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Abstract Background Biliary dilatation without obvious etiology on cross sectional imaging warrants further investigation. This study aimed to assess yield of endoscopic ultrasound in providing etiologic diagnosis in such situation. Methods Prospective cohort of consecutive patients with biliary dilatation & non diagnostic computed tomography (CT) and /or magnetic resonance imaging (MRI) underwent endoscopic ultrasound (EUS) with/without fine needle aspiration cytology (FNAC) and were followed clinically, biochemically with/without radiology for up to six months. The findings of EUS were corroborated with histopathology of surgical specimens and endoscopic retrograde cholangiography (ERCP) findings in relevant cases. Results Median age of 121 patients completing follow up was 55 years. 98.2% patients were symptomatic and median common bile duct (CBD) diameter was 13 mm. EUS was able to identify lesions attributable for biliary dilatation in (67 out of 121) 55.4% cases with ampullary neoplasm being the commonest (29 out of 67 i.e. 43%). Multivariate logistic regression analysis identified jaundice as the predictor of positive diagnosis on EUS, of finding ampullary lesion and pancreatic lesion on EUS. EUS had sensitivity, specificity, positive predictive value and diagnostic accuracy of 95.65%, 94.23%, 95.65% and 95.04% respectively in providing etiologic diagnosis. Threshold value for baseline bilirubin of 10 mg%, for baseline CA 19.9 of 225 u/L and for largest CBD diameter of 16 mm were determined to have specificity of 98%, 95%, 92.5% respectively of finding a positive diagnosis on EUS. Conclusion EUS provides considerable diagnostic yield with high accuracy in biliary dilatation when cross sectional imaging fails to provide etiologic diagnosis.

Background: Large core acute ischemic strokes have predominantly been excluded from endovascular therapy (EVT) studies due to perceived higher risks of hemorrhage and poorer functional outcomes. However, recent randomized controlled trials (RCTs) indicate that EVT for large vessel occlusion (LVO) strokes improves functional outcomes compared to medical management alone, despite higher hemorrhagic transformation rates, with no corresponding increase in symptomatic intracerebral hemorrhage (sICH) rates. The real-world outcomes of this intervention in Indian patients remain underexplored. Objectives: To evaluate the real-world outcomes of EVT for large core acute ischemic strokes with LVO in an Indian population. Methods: We conducted a single-center, retrospective observational study using a 7 years prospective database of EVT in anterior circulation stroke patients. Patients with Alberta Stroke Program Early Computed Tomography Score (ASPECTS) of 3–5 were included. Clinical and radiologic data were analyzed, with the primary endpoint being 90-day modified Rankin scale (mRS) scores. Safety outcomes included rates of sICH and mortality. Descriptive statistical analysis was done using Microsoft Excel. Results: The study included 25 patients who met the inclusion criteria. Mean age of patients was 52.9 ± 14.3 years, and there were 13 (52%) males. Median ASPECTS was 5 (interquartile range 4–5). Successful recanalization, classified by modified Thrombolysis in Cerebral Infarction score, was 92%. Good functional recovery, that is, 90-day mRS 0–3, was achieved in nine (36%) patients. Safety outcomes: sICH was seen in four (16%) and mortality was reported in nine (36%) patients. Conclusions: Our results reaffirm findings from RCTs, provide updated real-world evidence, and suggest that EVT is a viable option to be considered in selected patients with large core ischemic infarcts.

Aim: (1) To compare the temperature rise in the pulp chamber with different resin materials used for making provisional fixed partial dentures in anterior and posterior region while using Polyvinylsiloxane impression materials as matrix. (2) To identify a superior provisionalization material based on the amount of heat dissipated suitable for anterior and posterior provisional fixed partial denture fabrication. Settings and Design: Temporary crowns and bridges are integral to Fixed Prosthodontics. It has been observed that conventional fixed prosthesis temporisation materials release heat due to the exothermic polymerisation reaction. When such a provisional material is directly let to set on a vital tooth, the heat transfer causes irreversible changes in the pulp tissue depending of the degree of change. Hence, this study observes amount of heat generation in various materials during temporisation procedure, by simulating similar conditions. Materials and Methods: Two Models were fabricated, one simulating missing lateral incisor (Model A) and another simulating missing first molar (Model B). Intact maxillary central incisors and canine for Model A and intact mandibular Second Premolar and Second Molar were selected to act as abutments. These abutment teeth were fitted with the tip of a K-type Thermocouple inside their pulp chambers and these were connected to a digital thermometer. Five temporisation materials were chosen for fabrication of temporary crowns through Direct technique. (1) polymethy methacrylate (Self Cure acrylic), (2) bisacryl composite (Protemp 4), (3) visible light cure urethane dimethacrylate (Revotec LC), (4) barium glass and fumed silica infused methacrylate (Dentsply Integrity) and (5)nano-hybrid composite (VOCO Structur 3). Ten observations were made for each provisional material on each model. During each observation, temperature rise was recorded at 30s interval from the time of application, through the peak and till a decrease in temperature is observed. Polyvinyl siloxane was used as matrix for all except light cure resin, where polypropylene sheet was used. Statistical Analysis Used: Anova test used for statistical. Results: ANOVA test revealed that there was a significant difference in the temperature changes associated with the provisional restorative materials used. Among the five, polymethy methacrylate (self cure resin) showed the maximum rise in temperature, followed by bisacryl composite (Protemp 4), visible light cure urethane dimethacrylate (Revotec LC), barium glass and fumed silica infused methacrylate (Dentsply Integrity) and nano-hybrid composite (VOCO Structur 3). There was no comparable difference between Model A and B but an overall reduction of temperature rise was observed in model B. Conclusion: VOCO Structur 3 showed the least temperature rise in the pulp chamber, and overall temperature rise was less for model B which can be attributed to the residual dentin thickness.

In the current scenario, the world is focused on renewable energy generation to achieve sustainability by 2030 regarding clean and affordable energy. Lithium-ion (Li-ion)-based Battery Energy storage (BES) is a prominent approach that is widely adopted for managing large-scale renewable energy generation. Battery Management Systems (BMS) play a critical role in optimizing battery performance of BES by monitoring parameters such as overcharging, the state of health (SoH), cell protection, real-time data, and fault detection to ensure reliability. Previous studies have concluded that the implementation of Internet of Things (IoT) with LoRa ensures effective real-time monitoring of the BMS of Li-ion batteries. This study proposed and implemented a customized LoRa and IoT-based hardware system with a gateway to acquire parameters such as terminal voltage, current, charge voltage, charge current, cycle, temperature, state of charge (SoC), and SoH, and log them into the cloud server. An OMnet++-based Framework for LoRa (FLoRa) simulation was implemented to analyze the power consumption and residual energy of the customized LoRa nodes. The simulation was configured with a spread factor of 7, a carrier frequency of 433 MHz, a bandwidth of 125 KHz, and a transmission power of 2 dBm. The simulation results indicated that Node 3 had the highest mean power consumption (0.028233) and total energy consumption (0.146592), whereas Node 0 exhibited the lowest mean power consumption (0.023413) and total energy consumption (0.070204). Additionally, a comprehensive dataset encompassing voltage, current, and time was created and utilized for precise calculations of the battery's capacity and state of health, with potential use in future predictions.

Abstract Traditional alcoholic beverages have played a significant role in the cultural, social, and culinary fabric of societies worldwide for centuries. Studying the microbial community structure and their metabolic potential in such beverages is necessary to define product quality, safety, and consistency, as well as to explore associated biotechnological applications. In the present investigation, Illumina-based (MiSeq system) whole-genome shotgun sequencing was utilized to characterize the microbial diversity and conduct predictive gene function analysis of keem, a starter culture employed by the Jaunsari tribal community in India for producing various traditional alcoholic beverages. A total of 8,665,213 sequences, with an average base length of 151 bps, were analyzed using MG-RAST. The analysis revealed the dominance of bacteria (95.81%), followed by eukaryotes (4.11%), archaea (0.05%), and viruses (0.03%). At the phylum level, Actinobacteria (81.18%) was the most abundant, followed by Firmicutes (10.56%), Proteobacteria (4.00%), and Ascomycota (3.02%). The most predominant genera were Saccharopolyspora (36.31%), followed by Brevibacterium (15.49%), Streptomyces (9.52%), Staphylococcus (8.75%), Bacillus (4.59%), and Brachybacterium (3.42%). At the species level, the bacterial, fungal, and viral populations of the keem sample could be categorized into 3347, 57, and 106 species, respectively. Various functional attributes to the sequenced data were assigned using Cluster of Orthologous Groups (COG), Non-supervised Orthologous Groups (NOG), subsystem, and KEGG Orthology (KO) annotations. The most prevalent metabolic pathways included carbohydrate, lipid, and amino acid metabolism, as well as the biosynthesis of glycans, secondary metabolites, and xenobiotic biodegradation. Given the rich microbial diversity and its associated metabolic potential, investigating the transition of keem from a traditional starter culture to an industrial one presents a compelling avenue for future research.

Tribal populations in India have health care challenges marked by limited access due to geographical distance, historical isolation, cultural differences, and low social stratification, and that result in weaker health indicators compared to the general population. During the pandemic, Tribal districts consistently reported lower COVID-19 vaccination coverage than non-Tribal districts. We assessed the MOMENTUM Routine Immunization Transformation and Equity (the project) strategy, which aimed to increase access to and uptake of COVID-19 vaccines among Tribal populations in Chhattisgarh and Jharkhand using the reach, effectiveness, adoption, implementation, and maintenance framework. We designed a qualitative explanatory case study and conducted 90 focus group discussions and in-depth interviews with Tribal populations, community-based nongovernmental organizations that worked with district health authorities to implement the interventions, and other stakeholders such as government and community groups. The active involvement of community leaders, targeted counseling, community gatherings, and door-to-door visits appeared to increase vaccine awareness and assuage concerns about its safety and efficacy. Key adaptations such as conducting evening vaccine awareness activities, holding vaccine sessions at flexible times and sites, and modifying messaging for booster doses appeared to encourage vaccine uptake among Tribal populations. While we used project resources to mitigate financial and supply constraints where they arose, sustaining long-term uptake of project interventions appears dependent on continued funding and ongoing political support.

Implant-supported prostheses could serve as a reliable restorative option for partial edentulism. Various restorative materials have been utilized in fabricating these prostheses, impacting both esthetics and peri-implant health. The present systematic review aimed to assess the survival rate and mechanical complications of zirconia ceramic compared to metal-ceramic implant-supported multiunit fixed dental prostheses (FDPs). We conducted searches in online databases such as MEDLINE (PubMed), Scopus, and Cochrane up until December 2022. A risk-of-bias assessment was done for all the included studies. Data extraction was performed based on the following parameters: author, year, study design, number of implants, abutment material, age range, observation period, incidence of mechanical complications, and survival rate. This systematic review included six studies (four randomized controlled trials and two retrospective studies). The meta-analysis significantly favored metal-ceramic restorations regarding mechanical complications with a risk ratio (RR) value of 1.64 and P = 0.001. Meta-analysis showed no difference in metal-ceramic FDPs in prostheses survival rate (P = 0.63; RR: 1.27, 95% confidence interval: 0.52–3.37; heterogeneity: P = 0.65; I2: 0%). While metal-ceramic multiunit implant-supported prostheses exhibited fewer mechanical complications compared to zirconia-ceramic prostheses, there was no significant difference in terms of prosthesis survival rate between the two. Hence, both treatments appear to be viable options for long-term implant-supported prostheses.

Background: Biliary dilatation without obvious etiology on cross sectional imaging warrants further investigation. This study aimed to assess yield of endoscopic ultrasound in providing etiologic diagnosis in such situation. Methods: Prospective cohort of consecutive patients with biliary dilatation & non diagnostic computed tomography (CT) and /or magnetic resonance imaging (MRI) underwent endoscopic ultrasound (EUS) with/without fine needle aspiration cytology (FNAC) and were followed clinically, biochemically with/without radiology for up to six months. The findings of EUS were corroborated with histopathology of surgical specimens and endoscopic retrograde cholangiography (ERCP) findings in relevant cases. Results: Median age of 121 patients completing follow up was 55 years. 98.2% patients were symptomatic and median common bile duct (CBD) diameter was 13 mm. EUS was able to identify lesions attributable for biliary dilatation in (67 out of 121) 55.4% cases with ampullary neoplasm being the commonest (29 out of 67 i.e. 43%). Multivariate logistic regression analysis identified jaundice as the predictor of positive diagnosis on EUS, of finding ampullary lesion and pancreatic lesion on EUS. EUS had sensitivity, specificity, positive predictive value and diagnostic accuracy of 95.65%, 94.23%, 95.65% and 95.04% respectively in providing etiologic diagnosis. Threshold value for baseline bilirubin of 10 mg%, for baseline CA 19.9 of 225 u/L and for largest CBD diameter of 16 mm were determined to have specificity of 98%, 95%, 92.5% respectively of finding a positive diagnosis on EUS. Conclusion: EUS provides considerable diagnostic yield with high accuracy in biliary dilatation when cross sectional imaging fails to provide etiologic diagnosis. [ABSTRACT FROM AUTHOR]

The availability of high-power lasers open new frontiers of Terahertz (THz) optics. In this paper, we present a mechanism for the enhanced THz field generation from the laser wakefield excitation during the interaction of an amplitude-modulated laser filament with a magnetized plasma. The derivation of electric and magnetic wakefields in axially magnetized plasma is obtained using the perturbative approach. Amplitude-modulated laser filament generates a significantly stronger transverse current due to laser intensity redistribution by the amplitude modulation. The modulation index of the amplitude modulated laser pulse is used to control the transverse current at THz frequency. Fourfold enhancement takes place in THz field strength for higher values of the modulation index (0–0.4). Also, the conversion efficiency of this mechanism is estimated as 1 0 − 4 that can be enhanced for higher modulation index. Scaling laws are provided for controlling and optimization of generated THz field. This work may be crucial in exploring THz optical phenomena such as THz field-induced Kerr effects and many other nonlinear effects. [ABSTRACT FROM AUTHOR]

Coronavirus has long been considered a global epidemic. It caused the deaths of nearly 7.01 million individuals and caused an economic downturn. The number of verified coronavirus cases is increasing daily, putting the whole human race at danger and putting strain on medical experts to eradicate the disease as rapidly as possible. As a consequence, it is vital to predict the upcoming coronavirus positive patients in order to plan actions in the future. Furthermore, it has been discovered all across the globe that asymptomatic coronavirus patients play a significant part in the disease's transmission. This prompted us to incorporate similar examples in order to accurately forecast trends. A typical strategy for analysing the rate of pandemic infection is to use time-series forecasting technique. This would assist us in developing better decision support systems. To anticipate COVID-19 active cases for a few countries, we recommended a hybrid model utilizing a fuzzy time series (FTS) model mixed with a non-linear growth model. The coronavirus positive case outbreak has been evaluated for Italy, Brazil, India, Germany, Pakistan, and Myanmar through June 5, 2020 in phase-1, and January 15, 2022 in phase-2, and forecasts active cases for the next 26 and 14 days respectively. The proposed framework fitting effect outperforms individual logistic growth and the fuzzy time series techniques, with R-scores of 0.9992 in phase-1 and 0.9784 in phase-2. The proposed model provided in this article may be utilised to comprehend a country's epidemic pattern and assist the government in developing better effective interventions. [ABSTRACT FROM AUTHOR]