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Abstract The molecular mechanisms that link stress and biological rhythms still remain unclear. The habenula (Hb) is a key brain region involved in regulating diverse types of emotion-related behaviours while the suprachiasmatic nucleus (SCN) is the body’s central clock. To investigate the effects of chronic social stress on transcription patterns, we performed gene expression analysis in the Hb and SCN of stress-naïve and stress-exposed mice. Our analysis revealed a large number of differentially expressed genes and enrichment of synaptic and cell signalling pathways between resilient and stress-naïve mice at zeitgeber 16 (ZT16) in both the Hb and SCN. This transcriptomic signature was nighttime-specific and observed only in stress-resilient mice. In contrast, there were relatively few differences between the stress-susceptible and stress-naïve groups across time points. Our results reinforce the functional link between circadian gene expression patterns and differential responses to stress, thereby highlighting the importance of temporal expression patterns in homoeostatic stress responses.

Abstract Objectives/Hypothesis Socioeconomics and demographics have been shown to be determinates of healthcare in specialty clinics, in which thorough research is lacking in the setting of the United States clinical sphere. We set out to determine the impact of socioeconomic and demographic factors on patient preparedness in an otolaryngologic clinic as to highlight the need for awareness in this aspect of disparate and delayed clinical care. Study Design Retrospective chart review. Methods A chart review was conducted of 482 patients who visited our otolaryngology clinic between June 1, 2020 and June 1, 2023. Demographic data including marital status, gender, age, zip code, and race was collected. Results Our study found several interesting points of significance. Marital status was a significant determinant of whether patients had missing labs and/or imaging (p = .001). Age was a significant determinant of patients having their imaging (p

Introduction: Population pyramids are significantly impacted by the global phenomena of ageing. It has been reported that depression and cognitive function have an impact on the nutritional status of older adults. Depression is the most common psychiatric problem in old age, and cognitive deterioration is frequently observed in this age group. Objective: This descriptive and comparative study set out to compare the cognitive abilities, nutritional health and depression status of older adults who lived in community settings and in assisted living facilities. Materials and Methods: A total of 250 older women (125 from institutionalised old age home and 125 from community) participated in a cross-sectional study (residing at Rajarhat, Newtown area). The lengthy version of the Mini Nutritional Assessment tool (MNA®) was used to evaluate the participants’ nutritional status. The Geriatric Depression Scale (GDS 30) was used to evaluate the severity of the depression. Using the Folstein Mini-Mental State Examination (MMSE), cognitive function was assessed. Using SPSS software, the Chi-square, Kruskal–Wallis test, and Spearman’s rho correlation coefficient were computed. Results: In the present study, it was observed that only 30.4% of the respondents who are community-dwelling elderly had normal MNA score, whereas 69.6% were at risk of malnutrition or already malnourished. Considering institutionalised elderly it was observed that only 7.2% were normal and 92.8% were malnourished/at risk of malnutrition. Statistically significant association was observed between nutritional status and mental health status (P = 0.00) as well as cognitive function (P = 0.00) among old age home residing elderly. Among the community-dwelling elderly mental health status has significant association with their nutritional status (P = 0.00) and cognitive function (P = 0.00) as well. Conclusions: Community-dwelling elderly were relatively healthy compared to old age home residents. Maintaining the nutritional, cognitive, and mental health of institutionalised and community-dwelling elderly women requires the implementation of physical and cognitive stimulation activities as well as interventions targeted at improving a healthy diet.

Abstract The potential brain mechanism underlying resilience to socially transferred allodynia remains unknown. Here, we utilize a well-established socially transferred allodynia paradigm to segregate male mice into pain-susceptible and pain-resilient subgroups. Brain screening results show that ventral tegmental area glutamatergic neurons are selectively activated in pain-resilient mice as compared to control and pain-susceptible mice. Chemogenetic manipulations demonstrate that activation and inhibition of ventral tegmental area glutamatergic neurons bi-directionally regulate resilience to socially transferred allodynia. Moreover, ventral tegmental area glutamatergic neurons that project specifically to the nucleus accumbens shell and lateral habenula regulate the development and maintenance of the pain-resilient phenotype, respectively. Together, we establish an approach to explore individual variations in pain response and identify ventral tegmental area glutamatergic neurons and related downstream circuits as critical targets for resilience to socially transferred allodynia and the development of conceptually innovative analgesics.

Shigellosis remains a significant global health challenge, particularly in Asia and Africa, where it is a major cause of morbidity and mortality among children. Despite the urgent need, the development of a licensed Shigella vaccine has been hindered, partly due to the lack of suitable animal models for preclinical evaluation. In this study, we used an intragastric adult rhesus macaque challenge model to evaluate the safety, immunogenicity, and efficacy of five live-attenuated Shigella dysenteriae 1 vaccine candidates, all derived from the 1617 parent strain. The vaccine strains included WRSd1, a previously tested candidate with deletions in virG(icsA), stxAB, and fnr, and four other strains—WRSd2, WRSd3, WRSd4, and WRSd5—each containing deletions in virG and stxAB, but retaining fnr. Additionally, WRSd3 and WRSd5 had further deletions in the Shigella enterotoxin gene senA and its paralog senB, with WRSd5 having an extra deletion in msbB2. Rhesus monkeys were immunized three times at two-day intervals with a target dose of 2 × 1010 CFU of the vaccine strains. Thirty days after the final immunization, all monkeys were challenged with a target dose of 2 × 109 CFU of the S. dysenteriae 1 1617 wild-type strain. Safety, immunogenicity, and efficacy were assessed through physical monitoring and the evaluation of immunologic and inflammatory markers following immunization and challenge. Initial doses of WRSd1, WRSd3, and WRSd5 led to mild adverse effects, such as vomiting and loose stools, but all five vaccine strains were well tolerated in subsequent doses. All strains elicited significant IgA and IgG antibody responses, as well as the production of antibody-secreting cells. Notably, none of the vaccinated animals exhibited shigellosis symptoms such as vomiting or loose/watery stool post-challenge, in stark contrast to the control group, where 39% and 61% of monkeys exhibited these symptoms, respectively. The aggregate clinical score used to evaluate Shigella attack rates post-challenge revealed a 72% attack rate in control animals, compared to only 13% in vaccinated animals, indicating a relative risk reduction of 81%. This study highlights the potential of this NHP model in evaluating the safety, immunogenicity, and efficacy of live-attenuated Shigella vaccine candidates, offering a valuable tool for preclinical assessment before advancing to Phase 1 or more advanced clinical trials.

This review presents a comprehensive analysis of vascular access in hemodialysis, focusing on the current modalities, their associated challenges, and recent technological advancements. It closely examines the status of three primary types of vascular access: arteriovenous fistulas, arteriovenous grafts, and central venous catheters. The review delves into the complications and pathologies associated with these access types, emphasizing the mechanobiology-related pathogenesis of arteriovenous access. Furthermore, it explores recent clinical trials, biomaterials, and device innovations, highlighting novel pharmaceutical approaches, advanced materials, device designs, and cutting-edge technologies aimed at enhancing the efficacy, safety, and longevity of vascular access in hemodialysis. This synthesis of current knowledge and emerging trends underscores the dynamic evolution of vascular access strategies and their critical role in improving patient care in hemodialysis.

Background: Depressive disorders can present with psychotic features, which warrants a different diagnosis and a different phenomenological study. Aim: To study the phenomenology of depressive disorders with and without psychotic features. Methodology: One hundred and forty-eight patients presenting to psychiatry outpatient department of a tertiary care center were screened using Mini International Neuropsychiatric Interview questionnaire to select patients for our study. Sociodemographic data and some clinical variables of these patients were collected. These patients were further assessed for depression severity and psychotic symptoms by using Montgomery and Asberg Depression Rating Scale (MADRS) and Modified Psychotic Symptoms Ratings Scale (PSYRATS), respectively. Results: Mean MADRS score for patients with depression without psychotic features was 38.38 and for patients with depression with psychotic features was 44.51. Result was found to be significant. Suicidality was found to be on a higher side in patients of depression with psychotic features. Conclusion: Main finding related to our study was that depression severity was found to be more in patients of depression with psychotic features. There are certain phenomenological differences which warrant a separate diagnosis of depression with psychotic features. These include the increased intensity of suicidality, visible sadness, inner stress, difficulty in concentration, lassitude, altered ability to feel, and thoughts of suicide present in patients of depression with psychotic features.

Background: During the perimenopausal phase, women experience a myriad of somatic symptoms as well as changes in mood and emotions which could be related to the endocrine changes and psychological factors during this transition. Aim: The aim was to assess the prevalence of somatic symptoms and psychiatric morbidity in perimenopausal women. Material and Methods: By purposive sampling, 100 women in the age group of 45–55 years were included in the study with their consent. They were assessed with a self-made sociodemographic proforma, Mini-International Neuropsychiatric Interview (MINI), depression, anxiety, stress scale (DASS 21), Menopause Rating Scale, big five inventory scale (BFI-10), and social support scale. Results: Psychiatric morbidity was seen in 41% of perimenopausal women, out of which 32% showed somatic symptoms. Seventeen percent had mild-to-moderate depressive features, 17% showed mild-to-moderate anxiety, and 7% were dysthymic. Conclusion: Prevalent life stressors seemed to affect the transition into menopause for many women which directly corresponded to the prevalence of psychiatric morbidity and somatic symptoms in them.

Abstract This pragmatic review synthesises the current understanding of prodromal dementia with Lewy bodies (pDLB) and prodromal Alzheimer’s disease (pAD), including clinical presentations, neuropsychological profiles, neuropsychiatric symptoms, biomarkers, and indications for disease management. The core clinical features of dementia with Lewy bodies (DLB)—parkinsonism, complex visual hallucinations, cognitive fluctuations, and REM sleep behaviour disorder are common prodromal symptoms. Supportive clinical features of pDLB include severe neuroleptic sensitivity, as well as autonomic and neuropsychiatric symptoms. The neuropsychological profile in mild cognitive impairment attributable to Lewy body pathology (MCI-LB) tends to include impairment in visuospatial skills and executive functioning, distinguishing it from MCI due to AD, which typically presents with impairment in memory. pDLB may present with cognitive impairment, psychiatric symptoms, and/or recurrent episodes of delirium, indicating that it is not necessarily synonymous with MCI-LB. Imaging, fluid and other biomarkers may play a crucial role in differentiating pDLB from pAD. The current MCI-LB criteria recognise low dopamine transporter uptake using positron emission tomography or single photon emission computed tomography (SPECT), loss of REM atonia on polysomnography, and sympathetic cardiac denervation using meta-iodobenzylguanidine SPECT as indicative biomarkers with slowing of dominant frequency on EEG among others as supportive biomarkers. This review also highlights the emergence of fluid and skin-based biomarkers. There is little research evidence for the treatment of pDLB, but pharmacological and non-pharmacological treatments for DLB may be discussed with patients. Non-pharmacological interventions such as diet, exercise, and cognitive stimulation may provide benefit, while evaluation and management of contributing factors like medications and sleep disturbances are vital. There is a need to expand research across diverse patient populations to address existing disparities in clinical trial participation. In conclusion, an early and accurate diagnosis of pDLB or pAD presents an opportunity for tailored interventions, improved healthcare outcomes, and enhanced quality of life for patients and care partners.

Innate lymphoid cells (ILCs) are the most recently discovered class of innate immune cells found to have prominent roles in various human immune-related pathologies such as infection and autoimmune diseases. However, their role in cancer was largely unclear until recently, where several emerging studies over the past few years unanimously demonstrate ILCs to be critical players in tumour immunity. Being the innate counterpart of T cells, ILCs are potent cytokine producers through which they orchestrate the overall immune response upstream of adaptive immunity thereby modulating T cell function. Out of the major ILC subsets, ILC1s have gained significant traction as potential immunotherapeutic candidates due to their central involvement with the anti-tumour type 1 immune response. ILC1s are potent producers of the well-established anti-tumour cytokine interferon γ (IFNγ), and exert direct cytotoxicity against cancer cells in response to the cytokine interleukin-15 (IL-15). However, in advanced diseases, ILC1s are found to demonstrate an exhausted phenotype in the tumour microenvironment (TME) with impaired effector functions, characterised by decreased responsiveness to cytokines and reduced IFNγ production. Tumour cells produce immunomodulatory cytokines such as transforming growth factor β (TGFβ) and IL-23, and through these suppress ILC1 anti-tumour actfivities and converts ILC1s to pro-tumoural ILC3s respectively, resulting in disease progression. This review provides a comprehensive overview of ILC1s in tumour immunity, and discusses the exciting prospects of harnessing ILC1s for cancer immunotherapy, either alone or in combination with cytokine-based treatment. The exciting prospects of targeting the upstream innate immune system through ILC1s may surmount the limitations associated with adaptive immune T cell-based strategies used in the clinic currently, and overcome cancer immunotherapeutic resistance.

A draft genome sequence of an isolate of Arthrobacter koreensis BSB from Santiniketan soil is being published. A. koreensis BSB produces lignocellulases, which are crucial in plant biomass degradation. It is a potential source of enzymes of digestive importance, especially lignocellulases. Genomic DNA was isolated from a single bacterial colony using a QIAgen Blood and Tissue kit (QIAgen Inc., Canada). Illumina HiSeq X performed the DNA sequence, employing 2 × 150 paired-end chemistry, and 8,725,587 reads were obtained, corresponding to a sequence coverage of 755X. The draft genome assembly formed 15 contigs > 200 base pairs in length (N50 value= 446, 958 and L50= 3). The genome size is 3,466,004 base pairs with an average GC percentage of 65.94 %. Annotation and prediction of genes were carried out with Prokka v.1.14.6, and 3,172 CDS, 3236 genes, 58 tRNA genes, 4 rRNA genes, and 2 tmRNA genes were identified.

This paper proposes an inherent fault current blocking modular series multilevel converter (MSMC) using half-bridge (HB) sub-modules (SMs) for grid integration. The proposed converter uses passive filters to decouple the AC and DC side. Compared to conventional three-phase modular multilevel converters (MMCs) that use half-bridge sub-modules (HBSMs), the new MSMC design significantly reduces the number of switching devices required. Furthermore, one of the features of the proposed MSMC is its inherent ability to limit fault currents, which is achieved through its unique topological configuration whereas the conventional HB-MMC is susceptible to DC and AC faults. Despite these advancements, the new MSMC design retains all the desirable characteristics of conventional HB-MMCs, ensuring compatibility and ease of adoption. The paper thoroughly examines the operation of the MSMC under both steady-state and fault conditions. It also discusses the equivalent voltage decoupling circuit, energy balancing which is essential for the proper functioning of the converter. Additionally, the pre-charging process of the sub-module capacitors, a critical step for ensuring the safe start-up of the converter, is discussed in detail. Furthermore, Extended topologies can be derived from proposed topology for different applications.

Mercury, emitted from various industries, is toxic and has devastating environmental consequences. Therefore, it becomes imperative to monitor the levels of mercury closely. This work mainly focuses on preparing inexpensive zeolite-coated kaolin membranes for separating Hg2+ from water. The membrane support was prepared using kaolin (50 wt%), quartz (25 wt%), and calcium carbonate (25 wt%). This mixture was blended with a 3 % hydroxypropyl methylcellulose (HPMC) solution and then passed through an extruder to obtain tubular support, which was further sintered at 950 °C. The zeolite-coated membrane (ZP membrane) was fabricated by subjecting the sintered support to a 48-h hydrothermal synthesis in 7 Na2O: 1 Al2O3: 10 SiO2: 205H2O gel at 90 °C. The isoelectric point of the ZP membrane was estimated to be 4.5. The zeolite-coated membrane displayed a pure-water permeability of 22.7 × 10−9 m3/m2 s kPa, a porosity of 31.72 ± 0.86 %, and a pore size of 90 nm. The performance of the ZP membrane in separating the Hg2+ ion from an aqueous solution was investigated by pressure variations (69–345 kPa) and feed concentration (0.5–10 ppm). The results clearly showed that in all cases, the zeolite-P membrane exhibited more than 99 % rejection of Hg2+ ions from aqueous solutions during the filtration experiments. Thus, the prepared ZP membrane can effectively be used for the separation of Hg2+ ions from wastewater.

Aim: Pharmaceutical promotion is the principal aspect of the healthcare system. In this study, we aimed to portray the opinion of doctors and medical representatives (MRs) on conventional pharmaceutical ways (usage of promotional or educational paper materials and physician drug samples) for pharmaceutical promotion. Materials and Methods: In this cross-sectional observational study, data were collected from doctors and MRs across India using self-administered Google forms. Data were analyzed, and results were drawn. Results: A total of 314 doctors and 272 MRs participated in the study. As per 95.5% of doctors, continuing medical education (CME)/books/online information is the most common and convenient method to update medical knowledge, whereas 67.9% of MRs also think the same. Only 5.5% of doctors prefer paper material provided by pharmaceutical companies to update their knowledge. Most doctors say paper materials provided by pharmaceutical companies contribute less than 25% to product information, rather CME, books, and online information contribute significantly. MRs also think similarly. 66.2% of MRs agree that more than 25% of paper material gets wasted due to non-distribution. 73.2% of doctors and 75.4% of MRs agree that the use of paper materials for product promotion is not cost-effective, even if it contributes to deforestation. Only 51% of doctors use more than 50% of medical samples in patient care and only half of doctors and MRs think expired medical samples are disposed of correctly. 56.1% of doctors and 71.4% of MRs think a significant amount of medical samples are wasted and are hazardous to the environment. Conclusions: Both doctors and MRs are of the opinion that the conventional method of paper promotion, that is, paper material and drug samples, is not cost-effective and also not eco-friendly. Hence, need to rethink – is there a need to change with time?

Objective The modern era of cognitive intelligence in clinical space has led to the rise of ‘Medical Cognitive Virtual Agents’ (MCVAs) which are labeled as intelligent virtual assistants interacting with users in a context-sensitive and ambient manner. They aim to augment users' cognitive capabilities thereby helping both patients and medical experts in providing personalized healthcare like remote health tracking, emergency healthcare and robotic diagnosis of critical illness, among others. The objective of this study is to explore the technical aspects of MCVA and their relevance in modern healthcare. Methods In this study, a comprehensive and interpretable analysis of MCVAs are presented and their impacts are discussed. A novel system framework prototype based on artificial intelligence for MCVA is presented. Architectural workflow of potential applications of functionalities of MCVAs are detailed. A novel MCVA relevance survey analysis was undertaken during March-April 2023 at Bhubaneswar, Odisha, India to understand the current position of MCVA in society. Results Outcome of the survey delivered constructive results. Majority of people associated with healthcare showed their inclination towards MCVA. The curiosity for MCVA in Urban zone was more than in rural areas. Also, elderly citizens preferred using MCVA more as compared to youths. Medical decision support emerged as the most preferred application of MCVA. Conclusion The article established and validated the relevance of MCVA in modern healthcare. The study showed that MCVA is likely to grow in future and can prove to be an effective assistance to medical experts in coming days.

Background: As a prerequisite to start a medical practice in India, Foreign Medical graduates on returning have to sit for FMGE (Foreign Medical Graduate’s Exam), organized by NBE. The time and effort involved by the students with adjustments to various changes in educational and examination pattern may manifest as psychiatric morbidities while awaiting a positive outcome. Aim: To evaluate depression, anxiety, stress, and insomnia in Foreign Medical Graduate students and to understand the various factors associated with them. Materials and Methods: A total of 80 MBBS students appearing for FMGE were enrolled during the period of April 2023 to May 2023, after obtaining their written consent on the Google form to participate in this study. The participants answered a semi-structured proforma consisting of information about sociodemographic data, DASS-21 (depression, anxiety, and stress severity scale), ISI scale (insomnia severity index), and RSES (Rosenberg self-esteem scale). Results: In this study, 76.2%, 80%, 72.5%, and 78.8% of students were found to be suffering from depression, anxiety, stress, and insomnia, respectively. A significant statistical correlation was found between anxiety and the students appearing for July FMGE 2023. Stress and depression were associated with insecurities/comparisons faced by the participants due to peers clearing the examination before them. Low self-esteem was associated with 3 or more failed attempts for FMGE and the presence of other stressors preceding/concurrent while preparing for FMGE. Clinical insomnia was found to be statistically significant with depression, anxiety as well as stress in this study. Multiple regression analysis showed that stress and anxiety predicted depression while the young age of the student, low socioeconomic status, low self-esteem, stress, and depression predicted anxiety. Stress was found to be associated with anxiety, depression, and insomnia. Insomnia was corelated with having extension in the UG course and stress while low self-esteem was corelated with students who were attempting for the July 2023 examination and anxiety. Conclusion: The significantly high proportion of psychiatric morbidities among Foreign Medical Graduates is suggestive of the need for the necessary psychological aid and counseling as these foreign medical graduates can be viewed as an opportunity to correct India’s physician shortage.

Background: Progressive loss of visual acuteness is known to be associated with anxiety, insecurity, loss of independence, and altered social functioning, which may lead to low mood and subsequently depression. Emotionally adjusting to vision loss can dramatically change one’s independence. Reduced workplace productivity in adults with visual impairment is associated with lower rates of workforce participation and increased rates of anxiety and depression. Most studies for psychological comorbidities in the legally blind population are conducted in individuals who present to the psychiatry or psychology department/clinics or to facilities for blindness certification. Due to the paucity of community-based data in the Indian scenario, the current study was undertaken. Aim: To evaluate the psychological distress and satisfaction with life of people who were diagnosed as blind in the community. Materials and Methods: The sample was based on the identification of blind persons in a door-to-door screening for eye and vision problems in 44535 individuals conducted in 2015–16 in the middle to lower socioeconomic populations in the suburban area of Yerawada, Maharashtra. Those who were suspected of having low vision underwent a detailed clinical examination including visual acuity estimation, portable slit lamp examination, I-Kare tonometry, and fundoscopy, conducted by an ophthalmologist to assess and verify the lack of vision. Subsequently, the General Health Questionnaire-12 (GHQ-12) and Satisfaction with Life Scale (SWLS) were also applied upon revisiting the participants in 2020–2021. Results: The majority of participants were middle-aged or elderly and no significant gender variation was noted in terms of blindness. Maximum psychological disability was seen after 6 to 15 years after the onset of blindness. More than 80% of the patients with complete blindness had some psychiatric comorbidity or distress and more than half reported that their daily activities were affected due to their diagnosis. Blind persons had significantly higher scores on the GHQ-12 and significantly lower scores on SWLS. Complete blindness was positively correlated with GHQ-12 scores and negatively correlated with SWLS scores and the age of the subject. Conclusion: This study demonstrates that psychological distress and low levels of satisfaction with life are common among the severely visually impaired and blind. There is a dire need to improve access to rehabilitation services and psychological support for the blind and their caregivers.

Background: The COVID-19 pandemic affected almost all sections of society. The economy of the country collapsed and it affected the economic situation of the common man. Private shopkeepers also suffered as they could not open their shops. The current study was an effort to assess the psychological status of these people. Aim: To assess depression, anxiety, and stress levels among private shopkeepers in Mohali after the COVID-19 pandemic who were previously mentally healthy. Materials and Methods: This observational, cross-sectional study was conducted on 500 consenting private shopkeepers from 10 different topographically scattered markets of Mohali. Written informed consent was obtained. Ethical clearance was sorted by the institutional ethics committee. Sociodemographic data were recorded on sociodemographic proforma. Depression Anxiety Stress Scale -21 (DASS-21) was employed to assess depression, anxiety, and stress. The data obtained was statistically analyzed. Results: A total of 34.2% of shopkeepers had depression, 31.4% had anxiety, and 44.80% had stress. Out of which street vendors had more depression (6.60%), anxiety (6.80%), and stress (7.40%) compared to other shopkeepers. Depression (36.07%), anxiety (32.61%), and stress (46.87%) were comparatively more among shopkeepers who had incurred financial loss compared to those who had received gain. Shopkeepers who had their shops closed were suffering from depression (35.42%), anxiety (33.26%), and stress (46.65%) comparatively more than individuals who had their shops open. A total of 59.75%, 51.57%, and 72.96% of shopkeepers whose products expired during the pandemic were suffering from depression, anxiety, and stress respectively. Conclusion: Depression, anxiety, and stress are high in private shopkeepers after the pandemic. Mental health services should be more accessible, affordable, and available during a pandemic and its aftermath. The economy of the country should be strengthened after the pandemic keeping in interest the economic needs of the common man.

Background: Among the most demanding careers that many Indians choose is teaching. Teachers are under a lot of stress because of all the extra responsibilities and duties they have from the school, education boards, and institutions. This can be a fertile ground for psychological problems among teachers. Aim: To assess depression, anxiety, stress, and sleep disturbances among school teachers and to find out their correlates. Materials and Methods: A cross-sectional observational study was planned in 100 teachers working in the government schools of the rural catchment of Nandyal district, Andhra Pradesh. Teachers were assessed through a semistructured proforma containing sociodemographic information, information about job-related factors, and DASS 21 to assess depression, anxiety, and stress and Insomnia Severity Index to assess sleep disturbances. Results: The overall prevalence of depression, anxiety, and stress symptoms among teachers was found to be 28%, 61%, and 24%, respectively, and sleep disturbances were 38%. Depression was found to be independently associated with marital status (married > single, P < 0.001), position at workplace (secondary grade > primary grade, P < 0.001), mode of transport (public transport > personal, P = 0.001), source of income (single > family, P = 0.013), higher level of income (P < 0.001), stress (P < 0.001), and anxiety (P < 0.001). Anxiety was associated with migration for the job (P < 0.001), stress (P < 0.001), and depression (P < 0.001), while insomnia was associated with the type of family (nuclear > joint, P = 0.015), source of income (single > family, P = 0.039), no interaction with a colleague (P = 0.007), being dissatisfied with job (P = 0.002), and stress (P = 0.005). Conclusion: The significantly moderate proportion of depression, anxiety, stress, and insomnia among government schoolteachers is suggestive of the need for the necessary psychological aid and counseling for such teachers. Therefore, appropriate methods must be introduced to address the concerns of teachers, thereby reducing anxiety and stress among them.

Background: Recent lexical research in different languages has revealed that there are six personality dimensions instead of the previously proposed five dimensions. To address this issue, the HEXACO Personality Inventory-Revised (HEXACO PI-R), a self-rating scale to assess personality characteristics, was constructed. However, researchers in India faced a language barrier because it was only available in English. Aim: To evaluate the validity and reliability of the Hindi translation of the HEXACO PI-R. Materials and Methods: We followed WHO guidelines for the translation and adaptation of instruments. In forward translation, the scale was translated to Hindi independently by two independent bi-lingual authors. Both versions were reviewed, and a common Hindi version was made. Then, in the second step, an expert panel was formed comprising psychologists, authors, and senior psychiatrists. All the shortcomings were addressed, which resulted in a final Hindi version of the scale. Subsequently, a Hindi Professor, who had no background knowledge of the scale, was consulted to check the Grammar and meaning of the scale. Finally, an independent English Professor with no background knowledge of this scale was consulted to translate the Hindi version to English back. A small pilot study was conducted and a resultant Hindi version of the self-report HEXACO was applied to 10 patients to see the shortcomings, which resulted in the final Hindi version. By convenience sampling 300 volunteers, conversant in both the English and Hindi languages were included. The subjects were initially administered alternately the original English version or the Hindi version of the scale. Then after a gap of 14 days, those who initially received the English version filled up the Hindi translation, while those who received the Hindi version initially filled up the English version of the scale. Results: The scores on the original English scale and the Hindi versions were significantly positively correlated (Spearman’s rho 0.900; P < 0.001). The translated scale showed a high degree of internal consistency and acceptable reliability. An exploratory factor analysis with varimax rotation yielded 6 factors, which were found to have a further 24 facets. The fitness of the model for the overall scale and its sub-factors was found to be acceptable. Results of the Rasch analysis showed the scale had good infit and outfit values. The person’s reliability was good. The Wright map showed a good distribution of the items. Conclusion: The Hindi translation of the HEXACO PI-R is a valid and reliable tool to gauge the personality dimensions of the Hindi-speaking population of India.

Background: During the COVID-19 pandemic, migrant workers in India have gone through many hardships. After the lockdown, many construction sites, factories, and workplaces shut down, and innumerable migrant workers faced a loss of income, shortage of food, and uncertain future. This massive change in their living conditions made them vulnerable to psychological problems. Aim: To screen for depression, anxiety, stress, alcohol dependence, and resilience in migrant workers during the COVID-19 crisis. Materials and Methods: Migrant workers at seven camps in the Pimpri Chinchwad Municipal Corporation, Maharashtra, were surveyed with the help of the Depression Anxiety Stress (DASS-21) Scale to assess depression, anxiety, and stress levels, AUDIT C for assessing alcohol use disorders, and Connor–Davidson resilience scale short form (CD RISC) for assessing resilience. Results: A total of 1053 migrant workers were surveyed. It showed that 57.54% of workers had depressive symptoms, 64.96% had anxiety symptoms, and 39.32% had subjective stress. Female migrant workers had more severe depression, anxiety, and stress symptoms as compared to males while male workers were more at risk of alcohol use disorder as compared to females. Migrants without family had more symptoms of severe depression and alcohol use disorder as compared to those with family. Regression analysis showed that levels of anxiety were independently associated with female gender, unmarried status, stress, depression, and alcohol use disorder while resilience negatively predicted anxiety in these migrant workers. Conclusion: During the COVID-19 pandemic, migrant workers were at risk of depression, anxiety, stress, and alcohol use disorder. Females and migrants without families came out to be more vulnerable to these psychological problems. Hence during the pandemic situation, identifying this vulnerable population and special preventive or therapeutic programs for them can be of crucial importance.

Background: Mental well-being is important for medical students to perform effectively. The COVID-19 pandemic posed different stressors to medical students increasing their vulnerability to distress and impaired well-being. Aim: To assess the effect of the COVID-19 pandemic on the well-being of medical students and its relation with COVID-related psychological distress and fear as well as sleep quality. Materials and Methods: We planned a cross-sectional study on medical students with the help of an online Google Form including sociodemographic data, medical students well-being index (MSWBI), Psychological Distress Scale, fear of COVID-19 Scale (FCV-19S), and Pittsburgh Sleep Quality Index (PSQI). Results: 48.13% of students reported higher distress and impaired mental well-being. Impaired well-being is correlated with COVID-related psychological distress, fear of COVID-19, and disturbed sleep quality. Regression analysis showed that joint family and sleep disturbances significantly predicted distress or poor well-being in medical students. Conclusion: Almost half of the medical students revealed impaired mental well-being underlining the role of COVID-related stressors in worsening the psychological health of students. In this situation, it is important to take prompt measures to identify vulnerable students and help them.

Introduction: There remains an unmet need to reduce kidney and cardiovascular risk in patients with chronic kidney disease (CKD). This report is therefore intended to provide real-world clinical guidance to primary care providers on sodium-glucose co-transporter-2 (SGLT2) inhibitor use in patients with CKD, focusing on practical considerations. Initially developed as glucose-lowering drugs, SGLT2 inhibitors preserve kidney function and reduce risks of cardiovascular events and mortality. Clinical benefits of SGLT2 inhibitors in CKD have been demonstrated in multiple clinical trials, yet utilization in practice remains relatively low, likely due to the complexity of labeled indications (past and present) and misconceptions about SGLT2 inhibitors as a class. Methods: A panel of 8 US-based nephrologists convened in August 2022 to develop consensus guidance for the primary care community surrounding risk assessment as well as initiation and implementation of SGLT2 inhibitors in patients with CKD. Here, we provide an adapted version of the Kidney Disease: Improving Global Outcomes (KDIGO) heatmap and a treatment-decision algorithm. Conclusions: We advocate SGLT2 inhibitors as co-first-line therapy with renin-angiotensin-aldosterone system (RAAS) inhibitors, where RAAS inhibitor dose titration need not be completed before initiation of an SGLT2 inhibitor. In fact, SGLT2 inhibitor therapy may facilitate up-titration or maintenance of optimal RAAS inhibitor dosing. We describe potential strategies to aid implementation of an SGLT2 inhibitor in clinical practice, including improving education and awareness among care providers and patients and dispelling misconceptions about the safety of SGLT2 inhibitors. In summary, we support the use of SGLT2 inhibitors with RAAS inhibitors as co-first-line therapy in most patients with CKD.

Introduction Almonds have prebiotic potential to maintain gut health and regulate glycaemia. Western studies have shown their positive effects on preventing non-communicable diseases like diabetes and cardiovascular diseases. However, there is a lack of research involving Asian Indians, who have a higher predisposition to diabetes due to their unique ‘Asian phenotype’. Therefore, this study aims to evaluate the impact of almond supplementation on glycaemic control and gut health in adults with pre-diabetes in rural India through a randomised clinical trial.Methods and analysis A parallel cluster randomised controlled trial with 178 participants with pre-diabetes (assigned 1:1) aged 20–50 years, of both genders, with a body mass index of 18.9–25 kg/m2, will be conducted in rural areas of Chikkaballapur, Kolar and Rural Bangalore districts in India. The intervention group will receive 56 g of almonds as mid-morning snacks for 16 weeks, while the control group will receive cereal/pulse-based traditional isocaloric snacks under the closed supervision of the study investigators. The primary outcome of the study is HbA1c measured at the 16th week. The secondary outcomes—anthropometry, clinical and other biochemical parameters—will be measured at 0th, 8th and 16th weeks, and a subgroup of 120 participants will undergo gut health analysis. Glucagon-like peptide 1 analysis will be conducted on 30 participants at 0th and 16th weeks. Statistical analysis will be performed using SPSS for Windows V.27.0, and both intention-to-treat and per-protocol analyses will be conducted.Ethics and dissemination Ethics approval was obtained from the Institutional Ethics Committee at Ramaiah Medical College, Bangalore, Karnataka, India (DRPEFP7672021). We will obtain the informed written consent of the participants prior to screening and enrolling them in the study. Results from this trial will be disseminated through publication in peer-reviewed journals and scientific gatherings.Trial registration number Clinical Trial Registry of India (CTRI/2023/03/050421).

Introduction Most solid organ transplants originate from donors meeting criteria for death by neurological criteria (DNC). Within the organ donor, physiological responses to brain death increase the risk of ischaemia reperfusion injury and delayed graft function. Donor preconditioning with calcineurin inhibition may reduce this risk.Methods and analysis We designed a multicentre placebo-controlled pilot randomised trial involving nine organ donation hospitals and all 28 transplant programmes in the Canadian provinces of Ontario and Québec. We planned to enrol 90 DNC donors and their approximately 324 organ recipients, totalling 414 participants. Donors receive an intravenous infusion of either tacrolimus 0.02 mg/kg over 4 hours prior to organ retrieval, or a matching placebo, while monitored in an intensive care unit for any haemodynamic changes during the infusion. Among all study organ recipients, we record measures of graft function for the first 7 days in hospital and we will record graft survival after 1 year. We examine the feasibility of this trial with respect to the proportion of all eligible donors enrolled and the proportion of all eligible transplant recipients consenting to receive a CINERGY organ transplant and to allow the use of their health data for study purposes. We will report these feasibility outcomes as proportions with 95% CIs. We also record any barriers encountered in the launch and in the implementation of this trial with detailed source documentation.Ethics and dissemination We will disseminate trial results through publications and presentations at participating sites and conferences. This study has been approved by Health Canada (HC6-24-c241083) and by the Research Ethics Boards of all participating sites and in Québec (MP-31-2020-3348) and Clinical Trials Ontario (Project #3309).Trial registration number NCT05148715.

The draft genome sequence of an isolate of Bacillus safensis U41 from the soils of Santiniketan (23040′12″ N and 87039′52″ E) is reported here. Bacillus safensis is a bacterium that produces cellulases, which is essential for the breakdown of plant biomass. As such, it is a valuable source of digestive enzymes from plant biomass, especially cellulases. The genomic DNA was extracted from a single colony using a QIAgen Blood and Tissue kit (QIAgen Inc., Canada). Sequencing was performed via Illumina HiSeq X using 2 × 150 paired-end chemistry, generating 7,352,576 reads with sequence coverage of 509x. The assembly produced 20 contigs over 200 base pairs (bp) in length, with an N50 value of 901304 and an L50 of 2. The genome size was 3,732,407 bp, and the average GC content was 41.43 %. Genome annotation and gene predictions were performed using Prokka v.1.14.6, which identified 3783 coding sequences, 64 tRNA genes, and 3 rRNA genes.

Summary: We sought to replicate and expand previous work showing that the more human-like a robot appears, the more willing people are to attribute mind-like capabilities and socially engage with it. Forty-two participants played games against a human, a humanoid robot, a mechanoid robot, and a computer algorithm while undergoing functional neuroimaging. We confirmed that the more human-like the agent, the more participants attributed a mind to them. However, exploratory analyses revealed that the perceived socialness of an agent appeared to be as, if not more, important for mind attribution. Our findings suggest top-down knowledge cues may be equally or possibly more influential than bottom-up stimulus cues when exploring mind attribution in non-human agents. While further work is now required to test this hypothesis directly, these preliminary findings hold important implications for robotic design and to understand and test the flexibility of human social cognition when people engage with artificial agents.

Background. Ex vivo kidney perfusion is an evolving platform that demonstrates promise in preserving and rehabilitating the kidney grafts. Despite this, there is little consensus on the optimal perfusion conditions. Hypothermic perfusion offers limited functional assessment, whereas normothermic perfusion requires a more complex mechanical system and perfusate. Subnormothermic machine perfusion (SNMP) has the potential to combine the advantages of both approaches but has undergone limited investigation. Therefore, the present study sought to determine the suitability of SNMP for extended kidney preservation. Methods. SNMP at 22–25 °C was performed on a portable device for 24 h with porcine kidneys. Graft assessment included measurement of mechanical parameters and biochemical analysis of the perfusate using point-of-care tests. To investigate the viability of kidneys preserved by SNMP, porcine kidney autotransplants were performed in a donation after circulatory death (DCD) model. SNMP was also compared with static cold storage (SCS). Finally, follow-up experiments were conducted in a subset of human kidneys to test the translational significance of findings in porcine kidneys. Results. In the perfusion-only cohort, porcine kidneys all displayed successful perfusion for 24 h by SNMP, evidenced by stable mechanical parameters and biological markers of graft function. Furthermore, in the transplant cohort, DCD grafts with 30 min of warm ischemic injury demonstrated superior posttransplant graft function when preserved by SNMP in comparison with SCS. Finally, human kidneys that underwent 24-h perfusion exhibited stable functional and biological parameters consistent with observations in porcine organs. Conclusions. These observations demonstrate the suitability and cross-species generalizability of subnormothermic machine perfusion to maintain stable kidney perfusion and provide foundational evidence for improved posttransplant graft function of DCD kidneys after SNMP compared with SCS.

Summary: Motor proteins transport diverse membrane-bound vesicles along microtubules inside cells. How specific lipids, particularly rare lipids, on the membrane recruit and activate motors is poorly understood. To address this, we prepare spherical supported lipid bilayers (SSLBs) consisting of a latex bead enclosed within a membrane of desired lipid composition. SSLBs containing phosphatidic acid recruit dynein when incubated with Dictyostelium fractions but kinesin-1 when incubated with rat brain fractions. These SSLBs allow controlled biophysical investigation of membrane-bound motors along with their regulators at the single-cargo level in vitro. Optical trapping of single SSLBs reveals that motor-specific inhibitors can “lock” a motor to a microtubule, explaining the paradoxical arrest of overall cargo transport by such inhibitors. Increasing their size causes SSLBs to reverse direction more frequently, relevant to how large cargoes may navigate inside cells. These studies are relevant to understand how unidirectional or bidirectional motion of vesicles might be generated.