Search

Abstract This study systematically evaluates biomimicry research within the context of sustainable development goals (SDGs) to discern the interdisciplinary interplay between biomimicry and SDGs. The alignment of biomimicry with key SDGs showcases its interdisciplinary nature and potential to offer solutions across the health, sustainability, and energy sectors. This study identified two primary thematic clusters. The first thematic cluster focused on health, partnership, and life on land (SDGs 3, 17, and 15), highlighting biomimicry's role in healthcare innovations, sustainable collaboration, and land management. This cluster demonstrates the potential of biomimicry to contribute to medical technologies, emphasizing the need for cross-sectoral partnerships and ecosystem preservation. The second thematic cluster revolves around clean water, energy, infrastructure, and marine life (SDGs 6, 7, 9, and 14), showcasing nature-inspired solutions for sustainable development challenges, including energy generation and water purification. The prominence of SDG 7 within this cluster indicates that biomimicry significantly contributes to sustainable energy practices. The analysis of thematic clusters further revealed the broad applicability of biomimicry and its role in enhancing sustainable energy access and promoting ecosystem conservation. Emerging research topics, such as metaheuristics, nanogenerators, exosomes, and bioprinting, indicate a dynamic field poised for significant advancements. By mapping the connections between biomimicry and SDGs, this study provides a comprehensive overview of the field's trajectory, emphasizing its importance in advancing global sustainability efforts.

Abstract The goal of this research is to create an ensemble deep learning model for Internet of Things (IoT) applications that specifically target remote patient monitoring (RPM) by integrating long short-term memory (LSTM) networks and convolutional neural networks (CNN). The work tackles important RPM concerns such early health issue diagnosis and accurate real-time physiological data collection and analysis using wearable IoT devices. By assessing important health factors like heart rate, blood pressure, pulse, temperature, activity level, weight management, respiration rate, medication adherence, sleep patterns, and oxygen levels, the suggested Remote Patient Monitor Model (RPMM) attains a noteworthy accuracy of 97.23%. The model's capacity to identify spatial and temporal relationships in health data is improved by novel techniques such as the use of CNN for spatial analysis and feature extraction and LSTM for temporal sequence modeling. Early intervention is made easier by this synergistic approach, which enhances trend identification and anomaly detection in vital signs. A variety of datasets are used to validate the model's robustness, highlighting its efficacy in remote patient care. This study shows how using ensemble models' advantages might improve health monitoring's precision and promptness, which would eventually benefit patients and ease the burden on healthcare systems.

Introduction: Volleyball is a dynamic sport that places high demands on an athlete’s ability to move quickly and efficiently. Kettlebell training utilises a unique offset weight, challenging core stability, and multijoint coordination, potentially mimicking movements in volleyball. Plyometric training, on the other hand, focuses on rapid muscle contractions to develop power. Despite their popularity, limited research directly compares the effectiveness of these methods for enhancing the skills crucial for volleyball players. Need of the study: Lower limb injuries are common in volleyball players, and improving agility and balance can help in reducing the risk of these injuries. The purpose of the research is to bridge this information disparity by investigating the effects of both kettlebell training and plyometric training. By analysing the results, the authors can gain valuable insights into how each training approach influences these fundamental movement skills. This knowledge can ultimately help in the development of targeted training programs specifically designed to enhance performance and training strategies for volleyball athletes. Aim: To assess the subjects’ agility, static balance, and dynamic balance in volleyball players treated with kettlebell training and plyometric training. Materials and Methods: This two-arm parallel randomised experimental study will be conducted at the Department of Sports Physiotherapy of Ravi Nair Physiotherapy College, Wardha, Maharashtra, India, from July 2023 to July 2024. A total of 50 participants will be assigned to 2 groups, with one group receiving kettlebell training (Group-A) and the other group receiving plyometric training (Group-B). Assessments will be conducted on the first day of intervention and at the end of the sixth week of treatment, respectively. To evaluate the inequality in effect size between the groups, statistical significance will be assessed using either a parametric test or non parametric test at a 5% level of significance. For normally distributed values, a t-test (Unpaired) will be used and for non normally distributed data, non-parametric tests (Chi-square, Mann-Whitney U, and Wilcoxon’s test) will be utilised.

The Academy of Family Physicians of India (AFPI) is a professional association of physicians promoting the knowledge domain, academic discipline, and medical specialty of family medicine in India. AFPI was founded on 27 September 2010. In 2022, 27 September, the foundation day of AFPI, was for formally launched as the National Family Medicine Day (NFMD). NFMD is a momentous occasion dedicated to recognising and celebrating the vital role of family medicine, the academic discipline of family physicians, within the healthcare delivery system. NFMD is a significant event that underscores the essential role of family physicians in providing accessible, comprehensive, and continuous healthcare. This article is an account of the inaugural and initial years of NFMD and AFPI foundation day celebrations.

The purpose of this narrative review was to comprehensively elaborate the various components of artificial intelligence (AI), their applications in spine surgery, practical concerns, and future directions. Over the years, spine surgery has been continuously transformed in various aspects, including diagnostic strategies, surgical approaches, procedures, and instrumentation, to provide better-quality patient care. Surgeons have also augmented their surgical expertise with rapidly growing technological advancements. AI is an advancing field that has the potential to revolutionize many aspects of spine surgery. We performed a comprehensive narrative review of the various aspects of AI and machine learning in spine surgery. To elaborate on the current role of AI in spine surgery, a review of the literature was performed using PubMed and Google Scholar databases for articles published in English in the last 20 years. The initial search using the keywords “artificial intelligence” AND “spine,” “machine learning” AND “spine,” and “deep learning” AND “spine” extracted a total of 78, 60, and 37 articles and 11,500, 4,610, and 2,270 articles on PubMed and Google Scholar. After the initial screening and exclusion of unrelated articles, duplicates, and non-English articles, 405 articles were identified. After the second stage of screening, 93 articles were included in the review. Studies have shown that AI can be used to analyze patient data and provide personalized treatment recommendations in spine care. It also provides valuable insights for planning surgeries and assisting with precise surgical maneuvers and decision-making during the procedures. As more data become available and with further advancements, AI is likely to improve patient outcomes.

Background: Open-heart surgery is challenging in preterm neonates and infants, and its feasibility in low-resource settings has not been defined. We describe our institutional experience with open-heart surgeries performed on consecutive preterm infants. Materials, Methods and Results: This was a single-center retrospective cohort from a tertiary hospital in Southern India and included consecutive preterm neonates (

Introduction: In the field of biomedicine, marine algae have gained significant attention due to the abundance of bioactive compounds they contain. However, studies on the chronic toxicity of algae are limited. Aim: To evaluate the in-vitro, in-vivo acute, and subchronic toxicity of Sargassum tenerrimum (S. tenerrimum) in an adult zebrafish model. Materials and Methods: The current preclinical toxicological interventional study was conducted at the Department of Pharmacology, Sri Ramachandra Medical College and Research Institute, SRIHER, Chennai, Tamil Nadu, India, in September 2022. The algae S. tenerrimum was extracted with methanol using Soxhlet extraction. In-vitro toxicity of S. tenerrimum was performed using the MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) assay on the SH-SY5Y cell line. Acute toxicity was carried out for 96 hours according to Organisation for Economic Cooperation and Development (OECD) 203 guidelines, and subchronic toxicity was carried out for 14 days on the zebrafish model using the immersion method. Additionally, histopathological changes were observed after the acute toxicity study, and the Lethal Concentration 50 (LC50) value was analysed. Results: The MTT assay of the methanolic extract of S. tenerrimum revealed an LC50 value of 140.014 μg/mL. An acute toxicity study conducted on zebrafish for 96 hours showed an LC50 value of 504.669 mg/L. Subchronic toxicity was done for 14 days, and on the 14th day of exposure, the LC50 value was found to be 404.196 mg/L. Histopathological changes were observed at higher concentrations (800 mg/L) of algal extract. Conclusion: The present study revealed that the methanolic extract of S. tenerrimum showed a toxic effect at higher concentrations on the zebrafish model. However, at lower concentrations, S. tenerrimum was deemed safe for further exploration of pharmacological activities in a zebrafish model.

Background: The major membrane currents responsible for sinoatrial (SA) rhythm generation are generally studied in isolated cardiac cells using electrophysiological tools. Such studies are resource and labor-intensive. Materials and Methods: Here, we have studied four major currents in isolated rat heart preparations, perfused in Langendorff mode, and demonstrate that this is a good preparation for such studies. Heart rates of isolated perfused rat hearts were recorded using surface electrocardiogram before and after perfusion with drugs and solutions that affect the four major currents responsible for SA rhythm generation. Results: The rates of whole isolated hearts beating with SA rhythm decreased with cesium and decreased by about half with ivabradine, both blockers of the funny current (If). Importantly, the rhythm was not abolished even with a high dose of ivabradine at which total blockade of If is expected. The rate was not affected by nickel, a blocker of T-type calcium current. The SA rhythm was abolished by the reduction or removal of sodium from the perfusate (interventions that inhibit the calcium-extrusive mode of the sodium-calcium exchanger) or by nifedipine, the L-type calcium channel blocker. Discussion: The inferences made based on these observations are (a) If contributes significantly to pacemaking, (b) ICaT does not play a role and (c) INCX and ICaL are obligatory rhythm-generating currents in the SA node. Cyclical calcium release from SR during diastole (the calcium clock), responsible for driving INCX in its forward mode is probably a phenomenon independent of membrane events, as total If blockade did not abolish rhythm generation. These results corroborate with published literature where most studies were done on single cells.

Dr. Prakash Chand (PC) Bhatla MBBS was one of the illustrious past presidents (1975–76) of Indian Medical Association (IMA). He was a General Practitioner by vocation and a towering professional leader. He made an immense contribution to the discipline of Family Medicine – the academic discipline, medical specialty, and the knowledge domain of Family Physicians/Family Doctors within India as well as the global level. He was a brilliant human being and professional par excellence. He was probably one of the greatest leaders of the medical profession in India and a rightful successor to Dr BC Roy’s legacy. As a rare achievement, he received the Dr BC Roy National Award from the President of India twice. He received this prestigious recognition award in 1977 for socio-medical relief in India and again in 1982 for the promotion of Specialty of General Practice. He founded IMA CGP (Indian Medical College of General Practitioners), and his foundational work led to the recognition of Family Medicine as a specialty in India. Due to his efforts, Family Medicine was included in the list of recognized specialties by the National Board of Examinations (NBE) as well by the Medical Council of India (MCI). His contribution to medicine at a global level is also remarkable. He is also considered one of the founding forefathers of WONCA – World Organization of Family Doctors. He was associated with the foundation process of WONCA from the beginning (1964). The International Liaison Committee organized the first World meeting of General Practice in Montreal (Canada) in 1964 and the second meeting in Salsburg in 1966. Dr Bhatla was the convenor of the Third World Conference on General Practice in New Delhi, India, in 1968. A global representative body of Family Medicine/General Practice was launched in 1972 in Melbourne, Australia. Due to contribution to WONCA, he was elected for the first ever WONCA fellowship, the most prestigious global Family Medicine award. He was contemporary to other world leaders of Family Medicine and Primary Care such as Ian McWhinney and Barbara Starfeild. He is rightfully recognized and remembered as Father of Family Medicine. Dr Bhatla’s intellectual, professional, and administrative contribution laid down the sound background for the foundation of a Specialty body of Family Medicine in India called the Academy of Family Physicians of India. Life and work of Dr PC Bhatla continues to inspire family doctors, family physicians, general practitioners, and Family Medicine specialists across India, South Asia, and the World in the 21st century.

Abstract Reproductive tract infections (RTIs) are a persistent public health threat worldwide, particularly among women in low-income countries of Africa, including Ethiopia, where drug resistance is also a growing problem. It is crucial to address this problem to ensure women's health and well-being. A cross-sectional study was carried out among a cohort of 398 women of reproductive age who sought medical attention at the Gynecology Department of the Arba Minch General Hospital, southern Ethiopia, from January to June 2020. They were chosen through systematic random sampling, and a pre-tested structured questionnaire was used to collect the data. The collection of vaginal and/or cervical swabs were done to diagnose bacterial vaginosis (BV) and aerobic vaginitis (AV) using Nugent and AV score analyses, respectively. The swabs were subjected to standard microbiological culture techniques to detect the isolates causing AV and vaginal candidiasis (VC). The susceptibility profiles of the causative agents of AV were checked by the Kirby-Bauer disc diffusion technique. Descriptive and inferential statistical analyses were also done. Aerobic vaginitis was the predominantly diagnosed RTI (n = 122, 30.7%), followed by BV (n = 117, 29.4%) and VC (n = 111, 27.9%). The prominent bacteria of AV were Escherichia coli (n = 36, 34.2%) and Klebsiella pneumoniae (n = 30, 28.5%). The overall rate of multidrug-resistant (MDR) bacteria was 65.71% (n = 69). History of abortion (p = 0.01; AOR = 4.0, 95% CI = 2.1, 7.7) and the habit of using vaginal pH-altering contraceptives (p = 0.01; AOR = 4.7, 95% CI = 2.5, 8.8) have the greatest odds of RTI. The high prevalence of RTIs in our study warrants an urgent intervention to minimize the associated morbidities and complications. The overall rate of MDR bacterial isolates necessitates the implementation of an effective surveillance program in the study setting.

Background Insufficient and above WHO-recommended levels of iodine intake during pregnancy can lead to serious health outcomes. This study aimed to assess median urine iodine concentration and its associated risk factors among pregnant women in the Mbeya region, Tanzania. Method A cross sectional survey involving 420 pregnant women (n=420) aged 15-49, registered in Reproductive and Child Health Clinics was conducted. Socio-demographic and dietary factors were assessed by structured questionnaire and the urine samples were analyzed using the ammonium persulfate digestion method. Results Median urinary iodine concentration (mUIC) was 279.4μg/L and it ranged from 26.1 to 1915μg/L. Insufficient mUIC (below 150μg/L) was observed in 17.14% of participants, sufficient mUIC was 24.29% and 58.57% had mUIC above the recommended level (>250μg/L). Sample women who reported consuming fish in the last 24 hours had an increased risk of insufficient mUIC [Adjusted OR= 2.60 (95%CI 1.31-5.15)] while the risk was lower for those who attended at least primary education [AOR= 0.29 (CI 0.08-0.99)]. Further, sample women resident in Mbarali district, in the oldest age group (35-49) and having a higher socio-economic status were associated with an increased risk of having MUIC above recommended level [AOR=4.09 (CI 1.85-9.010], [AOR=2.51 (CI 0.99-6.330] and, [AOR=2.08 (CI 0.91-4.71) respectively. Conclusion This study demonstrated a significant association between geographical, age and socio-economic factors and median urine iodine concentration above the WHO-recommended level. Further, this study found association between inadequate iodine in diet and insufficient median urine iodine concentration. Therefore, educational programs on iodine intake should be strengthened.

Abstract Background and Aims Association of American Medical Colleges (AAMC) and Accreditation Council for Graduate Medical Education (ACGME) mandate training in handoff delivery for students and residents. Communication errors, including errors during handoffs of patient care, account for over 2/3 of sentinel events. This study aims to assess the effectiveness of peer‐assisted learning (PAL) in handoff education within a longitudinal framework. Methods This study involved the analysis of fourth‐year medical students (n = 67) enrolled in a transition to residency program designed to reinforce skills essential for success in internal medicine residencies. We modified the I‐PASS handoff rubric for a single‐encounter evaluation. Before attending the transitions of care workshop, students submitted one written handoff report. During high‐fidelity simulation sessions, peers evaluated the written document as well as verbal handoffs, while faculty evaluated a recorded verbal version. The primary outcome measured was improvement in handoff quality and accuracy over time and secondary outcomes compared peer‐ and self‐evaluations to faculty assessments. Results Overall, students demonstrated a statistically significant improvement in handoff quality and accuracy across all scoring criteria after completing the peer evaluation process. Peer evaluations did not demonstrate statistically significant differences in scores for quality or accuracy questions as compared to faculty. Conclusion Peer evaluators effectively assessed handoff reports using the modified I‐PASS checklist yielding outcomes similar to faculty while providing feedback. These findings provide exciting evidence that should prompt training programs to consider incorporating standardized peer review into handoff education for medical students and, potentially, residents. The detailed evaluation of individual handoff events fosters feedback skills essential for ongoing professional growth and clinical excellence.

Behavioral responses to many odorants are not fixed but are flexible, varying based on organismal needs. How such variations arise and the role of various neuromodulators in achieving flexible neural-to-behavioral mapping is not fully understood. In this study, we examined how serotonin modulates the neural and behavioral responses to odorants in locusts (Schistocerca americana). Our results indicated that serotonin can increase or decrease appetitive behavior in an odor-specific manner. On the other hand, in the antennal lobe, serotonergic modulation enhanced odor-evoked response strength but left the temporal features or the combinatorial response profiles unperturbed. This result suggests that serotonin allows for sensitive and robust recognition of odorants. Nevertheless, the uniform neural response amplification appeared to be at odds with the observed stimulus-specific behavioral modulation. We show that a simple linear model with neural ensembles segregated based on behavioral relevance is sufficient to explain the serotonin-mediated flexible mapping between neural and behavioral responses.

The dual burden of human immunodeficiency virus (HIV) and tuberculosis (TB) impacts people living with HIV (PLHIV) coinfected with TB. Although some primary studies have been reported on the burden of extrapulmonary TB (EPTB) among PLHIV in Southeast Asia (SEA), there is no systematic review or meta-analysis that attempts to summarize the available literature. Therefore, this review aims to summarize the prevalence of EPTB/HIV co-infection in SEA using meta-analysis based on a systematic review of published articles and gray literature. A comprehensive 3-stage methodology was adopted to conduct a thorough literature search, encompassing both published and gray literature. Data sources such as MEDLINE and Web of Science were searched for articles reporting data from SEA between 2010 and 2022. Findings were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and were sourced using a predefined search strategy from different databases. The Joanna Briggs Institute prevalence studies checklist was employed for critical appraisal. The meta-analysis of proportions was carried out using the "metaprop" function in R software (version 4.3.1) to generate pooled estimates. Effects were summarized using random-effects models, and sources of heterogeneity were explored through I2, utilizing subgroup and sensitivity analyses. Publication bias was assessed using funnel plots and pertinent statistical tests, including Egger's regression analysis. A total of 474 studies were initially identified in our search. After the removal of duplicates and a meticulous screening process of titles and abstracts, along with the application of exclusion criteria, 22 studies comprising 34,740 PLHIV were included in the final meta-analysis. The summary effect or pooled proportion estimate of EPTB among PLHIV was found to be 18% [95% confidence interval (CI): 15,22; heterogeneity: τ2=0.0056; degrees of freedom=21, p

Objectives Long-term sickness absence from employment has negative consequences for the economy and can lead to widened health inequalities. Sick notes (also called ‘fit notes’) are issued by general practitioners when a person cannot work for health reasons for more than 7 days. We quantified the sick note rate in people with evidence of COVID-19 in 2020, 2021 and 2022, as an indication of the burden for people recovering from COVID-19.Design Cohort study.Setting With National Health Service (NHS) England approval, we used routine clinical data (primary care, hospital and COVID-19 testing records) within the OpenSAFELY-TPP database.Participants People 18–64 years with a recorded positive test or diagnosis of COVID-19 in 2020 (n=365 421), 2021 (n=1 206 555) or 2022 (n=1 321 313); general population matched in age, sex and region in 2019 (n=3 140 326), 2020 (n=3 439 534), 2021 (n=4 571 469) and 2022 (n=4 818 870); people hospitalised with pneumonia in 2019 (n=29 673).Primary outcome measure Receipt of a sick note in primary care.Results Among people with a positive SARS-CoV-2 test or COVID-19 diagnosis, the sick note rate was 4.88 per 100 person-months (95% CI 4.83 to 4.93) in 2020, 2.66 (95% CI 2.64 to 2.67) in 2021 and 1.73 (95% CI 1.72 to 1.73) in 2022. Compared with the age, sex and region-matched general population, the adjusted HR for receipt of a sick note over the entire follow-up period (up to 10 months) was 4.07 (95% CI 4.02 to 4.12) in 2020 decreasing to 1.57 (95% CI 1.56 to 1.58) in 2022. The HR was highest in the first 30 days postdiagnosis in all years. Among people hospitalised with COVID-19, after adjustment, the sick note rate was lower than in people hospitalised with pneumonia.Conclusions Given the under-recording of postacute COVID-19-related symptoms, these findings contribute a valuable perspective on the long-term effects of COVID-19. Despite likely underestimation of the sick note rate, sick notes were issued more frequently to people with COVID-19 compared with those without, even in an era when most people are vaccinated. Most sick notes occurred in the first 30 days postdiagnosis, but the increased risk several months postdiagnosis may provide further evidence of the long-term impact.

Background and Aim: Huntington's disease is a chronic hereditary disorder that causes cognitive and movement defects in affected individuals by progressive destruction of neurons in the cerebral cortex, striatum and the hippocampus. Studies have shown that increased activity of cyclin-dependent kinase-5 (CDK5) plays an important role in the pathogenesis and occurrence of memory impairment in Huntington's disease. Recently, alpha-pinene has been reported to improve learning and memory performance in Alzheimer's and Parkinson's models. Therefore, the aim of this study was to investigate the effect of alpha-pinene on passive avoidance memory and CDK5 gene expression in Huntington's animal model induced by 3-nitro-propionic acid (3-NP). Materials and Methods: In this study, 40 male rats were randomly divided into 5 groups: sham, 3-NP (10 mg/kg),and 3 other groups receiving 3-NP (10 mg/kg) + alpha-pinene at doses of 1, 5 and 10 mg/kg (for 3 weeks,via intraperitoneal injection). Passive avoidance memory was assessed through the shuttle box device. Then, the expression level of CDK5 gene was measured by RT-qPCR method in brain cortex and hippocampus. Results: 3-NP injection caused memory impairment by decreasing step through latency (STL). Alpha-pinene at all three doses improved passive avoidance memory performance. Also, 3-NP injection caused a significant increase in CDK5 gene expression level in the brain cortex and hippocampus compared to that in the sham group. The groups which received alpha-pinene at doses of 5 and 10 mg/kg in brain cortex and 1 mg/kg in hippocampus showed decreased expression level of this gene compared to the group that received 3-NP. Conclusion: The results of this study showed that alpha-pinene improves passive avoidance memory performance probably by reducing the CDK5 gene expression level in Huntington's animal model induced by 3-NP.

Abstract Fins are widely used in many industrial applications, including heat exchangers. They benefit from a relatively economical design cost, are lightweight, and are quite miniature. Thus, this study investigates the influence of a wavy fin structure subjected to convective effects with internal heat generation. The thermal distribution, considered a steady condition in one dimension, is described by a unique implementation of a physics-informed neural network (PINN) as part of machine-learning intelligent strategies for analyzing heat transfer in a convective wavy fin. This novel research explores the use of PINNs to examine the effect of the nonlinearity of temperature equation and boundary conditions by altering the hyperparameters of the architecture. The non-linear ordinary differential equation (ODE) involved with heat transfer is reduced into a dimensionless form utilizing the non-dimensional variables to simplify the problem. Furthermore, Runge–Kutta Fehlberg’s fourth–fifth order (RKF-45) approach is implemented to evaluate the simplified equations numerically. To predict the wavy fin's heat transfer properties, an advanced neural network model is created without using a traditional data-driven approach, the ability to solve ODEs explicitly by incorporating a mean squared error-based loss function. The obtained results divulge that an increase in the thermal conductivity variable upsurges the thermal distribution. In contrast, a decrease in temperature profile is caused due to the augmentation in the convective-conductive variable values.

Abstract This investigation reported a one-step green synthesis of nickel oxide nanoparticles (NiO NPs) using aloe vera leaves extract solution for their application in a supercapacitor. This method used aloe vera leaves as a reducing agent, which is very simple and cost-effective. The synthesized NPs were thoroughly characterized using various techniques. The X-ray diffraction analysis unequivocally confirmed the crystalline nature; field emission scanning electron microscopy and transmission electron microscopy images showed different shapes and forms of an agglomerated cluster of synthesized NPs. The absorption spectra were recorded from UV visible spectroscopy, while Fourier transform infrared spectroscopy provided insights into the functional groups present. Electrochemical assessments were carried out via cyclic voltammetry, galvanostatic charging-discharging and electrochemical impedance spectroscopy. These experiments were performed using a 2 M KOH electrolyte within a 1.0 V potential window. Impressively, the single electrode displayed a remarkable specific capacitance of 462 F g−1 at a scan rate of 1 mV s−1 and 336 F g−1 at a current density of 0.76 A g−1. Further, a symmetric two-electrode device (NiO||NiO) has been successfully fabricated by employing a separator between the electrodes. The device exhibited an exceptional specific capacitance of approximately 239 F g−1, along with an energy density of 47.8 Wh kg−1 and a power density of 545 W kg−1 at 1 A g−1 current density within a 1.2 V potential window. The fabricated device also shows a retention capacity of 89% at 10 A g−1 after 2000 cycles with 114% of columbic efficiency. The present study underscores the effectiveness of the green synthesis approach in producing NiO NPs and establishes their potential as highly promising candidates for supercapacitor applications, showcasing both excellent electrochemical performance in a three-electrode system and remarkable stability in a practical two-electrode device. The results collectively highlight the efficacy of the green approach in producing NiO NPs, establishing its potential as a highly promising candidate for supercapacitor application.

Abstract Multi-parametric MRI (mpMRI) is widely used for prostate cancer (PCa) diagnosis. Deep learning models show good performance in detecting PCa on mpMRI, but domain-specific PCa-related anatomical information is sometimes overlooked and not fully explored even by state-of-the-art deep learning models, causing potential suboptimal performances in PCa detection. Symmetric-related anatomical information is commonly used when distinguishing PCa lesions from other visually similar but benign prostate tissue. In addition, different combinations of mpMRI findings are used for evaluating the aggressiveness of PCa for abnormal findings allocated in different prostate zones. In this study, we investigate these domain-specific anatomical properties in PCa diagnosis and how we can adopt them into the deep learning framework to improve the model’s detection performance. We propose an anatomical-aware PCa detection Network (AtPCa-Net) for PCa detection on mpMRI. Experiments show that the AtPCa-Net can better utilize the anatomical-related information, and the proposed anatomical-aware designs help improve the overall model performance on both PCa detection and patient-level classification.

Introduction: Globally, Chronic Obstructive Pulmonary Disease (COPD) is the third most common cause of mortality. More than 80% of these fatalities happened in low- and middleincome nations. Transient desaturation during sleep occurs in healthy persons during Rapid Eye Movement (REM) sleep. This phenomenon is aggravated in COPD patients. As Nocturnal Desaturation (NOD) in COPD has been suggested to increase mortality, its early identification will aid in early initiation of treatment and prevention of associated complications. Aim: To estimate the prevalence of nocturnal hypoxemia in COPD and determine its association with COPD severity. Materials and Methods: A cross-sectional study was carried out at the Department of General Medicine, Apollo Hospitals, Guwahati, Assam, India during January to December 2021 involving 100 patients who had COPD symptoms. Continuous oxygen saturation monitoring with transcutaneous finger probe was done for the entire duration of sleep at night. Patients whose oxygen saturation falls below 90% for at least 30% of recording time in sleep were classified as desaturators. Statistical Package for Social Sciences (SPSS) Version 26.0 was used for data analysis. Using the Chi-square test, the relationship between the qualitative variables was evaluated. The Mann-Whitney test or the unpaired t-test was used to analyse the quantitative data between the two groups. A p-value of less than 0.05 was considered significant. Results: Prevalence of NOD among cases of COPD was observed as 26% in present study. A significant association was observed between presence of NOD in COPD cases with severity of COPD and with desaturation in 6-Minute Walk Test (6-MWT) (p

Over the past few decades, society's perception of transgender individuals has significantly transformed, leading to increased recognition and acceptance. However, despite these positive changes, transgender people have historically faced numerous challenges and stigmatization. This article delves into psychiatric perspectives on transgender sexuality and its impact on mental health. It emphasizes the importance of integrating psychiatrists into primary care to enhance engagement in outpatient behavioral health services for transgender and nonbinary adults. Gender identity and sexuality are interconnected aspects of human experience, and understanding transgender sexuality is essential for mental health professionals to provide effective support and care. Gender dysphoria, a psychological condition stemming from incongruence between gender identity and assigned sex, profoundly affects the mental health of transgender individuals, emphasizing the necessity of affirming and comprehensive mental health care. The significance of cultural factors and intersectionality in supporting transgender individuals and mental health professionals play a critical role in identity development by creating safe and supportive environments for exploration and self-acceptance. Affirmative approaches and treatment options, such as hormone replacement therapy and gender confirmation surgery, are discussed, stressing the importance of collaborative care involving medical and mental health professionals. Ultimately, this article underscores mental health professionals' vital role in supporting transgender individuals' mental well-being, fostering inclusivity, and contributing to more affirming society.

Background: Adequate management of hypertension is crucial for decreasing the likelihood of cardiovascular ailments and associated complications. Nonetheless, in the Indian context, maintaining compliance with prescribed hypertensive therapies presents a notable hurdle, impeding the attainment of favorable health outcomes. Thus, this study was conducted with the aim to evaluate the prevalence of treatment adherence and explore the diverse factors that impact adherence patterns among individuals diagnosed with hypertension. Material and Methods: A community-based cross-sectional questionnaire-based study was carried out among the diagnosed hypertensive patients from 12 purposefully selected villages of Khagaul block, Patna. A total of 262 participants were recruited in the study by using non-probability sampling. The 8-item Morisky Medication Adherence Scale (MMAS-8) was used for measuring adherence. The Statistical Package for the Social Sciences (SPSS) for Windows version 21.0 (SPSS Inc; Chicago, IL, USA) was used for statistical analysis of data. Result: As per MMAS scores, 10 (3.8%) had high, 133 (50.8%) moderate, and 119 (45.4%) poor adherence. However, good adherence was reported among geriatric patients [1.65 (1.01–2.7)], those with a history of absence of comorbidities [2.15 (1.21–3.85)], more than 5 years' duration of hypertension [3.2 (1.89–5.41)], once-a-day drug intake [2.8 (1.61–4.87)], and having controlled blood pressure [5.2 (3.08–8.96)]. Controlled blood pressure (AOR = 0.048, 0.023-0.098), perception of high benefit of treatment [0.497 (0.255–0.97)], and absence of comorbidity [0.016 (0.168–0.832)] were identified as predictors of good treatment adherence. Conclusion: Overall medication adherence in the current study was 54.6%. Achieving treatment adherence frequently demands proactive patient engagement, highlighting their active role in disease management. Also, involving the patient's caregivers can offer an additional tactic to tackle non-adherence stemming from forgetfulness of the patient.

Family medicine is the academic discipline, knowledge domain and specialty of family physicians or family doctors globally. Family medicine is rapidly developing in India amidst resistance and criticism. Many opponents identify family medicine as a western concept and argue for its non suitability for implementation in India. Family medicine or family physician is not a new concept for the Indian people. The family doctor concept originated in India from the community-based Vaidya system – an ancient old tradition of the Indian civilisation. A 'Vaidya' typically refers to a local physician engaging with the population. The Vaidya used to provide personalised care and primary medical care to individuals and families. The Vaidya remained the 'Family Physician', and this identity and profession has an unbreeched association of more than several millennia with the Indian population. It is to be noted that all the goals of Bachelor of Medicine and Bachelor of Surgery (MBBS) training in India, the aspirations, skills and competencies for trainees, as defined by the National Medical Commission (NMC), can be identified as the academic discipline and vocation of family physicians. However, family medicine has not yet been included as a distinct and mandatory subject for MBBS students by the NMC. The demand for personalised health care within the community by the family doctors has never diminished but has only been artificially restricted. Family physicians contribute significantly to the promotion of health, prevention of diseases and the management of various health conditions in the Indian context. We look forward to the integration of family physician and family doctor concepts within the mainstream medical education system. It is expected that family medicine will become part of MBBS curriculum as promulgated in the NMC Act 2019.

Abstract Background The NHS Health Check is a preventive programme in the UK designed to screen for cardiovascular risk and to aid in primary disease prevention. Despite its widespread implementation, the effectiveness of the NHS Health Check for longer-term disease prevention is unclear. In this study, we measured the rate of new diagnoses in UK Biobank participants who underwent the NHS Health Check compared with those who did not. Methods Within the UK Biobank prospective study, 48,602 NHS Health Check recipients were identified from linked primary care records. These participants were then covariate-matched on an extensive range of socio-demographic, lifestyle, and medical factors with 48,602 participants without record of the check. Follow-up diagnoses were ascertained from health records over an average of 9 years (SD 2 years) including hypertension, diabetes, hypercholesterolaemia, stroke, dementia, myocardial infarction, atrial fibrillation, heart failure, fatty liver disease, alcoholic liver disease, liver cirrhosis, liver failure, acute kidney injury, chronic kidney disease (stage 3 +), cardiovascular mortality, and all-cause mortality. Time-varying survival modelling was used to compare adjusted outcome rates between the groups. Results In the immediate 2 years after the NHS Health Check, higher diagnosis rates were observed for hypertension, high cholesterol, and chronic kidney disease among health check recipients compared to their matched counterparts. However, in the longer term, NHS Health Check recipients had significantly lower risk across all multiorgan disease outcomes and reduced rates of cardiovascular and all-cause mortality. Conclusions The NHS Health Check is linked to reduced incidence of disease across multiple organ systems, which may be attributed to risk modification through earlier detection and treatment of key risk factors such as hypertension and high cholesterol. This work adds important evidence to the growing body of research supporting the effectiveness of preventative interventions in reducing longer-term multimorbidity.

Abstract Optimal integration of transcriptomics data and associated spatial information is essential towards fully exploiting spatial transcriptomics to dissect tissue heterogeneity and map out inter-cellular communications. We present SEDR, which uses a deep autoencoder coupled with a masked self-supervised learning mechanism to construct a low-dimensional latent representation of gene expression, which is then simultaneously embedded with the corresponding spatial information through a variational graph autoencoder. SEDR achieved higher clustering performance on manually annotated 10 × Visium datasets and better scalability on high-resolution spatial transcriptomics datasets than existing methods. Additionally, we show SEDR’s ability to impute and denoise gene expression (URL: https://github.com/JinmiaoChenLab/SEDR/ ).

New experimental findings continue to challenge our understanding of protein allostery. Recent deep mutational scanning study showed that allosteric hotspots in the tetracycline repressor (TetR) and its homologous transcriptional factors are broadly distributed rather than spanning well-defined structural pathways as often assumed. Moreover, hotspot mutation-induced allostery loss was rescued by distributed additional mutations in a degenerate fashion. Here, we develop a two-domain thermodynamic model for TetR, which readily rationalizes these intriguing observations. The model accurately captures the in vivo activities of various mutants with changes in physically transparent parameters, allowing the data-based quantification of mutational effects using statistical inference. Our analysis reveals the intrinsic connection of intra- and inter-domain properties for allosteric regulation and illustrate epistatic interactions that are consistent with structural features of the protein. The insights gained from this study into the nature of two-domain allostery are expected to have broader implications for other multi-domain allosteric proteins.

Abstract Background and Aim Goiter is a major source of morbidity in the world, especially in the developing world, where dietary iodine deficiency, a known cause of this condition, is endemic. The diagnosis is mostly by ultrasonography (USG) scan, which can give anatomical, pathological, and functional information for the management of goiter. This study aimed to determine the commonest ultrasound findings of goiter in Ghana. Method The records of all 213 patients with goiter diagnosed by USG scan over a 5‐year period were retrieved. Data collected were sociodemographics, ultrasound features, thyroid nodules diameter, and Thyroid Imaging Reporting and Data System (TI‐RADS) scores, which were analyzed using GNU PSPP, version 1.2.0‐3. χ2 and two‐tailed independent samples t‐test were also employed, with p ≤ 0.05. Results A total of 213 patients with goiter diagnosed by USG scan were obtained over the study period. The mean age of the participants was 50.01 ± 17.27 years, with an age range of 16−92 years and females constituting the majority (82.16%). The commonest ultrasound features were well‐defined solid nodules. The lesion sites for most patients were the whole thyroid (28.17%), both lobes (24.41%), and the right lobe (20.19%). The mean difference in sizes of cysts and solid nodules among genders was 0.26 (CI: −0.14 to 0.67, p = 0.20) and 0.12 (CI: −0.43 to 0.66, p = 0.67), respectively. The TI‐RADS score featured TI‐RADS 4 (36.62%), TI‐RADS 1 (28.17%), TI‐RADS 3 (25.82%), TI‐RADS 5 (5.16%), and TI‐RADS 2 (4.23%). Solid nodules (49.32%, p = 0.001) and cysts (35.71%, p = 0.003) were more common within 41−60 years and less frequent in those

Introduction There are around 250 million adolescents (10–19 years) in India. The prevalence of mental health-related morbidity among adolescents in India is approximately 7.3%. Vulnerable subpopulations among adolescents such as those living in slum communities are particularly at risk due to poor living conditions, financial difficulty and limited access to support services. Adolescents’ Resilience and Treatment nEeds for Mental Health in Indian Slums (ARTEMIS) is a cluster randomised controlled trial of an intervention that intends to improve the mental health of adolescents living in slum communities in India. The aim of this paper is to describe the process evaluation protocol for ARTEMIS trial. The process evaluation will help to explain the intervention outcomes and understand how and why the intervention worked or did not work. It will identify contextual factors, intervention barriers and facilitators and the adaptations required for optimising implementation.Methods Case study method will be used and the data will include a mix of quantitative metrics and qualitative data. The UK Medical Research Council’s guidance on evaluating complex interventions, the Reach, Efficacy, Adoption, Implementation and Maintenance Framework and the Affordability, Practicability, Effectiveness and cost-effectiveness, Acceptability, Safety/Side Effects and, Equity criteria will be used to develop a conceptual framework and a priori codes for qualitative data analysis. Quantitative data will be analysed using descriptive statistics. Implementation fidelity will also be measured.Discussion The process evaluation will provide an understanding of outcomes and causal mechanisms that influenced any change in trial outcomes.Ethics and dissemination Ethics Committee of the George Institute for Global Health India (project number 17/2020) and the Research Governance and Integrity Team, Imperial College, London (ICREC reference number: 22IC7718) have provided ethics approval. The Health Ministry’s Screening Committee has approved to the study (ID 2020-9770).Trial registration number CTRI/2022/02/040307.

Introduction The incidence of extraosseous Ewing sarcoma, a highly malignant mesenchymal tumor, is rare in the spinal cord and its clinical outcomes unknown. To date, few cases of primary intradural extramedullary Ewing sarcoma (PIEES) have been reported in the literature, with few follow-ups. Material and Methods Here, we aimed to perform a comprehensive review of all cases published in the literature and update previously reported cases with our single institution case. Institutional medical records were searched for cases of PIEES of the spine managed at our institution between the years 2017 and 2023. We performed a systematic search of two electronic databases (PubMed and Medline) from inception to December 2023 to obtain all published cases of PIEES. We used our institutional medical records to update cases reported from our institution. Results We identified a total of 40 cases with PIEES reported in the existing literature. Of the 41 cases, the median age of diagnosis was 31 years. The most common presentation pattern was PIEES in the lumbar/sacral region (61%, n = 27), with a majority (59%, n = 25) presenting initially with pain. The most common modality of treatment reported was surgery (41/41, 100%), followed by adjuvant chemotherapy (31/41, 75%) and local radiation therapy (29/41, 70%). Overall, recurrence was reported in 17/41 (34%) cases, with median progression free survival (PFS) of 12 months (range, 1–72). There were 12/37 (29.4%) deaths reported, with median overall survival (OS) of 14 months (range, 1–72). Conclusion We presented the most updated review of all reported cases of PIEES. While surgical resection is the mainstay of treatment, tumor recurrence is a great concern given the adhesive nature of the lesion preventing complete resection. Adjuvant chemotherapy and radiotherapy should be carefully considered to prevent recurrence and improve survival outcome.

Somewhat pitch-forked into a role it had been envisioning for itself for a long time now by the rapidly changing politico-administrative dynamics of the nations across the world and emerging and re-emerging crises limited not the least to wars and pandemics, India needs to leverage its strengths to deliver on the promise it has long held. But India's struggle to stem the outward flow of many of the brightest may just be one among the many factors that can play a spoilsport. The civilizational strength of India has been its cultural–scientific epistemology, strengthening the exploration of which will help it position itself as the global leader. The freedom to question and seek answers, no matter how successful a hypothesis has been in the past, is consistent with its (India's) epistemology, both scientific and cultural.

Introduction: Paralytic strabismus, a type of strabismus caused by paralysis of one or more extraocular muscles, can lead to a variety of ocular and psychosocial sequelae. Etiology varies in different types of paralytic strabismus. Numerous studies have shown that ocular motor cranial nerve palsies have a variety of causes including vascular disease, head trauma, intracranial tumour or aneurysm and inflammatory disorders.Materials and Methods: A cross-sectional study was conducted at a tertiary eye hospital to evaluate Paralytic squint by Neuroimaging in patients presenting to the Squint department of Sarojini Devi Eye Hospital Hyderabad from June 2021 to May 2022. Paralytic strabismus cases with limitation of ocular motility were enrolled and a detailed examination was performed to know the etiology. Results: 190 patients (1.35%) were diagnosed with paralytic strabismus. Ischemia constituted to be the major cause of paralytic strabismus i.e. (42.1%) followed by trauma (20%). The 3rd cranial nerve was the most commonly involved (34.73%), followed by the 6th cranial nerve (32.63%). Multiple cranial nerves were involved in 20% of cases. The 3rd CN was involved, primarily due to ischemia in both males and females while the 6th CN was affected with trauma, neoplasm, and ischemia being prominent causes. Conclusion: The study showed that ischemia, trauma and idiopathy are some of the major etiologies of paralytic strabismus with male predominance. The cranial nerve involvement also varied with the etiology of paralytic strabismus.

Abstract Stroke remains a global health concern, necessitating early prediction for effective management. Atherosclerosis-induced internal carotid and intra cranial stenosis contributes significantly to stroke risk. This study explores the relationship between blood pressure and stroke prediction, focusing on internal carotid artery (ICA) branches: middle cerebral artery (MCA), anterior cerebral artery (ACA), and their role in hemodynamics. Computational fluid dynamics (CFD) informed by the Windkessel model were employed to simulate patient-specific ICA models with introduced stenosis. Central to our investigation is the impact of stenosis on blood pressure, flow velocity, and flow rate across these branches, incorporating Fractional Flow Reserve (FFR) analysis. Results highlight differential sensitivities to blood pressure variations, with M1 branch showing high sensitivity, ACA moderate, and M2 minimal. Comparing blood pressure fluctuations between ICA and MCA revealed heightened sensitivity to potential reverse flow compared to ICA and ACA comparisons, emphasizing MCA's role. Blood flow adjustments due to stenosis demonstrated intricate compensatory mechanisms. FFR emerged as a robust predictor of stenosis severity, particularly in the M2 branch. In conclusion, this study provides comprehensive insights into hemodynamic complexities within major intracranial arteries, elucidating the significance of blood pressure variations, flow attributes, and FFR in stenosis contexts. Subject-specific data integration enhances model reliability, aiding stroke risk assessment and advancing cerebrovascular disease understanding.

Abstract Background SARS-CoV-2 infections caused mild-to-moderate illness. However, a sizable portion of infected people experience a rapid progression of hyper-inflammatory and hypoxic respiratory illness that necessitates an effective and safer remedy to combat COVID-19. Methods A total of 150 COVID-19-positive patients with no to mild symptoms, between the age groups 19–65 years were enrolled in this randomized, open-labeled three-armed clinical trial. Among them, 136 patients completed the study with RT-PCR negative reports. The patients received herbal drugs orally (Group A (Adhatoda vasica; AV; 500 mg; n = 50); Group B (Tinospora cordifolia; TC; 500 mg; n = 43), and Group C (AV + TC; 250 mg each; n = 43)) for 14 days. Clinical symptoms, vital parameters, and viral clearance were taken as primary outcomes, and biochemical, hematological parameters, cytokines, and biomarkers were evaluated at three time points as secondary outcomes. Results We found that the mean viral clearance time was 13.92 days (95% confidence interval [CI] 12.85–14.99) in Group A, 13.44 days (95% confidence interval [CI] 12.14–14.74) in Group B, and 11.86 days (95% confidence interval [CI] 10.62–13.11) days in Group C. Over a period of 14 days, the mean temperature in Groups A, and B significantly decreased linearly. In Group A, during the trial period, eosinophils, and PT/INR increased significantly, while monocytes, SGOT, globulin, serum ferritin, and HIF-1α, a marker of hypoxia reduced significantly. On the other hand, in Group B hsCRP decreased at mid-treatment. Eosinophil levels increased in Group C during the treatment, while MCP-3 levels were significantly reduced. Conclusions All the patients of the three-armed interventions recovered from COVID-19 and none of them reported any adverse effects from the drugs. Group C patients (AV + TC) resulted in a quicker viral clearance as compared to the other two groups. We provide the first clinical report of AV herbal extract acting as a modifier of HIF-1α in COVID-19 patients along with a reduction in levels of ferritin, VEGF, and PT/INR as the markers of hypoxia, inflammation, and thrombosis highlighting the potential use in progression stages, whereas the TC group showed immunomodulatory effects. Trial registration Clinical Trials Database -India (ICMR-NIMS), CTRI/2020/09/028043. Registered 24th September 2020, https://www.ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=47443&EncHid=&modid=&compid=%27,%2747443det%27 Graphical Abstract

AbstractIntroduction Mosquito-borne infections are of global health concern because of their rapid spread and upsurge, which creates a risk for coinfections. DENV and ZIKV are transmitted by Aedes aegypti and A. albopictus and are prevalent in Nigeria and neighbouring countries. However, their seroprevalence, burden, hidden endemicity and possible cocirculation are poorly understood in Nigeria.Methods We conducted a cross-sectional study of 871 participants from three regions of Nigeria. All serum samples were analysed using malaria RDT and the immunoblot molecular diagnostic assay recomLine Tropical Fever for the presence of arboviral antibody serological marker IgG (Mikrogen Diagnostik, Neuried, Germany) with DENV and ZIKV Nonstructural protein 1 (NS 1), DENV and ZIKV Equad (variant of the envelope protein with designated mutations to increase specificity), according to the manufacturer’s instructions.Results The overall IgG antibody seropositivity against DENV-flavivirus was 44.7% (389/871); 95% CI (41.41–47.99), while ZIKV-flavivirus was 19.2% (167/871); 95% CI (0.16–0.21), and DENV-ZIKV-flavivirus cocirculation antibody seropositivity was 6.2%5 (54/871); 95% CI (0.6–0.7) in the three study regions of Nigeria. The study cohort presented similar clinical signs and symptoms of flaviviruses (DENV and ZIKV) in all three study regions.Conclusion This study highlighted an unexpectedly high antibody seropositivity, burden, hidden endemicity, and regional spread of mono- and co-circulating flaviviruses (DENV and ZIKV) in Nigeria.Key messagesDengue flavivirus sero-cross-reactivity drives antibody-dependent enhancement of ZIKV infection.Both viruses share common hosts (humans) and vectors (primarily Aedes aegypti), and are thus influenced by similar biological, ecological, and economic factors, resulting in epidemiological synergy.Additionally, the actual burden in epidemic and interepidemic periods is grossly or chronically unknown and underreported. Despite this trend and the potential public health threat, there are no reliable data, and little is known about these arboviral co-circulation infections.

Abstract With the advent of long-term human habitation in space and on the moon, understanding how the built environment microbiome of space habitats differs from Earth habitats, and how microbes survive, proliferate and spread in space conditions, is becoming more important. The microbial tracking mission series has been monitoring the microbiome of the International Space Station (ISS) for almost a decade. During this mission series, six unique strains of Gram-stain-positive bacteria, including two spore-forming and three non-spore-forming species, were isolated from the environmental surfaces of the ISS. The analysis of their 16S rRNA gene sequences revealed > 99% similarities with previously described bacterial species. To further explore their phylogenetic affiliation, whole genome sequencing was undertaken. For all strains, the gyrB gene exhibited

Abstract Introduction Shock-induced endotheliopathy (SHINE), defined as a profound sympathoadrenal hyperactivation in shock states leading to endothelial activation, glycocalyx damage, and eventual compromise of end-organ perfusion, was first described in 2017. The aggressive resuscitation therapies utilised in treating shock states could potentially lead to further worsening endothelial activation and end-organ dysfunction. Objective This study aimed to systematically review the literature on resuscitation-associated and resuscitation-induced endotheliopathy. Methods A predetermined structured search of literature published over an 11-year and 6-month period (1 January 2011 to 31 July 2023) was performed in two indexed databases (PubMed/MEDLINE and Embase) per PRISMA guidelines. Inclusion was restricted to original studies published in English (or with English translation) reporting on endothelial dysfunction in critically ill human subjects undergoing resuscitation interventions. Reviews or studies conducted in animals were excluded. Qualitative synthesis of studies meeting the inclusion criteria was performed. Studies reporting comparable biomarkers of endothelial dysfunction post-resuscitation were included in the quantitative meta-analysis. Results Thirty-two studies met the inclusion criteria and were included in the final qualitative synthesis. Most of these studies (47%) reported on a combination of mediators released from endothelial cells and biomarkers of glycocalyx breakdown, while only 22% reported on microvascular flow changes. Only ten individual studies were included in the quantitative meta-analysis based on the comparability of the parameters assessed. Eight studies measured syndecan-1, with a heterogeneity index, I 2 = 75.85% (pooled effect size, mean = 0.27; 95% CI − 0.07 to 0.60; p = 0.12). Thrombomodulin was measured in four comparable studies (I 2 = 78.93%; mean = 0.41; 95% CI − 0.10 to 0.92; p = 0.12). Three studies measured E-selectin (I 2 = 50.29%; mean = − 0.15; 95% CI − 0.64 to 0.33; p = 0.53), and only two were comparable for the microvascular flow index, MFI (I 2 = 0%; mean = − 0.80; 95% CI − 1.35 to − 0.26; p

Abstract This work reports experimental investigation and numerical validation of millimeter-sized Spherical Bragg Resonators (SBRs) fabricated using 3D printing technology. The frequency dependencies of the reflection and transmission coefficients were analyzed, and eigenfrequency values were calculated to examine the density of photonic states in air/PLA-polylactide SBRs, showing the appearance of an eigenmode and an increase in the local density of states in the core of a defect cavity. A decay rate enhancement of $${\sim 10}^{2}$$ ∼ 10 2 was obtained for a dipole placed in the core of the defect SBR. The study also investigated the influence of the source position on the resonator's electromagnetic wave energy. Scattering efficiencies up to order twelve of the multipole electric and magnetic contribution in a 10-layer SBR were calculated to validate the presence of the resonant modes observed in the scattering measurements performed for parallel and perpendicular polarizations. The results demonstrate that SBRs can act as omnidirectional cavities to enhance or inhibit spontaneous emission processes by modifying the density of electromagnetic states compared to free space. This finding highlights the potential of SBRs engineering spontaneous electromagnetic emission processes in various applications, including dielectric nanoantennas, optoelectronics devices, and quantum information across the entire electromagnetic spectrum.

Abstract We have prepared novel potent breast cancer drug molecules from non-toxic and inexpensive method. Column chromatography is not necessary for purification of target molecules. The value of overall atom economy, environmental factor, environmental catalyst and product mass intensity gives additional merits for this synthetic method. Synthesized flexible dimeric imidazolium bromides showed less toxicity and gives excellent anticancer response against normal mammary epithelial cells. Novel dimeric pyridinium bromides showed excellent anticancer response against tested cancer cell lines. In cell cycle, novel flexible dimeric pyridinium bromides showed significant arrest in the G2/M phase by nearly three folds, when compared with control drug. We have studied the targeting epidermal growth factor receptor for all the synthesized flexible amino substituted and methyl substituted dimeric pyridinium bromides.

The role of the Academy of Family Physicians of India (AFPI) has been vital in promoting family medicine in India. Through its various initiatives, the AFPI has worked to enhance the quality of healthcare services, support the professional development of family physicians, and advocate for policies that recognize and strengthen the role of primary care in the healthcare system. By fostering education, research, and collaboration, the AFPI is working toward a healthcare system where everyone can access comprehensive and continuous primary care. This paper summarizes the vision, mission, goals, and objectives of AFPI.

Objectives: To understand the pattern of hysterosalpingographic (HSG) findings and annual trends among Ghanaian women with infertility over a five-year period. Methods: We retrospectively evaluated the hospital medical records of women with infertility who underwent HSG at a major tertiary center in Ghana between January 2018 and December 2022. The data was statistically analyzed. Results: The subjects comprised of 2324 Ghanaian women diagnosed with clinical infertility. HSG identified 1685 (72.5%) with primary infertility and they were also younger women with a mean age of 32.2±4.5 years. The remaining 639 (27.5%) women had secondary infertility and were older (34.2±5.3 years; p < 0.001). Primary infertility rate decreased with increasing age (p < 0.001). Bilateral tubal blockage was seen in 701 (41.6%) women with primary infertility and 365 (57.1%) women with secondary infertility. Hydrosalpinx was present in 236 (10.2%) women, fimbrial adhesions in 444 (19.1%), Asherman’s syndrome in four (0.2%), and bilateral beaded tubes/tubercular salpingitis in five (0.2%). HSG was unable to detect infertility-related abnormalities in 513 (22.1%) women despite their clinical infertility. The majority of patients (1502; 64.6%) had tubal blockage: bilateral in 1066 (45.9%) and unilateral in 436 (18.8%). Conclusions: Infertility rates among Ghanaian women increased at an accelerating rate over the years. Primary infertility was significantly more prevalent among younger women. Tubal and cervical abnormalities were the most prevalent HSG findings.

Key Clinical Message Acute leukemia, particularly AML, is closely associated with thrombotic events, driven by complex factors like coagulation system changes, endothelial dysfunction, and leukemic cell interactions with the vascular system. Certain chemotherapy drugs can exacerbate the prothrombotic state. Understanding these dynamics is crucial for effective thromboprophylaxis in carefully selected patients with leukemia. Abstract Thrombosis is a significant complication of acute leukemia. Thrombotic events mostly occur at diagnosis or during induction therapy. Here we report the occurrence of myocardial infarction (MI) before initiation of therapy, in a patient with acute myeloid leukemia not otherwise specified (AML NOS) who had no other significant risk factors for coronary artery disease. The occurrence of MI in this patient limited the choice of induction therapy and resulted in mortality. We discuss the pathogenesis and risk factors associated with increased thrombosis in AML and advocate for risk‐adapted thromboprophylaxis in this patient population.

Objective: Cervical cancer screening coverage remains low in many countries worldwide. Self-sampling approach for cervical cancer screening has a good potential to improve the screening coverage. This study aims to compare different types of HPV self-sampling devices for cervical cancer screening to identify the most accurate and acceptable device(s). Methods: A systematic review was performed on data extracted from all studies specific to HPV self-sampling devices by searching relevant articles in PubMed, Google Scholar, Scopus, Web of Science, ScienceDirect, Cochrane Library, and EBSCO published from 2013 to October 2023. The study was registered in PROSPERO (CRD42022375682). Results: Overall, 70 papers met the eligibility criteria for this systematic review and were included in the analysis: 22 studies reported self-sampling devices diagnostic accuracy, 32 studies reported self-sampling devices acceptability and 16 studies reported both (accuracy and acceptability). The most popular self-sampling devices were Evalyn Brush, FLOQ Swab, Cervex-Brush, and Delphi Screener. Out of overall 38 studies analyzing self-sampling devices’ diagnostic accuracy, 94.7% of studies reported that self-collected specimens provided sensitivity and specificity comparable with clinician-collected samples; acceptability of Evalyn Brush, FLOQ Swab, Delphi Screener, and Colli-Pee, varied between 84.2% and 100%. Conclusion: The self-sampling approach has a good potential to increase cervical cancer screening coverage. Evalyn Brush, Cervex-Brush, FLOQ Swab, and Delphi Screener self-sampling devices for HPV detection were the most commonly utilized and found to be the most accurate, and patient-acceptable. HPV detection accuracy using these self-sampling devices had no significant difference compared to the sampling performed by healthcare providers.

Aldehydes, being an integral part of carbon metabolism, energy generation, and signalling pathways, are ingrained in plant physiology. Land plants have developed intricate metabolic pathways which involve production of reactive aldehydes and its detoxification to survive harsh terrestrial environments. Here, we show that physiologically produced aldehydes, i.e., formaldehyde and methylglyoxal in addition to acetaldehyde, generate adducts with aminoacyl-tRNAs, a substrate for protein synthesis. Plants are unique in possessing two distinct chiral proofreading systems, D-aminoacyl-tRNA deacylase1 (DTD1) and DTD2, of bacterial and archaeal origins, respectively. Extensive biochemical analysis revealed that only archaeal DTD2 can remove the stable D-aminoacyl adducts on tRNA thereby shielding archaea and plants from these system-generated aldehydes. Using Arabidopsis as a model system, we have shown that the loss of DTD2 gene renders plants susceptible to these toxic aldehydes as they generate stable alkyl modification on D-aminoacyl-tRNAs, which are recycled only by DTD2. Bioinformatic analysis identifies the expansion of aldehyde metabolising repertoire in land plant ancestors which strongly correlates with the recruitment of archaeal DTD2. Finally, we demonstrate that the overexpression of DTD2 offers better protection against aldehydes than in wild type Arabidopsis highlighting its role as a multi-aldehyde detoxifier that can be explored as a transgenic crop development strategy.

A single 300 mg dose of tafenoquine, in combination with chloroquine, is currently approved in several countries for the radical cure (prevention of relapse) of Plasmodium vivax malaria in patients aged ≥16 years. Recently, however, Watson et al. suggested that the approved dose of tafenoquine is insufficient for radical cure, and that a higher 450 mg dose could reduce P. vivax recurrences substantially (Watson et al., 2022). In this response, we challenge Watson et al.'s assertion based on empirical evidence from dose-ranging and pivotal studies (published) as well as real-world evidence from post-approval studies (ongoing, therefore currently unpublished). We assert that, collectively, these data confirm that the benefit–risk profile of a single 300 mg dose of tafenoquine, co-administered with chloroquine, for the radical cure of P. vivax malaria in patients who are not G6PD-deficient, continues to be favourable where chloroquine is indicated for P. vivax malaria. If real-world evidence of sub-optimal efficacy in certain regions is observed or dose-optimisation with other blood-stage therapies is required, then well-designed clinical studies assessing safety and efficacy will be required before higher doses are approved for clinical use.

BackgroundTypical pneumonia is a pressing issue in the treatment of human immunodeficiency virus (HIV) patients, especially in Sub-Saharan Africa, where it remains a significant menace. Addressing this problem is crucial in improving health outcomes and the reduction of the burden of diseases in this vulnerable category of patients.ObjectiveTo determine the prevalence of community-acquired typical pneumonia among HIV patients in Public Hospitals in southern Ethiopia.MethodsA cross-sectional study was done among 386 HIV patients clinically suspected of typical pneumonia attending the anti-retroviral therapy (ART) clinics of two hospitals from March to September 2022. A pretested structured questionnaire was employed to collect the demographic, clinical, and behavioral data. Sputum samples were collected and inspected for bacteria following standard procedures, and antimicrobial susceptibility testing was performed employing the Kirby-Bauer disk diffusion method. Besides, extended-spectrum β-lactamase (ESβL) and carbapenemase-producing Gram-negative bacteria were inspected by the double disk synergy test and modified carbapenem inactivation method. Descriptive and inferential statistical analyses were also done.ResultsOverall, 39.1% (151/386) of sputum cultures (95% Confidence Interval: 32.4-44) were bacteriologically positive. A total of 151 bacteria were identified, comprising 72.8% (n = 110) of Gram-negative bacteria. The predominant isolate was Klebsiella pneumoniae (25.8%, n = 39), followed by Staphylococcus aureus (17.9%, n = 27); 59.6% (n = 90) of the entire isolates were multidrug-resistant (MDR). Forty percent (11/27) of S. aureus were methicillin-resistant S. aureus (MRSA), and 28.1% (n = 31) and 20.9% (n = 23) of Gram-negative bacteria were extended-spectrum beta-lactamases (ESBL) and carbapenemase producers, respectively. Occupational status, alcohol consumption, cluster of differentiation4 (CD4) Thymocyte cell count < 350, interruption of trimethoprim-sulfamethoxazole prophylaxis and antiretroviral treatment, and recent viral load ≥ 150 were found statistically significant.ConclusionThe higher rates of MDR, MRSA, ESBL, and carbapenem-resistant Enterobacterales (CRE) indicate that bacterial pneumonia is a vexing problem among HIV patients and therefore it is advisable to implement an antimicrobial stewardship program in the study area.

The world's health, economic, and social systems have been adversely impacted by the COVID-19 pandemic. With lockdown measures being a common response strategy in most countries, many individuals were faced with financial and mental health challenges. The current study explored the effect of the COVID-19 pandemic on the psychological well-being, perception of risk factors and coping strategies of two vulnerable groups in Malaysia, namely women and older adults from low-income households (USD592). A purposive sample of 30 women and 30 older adults was interviewed via telephone during Malaysia's Movement Control Order (MCO) regarding the challenges they faced throughout the pandemic. Thematic analysis was subsequently conducted to identify key themes. The themes identified from the thematic analysis indicated a degree of overlap between both groups. For women, seven themes emerged: 1) Psychological challenges due to COVID-19 pandemic, 2) Family violence, 3) Finance and employment related stress and anxiety, 4) Women's inequality and prejudice, 5) Coping strategies, 6) Professional support, and 7) Women's empowerment. Similarly, there were six themes for the older adults: 1) Adverse emotional experiences from COVID-19, 2) Threats to health security, 3) Loss of social connections, 4) Government aid to improve older adults' psychological well-being, 5) Psychological support from family members and pets, and 6) Self-reliance, religion, and spirituality. The findings provide valuable information on the specific burdens faced by these groups, and support psychological interventions and mitigations that would be appropriate to improve well-being during the recovery phase.