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Abstract The absorption of terahertz (THz) radiation by water molecules facilitates its application to several biomedical applications such as cancer detection. Therefore, it is critical for the THz technologies to be characterised with water content in a sample. In this paper, we analyse gelatine phantoms in the THz frequency range, with continuously varying hydration levels as they dry over time. Water molecules in close proximity to the protein molecule, termed ‘bound water’, feature properties different from the ‘free water’ molecules at larger distances. We find that a common model for predicting electromagnetic properties of phantoms and tissue samples, which assumes that only the free water varies with hydration while the bound water remains constant, does not agree well with measured results. To gain insight into this behaviour, we simultaneously measured the phantom in Raman spectroscopy, which shows a continuously varying concentration of bound water with hydration level. It follows from this investigation, that the permittivity contributions of neither the biomolecules nor water are expected to be linear with water density. This means that the often used, simple effective medium model will not be accurate for many biological tissues or phantoms.

Introduction: Nutritional status during pregnancy is a determining factor for maternal and neonatal health outcomes. Protein is an essential nutrient for foetal development. If pregnancy is associated with an improper diet leading to protein deficiency, the prospects for maternal and foetal outcomes may be catastrophic. An electrophoretic study of serum protein patterns in pregnancy can help identify pregnancy-specific protein markers and facilitate the monitoring of feto-maternal health. Aim: The aim of this study is to assess serum protein levels and their fractions (albumin, alpha-1 globulin, alpha-2 globulin, beta globulin, and gamma globulin) using gel electrophoresis in healthy pregnant women attending an antenatal clinic. Materials and Methods: This cross-sectional study was conducted in the Department of Medical Biochemistry in collaboration with the Department of Obstetrics and Gynecology at Sultania Zanana Hospital, associated with Gandhi Medical College, Bhopal, Madhya Pradesh, India, between January 2021 and February 2021. Fifty normal non-pregnant women of childbearing age and 50 normal pregnant women in the first trimester of pregnancy attending an antenatal clinic were enrolled and followed-up through the second and third trimesters for investigations. Serum total protein, albumin, and globulin levels were estimated using a fully automated chemistry analyser, and the electrophoretic patterns of serum protein fractions were analysed using an automated gel electrophoresis apparatus. Epi-Info statistical software was used for the statistical analysis of data, with p

Background: The delivery of dental treatment might be negatively impacted by a child’s unwillingness to cooperate. Judging a behavior-guiding strategy that successfully lowers fear and anxiety during dental treatment, results in a change in the child’s attitude toward the treatment, and is also accepted by the parents is necessary given the variety of behavior management strategies that are available. While conventional techniques of behavior modification have been effective, parents’ and dental professionals’ attitudes regarding them are evolving. New nonaversive approaches that are acceptable to parents are thus required. One such approach that may find favor with parents and dental professionals is music therapy. Methods: Pertinent medical databases such as PubMed, Cochrane, Embase, and Google Scholar were searched from January 1, 2001, to April 20, 2023, for randomized controlled trials and clinical studies that used music and no music (control) in children undergoing dental treatment. Primary outcomes included a decrease in pulse rate as measured through pulse oximeter in children undergoing dental treatment. Results: Through search strategy and screening through titles and abstracts, four randomized clinical trials (Grading of Recommendations, Assessment, Development, and Evaluation [GRADE] high certainty) and eight nonrandomized studies (GRADE high certainty) were included and the pooled results bared that the music pulse rate was significantly reduced in children who were made to listen to the music than those who did not listen to music during dental treatment. Conclusion: It was established that music distraction was a better behavior management technique as compared to no music group and instrumental music was better when compared to the nursery rhyme for anxiety reduction in children.

Context The global COVID-19 pandemic has universally impacted individuals, with lactating women being uniquely susceptible to severe infection. Vaccination plays a critical role in building population immunity, mitigating severe illness and curtailing the health crisis. However, data on adverse effects and vaccine safety in lactating women remains scarce. Aims To assess the prevalence and types of adverse effects post-COVID vaccination in lactating women. Methods This study was conducted at a tertiary care hospital’s COVID-19 vaccination centre in North India, and followed a prospective observational design over a specific timeframe. A total of 200 lactating women were surveyed, with specific inclusion and exclusion criteria applied. Telephonic follow-up was conducted for one month after the first dose for 152 participants and after the second dose for 123 participants. Adverse effects following immunization (AEFIs) were recorded and analyzed. Results Of the study cohort, 45 (29.60%) reported minor adverse effects following the first vaccine dose, with just four (3.25%) experiencing adverse effects after the second dose. Common AEFIs included fever (18.42%) and body aches (9.21%), along with headache, malaise, injection site pain and diffuse abdominal pain. Conclusions This study provides valuable insights into the adverse effects of COVID-19 vaccines in lactating women, which can help primary physicians and policy maker to improve vaccination policies and guidelines. The study revealed that lactating mothers experienced only mild AEFIs, aligning with current literature. Further broader, multicentre research is needed to reinforce these findings and to assess the long-term safety and efficacy of COVID-19 vaccines in this population.

Background: In spite of recent technical advances in the radiation field, exposure to non-target organs such as the thyroid gland remains unavoidable in locally advanced head and neck cancer (LAHNC) planning, which is associated with late toxicities, and this may affect the lifestyle of cancer survivors. Aim: The purpose of this study was to estimate the incidence of thyroid toxicity in LAHNC patients treated with three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT). To establish its correlation, we have analyzed thyroid profile levels, DVH, and the doses of radiation received by the thyroid volume in both radiotherapy planning methods. Material and Method: Sixty patients with LAHNC enrolled and were divided into two groups treated with 3D-CRT (group A) and IMRT (group B). The patient’s thyroid function test, which consisted of serumT3, T4, and TSH, was done before starting radiotherapy and at 6 months and 12 months follow-up. Absolute thyroid volume, maximum dose, minimum dose, mean dose to the thyroid gland, and percentage of thyroid volume receiving as V10, V20, V30, V40, and V50 were studied. Results: After 6-month post-RT, 6.7% of patients in group A showed biochemical hypothyroidism, whereas biochemical hypothyroidism, sub-clinical hypothyroidism, and hyperthyroidism were observed in 10%, 3.3%, and 10% patients of group B, respectively. After 12 months post-RT, 23.3% of patients in group A showed hypothyroidism. In the 3DCRT group, mean T3 was significantly higher for patients with no hypothyroidism (P < 0.05). Mean T4 was observed to be significantly lower in both the groups in hypothyroid patients (P < 0.05). Mean TSH was significantly higher for hypothyroid patients in the IMRT group (P > 0.01). The difference in thyroid volume and thyroid dose was observed to be statistically significant (P < 0.05). Conclusion: The incidence of thyroid toxicity may be decreased by sparing the volume of the thyroid gland and the thyroid dose kept to a minimum. As per dosimetric parameters, >V40 may predict the risk of developing hypothyroidism after irradiation in LAHNC patients. We recommend regular thyroid function tests on follow-up visits of irradiated patients of LAHNC.

Abstract Background A third of children born in England have at least one parent born outside the United Kingdom (UK), yet family migration history is infrequently studied as a social determinant of child health. We describe rates of hospital admissions in children aged up to 5 years by parental migration and socioeconomic group. Methods Birth registrations linked to Hospital Episode Statistics were used to derive a cohort of 4,174,596 children born in state-funded hospitals in England between 2008 and 2014, with follow-up until age 5 years. We looked at eight maternal regions of birth, maternal country of birth for the 6 most populous groups and parental migration status for the mother and second parent (UK-born/non-UK-born). We used Index of Multiple Deprivation (IMD) quintiles to indicate socioeconomic deprivation. We fitted negative binomial/Poisson regression models to model associations between parental migration groups and the risk of hospital admissions, including interactions with IMD group. Results Overall, children whose parents were both born abroad had lower emergency admission rates than children with parents both born in the UK. Children of UK-born (73.6% of the cohort) mothers had the highest rates of emergency admissions (171.6 per 1000 child-years, 95% confidence interval (CI) 171.4–171.9), followed by South Asia-born mothers (155.9 per 1000, 95% CI 155.1–156.7). The high rates estimated in the South Asia group were driven by children of women born in Pakistan (186.8 per 1000, 95% CI 185.4–188.2). A socioeconomic gradient in emergency admissions was present across all maternal regions of birth groups, but most pronounced among children of UK-born mothers (incidence rate ratio 1.43, 95% CI 1.42–1.44, high vs. low IMD group). Patterns of planned admissions followed a similar socioeconomic gradient and were highest among children with mothers born in Middle East and North Africa, and South Asia. Conclusions Overall, we found the highest emergency admission rates among children of UK-born parents from the most deprived backgrounds. However, patterns differed when decomposing maternal place of birth and admission reason, highlighting the importance of a nuanced approach to research on migration and health.

Background: Different clinical manifestations were revealed by the distinct waves of the coronavirus. The pandemic had a multifaceted impact on mental health, sleep patterns, and associated fear. MATERIALS AND METHODS: It was an observational online survey using by using Google Forms in the city of Chandigarh between April 2020 and April 2021 across three waves of the coronavirus outbreak (first wave from March 2020 to May 2020, second wave from June 2020 to January 2021, and third wave from February 2021 to April 2021). Fear of coronavirus disease (COVID), preventive behaviors, insomnia-related problems, and impact of the event were assessed by using standardized scales. Results: The participants who were infected during the first phase exhibited significantly higher levels of distress, loss of control over their reactions, increased fear of coronavirus and sleep problems, and also greater adherence to preventive behaviors compared to those who were infected during the second and third waves. A tendency to emerge post-traumatic stress disorder (PTSD) was seen in 68 (58.1%) of the participants (Peritraumatic Distress Inventory (PDI) score >14) and 34 (29.1%) of all the participants (PDI score >23). Overall, 66 (56.4%) participants reported having insomnia. About 24 people (20.5%) had clinical concerns about PTSD, 20 people (17.1%) had probable PTSD diagnoses, and 16 people (13.7%) experienced a severe coronavirus disease 2019 (COVID-19) pandemic impact on their lives. Conclusion: The first wave of COVID-19 had a greater psychological impact than subsequent waves. Further research must fill important gaps in our knowledge of the clinical range and long-term effects.

Introduction: Social Media (SM) has proven to be a valuable tool in various fields, including healthcare. However, its improper use can result in several ethical problems. Aim: To evaluate the knowledge, attitude, and practice of ethical SM usage for professional purposes. Materials and Methods: A cross-sectional study was conducted in the Department of Prosthodontics and Crown and Bridge at K.M. Shah Dental College and Hospital Vadodara, Gujarat, India between October 2022 and March 2023. A total of 319 respondents, including dental postgraduates, academicians, and dental practitioners, participated in the survey online through various SM groups. The questionnaire was created by analysing previous literature and reviewed by experts for accuracy. The survey comprised nine questions with three subsections to evaluate knowledge, attitude, and practice of ethical SM usage The survey was distributed through Google Forms, and the statistical analysis of the results was conducted using the Chi-square test (p

Abstract Recently, we have reported that extracellular vesicles (EVs) from the bone marrow mesenchymal stromal cells (BM-MSC) of aplastic anemia (AA) patients inhibit hematopoietic stem and progenitor cell (HSPC) proliferative and colony-forming ability and promote apoptosis. One mechanism by which AA BM-MSC EVs might contribute to these altered HSPC functions is through microRNAs (miRNAs) encapsulated in EVs. However, little is known about the role of BM-MSC EVs derived miRNAs in regulating HSPC functions in AA. Therefore, we performed miRNA profiling of EVs from BM-MSC of AA (n = 6) and normal controls (NC) (n = 6) to identify differentially expressed miRNAs. The Integrated DEseq2 analysis revealed 34 significantly altered mature miRNAs, targeting 235 differentially expressed HSPC genes in AA. Hub gene analysis revealed 10 HSPC genes such as IGF-1R, IGF2R, PAK1, PTPN1, etc., which are targeted by EV miRNAs and had an enrichment of chemokine, MAPK, NK cell-mediated cytotoxicity, Rap1, PI3k-Akt, mTOR signalling pathways which are associated with hematopoietic homeostasis. We further showed that miR-139-5p and its target, IGF-1R (hub-gene), might regulate HSPC proliferation and apoptosis, which may serve as potential therapeutic targets in AA. Overall, the study highlights that AA BM-MSC EV miRNAs could contribute to impaired HSPC functions in AA.

Abstract Mass vaccinations are crucial public health interventions for curbing infectious diseases. Canine rabies control relies on mass dog vaccination campaigns (MDVCs) that are held annually across the globe. Dog owners must bring their pets to fixed vaccination sites, but sometimes target coverage is not achieved due to low participation. Travel distance to vaccination sites is an important barrier to participation. We aimed to increase MDVC participation in silico by optimally placing fixed-point vaccination locations. We quantified participation probability based on walking distance to the nearest vaccination site using regression models fit to participation data collected over 4 years. We used computational recursive interchange techniques to optimally place fixed-point vaccination sites and compared predicted participation with these optimally placed vaccination sites to actual locations used in previous campaigns. Algorithms that minimized average walking distance or maximized expected participation provided the best solutions. Optimal vaccination placement is expected to increase participation by 7% and improve spatial evenness of coverage, resulting in fewer under-vaccinated pockets. However, unevenness in workload across sites remained. Our data-driven algorithm optimally places limited resources to increase overall vaccination participation and equity. Field evaluations are essential to assess effectiveness and evaluate potentially longer waiting queues resulting from increased participation.

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 High-altitude (HA) environment presents immense physiological adversities for humans that have been overcome by supplementing bio-active phytochemicals from functional foods that support and accelerate acclimatization under these extreme environmental conditions. Several agricultural interventions have been investigated to enhance the phytochemical content in vegetables however; these studies have been limited to low-altitude (LA) regions only. In view of an existing knowledge gap, current work is designed to compare the phytochemical compositions of HA and LA-grown Brassicaceae vegetables (cabbage, cauliflower, knol-khol, and radish) using organic treatments via farm yard manure (FYM) and Azotobacter. The open field study was conducted as a two-factorial randomized block design. The first factor was treatment (T1-FYM, T2-Azotobacter, T3-FYM + Azotobacter, and T4-control) while the second was locations (HA and LA). Among all these treatments, the application of treatment T3 in HA-grown cabbage showed the highest total phenolic content (TPC; 9.56 μg/mg), total flavonoids content (TFC; 14.48 μg/mg), and antioxidant potential using 2,2-diphenyl-1-picrylhydrazyl (DPPH; 85.97%) and ferric reducing antioxidant power (FRAP; 30.77 μg/mg) compared to LA grown samples. Reverse Phase high performance liquid chromatography (RP-HPLC) analysis showed that treatment T3 at HA led to significantly high kaempferol (0.92 μg/mg) and sulforaphane (8.94 μg/mg) contents in cabbage whereas, indole-3-carbinol (1.31 μg/mg) was higher in HA grown cauliflower. The present study provides scientific evidence for the enrichment of health-promoting phytochemical compounds in Brassicaceae vegetables grown with T3 treatment specifically at HA.

Introduction: Neonatal Thrombocytopenia (TCP) is frequently encountered in the Neonatal Intensive Care Unit (NICU), occurring either due to decreased production or increased destruction of platelets. This condition often leads to increased platelet transfusions in a NICU setting. Immature Platelet Fraction (IPF) and Absolute Immature Platelet Count (AIPC) are hypothesised to be surrogate markers of bone marrow activity and can help in differentiating between TCP caused by decreased production or increased destruction. Aim: To estimate the incidence of neonatal TCP in newborns admitted to a tertiary care NICU and to investigate the association of IPF percentage and AIPC values with the cause of TCP. Materials and Methods: This cross-sectional study was conducted in the Department of Paediatrics and Neonatology at Dr. D.Y. Patil Medical College, Navi Mumbai, Maharashtra, India, from April 2021 to May 2022. All 46 newborns admitted to the NICU with TCP were enrolled in the study. The total number of NICU admissions during the study period was used to calculate the incidence. The Complete Blood Count (CBC) with reticulocyte count and peripheral smear was examined using the impedance technique. The IPF and AIPC values were determined using an automated CBC counter based on flow cytometry principles. Statistical analysis was performed using the Chi-square test. Results: The study included a total of 46 neonates with TCP, with an incidence rate of 6.14%. Among the patients with TCP, 18 (39.13%) had mild, 17 (36.95%) had moderate, and 11 (23.91%) had severe TCP. The majority of neonates (21.7%) had a significant maternal history of Pregnancy Induced Hypertension (PIH). Of the neonates with TCP, 42 (91.3%) had high IPF and 4 (8.6%) had normal IPF. Regarding AIPC, 29 (63.04%) had normal values, 11 (23.91%) had high values, and 6 (13%) had low values. No significant association was found between IPF and AIPC values and the diagnosis of TCP in this study. Conclusion: The present study concludes that IPF and AIPC investigations cannot be recommended as markers to confirm the cause of TCP.

Background: A community-based study on childhood injuries would provide valuable information on the epidemiology of injuries to undertake appropriate preventive measures. Therefore, the current study was conducted in urban poor resettlements of Rishikesh to estimate the prevalence of unintentional injuries and to document the sociodemographic risk factors associated with unintentional injuries among under-five children. Aims and Objectives: Estimation of the prevalence of unintentional injuries and their risk factors among under-five children of urban poor resettlements in Rishikesh. Materials and Methods: A community-based cross-sectional study was conducted in urban poor resettlement areas of Rishikesh for a period of 1 year. It included 300 children selected using a simple random sampling technique to collect data on injury status. Results: The prevalence of unintentional injury among study participants was 16%. Falls were (64.6%) the major cause of injury, followed by dog bites (12.5%). The major sites of the injury were the head (25%), face (22.9%), upper limb (27.1%), and lower limb (18.8%).75% of the injuries happened at home. 66% of injuries happened when the child was playing alone or playing with peers. About 20.8% of injuries were bruises or superficial injuries. 39.6% of children had cut/bite/open wound injuries. Fractures happened in 14.6% of injured children. More than half (54.2%) of children did not develop any physical disability due to injury. Among children who developed a disability, more than 90% are able to recover completely. The majority of study participants were taken to nearby hospitals (66.6%) or health centers (10.4%). Only one of them went to a traditional bone setter, rest all visited either a general practitioner or pharmacy. The median expenditure for the treatment of the injured child was INR 425 (175-2750). The age of the child and unintentional injury showed a statistically significant association. Conclusion: The prevalence of the injury was 16% (12–20.7%) similar to a number of similar studies. Although the majority of the injuries were mild in severity, injuries have also contributed to temporary disability among children and have led to loss of school days.

Background: Ear pain, known as otalgia, has diverse origins, spanning from benign to severe conditions. Accurate diagnosis and treatment require an understanding of its etiology. Otalgia can be categorized as primary (ear-related) or referred (originating elsewhere). Referred otalgia poses unique challenges, as pain is perceived in the ear despite non-ear origins. Aim: The aim of present study is to investigate the potential causes of referred otalgia involving cranial and cervical nerves, and to explore the interplay between ear and distant body structures. Materials & Methods: A prospective study from March 2023 to June 2023 in an ENT OPD of Sharda Hospital, Greater Noida involved 360 patients. Evaluations encompassed dental, nasal, and head & neck assessments. Data included age, gender, side affected, and underlying cause statistical analysis was conducted using SPSS version. Results: Out of 360 patients, 16.1% had referred otalgia. Most were female (67.2%), and right-sided involvement was predominant (47%). Toothache (31.6%) and pharyngitis (29.1%) were the most common leading causes. Other causes included Gastroesophageal reflux disease, sinusitis, temporomandibular joint disease, cervical spine arthritis, and Bell's palsy. Two cases (0.5%) were associated with supraglottic and base of tongue malignancies. Conclusion: This study provides insights into referred otalgia's diverse origins, stressing the importance of comprehensive clinical evaluation for accurate diagnosis and tailored treatment. Collaboration among medical specialists is vital. Further research and clinical cooperation are needed to enhance our understanding of this complex condition.

This narrative review explores Cotard’s Syndrome (CS), a rare psychiatric condition characterised by delusions of death or non-existence, originally described by Jules Cotard in 1880. The syndrome presents a complex clinical picture, encompassing grandiosity, damnation, and physical breakdown. Despite its historical origins, CS remains poorly understood and often misdiagnosed. This review elucidates the clinical complexity, diagnostic challenges, and therapeutic strategies associated with CS. It highlights the neurological aspects, such as delusional misidentification and negation, shedding light on underlying mechanisms. Treatment approaches, including pharmacotherapy, Electroconvulsive Therapy (ECT), and psychotherapy, are discussed, emphasising the importance of ongoing mental health support across the illness’s stages. The review draws from a comprehensive search methodology, encompassing diverse scholarly sources, to provide a nuanced understanding of CS. By increasing awareness among clinicians and researchers, this review aimed to improve diagnosis and treatment outcomes for individuals affected by this enigmatic syndrome.

Abstract Current study is the first ever storage cum market trial of radiation processed (28 tons) of potato conducted in India at a commercial scale. The objective was to affirm the efficacy of very low dose of gamma radiation processing of potato for extended storage with retained quality and to understand the plausible mechanism at the gene modulation level for suppression of potato sprouting. Genes pertaining to abscisic acid (ABA) biosynthesis were upregulated whereas its catabolism was downregulated in irradiated potatoes. Additionally, genes related to auxin buildup were downregulated in irradiated potatoes. The change in the endogenous phytohormone contents in irradiated potato with respect to the control were found to be correlated well with the differential expression level of certain related genes. Irradiated potatoes showed retention of processing attributes including cooking and chip-making qualities, which could be attributed to the elevated expression of invertase inhibitor in these tubers. Further, quality retention in radiation treated potatoes may also be related to inhibition in the physiological changes due to sprout inhibition. Ecological and economical analysis of national and global data showed that successful adoption of radiation processing may gradually replace sprout suppressants like isopropyl N-(3-chlorophenyl) carbamate (CIPC), known to leave residue in the commodity, stabilize the wholesale annual market price, and provide a boost to the industries involved in product manufacturing.

Abstract Cervical cancer stands as a prevalent gynaecologic malignancy affecting women globally, often linked to persistent human papillomavirus infection. Biomarkers associated with cervical cancer, including VEGF-A, VEGF-B, VEGF-C, VEGF-D, and VEGF-E, show upregulation and are linked to angiogenesis and lymphangiogenesis. This research aims to employ in-silico methods to target tyrosine kinase receptor proteins—VEGFR-1, VEGFR-2, and VEGFR-3, and identify novel inhibitors for Vascular Endothelial Growth Factors receptors (VEGFRs). A comprehensive literary study was conducted which identified 26 established inhibitors for VEGFR-1, VEGFR-2, and VEGFR-3 receptor proteins. Compounds with high-affinity scores, including PubChem ID—25102847, 369976, and 208908 were chosen from pre-existing compounds for creating Deep Learning-based models. RD-Kit, a Deep learning algorithm, was used to generate 43 million compounds for VEGFR-1, VEGFR-2, and VEGFR-3 targets. Molecular docking studies were conducted on the top 10 molecules for each target to validate the receptor-ligand binding affinity. The results of Molecular Docking indicated that PubChem IDs—71465,645 and 11152946 exhibited strong affinity, designating them as the most efficient molecules. To further investigate their potential, a Molecular Dynamics Simulation was performed to assess conformational stability, and a pharmacophore analysis was also conducted for indoctrinating interactions.

Background: Globally, the rising caesarean section (CS) rate is of great concern as it is associated with increased maternal morbidity and mortality in subsequent pregnancies. It is essential to reanalyze the CS trend and curb the rising menace using a standardized uniform auditing system. This study aimed to analyze and evaluate the trend of CS using Modified Robson’s Ten Group classification system (RTGCS) in a teaching institution in Uttarakhand. Methodology: This cross-sectional study from October 2022 to March 2023 included 260 women undergoing elective or emergency CS. Data on maternal demographics, obstetrics, labour, and fetal outcomes were recorded. Indications for CS were analyzed using modified RTGCS. Results: The overall CS rate for the study period at our hospital was 31.4%. The major contributors to CS were Group 2 (21.5%), Group 10 (21.5%), and Group 5 (20.7%), while Group 6 and Group 8 contributed 10% and 7.6%, respectively. Group 9 had the least share (1%) in the study population. The two main indications for which CS was performed were prior Lower Section Caesarean Section (LSCS) and fetal distress, contributing to 24.6% and 19.2%, respectively. CS for breech presentation was done in 16% of the total cases. Conclusion: Modified RTGCS is an easy and effective method for auditing CS, preventing unnecessary procedures, and improving maternal care. Its implementation is crucial in addressing the increasing prevalence of CS and ensuring better maternal and fetal outcomes.

Abstract Self-reported shorter/longer sleep duration, insomnia, and evening preference are associated with hyperglycaemia in observational analyses, with similar observations in small studies using accelerometer-derived sleep traits. Mendelian randomization (MR) studies support an effect of self-reported insomnia, but not others, on glycated haemoglobin (HbA1c). To explore potential effects, we used MR methods to assess effects of accelerometer-derived sleep traits (duration, mid-point least active 5-h, mid-point most active 10-h, sleep fragmentation, and efficiency) on HbA1c/glucose in European adults from the UK Biobank (UKB) (n = 73,797) and the MAGIC consortium (n = 146,806). Cross-trait linkage disequilibrium score regression was applied to determine genetic correlations across accelerometer-derived, self-reported sleep traits, and HbA1c/glucose. We found no causal effect of any accelerometer-derived sleep trait on HbA1c or glucose. Similar MR results for self-reported sleep traits in the UKB sub-sample with accelerometer-derived measures suggested our results were not explained by selection bias. Phenotypic and genetic correlation analyses suggested complex relationships between self-reported and accelerometer-derived traits indicating that they may reflect different types of exposure. These findings suggested accelerometer-derived sleep traits do not affect HbA1c. Accelerometer-derived measures of sleep duration and quality might not simply be ‘objective’ measures of self-reported sleep duration and insomnia, but rather captured different sleep characteristics.

Background: Coronavirus disease 2019 (COVID-19) vaccination has proved its importance and effectiveness in the fight against COVID-19. India began the world’s largest vaccination campaign against COVID-19 on 16th January 2021 with two vaccines, namely, Covishield and Covaxin. Aims: The present study was conducted to understand the trend of COVID-19 vaccination during the 1st year of the vaccination drive at a COVID Vaccination Centre in a tertiary care hospital of Uttarakhand. Patients and Methods: It was a retrospective record-based study conducted at a COVID-19 Vaccination Centre in a tertiary care hospital of Uttarakhand. Vaccination-related data of 1-year period (16th January 2021–16th January 2022) had been collected from the CoWIN app and COVID-19 vaccination register and analysed. Results: The total dose administered was 63,015 over a time period of 1 year during 299 vaccination sessions that were conducted. Analysis of total doses administered in relation to vaccination sessions held during different months of 1-year study period shows that on average, 199 individuals per session were vaccinated. There was an overall declining trend in the COVID-19 vaccine wastage rate for 1-year period of COVID-19 vaccination. Conclusion: This study will help us to understand how this experience of the past 1 year can be utilised for further planning and policy making.

Introduction: Early Childhood Caries (ECC) is a pressing public health issue in preschool-aged children. Preventive guidelines have not significantly reduced ECC incidence. Maternal education programmes have been proposed as interventions, but systematic reviews on their effectiveness are scarce. Aim: To evaluate the effectiveness of oral health education programmes for mothers in preventing ECC. Materials and Methods: Eight eligible Randomised Controlled Trials (RCTs) were identified through searches in the Cochrane Oral Health Group’s Trial Register, PubMed, and Google Scholar, as well as manual review of references from English-only studies. The interventions targeted mothers starting from 12 weeks of pregnancy onwards, with the exclusion of treatment-based methods, pharmacological interventions, and post-pregnancy programmes. The primary outcome assessed was ECC incidence, analysed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Participants exclusively received oral health educational programmes designed to prevent ECC in their children, highlighting the importance of early preventive measures during pregnancy. Results: Global studies varied in interventions and outcomes. A study from Brazil showed no reduction in ECC, while a study from Uganda reported reduced dental caries. Another study from Australia demonstrated a significant reduction in severe ECC. Risk of bias analysis revealed that five studies had a low risk of bias while one study had an unclear risk of bias. Moderate risk of bias was found in one study. Conclusion: Evidence suggests a positive impact of maternal education on ECC prevention, supporting tailored programmes for mothers with lower education. The overall recommendation strength is modest due to intervention variations and limited trials. Tailored educational programmes for mothers, especially those with lower education levels, should be integrated into maternal and child health services to effectively address social determinants of oral health.

Abstract Background Evaluation of students’ learning strategies can enhance academic support. Few studies have investigated differences in learning strategies between male and female students as well as their impact on United States Medical Licensing Examination® (USMLE) Step 1 and preclinical performance. Methods The Learning and Study Strategies Inventory (LASSI) was administered to the classes of 2019–2024 (female (n = 350) and male (n = 262)). Students’ performance on preclinical first-year (M1) courses, preclinical second-year (M2) courses, and USMLE Step 1 was recorded. An independent t-test evaluated differences between females and males on each LASSI scale. A Pearson product moment correlation determined which LASSI scales correlated with preclinical performance and USMLE Step 1 examinations. Results Of the 10 LASSI scales, Anxiety, Attention, Information Processing, Selecting Main Idea, Test Strategies and Using Academic Resources showed significant differences between genders. Females reported higher levels of Anxiety (p

Abstract In the present study, ten (10) selected bacteria isolated from chasmophytic wild Chenopodium were evaluated for alleviation of drought stress in chickpea. All the bacterial cultures were potential P, K and Zn solubilizer. About 50% of the bacteria could produce Indole-3-acetic acid (IAA) and 1-aminocyclopropane-1-carboxylate (ACC) deaminase. The bacteria showed wide range of tolerance towards pH, salinity, temperature and osmotic stress. Bacillus paralicheniformis L38, Pseudomonas sp. LN75, Enterobacter hormachei subsp. xiangfengensis LJ89, B. paramycoides L17 and Micrococcus luteus LA9 significantly improved growth and nutrient (N, P, K, Fe and Zn) content in chickpea under water stress during a green house experiment conducted following a completely randomized design (CRD). Application of Microbacterium imperiale LJ10, B. stercoris LN74, Pseudomonas sp. LN75, B. paralicheniformis L38 and E. hormachei subsp. xiangfengensis LJ89 reduced the antioxidant enzymes under water stress. During field experiments conducted following randomized block design (RBD), all the bacterial inoculations improved chickpea yield under water stress. Highest yield (1363 kg ha−1) was obtained in plants inoculated with Pseudomonas sp. LN75. Pseudomonas sp. LN75, B. paralicheniformis L38 and E. hormachei subsp. xiangfengensis LJ89 have potential as microbial stimulants to alleviate the water stress in chickpea. To the best of our knowledge this is the first report of using chasmophyte associated bacteria for alleviation of water stress in a crop plant.

Context: Dengue disease severity and progression are determined by the host immune response, with both pro- and anti-inflammatory cytokines are key mediators. Aims: To study pro- and anti-inflammatory cytokines across dengue severity and as a biomarker for predicting severe dengue infection. Settings and Design: Hospital-based cross-sectional study was conducted on 125 dengue-positive subjects across the 5-60 years age group of either gender in 2022. Methods and Materials: Haematological parameters and blood samples were drawn to measure cytokines IL6, IL-10 and TNF alpha using the ELISA technique. Statistical Analysis: One-way ANOVA and the Kruskal − Wallis test were used to compare the dependent variables across categories of the dengue spectrum. Receiver operating characteristic curve was drawn to calculate the predictability of the cytokines as a predictor of severe dengue. A P < 0.05 was considered significant. Results: 34.4% of cases had severe dengue infection with 53.2% of severe cases reported in >40 years of age. Only IL-6 levels significantly increased (P < 0.01) across the spectrum of dengue infection across age groups >20 years with a consistent and significant fall in platelet levels (P < 0.01). The accuracy of IL-6 to predict severe dengue was 74.4% and platelet count was 16.2%. Conclusions: Only IL-6 cytokine levels were significantly increased across the spectrum of dengue infection observed in age >20 years and can significantly predict the probability of severe dengue by 74% (sensitivity 81.4%). A significant decrease in platelet values is consistent with the severity but is not a good predictor for severe dengue infection.

Aims and Objectives: To find out various risk factors affecting fetomaternal outcomes in preterm premature rupture of membranes (PPROM). Materials and Methods: A prospective study after approval from the ethical committee was conducted at VMMC and Safdarjung Hospital, New Delhi, Department of Obstetrics and Gynaecology from December 2020 to May 2022 in which 100 pregnant women with preterm premature rupture of membrane between 32 and 36 weeks of gestation were enrolled. Patients were followed with Total leucocyte count (TLC), urine R/M, urine C/S, high vaginal swab C/S, and C-reactive protein along with routine antenatal care investigations. Intravenous antibiotics were given to all patients for 48 h followed by oral antibiotics for 5 days. All patients were on follow-up and managed conservatively and induction of labor was done at 37 weeks or earlier in case of fetal distress and presence of signs and symptoms of chorioamnionitis. Both mother and baby were followed till 7 days after delivery. Results: In the present study, we observed the following risk factors that had adverse effects on fetomaternal outcomes in PPROM patients. The association of oligohydramnios (amniotic fluid index [AFI]

Introduction: A molecular diagnostic laboratory is the cornerstone of Coronavirus Disease-2019 (COVID-19) disease diagnosis, as the patient’s treatment and management protocol depend on molecular results. Therefore, the laboratory conducting these tests must adhere to quality management process to increase the accuracy and validity of the generated reports. Rajiv Gandhi Super Speciality Hospital established its molecular diagnostic set-up at the beginning of the pandemic. Hence, this study aims to generate quality management data to help improve weak points. Aim: To assess the quality management system for COVID-19 diagnosis. Materials and Methods: This retrospective observational study was conducted at Rajiv Gandhi Super Speciality Hospital in Delhi, India. A total of 14,561 samples were collected over six months, from February 2021 to July 2021. Data from all samples received during this period for COVID-19 Reverse-Transcriptase Polymerase Chain Reaction (RT-PCR) testing were included. Data were retrospectively collected from the electronic Laboratory Information Management System (LIMS). Quality variables were analysed over six months from July to December 2021 and classified into preanalytical, analytical, and postanalytical variables. Quality Indicators (QIs) were selected from a common model of QIs set by the International Federation of Clinical Chemistry and Laboratory Medicine. The results were presented in percentages, and descriptive statistics were analysed using Statistical Package for Social Sciences (SPSS) software. Results: During the six-month study period, the molecular laboratory received 14,561 samples. Among the preanalytical variables, sample leakage was the most common cause of sample rejection (134 samples, 0.92%), followed by the non generation of Specimen Referral Form (SRF) identification (76 samples, 0.52%), and non compliance with triple packaging (44 samples, 0.3%). Other preanalytical aspects assessed included incomplete patient identification (17 samples, 0.11%), insufficient sample quantity (12 samples, 0.08%), missing forms/samples (7 samples, 0.04%), samples in the wrong vials/empty Viral Transport Media (VTM) tubes (5 samples, 0.03%), and incomplete LIMS entry (2 samples, 0.01%). Internal Quality Control (QC) was not obtained in 55 samples (0.37%), and two incidents of cross-contamination resulted in false-positive results. Among the postanalytical factors, 11 samples (0.07%) could not be dispatched within the stipulated time frame. Conclusion: The assessment of the quality management system revealed some areas for improvement, emphasising the importance of adhering to QC processes for the smooth operation of diagnostic laboratories, especially those involved in critical reporting. The assessment of QIs helped monitor laboratory parameters effectively.

A rare and complex condition, severe gestational hypertriglyceridemia with acute pancreatitis in a primigravida poses a significant therapeutic challenge due to the absence of established guidelines. Many patients with hypertriglyceridemia exhibit concomitant insulin resistance, obesity, and fasting hyperchylomicronemia. This case report explores the successful management of a 20-year-old primigravida at 7 months of pregnancy presenting with severe gestational hypertriglyceridemia, diabetic ketoacidosis, and acute pancreatitis. Despite a lack of prior complications, the patient exhibited metabolic acidosis, hyperglycemia, hypertriglyceridemia, and acute kidney injury. A multifaceted approach involving insulin, statins, fenofibrate, antibiotics, and supportive measures resulted in improved lipid profiles and blood glucose levels. With induced labor and vaginal delivery, the intrauterine fetal death was addressed. The importance of routine lipid profile screening in high-risk pregnancies is underscored, emphasizing the need for early recognition and aggressive multidisciplinary management of severe metabolic complications in pregnant individuals with acute pancreatitis. This case stresses the critical role of a comprehensive approach for a successful outcome in such cases.

Abstract Background Collarbone fracture is a common injury, particularly among athletes involved in contact sports and participating in endurance activities. Conventional treatment requires surgery and postoperative immobilization, resulting in an average return-to-sport timeframe of approximately 13 weeks. This case challenges the established treatment protocols, aiming to expedite recovery and enable a quicker resumption of high-intensity athletic activities. Case presentation A 24-year-old Caucasian athlete completed a Half-Ironman Triathlon (70.3) merely three weeks post-collarbone fracture. Utilizing Extracorporeal Magneto-Transduction Therapy (EMTT) alongside surgical intervention, the patient achieved accelerated healing and remarkable performance outcomes without encountering any adverse effects. Conclusions The integration of EMTT into the treatment paradigm for bone fractures alters the traditional understanding of recovery timelines and rehabilitation strategies. This case highlights the potential benefits of electromagnetic wave therapy in expediting the healing process and enabling athletes to resume high-level sports activities at an earlier stage.

Abstract Stress is an adaptive response to the stressors that adversely affects physiological and psychological health. Stress elicits HPA axis activation, resulting in cortisol release, ultimately contributing to oxidative, inflammatory, physiological and mental stress. Nutritional supplementations with antioxidant, anti-inflammatory, and stress-relieving properties are among widely preferred complementary approaches for the stress management. However, there is limited research on the potential combined impact of vitamins, minerals and natural ingredients on stress. In the present study, we have investigated the effect of a multi-nutrient botanical formulation, Nutrilite® Daily Plus, on clinical stress parameters. The stress-modulatory effects were quantified at population level using a customized sub-clinical inflammation mathematical model. The model suggested that combined intervention of botanical and micronutrients lead to significant decline in physical stress (75% decline), mental stress (70% decline), oxidative stress (55% decline) and inflammatory stress (75% decline) as evident from reduction in key stress parameters such as ROS, TNF-α, blood pressure, cortisol levels and PSS scores at both individual and population levels. Further, at the population level, the intervention relieved stress in 85% of individuals who moved towards a healthy state. The in silico studies strongly predicts the use of Gotukola based Nutrilite® Daily Plus as promising anti-stress formulation.

Abstract This study discusses the feasibility of Ferroelectric Capacitors (FeCaps) and Ferroelectric Field-Effect Transistors (FeFETs) as In-Memory Computing (IMC) elements to accelerate machine learning (ML) workloads. We conducted an exploration of device fabrication and proposed system-algorithm co-design to boost performance. A novel FeCap device, incorporating an interfacial layer (IL) and $$\text {Hf}_{0.5}\text {Zr}_{0.5}\text {O}_2$$ Hf 0.5 Zr 0.5 O 2 (HZO), ensures a reduction in operating voltage and enhances HZO scaling while being compatible with CMOS circuits. The IL also enriches ferroelectricity and retention properties. When integrated into crossbar arrays, FeCaps and FeFETs demonstrate their effectiveness as IMC components, eliminating sneak paths and enabling selector-less operation, leading to notable improvements in energy efficiency and area utilization. However, it is worth noting that limited capacitance ratios in FeCaps introduced errors in multiply-and-accumulate (MAC) computations. The proposed co-design approach helps in mitigating these errors and achieves high accuracy in classifying the CIFAR-10 dataset, elevating it from a baseline of 10% to 81.7%. FeFETs in crossbars, with a higher on-off ratio, outperform FeCaps, and our proposed charge-based sensing scheme achieved at least an order of magnitude reduction in power consumption, compared to prevalent current-based methods.

Introduction: The number and characteristics of pregnant patients presenting to the emergency department (ED) has not been well described. Our objective in this study was to determine the prevalence and characteristics of pregnant patients presenting to EDs in the US between 2010–2020. Methods: We completed a retrospective, cross-sectional study of patient encounters at hospital-based EDs in the US from 2010–2020. Using the ED subsample of the National Hospital Ambulatory Medical Care Survey (NHAMCS) we identified ED visits for female patients aged 15–44 years. We defined a subsample of these as visits for pregnant patients using discharge diagnosis codes specific to pregnancy. We compared this population of pregnant patient visits to those for non-pregnant patients and computed point estimates for nationally weighted values. Multivariable linear regression was used to determine factors independently associated with pregnant patient visits. Results: The 2010–2020 NHAMCS dataset included 255,963 ED visits. Of these visits 59,080 were for female patients 15–44 years old, and 6,068 of those visits were for pregnant patients. Pregnant patients accounted for 3% (95% confidence interval [CI] 2.7–3.2) of all ED visits and 8.6% (95% CI 8–9.3) of all visits among female patients 15–44 years. Weighting to a national sample, this equates to 2.77 million pregnant patients presenting for ED visits annually. Pregnant patients were more likely to be Black, Hispanic, or to use public insurance. Conclusion: Pregnant patients make up a significant number of ED visits annually and are more likely to be people of color or publicly insured. Interventions to address the effects of changing abortion legislation on emergency medicine practice may benefit from consideration that certain populations of pregnant people are more likely to present to the ED for care.

Introduction: Following abdominal surgery, transversus abdominis plane (TAP) block, a peripheral nerve block, can be a useful supplement to multimodal postoperative analgesia. The aim was assessment of postoperative analgesic effectiveness of 0.25% ropivacaine with 4 mg of dexamethasone on each side and 0.25% ropivacaine alone in the management of postoperative pain following total abdominal hysterectomy (TAH). Materials and Methods: Sixty adult patients planned for elective TAH with ASA Grades I–II under general anesthesia participated in this prospective, randomized, double-blinded study. Patients of Group A were given 20 mL of 0.25% ropivacaine on both the sides and Group B patients were given 20 mL of 0.25% ropivacaine with dexamethasone 4 mg on each side. The primary objective of this study was a comparison of Visual Analog Scale (VAS) scores between the groups and comparison of mean time of first rescue analgesia. The secondary objectives of this study were a comparison of hemodynamic parameters, postoperative analgesic requirement, patient satisfaction, and incidence of side effects. Results: VAS shows no discernible variation in 1 and 4 h after administration of block in Groups A and B. However, a significant difference appeared in VAS 8 h (P = 0.007), VAS 12 h (P = 0.000), and VAS 24 h (P = 0.000) after the administration of block between Groups A and B. The median time for first rescue analgesia was 2.75 h (interquartile range [IQR] = 1 h) and 5.8 h (IQR = 1.6 h) in Groups A and B, respectively, which was highly significant. Conclusion: We concluded that, after abdominal hysterectomy, dexamethasone added to ropivacaine TAP block tends to prolong postoperative analgesia and decrease the need for analgesics.

Background: Neck swelling is one of the commonest presentations in otorhinolaryngological practice. Study aimed to analyze the demographics and symptomatology of cervical masses, the degree of accuracy of clinical examination as well as the correlation between the clinical diagnosis and pathological results in patients presenting with neck masses. Material & Method: The present prospective observational study is conducted among the patients attending the out-patient and in-patients setting of ENT department with complaints of neck mass/ masses either primarily or in conjunction with other complaints, for more than 3 weeks duration. The patients with complaints of neck mass of acute inflammatory origin of less than 3 weeks and patients with inflammatory causes of lymphadenopathy including those secondary to upper aero-digestive tract infection and those of tubercular origin on initial assessment were excluded. Following a thorough clinical examination appropriate radiological investigations were advised, followed by cytological evaluation. FNAC was performed, either guided or unguided as per the discretion of the pathologist. Further Histopathogical evaluation was conducted in tissue specimens, wherever required, after either surgical excision of the entire mass or a biopsy. Histopathology involves the examination of sampled whole tissues under the microscope. Results: Age distribution placed majority of females in the young adult (16-40 yrs) category and males in the late adult (> 40 yrs) group. The majority of neck masses were thyroid swellings (42%) followed by lymph nodal masses (29%) and salivary gland lesions (14%). Of all the neck masses in females 87% were benign whereas amongst males 62% were malignant. The accuracy of clinical pre-diagnosis was seen to be 93.4%. The sensitivity for thyroid lesions for suspicion of malignancy however, was seen to be only 33% as papillary carcinoma thyroid essayed no symptoms or signs of malignancy. FNAC as an investigation for pre-diagnosis, the accuracy on the whole was seen to be 84.7% with a sensitivity of 82.5% which is comparable to other Indian studies. For thyroid lesions however the sensitivity was very low, 33.3%. This may be due to the inconsistent use of guidance systems and inexperience of our junior aspirators which act as confounding factors. Conclusion: Accuracy of FNAC in comparison to the definitive diagnosis was 84.7%. Inconsistent use of guidance systems, inexperience of junior aspirators and aspiration from representative node/ part of the lesion may act as confounding factors resulting in the discordance between clinical pre-diagnosis and FNAC accuracy with respect to the definitive diagnosis

Uveal melanoma (UM) is a rare melanoma originating in the eye’s uvea, with 50% of patients experiencing metastasis predominantly in the liver. In contrast to cutaneous melanoma, there is only a limited effectiveness of combined immune checkpoint therapies, and half of patients with uveal melanoma metastases succumb to disease within 2 years. This study aimed to provide a path toward enhancing immunotherapy efficacy by identifying and functionally validating tumor-reactive T cells in liver metastases of patients with UM. We employed single-cell RNA-seq of biopsies and tumor-infiltrating lymphocytes (TILs) to identify potential tumor-reactive T cells. Patient-derived xenograft (PDX) models of UM metastases were created from patients, and tumor sphere cultures were generated from these models for co-culture with autologous or MART1-specific HLA-matched allogenic TILs. Activated T cells were subjected to TCR-seq, and the TCRs were matched to those found in single-cell sequencing data from biopsies, expanded TILs, and in livers or spleens of PDX models injected with TILs. Our findings revealed that tumor-reactive T cells resided not only among activated and exhausted subsets of T cells, but also in a subset of cytotoxic effector cells. In conclusion, combining single-cell sequencing and functional analysis provides valuable insights into which T cells in UM may be useful for cell therapy amplification and marker selection.

AIM OF THE STUDY: The purpose of the present study was to evaluate demographic characteristics of inmates in the Canton of Zurich (exposure), and investigate the changes in diseases and drug use between 2015 and 2020 (outcome). METHODS: The study prospectively evaluated 51,989 inmates admitted to the Police Prison Zurich in Switzerland between 1 April 2015 and 31 August 2020 and who were systematically medically assessed. A total of 19,027 (37%) inmates had one or more health conditions, which the authors recorded according to the International Classification of Diseases-10 (ICD-10), in addition to demographic data (country of origin, sex, age, year of imprisonment), as well as details of any drugs used (type and dosage). RESULTS: The 19,027 inmates with medical conditions had a mean age of 35.4±12.5 years (range 10–89) and comprised 16,489 males (87%). The inmates originated from 170 countries, including 4606 from Switzerland (24.2%), 4227 from Eastern Europe (22%) and 3432 from the Middle East & North Africa (18%). A total of 1631 inmates (9%) were enrolled in the medication-assisted treatment (MAT) programme, and 672 patients (4%) received a psychiatric evaluation. The proportions of foreign prisoners did not increase during the study period. There was a significant increase in the use of antipsychotics from year 1 to 5 (y = 0.866x; R2 = 0.902; p = 0.01) and anticonvulsants from year 1 to 4 (y = 1.27x; R2 = 0.823; p = 0.01), and a significant decrease in the use of analgesics from year 2 to 5 (y = -4.42x; R2 = 0.947; p = 0.03) and antianxiety drugs from year 1 to 4 (y = -3.31x; R2 = 0.989; p = 0.005). Inmates from Switzerland were most likely to use antianxiety drugs, while inmates from the Middle East & North Africa were most likely to use antipsychotics (OR 2.09; CI 1.88–2.34) and anticonvulsants (OR 3.52; CI 2.90–4.29), whereas inmates from Latin and North America were most likely to use herbal medicine (OR 1.50; CI 1.05–2.10). CONCLUSIONS: The findings of this study could help anticipate needs of prisons as well as improve treatment of disease and assist with substance use or abuse, particularly in the context of migration.

Introduction: For crafting complete dentures, Polymethylmethacrylate (PMMA) has long been the material of choice. Various reinforcements are being used to enhance the properties of PMMA and minimise denture fracture. Aim: The present in-vitro study compared the flexural strength of PMMA resin samples reinforced with Silver Nanoparticles (Ag NP), siwak, and fluconazole. Materials and Methods: The present in-vitro experiment was conducted from July to August 2017 at the Prosthodontics Department of a Dental College with technical support from the Centre for Scientific Research and Development (CSRD), affiliated with People’s University in Bhopal, Madhya Pradesh, India. Flexural testing was conducted at the Central Institute of Plastic Engineering and Technology (CIPET), Bhopal. A total of 120 acrylic resin samples, each measuring 65 mm in length, 10 mm in width, and 2.5 mm in thickness, were fabricated in accordance with American Dental Association (ADA) Specification No. 12. These specimens were categorised into four distinct groups. The first group consisted of only PMMA resin (Group A), while the remaining three groups comprised PMMA resin enhanced with AgNP (Group B), Siwak (Group C), and Fluconazole (Group D), respectively, with each group containing 30 samples. Subsequently, these specimens underwent a flexural strength assessment through a 3-point flexural test. The statistical analysis to assess and compare the mean flexural strength of the samples was conducted. The present analysis was performed first by applying an Analysis of Variance (ANOVA) test, followed by pairwise comparisons with Tukey’s Post-hoc test. A p-value less than 0.05 was used to determine statistical significance. Results: The mean flexural strength (±Standard Deviation) in N/mm2 for PMMA; PMMA+AgNP; PMMA+Siwak and PMMA+ Fluconazole was 82.33±5.18; 80.55±5.67; 71.50±10.15; and 74.03±10.84, respectively. The mean flexural strengths of the PMMA and PMMA+AgNP groups were similar (p=0.842). However, the flexural strength of the Siwak+PMMA and Fluconazole+PMMA groups was significantly less than that of the other two groups. Conclusion: The flexural strength of PMMA is unaffected by the inclusion of AgNP at a concentration of 1%, and its incorporation would allow the benefit from its antibacterial qualities. It is not advised to add fluconazole or siwak because doing so reduces the flexural strength.

Abstract 2D materials have important fundamental properties allowing for their use in many potential applications, including quantum computing. Various Van der Waals materials, including Tungsten disulfide (WS2), have been employed to showcase attractive device applications such as light emitting diodes, lasers and optical modulators. To maximize the utility and value of integrated quantum photonics, the wavelength, polarization and intensity of the photons from a quantum emission (QE) must be stable. However, random variation of emission energy, caused by the inhomogeneity in the local environment, is a major challenge for all solid-state single photon emitters. In this work, we assess the random nature of the quantum fluctuations, and we present time series forecasting deep learning models to analyse and predict QE fluctuations for the first time. Our trained models can roughly follow the actual trend of the data and, under certain data processing conditions, can predict peaks and dips of the fluctuations. The ability to anticipate these fluctuations will allow physicists to harness quantum fluctuation characteristics to develop novel scientific advances in quantum computing that will greatly benefit quantum technologies.

Abstract Background Computer-based assessment for sampling personal characteristics (Casper), an online situational judgement test, is a broad measure of personal and professional qualities. We examined the impact of Casper in the residency selection process on professionalism concerns, learning interventions and resource utilization at an institution. Methods In 2022, admissions data and information in the files of residents in difficulty (over three years pre- and post- Casper implementation) was used to determine the number of residents in difficulty, CanMEDS roles requiring a learning intervention, types of learning interventions (informal learning plans vs. formal remediation or probation), and impact on the utilization of institutional resource (costs and time). Professionalism concerns were mapped to the 4I domains of a professionalism framework, and their severity was considered in mild, moderate, and major categories. Descriptive statistics and between group comparisons were used for quantitative data. Results In the pre- and post- Casper cohorts the number of residents in difficulty (16 vs. 15) and the number of learning interventions (18 vs. 16) were similar. Professionalism concerns as an outcome measure decreased by 35% from 12/16 to 6/15 (p

Background: Ropivacaine is an ammino-amide local anesthetic agent with properties similar to bupivacaine, but its decreased lipophilicity is associated with reduced incidence of central nervous system toxicity and cardiotoxicity. This study evaluated the safety, efficacy, effects on hemodynamics and complications of spinal anesthesia using 0.5% hyperbaric bupivacaine and 0.75% hyperbaric ropivacaine in patients undergoing transurethral resection of the prostate (TURP). Aims and Objectives: The aim was to evaluate the safety, efficacy, hemodynamic stability, and side effects of spinal anesthesia using 0.5% hyperbaric bupivacaine and 0.75% hyperbaric ropivacaine in patients undergoing TURP. Materials and Methods: Sixty adult patients with physical status classes I and II, as determined by the American Society of Anesthesiologists, scheduled to undergo elective transurethral resection of prostate, were randomly allocated to receive either hyperbaric ropivacaine 0.75% 2.8 mL plus fentanyl 15 mcg or hyperbaric bupivacaine 0.5% 2.8 mL plus fentanyl 15 mcg. The parameters, such as demographic characteristics, duration of surgery, onset of sensory and motor blockade, hemodynamic stability, and complications, were compared in both groups. Results: Hyperbaric ropivacaine exhibited significantly slower onset times for sensory and motor blockade compared to hyperbaric bupivacaine. Patients in the ropivacaine group demonstrated better hemodynamic stability and experienced less hypotension compared to those who received bupivacaine. Moreover, the sensory and motor block lasted significantly longer in the bupivacaine group. Conclusion: About 0.75% hyperbaric ropivacaine is a better choice for spinal anesthesia in elderly patients undergoing TURP as compared to 0.5% hyperbaric bupivacaine.

Background and Aim: The threat of emerging and epidemic-prone diseases is a significant public health concern and there is an urgent need to work on the prevention and control of these diseases. In view of the limited time and other resources available to the animal and human health sector, it is crucial to prioritize the most essential and critical risk factors and diseases. This scoping review aims to document the available disease and risk prioritization tools by evaluating their characteristics and suitability from the One Health perspective. Materials and Methods: Databases such as PubMed, Scopus, and Google Scholar were used to extract available tools for prioritization. We compared and synthesized the objective of the tool, methodology and prioritization process of the available tools. Results: A total of six tools, including One Health Zoonotic Disease Prioritization, European Centre for Disease Prevention and Control, Strategic Toolkit for Assessing Risks, One Health Systems Mapping and Analysis Resource Toolkit, Health Hazard Assessment and Prioritization tool, Risk Ranger, are included in this scoping review. Various prioritization methods are available; however, multi-criteria decision analysis is the most commonly used. Conclusion: A thorough analysis showed that different tools employ different prioritizing approaches, including mixed-method, quantitative, and qualitative approaches. The summary of the findings suggests the development of a new robust tool with a One Health approach, which will focus on risk prioritization and disease prioritization.

Abstract A transparent polarisation-sensitive phase pattern changes the phase of transmitted light without absorption, whereas this change of phase depends on the polarisation of incident light. A position-localised polarisation-dependent phase pattern is imprinted onto the phase-space of atoms by using atomic state dependent velocity-selective hole burning. A phase-space localised pattern is a higher dimensional generalisation of patterns localised in the position-space. Such a pattern cannot be imaged with a lens. The imprinted pattern is localised in a unique three-dimensional subspace of the six-dimensional phase-space of atoms. The phase-space localised pattern transforms the polarisation of light transmitting through it. This pattern is tomographically imaged at room temperature by measuring the intensity of the transmitted imaging laser beam of variable frequency with a camera after its polarisation analysis. Two sub-tomographs of the imprinted phase-space localised pattern are constructed. This paper presents a concept and experiment of imprinting and imaging of a polarisation-sensitive phase pattern localised in the phase-space.

Abstract Ocean microbiome is crucial for global biogeochemical cycles and primary productivity. Despite numerous studies investigating the global ocean microbiomes, the microbiome composition of the Andaman region of the Indian Ocean remains largely unexplored. While this region harbors pristine biological diversity, the escalating anthropogenic activities along coastal habitats exert an influence on the microbial ecology and impact the aquatic ecosystems. We investigated the microbiome composition in the coastal waters of the Andaman Islands by 16S rRNA gene amplicon and metagenomic shotgun sequencing approaches and compared it with the Tara Oceans Consortium. In the coastal waters of the Andaman Islands, a significantly higher abundance and diversity of Synechococcus species was observed with a higher abundance of photosynthesis pigment-related genes to adapt to variable light conditions and nutrition. In contrast, Prochlorococcus species showed higher abundance in open ocean water samples of the Indian Ocean region, with a relatively limited functional diversity. A higher abundance of antibiotic-resistance genes was also noted in the coastal waters region. We also updated the ocean microbiome gene catalog with 93,172 unique genes from the Andaman coastal water microbiome. This study provides valuable insights into the Indian Ocean microbiome and supplements the global marine microbial ecosystem studies.

Background: Interactive teaching methods aid post graduate students in learning qualitative research. Four academic researchers from the United Kingdom had an opportunity to teach qualitative research methods, specifically consensus methods, to the Master of Public Health students (MPH) during a visit to India. This teaching formed part of a work package with All India Institute of Medical Sciences Rishikesh, India exploring the concept of family resilience among families with children under 6 years. Aims: To use the experiences of the MPH students to gain knowledge and create meaning about using the consensus methods. Participants: The participants were the MPH students. Methods: We used the workshop method to introduce the concept of family resilience by using the question, 'What will be the three top public health priorities in India to support family resilience in the 21st century?' as a central theme for all the workshops. Furthermore, we introduced qualitative research methods and hands on experience of consensus methods to the students. The students were introduced to Delphi and Group Concept Mapping (GCM) methods during workshop 1. Workshop 2 introduced Nominal Group Technique (NGT) through a short presentation followed by a practical hands on session using GCM data from workshop 1. The last workshop (3) focused on the World Café method. Results: The students evaluated the workshops highly and asked for online sessions on GCM, NGT, and World Café which will be planned in the future. Conclusion: We concluded that the post graduate curriculum for master's in public health studies would benefit from teaching using interactive research methods which will enhance their critical thinking and autonomy. Second, although the MPH curriculum had quantitative methods in place, introducing qualitative consensus methods will open new avenues into future research. Finally, teaching using practical demonstration gives students a voice and makes learning effective and enjoyable.

Abstract In the US, racial disparities in hospital outcomes are well documented. We explored whether race was associated with all-cause in-hospital mortality and intensive care unit (ICU) admission among COVID-19 patients in California. This was a retrospective analysis of California State Inpatient Database during 2020. Hospitalizations ≥ 18 years of age for COVID-19 were included. Cox proportional hazards with mixed effects were used for associations between race and in-hospital mortality. Logistic regression was used for the association between race and ICU admission. Among 87,934 COVID-19 hospitalizations, majority were Hispanics (56.5%), followed by White (27.3%), Asian, Pacific Islander, Native American (9.9%), and Black (6.3%). Cox regression showed higher mortality risk among Hispanics, compared to Whites (hazard ratio, 0.91; 95% CI 0.87–0.96), Blacks (hazard ratio, 0.87; 95% CI 0.79–0.94), and Asian, Pacific Islander, Native American (hazard ratio, 0.89; 95% CI 0.83–0.95). Logistic regression showed that the odds of ICU admission were significantly higher among Hispanics, compared to Whites (OR, 1.70; 95% CI 1.67–1.74), Blacks (OR, 1.70; 95% CI 1.64–1.78), and Asian, Pacific Islander, Native American (OR, 1.82; 95% CI 1.76–1.89). We found significant disparities in mortality among COVID-19 hospitalizations in California. Hispanics were the worst affected with the highest mortality and ICU admission rates.

Abstract Milk yield is the most complex trait in dairy animals, and mapping all causal variants even with smallest effect sizes has been difficult with the genome-wide association study (GWAS) sample sizes available in geographical regions with small livestock holdings such as Indian sub-continent. However, Transcriptome-wide association studies (TWAS) could serve as an alternate for fine mapping of expression quantitative trait loci (eQTLs). This is a maiden attempt to identify milk production and its composition related genes using TWAS in Murrah buffaloes (Bubalus bubalis). TWAS was conducted on a test (N = 136) set of Murrah buffaloes genotyped through ddRAD sequencing. Their gene expression level was predicted using reference (N = 8) animals having both genotype and mammary epithelial cell (MEC) transcriptome information. Gene expression prediction was performed using Elastic-Net and Dirichlet Process Regression (DPR) model with fivefold cross-validation and without any cross-validation. DPR model without cross-validation predicted 80.92% of the total genes in the test group of Murrah buffaloes which was highest compared to other methods. TWAS in test individuals based on predicted gene expression, identified a significant association of one unique gene for Fat%, and two for SNF% at Bonferroni corrected threshold. The false discovery rates (FDR) corrected P-values of the top ten SNPs identified through GWAS were comparatively higher than TWAS. Gene ontology of TWAS-identified genes was performed to understand the function of these genes, it was revealed that milk production and composition genes were mainly involved in Relaxin, AMPK, and JAK-STAT signaling pathway, along with CCRI, and several key metabolic processes. The present study indicates that TWAS offers a lower false discovery rate and higher significant hits than GWAS for milk production and its composition traits. Hence, it is concluded that TWAS can be effectively used to identify genes and cis-SNPs in a population, which can be used for fabricating a low-density genomic chip for predicting milk production in Murrah buffaloes.

Introduction: We examined the impact of a geriatric consult program in the emergency department (ED) and an ED observation geriatric care unit (GCU) setting on hospital admission rates for older ED patients. Methods: We performed a retrospective case control study from June 1–August 31, 2019 (pre-program) to September 24, 2019–January 31, 2020 (post-program). Post-program geriatric consults were readily available in the ED and required in the GCU setting. Hospital admission rates (outcome) are reported for patients who received a geriatric consult evaluation (intervention). We analyzed probability of admission using a mixed-effects logistic regression model that included age, gender, recent ED visit, Charlson Comorbidity Index, referral to ED observation, and geriatric consult evaluation as predictor variables. Results: A total of 9,663 geriatric ED encounters occurred, 4,042 pre-program and 5,621 post-program. Overall, ED admission rates for geriatric patients were similar pre- and post-program (44.8% vs 43.9%, P = 0.39). Of 243 geriatric consults, 149 (61.3%) occurred in the GCU. Overall admission rates post-program for patients receiving geriatric intervention were significantly lower compared to pre-program (23.4% vs 44.9%, P

Context: Breast carcinoma is a heterogenous disease and similar histological subtypes may exhibit different behavior and treatment response. The molecular classification may provide better prognostic, predictive and therapeutic information than histological classification. The study aimed at evaluating the distribution of molecular subtypes of breast cancer and its association with prognostic factors. Method: This prospective cross-sectional study was conducted on breast cancer cases, over a period of 2 years, at M.S. Ramaiah Medical College and Hospitals, Bengaluru. The resection specimens were evaluated for histopathological features. Immunohistochemical analysis for ER, PR, Her2neu and Ki-67 expression was performed to identify molecular subtypes. Correlation of molecular subtypes with histopathological prognostic factors was done by Chi- square test or Fischer’s exact test. Results: A total of 85 cases were evaluated and classified into Luminal A (50.6%), Basal like (27%), Luminal B (11.8%) and HER-2 enriched (10.6%) molecular subtypes. Invasive ductal carcinoma was the commonest histologic type across all the molecular subtypes. Majority of low-grade tumors were Luminal A and most of high-grade tumors were Basal like (p= 0.004). HER-2 enriched and Basal like tumors were relatively more frequent in ≤ 50 years of age and Luminal A tumors exhibited less frequent lymph node metastasis. However, these associations fell short of statistical significance. Conclusion: Luminal A tumors are the most common molecular subtype. Statistically significant correlation exists between histologic grade and molecular subtype. There is no significant correlation between molecular subtype and age, tumor size, nodal metastasis, pathological T stage and TNM stage. Keywords: Basal like, Breast carcinoma, HER2­Enriched, Luminal A, Luminal­ B, Molecular subtypes

Abstract It is well known that metal corrosion causes serious economy losses worldwide. One of the most effective ways to prevent corrosion is the continuous development of high-efficient and environment-friendly corrosion inhibitors. Among the widely used organic and inorganic corrosion inhibitors, plant extracts are top candidates due to their nontoxic nature. The present study reports a novel application of the methanolic extract of Terminalia bellerica fruits as an environment friendly corrosion inhibitor for steel in sulphuric acid medium. The phytochemicals of the extract, namely Ellagic, Gallic, and Malic acids, play a key role of the anti-corrosive behavior of the extract. The corrosion prevention activity was studied on the steel in 1 M H2SO4 using a variety of approaches including weight loss analysis (WL), scanning electron microscope (SEM), electrochemical impedance spectroscopy (EIS), density functional theory (DFT), natural bond orbital analysis (NBO), Fukui function and Monte Carlo simulations (MC). In 1 M H2SO4 solution, the maximum electrochemical inhibition efficiency of 91.79% was observed at 4000 mg/L concentration of the extract. The NBO analysis showed that the charge density of the double bonds and the oxygen atoms of carbonyl and hydroxyl groups of the phytochemicals lies on the top of the natural bond orbitals which promotes the anticorrosive properties of the investigated inhibitors. The surface coverage of steel was validated by SEM measurements. According to DFT studies, numerous nucleophilic regions were present in the active phytochemical constituents of the inhibitor, demonstrating their favorable nucleophilicity. The computed electronic structure of the phytochemicals revealed band gaps of 4.813, 5.444, and 7.562 eV for Ellagic, Gallic, and Malic acids respectively suggesting effective metal-inhibitor interactions. A good correlation between experimental and theoretical findings was addressed.