO3 (BBNT) composites when subjected to drop weight impact loads, aiming to explore their potential as sensors in civil structures. The generation of EMR in this context can be attributed to the increased movement of ions within pores and dipole oscillation along the grain boundaries of BBNT. The increase of BBNT content and impact load cause a noticeable rise in the values of EMR voltage, dominant frequency and the average rate of EMR energy release. Notably, the impact-generated EMR voltage data can be excellently fitted with a 5th-order bivariate polynomial function (adjusted r2 = 0.9353). Furthermore, the EMR voltage exhibits a decreasing pattern when measured at various distances from the sample, until it stabilizes after 12 cm. These findings suggest that the EMR technique holds promise as an effective tool for real-time monitoring of civil structures in situ.

Background: Nebivolol hydrochloride, a β1-receptor antagonist known for its antihypertensive properties, boasts a plasma half-life of 10 hours and an oral bioavailability of 12%. In this study, we aimed to enhance the therapeutic effectiveness of Nebivolol hydrochloride and circumvent its extensive hepatic first-pass metabolism by developing transdermal matrix patches. Methodology: Utilizing Central Composite Design (CCD), nine formulations were devised, comprising Hydroxypropyl methylcellulose K15M and Eudragit S100 as independent variables, with 10% w/w triethyl citrate as the plasticizer. Key dependent variables were evaluated, including folding endurance, moisture content, tensile strength, in vitro drug release, and flux. Fourier transform infrared spectroscopy (FTIR) assessed the compatibility between the drug and polymer. Results and discussion: Among the formulations, FP8 demonstrated the highest drug release (85.88% over 24 hours), attributed to its elevated concentration of hydrophobic polymer. The optimized formulation was determined based on the results of dependent variables. Conclusion: These findings suggest that the developed matrix transdermal film holds promise as a potential candidate for sustained drug release over a 24-hour.

The transportation network is the most important component of an urban infrastructure. The efficiency of a region’s transportation system can be understood by the effectiveness of its transport network arrangement. The current study employs Geographical Information Systems (GIS) to assess the structure of a transport network in various clusters of the Hyderabad Metropolitan Area (HMA). The study focuses on a thorough assessment of the transport (or) road network structure in terms of various criteria such as connectivity, accessibility, maturity, and development. The study also categorizes each Transport Network Structural Evaluation Criteria (TNSEC) level as “very low, low, medium, high, or very high”. The goal of this research is to create a Road Network Structural Performance Index (RNSPI), which is usually used to measure the efficiency of a study area’s transportation network structure. The study’s findings serve as a foundation for city transportation planners to put efforts in the planning to enhance network facilities in the study region. The study also investigates the utility of Arc GIS software in assessing the structure of an urban transport network.

Introduction: In the backdrop of escalating healthcare costs and an increasing focus on resource optimization, this audit study delves into the realm of anesthesia management, specifically exploring the application of low-flow anesthesia (LFA). The primary objective was to assess adherence to hospital standards and evaluate the economic implications of LFA (

Abstract Background Blood-based transcriptional gene signatures for tuberculosis (TB) have been developed with potential use to diagnose disease. However, an unresolved issue is whether gene set enrichment analysis of the signature transcripts alone is sufficient for prediction and differentiation or whether it is necessary to use the original model created when the signature was derived. Intra-method comparison is complicated by the unavailability of original training data and missing details about the original trained model. To facilitate the utilization of these signatures in TB research, comparisons between gene set scoring methods cross-data validation of original model implementations are needed. Methods We compared the performance of 19 TB gene signatures across 24 transcriptomic datasets using both rrebuilt original models and gene set scoring methods. Existing gene set scoring methods, including ssGSEA, GSVA, PLAGE, Singscore, and Zscore, were used as alternative approaches to obtain the profile scores. The area under the ROC curve (AUC) value was computed to measure performance. Correlation analysis and Wilcoxon paired tests were used to compare the performance of enrichment methods with the original models. Results For many signatures, the predictions from gene set scoring methods were highly correlated and statistically equivalent to the results given by the original models. In some cases, PLAGE outperformed the original models when considering signatures’ weighted mean AUC values and the AUC results within individual studies. Conclusion Gene set enrichment scoring of existing gene sets can distinguish patients with active TB disease from other clinical conditions with equivalent or improved accuracy compared to the original methods and models. These data justify using gene set scoring methods of published TB gene signatures for predicting TB risk and treatment outcomes, especially when original models are difficult to apply or implement.

Spur gear, helical gear, worm gear, and bevel gear are all important components in industrial applications such as vehicles, pushes, conveyors, elevators, bowl mill, rolling mills, ribbon blender, machine tools, aeroplanes, and windmills. When various types of defects, such as wear, tooth breakage, corrosion, and scratches on bearings, appear in gearboxes, normal machine function may be abruptly terminated. As a result, output and dependability suffer. As a result, several quality tracking and evaluation approaches have been adopted by companies. Finite element analysis (FEA) is one of the approaches. This research paper presents the FEA of a ribbon blender worm gear pair by using Ansys 18.0 to identify the weak gear of the worm gear pair, natural frequency, and deformation. Proe-5 utilized for creation of three-dimensional geometry of threaded worm and toothed worm wheels, as well as other related elements such as shafts and bearings. Steel is used for the worm, shaft, and bearing, whereas bronze is used for the worm wheel. Ansys 18.0 is implemented to carry out worm gear pair model analysis. The results demonstrate that the worm wheel had the most deformation when compared to the worm, and that the natural frequency is greater than the operational frequency of the worm gear pair. The findings of the research study, worm wheel deteriorate early than worm, model analysis plays a significant role in vibration monitoring of worm gear pair, and this work is valuable for further fault analysis of ribbon blender worm gearbox utilising vibration response.

Abstract Objectives The oak processionary moth (OPM) (Thaumetopoea processionea) is a species of moth (order: Lepidoptera) native to parts of central Europe. However, in recent years, it has become an invasive species in various countries, particularly in the United Kingdom and the Netherlands. The larvae of the OPM are covered with urticating barbed hairs (setae) causing irritating and allergic reactions at the three last larval stages (L3-L5). The aim of our study was to generate a de novo transcriptomic assembly for OPM larvae by including one non-allergenic stage (L2) and two allergenic stages (L4 and L5). A transcriptomic assembly will help identify potential allergenic peptides produced by OPM larvae, providing valuable information for developing novel therapeutic strategies and allergic immunodiagnostic assays. Data Transcriptomes of three larval stages of the OPM were de novo assembled and annotated using Trinity and Trinotate, respectively. A total of 145,251 transcripts from 99,868 genes were identified. Bench-marking universal single-copy orthologues analysis indicated high completeness of the assembly. About 19,600 genes are differentially expressed between the non-allergenic and allergenic larval stages. The data provided here contribute to the characterization of OPM, which is both an invasive species and a health hazard.

Background: Cystic fibrosis transmembrane conductance regulator metabolic syndrome/cystic fibrosis screen-positive, inconclusive diagnosis (CRMS/CFSPID) is a designation given following a positive newborn screen for cystic fibrosis (CF) when CF is not excluded but cannot be confirmed. We describe the long-term clinical outcomes of a CRMS/CFSPID cohort. Methods: A retrospective, single centre study of children with a current or previous diagnosis of CRMS/CFSPID. Study period extended from February 1, 2007 to August 1, 2022. Baseline and longitudinal data were assessed. Results: 30 children were designated as CRMS/CFSPID between 2007 and 2021. At baseline, 13 CFTR variants were identified, of which F508del and R117H 7T/9T were most common (occurring in 25 and 20 children respectively). Initial mean immunoreactive trypsinogen and sweat chloride were 82.8 mmol/L and 34.3 mmol/L respectively. During longitudinal assessment (n = 27), occurring over a mean duration of 8.5 years, five children progressed to CF at a mean age of 9.5 years. All children were pancreatic sufficient except one who reclassified to CF. Four isolated Pseudomonas aeruginosa and 12 isolated Staphylococcus aureus, of which one and two progressed to CF respectively. All recent Z-scores for weight and spirometry were above −2. Initial mean sweat chloride was higher in those who progressed to CF versus those who did not, although this did not reach statistical significance (38.4 mmol/L versus 32.0 mmol/L respectively, p = 0.105). Conclusions: Most children with CRMS/CFSPID remained well with a low progression rate to CF. This supports a less intensive medical surveillance approach. Our results highlight the importance of assessment in a dedicated CRMS/CFSPID clinic during adolescence to detect progression to CF after 6 years of age.

Background Diagnostic variables from insertable cardiac monitors may be useful in identifying patients at increased risk of heart failure (HF) events. High‐risk alerts must be coupled with interventions to improve outcomes. We aim to assess the safety of a predefined protocolized intervention pathway activated by insertable cardiac monitor high‐risk alerts. Methods and Results ALLEVIATE‐HF (Algorithm Using LINQ Sensors for Evaluation and Treatment of Heart Failure) Phase 1 was a randomized interventional study enrolling patients with New York Heart Association class II/III and a recent HF event. A HF risk score based on insertable cardiac monitor diagnostics, including impedance, respiration rate, atrial fibrillation burden, heart rate during atrial fibrillation, heart rate variability, and activity duration, was calculated. A protocolized intervention pathway was activated when high‐risk scores were detected that involved physician‐prescribed nurse‐implemented uptitration of diuretic for 4 days, unless safety rule‐out conditions were met. Interventions could be repeated if high‐risk scores persisted and did not require worsening symptoms. In total, 59 patients were randomized (mean age 68.2±11.8 years; 59.3% male); 67.8% with ejection fraction ≥50%. The mean follow‐up was 11.8±8.1 months. Overall, 146 high‐risk scores were recorded in 33 patients and 118 interventions occurred in 75 (51.4%) high‐risk alerts that did not meet safety rule‐out criteria. There were no serious adverse events and 13 adverse events related to interventions. In patients with symptoms at intervention initiation, symptoms resolved in 37 interventions (80%) and worsened in 8 (17%). In asymptomatic patients, symptoms developed in 3 interventions (7%). Conclusions A personalized medication intervention based on insertable cardiac monitor risk score can be safely instituted in patients with HF, irrespective of symptoms. Registration URL: https://www.clinicaltrials.gov; Unique Identifier: NCT04452149.

A pot culture experiment was conducted during rainy (kharif) season of 2021 at ICAR-Indian Institute of Rice Research, Hyderabad, Telangana to study the influence of the foliar application of various Zn sources such as nano ZnO, bulk ZnO, and ZnSO4 on rice crop. The experiment was laid out in a completely randomized design (CRD) with the following treatments, containing 3 concentrations of bulk ZnO (500 mg/litre, 1000 mg/litre, and 1500 mg/ litre), 3 concentrations of nano ZnO (50 mg/litre, 100 mg/ litre, and 150 mg/litre), 0.5% ZnSO4 and control with 3 replications. The findings revealed that ZnO nanoparticles (NPs) positively impacted rice grain yield, dry matter accumulation, and Zn content. Compared to the control (no zinc), ZnO NPs (150 mg/litre) and standard ZnSO4 treatments exhibited the highest plant height (83.3 cm and 73.7 cm, respectively), grain yield (5.97 g/pot and 6.03 g/pot), and straw yield (7.82 g/pot and 7.94 g/pot). The increased photosynthetic substances and higher dry matter accumulation throughout the rice growth stage contributed to the enhanced grain yield. Furthermore, supplementing Zn via nano ZnO (150 mg/litre) and 0.5% ZnSO4 resulted in significant Zn enrichment: 33,35; 77,87 and 21, 28% in straw, grain and soil, respectively over control plants. This study effectively demonstrates that ZnO nanoparticles have the potential to serve as high-performance fertilizers, benefiting both rice yield and quality.

IntroductionAntimicrobial resistance (AMR) in Brucella melitensis, the causative agent of brucellosis, is of growing concern, particularly in low and middle-income countries. This study aimed to explore the genetic basis of AMR in B. melitensis strains from India.MethodsTwenty-four isolates from humans and animals were subjected to antimicrobial susceptibility testing and whole-genome sequencing.ResultsResistance to doxycycline (20.80%), ciprofloxacin (16.67%), cotrimoxazole (4.17%), and rifampicin (16.67%) was observed. Genome analysis revealed efflux-related genes like mprF, bepG, bepF, bepC, bepE, and bepD across all isolates, however, classical AMR genes were not detected. Mutations in key AMR-associated genes such as rpoB, gyrA, and folP were identified, intriguingly present in both resistant and susceptible isolates, suggesting a complex genotype–phenotype relationship in AMR among Brucella spp. Additionally, mutations in efflux genes were noted in resistant and some susceptible isolates, indicating their potential role in resistance mechanisms. However, mutations in AMR-associated genes did not consistently align with phenotypic resistance, suggesting a multifactorial basis for resistance.DiscussionThe study underscores the complexity of AMR in B. melitensis and advocates for a holistic multi-omics approach to fully understand resistance mechanisms. These findings offer valuable insights into genetic markers associated with AMR, guiding future research and treatment strategies.

Monitoring the flight behaviour of mosquitoes is crucial for assessing their fitness levels and understanding their potential role in disease transmission. Existing methods for tracking mosquito flight behaviour are challenging to implement in laboratory environments, and they also struggle with identity tracking, particularly during occlusions. Here, we introduce FlightTrackAI, a robust convolutional neural network (CNN)-based tool for automatic mosquito flight tracking. FlightTrackAI employs CNN, a multi-object tracking algorithm, and interpolation to track flight behaviour. It automatically processes each video in the input folder without supervision and generates tracked videos with mosquito positions across the frames and trajectory graphs before and after interpolation. FlightTrackAI does not require a sophisticated setup to capture videos; it can perform excellently with videos recorded using standard laboratory cages. FlightTrackAI also offers filtering capabilities to eliminate short-lived objects such as reflections. Validation of FlightTrackAI demonstrated its excellent performance with an average accuracy of 99.9%. The percentage of correctly assigned identities after occlusions exceeded 91%. The data produced by FlightTrackAI can facilitate analysis of various flight-related behaviours, including flight distance and volume coverage during flights. This advancement can help to enhance our understanding of mosquito ecology and behaviour, thereby informing targeted strategies for vector control.

Corn silk (Zea mays L.), an abundant agricultural waste, contains various bioactive compounds that exhibit promising health benefits. The current study focuses on development and optimization of corn silk-based instant mix using response surface methodology. The optimized product, with 14.66% corn silk, 10% sugar and 0.22% xanthan gum in a skim milk powder base, scored 0.925 desirability. The physico-chemical and sensory parameters of optimized mix closely aligned with expected values. The instant mix packaged in metallised polyester yielded superior preservation of quality indicators over 120 days compared to low-density polyethylene (LDPE) and high-density polyethylene (HDPE). The microbial load in corn silk instant mix was observed across packaging materials and highlighting hydroxyl methyl furfural (HMF) as the primary predictor of product stability, the study calculated a 94.95 days half-life at 10 °C. Corn silk's rich bioactive compound supports its integration into nutraceuticals and instant mixes, mitigating food waste while enhancing nutritional value.Novelty statement.In this study, corn silk powder was utilized for the development of the instant mix. This innovative approach transforms corn silk, typically discarded as agricultural waste, into a commercially sustainable product that delivers the nutrients of corn silk to a broader population. Despite fresh corn silk being a perishable commodity, it has very low storage shelf life. The developed instant mix effectively preserves its nutritional value for up to six months, offering a sustainable and nutritious option for consumers.

Green leafy vegetables, especially microgreens are gaining popularity due to their high nutritional profiles, rich phytochemical content, and intense flavors. This review explores the growing commercial market for microgreens, especially in upscale dining and premium grocery outlets, highlighting consumer perceptions and their effect on market dynamics. Apart from these, the effect of modern agricultural methods that maximize the growth of microgreens is also examined. The value is anticipated to increase significantly, according to market predictions, from $1.7 billion in 2022 to $2.61 billion by 2029. Positive consumer views on microgreens health benefits drive this growth, although challenges such as varying levels of consumer awareness and income disparities affect sales. The review underscores the need for targeted research and strategic initiatives to enhance consumer understanding and improve cultivation methods to support market expansion in upcoming years.

The current diagnostic agronomy study of the Bankura region of West Bengal, India, examined the variations in crop yields through a socio-ecological analysis of multiple production system components. Envirotyping for root cause analysis was employed to delve into the variables that affect the performance of rainfed production systems. Mother Earth, man, machine, management, and materials (5Ms concept) were the five indicators under which the variables were grouped. Findings demonstrated the fragility of the region’s soils due to its undulating terrain, unpredictable rainfall patterns, and frequent drought scenarios. The LULC’s NDVI showed that the agricultural area is about 60% and 43% of the total geographical area in the Hirbandh and Ranibandh blocks, respectively. Soils are acidic and diagnosed with deficiency of both macro and micronutrients (phosphorous, sulfur, and boron) having poor water holding capacity (35 to 55 mm for a 50 cm soil depth). The sand and soil organic carbon contents ranged between 43.04%–82.32% and 0.17%–1.01%, respectively with a low bacterial population. These factors are the root cause for low cropping intensity (106%) and low paddy productivity (3,021 kg/ha). Overall, the study contributes to designing and scaling-up of sustainable landscape management practices that could ensure higher cropping intensity and system productivity in similar agro-ecologies with limited evidence.

Baby corn, characterized by its high water activity and elevated respiration rate, poses a formidable obstacle to prolonged storage under standard ambient conditions and necessitates specialized treatments for transportation to distant locations. One of the primary postharvest challenges associated with baby corn is the occurrence of brown pigment formation because of enzymatic browning at the apex of its immature ovules, cut surfaces, and silk attached to the young ears. The present study was undertaken to investigate the effect of different blanching treatments on peroxidase inactivation, physicochemical properties, and functional properties of baby corn. The treatments applied were hot water blanching (HWB) at temperatures ranging from 70°C to 90 °C for 30–240 s, steam blanching (SB) for 30–240 s, and microwave blanching (MWB) at power levels of 360 W–900 W for 30–300 s. Results indicated that 90 % peroxidase enzyme inactivation occurred under different methods as 90 °C for 60 s for HWB, 100 °C for 60 s for SB, and 540 W for 30 s for MWB. These blanching methods have shown significant effects on the properties under investigation. MWB demonstrated the highest retention of ascorbic acid (94.15 %) and minimal color changes (ΔE = 5.72) in comparison to hot water and steam blanching. Similarly, the result for total flavonoid content for 540 W, 90 °C and 100 °C for 30, 60, and 60 s were found to be 3.01,1.99 and 2.10 mg QE/100g, phenols 48.98, 47.99 and 48.03 mg GAE/100g and DPPH (%) 42.55, 34.20 and 37.08 % respectively. The findings suggest that microwave blanching of baby corn at 540 W for 30 s holds promise to inactivate the peroxidase enzyme with better retention of physicochemical and functional properties.