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Biomedical Quality Engineers (QEs) ensure that medical devices are safe, reliable, and consistent. To better understand career pathways for biomedical QEs, we (1) quantified the prevalence of QE skills in entry-level biomedical engineering (BME) job listings and (2) interviewed seven biomedical Quality Engineers with a BME bachelor's degree. We mapped participant responses to the mechanisms in Social Cognitive Career Theory and identified common career pathways for biomedical QEs. To our surprise, over 40% of entry-level BME jobs were QE positions and 70% required QE-related skills. The interview participants were unaware of careers in QE careers as undergraduates and learned about QE while entering the job market--a surprising finding given the prevalence of entry-level QE jobs. The participants had low outcome expectations for QE careers and higher outcome expectations for research and development positions; instructors should be aware that a design-focused curriculum can bias students against QE careers. BME departments should introduce QE topics and experiences to help students make informed career decisions and be competitive in the sizable biomedical QE job market.

Abstract Several farmed fish species, including carps, tilapia, salmon, and catfish, have experienced significant economic losses in aquaculture due to motile Aeromonas septicemia caused by Aeromonas hydrophila. In the present study, a novel lytic bacteriophage infecting hypervirulent Aeromonas hydrophila (vAh) was isolated and characterized. This is the first report of a phage against vAh. Phage AhFM11 demonstrated lytic activity against both vAh strains and the A. hydrophila reference strain ATCC 35654. The AhFM11 genome was sequenced and assembled, comprising 168,243 bp with an average G + C content of 41.5%. The genome did not harbor any antibiotic resistance genes. Genomic information along with transmission electron microscopy revealed that phage AhFM11 belongs to the Straboviridae family. Therapeutic application of monophage AhFM11 in fish showed 100% survival in injection, 95% in immersion and 93% in oral feeding of phage top-coated feed. Fish and chicken meat spiked with A. hydrophila and phage showed significant reduction of A. hydrophila. These findings support that phage AhFM11 can be used as a biocontrol agent against vAh as an alternative to antibiotics.

Introduction: Helicobacter pylori (H. pylori), despite its high prevalence in the Indian population, has been subjected to limited studies concerning its potential role as a risk factor for Metabolic Syndrome (MetS) and Insulin Resistance (IR). Proposed mechanisms include inflammatory mediators, atherogenic lipid profiles, and vasoconstriction. Aim: To determine the association between H. pylori infection and MetS components, focusing on Highly sensitive C-Reactive Protein (hs-CRP) levels, to enhance understanding and management of these conditions. Materials and Methods: This cross-sectional study was conducted at the Department of Medicine, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, Maharashtra, India spanning from September 2017 to August 2019. This study involved 100 dyspeptic patients aged 18 years or older undergoing upper Gastrointestinal (GI) endoscopy. Data collection included fasting/postprandial blood parameters, serum lipids, hs-CRP, and H. pylori detection via both rapid urease test and Histopathological Examination (HPE). Physical assessments covered height, weight, Waist Circumference (WC), and blood pressure. MetS was evaluated using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Statistical analysis employed unpaired t-tests, Chi-square tests, and Fisher-Exact tests using IBM Statistical Package for Social Sciences (SPSS) version 21.0. Results: The study of 100 dyspeptic patients, predominantly females, revealed a significant association between H. pylori infection and MetS (p-value

Abstract Oligodeoxynucleotides containing CpG motifs (CpG-ODN) can promote antimicrobial immunity in chickens by enriching immune compartments and activating immune cells. Innate memory, or trained immunity, has been demonstrated in humans and mice, featuring the absence of specificity to the initial stimulus and subsequently cross-protection against pathogens. We hypothesize that CpG-ODN can induce trained immunity in chickens. We delivered single or multiple administrations of CpG-ODN to birds and mitochondrial oxidative phosphorylation (OXPHOS) and glycolysis of peripheral blood mononuclear cells were quantified using Seahorse XFp. Next, chickens were administered with CpG-ODN twice at 1 and 4 day of age and challenged with Escherichia coli at 27 days of age. The CpG-ODN administered groups had significantly higher mitochondrial OXPHOS until 21 days of age while cellular glycolysis gradually declined by 14 days of age. The group administered with CpG-ODN twice at 1 and 4 days of age had significantly higher survival, lower clinical score and bacterial load following challenge with E. coli at 27 d of age. This study demonstrated the induction of trained immunity in broiler chickens following administration of CpG-ODN twice during the first 4 days of age to protect birds against E. coli septicemia at 27 days of age.

Abstract Background Rare disorders comprise of ~ 7500 different conditions affecting multiple systems. Diagnosis of rare diseases is complex due to dearth of specialized medical professionals, testing labs and limited therapeutic options. There is scarcity of data on the prevalence of rare diseases in different populations. India being home to a large population comprising of 4600 population groups, of which several thousand are endogamous, is likely to have a high burden of rare diseases. The present study provides a retrospective overview of a cohort of patients with rare genetic diseases identified at a tertiary genetic test centre in India. Results Overall, 3294 patients with 305 rare diseases were identified in the present study cohort. These were categorized into 14 disease groups based on the major organ/ organ system affected. Highest number of rare diseases (D = 149/305, 48.9%) were identified in the neuromuscular and neurodevelopmental (NMND) group followed by inborn errors of metabolism (IEM) (D = 47/305; 15.4%). Majority patients in the present cohort (N = 1992, 61%) were diagnosed under IEM group, of which Gaucher disease constituted maximum cases (N = 224, 11.2%). Under the NMND group, Duchenne muscular dystrophy (N = 291/885, 32.9%), trinucleotide repeat expansion disorders (N = 242/885; 27.3%) and spinal muscular atrophy (N = 141/885, 15.9%) were the most common. Majority cases of β-thalassemia (N = 120/149, 80.5%) and cystic fibrosis (N = 74/75, 98.7%) under the haematological and pulmonary groups were observed, respectively. Founder variants were identified for Tay-Sachs disease and mucopolysaccharidosis IVA diseases. Recurrent variants for Gaucher disease (GBA:c.1448T > C), β-thalassemia (HBB:c.92.+5G > C), non-syndromic hearing loss (GJB2:c.71G > A), albinism (TYR:c.832 C > T), congenital adrenal hyperplasia (CYP21A2:c.29–13 C > G) and progressive pseudo rheumatoid dysplasia (CCN6:c.298T > A) were observed in the present study. Conclusion The present retrospective study of rare disease patients diagnosed at a tertiary genetic test centre provides first insight into the distribution of rare genetic diseases across the country. This information will likely aid in drafting future health policies, including newborn screening programs, development of target specific panel for affordable diagnosis of rare diseases and eventually build a platform for devising novel treatment strategies for rare diseases.

Introduction: Damage Associated Molecular Patterns (DAMPs) can initiate and amplify immune responses and can play an important role in the sustenance and progression of periodontal diseases. S100A8, S100A9 and their heterodimer, S100A8/9, are DAMPs or alarmins currently being evaluated for their potential as biomarkers in periodontal diseases. Aim: To quantify and compare salivary levels of S100A8, S100A9 and S100A8/9 in periodontal health, gingivitis or stage 1 periodontitis and stages 3 or 4 periodontitis. Materials and Methods: A cross-sectional analytical study was carried out in the Department of Periodontics, Saveetha Dental College and Hospital, Chennai, India, from December 2022 to February 2023. Periodontal examination and saliva sample collection were done for sixty-eight consecutively enrolled subjects who met the inclusion and exclusion criteria. Study subjects were categorised as group 1, which comprised participants with clinical periodontal health (n=20), group 2, subjects with gingivitis or stage 1 periodontitis (n=20), and group 3, which included patients with stages 3 or 4 periodontitis (n=28). Detailed clinical examination and periodontal charting were done in all study subjects. Saliva samples were processed and stored at -80°C, and enzyme-linked immunosorbent assay was done to quantify S100A8, S100A9 and S100A8/9. Data were analysed using International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) software version 25.0. Salivary levels of S100A8, S100A9 and S100A8/9 were expressed as mean and standard deviation values. Mean values of the three salivary proteins were compared using the non parametric Kruskal-Wallis test. Bonferroni adjusted pairwise comparisons were also done. The p-values less than 0.05 were considered statistically significant. Results: The mean age of study participants was 38.97±7.62 years. Salivary levels of S100A8 were 41.34±14.34, 141.95± 185.25 and 901.37±65.60 pg/mL in groups 1, 2 and 3, respectively. A statistically significant difference was present among the three groups for mean salivary levels of S100A8 (p-value

Abstract This research paper introduces an avant-garde poly-input DC–DC converter (PIDC) meticulously engineered for cutting-edge energy storage and electric vehicle (EV) applications. The pioneering converter synergizes two primary power sources—solar energy and fuel cells—with an auxiliary backup source, an energy storage device battery (ESDB). The PIDC showcases a remarkable enhancement in conversion efficiency, achieving up to 96% compared to the conventional 85–90% efficiency of traditional converters. This substantial improvement is attained through an advanced control strategy, rigorously validated via MATLAB/Simulink simulations and real-time experimentation on a 100 W test bench model. Simulation results reveal that the PIDC sustains stable operation and superior efficiency across diverse load conditions, with a peak efficiency of 96% when the ESDB is disengaged and an efficiency spectrum of 91–95% during battery charging and discharging phases. Additionally, the integration of solar power curtails dependence on fuel cells by up to 40%, thereby augmenting overall system efficiency and sustainability. The PIDC’s adaptability and enhanced performance render it highly suitable for a wide array of applications, including poly-input DC–DC conversion, energy storage management, and EV power systems. This innovative paradigm in power conversion and management is poised to significantly elevate the efficiency and reliability of energy storage and utilization in contemporary electric vehicles and renewable energy infrastructures.

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 Objective miR-497/195, located at 17p13.1, is a highly conserved miRNA cluster whose abnormal expression is a key regulator of carcinogenesis. We performed a comprehensive analysis of the miR-497/195 cluster to determine its prognostic utility and role in cervical cancer (CC) using publicly available datasets. Results In silico analysis and validation revealed that this cluster is downregulated in CC. A total of 60 target genes of miR-497/195 cluster were identified as differentially expressed between normal and CC samples. ShinyGO, STRING, CytoHubba, Timer 2.0, HPA, and HCMBD were used for functional enrichment, PPIN network construction, hub gene identification, immune infiltration correlation, histopathological expression, and determination of the metastatic potential of miR-497/195 cluster and their target genes. PPIN analysis identified CCNE1, CCNE2, ANLN, RACGAP1, KIF23, CHEK1, CDC25A, E2F7, CDK1, and CEP55 as the top 10 hub genes (HGs). Furthermore, the upregulation of RECK, ATD5, and BCL2, downregulation of OSBPL3, RCAN3, and HIST1H3H effected overall survival of CC patients. We identified 6 targets (TFAP2A, CLSPN, RASEF, HIST1H3H, AKT3, and ITPR1) of miR-497/195 cluster to influence metastasis. In addition, 8 druggable genes and 38 potential drugs were also identified. Our study identified miR-497/195 cluster target genes and pathways that could be used for prognostic and therapeutic applications in CC.

Abstract Background Efficient doctor-patient communication is essential for improving patient care. The impact of educational interventions on the communication skills of male and female students has not been systematically reviewed. The aim of this review is to identify interventions used to improve communication skills in medical curricula and investigate their effectiveness in improving the communication skills of male and female medical students. Methods A systematic review of the literature was conducted using the PRISMA guidelines. Inclusion criteria were as follows: used intervention strategies aiming to improve communication skills, participants were medical students, and studies were primary research studies, systematic reviews, or meta-analyses. Results 2913 articles were identified based on search terms. After title, abstract, and full-text review, 58 studies were included with interventions consisting of Training or Drama Courses, Curriculum-Integrated, Patient Learning Courses, and Community-Based Learning Courses. 69% of articles reported improved communication skills for both genders equally, 28% for women more than men, and 3% for men more than women. 16 of the 58 articles reported numerical data regarding communication skills pre-and post-intervention. Analysis revealed that post-intervention scores are significantly greater than pre-intervention scores for both male (p

Coronal fracture of the anterior teeth is a commonly occurring dental trauma often seen in young individuals. Such fractures can be conservatively managed with fragment reattachment procedure when the fragment is available and preserved in correct storage media. Due to advancements in adhesive dentistry, fragment reattachment is a simple, esthetic and fast treatment option. This article reports a case of fragment reattachment of a complicated crown root fracture using fibre post as an intraradicular splint.

Abstract The purpose of the current study was to examine chemical composition, antioxidant, anti-inflammatory and antibacterial properties of leaves extract of Ajuga integrifolia Buch.-Ham. The antibacterial and antioxidant properties of three different solvents i.e. methanol (AIM), hexane (AIH), and water (AIW) were tested against two bacterial strains Staphylococcus aureus and Escherichia coli. The presence of antioxidant and antibacterial chemicals, such as hexanedioic acid, hexadecanoic acid, nonadecadiene, hexadecen-1-ol, octadecadienoic acid, nonane, phytol, henicosanal, stearyl aldehyde, and neophytadiene, were depicted in the GCMS chromatograms of three extracts. After the extracts' FTIR peaks were examined, it was discovered that phenols, amines, hydroxy groups, and components linked to amino acids were present. Compared to the Hexane and Water extracts, the Methanol extract showed a greater phenolic (196.16 ± 0.0083 mg gallic acid equivalent/gram), flavonoid (222.77 ± 0.002 mg rutin equivalents/g) and phosphomolybdate assay for total antioxidant activity (557.62 ± 0.0023 mg AAE/g). Methanol extract showed the highest scavenging activity with a minimum IC50 value was observed in DPPH assay. AIM showed its maximum anti-denaturation activity i.e. 3.75 ± 0.28%. For antibacterial activities, best zone of inhibition (ZOI) and minimum inhibitory concentration (MIC) was observed in case of the methanol extract as compared to other extracts against methicillin-resistant Staphylococcus aureus and β-lactam-resistant Escherichia coli.

Abstract Flue gas emissions are the waste gases produced during the combustion of fuel in industrial processes, which are released into the atmosphere. These identical processes also produce a significant amount of wastewater that is released into the environment. The current investigation aims to assess the viability of simultaneously mitigating flue gas emissions and remediating wastewater in a bubble column bioreactor utilizing bacterial consortia. A comparative study was done on different growth media prepared using wastewater. The highest biomass yield of 3.66 g L−1 was achieved with the highest removal efficiencies of 89.80, 77.30, and 80.77% for CO2, SO2, and NO, respectively. The study investigated pH, salinity, dissolved oxygen, and biochemical and chemical oxygen demand to assess their influence on the process. The nutrient balance validated the ability of bacteria to utilize compounds in flue gas and wastewater for biomass production. The Fourier Transform–Infrared Spectrometry (FT–IR) and Gas Chromatography–Mass Spectrometry (GC–MS) analyses detected commercial-use long-chain hydrocarbons, fatty alcohols, carboxylic acids, and esters in the biomass samples. The nuclear magnetic resonance (NMR) metabolomics detected the potential mechanism pathways followed by the bacteria for mitigation. The techno-economic assessment determined a feasible total capital investment of 245.74$ to operate the reactor for 288 h. The bioreactor’s practicability was determined by mass transfer and thermodynamics assessment. Therefore, this study introduces a novel approach that utilizes bacteria and a bioreactor to mitigate flue gas and remediate wastewater.

Abstract In response to the COVID-19 pandemic, the American Board of Anesthesiology transitioned from in-person to virtual administration of its APPLIED Examination, assessing more than 3000 candidates for certification purposes remotely in 2021. Four hundred examiners were involved in delivering and scoring Standardized Oral Examinations (SOEs) and Objective Structured Clinical Examinations (OSCEs). More than 80% of candidates started their exams on time and stayed connected throughout the exam without any problems. Only 74 (2.5%) SOE and 45 (1.5%) OSCE candidates required rescheduling due to technical difficulties. Of those who experienced “significant issues”, concerns with OSCE technical stations (interpretation of monitors and interpretation of echocardiograms) were reported most frequently (6% of candidates). In contrast, 23% of examiners “sometimes” lost connectivity during their multiple exam sessions, on a continuum from minor inconvenience to inability to continue. 84% of SOE candidates and 89% of OSCE candidates described “smooth” interactions with examiners and standardized patients/standardized clinicians, respectively. However, only 71% of SOE candidates and 75% of OSCE candidates considered themselves to be able to demonstrate their knowledge and skills without obstacles. When compared with their in-person experiences, approximately 40% of SOE examiners considered virtual evaluation to be more difficult than in-person evaluation and believed the remote format negatively affected their development as an examiner. The virtual format was considered to be less secure by 56% and 40% of SOE and OSCE examiners, respectively. The retirement of exam materials used virtually due to concern for compromise had implications for subsequent exam development. The return to in-person exams in 2022 was prompted by multiple factors, especially concerns regarding standardization and security. The technology is not yet perfect, especially for testing in-person communication skills and displaying dynamic exam materials. Nevertheless, the American Board of Anesthesiology’s experience demonstrated the feasibility of conducting large-scale, high-stakes oral and performance exams in a virtual format and highlighted the adaptability and dedication of candidates, examiners, and administering board staff.

Abstract Background Effective mentorship is an important component of medical education with benefits to all stakeholders. In recent years, conceptualization of mentorship has gone beyond the traditional dyadic experienced mentor-novice mentee relationship to include group and peer mentoring. Existing theories of mentorship do not recognize mentoring’s personalized, evolving, goal-driven, and context-specific nature. Evidencing the limitations of traditional cause-and-effect concepts, the purpose of this review was to systematically search the literature to determine if mentoring can be viewed as a complex adaptive system (CAS). Methods A systematic scoping review using Krishna’s Systematic Evidence-Based Approach was employed to study medical student and resident accounts of mentoring and CAS in general internal medicine and related subspecialties in articles published between 1 January 2000 and 31 December 2023 in PubMed, Embase, PsycINFO, ERIC, Google Scholar, and Scopus databases. The included articles underwent thematic and content analysis, with the themes identified and combined to create domains, which framed the discussion. Results Of 5,704 abstracts reviewed, 134 full-text articles were evaluated, and 216 articles were included. The domains described how mentoring relationships and mentoring approaches embody characteristics of CAS and that mentorship often behaves as a community of practice (CoP). Mentoring’s CAS-like features are displayed through CoPs, with distinct boundaries, a spiral mentoring trajectory, and longitudinal mentoring support and assessment processes. Conclusion Recognizing mentorship as a CAS demands the rethinking of the design, support, assessment, and oversight of mentorship and the role of mentors. Further study is required to better assess the mentoring process and to provide optimal training and support to mentors.

Abstract Background: Cardiovascular diseases are the major non-communicable disease causing increased mortality and morbidity worldwide. Among cardiovascular diseases, coronary artery disease is one of the life-threatening diseases. The majority of patients, after the acute event of coronary artery disease, suffer from mental stress, depression, and cognitive impairments. Therefore, this study mainly focuses on the effect of the Cognitive and Emotional Impairment Management Bundle (CEIMB) among patients with coronary artery disease. Methods: This randomized, controlled, double-blinded trial was conducted in a tertiary care center among patients with coronary artery disease. The samples were recruited from the coronary intensive care unit through purposive sampling technique. After the sample selection, they were allotted to control (n 1 = 55) and intervention (n 2 = 56) groups through block randomization. The intervention was provided through three sessions. The study was registered under the Clinical Trial registry of the country. The statistical analysis was done using the SPSS ver. 25. The analysis was done by mean, standard deviation, frequency, percentage, and two-way repeated measures ANOVA. Results: The mean age of the participants in the control group was 56.6 ± 6.1 years, and in the experimental group was 57.6 ± 6.4 years. The majority of the participants (39.3%) in the intervention group had severe depression, moderate levels of stress (30.4%), and medication adherence (96.4%). In the experimental group, depression, stress, medication adherence, and cognition had a statistically significant difference at different periods ( < 0.05). Conclusion: The impaired mental status and cognitive level of the patients after the cardiac event negatively influences the patient's prognosis, contributing to readmission and premature death.

Abstract Advances in tagging technologies are expanding opportunities to estimate survival of fish and wildlife populations. Yet, capture and handling effects could impact survival outcomes and bias inference about natural mortality processes. We developed a multistage time-to-event model that can partition the survival process into sequential phases that reflect the tagged animal experience, including handling and release mortality, post-release recovery mortality, and subsequently, natural mortality. We demonstrate performance of multistage survival models through simulation testing and through fish and bird telemetry case studies. Models are implemented in a Bayesian framework and can accommodate left, right, and interval censorship events. Our results indicate that accurate survival estimates can be achieved with reasonable sample sizes ( $$n\approx 100+)$$ n ≈ 100 + ) and that multimodel inference can inform hypotheses about the configuration and length of survival stages needed to adequately describe mortality processes for tracked specimens. While we focus on survival estimation for tagged fish and wildlife populations, multistage time-to-event models could be used to understand other phenomena of interest such as migration, reproduction, or disease events across a range of taxa including plants and insects.

Abstract Spatial and temporal shifts in rainfall patterns over South Asia and the adjoining Seas during the pre-monsoon season have been observed over the past 2 decades from 2000 to 2019. Aerosol particles suspended above the boundary layer are a contributing factor to these changes. These particles not only alter cloud characteristics, but also diminish the lapse rate, thereby suppressing convective activity, leading to precipitation anomalies. Over the past 2 decades, high-rainfall regions have experienced declining rainfall, while low-rainfall regions have received increased rainfall. Coinciding with notable anomalies in precipitation, contrasting trends in aerosol optical depth, particularly due to absorbing aerosols in the elevated regions of the atmosphere, are seen. Apart from aerosols, several factors are considered that are critical in modifying precipitation patterns over the study region, such as water vapor content, convective processes, and lower-level relative humidity. We observed a potential transport of excess water vapor by ambient circulation from the oceanic regions having reduced rain, such as Bay of Bengal and the Arabian Sea, to higher latitudes enabling precipitation anomaly at distant locations.

Abstract Optimized production of Aspergillus niger ATCC 26011 endo-β-mannanase (ManAn) on copra meal resulted in 2.46-fold increase (10,028 U/gds). Purified ManAn (47 kDa) showed high affinity towards guar gum (GG) as compared to konjac gum and locust bean gum with Km 2.67, 3.25 and 4.07 mg/mL, respectively. ManAn efficiently hydrolyzed GG and liberated mannooligosaccharides (MOS). Changes occurring in the rheological and compositional aspects of GG studied using Differential scanning calorimetry (DSC), Thermal gravimetric analysis (TGA) and X-ray diffraction (XRD) revealed increased thermal stability and crystallinity of the partially hydrolyzed guar gum (PHGG). Parametric optimization of the time and temperature dependent hydrolysis of GG (1% w/v) with 100 U/mL of ManAn at 60 °C and pH: 5.0 resulted in 12.126 mg/mL of mannotetraose (M4) in 5 min. Enhanced growth of probiotics Lactobacilli and production of short chain fatty acids (SCFA) that inhibited enteropathogens, confirmed the prebiotic potential of PHGG and M4.

Abstract Brain-inspired resistive random-access memory (RRAM) technology is anticipated to outperform conventional flash memory technology due to its performance, high aerial density, low power consumption, and cost. For RRAM devices, metal oxides are exceedingly investigated as resistive switching (RS) materials. Among different oxides, tin oxide (SnOx) received minimal attention, although it possesses excellent electronic properties. Herein, we demonstrate compliance-free, analog resistive switching behavior with several stable states in Ti/Pt/SnOx/Pt RRAM devices. The compliance-free nature might be due to the high internal resistance of SnOx films. The resistance of the films was modulated by varying Ar/O2 ratio during the sputtering process. The I–V characteristics revealed a well-expressed high resistance state (HRS) and low resistance states (LRS) with bipolar memristive switching mechanism. By varying the pulse amplitude and width, different resistance states have been achieved, indicating the analog switching characteristics of the device. Furthermore, the devices show excellent retention for eleven states over 1000 s with an endurance of > 100 cycles.

Abstract The ongoing COVID-19 pandemic continues to pose significant challenges worldwide, despite widespread vaccination. Researchers are actively exploring antiviral treatments to assess their efficacy against emerging virus variants. The aim of the study is to employ M-polynomial, neighborhood M-polynomial approach and QSPR/QSAR analysis to evaluate specific antiviral drugs including Lopinavir, Ritonavir, Arbidol, Thalidomide, Chloroquine, Hydroxychloroquine, Theaflavin and Remdesivir. Utilizing degree-based and neighborhood degree sum-based topological indices on molecular multigraphs reveals insights into the physicochemical properties of these drugs, such as polar surface area, polarizability, surface tension, boiling point, enthalpy of vaporization, flash point, molar refraction and molar volume are crucial in predicting their efficacy against viruses. These properties influence the solubility, permeability, and bio availability of the drugs, which in turn affect their ability to interact with viral targets and inhibit viral replication. In QSPR analysis, molecular multigraphs yield notable correlation coefficients exceeding those from simple graphs: molar refraction (MR) (0.9860), polarizability (P) (0.9861), surface tension (ST) (0.6086), molar volume (MV) (0.9353) using degree-based indices, and flash point (FP) (0.9781), surface tension (ST) (0.7841) using neighborhood degree sum-based indices. QSAR models, constructed through multiple linear regressions (MLR) with a backward elimination approach at a significance level of 0.05, exhibit promising predictive capabilities highlighting the significance of the biological activity $$IC_{50}$$ I C 50 (Half maximal inhibitory concentration). Notably, the alignment of predicted and observed values for Remdesivir’s with obs $${pIC_{50} = 6.01}$$ p I C 50 = 6.01 ,pred $${pIC_{50} = 6.01}$$ p I C 50 = 6.01 ( $$pIC_{50}$$ p I C 50 represents the negative logarithm of $$IC_{50}$$ I C 50 ) underscores the accuracy of multigraph-based QSAR analysis. The primary objective is to showcase the valuable contribution of multigraphs to QSPR and QSAR analyses, offering crucial insights into molecular structures and antiviral properties. The integration of physicochemical applications enhances our understanding of factors influencing antiviral drug efficacy, essential for combating emerging viral strains effectively.

Abstract Mesenchymal stromal cells (MSC) from adult bone marrow are the most commonly used cells in clinical trials. MSCs from single donors are the preferred starting material but suffer from a major setback of being heterogeneous that results in unpredictable and inconsistent clinical outcomes. To overcome this, we developed a method of pooling MSCs from different donors and created cell banks to cater clinical needs. Initially, the master cell banks (MCBs) were created at passage 1 (P1) from the bone marrow MSCs isolated from of nine different donors. At this stage, MCBs from three different donors were mixed in equal proportion and expanded till P3 to create working cell banks. Further, the pooled cells and individual donor MSCs were expanded till P5 and cryopreserved and extensively characterised. There was a large heterogeneity among the individual donor MSCs in terms of growth kinetics (90% Coefficient of variation (CV) for cell yield and 44% CV for population doubling time at P5), immunosuppressive ability (30% CV at 1:1 and 300% CV at 1:10 ratio), and the angiogenic factor secretion potential (20% CV for VEGF and71% CV for SDF-1). Comparatively, the pooled cells have more stable profiles (60% CV for cell yield and 7% CV for population doubling time at P5) and exhibit better immunosuppressive ability (15% CV at 1:1 and 32% CV at 1:10 ratio ) and consistent secretion of angiogenic factors (16% CV for VEGF and 51% CV for SDF-1). Further pooling does not compromise the trilineage differentiation capacity or phenotypic marker expression of the MSCs. The senescence and in vitro tumourigenicity characteristics of the pooled cells are also similar to those of individual donor MSCs. We conclude that pooling of MSCs from three different donors reduces heterogeneity among individual donors and produces MSCs with a consistent secretion and higher immunosuppressive profile.

Background: Children who develop cytopenias present with several etiological causes, posing diagnosis, and management difficulties for both physicians and pathologists. With these in mind, we assessed the clinical profile and etiology of children who attended a healthcare facility in South India with bicytopenia or pancytopenia. Aims and Objectives: (1) The primary objective of this study was to find out the clinical and etiological spectrum in children with bicytopenia and pancytopenia who were admitted to the Institute of Child Health and Research Center, Government Rajaji Hospital, Madurai. (2) The secondary objective of this study is to follow-up children with bicytopenia and pancytopenia to find out the outcome and prognosis. Materials and Methods: This study was in the Department of Pediatrics at the Government Rajaji Hospital in Madurai, Madurai Medical College’s Institute of Child Health and Research Center, which is where we carried out the study. Two hundred and sixty-four patients with bicytopenia and 36 patients with pancytopenia were included in this study. Once in 2 weeks, all children with bicytopenia and pancytopenia were assessed in our Saturday hematology outpatient clinics. Results: Fever was the most prevalent sign of both pancytopenia and bicytopenia in this investigation. Etiological variables among cases of pancytopenia, cancer, infections, non-infections, and idiopathic causes were recorded in 11%, 58%, 17%, and 14% of cases, respectively. Similarly, bicytopenia, malignancy, infections, non-infections, and idiopathic causes were found in 23%, 70%, 4%, and 3% of cases, respectively. According to the prognosis, 28%, 33%, 6%, and 33% of cases with pancytopenia recovered, passed away, were lost to follow-up, or were undergoing treatment, respectively. Similar to those individuals, 67%, 11%, 4%, and 18% of bicytopenia cases were treated, recovered, or lost to follow-up, respectively. Conclusion: In children, there is a wide etiological range of cytopenias. Infections and dangerous diseases like acute leukemia are among the reasons. The geographical location of the hospital, the frequency of malnutrition, and the regional presence of certain diseases such as malaria and enteric fever determine the causes reported in a hospital environment.

Introduction: Sleep is a fundamental necessity for the human body, particularly for ensuring optimal brain function, and health science students are predisposed to experiencing lower-quality sleep than the general population. Aim: To assess the knowledge, attitudes, and awareness of health science students regarding the influence of sleep quality on the brain. Materials and Methods: This descriptive cross-sectional study included male and female students from diverse Colleges at King Saud bin Abdulaziz University for Health Sciences in Jeddah, Saudi Arabia, encompassing the College of Science and Health Professions, College of Medicine, College of Applied Medical Sciences, and College of Nursing. The study spanned one year, commencing in September 2022 and concluding in September 2023. It included 361 participants who completed a self-administered validated questionnaire. Participants were chosen through non probability consecutive sampling, and the questionnaire covered demographic characteristics, attitudes towards sleep quality, awareness of its importance, and knowledge of its impact on the brain. Data analysis encompassed descriptive statistics and inferential tests, including the Independent t-test, and Chi-square test with a significance level of p-value

A neonate born of third-degree consanguineous marriage presented on day 12 of life with congestive cardiac failure. A male sibling died at 3 months of age, cause of which was not known. He was treated with decongestive measures and multiple inotropes. 2D Echocardiogram revealed severe Left ventricular dysfunction with prominent trabeculations and deep recesses in the left ventricle suggestive of Left ventricular non-compaction. He was also found to have horse-shoe kidney. Considering the presence of cardiac left ventricular non compaction, horse-shoe kidney and family history of neonatal death and pregnancy loss clinical exome sequencing was done. It detected a homozygous missense variant in exon 6 of the AGK gene suggestive of Senger’s syndrome. Baby was on regular follow-up and was thriving well on diuretics, sacubitril-valsartan and weekly levosimendan infusions. At 8 months of age, cardiac transplantation was successfully done and baby has been doing well post-transplantation. LVNC in children is rare with an estimated incidence of 0.11 per 100,000, the highest incidence being during infancy. Senger’s syndrome is autosomal recessive in inheritance. Senger’s syndrome associated with Left ventricular non compaction has been reported only once in literature so far. Renal manifestations in the form of horse shoe kidney like in our index baby has not been reported previously with Senger’s syndrome.

Abstract The Schockley–Quisser (SQ) limit of 28.64% is distant from the Sb2S3 solar cells’ record power conversion efficiency (PCE), which is 8.00%. Such poor efficiency is mostly owing to substantial interface-induced recombination losses caused by defects at the interfaces and misaligned energy levels. The endeavor of this study is to investigate an efficient Sb2S3 solar cell structure via accurate analytical modeling. The proposed model considers different recombination mechanisms such as non-radiative recombination, Sb2S3/CdS interface recombination, Auger, SRH, tunneling-enhanced recombination, and their combined impact on solar cell performance. This model is verified against experimental work (Glass/ITO/CdS/Sb2S3/Au) where a good coincidence is achieved. Several parameters effects such as thickness, doping, electronic affinity, and bandgap are scrutinized. The effect of both bulk traps located in CdS and Sb2S3 on the electrical outputs of the solar cell is analyzed thoroughly. Besides, a deep insight into the effect of interfacial traps on solar cell figures of merits is gained through shedding light into their relation with carriers’ minority lifetime, diffusion length, and surface recombination velocity. Our research findings illuminate that the primary contributors to Sb2S3 degradation are interfacial traps and series resistance. Furthermore, achieving optimal band alignment by fine-tuning the electron affinity of CdS to create a Spike-like conformation is crucial for enhancing the immunity of the device versus the interfacial traps. In our study, the optimized solar cell configuration (Glass/ITO/CdS/Sb2S3/Au) demonstrates remarkable performance, including a high short-circuit current (J SC ) of 47.9 mA/cm2, an open-circuit voltage (V OC ) of 1.16 V, a fill factor (FF) of 54%, and a notable improvement in conversion efficiency by approximately 30% compared to conventional solar cells. Beyond its superior performance, the optimized Sb2S3 solar cell also exhibits enhanced reliability in mitigating interfacial traps at the CdS/Sb2S3 junction. This improved reliability can be attributed to our precise control of band alignment and the fine-tuning of influencing parameters.

Abstract Reduction of fossil fuel usage, clean energy supply, and dependability are all major benefits of integrating distributed energy resources (DER) with electrical utility grid (UG). Nevertheless, there are difficulties with this integration, most notably accidental islanding that puts worker and equipment safety at risk. Islanding detection methods (IDMs) play a critical role in resolving this problem. All IDMs are thoroughly evaluated in this work, which divides them into two categories: local approaches that rely on distributed generation (DG) side monitoring and remote approaches that make use of communication infrastructure. The study offers a comparative evaluation to help choose the most efficient and applicable IDM, supporting well-informed decision-making for the safe and dependable operation of distributed energy systems within electrical distribution networks. IDMs are evaluated based on NDZ outcomes, detection duration, power quality impact, multi-DG operation, suitability, X/R ratio reliance, and efficient functioning.

Abstract A novel auxetic structure applicable to airless tire spokes is designed based on the primitive-type triply periodic minimal surface (P-TPMS) to have higher stiffness through deformation under compressive force. For becoming higher stiffness by deformation, an unit cell of auxetic structure is proposed and its characteristics according to design parameters are studied. Based on the parametric study, a rotated primitive-type auxetic structure (RPAS) is designed, and the deformative behaviors of an airless tire with the RPAS spokes are compared with a generally used honeycomb spoke. Simulation and experiment results show that the designed RPAS tire exhibits more stable behavior through higher rigidity depending on the deformation state when compressed on flat ground and obstacles. This variable stiffness characteristic of RPAS tires can be advantageous for shock absorption and prevention of large local deformations. Also, the manufacturability of the designed auxetic structure is evaluated using real rubber-based additive manufacturing processes for practical application in the tire manufacturing industry.

Abstract Background Current clinical diagnosis pathway for lysosomal storage disorders (LSDs) involves sequential biochemical enzymatic tests followed by DNA sequencing, which is iterative, has low diagnostic yield and is costly due to overlapping clinical presentations. Here, we describe a novel low-cost and high-throughput sequencing assay using single-molecule molecular inversion probes (smMIPs) to screen for causative single nucleotide variants (SNVs) and copy number variants (CNVs) in genes associated with 29 common LSDs in India. Results 903 smMIPs were designed to target exon and exon–intron boundaries of targeted genes (n = 23; 53.7 kb of the human genome) and were equimolarly pooled to create a sequencing library. After extensive validation in a cohort of 50 patients, we screened 300 patients with either biochemical diagnosis (n = 187) or clinical suspicion (n = 113) of LSDs. A diagnostic yield of 83.4% was observed in patients with prior biochemical diagnosis of LSD. Furthermore, diagnostic yield of 73.9% (n = 54/73) was observed in patients with high clinical suspicion of LSD in contrast with 2.4% (n = 1/40) in patients with low clinical suspicion of LSD. In addition to detecting SNVs, the assay could detect single and multi-exon copy number variants with high confidence. Critically, Niemann-Pick disease type C and neuronal ceroid lipofuscinosis-6 diseases for which biochemical testing is unavailable, could be diagnosed using our assay. Lastly, we observed a non-inferior performance of the assay in DNA extracted from dried blood spots in comparison with whole blood. Conclusion We developed a flexible and scalable assay to reliably detect genetic causes of 29 common LSDs in India. The assay consolidates the detection of multiple variant types in multiple sample types while having improved diagnostic yield at same or lower cost compared to current clinical paradigm.

Background: Blood transfusions play a pivotal role in medical care, saving millions of lives annually. The timely provision of safe blood is critical in various clinical scenarios, necessitating a careful balance between supply and demand. Despite advanced blood banking facilities globally, challenges persist in ensuring appropriate blood component utilization, prompting a need for clinical audits and optimization strategies. Aims and Objectives: This study aims to analyze the patterns of blood product utilization in a tertiary care hospital in Madhya Pradesh over 1 year, focusing on transfusion requests, cross-match-to-transfusion (C/T) ratios, transfusion indices (TIs), and indications for transfusions. Materials and Methods: A retrospective study was conducted at Shyam Shah Medical College from January 01, 2023, to December 31, 2023. Data from transfusion and cross-match requests in various departments were collected. C/T ratios, TI, and non-usage probability were computed to assess blood utilization efficiency. Results: Out of 16,682 cross-matched units, 71.93% were transfused. The overall C/T ratio was 1.39. The department of medicine demonstrated the most efficient blood usage with a C/T ratio of 1.16. Obstetrics and gynecology had the highest TI (1.06), while surgery had the lowest (0.71). Indications for transfusion included anemia (29.9%), pre-operative (17.2%), intraoperative (21.8%), and post-operative (31.1%). Conclusion: This study provides valuable insights into blood utilization patterns, offering a foundation for refining transfusion practices and enhancing the efficiency of blood management in the studied tertiary care hospital.

Background: Salivary gland tumors (SGTs) globally account for

Prehabilitation is a multidisciplinary health enhancement programme offered before a disease intervention, such as surgery or chemotherapy/radiotherapy. It is a holistic patient care model that focuses on providing nutritional, psychological and functional care to patients before their intervention. Researchers have found that prehabilitation can improve patient outcomes by preparing for a surgery-associated physiological challenge. While studies have been limited, prehabilitation remains a promising strategy for cancer surgery with potential benefits such as improved outcomes, early recovery and lower hospital stay. The concept of prehabilitation has been growing rapidly, and it aims to enhance a patient’s overall health and well-being before surgery or other therapeutic interventions. Prehabilitation can be a valuable tool for cancer patients, providing advantages such as improved outcomes, early recovery and reduced hospital stay after surgery. However, more evidence is needed to support the effectiveness of prehabilitation. This review paper provides an overview of current knowledge and results of studies on the role of prehabilitation in cancer surgery, highlighting the positive effects of prehabilitation on physical performance, nutritional status, quality of life and sometimes reduced morbidity. Allied interventions, such as cardiac and pulmonary rehabilitation, can also provide valuable lessons for prehabilitation in practice. This comprehensive review provides a well-structured and informative presentation, ensuring clarity and ease of understanding for a technical audience. The technical details are well-supported by appropriate references, ensuring accuracy and credibility. Overall, the paper is a thorough and informative review of prehabilitation in cancer patients, outlining key concepts and evidence and providing insights for future research and practice.

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.

Study Design A retrospective cohort study. Purpose This study aimed to understand the role of magnetic resonance imaging (MRI) in predicting neurological deficits in traumatic lower lumbar fractures (LLFs; L3–L5). Overview of Literature Despite studies on the radiological risk factors for neurological deficits in thoracolumbar fractures, very few have focused on LLFs. Moreover, the potential utility of MRI in LLFs has not been evaluated. Methods In total, 108 patients who underwent surgery for traumatic LLFs between January 2010 and January 2020 were reviewed to obtain their demographic details, injury level, and neurology status at the time of presentation (American Spinal Injury Association [ASIA] grade). Preoperative computed tomography scans were used to measure parameters such as anterior vertebral body height, posterior vertebral body height, loss of vertebral body height, local kyphosis, retropulsion of fracture fragment, interpedicular distance, canal compromise, sagittal transverse ratio, and presence of vertical lamina fracture. MRI was used to measure the canal encroachment ratio (CER), cross-sectional area of the thecal sac (CSAT), and presence of an epidural hematoma. Results Of the 108 patients, 9 (8.3%) had ASIA A, 4 (3.7%) had ASIA B, 17 (15.7%) had ASIA C, 21 (19.4%) had ASIA D, and 57 (52.9%) had ASIA E neurology upon admission. The Thoracolumbar Injury Classification and Severity score (p=0.000), CER (p=0.050), and CSAT (p=0.019) were found to be independently associated with neurological deficits on the multivariate analysis. The receiver operating characteristic curves showed that only CER (area under the curve [AUC], 0.926; 95% confidence interval [CI], 0.860–0.968) and CSAT (AUC, 0.963; 95% CI, 0.908–0.990) had good discriminatory ability, with the optimal cutoff of 50% and 65.3 mm2, respectively. Conclusions Based on the results, the optimal cutoff values of CER >50% and CSAT >65.3 mm2 can predict the incidence of neurological deficits in LLFs.

Abstract The conventional MPPT method has drawbacks, such as that under partial shading conditions, several peaks occur and identifying the global peak is difficult. It may converge to a local peak and lead to poor conversion efficiency and tracking efficiency. Implementation of a hybrid algorithm by integrating P&O and metaheuristic algorithms can perform better under partial shading conditions. But the tracking speed is low and the response time is longer. To mitigate the issues mentioned above, a new hybrid algorithm has been suggested that integrates GWO and a modified fast terminal sliding mode controller (MFTSMC). The suggested method with three phase ILBC is incorporated into the PV system. The MATLAB tool is employed to experiment with this study. The performance of GWO-MFTSMC is analysed through MATLAB/ SIMULINK and compared with the performance of ANN-FTSMC and PSO-FTSMC algorithm based MPPT techniques. A hardware prototype is developed and tested for 5 × 200 W solar PV modules with the GWO-MFTSMC algorithm. The proposed method conversion efficiency is 99.72% and 96.15% under simulation and hardware realisation, respectively, which is higher than the ANN-FTSMC and PSO-FTSMC methods.

Abstract Brain tumor glioblastoma is a disease that is caused for a child who has abnormal cells in the brain, which is found using MRI “Magnetic Resonance Imaging” brain image using a powerful magnetic field, radio waves, and a computer to produce detailed images of the body's internal structures it is a standard diagnostic tool for a wide range of medical conditions, from detecting brain and spinal cord injuries to identifying tumors and also in evaluating joint problems. This is treatable, and by enabling the factor for happening, the factor for dissolving the dead tissues. If the brain tumor glioblastoma is untreated, the child will go to death; to avoid this, the child has to treat the brain problem using the scan of MRI images. Using the neural network, brain-related difficulties have to be resolved. It is identified to make the diagnosis of glioblastoma. This research deals with the techniques of max rationalizing and min rationalizing images, and the method of boosted division time attribute extraction has been involved in diagnosing glioblastoma. The process of maximum and min rationalization is used to recognize the Brain tumor glioblastoma in the brain images for treatment efficiency. The image segment is created for image recognition. The method of boosted division time attribute extraction is used in image recognition with the help of MRI for image extraction. The proposed boosted division time attribute extraction method helps to recognize the fetal images and find Brain tumor glioblastoma with feasible accuracy using image rationalization against the brain tumor glioblastoma diagnosis. In addition, 45% of adults are affected by the tumor, 40% of children and 5% are in death situations. To reduce this ratio, in this study, the Brain tumor glioblastoma is identified and segmented to recognize the fetal images and find the Brain tumor glioblastoma diagnosis. Then the tumor grades were analyzed using the efficient method for the imaging MRI with the diagnosis result of partially high. The accuracy of the proposed TAE-PIS system is 98.12% which is higher when compared to other methods like Genetic algorithm, Convolution neural network, fuzzy-based minimum and maximum neural network and kernel-based support vector machine respectively. Experimental results show that the proposed method archives rate of 98.12% accuracy with low response time and compared with the Genetic algorithm (GA), Convolutional Neural Network (CNN), fuzzy-based minimum and maximum neural network (Fuzzy min–max NN), and kernel-based support vector machine. Specifically, the proposed method achieves a substantial improvement of 80.82%, 82.13%, 85.61%, and 87.03% compared to GA, CNN, Fuzzy min–max NN, and kernel-based support vector machine, respectively.

Abstract In wireless networking, the security of flying ad hoc networks (FANETs) is a major issue, and the use of drones is growing every day. A distributed network is created by a drone network in which nodes can enter and exit the network at any time. Because malicious nodes generate bogus identifiers, FANET is unstable. In this research study, we proposed a threat detection method for detecting malicious nodes in the network. The proposed method is found to be most effective compared to other methods. Malicious nodes fill the network with false information, thereby reducing network performance. The secure ad hoc on-demand distance vector (AODV) that has been suggested algorithm is used for detecting and isolating a malicious node in FANET. In addition, because temporary flying nodes are vulnerable to attacks, trust models based on direct or indirect reliability similar to trusted neighbors have been incorporated to overcome the vulnerability of malicious/selfish harassment. A node belonging to the malicious node class is disconnected from the network and is not used to forward or forward another message. The FANET security performance is measured by throughput, packet loss and routing overhead with the conventional algorithms of AODV (TAODV) and reliable AODV secure AODV power consumption decreased by 16.5%, efficiency increased by 7.4%, and packet delivery rate decreased by 9.1% when compared to the second ranking method. Reduced packet losses and routing expenses by 9.4%. In general, the results demonstrate that, in terms of energy consumption, throughput, delivered packet rate, the number of lost packets, and routing overhead, the proposed secure AODV algorithm performs better than the most recent, cutting-edge algorithms.

Abstract Solar energy is the most promising among many renewable energy sources to meet the increasing demand. Photovoltaic (PV) based power generating solutions are expected to gain popularity as a power source for different applications, including independent and grid connected loads, due to their cleanliness, high performance, and high dependability. The efficacy of photovoltaic systems is impacted by several elements, including geographical location, positioning, shadowing effects, and local climate conditions. In order to fulfil the demands of loads, an interleaved boost converter is utilized, which has a reduced number of filters with less stress on the devices. Solar powered systems employ several maximum power point tracking (MPPT) methodologies. However, when there is partial shading, many power peaks arise, which complicates the identification of the overall peak. Although MPPT approaches are designed to measure and maintain the global maximum power point (GMPP), there are still significant oscillations observed around the GMPP with subpar settling time, tracking efficiency, and conversion efficiency. In this work, novel hybrid MPPT technique called artificial neural network supported adaptable stepped-scaled perturb and observe (ANN-ASSPO) method and water cycle optimization based perturb and observe (WCO-PO) have been proposed. Artificial neural network (ANN) has been used to determine the best scaling factor in ANN-ASSPO MPPT. Performance is enhanced in ANN-ASSPO MPPT by using the optimum scaling factor, particularly in situations when the irradiance is rapidly changing/partial shading conditions. Similarly, in WCO-PO MPPT water cycle optimization is used to determine the peak power when the PV panel is subjected to partial shading conditions. The performances of proposed hybrid MPPT ANN-ASSPO and WCO-PO techniques have been compared in terms of power generated, output voltage, average settling time and conversion efficiency. The MATLAB/Simulink tool is employed to carry out the experiment for this study.

Abstract Background A major contributing factor to glioblastoma (GBM) development and progression is its ability to evade the immune system by creating an immune-suppressive environment, where GBM-associated myeloid cells, including resident microglia and peripheral monocyte-derived macrophages, play critical pro-tumoral roles. However, it is unclear whether recruited myeloid cells are phenotypically and functionally identical in GBM patients and whether this heterogeneity is recapitulated in patient-derived orthotopic xenografts (PDOXs). A thorough understanding of the GBM ecosystem and its recapitulation in preclinical models is currently missing, leading to inaccurate results and failures of clinical trials. Methods Here, we report systematic characterization of the tumor microenvironment (TME) in GBM PDOXs and patient tumors at the single-cell and spatial levels. We applied single-cell RNA sequencing, spatial transcriptomics, multicolor flow cytometry, immunohistochemistry, and functional studies to examine the heterogeneous TME instructed by GBM cells. GBM PDOXs representing different tumor phenotypes were compared to glioma mouse GL261 syngeneic model and patient tumors. Results We show that GBM tumor cells reciprocally interact with host cells to create a GBM patient-specific TME in PDOXs. We detected the most prominent transcriptomic adaptations in myeloid cells, with brain-resident microglia representing the main population in the cellular tumor, while peripheral-derived myeloid cells infiltrated the brain at sites of blood–brain barrier disruption. More specifically, we show that GBM-educated microglia undergo transition to diverse phenotypic states across distinct GBM landscapes and tumor niches. GBM-educated microglia subsets display phagocytic and dendritic cell-like gene expression programs. Additionally, we found novel microglial states expressing cell cycle programs, astrocytic or endothelial markers. Lastly, we show that temozolomide treatment leads to transcriptomic plasticity and altered crosstalk between GBM tumor cells and adjacent TME components. Conclusions Our data provide novel insights into the phenotypic adaptation of the heterogeneous TME instructed by GBM tumors. We show the key role of microglial phenotypic states in supporting GBM tumor growth and response to treatment. Our data place PDOXs as relevant models to assess the functionality of the TME and changes in the GBM ecosystem upon treatment. Graphical Abstract

Background: Endoscopic biliary stenting is a common procedure in gastroenterology that uses plastic stents for short-term bile drainage. Aims and Objectives: This study explores the occurrence and consequences of forgotten or retained biliary stents. Materials and Methods: Conducted at King George Hospital in Visakhapatnam over 8 months, the study includes 12 patients with forgotten biliary stents. Diagnostic confirmation used X-rays, abdominal ultrasound, and magnetic resonance cholangiopancreatography. Four patients faced complications such as fractured distal pigtails and blocked stents, making retrieval challenging through standard methods like endoscopic retrograde cholangiopancreatography (ERCP) and cholangioscopy. Results: The study involved 12 patients (median age: 48 years), with choledocholithiasis being the main reason for stent placement in 10 cases (83.3%). On average, patients showed symptoms 31.3 months after stenting, mostly presenting with cholangitis (83.3%). Stent removal was successful in 8 cases (66.6%) using ERCP, while advanced procedures like cholangioscopy or surgery were needed in the rest. No mortality was reported. Conclusion: Conducted during the COVID-19 pandemic, this study reveals a rise in neglected plastic biliary stents. Cholangitis, often with common bile duct stones, was a common complication. Standard ERCP techniques were less effective in cases with complicated stents, requiring alternative approaches like cholangioscopy or surgery. The cases emphasize the urgency of timely stent retrieval and the need to improve management protocols to prevent complications.

Background: Adverse drug reactions (ADRs) significantly impact public healthcare, especially among HIV patients. These reactions, which range from mild pruritus to severe conditions such as Steven-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), affect the quality of life and treatment outcomes. Aims and Objectives: The current study was designed to evaluate the various types of cutaneous ADRs (CADRs) in adult HIV patients undergoing antiretroviral therapy (ART). Materials and Methods: A retrospective record-based study was conducted at the Department of Dermatology, Venereology, and Leprosy, Government Medical College/Government General Hospital, Suryapet, Telangana, India. Data from November 2017 to October 2020 were analyzed, focusing on patients over 18 years on ART. Relevant demographic and medical data, including blood tests, liver and renal function, and CD4 counts, were collected. Results: Out of 3532 patients on ART, 568 (16.08%) developed CADRs. Females represented 54.2% of these cases. The age group most affected was between 29 and 48 years. The most common ART regimen was Tenofovir+Lamivudin+Dolutegravir, followed by zidovudine-based combinations. Nevirapine-based regimens had a higher association with CADRs, particularly severe reactions such as SJS and TEN. Conclusion: A significant proportion of HIV patients on ART experience CADRs, with certain drug combinations posing higher risks. This study highlights the need for careful monitoring and selection of ART regimens to minimize the risk of severe CADRs, thereby improving patient outcomes and quality of life in HIV treatment.

Background: Chronic suppurative otitis media (CSOM) poses a recurring and persistent challenge in otolaryngology, stemming from diverse etiologies. Understanding the regional prevalence of the predominant etiological agent and its antimicrobial susceptibility is crucial for effective management. Aims and Objectives: This study aims to determine the aerobic bacterial profile and prevalent bacterial etiology responsible for CSOM in our geographical setting. Materials and Methods: Conducted over 2 years in the microbiology department of a tertiary care hospital, this study enrolled 504 clinically diagnosed otitis media cases. Participants, presenting with discharging ears at the E.N.T. department, met inclusion criteria of chronic otitis media with or without complications. Patients had not received treatment for at least 7 days before sample collection. Results: Among the 402 CSOM samples, aerobes were isolated from 70.15%, anaerobes from 73.63%, and mixed isolates (aerobes+anaerobes) from 38.06%. Solely aerobes were present in 32.08% of samples, while solely anaerobes were found in 35.57%. Monomicrobials constituted 75.88%, and polymicrobials accounted for 24.11% of the samples. Conclusion: In conclusion, this study enhances our understanding of CSOM microbiology in our region, providing insights into organism prevalence, mixed infections, and antibiotic sensitivity. The findings offer clinicians valuable data for tailored treatment strategies, emphasizing the need for individualized scrutiny to address the dynamic nature of CSOM bacteriology over time.

Background: Obesity is linked to an unhealthy diet and lack of exercise, elevating the risk of hypertension. Elevated blood pressure and a higher risk of hypertension are linked to an increased BMI. Lifestyle changes in adults, like inactivity and poor diet, contribute to the rise in cardiovascular diseases among younger people. Objectives: This study aimed to evaluate the relationship in a young adult population between Mean Arterial Pressure (MAP) and Body Mass Index (BMI), Relative Fat Mass (RFM), Waist-to-Hip Ratio (WH ratio), and Waist-to-Height ratio (WHtR). Additionally, the study objective was to determine the predictive value of BMI and RFM for hypertension in young adults. Methods: Participants were selected using opportunistic sampling of medical students presenting for the Physiology practical as a representative sample of young adults in this cross-sectional study. The anthropometric measurements of BMI, RFM, WH ratio, and WHtR were measured and compared between subjects with MAP≤90 mmHg and MAP>90 mmHg. Results: The chi-square test revealed a strong association between obesity and elevated mean arterial pressure (>90 mmHg). Employing a BMI cut-off (>25kg/m2) demonstrated 67.74% sensitivity and 77.78% specificity for hypertension detection, while RFM (cut-off 36.6) exhibited 52.17% sensitivity and 64.52% specificity. There was a significant positive correlation of BMI with MAP (r = 0.408, p < 0.001) and a significant difference between groups (p < 0.001). Conclusion: The effectiveness of BMI and WHtR in our study underscore the significance of multiple anthropometric indices for comprehensive obesity and cardiovascular risk assessment. Future prospective studies play a crucial role in uncovering the clinical importance of modern anthropometric measurements and biomarkers, providing valuable information to improve tools for assessing obesity and accurately representing public health.

Introduction: Human Immunodeficiency Virus (HIV) infection among antenatal women has been reported throughout the country, with a relatively high prevalence in the state of Maharashtra. Data on HIV seroprevalence in antenatal women serve as an indirect indicator of the HIV epidemic's burden in the general population and aid in predicting the same in young children. Diagnostic and treatment services for HIV are concentrated in selected states and districts with high seroprevalence, making it necessary to accurately calculate the prevalence of HIV. Aim: To assess the effectiveness of Prevention of Parent-to-Child Transmission (PPTCT) services and to study the effectiveness of the National Acquired Immunodeficiency Syndrome (AIDS) Control Programme (NACP) in the functioning of PPTCT services. Materials and Methods: A retrospective observational analysis of 12-year data, from January 2007 to December 2018, was conducted in the Department of Microbiology at the Government Medical College and Hospital, Nagpur, Maharashtra, representing Central India. Data collection took place from June 2019 to December 2019, and analysis occurred over the subsequent two months (January 2020 to February 2020). The total sample size was 101,865 patients. All pregnant women registered in the Antenatal Clinic (ANC) under the PPTCT Program were included in the present study, and Strategy III of the National HIV testing algorithm was followed. The women's ages, their partners' serostatus, and records of babies born to HIV seropositive mothers were obtained and analysed. The statistical analysis of the data was performed using Stata (version 10.4.2009, STATA Corp., Texas, USA) and Epi Info 7 (version 7.1.06, 2012, CDC, Atlanta, USA), employing the Chi-square test for linear trend (Extended Mantel-Haenszel). A p-value

Multiple myeloma (MM) is a plasma cell neoplasm that is characterized by the clonal proliferation of malignant plasma cells in the bone marrow. It is considered the second most common hematological malignancy which accounts for approximately 1% - 2% of all cancers and among 10% of hematological malignancies. Autologous peripheral blood stem cell Transplantation (PBSCT) is the best treatment for MM. Since the optimum harvested stem cell yield is a crucial factor for sufficient engraftment, the enumeration of Mononuclear cell (MNC) count in peripheral blood and harvested CD 34+ stem cell count can be considered as the best predictive markers for the best timing of apheresis which positively correlates with engraftment outcome of PBSCT. MNC count can be obtained using either a hematological analyzer or peripheral blood smear while flow cytometry is the advanced technology that can be used to enumerate CD 34+ stem cell count other than peripheral blood smear. The unavailability of a flow cytometer, the expensiveness of this method, and the lack of trained personnel regarding this new technology, especially in lower-middle-income countries cause disturbance in the enumeration of stem cells. In such a situation, this review describes the importance of establishing an association between peripheral blood MNCs and harvested CD 34+ cells. Furthermore, this association facilitates conducting effective PBSCT for MM patients even in the absence of a flow cytometer and eventually, it focuses on decentralizing the treatment of PBSCT.

Abstract Establishing sustainable communities requires bridging the gap between academic knowledge and societal requirements; this is where entrepreneurial education comes in. The first phase involved a comprehensive review of the literature and extensive consultation with experts to identify and shortlist the components of entrepreneurship education that support sustainable communities. The second phase involved Total Interpretative Structural Modelling to explore or ascertain how the elements interacted between sustainable communities and entrepreneurial education. The factors are ranked and categorized using the Matrice d'impacts croises multiplication appliquee an un classement (MICMAC) approach. The MICMAC analysis classifies partnerships and incubators as critical drivers, identifying Student Entrepreneurship Clubs and Sustainability Research Centers as dependent elements. The study emphasizes alumni networks and curriculum designs as key motivators. The results highlight the critical role that well-designed entrepreneurial education plays in developing socially conscious entrepreneurs, strengthening communities, and generating long-term job prospects. The study provides a valuable road map for stakeholders dedicated to long-term community development agendas by informing the creation of strategic initiatives, curriculum updates, and policies incorporating entrepreneurial education.

Abstract Industrial advancements and utilization of large amount of fossil fuels, vehicle pollution, and other calamities increases the Air Quality Index (AQI) of major cities in a drastic manner. Major cities AQI analysis is essential so that the government can take proper preventive, proactive measures to reduce air pollution. This research incorporates artificial intelligence in AQI prediction based on air pollution data. An optimized machine learning model which combines Grey Wolf Optimization (GWO) with the Decision Tree (DT) algorithm for accurate prediction of AQI in major cities of India. Air quality data available in the Kaggle repository is used for experimentation, and major cities like Delhi, Hyderabad, Kolkata, Bangalore, Visakhapatnam, and Chennai are considered for analysis. The proposed model performance is experimentally verified through metrics like R-Square, RMSE, MSE, MAE, and accuracy. Existing machine learning models, like k-nearest Neighbor, Random Forest regressor, and Support vector regressor, are compared with the proposed model. The proposed model attains better prediction performance compared to traditional machine learning algorithms with maximum accuracy of 88.98% for New Delhi city, 91.49% for Bangalore city, 94.48% for Kolkata, 97.66% for Hyderabad, 95.22% for Chennai and 97.68% for Visakhapatnam city.

Abstract The genus Melia is known for its secondary metabolites and recently, this genus is being explored for its timber. There are vast differences among its species. For instance, Melia azedarach is reported to be invasive and while another species, M. dubia, has diverse utility with complex germination and regeneration characteristics. Researchers globally have been working on various aspects of this genus; In this study, using topic modelling and science mapping approach, we attempted to understand research facets on this genus. The literature corpus of the Web of Science database was explored using a single keyword—“Melia” which yielded 1523 publications (1946–2022) and after scrutiny metadata of 1263 publications were used in the study. Although nine individual species were cited in the publications, only three species are accepted viz., M. dubia, M. azedarach, and M. volkensii. This implies taxonomic uncertainty, with potential confusion in assigning scientific findings to particular species. Thus, a taxonomic relook on this genus is warranted for a better assessment of the economic utility in many countries. More importantly, our results indicate that the research interests have recently shifted from the secondary metabolite constituents towards growth, biomass, wood properties, germination, plantation, and green synthesis. The shift in research focus toward wood properties of Melia sp. can impact the wood demand–supply at a global scale owing to its fast growth and the possibility of cultivation over a wider geographical range.

Abstract The bubble column reactor of 10 and 20 L capacity was designed to bio-mitigate 10% CO2 (g) with 90% air utilizing thermophilic bacteria (Bacillus cereus SSLMC2). The maximum biomass yield during the growth phase was obtained as 9.14 and 10.78 g L−1 for 10 and 20 L capacity, respectively. The maximum removal efficiency for CO2 (g) was obtained as 56% and 85% for the 10 and 20 L reactors, respectively. The FT-IR and GC–MS examination of the extracellular and intracellular samples identified value-added products such as carboxylic acid, fatty alcohols, and hydrocarbons produced during the process. The total carbon balance for CO2 utilization in different forms confirmed that B. cereus SSLMC2 utilized 1646.54 g C in 10 L and 1587 g of C in 20 L reactor out of 1696.13 g of total carbon feed. The techno-economic assessment established that the capital investment required was $286.21 and $289.08 per reactor run of 11 days and $0.167 and $0.187 per gram of carbon treated for 10 and 20 L reactors, respectively. The possible mechanism pathways for bio-mitigating CO2 (g) by B. cereus SSLMC2 were also presented utilizing the energy reactions. Hence, the work presents the novelty of utilizing thermophilic bacteria and a bubble column bioreactor for CO2 (g) bio-mitigation.