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Antibiotic-resistant bacteria present an emerging challenge to human health. Their prevalence has been increasing across the globe due in part to the liberal use of antibiotics that has pressured them to develop resistance. Those bacteria that acquire mobile genetic elements are especially concerning because those plasmids may be shared readily with other microbes that can then also become antibiotic resistant. Serious infections have recently been related to the contamination of preservative-free eyedrops with extensively drug-resistant (XDR) isolates of Pseudomonas aeruginosa, already resulting in three deaths. These drug-resistant isolates cannot be managed with most conventional antibiotics. We sought to identify alternatives to conventional antibiotics for the lysis of these XDR isolates and identified multiple bacteriophages (viruses that attack bacteria) that killed them efficiently. We found both jumbo phages (>200 kb in genome size) and non-jumbo phages that were active against these isolates, the former killing more efficiently. Jumbo phages effectively killed the three separate XDR P. aeruginosa isolates both on solid and liquid medium. Given the ongoing nature of the XDR P. aeruginosa eyedrop outbreak, the identification of phages active against them provides physicians with several novel potential alternatives for treatment.

Abstract Cancer stem cells (CSCs) are a group of specially programmed tumor cells that possess the characteristics of perpetual cell renewal, increased invasiveness, and often, drug resistance. Hence, eliminating CSCs is a major challenge for cancer treatment. Understanding the cellular programs that maintain CSCs, and identifying the critical regulators for such programs, are major undertakings in both basic and translational cancer research. Recently, we have reported that RAB4A is a major regulator of epithelial-to-mesenchymal transition (EMT) and it does so mainly through regulating the activation of RAC1 GTPase. In the current study, we have delineated a new signaling circuitry through which RAB4A transmits its control of cancer stemness. Using in vitro and in vivo studies, we show that RAB4A, as the upstream regulator, relays signal stepwise to NUMB, NOTCH1, RAC1, and then SOX2 to control the self-renewal property of multiple cancer cells of diverse tissue origins. Knockdown of NUMB, or overexpression of NICD (the active fragment NOTCH1) or SOX2, rescued the in vitro sphere-forming and in vivo tumor-forming abilities that were lost upon RAB4A knockdown. Furthermore, we discovered that the chain of control is mostly through transcriptional regulation at every step of the pathway. The discovery of the novel signaling axis of RAB4A–NUMB–NOTCH–SOX2 opens the path for further expansion of the signaling chain and for the identification of new regulators and interacting proteins important for CSC functions, which can be explored to develop new and effective therapies.

Embryologically, the left brachiocephalic vein (LBV) originates as an anastomotic channel between the right and left anterior cardinal veins. This positions the LBV between the manubrium sterni anteriorly and the innominate artery posteriorly. This pattern of adjacency of the aorta to the LBV is unique to mammals and results from a quirk of evolution. With age, the ascending aorta unfolds, elongates and dilates. Simultaneously, there is a change in the thoracic geometry that reduces the thoracic volume primarily from disc height loss and kyphosis. These transitions progressively compress the LBV. Normally, this compression is circumvented via collateral pathways and “Blood finds a way”. However, traversing these circuitous pathways comes at a cost and can result in delayed transit times and venous congestion. While it is possible that compression of the LBV in the setting of adequate collateral channels may fail to provoke any pathologic sequelae, we propose a phenomenon in which such compression in the setting of inadequate collateral circulation may lead to a state of pathologic venous congestion. This anatomic anomaly and its associated clinical features, if identified, can offer a new avenue for treatment options for some of the hitherto unexplained neurologic disorders.

Abstract Energy harvesters based on nanomaterials are getting more and more popular, but on their way to commercial availability, some crucial issues still need to be solved. The objective of the study is to select an appropriate nanomaterial. Using features of the Reinforcement Deep Q-Network (DQN) in conjunction with Fuzzy PROMETHEE, the proposed model, we present in this work a hybrid fuzzy approach to selecting appropriate materials for a vehicle-environmental-hazardous substance (EHS) combination that operates in roadways and under traffic conditions. The DQN is able to accumulate useful experience of operating in a dynamic traffic environment, accordingly selecting materials that deliver the highest energy output but at the same time bring consideration to factors such as durability, cost, and environmental impact. Fuzzy PROMETHEE allows the participation of human experts during the decision-making process, going beyond the quantitative data typically learned by DQN through the inclusion of qualitative preferences. Instead, this hybrid method unites the strength of individual approaches, as a result providing highly resistant and adjustable material selection to real EHS. The result of the study pointed out materials that can give high energy efficiency with reference to years of service, price, and environmental effects. The proposed model provides 95% accuracy with a computational efficiency of 300 s, and the application of hypothesis and practical testing on the chosen materials showed the high efficiency of the selected materials to harvest energy under fluctuating traffic conditions and proved the concept of a hybrid approach in True Vehicle Environmental High-risk Substance scenarios.

Abstract Periodontitis is a highly prevalent inflammatory illness that leads to the destruction of tooth supporting tissue structures and has been associated with an increased risk of cardiovascular disease (CVD). Precision medicine, an emerging branch of medical treatment, aims can further improve current traditional treatment by personalizing care based on one’s environment, genetic makeup, and lifestyle. Genomic databases have paved the way for precision medicine by elucidating the pathophysiology of complex, heritable diseases. Therefore, the investigation of novel periodontitis-linked genes associated with CVD will enhance our understanding of their linkage and related biochemical pathways for targeted therapies. In this article, we highlight possible mechanisms of actions connecting PD and CVD. Furthermore, we delve deeper into certain heritable inflammatory-associated pathways linking the two. The goal is to gather, compare, and assess high-quality scientific literature alongside genomic datasets that seek to establish a link between periodontitis and CVD. The scope is focused on the most up to date and authentic literature published within the last 10 years, indexed and available from PubMed Central, that analyzes periodontitis-associated genes linked to CVD. Based on the comparative analysis criteria, fifty-one genes associated with both periodontitis and CVD were identified and reported. The prevalence of genes associated with both CVD and periodontitis warrants investigation to assess the validity of a potential linkage between the pathophysiology of both diseases.

Abstract Wound infections resulting from pathogen infiltration pose a significant challenge in healthcare settings and everyday life. When the skin barrier is compromised due to injuries, surgeries, or chronic conditions, pathogens such as bacteria, fungi, and viruses can enter the body, leading to infections. These infections can range from mild to severe, causing discomfort, delayed healing, and, in some cases, life-threatening complications. Zinc oxide (ZnO) nanoparticles (NPs) have been widely recognized for their antimicrobial and wound healing properties, while cinnamic acid is known for its antioxidant and anti-inflammatory activities. Based on these properties, the combination of ZnO NPs with cinnamic acid (CA) was hypothesized to have enhanced efficacy in addressing wound infections and promoting healing. This study aimed to synthesize and evaluate the potential of ZnO-CN NPs as a multifunctional agent for wound treatment. ZnO-CN NPs were synthesized and characterized using key techniques to confirm their structure and composition. The antioxidant and anti-inflammatory potential of ZnO-CN NPs was evaluated through standard in vitro assays, demonstrating strong free radical scavenging and inhibition of protein denaturation. The antimicrobial activity of the nanoparticles was tested against common wound pathogens, revealing effective inhibition at a minimal concentration. A zebrafish wound healing model was employed to assess both the safety and therapeutic efficacy of the nanoparticles, showing no toxicity at tested concentrations and facilitating faster wound closure. Additionally, pro-inflammatory cytokine gene expression was analyzed to understand the role of ZnO-CN NPs in wound healing mechanisms. In conclusion, ZnO-CN NPs demonstrate potent antioxidant, anti-inflammatory, and antimicrobial properties, making them promising candidates for wound treatment. Given their multifunctional properties and non-toxicity at tested concentrations, ZnO-CN NPs hold significant potential as a therapeutic agent for clinical wound management, warranting further investigation in human models.

Abstract Solar energy, a prominent renewable source, has reached an installed capacity of 71.78 GW in India. This research explored the load demands of the computer center at an engineering college in Tanjore, Tamil Nadu, India. The computer center at the engineering college has an annual energy requirement of 260,552 kWh/Year. Consequently, the research focused on the planning and implementation of a standalone photovoltaic (SAPV) system, assessing it against the institution's total annual energy consumption. The performance ratio and losses of the SAPV system with both direct coupling and an MPPT charge controller was compared. This comparative analysis aimed to evaluate the efficacy of two solar photovoltaic control methods—SAPV direct coupling and Maximum Power Point Tracking control—in optimizing energy harvesting from solar panels.

Purpose: Non-obstructive azoospermia (NOA) represents the persistent absence of sperm in ejaculate without obstruction, stemming from diverse disease processes. This survey explores global practices in NOA diagnosis, comparing them with guidelines and offering expert recommendations. Materials and Methods:Materials and Methods: A 56-item questionnaire survey on NOA diagnosis and management was conducted globally from July to September 2022. This paper focuses on part 1, evaluating NOA diagnosis. Data from 367 participants across 49 coun-tries were analyzed descriptively, with a Delphi process used for expert recommendations. Results:Results: Of 336 eligible responses, most participants were experienced attending physicians (70.93%). To diagnose azoosper-mia definitively, 81.7% requested two semen samples. Commonly ordered hormone tests included serum follicle-stimulating hormone (FSH) (97.0%), total testosterone (92.9%), and luteinizing hormone (86.9%). Genetic testing was requested by 66.6%, with karyotype analysis (86.2%) and Y chromosome microdeletions (88.3%) prevalent. Diagnostic testicular biopsy, distinguishing obstructive azoospermia (OA) from NOA, was not performed by 45.1%, while 34.6% did it selectively. Differ-entiation relied on physical examination (76.1%), serum hormone profiles (69.6%), and semen tests (68.1%). Expectations of finding sperm surgically were higher in men with normal FSH, larger testes, and a history of sperm in ejaculate. Conclusions:Conclusions: This expert survey, encompassing 367 participants from 49 countries, unveils congruence with recommended guidelines in NOA diagnosis. However, noteworthy disparities in practices suggest a need for evidence-based, international consensus guidelines to standardize NOA evaluation, addressing existing gaps in professional recommendations.

Introduction: The prevalence of oral cancer is extremely high in India, contributing significantly to morbidity and mortality. Public awareness of oral cancer may aid in the prevention and early detection of the disease. To achieve successful prevention, it is essential to analyse the level of awareness among the rural Indian population, who often lacks access to healthcare. Aim: To assess the awareness and perception of oral cancer, including its signs, symptoms and treatment options in the rural population. Materials and Methods: This cross-sectional study was conducted in the Department of Oral and Maxillofacial Surgery, Karpaga Vinayaga Institute of Dental Sciences, Madhuranthagam, Tamil Nadu, India over a period of eight months (September 2022 to April 2023) among 350 participants who visited the Dental and Medical College, Outpatient Department (OPD) from the rural population of Chengalpattu district, Tamil Nadu, India. A pretested, self-administered questionnaire consisting of 15 questions was distributed. These questions addressed knowledge and awareness of the signs and symptoms of oral cancer, various aetiological factors, risk factors associated with tobacco use, treatment options, and the quality of life of patients after receiving treatment. Responses were collected and tabulated for data analysis. Statistical analysis was performed using the IBM Corp. Statistical Package for the Social Sciences (SPSS) software for Windows, version 22.0 (Armonk, NY). The Chi-square test with Yates correction was used to compare the associations between males and females regarding awareness and perception of oral cancer. A p-value of

Cerclage wiring may be used to optimize the stability of intramedullary nail or plate fixations in comminuted proximal femoral fractures, periprosthetic fractures, and other selected cases. In this article, we presented a novel case of iatrogenic sciatic nerve entrapment from cerclage wiring used to supplement intramedullary nail fixation. We also illustrate and highlight the role of ultrasound in assessing the sciatic nerve to make a timely diagnosis.

Background: A healthy lower back is essential for optimal spinal function and overall wellness. Magnetic resonance imaging (MRI) has become the gold standard in assessing lumbar spine disease. This article aims to evaluate the precision and efficacy of the lumbar offset distance (LOD) as a novel MRI parameter designed to determine the lumbar spine alignment. normally measured as we compared it to a new parameter based on length. MATERIALS AND METHODS: Supine sagittal magnetic resonance images of 101 patients who underwent lumbar spine MRI scans were analyzed. We focused on L1–L5 lumbar lordosis angle (LLA) and LOD to assess lumbar spine alignment. Diagnostic cutoff values for LOD measurements were determined, and their diagnostic accuracies were evaluated. Results: The normal LLA in our dataset was 23°–45°, and the normal LOD was 5–15 mm. Using linear regression, the range of 6–14 mm correlates to the LLA range of 20°–45°, which would define the standard lumbar offset as normal between 6 and 14 mm. Hence, lumbar hypolordosis was defined as

Grade 1 spondylolisthesis can be challenging to detect on magnetic resonance imaging (MRI), particularly for spinal surgeons and radiologists with limited experience interpreting spinal MRIs. This study aims to describe a unique sign described as a “mustache sign,” which may assist in detecting subtle Grade I spondylolisthesis on sagittal sequences on MRI of the spine. PATIENTS AND METHODS: A retrospective review of 50 lumbar spine MRI scans of patients with Grade I spondylolisthesis of L5/S1 performed over 3 years was conducted at a tertiary orthopedic spinal center in the United Kingdom. The scans were assessed for the presence of the “mustache sign” and findings were independently recorded by one musculoskeletal radiology registrar and one fellowship trained musculoskeletal radiologist with over 10 years of experience. Results: There were 35 females (70%) and 15 males (30%). The patient’s mean age was 54.3 years (13–82). The “mustache sign” was present in 13 (26%) of these patients. Twelve of 13 scans (92%) positive for the sign also demonstrated pars interarticularis defects (P < 0.001, Fisher’s Exact test), compared to those without the sign. There was excellent interobserver reliability with a kappa of 1. Conclusion: The “mustache sign” on MRI spine correlates well with the presence of Grade I spondylolisthesis. This ancillary sign can complement other previously described radiological findings on sagittal MRI sequences to confirm Grade I spondylolisthesis.

Abstract Retinopathy of prematurity (ROP) is a severe retinal disease in premature infants characterized by pathological neovascularization, obliteration of retinal vessels and increased vessel tortuosity. Currently, there are no completely satisfactory treatments for ROP. Pigment epithelium‐derived factor (PEDF), a potent inhibitor of angiogenesis, appears late in gestation and its deficiency may be linked to development of ROP. This study investigates the preclinical efficacy of PEDF protein alone or in combination with VEGF antagonists for treating ROP. The safety of PEDF protein in the rat eye was assessed using functional in vivo measurements and histology. The efficacy of intravitreal injections (IVI) of various treatments was evaluated in a rat oxygen‐induced retinopathy (OIR) model using in vivo imaging and flatmount analyses. No functional or histological side‐effects were found in rat eyes after intravitreal PEDF protein injection. PEDF protein alone or combined with anti‐VEGF drugs significantly reduced pathological neovascularization and vessel obliteration, comparable to the effects of anti‐VEGF drugs alone. Regarding arterial tortuosity, treatment with a combination of PEDF, and VEGF antagonist was more effective than treatment with anti‐VEGF alone. IVI of PEDF protein is safe. PEDF protein alone or combined with VEGF antagonists shows similar efficacy in reducing pathological neovascularization and vessel obliteration as anti‐VEGF agents. Furthermore, only treatments involving PEDF protein, alone or with VEGF antagonists, significantly improved the quality of retinal vasculature. Thus, PEDF protein alone or combined with anti‐VEGF agents presents a promising alternative to current anti‐VEGF treatments for ROP.

Background: The pathology of the maxillary sinus (MS) can be treated using the prelacrimal recess approach, an intranasal method for accessing the MS. This approach exhibits significant individual variations in its prevalence and varying widths. Aim: To determine the occurrence of the prelacrimal recess (PLR) in the MS and explore its morphological variations. Methods: A retrospective analysis was performed on 225 cone beam computed tomography scans obtained from the department’s archives. The patients ranged in age from 18 to 78. Statistical analysis were conducted to evaluate the frequency of PLR occurrence in the MS. Data from both sides were compared between males and females. Results: The analysis of the data revealed that PLR was present in 84.9% of patients with MS. Each patient exhibited asymmetry between the left and right sides. Although PLR was less likely to occur in women, the difference was not statistically significant. Conclusion: The anatomical variations of the PLR in individuals should be considered prior to procedures to prevent complications.

Abstract Genomic alterations in fibroblast growth factor receptor (FGFR) genes are present in a small number of metastatic pancreatic ductal adenocarcinomas (PDAC) and may represent an emerging subgroup of patients likely to benefit from FGFR targeted therapies. Here we present four FGFR2 fusion-positive metastatic PDAC patients who exhibited durable responses or disease control to FGFR kinase inhibitors. Utilizing our custom FGFR focused cell-free DNA assay, FGFR-Dx, we serially monitored variant allele fractions of FGFR2 fusions during FGFR inhibitor treatment and observed dynamic changes correlating with clinical responses. Genomic analysis of 30,229 comprehensively profiled pancreatic cancers revealed FGFR1-3 fusions in 245 cases, an incidence of 0.81%. FGFR fusions were generally mutually exclusive from other known oncogenes. Our findings provide clinical evidence for identifying and treating FGFR2 fusion-positive PDAC patients with FGFR targeted therapy.

Understanding and harnessing quorum sensing activity and identifying bioactive substances produced by marine-derived bacteria are essential for exploring their potential applications in various fields, including biotechnology, pharmaceuticals, and environmental management. This research aims to investigate the quorum-sensing activities employed by these bacteria and to characterize the bioactive compounds they produce, to unlock their therapeutic, industrial, and ecological potentials. This study focuses on screening, isolation and characterization of marine bacteria from Thoothukudi Harbour Beach, India, and potential antibacterial and anti-quorum sensing activities of their respective spent media against biofilm forming pathogens. Three soil samples were collected and processed for bacterial isolation. Seventeen different bacterial isolates were obtained and identified after prior culture. Antibacterial activity was evaluated against four pathogenic bacteria, with some isolates demonstrating significant inhibition. Additionally, biofilm inhibition assays were conducted, revealing the ability of certain isolates to inhibit the formation of biofilms. The secondary metabolites present in the ethyl acetate fraction of I.B 6 isolate exhibiting relatively high antibacterial and antibiofilm properties were identified by GC-MS. Anti-quorum sensing activity was also investigated using swarming assay and the MIC was determined accordingly for the ethyl acetate fraction. Hence, these marine bacteria hold for producing bioactive compounds with potential pharmaceutical and industrial applications. Finally, the positive organism is subjected to 16S rRNA sequencing for identification and was found to be Bacillus thuringiensis.

The seed kernels of Caesalpinia bonducella, a traditional medicinal plant in India, are widely used to treat various disorders, including polycystic ovary syndrome. The seed kernel possesses anti-bacterial properties against many pathogenic bacteria. However, their impact on Lactobacillus spp., a prominent gram-positive gut bacterium, has not been studied till date. The present study employed both in vitro and in silico methods to illustrate the effect of seed extract of C. bonducella against Lactobacillus rhamnosus GG. For this, disc diffusion assay was performed with 100, 500, and 1000 µg/ml of aqueous and methanolic seed extract against L. rhamnosus and E. coli, and the zone of inhibition was measured. While both the extracts inhibited the growth of E. coli, it did not show any zone of inhibition against L. rhamnosus. The latter possess surface layer proteins, SlpX and SlpA, which prevented the influx of the phytocompounds of C. bonducella, as demonstrated by molecular docking using Autodock Vina. Docking results showed that the binding of the phytocompounds to the SlpX and SlpA proteins was not in the active pockets. These findings conclude that C. bonducella seed kernel extracts are safe against the gut bacteria L. rhamnosus.

Our aim was to develop a new class of bi starlike functions by utilizing the concept of subordination, driven by the idea of multiplicative calculus, specifically multiplicative derivatives. Several restrictions were imposed, which were indeed strict constraints, because we have tried to work within the current framework or the design of analytic functions. To make the study more versatile, we redefined our new class of function with Miller-Ross Poisson distribution (MRPD), in order to increase the study's adaptability. We derived the first coefficient estimates and Fekete-Szegő inequalities for functions in this new class. To demonstrate the characteristics, we have provided a few examples.

Nodular scabies (NS) is a relatively common variant of classical scabies whose pathogenesis is unclear. It is clinically characterized by pruritic, firm nodules most commonly involving the genitalia followed by axilla and groin region. A clinical diagnosis of NS is often straightforward. NS may persist despite the administration of antiscabicidal drugs such as permethrin and ivermectin. Topical and intralesional corticosteroids form the mainstay of treatment. Postscabietic nodule is a complication that primarily occurs in patients with previous history of scabies that had been successfully treated.

Rationale: Lepromatous leprosy is a skin condition. Erythema nodosum leprosum (ENL) aids in its diagnosis. ENL is a type- 2 immune response, whereas lepra ENL is characterized by a hypersensitivity reaction and an exaggerated immune response through a different pathway. Patient's Concern: A 40-year-old male patient, previously diagnosed with lepromatous leprosy, displayed painful skin lesions on his extremities. Diagnosis: Type-2 lepra reaction, specifically erythema nodosum leprosum. Interventions: The patient was initially treated with 100 mg dapsone daily and then with fusidic acid, prednisone, and other MDT agents, after development of dapsone resisitance. After type- 2 lepra reaction was lessened in just two weeks, the regimen was adjusted to prednisolone (up to 2 g daily), thalidomide (300 mg daily), minocycline (1.5 g daily), ofloxacin (1 g twice daily), and pentoxifylline (400 mg three times daily) over a six-month period. Outcomes: The treatment effectively reduced the type-2 lepra reaction and improved the patient's skin lesions and overall health. Lessons: Healthcare providers should maintain a high level of awareness regarding the symptoms and medical history associated with ENL to facilitate timely diagnosis and appropriate management strategies. It is critical to tailor treatment to each patient’s symptoms and responses for successful management. Consistent monitoring of inflammatory markers and regular follow-up appointments play vital roles in preventing complications and ensuring positive outcomes for patients with ENL.

Abstract Background Bioinspired nanomaterials have widely been employed as suitable alternatives for controlling biofilm and pathogens due to their distinctive physico-chemical properties. Methodology This study explored the antibiofilm as well as photocatalytic potential of silver (Ag) nanoparticles (NPs) synthesized using the cell-free supernatant of Lactobacillus acidophilus for the disinfection of multi-drug-resistant (MDR) strains of enteroaggregative E. coli (EAEC), Salmonella Typhimurium, S. Enteritidis and methicillin-resistant Staphylococcus aureus (MRSA) on exposure to LED light. In addition, the removal of toxic cationic dyes i.e., methylene blue (MB), rhodamine B (RhB) and crystal violet (CV) was explored on exposure to sunlight, LED and UV lights. Results Initially, the synthesis of AgNPs was verified using UV- Vis spectroscopy, X-ray diffraction and transmission electron microscopy. The synthesized AgNPs exhibited MIC and MBC values of 7.80 and 15.625 µg/mL, respectively. The AgNPs exhibited significant inhibition (P

The present research computes the impact of process parameters of squeeze casting on AA8011/Si3N4/ZrO2 Hybrid Metal Matrix Composites (HMMCs). The melting temperatures (700 to 800°C), Si3N4 + ZrO2 (5 to 15 wt.%) and stirring speed (550 to 750 rpm) were selected as parameters for input. The AA8011 HMMCs were fabricated as per the combination of L9 input parameters, and they were subjected to Energy Dispersive X Ray Analysis (EDAX) and Scanning Electron Microscope (SEM) tests to compute the presence of wt.% of matrix and reinforcements and to confirm the uniform distribution of Si3N4 + ZrO2 in matrix AA8011. Besides, fabricated composites were subjected to tensile and micro hardness test after subjecting to Salt spray test (3.5% NaCl, 120 hours exposing duration and 1.2 kg/cm2 spray pressure) for computing the Ultimate Tensile Strength (UTS) and micro hardness. The Grey Relational Analysis (GRA) was employed for optimizing process parameters of squeeze casting on AA8011 based composites. The EDAX test results confirms that the increasing wt.% of silicon nitride and zirconium dioxide reinforcements enhances the presence of elements such as Si, N, Zr and O in manufactured composites. The higher dense reinforcements are uniformly distributed in the matrix AA8011 at the blend of input parameters of AA8011 composite. Based on the Taguchi approach, the medium level of melting temperature (750°C), higher level of wt.% of Si3N4 and ZrO2 reinforcements (15 wt.%) and higher level for speed of stirring (750 rpm) is the optimized combination parameters of squeeze casting for UTS and microhardness are identified. Based on the GRA technique, the influencing sequence are identified for squeeze casting process parameters are wt.% of Si3N4 + ZrO2 reinforcements, stirring speed and melting temperature for both UTS and Micro hardness. The contribution percentage of melting temperature, wt.% of reinforcements and stirring speed are 20.26%, 48.102% and 29.23% respectively. The confirmation test was done for optimized input parameters and it exhibit 56% higher UTS and 48.2% higher micro hardness of than AA8011 matrix material.

Background and Aim: Endothelial dysfunction is a crucial precursor to atherosclerosis and cardiovascular complications, particularly prevalent in individuals with type 2 diabetes mellitus (T2DM). This study aimed to assess endothelial impairment in T2DM using flow-mediated dilatation (FMD) and to determine its correlation with body mass index (BMI), duration of diabetes, C-reactive protein (CRP) levels, and glycemic control. Materials and Methods: A total of 100 T2DM patients aged thirty to sixty participated. Doppler ultrasonography was used to measure brachial artery FMD, while blood samples were used to assess glycosylated hemoglobin A1c (HbA1c) and CRP levels. Correlations were evaluated using the Pearson correlation coefficient. Result: The duration of diabetes r value is negative 0.866, p-value less than 0.001, CRP levels as “r value” is negative 0.724, “P-value” less than 0.001, and HbA1c levels “r value” is negative 0.722, “P-value” less than 0.001 were observed to have negative relationships with FMD. Additionally, there was a significant association r value was negative 0.342, “P-value” less than 0.001 between BMI and FMD. These results were corroborated by subgroup analyses, which highlighted the intricacy of “endothelial dysfunction” in T2DM and the significance of comprehensively addressing several risk variables. This study elucidates the intricate interplay of metabolic, inflammatory, and vascular factors contributing to “endothelial dysfunction” in T2DM patients. Elevated HbA1c and CRP levels, prolonged diabetes duration, and high BMI were linked to impaired endothelial function, underscoring the importance of holistic risk factor management. Conclusion: For patients with T2DM, maintaining endothelial function and reducing cardiovascular risk require comprehensive treatment plans that target inflammation, obesity, and glycaemic management. Timely intervention and vigilant monitoring of risk factors are crucial to prevent vascular complications in high-risk populations.

Abstract Background The Surgical Tool for Auditing Records scoring system [STAR] focuses on surgical record auditing with promising outcomes. It offers a structured approach to evaluating the quality of surgical notes. Aims and objectives This study aimed to assess the effectiveness of the STAR in evaluating oral surgical records and identifying areas for improvement in documentation practices. Materials and methods The data was obtained from the Dental Information Archival Software (DIAS) of our institution. The sample size was determined using G*Power 3.1.9.4 software. Fifty consecutive oral surgery clinical records of oral squamous cell carcinoma patients were evaluated using STAR. Each record was reviewed for adherence to documentation standards including Initial Assessment (10 points), Follow-up Entries (8 points), Consent Documentation (7 points), Anesthesia Report (7 points), Surgical Log (9 points), and Discharge Synopsis (9 points). compiling a total STAR score (50 points). The data was tabulated in Google Sheets. The descriptive statistics with inter-observer agreement and the mean score were recorded. Results We observed that each of the 50 records received a score of 49/50 points on the STAR. Deductions were necessary in the Operative record section due to the lack of information regarding the sutures used. Conclusion To summarize, this study emphasizes the effectiveness of the STAR scoring system in evaluating the quality of oral surgical records. Identifying deficiencies, particularly in documenting operative details, can improve the completeness and accuracy of patient records. It can ultimately enhance patient care and facilitate better communication among healthcare professionals.

Introduction: Dental local anaesthesia serves several purposes, the most common of which is to minimise pain during dental procedures, thereby improving patient comfort and facilitating treatment. It can also have therapeutic effects, such as temporarily relieving pulpitis pain. Patients often experience anxiety before and after receiving local anaesthesia. Aim: To evaluate the perceptions and attitudes of patients receiving local anaesthesia through a self-administered questionnaire. Materials and Methods: This cross-sectional study was conducted among 398 patients, including 218 males and 180 females, between August 2022 and October 2022, who underwent dental extractions at a dental hospital in Chengalpattu district, Tamil Nadu, India. A 15-item questionnaire was administered to the patients. The questionnaire comprised three domains: the first domain included questions before the administration of local anaesthesia, the second domain included questions during the administration of local anaesthesia, and the third domain included questions after the administration of local anaesthesia. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) software. Results: Of the participants, 126 (40.20%) were between 46 and 60 years of age. Males constituted 218 (54.8%) and females constituted 180 (45.2%) of the sample. Additionally, 76.38% of the patients were unaware of the preinjection topical anaesthesia. Moreover, 70.35% of patients experienced anxiety before the administration of local anaesthesia. During the administration of local anaesthesia, 300 (75.4%) of patients reported experiencing moderate pain. Many patients exhibited physical manifestations of fear, including sweating in 92 (23.12%), light-headedness in 102 (25.63%), and palpitations after the administration of local anaesthesia in 190 (47.74%). Conclusion: Anxiety was more prevalent among patients prior to the administration of local anaesthesia. Patients were more anxious about the fear of the injection rather than the fear of the extraction itself. The outcomes of anaesthesia may be significantly improved by educating patients about dental treatment processes.

Abstract Background End-stage renal disease (ESRD) poses a significant burden globally and in India. However, access to treatment remains limited due to resource and cost constraints. This study aimed to evaluate the health-related quality of life (HRQoL) and economic burden among haemodialysis patients. Methods A descriptive cross-sectional study using European Quality of life, EQ-5D-5L, to measure health-related quality of life across 5 domains, i.e. mobility, self-care, usual activities, pain/discomfort and anxiety/depression, was administered, across three settings—government dialysis centre, private dialysis centre and charity based dialysis centre. The health utility values were also calculated. Also, the costs incurred in dialysis were done. Results The mean (± SD) age of the participants was 55 (± 11) years, the majority of the participants were male (n = 61), 80% (n = 64) of the participants were employed before and 40% of them had lost a job, due to the morbidity of the disease. Upon analyzing the EQ-5D-5L data, it is inferred that all five domains were the same across all three setups. The direct cost incurred on the haemodialysis ranged from INR.600 to INR.3500 per month, and the indirect cost ranged fromINR.50 to INR. 3000, which is borne by the participants, in about 70% of the cases. Chief Minister Health Insurance Scheme was found to be extremely useful, wherein only 30% (n = 25) of the study participants (n=81) were insured beneficiaries. Conclusion HRQoL was moderately impaired, and treatment posed substantial financial hardship among hemodialysis patients. Expanding access to decentralized and community-based care models could help address the challenges of regular treatment and lost productivity.

Wound healing is a crucial biological process for tissue repair and regeneration, preventing infections and complications. There's been a growing interest in exploring sustainable wound healing strategies in recent years. This review examines the use of green-synthesized silver nanoparticles (AgNPs) in sustainable wound healing strategies. It highlights the need for innovative approaches and the challenges posed by infections. The current wound therapies and treatments, highlighting gaps in existing methodologies, are evaluated. This review provides a comprehensive overview of the current state-of-the-art in green synthesis techniques for the synthesis of AgNPs. The properties and characterization of AgNPs are elucidated, providing insights into their efficacy. The biocompatibility of AgNPs in wound healing is also explored, emphasizing safety in medical applications. Green synthesized AgNPs incorporated wound dressings are detailed, showcasing their potential in clinical settings. Challenges and future perspectives are discussed, addressing hurdles to widespread implementation. The conclusion consolidates key findings, offering a synthesized perspective on the potential of green-synthesized AgNPs in revolutionizing current knowledge on innovative approaches for sustainable wound healing practices.

This article addresses the crucial challenge of maintaining a reliable power supply in integrated electric systems that combine solar power and energy storage. It focuses on optimizing key parameters for remote photovoltaic, wind, and battery energy storage within the grid, with a primary goal of sustaining 24-hour load demand. The study introduces a comprehensive approach that integrates fuel price dynamics and battery depletion costs into the optimization model for hybrid grids. This approach seeks a delicate balance between sustainable energy usage and cost-effectiveness. To achieve this balance, the research employs genetic algorithms, a robust computational technique. These algorithms play a vital role in calculating discharge-charge cycles and assessing battery health, addressing concerns about battery longevity and performance. Additionally, the study explores a machine learning framework, specifically nested learning, to further enhance the optimization process. Nested learning allows for the development of a sophisticated target function that considers various grid operation parameters and constraints. This machine learning approach enhances the system's ability to dynamically monitor power consumption and generation. Within this machine learning framework, the TD Lambda learning algorithm takes a prominent role in identifying the optimal function. This algorithm is well-known for its efficiency, particularly in non-Markovian scenarios. Its quick convergence enhances the overall performance of the hybrid grid, ensuring efficiency in changing conditions. The research also evaluates the impact of weight factors on various aspects, including battery charging status, algorithmic decisions, and their consequences on optimal energy pricing within the hybrid grid. This comprehensive assessment deepens the understanding of how these weight factors influence grid performance and economic viability.

During the COVID-19 pandemic, wastewater surveillance of the SARS CoV-2 virus has been demonstrated to be effective for population surveillance at the county level down to the building level. At the University of California, San Diego, daily high-resolution wastewater surveillance conducted at the building level is being used to identify potential undiagnosed infections and trigger notification of residents and responsive testing, but the optimal determinants for notifications are unknown. To fill this gap, we propose a pipeline for data processing and identifying features of a series of wastewater test results that can predict the presence of COVID-19 in residences associated with the test sites. Using time series of wastewater results and individual testing results during periods of routine asymptomatic testing among UCSD students from 11/2020 to 11/2021, we develop hierarchical classification/decision tree models to select the most informative wastewater features (patterns of results) which predict individual infections. We find that the best predictor of positive individual level tests in residence buildings is whether or not the wastewater samples were positive in at least 3 of the past 7 days. We also demonstrate that the tree models outperform a wide range of other statistical and machine models in predicting the individual COVID-19 infections while preserving interpretability. Results of this study have been used to refine campus-wide guidelines and email notification systems to alert residents of potential infections.

PURPOSE: To characterize the recovery of diagnostic cardiovascular procedure volumes in U.S. and non-U.S. facilities in the year following the initial COVID-19 outbreak. MATERIALS AND METHODS: The International Atomic Energy Agency (IAEA) coordinated a worldwide study called the IAEA Noninvasive Cardiology Protocols Study of COVID-19 2 (INCAPS COVID 2), collecting data from 669 facilities in 107 countries, including 93 facilities in 34 U.S. states, to determine the impact of the pandemic on diagnostic cardiovascular procedure volumes. Participants reported volumes for each diagnostic imaging modality used at their facility for March 2019 (baseline), April 2020, and April 2021. This secondary analysis of INCAPS COVID 2 evaluated differences in changes in procedure volume between U.S. and non-U.S. facilities and among U.S. regions. Factors associated with return to prepandemic volumes in the United States were also analyzed in a multivariable regression analysis. RESULTS: Reduction in procedure volumes in April 2020 compared with baseline was similar for U.S. and non-U.S. facilities (-66% vs -71%, P = .27). U.S. facilities reported greater return to baseline in April 2021 than did all non-U.S. facilities (4% vs -6%, P = .008), but there was no evidence of a difference when comparing U.S. facilities with non-U.S. high-income country (NUHIC) facilities (4% vs 0%, P = .18). U.S. regional differences in return to baseline were observed between the Midwest (11%), Northeast (9%), South (1%), and West (-7%, P = .03), but no studied factors were significant predictors of 2021 change from prepandemic baseline. CONCLUSION: The reductions in cardiac testing during the early pandemic have recovered within a year to prepandemic baselines in the United States and NUHICs, while procedure volumes remain depressed in lower-income countries.Keywords: SPECT, Cardiac, Epidemiology, Angiography, CT Angiography, CT, Echocardiography, SPECT/CT, MR Imaging, Radionuclide Studies, COVID-19, Cardiovascular Imaging, Diagnostic Cardiovascular Procedure, Cardiovascular Disease, Cardiac Testing Supplemental material is available for this article. © RSNA, 2023.

ABSTRACTThe authors introduce new classes of analytic function with respect [Formula: see text]-symmetric points subordinate to a domain that is not Carathéodory. To use the existing infrastructure or framework, usually, the study of analytic function have been limited to a differential characterization subordinate to functions which are Carathéodory. Here, we try to obtain various interesting properties of functions which are not Carathéodory. Integral representation, interesting conditions for starlikeness and inclusion relations for functions in these classes are obtained.