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Post-intensive care syndrome (PICS) refers to persistent or new onset physical, mental, and neurocognitive complications that can occur following a stay in the intensive care unit. PICS encompasses muscle weakness; neuropathy; cognitive deficits including memory, executive, and attention impairments; post-traumatic stress disorder; and other mood disorders. PICS can last long after hospital admission and can cause significant physical, emotional, and financial stress for patients and their families. Several modifiable risk factors, such as duration of sepsis, delirium, and mechanical ventilation, are associated with PICS. However, due to limited awareness about PICS, these factors are often overlooked. The objective of this paper is to highlight the pathophysiology, clinical features, diagnostic methods, and available preventive and treatment options for PICS.

Background: Airborne transmission of tuberculosis (TB) is a major route of spread. Household contacts of TB patients are at high risk of infection. However, there is limited evidence on airborne infection control knowledge and practices among TB patients in India. This study was done to assess the knowledge and practices related to airborne infection control among pulmonary TB (PTB) patients at the household level and determine associated factors. Subjects and Methods: A cross-sectional study was conducted among 157 smear-positive PTB patients at a tertiary care hospital in Karnataka, India, using a pretested questionnaire. Knowledge and self-reported practices regarding airborne precautions were assessed. Bivariate analysis was done to determine associated factors. P

Background: Digitalization in the form of increased Internet use through screen media has also shown its ramification like cyberbullying. They are aggressive acts with the intention or motivation to harm another person through technology. The aim is to study the prevalence of cyberbullying and its association with mental illness in the adolescent age group (15–19 years). Methods: This community-based cross-sectional study was rolled out among adolescents aged 15–19 years. A total of 387 were given a semistructured interviewer-administered questionnaire consisting of general details, cyberbullying victimization, and offending questions, PHQ-9 and GAD-7. Results: The mean (SD) age was 16.8 (1.3) years. More than half (53.2%) were males, and nearly three-fourths (74.4%) were school-going. Around 28.2% reported being cyberbullied at least once in their lifetime. About 7.0% of adolescents were cyberbullied more than once, and 0.8% more than five times in the past 30 days. The most common ways were posting a mean or hurtful picture (31.9%) and the concerned person’s comments (24.2%) online. Multivariable logistic regression analysis found that adolescents attending colleges (AOR 1.9, 95% CI 1.1 to 3.4), using tobacco (AOR 2.5, 95% CI 1.4 to 4.5), and depressed (of any severity, AOR 2.0, 95% CI 1.1 to 4.3) were at significantly increased risk of being cyberbullied (P < 0.05). Conclusion: The prevalence of cyberbullying among adolescents aged 15–19 is notable, with significant associations found between cyberbullying and attending college, tobacco use, and depression. Understanding the correlates of cyberbullying can inform targeted interventions to support mental health and well-being among adolescents.

Introduction: Rabies has significant health and economic consequences for both humans and animals. Annually, India witnesses 17.4 million dog bites, yet only 3 million individuals receive post-exposure prophylaxis (PEP). There is a shortage of anti-rabies vaccine in India as quoted in many news reports. In India, lack of documentation of previous vaccination against animal bites is there, hence resulting in the re-administration of the anti-rabies vaccine, leading to a significant biological loss (anti-rabies vaccine) Material and Methods: A cross-sectional, retrospective study was conducted. Data was collected, and analyzed from June 2021 to June 2023 a period of 2 years. Results: Majority of the patients reported within the first 24 hours after being bitten while approximately one-third reported after 24 hours. Majority were Category 3 bites and unprovoked. Males, lower-middle class, and bites on lower extremities were common among 4291 patients attending the clinic. Out of 217 re-exposure cases, 185 did not have any documentation regarding their previous treatment of animal bites. Conclusion: Among 4291 patients attending the clinic, majority were Category 3 bites on the lower extremities. 85.25% of re-exposure cases had to be administered a full course of treatment due to a lack of documentation leading to rabies as a biological wastage. This avoidable wastage can be a resource for treating more patients.

BACKGROUND: Self-assessment (SA) as a learning skill ascends engagement in learning but also promotes learners to take responsibility in understanding their current performance and revise on shortcomings. Pedagogical strategies involving the role of self-assessment skills at varied levels of curriculum, classroom, portfolios, and reflective writing are evidenced in the literature. Health-care providers have to continuously implement changes and keep upgrading their knowledge to fetch better results during their professional career actuating the necessity of SA during students’ training. Although recommendations from the Commission on Dental Accreditation to incorporate self-assessment as early as in predoctoral education have been emphasized, the need to enforce it in the Indian curriculum is not realized. The purpose of this study was to ascertain dental postgraduate students’ perceptions of self-assessment and how it related to their performance in the classroom and in the clinic. MATERIAL AND METHODS: This is a cross-sectional study to assess the awareness and perception of SA, carried out among 120 dental postgraduate students. Over a three-month period, postgraduate students from our institution across all three years participated. A prevalidated, self-administered structured questionnaire that was pilot tested and further given to the participants was used to collect the data. Data were interpreted and analyzed. RESULTS: With an overall mean score of 4.101 ± 0.352, the relevance of employing self-assessment as a learning tool obtained the highest mean score among 2nd-year postgraduate dental students (4.167 ± 0.306) and the lowest among 1st-year postgraduate dental students (3.975 ± 0.477). A one-way analysis of variance test revealed that the total year-wise mean score difference was statistically significant. The mean score for using self-assessment as a learning tool varied significantly between 1st-year postgraduate students and those in their 2nd and 3rd years, but not significantly between 2nd- and 3rd-year postgraduate students, according to a post hoc test conducted among the study groups. This expression of results implies that postdoctoral students highly value SA skills as necessary for achieving a competent endpoint. CONCLUSION: The importance of self-assessment abilities in one’s academic and clinical performance is greatly valued by study participants. To comprehend the use of SA skills and quantify their utilization in performance evaluation, training programs are required.

Groundwater is a crucial water resource for various usages worldwide. The Quetta Valley of Pakistan was investigated regarding its groundwater quality sustainability based on integrated approaches of hydrochemistry, geographic information system, and multivariate statistics. A total of 29 groundwater samples were collected from monitoring wells to get insights into the hydrochemical suitability of groundwater for sustainable irrigation and drinking utilization. The results indicate groundwater is mainly featured by the hydrochemical facies of HCO3·Cl-Ca. Groundwater hydrochemical composition is dominantly governed by the dissolution of carbonates and silicate minerals in combination with positive cation exchange in the valley. Principal component analysis reveals a significant influence of geogenic factors on groundwater chemistry, further supported by PHREEQC simulation that detects a supersaturation of calcite, dolomite, and sulphate minerals in the aquifer. The irrigation water quality index divides groundwater in the study area into three zones, which signify low restriction and no restriction, except for a severe restriction in the southwestern part of the valley. Groundwater is generally suitable for irrigation across the valley. The entropy-weighted water quality index classifies groundwater as excellent and good quality for drinking. This study can provide crucial insights for authorities on groundwater suitability in Quetta Valley and similar regions worldwide. HIGHLIGHTS Traditional hydrochemical techniques integrated with multivariate statistical analysis and Geographic Information System (GIS)-based methods were employed to provide a nuanced understanding of hydrochemical parameters and their spatial distribution.; Hydrochemical fingerprints were recognized to assess groundwater quality for drinking and irrigation purposes.; The irrigation water quality index delineates zones for irrigation suitability, while the entropy-weighted water quality index ranks water quality for drinking purposes.;

Abstract Calcification of aortic valve leaflets is a growing mortality threat for the 18 million human lives claimed globally each year by heart disease. Extensive research has focused on the cellular and molecular pathophysiology associated with calcification, yet the detailed composition, structure, distribution and etiological history of mineral deposition remains unknown. Here transdisciplinary geology, biology and medicine (GeoBioMed) approaches prove that leaflet calcification is driven by amorphous calcium phosphate (ACP), ACP at the threshold of transformation toward hydroxyapatite (HAP) and cholesterol biomineralization. A paragenetic sequence of events is observed that includes: (1) original formation of unaltered leaflet tissues: (2) individual and coalescing 100’s nm- to 1 μm-scale ACP spherules and cholesterol crystals biomineralizing collagen fibers and smooth muscle cell myofilaments; (3) osteopontin coatings that stabilize ACP and collagen containment of nodules preventing exposure to the solution chemistry and water content of pumping blood, which combine to slow transformation to HAP; (4) mm-scale nodule growth via ACP spherule coalescence, diagenetic incorporation of altered collagen and aggregation with other ACP nodules; and (5) leaflet diastole and systole flexure causing nodules to twist, fold their encasing collagen fibers and increase stiffness. These in vivo mechanisms combine to slow leaflet calcification and establish previously unexplored hypotheses for testing novel drug therapies and clinical interventions as viable alternatives to current reliance on surgical/percutaneous valve implants.

Abstract Phase separation and percolation contribute to phase transitions of multivalent macromolecules. Contributions of percolation are evident through the viscoelasticity of condensates and through the formation of heterogeneous distributions of nano- and mesoscale pre-percolation clusters in sub-saturated solutions. Here, we show that clusters formed in sub-saturated solutions of FET (FUS-EWSR1-TAF15) proteins are affected differently by glutamate versus chloride. These differences on the nanoscale, gleaned using a suite of methods deployed across a wide range of protein concentrations, are prevalent and can be unmasked even though the driving forces for phase separation remain unchanged in glutamate versus chloride. Strikingly, differences in anion-mediated interactions that drive clustering saturate on the micron-scale. Beyond this length scale the system separates into coexisting phases. Overall, we find that sequence-encoded interactions, mediated by solution components, make synergistic and distinct contributions to the formation of pre-percolation clusters in sub-saturated solutions, and to the driving forces for phase separation.

Abstract The Himalayas are highly susceptible to various natural disasters, such as the tectonically induced land deformation, earthquakes, landslides, and extreme climatic events. Recently, the Joshimath town witnessed a significantly large land subsidence activity. The phenomenon resulted in the development of large cracks in roads and in over 868 civil structures, posing a significant risk to inhabitants and infrastructure of the area. This study uses a time-series synthetic aperture radar (SAR) interferometry-based PSInSAR approach to monitor land deformation utilizing multi-temporal Sentinel-1 datasets. The line of sight (LOS) land deformation velocity for the Joshimath region, calculated for the year 2022–2023 using a PSInSAR-based approach, varies from − 89.326 to + 94.46 mm/year. The + ve sign indicates the LOS velocity/displacement away from the SAR sensor, whereas − ve sign signifies the earth's movement towards the SAR sensor in the direction of LOS. In addition, the study investigates feature tracking land displacement analysis using multi-temporal high-resolution Planet datasets. The result of this analysis is consistent with the PSInSAR results. The study also estimated the land deformation for the periods 2016–2017, 2018–2019, and 2020–2021 separately. Our results show that the Joshimath region experienced the highest land deformation during the year 2022–2023. During this period, the maximum land subsidence was observed in the north-western part of the town. The maximum LOS land deformation velocity + 60.45 mm/year to + 94.46 mm/year (2022–2023), occurred around Singhdwar, whereas the north and central region of the Joshimath town experienced moderate to high subsidence of the order of + 10.45 mm/year to + 60.45 mm/year (2022–2023), whereas the south-west part experienced an expansion of the order of 84.65 mm/year to − 13.13 mm/year (2022–2023). Towards the south-east, the town experienced rapid land subsidence, − 13.13 mm/year to − 5 mm/year (2022–2023). The study analyzes the causative factors of the observed land deformation in the region. Furthermore, this work assesses the ground conditions of the Joshimath region using UAV datasets acquired in the most critically affected areas such as Singhdhaar, Hotel Mountain View, Malhari Hotel, and Manoharbagh. Finally, the study provides recommendations and future prospects for the development policies that need to be adopted in the critical Himalayan regions susceptible to land deformation. The study suggests that land deformation in the region is primarily attributed to uncontrolled anthropogenic activities, infrastructural development, along with inadequate drainage systems.

Abstract Background Glycosylation is an enzyme-catalyzed post-translational modification that is distinct from glycation and is present on a majority of plasma proteins. N-glycosylation occurs on asparagine residues predominantly within canonical N-glycosylation motifs (Asn-X-Ser/Thr) although non-canonical N-glycosylation motifs Asn-X-Cys/Val have also been reported. Albumin is the most abundant protein in plasma whose glycation is well-studied in diabetes mellitus. However, albumin has long been considered a non-glycosylated protein due to absence of canonical motifs. Albumin contains two non-canonical N-glycosylation motifs, of which one was recently reported to be glycosylated. Methods We enriched abundant serum proteins to investigate their N-linked glycosylation followed by trypsin digestion and glycopeptide enrichment by size-exclusion or mixed-mode anion-exchange chromatography. Glycosylation at canonical as well as non-canonical sites was evaluated by liquid chromatography–tandem mass spectrometry (LC–MS/MS) of enriched glycopeptides. Deglycosylation analysis was performed to confirm N-linked glycosylation at non-canonical sites. Albumin-derived glycopeptides were fragmented by MS3 to confirm attached glycans. Parallel reaction monitoring was carried out on twenty additional samples to validate these findings. Bovine and rabbit albumin-derived glycopeptides were similarly analyzed by LC–MS/MS. Results Human albumin is N-glycosylated at two non-canonical sites, Asn68 and Asn123. N-glycopeptides were detected at both sites bearing four complex sialylated glycans and validated by MS3-based fragmentation and deglycosylation studies. Targeted mass spectrometry confirmed glycosylation in twenty additional donor samples. Finally, the highly conserved Asn123 in bovine and rabbit serum albumin was also found to be glycosylated. Conclusions Albumin is a glycoprotein with conserved N-linked glycosylation sites that could have potential clinical applications.

Introduction: The prognostic significance of steroid receptors in bladder cancer remains controversial. This study was designed to determine the expression status of androgen receptor (AR), estrogen receptors (ERα and Erβ), and its potential role in predicting survival in patients with nonmuscle invasive bladder cancer (NMIBC). Methods: Sixty patients of NMIBC were screened and 57 (41 males and 16 females) were included in our study. The tissue microarray slides were evaluated by pathologists blinded to the clinical information. Association of distribution of steroid receptors with stage, grade, progression, and recurrence was seen. Results: The mean age of the population was 60.9 ± 9.3 years. Pathologically, majority of the patients were Ta (Ta: T1 stage 61.4% vs. 38.6%). Nine (15.8%) of the tumors stained positive for AR while one (1.8%) tumor stained positive for ERα and 36 (63.2%) tumors stained for ERβ. A higher proportion of male NMIBC stained positive for AR (19.5% vs. 6.2%, P = 0.420) while ERβ positivity was higher in females (58.5% vs. and 75%,P = 0.247). AR-negative tumors showed higher recurrence (20/48%–42%) as compared to AR-positive tumors (2/9%–22%). ERβ-positive tumors showed higher recurrence (15/36%–42% vs. 7/21%–33%, P = 0.179). Progression-free survival (PFS) was found to be significantly lower for ERβ-negative group (log-rank test P = 0.035). Conclusion: AR and ERβ positivity is found in NMIBC patients while ERα shows minimal staining in NMIBC patients. Although it did not reach a statistical significance, a higher proportion of AR-negative and ERβ-positive tumors recurred as compared to AR-positive and ERβ-negative patients. PFS was significantly lower in ERβ-negative group. Further exploratory studies on larger sample sizes are required to validate these findings in NMIBC patients.

Background: Mechanical ventilation is essential for managing acute respiratory failure, but traditional methods of assessing oxygenation, like the PaO2/FiO2 ratio, pose challenges due to invasiveness and cost. Objective: This single-centre prospective observational study aimed to assess the potential of the non-invasive Oxygen Saturation Index (OSI), utilising SpO2 measurements, to diagnose hypoxemia in mechanically ventilated adults. The study sought to establish correlations between OSI, oxygenation index (OI), PaO2/FiO2 ratio and SpO2/FiO2 ratio. Methods: From August 2022 to July 2023, data was collected from 1055 mechanically ventilated intensive care unit patients. Statistical analysis included correlation tests, receiver operating curve (ROC) analysis and cut-off value determination for hypoxemia diagnosis. Results: We found that the P/F ratio had a statistically significant negative correlation with OI (correlation coefficient -0.832, P value: 0.000 in hypoxemic group and correlation coefficient -0.888, P value: 0.000 in the non-hypoxemic group), and OSI (correlation coefficient -0.746, P value: 0.000 in hypoxemic group and correlation coefficient -0.629, P value: 0.000 in non-hypoxemic group) and has a positive correlation with P/F ratio (correlation coefficient 0.92, P value: 0.000 in hypoxemic group and correlation coefficient -0.67, P value: 0.000 in non-hypoxemic group). OI and OSI had a statistically significant correlation (correlation coefficient 0.955, P value: 0.000 in hypoxemic group and correlation coefficient 0.815, P value: 0.000 in non-hypoxemic group). on ROC analysis P/F ratio was the most accurate in predicting hypoxia followed by OI and OSI. with a cut-off value, of OI being 7.07, and that for OSI being 3.90, at an 80% sensitivity level to diagnose hypoxemia. Conclusion: OSI can serve as a dependable surrogate for OI, simplifying ARDS severity assessment. The P/F ratio is the most accurate predictor of hypoxia. Further research, especially in larger multicentre studies, is needed to validate these findings and explore the long-term clinical implications of using OSI for oxygenation monitoring in mechanically ventilated patients.

Abstract The functions of biomolecular condensates are thought to be influenced by their material properties, and these will be determined by the internal organization of molecules within condensates. However, structural characterizations of condensates are challenging, and rarely reported. Here, we deploy a combination of small angle neutron scattering, fluorescence recovery after photobleaching, and coarse-grained molecular dynamics simulations to provide structural descriptions of model condensates that are formed by macromolecules from nucleolar granular components (GCs). We show that these minimal facsimiles of GCs form condensates that are network fluids featuring spatial inhomogeneities across different length scales that reflect the contributions of distinct protein and peptide domains. The network-like inhomogeneous organization is characterized by a coexistence of liquid- and gas-like macromolecular densities that engenders bimodality of internal molecular dynamics. These insights suggest that condensates formed by multivalent proteins share features with network fluids formed by systems such as patchy or hairy colloids.

Abstract Biogenic coalbed methane (BCBM) reservoirs aim to produce methane from in situ coal deposits following microbial conversion of coal. Success of BCBM reservoirs requires economic methane production within an acceptable timeframe. The work reported here quantifies the findings of previously published qualitative work, where it was found that bioconversion induces strains in the pore, matrix and bulk scales. Using imaging and dynamic strain monitoring techniques, the bioconversion induced strain is quantified here. To understand the effect of these strains from a reservoir geomechanics perspective, a corresponding poromechanical model is developed. Furthermore, findings of imaging experiments are validated using core-flooding flow experiments. Finally, expected field-scale behavior of the permeability response of a BCBM operation is modeled and analyzed. The results of the study indicated that, for Illinois coals, bioconversion induced strains result in a decrease in fracture porosity, resulting in a detrimental permeability drop in excess of 60% during bioconversion, which festers itself exponentially throughout its producing life. Results indicate that reservoirs with high initial permeability that will support higher Darcian flowrates, would be better suited for coal bioconversion, thereby providing a site-selection criteria for BCBM operations.

Dextrocardia with situs inversus totalis is a rare hereditary condition characterized by reversed orientation of the major thoracic and abdominal organs. Though dextrocardia itself is not believed to increase the risk of coronary artery disease, the workup and surgical management of patients with this condition may be technically challenging to heart team clinicians. This report describes the case management of a high-risk 56-year-old man with dextrocardia who presented with multivessel coronary artery disease.

Abstract Background In patients with spinal cord compression behind the cervical vertebra who presented with myelopathy, one of the treatment modalities is anterior cervical corpectomy followed by insertion of graft or implant. Autogenous bone graft has been the choice of implant for corpectomy in the past, but due to donor site complications, it has been majorly replaced with other implants like titanium made expandable and non-expandable cages. Studies on titanium made implants for cervical compressive myelopathy have mostly focused on expandable cages with separate plates. Studies on hybrid cages and winged expandable titanium cages with (WETC) are lacking, especially in patients with poor Nurick grade. Here, we present clinical outcomes and side effects of WETC use following cervical corpectomy in 81 participants from a tertiary care center from Eastern India with 6 months of follow-up. Results We observed a considerable improvement in clinical outcomes which was measured using Nurick grade as mean scores changed from 4.06 ± 0.85 during the pre-operative stage to 2.85 ± 1.16 post-operation (P

Abstract Background Varicose vein is a chronic condition that affects the lower extremities of the human body. Several factors have been implicated in the development of this disease, viz age, gender, weight, height and prolonged standing. Recently, genome-wide studies have identified genetic biomarkers that are associated with varicose veins in different ethnic groups. Such genetic studies are lacking in South Asians specifically in Indians where the prevalence of varicose veins is high, and it is important to replicate these variants in the stated population. The study aimed to replicate the association of genetic variants associated with varicose veins in this target population, which were found to be associated with the other ethnic groups. Methodology The studied cohort is of the Indian population comprising unrelated 104 varicose veins cases and 448 non-varicose vein controls. The samples were genotyped using the Illumina Global Screening Array. Using the genomic data from UK BioBank and 23andMe studied cohorts; eight genetic variants were selected to replicate in our dataset. The allelic association was performed to identify the effective allele and risk was estimated using odds ratio and p-value as level of significance. Multifactor Dimensionality Reduction was used to estimate the cumulative effect of variants in Indians. Result Variant rs3791679 of EFEMP1 was found to be associated with varicose veins in Indians. After observing the association of the EFEMP1 with varicose veins, we further ensued to identify all genetic variants within EFEMP1 to uncover the additional variants associated with this trait. Interestingly, we identified six new variants of EFEMP1 gene that have shown association. Moreover, the cumulative effect of all associated variations was estimated and the risk was 2.7 times higher in cases than controls whereas independently their effect ranges from 0.37–1.58. Conclusion This study identifies EFEMP1 as a potential gene related to the risk of varicose veins in Indians. It also highlights that evaluating the maximum number of variants of a gene rather than focusing solely on replicating single variations offers a more comprehensive and nuanced understanding of the genetic factors contributing to a complex trait like varicose veins.

Objective: The most dreaded long-term complication of axillary lymph node dissection remains upper arm lymphedema. Our study has strategized the three most common identified causes of post treatment arm lymphedema, i.e., obesity, radiation, and neoadjuvant chemotherapy and tried to identify the histopathological and clinical or surgical factors which can predict arm lymphedema. Materials and Methods: This is a prospective observational study was conducted at a tertiary care referral centre in India, with strict inclusion criteria of BMI

Background: Pulmonary rehabilitation (PR) is a well-recognized intervention in the management of individuals with chronic obstructive pulmonary disease (COPD) that is designed to improve patients’ physical and psychosocial conditions. The primary aim of the study was to determine the effect of PR on ultrasonography (USG) assessment of diaphragmatic excursion. Materials and Methods: The current study is a prospective, interventional study in COPD (Group D) patients. All subjects underwent 8 weeks of supervised PR. The baseline assessment with USG diaphragmatic excursion, quadriceps femoris (QF) thickness, biceps brachii (BB) thickness, mid-thigh circumference, mid-arm circumference, modified Medical Research Council score, 6-min walk distance, COPD assessment test score, and after 8 weeks of supervised rehabilitation same parameters observed. Results: About 25.71% of the study population was in the age group range of 45–55 years, 51.43% between 56 and 65 years and 22.86% within 66–75 years of the age group. Out of 35 patients, 15 (42.86%) were females and the rest 20 (57.14%) were males. A significant increase was found in the diaphragmatic excursion (cm) from (P < 0.0001), mid-arm circumference (cm) (P < 0.0001), BB thickness (cm) (P < 0.0001) (upper limb strength and endurance training), and mid-thigh circumference (cm) (P < 0.0001) along with QF thickness (cm) (P < 0.0001) (lower limb strength and endurance training). Conclusion: An 8-week physical and PR program in COPD patients can lead to an improved USG diaphragmatic excursion.

Purpose: To compare various ocular thermography parameters in posterior scleritis (PS), choroiditis (choroidal granuloma [CG], Vogt–Koyanagi–Harada [VKH] syndrome), central serous chorioretinopathy (CSCR), and healthy controls. Methods: This retrospective, observational, comparative study evaluated cases undergoing ocular thermography between April 2017 and October 2023. The study groups included cases of PS, CG, and VKH, while the control group comprised CSCR cases and healthy individuals. Various thermography parameters were assessed, which were as follows: Ocular surface temperature (OST), central corneal temperature (CCT), average scleral temperature (ST), nasal scleral temperature (nST), temperature difference between both the eyes (∆t), and difference between scleral and corneal temperatures (ST – CCT, nST – CCT). Results: It was found that ∆t was significantly higher in the PS group compared to the CG (P = 0.005), CSCR (P = 0.0001), and control groups (dilated control: P =0.006, undilated control: P = 0.0001). ST – CCT and nST – CCT were significantly higher in the undilated control and CSCR groups and significantly lower in the PS group. ST – CCT and nST – CCT showed less difference in the affected eyes compared to contralateral healthy eyes of PS and CG cases. OST, CCT, ST, and nST displayed statistically insignificant differences across all groups. Conclusion: It is advisable to focus on temperature differences between the affected and healthy eyes, or the difference between the central corneal and scleral temperature of the affected eye, utilizing parameters such as ∆t, ST – CCT, and nST – CCT. These composite parameters offer a more effective approach than individual measurements like OST, CCT, ST, and nST. Thermography can serve as a screening tool to suspect and differentiate PS.

Introduction: Stature is one of the most commonly used anthropometric dimensions for identification purposes in forensic investigations and for assessing the development and growth of individuals. It is well-known that various anatomical anthropometric parameters can accurately estimate stature. Aim: To estimate stature among healthcare workers in Himachal Pradesh using linear regression equations based on percutaneous anthropometric parameters of the upper limbs and trunk. Materials and Methods: This cross-sectional study was conducted on healthcare workers at Dr. Rajendra Prasad Government Medical College, Kangra, Tanda, Himachal Pradesh for a one year (September 2021-August 2022) duration. The study included 360 healthy healthcare workers from the Himachal Pradesh population, 180 females and 180 males, aged 21 years and above. Stature, arm span, Biacromial Breadth (BAB), and forearm length dimensions were measured for each subject. Statistical analysis was done using Microsoft Excel and Epi-Info version 7.1 software. The Pearson Correlation Coefficient was used to determine the correlation between stature and different anatomical anthropometric parameters. Linear regression equations were developed to estimate stature, with significance set at p-value ≤0.001. Results: The mean age of the study population was 41.33±28.91 years. The descriptive anthropometric parameters measured in the study were as follows: stature 162.4±6.85 and 149.4±7.15, arm span 165.67±7.5 and 150.31±8.33, right forearm length 26.68±1.33 and 24.36±1.59, left forearm length 26.47±1.30 and 24.30±1.55, BAB 34.11±2.16 and 31.74±2.32, respectively for males and females. Conclusion: The regression equations derived from this study can be valuable for estimating stature in situations where accurate stature measurements are not feasible.

Abstract Introduction The study aimed to evaluate comparability in terms of efficacy, safety and immunogenicity of Sun’s ranibizumab biosimilar with reference ranibizumab in patients with neovascular age-related macular degeneration (nAMD). Methods This prospective, randomised, double-blind, two-group, parallel-arm, multicentre, phase 3 comparative study included patients with nAMD ≥ 50 years, randomised (in a 2:1 ratio) in a double-blind manner to receive 0.5 mg (0.05 mL) intravitreal injection of either Sun’s ranibizumab or reference ranibizumab in the study eye every 4 weeks until week 16 (total of four doses). Results Primary endpoint results demonstrated equivalence in the proportion of patients who lost fewer than 15 letters from baseline best-corrected visual acuity (BCVA) to the end of week 16 (99% of patients in Sun’s ranibizumab and 100% in reference ranibizumab; p > 0.9999), with the proportional difference (90% confidence interval) at −1% (−2.51, +0.61) lying within a pre-specified equivalence margin. Visual acuity improved by 15 or more letters in 43% of Sun’s ranibizumab group and 37% of the reference ranibizumab group (p = 0.4267). The mean increase in BCVA was 15.7 letters in Sun’s ranibizumab group and 14.6 letters in the reference ranibizumab group (p

This article presents a four-element directional multiple input multiple output (MIMO) rectangular dielectric resonator antenna (RDRA) equipped with strategically placed copper reflector plates to enhance port isolation. This design aims to achieve an extended coverage range without compromising the coverage area. The proposed MIMO antenna is 3D printed using biodegradable polylactic acid to ensure mechanical robustness and then integrated with the substrate to prevent mis-mounting issues. The proposed design exhibits good MIMO characteristics, registering a 3-GHz bandwidth (4–7 GHz) for |S11|≤−10 dB and a minimum radiation gain of 7 dBi for all four RDRAs. The antenna demonstrates a rotation of radiation patterns for different ports, thus enabling beam formation in specific directions. With a beam width of 71.2°, the antenna covers all directions without any fade zones. The proposed 3D printed antenna offers simplicity, strong MIMO properties, and practicality for wireless communication systems, making it suitable for industrial, scientific, and medical band applications.

Abstract Glaucoma is the leading cause of irreversible blindness worldwide. Among all glaucoma types, primary angle closure glaucoma (PACG) affects approximately 23 million people worldwide, and is responsible for 50% of glaucoma-related blindness, highlighting the devastating consequences of this disease. The main mechanism of PACG is relative pupillary block. High-risk populations are female gender, Asian ethnicity, high hyperopia, short axial length, and a thick/anteriorly positioned lens. This review discusses the clinical diagnosis, classification, and management of patients with a narrow angle with and without intraocular pressure (IOP) elevation and glaucomatous optic nerve damage, including laser peripheral iridotomy (LPI), endocycloplasty (ECPL), lens extraction, and goniosynechialysis.

Abstract Background Clinical practice guidelines on limitation of life-sustaining treatments (LST) in the intensive care unit (ICU), in the form of withholding or withdrawal of LST, state that there is no ethical difference between the two. Such statements are not uniformly accepted worldwide, and there are few studies on LST limitation in Asia. This study aimed to evaluate the predictors and outcomes of withholding and withdrawal of LST in Singapore, focusing on the similarities and differences between the two approaches. Methods This was a multicentre observational study of patients admitted to 21 adult ICUs across 9 public hospitals in Singapore over an average of three months per year from 2014 to 2019. The primary outcome measures were withholding and withdrawal of LST (cardiopulmonary resuscitation, invasive mechanical ventilation, and vasopressors/inotropes). The secondary outcome measure was hospital mortality. Multivariable generalised mixed model analysis was used to identify independent predictors for withdrawal and withholding of LST and if LST limitation predicts hospital mortality. Results There were 8907 patients and 9723 admissions. Of the former, 80.8% had no limitation of LST, 13.0% had LST withheld, and 6.2% had LST withdrawn. Common independent predictors for withholding and withdrawal were increasing age, absence of chronic kidney dialysis, greater dependence in activities of daily living, cardiopulmonary resuscitation before ICU admission, higher Acute Physiology and Chronic Health Evaluation (APACHE) II score, and higher level of care in the first 24 h of ICU admission. Additional predictors for withholding included being of Chinese race, the religions of Hinduism and Islam, malignancy, and chronic liver failure. The additional predictor for withdrawal was lower hospital paying class (with greater government subsidy for hospital bills). Hospital mortality in patients without LST limitation, with LST withholding, and with LST withdrawal was 10.6%, 82.1%, and 91.8%, respectively (p

Abstract To meet the growing demand for vegetable production and promote sustainable agriculture, it is imperative to implement effective input management and adopt eco-friendly farming practices. This study aims to compare the environmental impacts of conventional and organic tomato cultivation in the northern plains of India. This study utilizes SimaPro 9.1.1 software for a comprehensive cradle-to-farm gate Life Cycle Assessment (LCA), assessing production stages, identifying key environmental factors, and incorporating ReCiPe Midpoint and Endpoint methods with one-hectare as a functional unit. Findings reveal that conventional cultivation is more affected by fertilizer application and transplanting, while organic cultivation emphasizes transplanting and irrigation. Organic cultivation contributes 904.708 kg CO2, while conventional cultivation contributes 1307.917 kg CO2 to Global Warming potential. Switching to organic cultivation leads to a significant 35.04% decrease in all impact categories. Using the endpoint method, organic cultivation achieves a notable 27.16% reduction, scoring 58.30 compared to conventional cultivation's 80.04. The LCA analysis of tomato cultivation highlights Fertilizer application as the predominant environmental concern, emphasizing the need for sustainable techniques to minimize waste and mitigate environmental impacts. This study recommends imposing restrictions on fertilizer and pesticide use and formulating effective policies to promote the adoption of sustainable practices.

Abstract Immune checkpoint inhibitor-mediated colitis (IMC) is a common adverse event of treatment with immune checkpoint inhibitors (ICI). We hypothesize that genetic susceptibility to Crohn’s disease (CD) and ulcerative colitis (UC) predisposes to IMC. In this study, we first develop a polygenic risk scores for CD (PRSCD) and UC (PRSUC) in cancer-free individuals and then test these PRSs on IMC in a cohort of 1316 patients with ICI-treated non-small cell lung cancer and perform a replication in 873 ICI-treated pan-cancer patients. In a meta-analysis, the PRSUC predicts all-grade IMC (ORmeta=1.35 per standard deviation [SD], 95% CI = 1.12–1.64, P = 2×10−03) and severe IMC (ORmeta=1.49 per SD, 95% CI = 1.18–1.88, P = 9×10−04). PRSCD is not associated with IMC. Furthermore, PRSUC predicts severe IMC among patients treated with combination ICIs (ORmeta=2.20 per SD, 95% CI = 1.07–4.53, P = 0.03). Overall, PRSUC can identify patients receiving ICI at risk of developing IMC and may be useful to monitor patients and improve patient outcomes.

Abstract Background Aerobic anoxygenic phototrophic (AAP) bacteria are heterotrophic bacteria that supply their metabolism with light energy harvested by bacteriochlorophyll-a-containing reaction centers. Despite their substantial contribution to bacterial biomass, microbial food webs, and carbon cycle, their phenology in freshwater lakes remains unknown. Hence, we investigated seasonal variations of AAP abundance and community composition biweekly across 3 years in a temperate, meso-oligotrophic freshwater lake. Results AAP bacteria displayed a clear seasonal trend with a spring maximum following the bloom of phytoplankton and a secondary maximum in autumn. As the AAP bacteria represent a highly diverse assemblage of species, we followed their seasonal succession using the amplicon sequencing of the pufM marker gene. To enhance the accuracy of the taxonomic assignment, we developed new pufM primers that generate longer amplicons and compiled the currently largest database of pufM genes, comprising 3633 reference sequences spanning all phyla known to contain AAP species. With this novel resource, we demonstrated that the majority of the species appeared during specific phases of the seasonal cycle, with less than 2% of AAP species detected during the whole year. AAP community presented an indigenous freshwater nature characterized by high resilience and heterogenic adaptations to varying conditions of the freshwater environment. Conclusions Our findings highlight the substantial contribution of AAP bacteria to the carbon flow and ecological dynamics of lakes and unveil a recurrent and dynamic seasonal succession of the AAP community. By integrating this information with the indicator of primary production (Chlorophyll-a) and existing ecological models, we show that AAP bacteria play a pivotal role in the recycling of dissolved organic matter released during spring phytoplankton bloom. We suggest a potential role of AAP bacteria within the context of the PEG model and their consideration in further ecological models.

Abstract Background Intravenous fluid administration is regarded as a universal therapy in critical care. It is the mainstay of treatment in patients with dehydration, blood loss, sepsis, electrolyte imbalance, and shock. Crystalloids (for example, normal saline, lactated Ringer’s, Hartmann’s, Normosol, Isolyte, and PlasmaLyte solutions) and colloids (for example, albumin, or synthetic dextrans, gelatins, and starches) are the two types of commonly used IV fluids. Main text Resuscitation, replacement, and maintenance are the three main indications for intravenous fluid administration. Despite their widespread use, there is no standard therapeutic dose for IV fluids and clinicians are less familiar with the indications to stop IV fluid administration. Appropriate fluid management to maintain tissue perfusion while avoiding potentially harmful effects of IV fluid administration such as fluid overloading, metabolic acidosis, acute kidney injury, and electrolyte imbalance should be the core principle of treatment. Conclusion This review will focus on the role of different types of intravenous fluid in critically ill patients, including their side effects and applications in various types of shock.

The onset of metabolic dysfunction-associated steatohepatitis (MASH) or non-alcoholic steatohepatitis (NASH) represents a tipping point leading to liver injury and subsequent hepatic complications in the natural progression of what is now termed metabolic dysfunction-associated steatotic liver diseases (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD). With no pharmacological treatment currently available for MASH/NASH, the race is on to develop drugs targeting multiple facets of hepatic metabolism, inflammation, and pro-fibrotic events, which are major drivers of MASH. Nuclear receptors (NRs) regulate genomic transcription upon binding to lipophilic ligands and govern multiple aspects of liver metabolism and inflammation. Ligands of NRs may include hormones, lipids, bile acids, and synthetic ligands, which upon binding to NRs regulate the transcriptional activities of target genes. NR ligands are presently the most promising drug candidates expected to receive approval from the United States Food and Drug Administration as a pharmacological treatment for MASH. This review aims to cover the current understanding of NRs, including nuclear hormone receptors, non-steroid hormone receptors, circadian NRs, and orphan NRs, which are currently undergoing clinical trials for MASH treatment, along with NRs that have shown promising results in preclinical studies.

There are proponents of decompressive craniectomy (DC) and its various modifications who claim reasonable clinical outcomes for each of them. Clinical outcome in cases of traumatic brain injury, managed conservatively or aided by different surgical techniques, depends on multiple factors, which vary widely among patients and have complex interplay, making it difficult to compare one case with another in absolute terms. This forms the basis of the perceived necessity to have a standard model to study, compare, and strategize in this field. We designed a phantom-based model and present the findings of the study aimed at establishing a correlation of the volume of intracranial space and changes in intracranial pressure (ICP) with surface area of the craniectomy defect created during DC and brain herniation volume. A roughly hemispherical radio-opaque container was scanned on a 128-slice computed tomography scanner. Craniectomies of different sizes and shapes were marked on the walls of the phantom. Two spherical sacs of stretchable materials were subsequently placed inside the phantom, fixed to three-way connectors, filled with water, and connected with transducers. The terminals of the transducer cables were coupled with the display monitor through a signal amplifier and processor module. Parts of the wall of the phantom were removed to let portions of the sac herniate through the defect, simulating a DC. Volume measurements using AW volume share 7? software were done. Resection of a 12.7???11.5?cm part of the wall resulted in a 10-cm-diameter defect in the wall. Volume differential of 35?mL created a midline shift of 5?mm to the side with lesser volume. When measuring pressure in two stretchable sacs contained inside the phantom, there always remained a pressure differential ranging from 1 to 2?mm Hg in different recordings, even with sacs on both sides containing an equal volume of fluids. Creating a circular wall defect of 10?cm in diameter with an intracavitary pressure of 35?mm Hg on the ipsilateral sac and 33?mm on the contralateral sac recorded with intact walls, resulted in a true volume expansion of 48.411?cm3. The herniation resulted in a reduction of pressure in both sacs, with the pressure recorded as 25?mm in the ipsilateral sac and 24?mm in the contralateral sac. The findings closely matched those of the other model-based studies. Refinement of the materials used is likely to provide a valid platform to study cranial volume, ICP, craniectomy size, and brain prolapse volume in real time. The model will help in pre-operatively choosing the most appropriate technique between a classical DC, a hinge craniotomy, and an expansive cranioplasty technique in cases of refractory raised ICP.

Abstract Background Public–private partnerships (PPP) are often how health improvement programs are implemented in low-and-middle-income countries (LMICs). We therefore aimed to systematically review the literature about the aim and impacts of quality improvement (QI) approaches in PPP in LMICs. Methods We searched SCOPUS and grey literature for studies published before March 2022. One reviewer screened abstracts and full-text studies for inclusion. The study characteristics, setting, design, outcomes, and lessons learned were abstracted using a standard tool and reviewed in detail by a second author. Results We identified 9,457 citations, of which 144 met the inclusion criteria and underwent full-text abstraction. We identified five key themes for successful QI projects in LMICs: 1) leadership support and alignment with overarching priorities, 2) local ownership and engagement of frontline teams, 3) shared authentic learning across teams, 4) resilience in managing external challenges, and 5) robust data and data visualization to track progress. We found great heterogeneity in QI tools, study designs, participants, and outcome measures. Most studies had diffuse aims and poor descriptions of the intervention components and their follow-up. Few papers formally reported on actual deployment of private-sector capital, and either provided insufficient information or did not follow the formal PPP model, which involves capital investment for a explicit return on investment. Few studies discussed the response to their findings and the organizational willingness to change. Conclusions Many of the same factors that impact the success of QI in healthcare in high-income countries are relevant for PPP in LMICs. Vague descriptions of the structure and financial arrangements of the PPPs, and the roles of public and private entities made it difficult to draw meaningful conclusions about the impacts of the organizational governance on the outcomes of QI programs in LMICs. While we found many articles in the published literature on PPP-funded QI partnerships in LMICs, there is a dire need for research that more clearly describes the intervention details, implementation challenges, contextual factors, leadership and organizational structures. These details are needed to better align incentives to support the kinds of collaboration needed for guiding accountability in advancing global health. More ownership and power needs to be shifted to local leaders and researchers to improve research equity and sustainability.

Abstract Epilepsy is one of the most common neurologic conditions. Its clinical manifestations are not restricted to seizures but often include cognitive disturbances and psychiatric disorders. Prospective population-based studies have shown that people with epilepsy have an increased risk of developing mood disorders, and people with a primary mood disorder have an increased risk of developing epilepsy. The existence of common pathogenic mechanisms in epilepsy and mood disorders may explain the bidirectional relation between these two conditions. Recognition of a personal and family psychiatric history at the time of evaluation of people for a seizure disorder is critical in the selection of antiseizure medications: those with mood-stabilizing properties (e.g., lamotrigine, oxcarbazepine) should be favoured as a first option in those with a positive history while those with negative psychotropic properties (e.g., levetiracetam, topiramate) avoided. While mood disorders may be clinically identical in people with epilepsy, they often present with atypical manifestations that do not meet ICD or DSM diagnostic criteria. Failure to treat mood disorders in epilepsy may have a negative impact, increasing suicide risk and iatrogenic effects of antiseizure medications and worsening quality of life. Treating mood disorders in epilepsy is identical to those with primary mood disorders. Yet, there is a common misconception that antidepressants have proconvulsant properties. Most antidepressants are safe when prescribed at therapeutic doses. The incidence of seizures is lower in people randomized to antidepressants than placebo in multicenter randomized placebo-controlled trials of people treated for a primary mood disorder. Thus, there is no excuse not to prescribe antidepressant medications to people with epilepsy.

Abstract Lysosomal storage disorders (LSDs) are predominantly enzyme deficiencies leading to substrate accumulation, causing progressive damage to multiple organs. To date, a crucial part of diagnosing LSDs is measuring enzymatic activity in leucocytes, plasma, or dried blood spots (DBS). Here, we present results from a proof‐of‐principle study, evaluating an innovative digital microfluidics (DMF) platform, referred to as SEEKER®, that can measure the activity of the following four lysosomal enzymes from DBS: α‐L‐iduronidase (IDUA) for mucopolysaccharidosis I (MPS I), acid α‐glucosidase (GAA) for Pompe disease, β‐glucosidase (GBA) for Gaucher disease, and α‐galactosidase A (GLA) for Fabry disease. Over 900 DBS were analysed from newborns, children, and adults. DMF successfully detected known patients with MPS I, Pompe disease, and Gaucher disease, and known males with Fabry disease. This is the first demonstration of this multiplexed DMF platform for identification of patients with LSDs in a specialised diagnostic enzyme laboratory environment. We conclude that this DMF platform is relatively simple, high‐throughput, and could be readily accommodated into a specialised laboratory as a first‐tier test for MPS I, Pompe disease, and Gaucher disease for all patients, and Fabry disease for male patients only.

In a span of 4 months, there were 7 cases of meningococcal meningitis who presented with diagnostic dilemma and also a few atypical manifestations. A retrospective data analysis was carried out in children diagnosed with meningococcal meningitis who were admitted from October 2022 to January 2023. There were 7 confirmed cases of Neisseria meningitidis infections during the study period. The median age of presentation was 6 years (range: 4.5 months–9 years) with four males and three females. All the children presented with fever, but none had signs of meningeal irritation as such. Routine blood and cerebrospinal fluid (CSF) analysis were also near normal. Reverse transcriptase polymerase chain reaction (RT-PCR) for N. meningitidis was positive in the CSF samples of all the seven cases. All of the patients recovered completely, except that there were residues of neurodeficit in one patient. In endemic areas, pediatricians should have a low threshold of suspicion for N. meningitidis in children presenting with signs and symptoms involving the central nervous system and consider an RT-PCR of the CSF sample even if routine blood and CSF studies are near normal.

Objective Decompressive craniectomy (DC) is an urgent procedure which is done to decrease intracranial pressure. A study of the complications would suggest measures to improve the care. This study was focused on analyzing the complications after cranioplasty (CP) and to identify risk factors that may be associated with the failure of the procedure.

Background: Minimal intrusive TMJ operations have been recommended as a substitute for conservative therapy when conservative measures fail to relieve significant acute pain, chronic discomfort, inflammation, and/or degenerative illness, specifically in TMD cases. Aim: This study was conducted to investigate minimally invasive approaches (TMJ arthrocentesis and TMJ arthroscopy) in the treatment of temporomandibular joint (TMJ) disorders. Methods and Materials: It was a prospective study which included 30 clinically and radiographically diagnosed cases of TMDs. The study participants underwent two main therapy was carried out: TMJ arthrocentesis and TMJ arthroscopy. There was assessment of pain through VAS scale and maximum mouth opening (MMO) 1 month preoperatively as well as 3 months postoperatively. Results: There was statistically significant decrease in mean VAS score and increase in MMO in patients treated with TMJ arthrocentesis and TMJ arthroscopy. When there is comparison between TMJ arthrocentesis and TMJ arthroscopy, then there was more reduction in pain and increase in MMO in TMJ arthroscopy; however, the difference was non-significant statistically at both preoperative and postoperative situations. Conclusion: Minimally invasive approaches like TMJ arthrocentesis and TMJ arthroscopy can be useful in the treatment of TMJ disorders.

Conventional breeding approaches have played a significant role in meeting the food demand remarkably well until now. However, the increasing population, yield plateaus in certain crops, and limited recombination necessitate using genomic resources for genomics-assisted crop improvement programs. As a result of advancements in the next-generation sequence technology, GABs have developed dramatically to characterize allelic variants and facilitate their rapid and efficient incorporation in crop improvement programs. Genomics-assisted breeding (GAB) has played an important role in harnessing the potential of modern genomic tools, exploiting allelic variation from genetic resources and developing cultivars over the past decade. The availability of pangenomes for major crops has been a significant development, albeit with varying degrees of completeness. Even though adopting these technologies is essentially determined on economic grounds and cost-effective assays, which create a wealth of information that can be successfully used to exploit the latent potential of crops. GAB has been instrumental in harnessing the potential of modern genomic resources and exploiting allelic variation for genetic enhancement and cultivar development. GAB strategies will be indispensable for designing future crops and are expected to play a crucial role in breeding climate-smart crop cultivars with higher nutritional value.

Hercynite i.e.,FeAl2O4 is an earth-abundant spinel mineral with a cubic crystal structure and belongs to the normal spinel ferrites possessing optical absorption in the visible range as well as superior magnetic and thermal properties. Herein, we synthesized nanosized FeAl2O4 where the citric acid-mediated sol–gel auto-combustion method was employed to achieve its pure phase and studied its physicochemical properties. Furthermore, the superior colloidal dispersion stability of the FeAl2O4 nanoparticles was achieved required for antibacterial activity and standardised via post-synthesis surface functionalisation using amino-propyl-triethoxysilane (APTES). We further characterised the material using states of art characterisation techniques for their structural, morphological, optical and thermal properties. Finally, the antibacterial activity of pure and surface functionalised FeAl2O4 nanoparticles was investigated against the Escherichia coli (E. coli) strain. We observed good penetration of surface functionalised FeAl2O4 nanoparticles into the bacterial membranes due to the high degree of dispersion achieved via cationic surface charge. Conclusively, a key finding of this study is the enhanced antibacterial properties of surface functionalised FeAl2O4 nanoparticles for the concentration of 31 µg/mL compared to pure FeAl2O4 nanoparticles at 62 µg/mL. This study has great relevance in the area of wound healing and tissue regeneration in the future.

Anaerobic digestion (AD) offers a sustainable solution for clean energy production, with the potential for significant revenue enhancement through enhanced decision-making. However, the complexity and limited flexibility of AD systems pose challenges in developing reliable optimisation methods. Changing feeding strategies provides opportunities for efficient feedstock utilisation and optimal gas production, especially in volatile gas markets.To provide better decision-making tools in AD for energy production, we propose an integrated site model for the dynamic behaviour of the AD process in a biomethane-to-grid system and optimise production based on predicted gas prices. The model includes methods for optimal feed co-digestion strategies and integrates these results into a scheduling model to identify the optimal feedstock acquisition, feeding pattern, and potential gas storage operation considering feedstock availability, properties, sustainability, and fluctuating gas demand under different pricing variations.The methodology was tested on a 150 tonnes per day farm-scale AD plant in the UK, processing energy crops and manure considering both environmental (global warming potential) and economic objectives. The results showed strong adaptability of the proposed feeding schedule to the general trend of gas prices over time. To address the challenge of immediate price peaks, typically unattainable due to the system's sluggish behaviour and high retention times, the impacts of on-site storage were explored, leading to annual revenue increases ranging from 2 % to 7.4 %, depending on the pricing scheme, which translates to a significant boost in terms of revenue.

Microbreweries have greater production costs per litre of beer compared to large breweries, as well as higher carbon footprints. Due to the range of different retrofit technologies available and the different capacities and configurations of microbreweries, it is not always clear what retrofits will improve operations. Therefore, this work proposes a novel mixed-integer nonlinear programming decision-making tool to be used by any microbrewery, that determines the technoeconomic feasibility and sizing of energy efficiency-improving retrofits, including solar and wind power, battery storage, anaerobic digestion, boiler type selection, heat integration by heat storage, and carbon capture via dual-function materials. The model was demonstrated on a real UK microbrewery case study. The model gave an optimal configuration of a 10 m3 anaerobic digester, 30 solar panels outputting 380 W each, an 800 W wind turbine and a 2.3 m3 heat storage tank, reducing annual operating costs by 62.9 % and carbon dioxide emissions by 77.1 % with a payback period of 8 years. The tool is designed to be flexible for use by any microbrewery in any location with any brewing recipe and allow the owner(s) to develop more profitable and sustainable microbreweries.Tweetable abstractMicrobreweries can implement mathematically optimised renewable energy, heat integration and anaerobic digestion to reduce operating costs by 62.9 % and carbon emissions by 77.1 %.

Consumers can receive guarantees through the certified evaluation tool of agriculture resources analysis of natural farming (CETARA NF) without having to deal with costly third-party certification's entry obstacles or complex participatory guarantee systems. The purpose of this study is to examine the reasons for farmers' engagement in CETARA-NF as well as their experiences and results. 400 farmers randomly interviewed from 4 agroclimatic zones using the well-structured questionnaire from a 135,000 certified farmers list. Most farmers fall under the Two Star category (61.5 %), followed by One Star (28.5 %) and Three Star (10 %). The findings imply that 61 per cent of farmers are transitioning towards natural farming as these farmers have minimised or eliminated the chemical use in their farming practices. Significant factors of adoption for this certification system were increased marketed quantity, chemical fertiliser cost and no certification cost. Also, market access (Rank 1), no cost of certification (Rank 2) and women friendly (Rank 3) recognized as the major advantages of this certification. CETARA-NF can be an alternative certification solution for smallholders by securing the integration of grassroots agroecological cooperation and customs inside natural farming systems, thereby overcoming certification barriers.

In pharmaceutical manufacturing, integrating model-based design and optimization can be beneficial for accelerating process development. This study explores the utilization of Machine Learning (ML) techniques as a surrogate model for the optimization of a three-unit wet-granulation based flowsheet model for solid dosage form manufacturing. First, a reduced representation of a wet granulation flowsheet model is developed, incorporating a granulation and milling process, along with a novel dissolution model that accounts for the effect of particle size, porosity, and microstructure on dissolution rate. Two optimization approaches are compared, including an autoencoder-based inverse design and a surrogate-based forward optimization. Both methods address the bi-objective problem of maximizing dissolution time and product yield by identifying the optimal granulation and mill process parameters. For this case study, both approaches were effective and incurred a similar computational cost, averaging under 4 s. However, the autoencoder approach offers an advantage through dimensionality reduction, a feature not available in surrogate-based optimization. Dimensional reduction is particularly beneficial for complex process designs with numerous inputs and outputs. The lower dimensional representation helps improve process understanding through enhanced visualization of the process design space and facilitates feasibility studies involving multiple constraints. The autoencoder-based inverse design introduced in this work showcases an implementation of AI and ML in pharmaceutical process development, demonstrating the potential to enhance process efficiency and product quality in complex manufacturing scenarios.

Carotenoids are potential antioxidants offering extensive human health benefits including protection against chronic diseases. Augmenting the supply of health-benefiting compounds/metabolites through dietary supplements is the most sustainable way for a healthy life. Our study compares the traditional rice cultivar Kavuni and the white rice variety ASD 16. RNA-Seq analysis was carried out in the maturing panicles of Kavuni, which are enriched with antioxidants such as the therapeutic carotenoid lutein, polyphenols, and anthocyanins, along with “ASD 16”, a popularly eaten white rice variety, to elucidate the molecular networks regulating accumulation of health benefiting compounds. Systematic analysis of transcriptome data identified preferential up-regulation of carotenoid precursors (OsDXS, OsGGPS) and key carotenoid biosynthetic genes (OsPSY1, OsZ-ISO) in the maturing grains of Kavuni. Our study also identified enhanced expression of OsLYC-E, OsCYP97A, and OsCYP97C transcripts involved in the alpha-carotenoid biosynthetic pathway and thereby leading to elevated lutein content in the grains of Kavuni. Kavuni grains showed preferential down-regulation of negative regulators of carotenoid metabolism viz., AP2 and HY5 and preferential up-regulation of positive modulators of carotenoid metabolism viz., Orange, OsDjB7, and OsSET29, thus creating a favorable molecular framework for carotenoid accumulation. Our study has unearthed valuable gene control points for precise manipulation of carotenoid profiles through CRISPR-based gene editing in rice grains. Perturbation of carotenoid biosynthesis holds unprecedented potential for the rapid development of the next generation of ‘Golden rice’.

An environmentally benign green and metal-free visible light mediated approach for the synthesis of biologically potent 4(3H)-quinazolinone through multicomponent reaction of readily available starting materials potassium salt of anthranilic acid, aryl carboxylic acid, aliphatic/aromatic amine catalyzed by Eosin-Y has been developed with wide range of applications in pharmaceutical. Integrated process reduces the mechanical loss of the intermediate during the process of isolation.

This study reports the synthesis and characterization of a novel series of 5-nitro-N-phenyl-3-(phenylamino)-1H-indazole-1-carboxamide derivatives (5a-5v) obtained through the reaction of 3-chloro-5-nitro-N-phenyl-1H-indazole-1-carboxamide (4) with diverse aniline derivatives in isopropanol. The compounds underwent thorough biological evaluation encompassing antibacterial, antifungal, and in addition to antioxidant potential assessed through DPPH (IC50 = 0.105-0.513 μmol/mL) and ABTS assays (IC50 = 0.124-0.538 μmol/mL). Remarkably, compound 5b displayed exceptional antibacterial efficacy, while compounds 5k, 5p, and 5q exhibited noteworthy antifungal potential. Compound 5k showed the most significant antioxidant activity. Molecular docking studies unveiled robust binding interactions with target enzymes (PDB ID: 3SRG), and molecular dynamics simulations indicated the stability of the most active compound at the binding site. Additionally, favourable drug-likeness and ADMET properties underscore the promising therapeutic potential of these derivatives, urging further investigations for potential clinical applications. The multifaceted activities, including antibacterial, antifungal, and antioxidant properties, make these derivatives compelling candidates for in-depth exploration in the pursuit of novel therapeutic agents.

This study presents a facile method for assessing the effect of anion functional group substitution on the water affinity of phosphonium-acetate ionic liquids. By combining the same cation with three different α-substituted carboxylate anions, the effect of anion functional group substitution on the IL miscibility with water and hygroscopicity was experimentally evaluated and rationalized using COSMO-RS sigma profile analysis. Lower critical solution temperature (LCST) phase separation experiments and water vapor partial pressure measurements revealed that there is a stark α-substitution dependency on the affinity of water for acetate [AcO], pivalate [PivO], and trifluoroacetate [TFA] derived tributyl(octyl)phosphonium [P4448] ILs. It was found that the IL water affinities varied as: [P4448][AcO] > [P4448][PivO] > [P4448][TFA]. With the lowest water partial pressure and no LCST driven phase separation, [P4448][AcO] exhibited a high affinity for water. On the other hand, [P4448][PivO] and [P4448][TFA] exhibited LCST-driven phase separation and room temperature immiscibility, respectively, with higher water partial pressures, as a result of relatively weak water affinities. COSMO-RS sigma profile analysis revealed that the aliphatic carboxylate anions should incorporate apolar interactions commensurate with or greater than the polar hydrogen bond acceptor interactions for phase immiscibility of the corresponding IL with water. It was found that the relative magnitudes of apolar and polar interactions, assessed using the anion sigma profile peak intensity ratio (Ir), are directly correlated with the IL water affinity, and inversely correlated with the solution water activity coefficient. Therefore, it was concluded that Ir forms a quantitative link between the structural changes at the molecular level and the bulk water affinity exhibited by the ionic liquid as a whole.

Introduction: As prevalence of patients with steatotic liver diseases increases throughout the world, it is necessary to have accurate and accessible methods to estimate liver fat content. Using quantitative ultrasound parameters, such as attenuation and backscatter, it is possible to estimate liver fat with MRI proton density fat fraction as the reference standard. Velacur determined fat fraction (VDFF) is a new output measurement on Velacur (Sonic Incytes Medical Corp, Vancouver, BC). Methods: This study described the results of parameter fitting and validation of VDFF, which is a combination of quantitative ultrasound parameters. Patients were recruited from sites within the US and Canada. All patients had contemporaneous Velacur and MRI proton density fat fraction scans. The quantitative ultrasound parameter fitting was completed using linear regression on a random sub-sample approach, and a separate cohort was used for validation. The AUC for detection of 5 % liver fat based on MRI-PDFF and the correlation between MRI-PDFF and VDFF was measured in both cohorts. Results: VDFF had an AUROC of 0.97 for the detection of MRI-PDFF >5 % in the parameter fitting cohort, and 0.99 in the validation cohort. The correlation [95 % CI] between MRI-PDFF and VDFF was r = 0.84 [0.78–0.89] for the parameter fitting cohort and r = 0.90 [0.82–0.95] for the validation cohort. Conclusion: The Velacur Determined Fat Fraction (VDFF) is an accurate and accessible way to estimate steatosis as measured by MRI-PDFF. Velacur VDFF can fill the unmet need of an accurate means to diagnosis hepatic steatosis and serve as a potential alternative to biopsy or MRI-PDFF.