Search

An extremely rare case of long, thin and sharp pin in a young boy which was inhaled initially and defied removal at branchoscopy was eventually recovered in stool after a long and variable course through alimentary tract has been reported. [ABSTRACT FROM AUTHOR]

Abstract Background In resource limited settings non-availability of CD4 count facility at the site could adversely affect the ART roll out programme. Point of care CD4 enumerating equipments can make the CD4 count available at the site of care and improve the patients’ management considerably. This study is aimed at determining the utility of a Point of Care PIMA CD4 analyzer (Alere, Germany) in the field settings in India. Method The blood samples were collected from 1790 participants at 21 ART centers from different parts of the country and tested using PIMA and the reference methods (FACSCalibur, FACSCount and CyFlow SL3). The paired finger prick and venous blood samples from 175 participants were tested by the PIMA CD4 Analyzer and then by FACSCalibur. Result The CD4 counts obtained by PIMA CD4 analyzer showed excellent correlation with the counts obtained by the reference methods; for venous blood the Pearson’s r was 0.921, p 500 cells/mm3, the differences in the median CD4 counts obtained by the reference method and the PIMA analyzer were not significant (P > 0.05) and the relative bias were low (−7 to 5.1%). The Intermachine comparison showed variation within the acceptable limit of%CV of 10%. Conclusion In the field settings, the POC PIMA CD4 analyzer gave CD4 counts comparable to the reference methods for all CD4 ranges. The POC equipment could identify the patients eligible for ART in 91% cases. Adequate training is necessary for finger prick sample collection for optimum results. Decentralization of CD4 testing by making the CD4 counts available at primary health centers, especially in remote areas with minimum or no infrastructure would reduce the missed visits and improve adherence of the patients.

Abstract Background The World Health Organization (WHO) recommends that the role of pharmacists in low-income settings be expanded to address the increasing complexity of HIV antiretroviral (ARV) and co-infection drug regimens. However, in many such settings including in India, many pharmacists and pharmacy workers are often neither well trained nor aware of the intricacies of HIV treatment. The aims of our study were; to determine the availability of ARVs, provision of ARVs, knowledge about ARVs, attitudes towards HIV-infected persons and self-perceived need for training among community-based pharmacies in an urban area of India. Methods We performed a survey of randomly selected, community-based pharmacies located in Pune, India, in 2004-2005 to determine the availability of ARVs at these pharmacies, how they were providing ARVs and their self-perceived need for training. We also assessed knowledge, attitudes and perceptions on HIV and ARVs and factors associated with stocking ARVs. Results Of 207 pharmacies included in the survey, 200 (96.6%) were single, private establishments. Seventy-three (35.3%) pharmacies stocked ARVs and 38 (18.4%) ordered ARVs upon request. The reported median number of ARV pills that patients bought at one time was 30, a two week supply of ARVs (range: 3-240 pills). Six (2.9%) pharmacy respondents reported selling non-allopathic medicines (i.e. Ayurvedic, homeopathy) for HIV. Ninety (44.2%) pharmacy respondents knew that ARVs cannot cure HIV, with those stocking ARVs being more likely to respond correctly (60.3% vs. 34.8%, p = 0.001). Respondents of pharmacies which stocked ARVs were also more likely to believe it was a professional obligation to provide medications to HIV-infected persons (91.8% vs. 78.8%, p = 0.007) but they were also more likely to believe that HIV-infected persons are unable to adhere to their medicines (79.5% vs. 40.9%, p < 0.01). Knowledge of the most common side effects of nevirapine, abnormal liver enzyme profile and skin rash, was reported correctly by 8 (3.9%) and 23 (11.1%) respondents, respectively. Seven (3.4%) respondents reported that they had received special training on HIV, 3 (1.5%) reported receipt of special training on ART and 167 (80.7%) reported that they believed that pharmacy staff should get special training on ART. Conclusion There is a high willingness to participate in HIV management among community-based pharmacies but there is a tremendous need for training on HIV therapies. Furthermore, stigmatizing attitudes towards HIV-infected persons persist and interventions to reduce stigma are needed, particularly among those that stock ARVs.

Background & objectives: Enteric parasites are major cause of diarrhoea in HIV infected individuals. The present study was undertaken to detect enteric parasites in HIV infected patients with diarrhoea at different levels of immunity. Methods: The study was carried out at National AIDS Research Institute, Pune, India, between March 2002 and March 2007 among consecutively enrolled 137 HIV infected patients presenting with diarrhoea. Stool samples were collected and examined for enteric parasites by microscopy and special staining methods. CD4 cell counts were estimated using the FACS count system. Results: Intestinal parasitic pathogens were detected in 35 per cent patients, and the major pathogens included Cryptosporidium parvum (12%) the most common followed by Isospora belli (8%), Entamoeba histolytica/Enatmoeba dispar (7%), Microsporidia (1%) and Cyclospora (0.7%). In HIV infected patients with CD4 count < 200 cells/µl, C. parvum was the most commonly observed (54%) pathogen. Proportion of opportunistic pathogens in patients with CD4 count <200 cells//µl was significantly higher as compared with other two groups of patients with CD4 count ≥200-499 and ≥ 500 cells/µl (P=0.001, P=0.016) respectively. Interpretation & conclusions: Parasitic infections were detected in 35 per cent HIV infected patients and low CD4 count was significantly associated with opportunistic infection. Detection of aetiologic pathogens might help clinicians decide appropriate management strategies. [ABSTRACT FROM AUTHOR]

The next generation of stretchable electronics seeks to integrate superior mechanical properties with sustainability and sensing stability. Ionically conductive and liquid-free elastomers have gained recognition as promising candidates, addressing the challenges of evaporation and leakage in gel-based conductors. In this study, a sustainable polymeric deep eutectic system is synergistically integrated with amino-terminated hyperbranched polyamide-modified fibers and aluminum ions, forming a conductive supramolecular network with significant improvements in mechanical performance. The elastomer exhibits remarkable tensile strength (6.69 MPa) and ultrahigh toughness (275.7 MJ/m 3 ), capable of lifting loads 8300 times its own weight and demonstrated notch-insensitive properties. The elastomer also possessed degradable and stepwise recyclable properties, supporting its sustainability. Its excellent mechanical performance and conductivity enable stable signal output for multifunctional electronics. A wearable strain sensor is developed, demonstrating high sensitivity (gauge factor up to 4.52) and reliable repeatability under strain. Furthermore, a durable triboelectric nanogenerator is also fabricated, delivering stable signal output over one month and demonstrating strong potential for tactile sensing across various contact materials, making it highly promising for future human-machine interaction applications. This work offers feasible strategy for the design of solid elastomer-based durable electronics and highlights the potential for multifunctional applications.

Background: Shoulder rotator cuff repair postoperative pain management is more critical than orthopedic surgeries in other limbs. This study aimed to investigate the effect of adding dexmedetomidine as an adjuvant to bupivacaine for postoperative pain management., Materials and Methods: This double-blind, randomized clinical trial was performed on 80 patients aged 20 to 60 with ASA I and II who were candidates for elective shoulder rotator cuff repair. Forty candidates in the control group received 0.1% bupivacaine intra-articular and extra-articular before surgical wound closure, and 40 patients in the intervention group received 0.1% bupivacaine and dexmedetomidine 1 µg/kg intra-articular and extra-articular. Postoperative sleep disturbance and pain intensity were measured at recovery, 4, 8, 12, 18, and 24 hours after surgery. The results were analyzed by SPSS software version 23, and a P value ≤0.05 was considered significant., Results: There were no significant differences between the two groups regarding the hemodynamic variations ( P > 0.05), except 4 hours after surgery when the mean arterial pressure in the intervention group was significantly lower than the control group ( P = 0.026). There was a significant reduction in pain scores at 8 and 12 hours after surgery in the intervention group. The night after surgery, sleep quality and the overall RCSQ score in the intervention group were significantly higher than those in the control group., Conclusion: Administering 0.1% bupivacaine and dexmedetomidine 1 µg/kg intra-articular and extra-articular before surgical wound closure effectively reduced the pain intensity and analgesic consumption. Also, it maintained patients' hemodynamic stability and enhanced sleep quality without significant adverse effects., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Advanced Biomedical Research.)

This paper introduces the Morphologically-Analyzed and Syntactically-Annotated Quran (MASAQ) dataset, a comprehensive resource designed to address the scarcity of annotated Quranic Arabic corpora and facilitate the development of advanced Natural Language Processing (NLP) models. The Quran, being a cornerstone of classical Arabic, presents unique challenges for NLP due to its sacred nature and complex linguistic features. MASAQ provides a detailed syntactic and morphological annotation of the entire Quranic text, utilizing a rigorously verified text from Tanzil.net. The dataset includes more than 131K morphological entries and 123K instances of syntactic functions, covering a wide range of grammatical roles and relationships. The annotation process involved a team of expert Arabic linguists who employed traditional i'rab methodologies to ensure high accuracy and consistency. The dataset is structured in multiple formats (tab-separated text file (tsv), SQLite3 database (.db), comma-separated file (csv), and JavaScript Object Notation (.JSON)) to cater to various research needs. MASAQ's unique features include a comprehensive tagset of 72 syntactic roles, detailed morphological analysis, and context-specific annotations. This dataset is particularly valuable for tasks such as dependency parsing, grammar checking, machine translation, and text summarization. The potential applications of MASAQ are vast, ranging from pedagogical uses in teaching Arabic grammar to developing sophisticated NLP tools. By providing a high-quality, syntactically annotated dataset, MASAQ aims to advance the field of Arabic NLP, enabling more accurate and more efficient language processing tools. The dataset is made available under the Creative Commons Attribution 3.0 License, which governs its use and distribution. It has been created in compliance with ethical guidelines and with respect for the integrity of the Quranic text., (© 2024 The Authors.)

A cross-sectional survey was conducted at Polytechnic High School (PHS) to assess the spread of COVID-19 infection among students and staff. A random cluster sampling was conducted between May 19 and August 18, 2022, after the fourth wave of COVID-19 in Senegal. IgM and IgG SARS-CoV-2 antibodies were screened using WANTAI SARS-CoV-2 ELISA assays. Seroprevalence and descriptive statistics were calculated, and associations between seropositivity and different factors were determined using logistic regression. A total of 637 participants were recruited and the median age was 21 years [18-63]. 62.0% of the participants were female, and 36.89% were male, with a male-to-female ratio = 0.59. The overall IgG and IgM seroprevalence were 92% and 6.91% respectively. Among those who tested positive for IgM, 6.75% were also positive for IgG, and 0.15% were negative for IgG. Interestingly, 6.90% of participants tested negative for both IgM and IgG. We found a higher IgM seroprevalence in men than women (9.4% vs. 5.6%) and a lower IgM seroprevalence in (18-25) age group compared to (55-65) years. We revealed a significant difference according to IgG seroprevalence among participants who declared fatigue symptoms [92.06% (95% CI: 89.96-94.16)] compared to those who did not [80.39% (95% CI: 77.31-83.47)], p = 0.0027. IgM seropositivity was found to be associated with Body Mass Index (BMI) categories (O.R. 0.238, p = 0.043), ethnic group (O.R. 0.723, p = 0.046), and marital status (O.R. 2.399, p = 0.021). Additionally, IgG seropositivity was linked to vaccination status (O.R. 4.741, p < 0.001). Our study found that most students and staff at PHS were exposed to SARS-CoV-2, confirming the virus's circulation at the time of the survey. We also identified differences in individual susceptibility that need further clarification. Our results highlight the importance of seroepidemiological surveys to assess the true impact of the COVID-19 pandemic in a community and to monitor variations in antibody response., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 THIAM et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

In the context of food transition, the agrifood sector has experienced increasingly strong demand for horticultural products. Fresh fruits and vegetables are mainly vehicles of microorganisms, including pathogens that cause human infections. Food safety and compliance with health standards in the fruits and vegetable value chain are significant concerns and multiple challenges, given the prevalence of foodborne pathologies in Southern countries, particularly in Senegal. This study aimed to describe the bacterial community and assess the microbiological quality of a range of fruits and vegetables sold on street stalls and open-air markets in Dakar, the capital city of Senegal. Samples purchased in seven sites were analyzed to isolate Escherichia coli (E. coli), Salmonella spp. and Vibrio spp. Some primary samples with a positive microbiological culture were subjected to DNA extraction and subsequent metagenomic analysis. A total of 240 fresh fruit and vegetable samples were collected, including lettuce (n = 40), tomatoes (n = 40), mango slices (n = 40), onion slices (n = 40), mint leaves (n = 40), strawberries and grapes (each n = 20). Of these samples, 50.83% (122/240) and 60.41% (145/240) were contaminated with E. coli and Vibrio spp., respectively, while Salmonella was not isolated in any product. E. coli and Vibrio spp. contamination levels, 1.3 10 3 to 6 10 6 Colonies Forming Units per gram of sample (CFU/g) and 4.55 10 2 to 8.73 10 6  CFU/g, respectively, were significantly above the thresholds acceptable for human consumption. The most contaminated samples were lettuce, with a prevalence of 98% (39/40) for E. coli and Vibrio spp. followed by mint leaves with 100% (40/40) and 93% (37/40) of the samples containing E. coli and Vibrio spp. respectively. Out of 46 samples sequenced, the metagenomic analysis revealed high contamination rates for E. coli, Vibrio spp. and Salmonella spp., with 100%, 67.39% and 93.47% of prevalence, respectively. On the other hand, the alpha diversity analysis shows high bacterial diversity in lettuce and mint leaf samples, while the beta diversity analysis highlighted the presence of two major clusters. Our results stress the need for a surveillance system that extends this investigation to a national scale while increasing the number of sampling sites and products analyzed., Competing Interests: Declarations Ethics approval and consent to participate Not applicable. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Despite considerable advances to improve colorectal cancer (CRC) survival over the last decade, therapeutic challenges remain due to the rapid metastatic dissemination of primary tumors and screening limitations. Meanwhile, the rise of CRC in younger adults (Early-onset CRC), commonly diagnosed with a metastatic form of the disease, shows the pressing need to develop more effective targeted therapies to decrease the high mortality rates associated with metastatic disease. Hyperactivation of the Rictor-mTORC2-AKT signaling pathway drives key metastatic players in diverse malignant tumors, including early- and late-onset colorectal cancer. Selective mTORC2 inhibitors are becoming a potential treatment strategy for CRC due to the therapeutic limitations of mTORC1 inhibitors. Veratridine (VTD), a lipid-soluble alkaloid extracted from Liliaceae plants, can transcriptionally increase UBXN2A, which induces 26S proteasomal degradation of the Rictor protein, a key member in the mTORC2 complex. Destabilization of Rictor protein by VTD decreases Akt phosphorylation on Ser 473 , which is responsible for metastatic signaling downstream of the mTORC2 pathway in diverse malignant tumors. VTD decreases the population of metastatic colon cancer stem cells and functions as an angiogenesis inhibitor. VTD effectively reduces the spheroid growth rate and restricts cell migration. Live cell migration and invasion assays alongside biomechanical-force-based experiments revealed that VTD suppresses colon cancer cell invasiveness and the ensuing risk of tumor metastasis. A CRC mouse model that mimics the natural stages of human sporadic CRC revealed that VTD treatment significantly decreases tumor growth in a UBXN2A-dependent manner. This study showed a novel mechanistic connection between a ubiquitin-like protein and mTORC2-dependent migration and invasion in CRC tumors. This study revealed the therapeutic benefit of selective inhibition of Rictor in CRC, particularly in tumors with a hyperactive Rictor-mTORC2 signaling pathway. Finally, this study opened a new platform for repurposing VTD, a supplemental anti-hypertension molecule, into an effective targeted therapy in CRC tumors., Competing Interests: Declarations Competing Interests The authors declare no competing financial interests.

Background: Considering the vasopressor drug categories and doses that can be used for elderly patients following hypotension are few, the present trial aimed to compare the effect of different doses of phenylephrine infusion on the prevention of hypotension in elderly patients undergoing orthopaedic lower extremities surgery., Methods: This randomised, double-blind prospective clinical trial was conducted by including 60 elderly patients older than 60 years and classified as American Society of Anesthesiology class I and II who were candidates for femur fracture fixation surgery. White and black cards randomly allocated patients to: group A (25µg/kg/h phenylephrine) or group B (35µg/kg/h phenylephrine)., Results: At the T 3 -T 7 time points, group A's systolic and diastolic blood pressure was significantly higher than in group B's (p < 0.05). However, after 27 minutes (T 0 -T 7 ) of phenylephrine infusion, statistical analysis showed no significant difference between the two groups regarding blood pressure (T 8 -T end ). The frequency of bradycardia and reactive hypertension in group B were significantly higher than in group A (p = 0.02) and (p = 0.03), respectively. There was no significant difference between the bleeding loss, blood transfusion and crystalloid volume in both groups (p > 0.05)., Conclusion: Our trial illustrated that high-dose phenylephrine infusion could not assure haemodynamic stability and may cause some side effects., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Repair of a paraconduit hernia post oesophagectomy can be challenging. We present a safe and effective method of left hiatoplasty which is feasible in the majority of cases, achieving primary no-mesh repair while protecting the gastric conduit. Operative photos and videos describe the technique and key considerations., (© 2024 The Author(s). ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons.)

Polylactic acid (PLA) is widely known for its biocompatibility, biodegradability, and high transparency. However, it still has varied limitations such as flammability, UV sensitivity, and poor oxygen barrier properties. To address these issues, a bio-based compound, hexasubstituted cyclotriphosphazene (HVP), was synthesized by using vanillin and hexachlorocyclotriphosphazene to enhance the overall performance of PLA. The resulting PLA/HVP composites demonstrated improved mechanical strength and UV resistance. Specifically, PLA/3HVP, with a 3 wt% HVP loading, achieved a UL-94 V-0 rating and a high limiting oxygen index of 26.5 %. Cone calorimeter tests revealed that PLA/3HVP possessed a significantly longer ignition time and a lower peak heat release rate compared to pure PLA. These burning testing results indicated the enhanced fire resistance. Additionally, the oxygen transmission rate of PLA/3HVP was reduced by 81.1 % compared to pure PLA. When used as food packaging, the weight loss of mangoes covered with PLA/3HVP film was 2.2 % after 7 days, compared to 2.5 % with pure PLA film, highlighting its potential for food preservation applications., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Autism is a severe neurodevelopmental condition with unknown pathobiology. Nevertheless, multiple pieces of evidence suggest long non-coding RNA (lncRNA) dysregulation may be a contributing factor to this disorder. We investigated the association between the expression of five specific lncRNAs and autism. Peripheral blood was collected from 30 children with autism and 41 healthy children. The expression levels of PCAT-29, lincRNA-ROR, LINC-PINT, lincRNA-p21, and PCAT-1 were calculated. Then, their significance as biomarkers was also evaluated. The expression of LincRNA-ROR (27 times), LINC-PINT (5.26 times), LincRNA-p21 (4.54 times), PCAT-29 (16.66 times), and PCAT-1 (25 times) genes was significantly decreased in patients compared to the control group (p values < 0.05). According to the ROC curve analysis for each lncRNA, LincRNA-ROR, LINC-PINT, LincRNA-p21, PCAT-29, and PCAT-1 lncRNAs with diagnostic power of 0.85, 0.67, 0.64, 0.74, and 0.84, respectively, could be used as diagnostic biomarkers for autism. Additionally, significant positive correlations were reported between expression levels of PCAT-1 and PCAT-29 genes. Moreover, a positive correlation was detected between expression levels of lincRNA-ROR and patients' age. The current study shows further pieces of evidence for deregulation of lncRNAs in autistic patients that show these lncRNAs may play an important part in the pathogenesis of ASD. However, the role of lncRNA in the neurobiology of autism needs to be investigated further., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: Emergence agitation (EA) is one of the common problems during recovery from general anesthesia, especially in children. In this study, we investigated the effect of dexmedetomidine on the control of agitation after anesthesia with sevoflurane in children., Method: This randomized control-placebo, double-blind prospective clinical trial was conducted on seventy-six children between 2 and 7 years with ASA (American Society of Anesthesiologists) class I who were candidates for elective adenoidectomy surgery and tonsillectomy. Participants were selected by an available sampling method. Patients were randomly placed in one of the two groups D (dexmedetomidine 0.5  μ g/kg infusion within ten minutes) or P (placebo: normal saline infusion within ten minutes). A four-point scale evaluated agitation. Pain evaluation was done by FLACC (faces, legs, activity, cry, and consolability). The statistical software was SPSS version 23. P < 0.05 was considered statistically significant., Results: The level of agitation was significantly lower in the intervention group ( P < 0.05), except after 40 minutes in the PACU (Post Anesthesia Care Unit) ( P =1.00). Patients in the control group experienced high pain scores when admitted at PACU, 10, 20, and 30 minutes after admission at PACU ( P < 0.05). Pethidine and metoclopramide prescriptions in the intervention group were lower than in the control group ( P < 0.05). Shivering occurred in five patients in the intervention group and nine in the control groups ( P =0.032). Hypotension that required intervention occurred in 3 patients in the intervention group and one in the control group ( P =0.024)., Conclusion: Our trial demonstrated that the prescription of 0.5  μ g/kg of dexmedetomidine within ten minutes after intubation significantly reduced the EA frequency, pain severity, analgesic consumption, and PONV (postoperative nausea and vomiting). However, it caused delays in the emergence from anesthesia. This trial is registered with IRCT20160430027677N14., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2024 Mitra Golmohammadi et al.)

Background: Postoperative pain management can be achieved by adjuvant medications during the analgesia procedure. The study investigated the effect of intrathecal dexamethasone-bupivacaine combination with bupivacaine alone in spinal anesthesia for cesarean delivery., Methods: This randomized, double-blind clinical examination included 50 females who had previously experienced a cesarean section. The participants were assigned randomly into two categories: the intervention group, received intrathecal bupivacaine-dexamethasone, and the control group, received intrathecal bupivacaine-normal saline. Levels of pain were evaluated using a 10 cm visual analog scale (VAS) at intervals of 30 minutes, 1 hour, 2 hours after the operation. The span of the sensory block and postoperative analgesia were assessed., Results: The inclusion of intrathecal dexamethasone with bupivacaine resulted in a significant enhancement in the duration of pain relief during the intervention, lasting for an average of 473.4 ± 39.95 minutes (p<0.001). The duration of sensory and motor block analgesia in the intervention group was more than the control group (128.32 ± 7.30 vs. 92.84 ± 7.84) and (155.6±12.34 vs. 126.16±11.89), respectively ( p <0.001). Pain score on the VAS scale at 30, 60, and 120 minutes was significantly lower in the intervention group (p<0.001). There was no difference in side effects and onset time between the study groups., Conclusion: The inclusion of intrathecal dexamethasone alongside bupivacaine has demonstrated enhancement in the duration of sensory block during spinal anesthesia. This improvement was observed without any alterations in the time it takes for the anesthesia to take effect and without any adverse effects during the postoperative period., Competing Interests: The authors report there are no competing interests to declare., (© The Author(s).)

Functionalized hexagonal boron nitride nanosheets (BNNSs) have arisen as compelling anticorrosive additives, yet the precise mechanism of their corrosion resistance enhancement in coatings remains unclear. Here, polyethylenimine functionalized BNNSs (PEI-BNNSs) with approximately 6-11 layers were prepared through a "one-step" method. Then, the PEI-BNNSs/Waterborne epoxy (WEP) composite coatings were incorporated via the waterborne latex blending method for the anticorrosion of the Q235 substrate. The impedance modulus (| Z | f = 0.01 Hz) of 0.5 wt % PEI-BNNSs/WEP composite coating soaked in 3.5 wt % NaCl solution for 35 days increased by 4 orders of magnitude compared to pure WEP coating, exhibiting exceptional long-term resistance against corrosion. The positron annihilation lifetime spectroscopy and corrosion product analysis demonstrated that the reinforced anticorrosion capabilities are not solely ascribed to the "tortuous path effect" arising from BNNSs impermeability. These mechanisms also encompass the reduction in free volume fraction and radius of the free volume cavities within the composite coating brought about by the PEI molecules. Additionally, the increase in coating adhesion, promoted by PEI, plays an important role in augmenting the barrier properties against corrosive agents. This study provided a full comprehension of the role played by functionalized BNNSs in fortifying the anticorrosion attributes of WEP coatings.

Purpose: In this study, we investigated the effect of local injection of ropivacaine and bupivacaine with magnesium sulfate on postoperative pain in vertebral laminectomy surgery., Design: This randomized double-blind prospective study was conducted among 60 patients aged 18-65 years old with ASA class I and II., Methods: Group RM: (30 people) received 70 mg ropivacaine (14 ml) plus 1 ml magnesium sulfate (500 mg) volume up to 20 ml with normal saline. Group BM: (30 people) received 70 mg bupivacaine (14 ml) plus 1 ml magnesium sulfate (500 mg) volume up to 20 ml with normal saline. The results were analyzed by SPSS 23 software, and statistical analysis consisted of χ 2 test and t -test, and a p value less than .05 was considered significant., Findings: Mean pain score based on VAS in 6 and 12 h after surgery in the RM group was lower in the BM group ( p  < 0.05). The analgesic request frequency in the RM group was lower than the BM group ( p = 0.01). The mean morphine consumption in the RM group was 185 mg and in the BM group was 220 mg. According to the T -test, there was a significant difference between the two groups ( p = 0.03). there was no significant difference between the mean arterial blood pressure and mean heart rate between the two groups at 6, 12, 24 and 24 h after surgery ( p > 0.05)., Conclusion: This study showed that wound infiltration with ropivacaine and magnesium sulfate compared to bupivacaine and magnesium sulfate provided better postoperative analgesia and significantly reduced postoperative opioid consumption in patients undergoing lumbar laminectomy.

Background: The ganglion impar block is a minimally invasive technique used for alleviating pain associated with coccydynia., Objectives: This research evaluates the effectiveness of the ganglion impar block in treating patients with coccydynia who have not benefited from conservative treatments., Methods: This cross-sectional analysis reviewed the clinical records of coccydynia patients who received ganglion impar block injections at Urmia Imam Khomeini Hospital, Urmia, Iran, between 2020 and 2022. Data regarding age, gender, body mass index (BMI), onset of pain, and levels of patient satisfaction post-treatment were gathered from the medical records., Results: The study comprised 26 patients, with 4 (15.4%) being male and 22 (84.6%) female. The average age and BMI were 39.15 ± 14.24 years and 28.91 ± 2.14 kg/m 2 , respectively, which did not show significant variation (P = 0.19). The average Visual Analogue Scale (VAS) score before the ganglion impar block was 6.23 ± 2.35, which reduced to 4.47 ± 2.41 immediately after the procedure. At the 1-month follow-up, the average VAS score had further decreased to 3.47 ± 0.79. The decrease in VAS scores, both immediately after the procedure and at the 1-month follow-up, was statistically significant. The success rate of the block (defined as a reduction in pain of at least 20% from the baseline) was significantly high immediately and one-month post-procedure (P < 0.001). Out of the 26 patients treated with the impar block, satisfaction rates were 42.3% excellent, 27% good, 19.2% fair, and 11.5% poor., Conclusions: The study endorses the trans-sacro-coccygeal "needle inside needle" method for providing relief to patients suffering from coccydynia. The findings revealed significant patient satisfaction, with the majority describing their experience as excellent., Competing Interests: The authors report there are no competing interests to declare., (Copyright © 2024, Nasiri et al.)

About 1.5% of tuberculosis manifestations is cutaneous and accounts for 0.1-0.9% of total OPD patients in India. Forty first-year postgraduate medical students were taught cutaneous TB though conventional PPT, 'Carousel Role Play' and 'Theatre of the Oppressed' technique. The statistically significant effectiveness of theatrical workshops was noted., Competing Interests: Competing InterestsThe authors declare no competing interests., (© The Author(s) under exclusive licence to International Association of Medical Science Educators 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Arabic, unlike many languages, suffers from punctuation inconsistency, posing a significant obstacle for Natural Language Processing (NLP). To address this, we present the Arabic Punctuation Dataset (APD), a large collection of annotated Modern Standard Arabic texts designed to train machine learning models in sentence boundary identification and punctuation prediction. APD leverages the "theme-rheme completion" principle, a grammatical feature closely linked to consistent punctuation placement. It consists of an annotated collection of Modern Standard Arabic (MSA) texts that encompass 312 million words in approximately 12 million sentences. It comprises three diverse components: Arabic Book Chapters (ABC): Manually annotated, non-fiction, book excerpts, constituting a gold-standard reference. Complete Book Translations (CBT): Parallel English-Arabic book translations with aligned sentence endings, ideal for machine translation training. Scrambled Sentences from the Arabic Component of the United Nations Parallel Corpus (SSAC-UNPC): Jumbled sentences for model training in automatic punctuation restoration. Beyond NLP, APD serves as a valuable resource for linguistics research, language learning, and real-time subtitling. Its authentic, grammar-based approach can enhance the readability and clarity of machine-generated text, opening doors for various applications such as automatic speech recognition, text summarization, and machine translation., (© 2024 The Author(s).)

The present study aimed to determine diagnostic performance of dried blood spot (DBS) for the detection of Hepatitis B surface antigen (HBsAg) and Hepatitis C virus antibodies (anti-HCV) using CLIA at 3 different laboratories across India. DBS can serve as a simple and convenient alternative to plasma/serum for HBsAg detection. However for anti-HCV, site-specific validation of the assay is warranted., Competing Interests: Declaration of Competing Interest The authors declare that there are no conflicts of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Introduction: India launched the COVID-19 vaccination drive on 16th January 2021 by vaccinating the adult population above 18 years of age. This was followed by the introduction of an additional precaution dose. As on 18th October 2022, 1,02,66,96,808 (1.02 Billion) first dose and 94, 95, 39,516 (949 Million) second doses of COVID-19 vaccine were administered. However, when compared to the uptake of the primary doses, the precaution dose uptake lagged behind with only 21,75, 12,721 (217 million) doses administered. Even though, the uptake of the primary doses remained optimal, irrespective of different interventions by the Government of India, the uptake of the precaution dose remained poor. In this context, the Ministry of Health & Family Welfare wanted to understand the facilitators and Barriers for precaution dose uptake among adults so that future immunization campaigns could address these issues., Methods: An exploratory qualitative study was conducted to assess the facilitators and barriers for COVID-19 precaution dose uptake at community level across 6 different states in India. From each of the states, two districts with the highest and lowest rates of COVID-19 vaccine precaution dose uptake were selected. In each of these districts, 2 block Primary Healthcare Centres (PHCs), one with high and one with low uptake were identified. Within these block PHCs, a PHC field area with high and low precaution dose uptakes was identified. From the identified sites a minimum of four IDIs, four FGDs were conducted among the community members. KIIs of the State Immunization Officers, District Immunisation Officers, PHC Medical Officers, healthcare workers like Accredited Social Health Activist/Auxiliary Nurse Midwife were also conducted. The data was audio recorded and it was transcribed, translated and analysed using framework approach., Results: It was observed that rise in COVID-19 cases prompted the community to take the precaution dose, this along with the cost of hospitalization and the number of productive days being lost as a result of being infected resulted in vaccine uptake. The fear of non-availability of COVID-19 vaccines latter on also prompted people for vaccine uptake. While the barriers were, poor accessibility to vaccination centers, long hours of travel, poor road connectivity and lack of transportation facilities. However, the most prominent barriers observed across all study sites was that a sense of pandemic fatigue and complacency had developed both among the providers as well as the beneficiaries. Other barriers include differences in vaccination schedules and longer duration between the primary doses of some vaccines. Media was identified to be both a barrier and facilitator for Covid-19 Precaution dose uptake. Even though media played an important role in disseminating information in the beginning of the campaign, it was soon followed by the circulation of both misinformation and disinformation., Discussion: The study identified that dissemination of accurate information and community involvement at each stage of planning and implementation are crucial for the success of any campaign. Efforts should be constantly made to address and re-invent strategies that will be most suitable for the needs of the community. Therefore, in order to ensure successful vaccination campaigns, it is crucial that along with political will it is also important to have a decentralized approach with inter-sectoral coordination with different stakeholders such as healthcare workers, community members and the different departments such as the local self-governments, education department, law & order department etc. These lessons learnt from COVID-19 vaccination campaigns must not be forgotten and must be applied in future vaccination campaigns and while framing public health policies., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Godbole, Diwan, Das, Reddy, Kalyanasundaram, Rajendran, Biswas, Mamulwar, Tiwari, Majumder, Mishra, Muthusamy, Memeenao, Gupta, Gupta, George, Kadale, Trushna, Saha, Alam, Kathiresan, Phukan, Sane, Bhowmik, Yadav, Krishnamurthy, Gogoi, Padhye, Kant, Ghosh, Kharat and Kulkarni.)

Extracellular vesicles (EVs) are membrane-enclosed particles secreted by a variety of cell types. These vesicles encapsulate a diverse range of molecules, including proteins, nucleic acids, lipids, metabolites, and even organelles derived from their parental cells. While EVs have emerged as crucial mediators of intercellular communication, they also hold immense potential as both biomarkers and therapeutic agents for numerous diseases. A thorough understanding of EV biogenesis is crucial for the development of EV-based diagnostic developments since the composition of EVs can reflect the health and disease status of the donor cell. Moreover, when EVs are taken up by target cells, they can exert profound effects on gene expression, signaling pathways, and cellular behavior, which makes these biomolecules enticing targets for therapeutic interventions. Yet, despite decades of research, the intricate processes underlying EV biogenesis by donor cells and subsequent uptake by recipient cells remain poorly understood. In this review, we aim to summarize current insights and advancements in the biogenesis and uptake mechanisms of EVs. By shedding light on the fundamental mechanisms governing EV biogenesis and delivery, this review underscores the potential of basic mechanistic research to pave the way for developing novel diagnostic strategies and therapeutic applications., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Yu, Sane, Kim, Yun, Kim, Jo, Wright, Khoshdoozmasouleh, Lee, Oh, Thiel, Parvin, Williams, Hannon, Lee and Kim.)

In temperate and boreal regions, perennial plants adapt their annual growth cycle to the change of seasons. In natural forests, juvenile seedlings usually display longer growth seasons compared to adult trees to ensure their establishment and survival under canopy shade. However, how trees adjust their annual growth according to their age is not known. In this study, we show that age-dependent seasonal growth cessation is genetically controlled and found that the miR156-SPL3/5 module, a key regulon of vegetative phase change (VPC), also triggers age-dependent growth cessation in Populus trees. We show that miR156 promotes shoot elongation during vegetative growth, and its targets SPL3/5s function in the same pathway but as repressors. We find that the miR156-SPL3/5s regulon controls growth cessation in both leaves and shoot apices and through multiple pathways, but with a different mechanism compared to how the miR156-SPL regulon controls VPC in annual plants. Taken together, our results reveal an age-dependent genetic network in mediating seasonal growth cessation, a key phenological process in the climate adaptation of perennial trees., Competing Interests: Competing interests statement:The authors declare no competing interest.

Summary: This paper explores the potential for occupational therapists (OTs) to manage medicines and support patients in an in-patient psychiatric ward to effectively and safely self-administer their medication. Connelly House is an occupational therapy-led six-bed, open psychiatric rehabilitation in-patient ward supporting people transitioning from being in-patients to living in the community. Policy, process, governance and training needs are identified and discussed. Positive feedback was received from patients and staff involved with the service development, opening the door for OTs to manage medicines and support the self-administration of medication on other psychiatric rehabilitation in-patient wards using focused occupational interventions.

Background: Galectin-9 induces HIV reactivation and also contributes to non-AIDS events through inflammaging. Hence, it is important to assess its levels in HIV-infected individuals to determine their association with HIV viremia and other comorbidities., Methods: Plasma galectin-9 levels were estimated in viremic (n = 152) and aviremic ( n = 395) individuals on first-line antiretroviral therapy (ART). They were assessed for correlation with HIV-1 viral load (VL), CD4 count, and ART duration, as well as for receiver operating characteristic curve analysis., Result: Plasma galectin-9 levels correlated positively with VL (r = 0.507, p < 0.0001) and ART duration (r = 0.308, p = 0.002) and negatively with CD4 count (r = -0.186, p < 0.0001). Area under the curve for galectin-9/CD4 count ratio for identifying viremic individuals was 0.906. Sensitivity and specificity of the ratio at a cutoff of 14.47 were 90.13% and 70.05%, respectively, for detecting viremic individuals. Further, galectin-9 levels correlated with cystatin C (r = 0.239, p = 0.0183), IL-18 (r = 0.311, p = 0.006), and systolic blood pressure (r = 0.220, p = 0.0355). Galectin-9-induced HIV reactivation was significantly lower in individuals on long-term ART than those on short-term ART., Conclusion: The galectin-9-to-CD4 count ratio indicated the potential of galectin-9 as a cheaper monitoring tool to detect HIV viremia. Strategies for countering the effects of galectin-9 for controlling HIV viremia and non-AIDS events are urgently warranted.

The mTORC2 pathway plays a critical role in promoting tumor progression in human colorectal cancer (CRC). The regulatory mechanisms for this signaling pathway are only partially understood. We previously identified UBXN2A as a novel tumor suppressor protein in CRCs and hypothesized that UBXN2A suppresses the mTORC2 pathway, thereby inhibiting CRC growth and metastasis. We first used murine models to show that haploinsufficiency of UBXN2A significantly increases colon tumorigenesis. Induction of UBXN2A reduces AKT phosphorylation downstream of the mTORC2 pathway, which is essential for a plethora of cellular processes, including cell migration. Meanwhile, mTORC1 activities remain unchanged in the presence of UBXN2A. Mechanistic studies revealed that UBXN2A targets Rictor protein, a key component of the mTORC2 complex, for 26S proteasomal degradation. A set of genetic, pharmacological, and rescue experiments showed that UBXN2A regulates cell proliferation, apoptosis, migration, and colon cancer stem cells (CSCs) in CRC. CRC patients with a high level of UBXN2A have significantly better survival, and high-grade CRC tissues exhibit decreased UBXN2A protein expression. A high level of UBXN2A in patient-derived xenografts and tumor organoids decreases Rictor protein and suppresses the mTORC2 pathway. These findings provide new insights into the functions of an ubiquitin-like protein by inhibiting a dominant oncogenic pathway in CRC., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

A panchromatic light-absorbing [70]fullerene-perylene-BODIPY triad ( C 70 -P-B ) was synthesized and applied as a heavy atom-free organic triplet photosensitizer for photooxidation. The photophysical processes were comprehensively investigated by the methods of steady-state spectroscopy, time-resolved spectroscopy, as well as theoretical calculations. C 70 -P-B shows a strong absorption ability from 300-620 nm. Efficient cascading intramolecular singlet-singlet energy transfer in C 70 -P-B was confirmed by the luminescence study. The backward triplet excited state energy transfer from C 70 moiety to perylene then occurs to populate 3 perylene*. Thus, the triplet excited states of C 70 -P-B are distributed on both C 70 and perylene moiety with lifetimes of 23 ± 1 μs and 175 ± 17 μs, respectively. C 70 -P-B exhibits excellent photooxidation capacity, and its yield of singlet oxygen reaches 0.82. The photooxidation rate constant of C 70 -P-B is 3.70 times that of C 70 -Boc and 1.58 times that of MB, respectively. The results in this paper are useful for designing efficient heavy atom-free organic triplet photosensitizers for practical application in photovoltaics, photodynamic therapy, etc.

Objectives: The effectiveness of lactobacilli-containing vaginal tablets (VT) in bacterial vaginosis (BV) recurrence prevention among women infected with HIV treated with standard oral metronidazole in Pune, India was studied., Methods: Women infected with HIV with confirmed BV diagnosis (Nugent score ≥7 and Amsel criteria >3) were enrolled in a 12-month, double-blind, randomized, placebo-controlled, phase IV study between 2018 and 2021. After a standard course of oral metronidazole for 7 days (400 mg three times a day), women were randomly assigned to either lactobacilli-containing or placebo VT arms to receive VTs for 4 months. BV recurrence was assessed after the initial cure from BV., Results: Of the 464 women infected with HIV, 80 women with confirmed BV were enrolled. The retention was affected due to the COVID-19 pandemic (6-month retention rates 78%). The cure was seen in 85% and 93.5% of participants from the treatment and placebo arms, respectively, after four VT cycles. BV recurrence was seen in 41.4% and 44.8% in the treatment and placebo arm, respectively, with no significant difference in the two groups., Conclusion: The lactobacilli-containing VT was acceptable and safe; however, the addition of VT over standard oral metronidazole did not show any additional benefit in the prevention of BV recurrence in women infected with HIV, indicating the need for long-term randomized trials among them. Registered at Clinical Trials Registry- India, (CTRI) Number: CTRI/2018/04/013298., Competing Interests: Declaration of competing interest The authors have no competing interests to declare., (Copyright © 2023. Published by Elsevier Ltd.)

Purpose: This study investigated the effect of oral melatonin as a premedication before cataract surgery on pain score, anxiety, surgical conditions, and intraocular pressure (IOP) during cataract surgery with phacoemulsification under topical anesthesia., Design: This randomized, double-blind prospective study was conducted among 120 patients aged 50 to 80., Methods: Patients were randomly assigned to receive either sublingual melatonin 3 mg or placebo 60 min before surgery. Verbal anxiety and pain scores, heart rate, systolic and diastolic blood pressure, intraocular pressure, and quality of surgical conditions were recorded. The results were analyzed using SPSS 23 software, and statistical analysis consisted of χ 2 test and t-test, and a P value less than .05 was considered significant., Findings: There was a significant difference between the two groups regarding pain after the surgery before being discharged from the recovery room. The mean pain score in the melatonin group was lower than the placebo group in T4 (in the postoperative ward) (P < .05). The anxiety score of patients was lower in the melatonin group in T3 and T4 (during surgery and in the postoperative ward, respectively) (P < .05). IOP was significantly lower in the case group at the end of the surgery after receiving premedication (P = .021)., Conclusions: This study showed that 3 mg Sublingual melatonin premedication for patients undergoing cataract surgery under topical anesthesia reduced patients' anxiety scores, pain score, and IOP., (Copyright © 2022 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)

Background: Shoulder pain is considered as the most important and relatively common postoperative cholecystectomy complications that often controls in recovery room by systemic narcotics that may have some side effects. The aim of this study was to evaluate the effect of premedication with oral tizanidine on shoulder pain relief after elective laparoscopic cholecystectomy., Materials and Methods: In this double-blinded clinical trial, 75 adults of American Society of Anesthesiologist physiologic state 1 and 2 scheduled for elective laparoscopic cholecystectomy under general anesthesia were selected and randomly divided in three groups of T, P, and control groups. Ninety minutes before the induction of anesthesia, patients received either 4 mg tizanidine (T group), 100 mg pregabalin (P group), or orally in 50cc or the same volume of plain water as a placebo (control group). Then, the vital signs, pain intensity, and the need for analgesic were measured during 24 hours and then compared in the groups., Results: There was no significant difference in patient characteristics, with respect to age, weight, gender, and duration of anesthesia and surgery between the groups ( P > 0.05). The pain intensity and need for analgesic were significantly lower in tizanidine and pregabalin groups than the control group ( P < 0.003) vs ( P < 0.001). There was no significant difference in vital signs characteristics between the groups., Conclusion: Oral administration of 4 mg tizanidine and 100 mg pregabalin 90 minutes before laparoscopic cholecystectomy significantly relive postoperative shoulder pain and analgesic consumption without any complication., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Advanced Biomedical Research.)

Background: Surgical procedures performed in the suboccipital and subtemporal regions are associated with severe pain. The present study was designed to determine pregabalin's effect on postoperative pain in elective craniotomy., Method: This double-blind prospective randomized clinical trial was conducted on 50 patients aged 20-60 with ASA classifications I and II. The patients who qualified for elective craniotomies were split into intervention (two capsules =300 mg pregabalin) and control groups (two capsule starch). Patients were also assessed at recovery, 2, 6, 12, and 24 h after surgery for their pain and level of sedation. Data were analyzed by SPSS software version 23, and a P-value ≤ 0.05 was considered significant., Results: The mean pain score in the intervention group was lower than the control group at recovery (p = 0.224), 2 h (p = 0.001), 6 h (p = 0.011), and 12 h (p = 0.032) after surgery. The methadone consumption in the control group was significantly higher than the intervention group (p < 0.05). There was no significant difference between the two groups regarding the level of sedation (p > 0.05). The mean heart rate at induction (p = 0.01), 15 min (p = 0.01), 30 min (p = 0.025), recovery (p = 0.031), and 2 h (p = 0.021) after surgery and the MAP at recovery, 2 h, and 6 h after surgery was significantly lower than the control group (p = 0.029), (p = 0.013), and (p = 0.038), respectively., Conclusion: Our investigation demonstrated the effectiveness of pregabalin two hours before surgery on decreasing postoperative pain and analgesic consumption without disturbance in neurological examinations and any specific adverse effects., Competing Interests: Conflict of Interests The authors declare that there were no competing interests., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Performing spinal anesthesia with at least hemodynamic variation and complications is always challenging for anesthesiologists. In this study, we investigated the effect of ephedrine and placebo on hemodynamic changes in patients undergoing percutaneous nephrolithotomy with spinal anesthesia., Methods: This randomized, double-blind prospective clinical trial was conducted on 120 patients aged 20‒60 years with ASA (American Society of Anesthesiologists) classes I and II. Patients who were candidates for percutaneous nephrolithotomy with spinal anesthesia were divided into intervention (received 1 cc = 5 mg ephedrine) and control groups (received 1 cc normal saline). All vital parameters, including HR (heart rate) and NIBP (noninvasive blood pressure), were recorded perioperatively T0-T25) and finally at the end of surgery time (Tf). The results were analyzed by SPSS software version 23, and a P value ≤0.05 was considered significant., Results: The mean arterial pressure during surgery between T3 and T9 and the mean heart rate in times of T3-T8 in the intervention group were higher than in the control group, and this difference was statistically significant ( P < 0.05). The incidence of hypotension, bradycardia, nausea, and vomiting and the amount of prescribed ephedrine, atropine, and ondansetron in the control group were higher than in the intervention group ( P =0.001). Seven patients in the control group and four in the intervention group had shivering, but this difference was not statistically significant ( P =0.43)., Conclusion: This study showed the effectiveness of the prescription of 5 mg ephedrine two minutes before changing from the lithotomy position to the supine in maintaining hemodynamic stability, reducing hypotension, bradycardia, nausea, and vomiting, and the amount of prescribed ephedrine, atropine, and ondansetron. Trial Registrations . This trial is registered with IRCT20160430027677N22., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2023 Shahryar Sane et al.)