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Background: Absence of anterior maxillary teeth has a significantly impact on esthetics, speech, mastication, and psychosocial well-being in young patients. Materials and methods: A retrospective study was conducted from January 2012 to January 2022, the data include children (8–15 years) with maxillary impacted incisors. After initial screening of the digital records, 75 cases with 80 impacted maxillary central incisors were recruited; 9 cases were excluded due to incomplete records. Results: 75 patients were found to have impacted incisors with a prevalence of 0.21 %. Patients were then divided into group 1 (

Physical dynamical systems can be described through mathematical models using the theory of differential equations. Many different types of uncertain healing occur in the real-world. Fuzzy logic is an effective mathematical tool for defining the sense of non-random uncertainty. Since fuzzy arithmetic differs from its counterparts, it would be more reliable if we use the differential equation to construct models involving uncertain decision parameters. In this paper, we attempt a detailed review of the existing literature related to the theory and application of fuzzy differential equations. The scientific review of this paper includes surveys of the Literature involving different definitions of fuzzy derivation. Distinguished solution approaches and applications of fuzzy differential equations in the fields of science, technology, and management are discussed in this paper. We also provide hints regarding future research challenges and scopes with the theory of fuzzy differential equations. This paper may be impactful documentation of the history of differential equations linking the past, present and future of the concerned research topic.

Abstract Microalgae are promising sources of valuable carotenoids like β-carotene and astaxanthin with numerous health benefits. This review summarizes recent studies on producing these carotenoids in microalgae under different salinity and light-intensity conditions, which are key factors influencing their biosynthesis. The carotenoid biosynthesis pathways in microalgae, involving the methylerythritol phosphate pathway in chloroplasts, are described in detail. The effects of high salinity and light stress on stimulating astaxanthin accumulation in species like Haematococcus pluvialis and Chromochloris zofingiensis and their synergistic impact are discussed. Similarly, the review covers how high light and salinity induce β-carotene production in Dunaliella salina and other microalgae. The diverse health-promoting properties of astaxanthin and β-carotene, such as their antioxidant, antiinflammatory, and anticancer activities, are highlighted. Strategies to improve carotenoid yields in microalgae through environmental stresses, two-stage cultivation, genetic engineering, and metabolic engineering approaches are evaluated. Overall, this review highlights advancements in β-carotene and astaxanthin production reporting the different microalgal capability to produce carotenoids under different stress level like 31.5% increase in β-carotene accumulation in Dunaliella salina and astaxanthin productivity reaching 18.1 mg/L/day in Haematococcus lacustris. It also explores novel biotechnological strategies, including CRISPR–Cas9, for enhancing carotenoid yield. Graphical Abstract

Abstract Oncogene amplification is a key driver of cancer pathogenesis. Both breakage fusion bridge (BFB) cycles and extrachromosomal DNA (ecDNA) can lead to high oncogene copy numbers, but the impact of BFB amplifications on intratumoral heterogeneity, treatment response, and patient survival remains poorly understood due to detection challenges with DNA sequencing. We introduce an algorithm, OM2BFB, designed to detect and reconstruct BFB amplifications using optical genome mapping (OGM). OM2BFB demonstrates high precision (>93%) and recall (92%) in identifying BFB amplifications across cancer cell lines, patient-derived xenograft models, and primary tumors. Comparisons using OGM reveal that BFB detection with our AmpliconSuite toolkit for short-read sequencing also achieves high precision, though with reduced sensitivity. We identify 371 BFB events through whole genome sequencing of 2557 primary tumors and cancer cell lines. BFB amplifications are prevalent in cervical, head and neck, lung, and esophageal cancers, but rare in brain cancers. Genes amplified through BFB exhibit lower expression variance, with limited potential for regulatory adaptation compared to ecDNA-amplified genes. Tumors with BFB amplifications (BFB(+)) show reduced structural heterogeneity in amplicons and delayed resistance onset relative to ecDNA(+) tumors. These findings highlight ecDNA and BFB amplifications as distinct oncogene amplification mechanisms with differing biological characteristics, suggesting distinct avenues for therapeutic intervention.

Abstract Background This review aims to assess the effect of oral administration of probiotics and/or prebiotics in children and women of reproductive age (WRA) to improve intestinal iron absorption, hemoglobin, and ferritin levels. Methods Randomized controlled trials from published literature on probiotics and or prebiotics for prevention or treatment of anemia as a supplement or fortification in children or WRA till Jan 31, 2023, were included. Studies on probiotics and prebiotics in patients with anemia due to other causes were excluded. Screening and data extraction was done using Distiller SR and meta-analysis was performed using Revman 5.4.1. Results A total of 1925 records were identified from Pubmed, Embase, and Cochrane, of which 29 were included in the systematic review (14 supplementation and 15 fortification studies; 15 studies in children and 14 studies in WRA). The major interventions included galacto-oligosaccharide, inulin, heat-killed H61, Lactobacillus plantarum 299v, Lactobacillus reuteri, Lactobacillus acidophilus. Meta-analysis of 5 studies in WRA showed that the use of prebiotics and/or probiotics with or without iron was associated with little or no effect on hemoglobin. However, there is low certainty of evidence that the intervention led to improvement in fractional absorption of iron as compared to placebo or iron [8 studies, n = 335, mean increase 0.74%, 95%CI-0.11–1.38, p = 0.02]. Meta-analysis of 6 studies in WRA using prebiotics and/or probiotics with or without iron led to a significant increase in ferritin levels in WRA (mean increase 2.45 ng/ml, 95% CI 0.61–4.3, p = 0.009, n = 320) [Moderate certainty of evidence]. In children, meta-analysis of up to 8 studies did not result in any significant change in hemoglobin, ferritin and fractional iron absorption [low or very low certainty of evidence]. Conclusion There is some evidence to show that the use of prebiotics or probiotics (especially Lp299v and GOS) with or without oral iron can improve iron absorption in women and lead to improvement in ferritin levels in women. However, the current evidence does not conclusively show the benefit of these interventions in improving hemoglobin levels in women and children.

Abstract Objective Peri-implant diseases (peri-implant mucositis and peri-implantitis) are inflammatory conditions that affect the peri-implant tissues and are induced by microbial biofilms (dental plaque) formed around the implant. Removal of biofilm is the fundamental step in managing peri-implant diseases. Interdental cleaning aids such as interdental brush, unitufted brush, or oral irrigation along with regular toothbrushing are recommended for effective plaque control around implants. The present systematic review aims to evaluate the efficacy of home use of oral irrigators compared to other plaque control methods for managing peri-implant diseases. Method This systematic review has been prepared using the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA) checklist. Five databases were searched using the following keywords: “Peri-implantitis” OR Periimplantitis OR “Peri-implant disease” OR “Peri-implant Mucositis” AND “Oral irrigation” OR “Oral Irrigator” OR Waterpik OR “Interdental irrigation” OR “Oral Spray” OR “Oral Irrigants”. Results Oral irrigator along with mechanical brushing was found to be more effective than mechanical brushing alone in reducing the plaque index (PI), gingival index (GI), and bleeding on probing (BOP). No statistically significant difference in improvement in quality of life and patient satisfaction with regard to comfort and ease of use was noted upon using mechanical toothbrushing alone and an oral irrigator. Implant sites where an oral irrigator was used showed more reduction in BOP (81.8% vs 33.35%) compared to sites where the floss was used (P = 0.0018). The levels of the red and orange complex bacteria in the peri-implant biofilm were lower with the use of an oral irrigator than with toothbrushing alone. Conclusion Oral irrigators along with toothbrushing were found to be more effective in removing microbial plaque around implants and controlling peri-implant inflammation compared to mechanical brushing alone. The reduction in BOP was better with the use of oral irrigation compared to floss and interdental brush.

Flavored tobacco products (FTPs) have gained global popularity but are associated with significant health concerns. These products, which include flavored cigarettes, cigars, e-cigarettes, hookahs, and nicotine dissolvable, come in a range of different flavors. For example, cigarettes come in a variety of flavors, including menthol, alcohol, spices, and herbs, which are more appealing to young adults, and fruit or candy, which are more appealing to kids. Despite the perceived safety of these flavorings for consumption, their toxicity remains largely unknown. Additionally, the deliberate promotion of FTPs by the tobacco industry in emerging nations such as India has hindered tobacco control efforts. The current review seeks to offer a thorough examination of additives used in tobacco, the various flavors found in emerging tobacco products, patterns of consumption, strategies employed in marketing, and the necessity for regulating these emerging tobacco products. A systematic review methodology was employed for this narrative review using relevant medical subject headings (MeSH) terms. The literature search was conducted between March 2022 and March 2023, utilizing databases such as PubMed, Scopus, Google Scholar, guidelines, advisory, survey reports, factsheets, editorial, communication, and news related to topic of interest. Pertinent articles were selected based on specific inclusion and exclusion criteria. The synthesized results illuminate the prevalence and usage of tobacco products with flavors in the market, effectively fulfilling the research objectives. Moreover, in addition to fulfilling the research objectives, the synthesized results offer valuable perspectives on how FTPs influence patterns of tobacco use, particularly among the younger population. These findings underscore the need for effective regulations and guidelines to curb the appeal and consumption of FTPs, ultimately reducing the prevalence of smoking-related disorders and promoting public health.

Abstract Introduction Treatment-resistant depression (TRD) is related to disproportionate unemployment and productivity burden in the USA. The current study describes real-world mental health (MH)-related disability days and costs of patients with TRD initiated on esketamine nasal spray or conventional therapies in the USA. Methods Adults with TRD were selected from Merative™ MarketScan® Commercial database (from January 2016 to January 2023) and classified into four cohorts (esketamine, ECT [electroconvulsive therapy], TMS [transcranial magnetic stimulation], and SGA [second-generation antipsychotics] augmentation) based on therapy initiated (index date) on/after 5 March 2019 (esketamine approval date for TRD). Patients had ≥ 12 months of health plan eligibility pre-index date and disability information available pre- and post-index in the Merative™ MarketScan® Health and Productivity Management database (from January 2016 to December 2021). MH-related disability days (i.e., short- or long-term) and associated costs (US dollars [USD] 2022) were reported per-patient-per-month for the 6 months pre- and post-index. Results The study comprised four cohorts: esketamine (n = 107; mean age: 45.5 years, female: 54.2%), ECT (n = 55; mean age: 47.6 years, female: 41.8%), TMS (n = 443; mean age: 46.1 years, female: 57.3%), and SGA (n = 4374; mean age: 44.8 years, female: 59.1%). In month 6 pre-index, mean number of MH-related disability days was 1.7 in the esketamine cohort, 1.2 in the TMS cohort, 1.3 in the ECT cohort, and 0.8 in the SGA augmentation cohort; mean MH-related disability costs were US $443 in the esketamine cohort, US $339 in the TMS cohort, US $178 in the ECT cohort, and US $143 in the SGA augmentation cohort. In all cohorts, a peak in mean MH-related disability days and costs was observed 1 month after therapy initiation followed by a decreasing trend. In month 6 post-index versus month 6 pre-index, the mean number of MH-related disability days trended lower in the esketamine cohort (− 0.4 days), remained the same in the TMS cohort and largely the same in the SGA augmentation cohort (+ 0.1 days), and trended higher (+ 1.6 days) in the ECT cohort. In the same timeframe, MH-related disability costs trended lower in the esketamine and TMS cohorts, with observed reductions of US $312 and US $123, respectively. Costs remained largely the same in the SGA augmentation cohort (+ US $26), and trended higher (+ US $353) in the ECT cohort. Conclusions In this descriptive study, initiation of esketamine was associated with trends toward lower MH-related disability days and costs. Conventional therapies demonstrated varied patterns, with no consistent trend toward reductions in disability days across all therapies and no observed cost-savings trends for SGA augmentation and ECT. These trends suggest potential economic and societal gains of esketamine treatment for TRD but warrant further investigation with larger samples and robust statistical comparisons.

Background: Women are highly motivated and receptive to accepting family planning methods during the antenatal period. Hence, we conducted this study to evaluate the refusal rate and reasons for the refusal of postpartum Intrauterine Contraceptive Devices (PPIUCD). Material and Methods: The present cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, at a tertiary Care Centre, on 400 antenatal women from November 2023 for 2 months. Results: In present study, 331 (82.8%) subjects were knowing condom as contraceptive, followed by 310 (77.5%) subjects knowing about copper T. 282 (70.5%) subjects were knowing tubectomy, 264 (68.5%) were knowing oral contraceptives, 264 (66%) were knowing vasectomy, 205 (51.2%) were knowing natural methods, 179 (44.8%) were knowing injectable contraceptive, 83 (20.8%) were knowing Saheli, and 27 (6.8%) subjects were not knowing any contraceptive method. In total, 185 (46.5%) subjects knew that Copper T could be inserted immediately after delivery followed by 83 (20.9%) who knew that copper T could be inserted after menses. Sixty-nine (17.3%) knew that copper T could be inserted during a cesarean section. A total of 352 (88%) subjects refused postpartum copper T as a method of contraception. Only 48 (12%) subjects were willing to insert postpartum copper T. After counseling, the rate of acceptance of copper T insertion increased from 48 (12%) to 102 (25.5%). Conclusion: Knowledge of PPIUCD in the present study was good, but the refusal rate was high. The commonest reason was fear of side effects.

Background: The Schneiderian first-rank symptoms (SFRS) have played an extremely important role in the diagnostic systems in psychiatry. However, all studies do not seem to support Schneider’s claim that FRS confer a clear indication of schizophrenia when no organic syndrome is present. Objectives: The objectives of this study were as follows: (1) to examine the presence of SFRS in untreated cases of psychosis, (2) to see the degree of improvement in SFRS with treatment over 12 weeks of short-term follow-up, (3) to see correlation of SFRS with sociodemographic and clinical parameters in our patients, and (4) to see the correlation of SFRS among diagnostic subgroups in our patients. Materials and Methods: Setting: Psychiatry department of a multi specialty tertiary care center in North India. Study Design: This was a short-term prospective study. After taking ethical clearance from the institutional ethics committee and written informed consent from all the patients, data sets were prepared for 60 patients of untreated psychosis. Data analysis was done using the SPSS version 20.0. Results: Voices discussing (83.33%) and voices commenting (80%) were the most commonly noted SFRS, and the mean number of SFRS in our sample was 3.34. Somatic passivity (f = 10.80, P = 0.0001) and thought insertion (f = 6.75 and P = 0.004) could significantly differentiate between schizophrenia and other diagnostic subgroups of untreated psychosis in our study. Conclusions: Only somatic passivity, delusional perception, and thought insertion were extremely specific in distinguishing the patients of schizophrenia from nonschizophrenic patients.

The 2030 Sustainable Development Goal (SDG) envisions eliminating preventable newborn deaths and reducing neonatal mortality to 12 per 1000 live births. There is a paucity of data on outborn newborns. By doing this study, areas for further reductions in neonatal mortality rate (NMR) can be identified and interventions can target these areas for reduction of NMR. The objectives of this study were to determine the causes of admission of outborn newborns, identify the timing and causes of mortality, distinguish between possibly preventable or probably unpreventable deaths, and identify areas for further reductions in NMR. A cross-sectional, retrospective, and descriptive study was conducted on outborn newborns at a Special Newborn Care Unit (SNCU) of a medical college hospital in eastern India from January 1, 2021 to December 31, 2021. Admission and mortality data were collected after ethics committee approval and analyzed. Sick outborn newborns admitted to the SNCU were 1671. Deaths occurred in 281. Males were 62.28%. The highest number of deaths occurred in birth weight ≤999 g, (91.84%), gestational age

Introduction: Allogeneic haematopoietic stem cell transplantation (allo-HSCT) is a curative option for relapse/refractory (R/R) lymphomas that have failed autologous transplantation or for high-risk lymphomas in the upfront setting. We conducted a retrospective analysis on consecutive lymphoma patients who underwent allo-HSCT over a 20-year period (2003– 2022) at Singapore General Hospital and National University Hospital Singapore. Method: A total of 121 patients were included in the study. Median age was 41 years. Diagnoses include Hodgkin lymphoma (HL, 15%), B-cell non- Hodgkin lymphoma (B-NHL, 34%), T-cell non-Hodgkin lymphoma (T-NHL, 31%) and natural killer T-cell lymphoma (NKTL, 20%). Moreover, 27% of patients had prior auto-haematopoietic stem cell transplanta-tion (auto-HSCT), and 84% received reduced intensity conditioning (RIC). Donor types were matched sibling donor (45%), matched unrelated donor (29%), haploidentical donor (19%) and cord blood (CB, 7%). Results: After median follow-up of 56 months, estimated 4-year progression-free survival (PFS) and overall survival (OS) for all patients were 38% and 45%, respectively. Non-relapse mortality (NRM) was 15% at day 100 and 24% at 1 year. On univariate analysis, complete remission status at transplant and RIC confers superior OS. On multivariate analysis, HL was associated with superior OS compared to NHL, whereas matched unrelated donor transplant was associated with significantly inferior OS compared to matched sibling donor. Conclusion: Long-term curative durability was observed with allo-HSCT for patients with relapsed/ refractory lymphomas. This real-world data serves as a valuable historical benchmark for future studies on lymphomas in Singapore and the Asia Pacific region.

Abstract We compute trace relations governing chiral ring elements of fully Ω-deformed N $$ \mathcal{N} $$ = 2⋆ gauge theories with SU(N) gauge groups by demanding the regularity of the fundamental qq-character.

Abstract Background Conduction disturbances are a frequent occurrence after tricuspid valve surgeries, and their management is challenging. Case presentation We present a case of 16-year-old male patient who presented with episodes of presyncope. At the age of 7 years, he underwent tricuspid valve replacement surgery with a biological prosthesis for infective endocarditis sourced from a gluteal abscess. Post-operatively, he had complete atrioventricular block and underwent epicardial pacing. Epicardial lead impedance increased at follow-up and led to failure of pacing. At the time of presentation he had prosthetic tricuspid valve dysfunction with increased gradients. We did tricuspid valve balloon valvotomy but the gradients did not improve and patient developed tricuspid regurgitation. In view of difficulty in placing the lead through degenerated tricuspid valve, we have decided to place the lead in coronary sinus. He underwent successful lead placement in posterolateral tributary of coronary sinus with acceptable parameters. He had an uneventful follow-up at 1 year. Conclusion TV surgeries create a unique problem for pacing. Coronary sinus pacing offers an effective alternative to conventional RV pacing in such cases.

Abstract FMS-like tyrosine kinase 3 (FLT3) genetic variants are commonly seen in high-grade myeloid neoplasms and are typically gain-of-function mutations associated with a proliferative disease phenotype. Inactivating FLT3 variants have been less frequently described in non-malignant, autoimmune disorders and are uncommon in aplastic anemia (AA). Herein, we report the first to our knowledge, and unusual case of a germline, gain-of-function, FLT3 variant in a patient with severe AA treated successfully with immunosuppressive therapy. Although a proposed link between dysregulated FLT3 signaling and autoimmunity has been described and could be speculated in the case of AA, it is currently unknown whether a pathogenetic connection between an activating germline FLT3 variant and AA truly exists and whether the mutation signifies a lifelong risk of disease recurrence and/or clonal evolution. However, the recognition of the FLT3 gene as subject not only to somatic but also germline mutations is the first step in interrogating its functional implications. Further study of unusual genotype-phenotype combinations, such as in the case presented, may shed light on a potential pathogenetic link.

Abstract Background Premarital sex in India is hugely stigmatized. With the widespread use of mobile phones and the internet, attitudes and behaviors towards premarital sexual activities are inevitably shifting. This study investigates the impact of digital exposure, specifically mobile phones and the internet on premarital sex and contraception use among unmarried Indian youths. Methodology Utilizing data from the 5th National Family Health Survey, the analysis includes 172,568 women and 33,397 men aged 15–29 years. The study applies univariate, bivariate, and multivariate statistical methods, such as Chi-square tests and Multiple Logistic Regression. Propensity Score matching addresses selection bias, estimating the impact of digital exposure on premarital sexual activities and condom use. Results The findings show that youth exposed to mobile phones and the internet are more likely to engage in premarital sex and use condoms during their first sexual encounter. Specifically, 13.46% of men and 2.83% of women reported premarital sex, with 60.84% of men using condoms at first sex. These behaviors are significantly associated with age, education, urban residence, and mass media exposure. Conclusion Digital exposure significantly influences premarital sexual behaviors and contraception use among unmarried Indian youth. Adoption of mobile devices and internet usage in India should be accompanied by the implementation of holistic and culturally appropriate technology-driven interventions to provide sex education in India.

Abstract Background Exclusive breastfeeding (EBF) is defined as feeding infants only breast milk of the mother or a wet nurse for the first six months, without additional food or liquids except the oral rehydration solution or drops/syrups of vitamins, minerals or medicines. The working status of women in developed countries adversely affects the EBF rates, which calls for an assessment in rapidly developing countries like India. Therefore, the primary aim of the present study is to determine the prevalence of EBF using the data from the National Family Health Surveys (NFHS 3, 4, 5) conducted between 2005 and 06, 2015-16 and 2019-21 to estimate the likelihood EBF according to mothers’ employment status. Methods We did a secondary data analysis of the cross-sectional surveys. Exclusive breastfeeding was the primary dependent variable and defined as the percentage of youngest children under six months exclusively breastfed per last 24 h. The employment status of the mother was the primary independent variable and was coded dichotomously (yes/no). Chi-square analysis assessed the association of EBF with the outcome variable of interest. A multi-level modelling approach has been used for portioning variation in the prevalence of exclusive breastfeeding at different geographical levels. Results From NFHS rounds 3 to 5, the overall prevalence of exclusive breastfeeding was 47.45%, 54.85%, and 64.01% respectively. On segregating the women as per their employment status, the prevalence among employed women was 51.1%, 51.1%, and 60.3%, while in unemployed women the prevalence was 45.9%, 54.8%, and 67.3% respectively. The odds of practising EBF in NFHS-5 doubled since NFHS-3 (Adjusted Odds Ratio: 2; 95% Confidence Interval: 1.08, 3.67). Employed mothers had a significantly lower odds ratio (0.94, 0.91, 0.98) of practising exclusive breastfeeding. The likelihood increased when mothers were exposed to media, had normal BMI, and visited health centres > 4 times during pregnancy. The likelihood decreased in older mothers, birth of infant in a health facility, female gender of the child, and late initiation of breastfeeding. Conclusions The lower prevalence of exclusive breastfeeding among working mothers calls for an urgent need to improve policies around maternity benefits at workplaces.

Introduction: Early childhood caries (ECC) affects almost 50% of preschool children and may lead to chronic pain, halitosis, fever, trismus, poor growth and development, and repeated airway and gastrointestinal infections. Managing this is challenging in the face of anxiety, developmental delay, and other comorbidities in children. This necessitates their management under general anesthesia (GA). Methodology: We carried out a retrospective descriptive study to analyze the characteristics of pediatric patients who underwent oral rehabilitation under GA at a tertiary care service hospital. Results: The data of 20 children inflicted with ECC who underwent full-mouth rehabilitation under GA were analyzed. The majority were boys and the mean age was 69.5 months. Five of these children had comorbidities. The most common indication for GA was the uncooperation of the child. Inhalational induction was carried out for most of them, and postoperatively, two children had emergence delirium and one child had nausea and vomiting. Conclusion: We share our experiences toward standardization of safe anesthesia practices.

Purpose: To study the ophthalmologic manifestations of systemic sclerosis (SSc) and its correlation with autoantibody profile. Methods: A cross-sectional study on 200 eyes of 100 consecutive adult patients diagnosed with SSc was performed at a tertiary care center in Northern India. The examination of ocular adnexa, anterior segment, and posterior segment with slit-lamp biomicroscopy, tear film break-up time (TBUT), Schirmer’s II test, and choroidal thickness measurement by swept-source ocular coherence tomography was done. Autoantibody profile was available for 85 patients, and its statistical association with the ocular examination findings was analyzed. Results: In total, 100 patients (93 females and 7 males) were included. The mean age was 45.11 ± 11.68 years, and the mean disease duration was 6.93 ± 3.68 years. Meibomian gland disease was more commonly found in patients with the diffuse subtype of SSc (P = 0.037). Choroidal thickness was increased in 34% and decreased in 7% (reference range = 307 ± 79 µm) patients. Reduced TBUT, meibomian gland dysfunction, and eyelid stiffness had a statistically significant association with the presence of anti-Scl-70 antibody (P = 0.003,

Introduction: Spatholobus littoralis is widely used as an anticancer herbal medicine in Kalimantan, Indonesia. This study aims to determine the cytotoxic effect of S. littoralis on breast cancer cells in vitro and predict the mechanism of its activity on the estrogen receptors (ER) in silico. Methods: Dry wood of S. littoralis was extracted using ethanol solvent by maceration and fractionated using n-hexane, chloroform, and ethyl acetate. The cytotoxic assay was evaluated using MTT reagent in T47D and 4T1 cells. Prediction of the interaction mechanism of phenolic compounds from the genus Spatholobus with ER-α and ER-β was carried out in silico. Results: The results showed that the ethanolic extract of S. littoralis did not show a cytotoxic effect on T47D cells, but showed weak toxicity on 4T1 cells. Furthermore, n-hexane, chloroform, and ethyl acetate fractions of S. littoralis showed strong to moderate cytotoxic effects on T47D and 4T1 cells. In silico test results showed that 3’-4’-7-trihydroxy flavone was a phenolic compound with the highest binding energy compared to the ER native ligand Genistein in ER-α (-10.2 kcal/mol) and ER-β (-10.9 kcal/mol). The 3’-4’-7-trihydroxy flavone binding site in ER-α was bound to amino acid residues Arg394, Glu353, and Leu387, while in ER-β it was found at Arg346, Glu305, and Leu339. Conclusion: These findings indicate that S. littoralis contains phenolic compounds that can inhibit the growth of breast cancer cells, so it may have the potential to be developed as a new drug for breast cancer.

Place identity constitutes a crucial component of children’s sense of self as they learn to locate themselves and others around them in relational social networks. Picturebooks – owing to their multimodality – can be employed to decode the meanings that the spaces inhabited by children are imbued with, and how they, in turn, shape children’s spatial experiences of the world. An exploration of the intersection of identity with the sense of place in children’s literature begets various questions – of access and attachment, belonging or a lack thereof, curtailment within and transgression of spatial boundaries, and the ways in which these negotiations shape children’s sense of self-identity. This paper locates fourteen contemporary Indian picturebooks within two arenas of conceptual enquiry – space and self-identity within childhood, and the multicultural experientiality of childhood as encompassing differences and structural inequalities – and studies the links between marginalisation and space in children’s literature. As the systematic disparities of caste, class, gender and indigeneity add a note of dissonance into a universal notion of childhood, children’s experiences of their physical surroundings become diverse and political. By coalescing Developmental and Environmental Psychology with content analysis, the paper addresses the spatial manifestations of marginalities within childhood and makes a case for identity-affirming, democratic and diverse socio-spatial representations of childhoods in multicultural children’s literature.

Introduction: Adult immunization is an important but neglected health-care service. The adult population needs to keep their vaccination up to date because immunity provided through childhood vaccines weans off eventually making the adult and elderly prone to acquiring some of the vaccine-preventable diseases. Objectives: The objectives of this study were to assess the knowledge of postgraduate resident doctors regarding recommended adult vaccination. Materials and Methods: A cross-sectional study was conducted among 261 postgraduate resident doctors of tertiary care medical institutions in Navi Mumbai. Participants were selected on the basis of eligibility criteria those who gave consent for the study. Prestructured and pretested questionnaires were used to assess the participants and their knowledge regarding adult immunization based on Centers for Disease Control and Prevention Guidelines(recommended vaccines for adults, others recommended vaccines based on age, life events such as pregnancy/international traveler/health care workers/immigrants, and health conditions). Results and Conclusion: About 27.6% of resident doctors did not even know that an adult immunization schedule exists. The best known to them were COVID-19 (98.3%, i.e. 57 residents) and hepatitis B vaccine (82.8%, i.e. 42 residents). Some of the special conditions were known to them, i.e. Td or TdaP during pregnancy. The lack of knowledge and practices were clearly observed during the study among postgraduate resident doctors. To implement and execute this idea of universal health coverage through the Universal Immunization Program, resident doctors must have basic knowledge regarding the adult immunization schedule. Primary care physicians and general public need to be more aware of the benefits and availability of adult vaccination.

Substance use disorders affect 17.3% of Americans. Digital health solutions that use machine learning to detect substance use from wearable biosignal data can eventually pave the way for real-time digital interventions. However, difficulties in addressing severe between-subject data heterogeneity have hampered the adaptation of machine learning approaches for substance use detection, necessitating more robust technological solutions. We tested the utility of personalized machine learning using participant-specific convolutional neural networks (CNNs) enhanced with self-supervised learning (SSL) to detect drug use. In a pilot feasibility study, we collected data from 9 participants using Fitbit Charge 5 devices, supplemented by ecological momentary assessments to collect real-time labels of substance use. We implemented a baseline 1D-CNN model with traditional supervised learning and an experimental SSL-enhanced model to improve individualized feature extraction under limited label conditions. Results: Among the 9 participants, we achieved an average area under the receiver operating characteristic curve score across participants of 0.695 for the supervised CNNs and 0.729 for the SSL models. Strategic selection of an optimal threshold enabled us to optimize either sensitivity or specificity while maintaining reasonable performance for the other metric. Conclusion: These findings suggest that Fitbit data have the potential to enhance substance use monitoring systems. However, the small sample size in this study limits its generalizability to diverse populations, so we call for future research that explores SSL-powered personalization at a larger scale.

Abstract Ovarian cancer is known to be a challenging disease to detect at an early stage and is a major cause of death among women. The current treatment for ovarian cancer typically involves a combination of surgery and the use of drugs such as platinum-based cytotoxic agents, anti-angiogenic drugs, etc. However, current treatment methods are not always effective in preventing the recurrence of ovarian cancer. As a result, the treatments administered after a relapse need to be more aggressive, leading to increased toxicity and drug resistance. To address this issue, researchers are exploring the potential of combining existing anticancer agents with novel or repurposed drugs to reduce the side effects and improve the effectiveness of treatment. In this study, we have investigated the use of rosiglitazone, a well-known anti-diabetic drug, in combination with the chemotherapeutic drug, paclitaxel for the prevention of ovarian cancer. The study utilized the SKOV-3 ovarian cancer cell line to assess the effects of this combination treatment. The results of the study showed that the combination of paclitaxel with rosiglitazone inhibited cell proliferation at much lower concentrations of paclitaxel as compared to paclitaxel alone. The combined treatment also induced cell cycle arrest at the G2/M phase and increased apoptosis by altering the mitochondrial membrane potential of the cells. Additionally, the combination treatment activated the PPAR-γ pathway and downregulated expression of genes associated with cancer stemness, such as NANOG, OCT4, and EHF. Furthermore, the CAM assay substantiated the anti-angiogenic potential of the synergistic treatment of paclitaxel and rosiglitazone. The findings of the study suggest that repurposing rosiglitazone as an anticancer agent in combination with paclitaxel has immense potential to target cancer cell cycle progression and apoptosis, making it a promising therapeutic approach for sensitizing chemo-resistant population of ovarian cancer cells.

Introduction: Exposure to air pollution has long been associated with mortality and shortened life expectancy and has been acknowledged as one of the growing risk factors that affect human health. Although air pollution is considered a global problem affecting rural and urban equally, it is still observed that the people of developing countries are disproportionately affected by it. Objectives of the Study: The present study aims to (1) understand the prevalence of upper respiratory symptoms, lower respiratory symptoms, and cardiometabolic and psychological health issues; (2) analyze the dichotomy in the degree of upper and lower respiratory symptoms based on the type of residence (rural/urban), age group, job profile (indoor/outdoor), and degree of pollution exposure; and (3) map the extent of reported health issues in the city of Kolkata. Methodology: A primary questionnaire survey was conducted in West Bengal and Jharkhand, where respondents were enquired about their health symptoms and their level of awareness of air pollution. An attempt was made to conduct a census survey in all of the target health camps, and only those who gave their consent were surveyed. Sample Description: The total sample (N) size was 2784 respondents (Jharkhand and West Bengal), with 1456 respondents from West Bengal and 1328 from Jharkhand. The total rural sample size was 417 respondents. The total urban sample size was 2367 respondents. Among the samples, 1369 were involved in indoor jobs (49%), 1415 were involved in outdoor jobs (51%), 2404 were exposed to both indoor and outdoor air, and 380 were exposed to only outdoor air pollution. Results and Discussion: More than 40% of the respondents reported sneezing, coughing, nasal congestion, or mood-related problems. More than 30% of the respondents reported sore throat or sleep-related problems, 14% had hypertension and 6% had diabetes. Among the various symptoms, cough was the predominant symptom in both rural and urban areas. Other than cough, all other symptoms suggestive of lower respiratory tract involvement were marginally higher in the urban areas in comparison to the rural areas. The urban population had higher numbers of symptoms per respondent than the rural counterparts. Lower respiratory symptoms (cough, chest discomfort, breathlessness) primarily increase with age and were the highest in the old age group (61 years and above). Lower respiratory symptoms were observed to be higher among outdoor workers, in comparison to indoor workers. Upper respiratory symptoms (sore throat, nasal congestion, and sneezing) except sinusitis were higher among outdoor workers in comparison to indoor workers. Except for cough and wheezing, most other lower respiratory symptoms (chest discomfort and tightening/degree of breathlessness) were observed to be higher among respondents who were exposed to both indoor and outdoor air pollution. Nasal congestion and sneezing were comparatively higher among people exposed to only outdoor air pollution. Sore throat and sinusitis were seen to be higher among respondents who were exposed to both indoor and outdoor air pollution. Population with both indoor and outdoor pollution exposure was more likely to have a higher number of symptoms per respondent than population with only outdoor pollution exposure. More than half of the respondents used liquified petroleum gas as their primary cooking fuel. At least 12% of the respondents use cooking fuel, which is attributed to the generation of unhealthy smoke. People of Kolkata also associated lifestyle diseases and psychological issues related to air pollution. Conclusion: Exposure to air pollution was associated with various upper and lower respiratory tract symptoms in more than half of exposed individuals. Symptoms suggestive of lower respiratory tract involvement were marginally higher in the urban areas in comparison to the rural areas. The urban population had higher numbers of symptoms per respondent than the rural counterparts. Symptoms suggestive of lower respiratory tract involvement increased with age and were highest after 61 years of age. Both upper and respiratory symptoms were more common in outdoor workers. Overall symptoms burden was more in Kolkata as compared to the overall study.

Introduction: India is committed to achieving universal health care for all by 2030. The objective of social marketing is to promote public health and its goal is to improve health for all, but there are some challenges like irregular availability, quality issue, inadequacy of marketing causes under- utilization of the government supplied health consumables. Objectives: Present study aims to find out the usage pattern and assess the perceived satisfaction level of beneficiaries of using various socially marketed health consumables at government settings and explore the perception of healthcare personnel regarding barriers to its usage in a rural area of India. Materials and Methods: A community-based, Mixed-Methods study (Convergent parallel design) was done in the service area of the Rural Health Unit and Training Centre (RHU&TC), Singur of Hooghly district, West Bengal, between January 2023 and December 2023, where the quantitative component was carried out by face-to-face interview among 150 beneficiary household respondents selected by two-stage cluster sampling; and qualitative component was done by 4 Key informant interviews (KII) among healthcare personnel (medical officer, public health nurse, pharmacist). Statistical data were analyzed by descriptive statistics using SPSS 16 version and Microsoft Excel for the quantitative part, and thematic analysis was done for the qualitative part. Institutional Ethics Committee clearance was obtained. Results: Ever use of government-supplied contraceptives like Chhaya (Ormeloxifene), Antara (Injectable contraceptive), emergency contraceptive pills, and intrauterine contraceptive devices (IUCD) was done by only 15.3%, 10.7%, 7.3%, 32% of eligible beneficiary households, respectively. The major reasons cited for irregular use were unawareness of availability of the products (Chhaya = 76.3%, Antara = 64.9%, EC pills = 46.7%), poor faith regarding quality (Male condom = 40%, Generic medicines = 70%), inadequate promotion (IUCD = 53.9%). The majority of users of male condoms (90%), IFA tablets (52.9%), ORS (51.1%), and generic medicines (55.7%) were not satisfied after using those products. Key informant interviews among healthcare personnel revealed avoidance of using modern contraceptive methods and frequent unavailability of some socially marketed health consumables were the predominant causes of reduced uptake of those products by beneficiaries. Conclusions: Proper social marketing strategies, adequate promotion, regular awareness campaigns, and tailored training of field healthcare workers are required to improve the acceptability, availability, and marketing of these health consumables.

Aim: To assess the risk of developing oral cancer (OC) in individuals who have diabetes mellitus (DM) and to predict the prognosis for OC patients with DM. Methodology: The review adhered to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 guidelines and was registered in PROSPERO (CRD42024517197). A thorough search of databases was conducted from January 2000 to May 2024 to identify studies reporting the reporting association between DM and the development of OC. Quality assessment was performed using the Newcastle Ottawa Scale for included studies. The odds ratio (OR) and risk ratio (RR) served as the summary statistic measure, employing a random-effect model with a significance threshold set at P < 0.05. Results: Twelve studies met the eligibility criteria and underwent qualitative synthesis, with eight studies in meta-analysis. Upon quality assessment, the studies demonstrated a range of moderate to low risk of bias (ROB), ensuring a comprehensive evaluation of the evidence base. Meta-analysis showed that individuals with type 2 diabetes mellitus had a higher shown high association (OR = 2.07 (0.52–8.18) and risk (RR =1.31 (0.70–2.43) for the development of OC compared to nondiabetics (P > 0.05). The funnel plot did show presence of possible publication bias in meta-analysis. Conclusion: It was found that DM patients were at higher risk and more associated with the development of OC. However, as OC is multifactorial disease, the presence of a single factor cannot have a significant effect on disease progression. Therefore, furthermore prospective studies with a greater sample size and follow-up period should be conducted so as to validate the findings of this study.

Aim and Objective: The aim of this study was to perform surface and elemental analysis of used titanium and stainless steel miniscrews to investigate their behavior while in association with bone, surrounding tissues, oral fluid, and food. Materials and Methods: Fifteen patients were included in this split-mouth study, where in mini-implants were placed between the maxillary second premolar and first molar: titanium mini-implants on the left side and stainless steel mini-implants on the right side. They were placed in the mouth for 4–8 months. Energy dispersive spectroscopy (EDS) was used for the elemental analysis of the retrieved mini-implants and a scanning electron microscope was used to detect the surface changes in the retrieved mini-implants in four areas, namely head, neck, body, and tip. Surface changes and elemental changes were compared between the as-received mini implants and the retrieved mini implants. Surface changes in the form of cracks, craters, deposits, and blunting were observed on the used miniscrews. Results: Craters and blunting were seen predominantly in the tip region of the miniscrews, whereas deposits were noted on the head-and-neck region as well. Elemental analysis showed that oxygen, carbon, nitrogen, and calcium were found in significant amount on the retrieved titanium implants, whereas only oxygen and carbon content increase was seen on the retrieved stainless steel implants. The presence of calcium on the retrieved titanium implants could be the reason for its better stability compared to stainless steel implants due to its ability to osseointegrate. Conclusion: Surface changes in the form of dullness. loss of gloss, blunting and crater formation were observed, while elemental changes in the form of statistically significant increase in the oxygen, nitrogen , carbon and calcium content were observed on the retrieved mini-implants.

Machine Learning centers on applications that gain for a fact and further develop their dynamic or prescient exactness over the long run. Behavioral Modification is the use of basic learning techniques such as conditioning, biofeedback, assertiveness training, positive or negative reinforcement, aversion therapy to change unwanted individual or group behavior. Behavior change is vital to addressing both the challenges facing human health and wellbeing and to promoting the uptake of research findings in health policy and practice. This paper provides a solution about the utilization of machine learning in behavioral modification by giving some real-time examples. The device based on machine learning is used to develop and evaluate a ‘Knowledge System’ that automatically extracts, synthesizes, and interprets findings from Brain Computer Interface (BCI) evaluation reports to generate new insights to conduct change and further develop forecast of intervention viability and permits clients to effectively and productively examine the framework to find solutions. Organizations engaged in healthcare are charged with the complex task of keeping expenses down without compromising healthcare quality. The key prerequisite is to focus instead of fix, with the greatest test being the need to follow up on enormous volumes of totaled medical care driven Big Data.

Abstract Background This study is aimed to develop a simple, effective and economic method for the UV spectrophotometric analysis of amoxicillin trihydrate in the presence of acetaminophen. The Beer–Lambert law was obeyed in the concentration range of 2–10 µg/ml for amoxicillin trihydrate, acetaminophen and combinations, in all the different pH media: pH 1.2, 6.8, 7.4 and neutral (double-distilled water). For the simultaneous equation method, the absorbance maxima of amoxicillin trihydrate was found at 228 nm, and for acetaminophen, it was found at 243 nm, after scanning the solutions in respective buffers. Result The standard curve of amoxicillin trihydrate and acetaminophen was plotted, and the correlation coefficient (R2) value was found to be in the range of 0.991–0.994 and 0.993–0.999, respectively. These two drugs were combined in a ratio of 5:3 (amoxicillin trihydrate: acetaminophen), and its absorbance maxima was discovered at 232 nm (isoabsorptive point), where its correlation coefficient was calculated from the standard curve which is in range of 0.993–0.996. The above-mentioned method was found to comply all the validation parameters as per the ICH guidelines such as accuracy, precision, linearity, LOD, LOQ, reproducibility and recovery. This method is successfully applied to estimate the combination of these two drugs in their pharmaceutical dosage forms without and interaction of their excipients. This method is based on to check the stability of amoxicillin trihydrate in different pH media in the presence of acetaminophen. Conclusion Hydrolysis of beta-lactam ring of amoxicillin trihydrate occurs in acidic pH (below 2) which causes the formation of amoxicilloic acid which may cause reduction in its microbial activity but neither shifting of wavelength nor appearance of extra peak occurred in UV spectroscopy. Although some changes of % area of amoxicillin trihydrate is observed in acidic media in HPLC method, there are no significant changes observed among the amoxicillin trihydrate solutions with acetaminophen prepared in different pH media, when using UV spectrophotometric method.

Abstract In this work, we propose and assess the potential of generative artificial intelligence (AI) as a tool for facilitating public engagement around potential clean energy sources. Such an application could increase energy literacy—an awareness of low-carbon energy sources among the public therefore leading to increased participation in decision-making about the future of energy systems. We explore the use of generative AI to communicate technical information about low-carbon energy sources to the general public, specifically in the realm of nuclear energy. We explored 20 AI-powered text-to-image generators and compared their individual performances on general and scientific nuclear-related prompts. Of these models, DALL-E, DreamStudio, and Craiyon demonstrated promising performance in generating relevant images from general-level text related to nuclear topics. However, these models fall short in three crucial ways: (1) they fail to accurately represent technical details of energy systems; (2) they reproduce existing biases surrounding gender and work in the energy sector; and (3) they fail to accurately represent indigenous landscapes—which have historically been sites of resource extraction and waste deposition for energy industries. This work is performed to motivate the development of specialized generative tools to improve energy literacy and effectively engage the public with low-carbon energy sources.

Abstract Boston Children’s Hospital has established a genomic sequencing and analysis research initiative to improve clinical care for pediatric rare disease patients. Through the Children’s Rare Disease Collaborative (CRDC), the hospital offers CLIA-grade exome and genome sequencing, along with other sequencing types, to patients enrolled in specialized rare disease research studies. The data, consented for broad research use, are harmonized and analyzed with CRDC-supported variant interpretation tools. Since its launch, 66 investigators representing 26 divisions and 45 phenotype-based cohorts have joined the CRDC. These studies enrolled 4653 families, with 35% of analyzed cases having a finding either confirmed or under further investigation. This accessible and harmonized genomics platform also supports additional institutional data collections, research and clinical, and now encompasses 13,800+ patients and their families. This has fostered new research projects and collaborations, increased genetic diagnoses and accelerated innovative research via integration of genomics research with clinical care.

Abstract Background Cross-sectoral collaborations as exemplified by the One Health approach, are widely endorsed as pragmatic avenues for addressing zoonotic diseases, but operationalisation remain limited in low-and-middle income countries (LMICs). Complexities and competing interests and agendas of key stakeholders and the underlying politico-administrative context can all shape outcomes of collaborative arrangements. Evidence is building that organised collaborations are complex political initiatives where different objectives; individual and institutional agendas need to be reconciled to incentivise collaborations. Methods Drawing on a qualitative network analysis of published sources on ‘One Health’ stakeholders supplemented with 26 multi-scale (national-state-district level) key-informant interviews (including policymakers, disease managers and public health experts), this paper characterises the fragmented and complex characteristics of institutional networks involved in zoonoses prevention and control in India. Results Our results highlight how the local socio-political and institutional contexts interact to modulate how and when collaborations occur (or not), the associated contingencies and stakeholder innovations in circumventing existing barriers (e.g. competing interests, distrust between actors, departmental bureaucracy) to cross-sector collaborations and zoonoses management. Aside from principal actors negotiating common ground in some instance, they also capitalised on political/institutional pressure to subtly ‘manipulate’ their subordinates as a way of fostering collaboration, especially in instances when the institutional and political stakes are high. Conclusion Altogether our findings suggest that cross-sectoral collaborations are by-product of political and institutional tinkering as long as individual actors and institutional interests converge and these dynamics must be embraced to embed meaningful and sustainable collaborations in local socio-political and administrative contexts.

Background/Objective: Diabetic ketoacidosis (DKA) is typically but not exclusively seen in patients with a history of diabetes mellitus. Case Report: This is a case of 39 year-old male who was diagnosed with acute pancreatitis based on characteristic symptoms and positive CT findings on presentation. Laboratory testing revealed elevated serum glucose 251 mg/dL, low serum bicarbonate 8 mmol/L, increased anion gap 21, and elevated serum beta-hydroxybutyrate 9.62 mmol/L. Diagnosis of DKA was made, however patient did not carry a diagnosis of diabetes mellitus. His hemoglobin A1c in hospital was normal at 5.4%. Additionally, follow-up hemoglobin A1c at 4 months and 10 months postdischarge did not imply diabetes mellitus, 5.8% at both time points. The patient who was initially managed with intravenous insulin required no insulin or oral diabetic medication on discharge. All these findings argued against new onset diabetes mellitus. Discussion: This case explores the potential pathophysiology that underlies this phenomenon including possible transient insulin insufficiency due to beta cell dysfunction from pancreatic inflammation. It also highlights the reversibility and transiency of possible beta cell dysfunction during acute pancreatitis and emphasizes the importance of closely assessing the patients' insulin requirements upon discharge, especially when a prior history of diabetes mellitus is absent. Conclusion: DKA can occur as a rare complication of acute pancreatitis in a nondiabetic patient. Hyperglycemia associated with acute pancreatitis-induced DKA can be temporary and these patients might not necessarily require insulin upon discharge. Therefore, careful discharge planning is very important in such patients.

Objective: To investigate the epidemiology of injuries and risk factors in Raipur, Chhattisgarh, India. Methods: A community-based cross-sectional study was conducted in 10 selected wards of Raipur. Data were collected from injured individuals using a structured questionnaire. Socio-demographic characteristics, injury mechanisms, medical care-seeking behavior, and outcomes were assessed. Results: 312 individuals with injuries were included, with 193 men and 119 women. Males were more likely to be injured than females (61.86% v.s. 38.14%). Younger adults aged 21-30 were at highest risk (21.5%). The most common injuries were falls (38.8%) and road traffic accidents (34.9%). Injuries occurring on-road are the most frequent, followed by, at home with a highly significant association (P

Phytochemicals, naturally occurring compounds in plants, possess a wide range of therapeutic properties, including antioxidant, anti-inflammatory, anticancer, and antimicrobial activities. However, their clinical application is often hindered by poor water solubility, low bioavailability, rapid metabolism, and instability under physiological conditions. Polymer lipid hybrid nanoparticles (PLHNPs) have emerged as a novel delivery system that combines the advantages of both polymeric and lipid-based nanoparticles to overcome these challenges. This review explores the potential of PLHNPs to enhance the delivery and efficacy of phytochemicals for biomedical applications. We discuss the obstacles in the conventional delivery of phytochemicals, the fundamental architecture of PLHNPs, and the types of PLHNPs, highlighting their ability to improve encapsulation efficiency, stability, and controlled release of the encapsulated phytochemicals. In addition, the surface modification strategies to improve overall therapeutic efficacy by site-specific delivery of encapsulated phytochemicals are also discussed. Furthermore, we extensively discuss the preclinical studies on phytochemical encapsulated PLHNPs for the management of different diseases. Additionally, we explore the challenges ahead and prospects of PLHNPs regarding their widespread use in clinical settings. Overall, PLHNPs hold strong potential for the effective delivery of phytochemicals for biomedical applications. As per the findings from pre-clinical studies, this may offer a promising strategy for managing various diseases.

Among the primary non haematopoietic neoplasms of the spleen, vascular neoplasms are the most common. These vascular neoplasms consist of haemangiomas, littoral cell angiomas, lymphangiomas, Splenic Hamartomas (SHs), haemangioendotheliomas, angiosarcomas and Sclerosing Angiomatoid Nodular Transformation (SANT). SANT is a recently described, rare non neoplastic vascular entity of the spleen. The majority of patients are asymptomatic and are incidentally picked up on Computed Tomography (CT) or Magnetic Resonance Imaging (MRI), but the diagnosis can mimic malignant lesions of the spleen on imaging studies. SANT is considered a female-predominant disease with a wide age distribution. Majority of cases have been reported in the adult age group, in paediatric age it is very rare. Hereby, the authors present a case series of four patients diagnosed with SANT in tertiary care hospital. Two of them were in the paediatric age group (four-year-old boy and 14-year-old girl), while the other two were middle-aged adults (46-year-old female and 41-year-old male). Both paediatric patients presented with symptoms of abdominal pain and discomfort and underwent an Ultrasonographic (USG) examination, which showed a well-circumscribed hypoechoic mass. Laboratory findings showed increased Erythrocyte Sedimentation Rate (ESR) and anaemia. Based on the clinical and radiological findings, diagnosis of splenic hamartoma and inflammatory pseudotumour were made in these cases. Unlike the paediatric patients, both adult patients were asymptomatic and diagnosed incidentally during routine radiological examinations. The USG examination showed a well-circumscribed hypoechoic mass, with a difference in the size of the lesions. Light microscopic examination and immunohistochemical staining confirmed the diagnosis of SANT in all cases. The patients were followed for six months, during which no recurrences occurred. Although SANT is a benign tumour, it can sometimes be misdiagnosed by radiological studies, so surgical removal followed by histopathological and immunohistochemical examinations is required for an accurate diagnosis.

Complex physical occurrences currently need the use of nonlinear fractional partial differential equations. This paper provides a new approach to using the conformable derivative of Atangana to achieve exact travelling wave solutions to the space time-fractional Phi-4 problem. Our method enables a more profound comprehension of complex mathematical physics processes. We validate the solutions and demonstrate the effectiveness of our approaches in solving difficult nonlinear problems in nuclear and particle physics. Singular solutions can be retrieved by using the proposed method on nonlinear partial differential equations (NFPDEs). Our results are shown using contour and three-dimensional charts, which demonstrate various soliton formations for varying parameter values in the nonlinear zone. This study contributes to our growing knowledge of optical soliton.

Abstract Introduction Chronic kidney disease (CKD) demonstrates a complex interaction with tobacco exposure and sex differences, where females and males may experience varying risks and outcomes. This study aims to investigate how sex differences mediate the relationship between tobacco exposure and CKD development, with a secondary focus on regional variability and social determinants of health. Study selection and criteria Comprehensive searches on MEDLINE, EMBASE, clinicaltrials.gov, and MedRxiv until October 6, 2022, were conducted. Eligibility criteria involved any study that reported primary data on the prevalence of CKD, with information pertaining to both sex and tobacco exposure. Data extraction Data retrieved include patient socio-demographic characteristics, general study information, diagnostic methods, social determinants of health, and the cause of CKD (e.g., tobacco-related or non-tobacco-related). Results Studies were selected through a comprehensive search using key terms such as "chronic kidney disease," "smoking," and "sex differences," which identified 3,025 articles, of which 28 were selected for full texts after screening titles, abstracts. Among the 28 included studies, smoking was consistently identified as a significant risk factor for CKD, with notable disparities related to sex, socioeconomic status, race, and urban versus rural settings. Significant geographical variability in CKD prevalence was observed, ranging from 2.5% to 68.1%, with the highest prevalence in Asia. However, due to high heterogeneity and methodological limitations, a meta-analysis of CKD prevalence stratified by sex and tobacco exposure was not feasible. Conclusions The findings emphasize the need for further research to comprehend the intricate relationship between, tobacco exposure, sex, and CKD management, as well as the consideration of cultural, geographical, socioeconomic, political, and structural factors when understanding the pathophysiology and management of CKD.

Abstract This comprehensive examination delves into the multifaceted characteristics of edible flowers, underlining their significance as sources of natural ingredients and their medicinal properties. The review commences with an introductory section emphasizing edible flowers' cultural and health importance. It proceeds to explore the botanical diversity of edible flowers, encompassing their geographical distribution. Emphasis is placed on the bioactive constituents of these flowers, with a focus on their potential health benefits and various molecular targets for the treatment of several chronic disorders. Culinary and medicinal uses are examined, illustrating their adaptability across diverse cultural contexts. Their nutritional richness is highlighted through comparative analysis. Safety considerations and regulatory frameworks ensure consumer protection. Future prospects underscore innovation, discussing potential applications in the food industry and avenues for further research. The analysis concludes by summarizing key findings and discussing future implications, highlighting the intriguing potential of edible flowers as natural components for various applications in food, health, and beyond. Graphical abstract

Abstract CGGBP1 is a GC-rich DNA-binding protein which is important for genomic integrity, gene expression and epigenome maintenance through regulation of CTCF occupancy and cytosine methylation. It has remained unclear how CGGBP1 integrates multiple diverse functions with its simple architecture of only a DNA-binding domain tethered to a C-terminal tail with low structural rigidity. We have used truncated forms of CGGBP1 with or without the DNA-binding domain (DBD) to assay cytosine methylation and global gene expression. Proximal promoters of CGGBP1-repressed genes, although significantly GC-poor, contain GC-rich transcription factor binding motifs and exhibit base compositions indicative of low C-T transition rates due to prevention of cytosine methylation. Genome-wide analyses of cytosine methylation and binding of CGGBP1 DBD show that CGGBP1 restricts cytosine methylation in a manner that depends on its DBD and its DNA-binding. The CGGBP1-repressed genes show an increase in promoter cytosine methylation alongside a decrease in transcript abundance when the DBD-deficient CGGBP1 is expressed. Our findings suggest that CGGBP1 protects transcription factor binding sites (TFBS) from cytosine methylation-associated loss and thereby regulates gene expression. By analysing orthologous promoter sequences we show that restriction of cytosine methylation is a function of CGGBP1 progressively acquired during vertebrate evolution. A superimposition of our results and evolution of CGGBP1 suggests that mitigation of cytosine methylation is majorly achieved by its N-terminal DBD. Our results position CGGBP1 DNA-binding as a major evolutionarily acquired mechanism through which it keeps cytosine methylation under check and regulates TFBS retention and gene activity.

Introduction: Nurses are the primary contact for caregivers of Children with Special Healthcare Needs (CSHCN). Parent counselling and health screening programs are undertaken in which nurses play an important role. Along with this, it is also essential to have knowledge of oral health and the importance of maintaining oral hygiene, especially for CSHCN. Aim: To evaluate the knowledge of nursing graduates regarding oral healthcare for CSHCN at baseline, one week and one month after a Structured Visual Pedagogy (SVP) intervention, and to compare their knowledge scores before and after the intervention. Materials and Methods: This pretest-posttest quasi-experimental study was conducted at Dr. D.Y. Patil College of Nursing, Pune, Maharashtra, India, between February 2023 and June 2023, among 60 nursing graduates. An SVP was curated and delivered to the study population. It was an audio-video discussion-based intervention covering the various domains of oral healthcare for CSHCN, including their oral manifestations, barriers to oral hygiene maintenance, and their management through counselling and timely referrals. Participants completed a pre-validated questionnaire at three intervals: before the intervention, one week after and one month after the intervention, and their knowledge was analysed. The data were analysed using International Business Machines (IBM) Statistical Package for Social Science (SPSS) software version 21.0, USA. Results: The mean age of study group was 21±0.85 years. Among the participants, 52 (86.6%) were females and 8 (13.4%) were males. Between the baseline and the first week of the SVP, as well as, between the baseline and the first month, nursing graduates’ understanding of the oral health requirements of CSHCN increased. The mean knowledge score at the pre-intervention stage was 6.83±2.35; at one week post-intervention, the mean knowledge score was 14.40±1.50; and one month post-intervention, the mean knowledge score was 13.65±1.40. It was observed that there was a statistically significant increase in the mean knowledge score one week, as well as, one month post-intervention compared to the baseline (p-value

Abstract Histolocalization and quantification of secondary metabolites established the occurrence of alkaloids, phenols and acetogenins in various plant organs of A. muricata at different stages of plant growth. Annona muricata L. possesses broad assemblage of ethno-pharmaceutical and therapeutic upsides ascribed to biosynthesis of secondary metabolites. Currently, the bioactivity is characterized by the production of acetogenins (ACGs), and also by the biosynthesis of alkaloids, primarily benzylisoquinolines derived from tyrosine and phenolic compounds. As a result of high variability of metabolite production in A. muricata, the present study evaluated the histochemical analysis of various plant parts at different developmental stages of growth. Presences of phytometabolites were determined using in-situ histochemical localization of alkaloids, phenolic compounds and acetogenins, while its estimation employing spectroscopic quantification techniques to understand structure, development, time-course deposition, content and distribution of secondary phytoconstituents. Study revealed distinct presence of secondary metabolites in cells and tissues of all plant organs in various intensities and patterns. Alkaloids and acetogenins occurred mostly in secretory cavities or idioblast cells while sparsely associated with other cells or tissues. Phenolic compounds emerged widely, with no confined distribution patterns occurring in storage cells and tissues. Quantitative analysis revealed highest accumulation of alkaloids, phenols and acetogenins in mature root-barks, mature unripe fruit rind and mature leaf respectively. Secondary metabolites generally occurred in young stages at low concentrations as compared to matured growth stages of plant parts. Such in-situ histochemical and biochemical approach will help in identifying the cells and tissues responsible for synthesis, storage and biological effects of potential secondary metabolites which could be further used for culturing and enhancing its production with biotechnological aids.

Abstract Insecticidal potential of seven commonly available alkaloids against melon thrips (Thrips palmi Karny) was investigated through in vivo experiments and the bioactivity was explained via in silico approaches. In vivo screening showed highest mortality of T. plami larvae for reserpine (43%), closely followed by tropinone (41%) after 24 h of incubation. After 48 h, tropinone surpassed reserpine with 83% mortality, indicating its prolonged insecticidal activity. A detailed bioassay of tropinone revealed its LC50 values as 1187.9 and 686.9 µg mL−1 after 24 and 48 h, respectively. While studying the molecular interactions between the alkaloids and four physiologically important target proteins of T. palmi, tropinone demonstrated the highest ligand efficiency and lowest predicted inhibitory constant, particularly when forming complexes with CathB protein. However, binding energy calculations of the docked complexes showed most favorable binding of reserpine with CathB. To clear the ambiguity, considering both binding energy and ligand efficiency as the evaluation parameters, a molecular dynamics study was carried out, which predicted higher stability of CathB-tropinone complex than CathB-reserpine complex in terms of the total energy of the system. These in silico findings aligned well with the in vivo results, confirming tropinone as a promising candidate for effective thrips management programs.

Abstract Constructed with used plastic bottles, the eco-cooler has been widely adopted in resource-poor communities in Bangladesh and other countries. We tested the eco-cooler under controlled conditions using a scientific wind tunnel in a climatic chamber. In our tests, we used seven eco-cooler designs in 27 climate conditions typical of Bangladesh (temperatures of 40 °C, 35 °C, and 30 °C; humidity levels of 70%, 60%, and 40%; and wind speeds of 4.0 m s−1, 2.0 m s−1, and 0.2 m s−1) in 92 experiments (N = 7686 measurements in 87 short experiments and N = 23,428 measurements in five long experiments). We found no significant temperature reductions with eco-cooler use, except at low wind speeds, where temperature reduced by up to 0.2 °C. In theoretical calculations extending our empirical findings, the greatest temperature drop was 0.85 °C at 4.0 m s−1 with a 40 °C static air inflow temperature. However, this temperature drop did not extend beyond the nozzles of the bottles in the eco-cooler. The eco-cooler did not work effectively as an indoor air cooler.

Abstract Background The clinical utility of whole genome sequencing (WGS) in paediatric cancer has been demonstrated in recent years. WGS has been routinely available in the National Health Service (NHS) England for all children with cancer in England since 2021, but its uptake has been variable geographically. To explore the underlying barriers to routine use of WGS in this population across England and more widely in the United Kingdom (UK) and the Republic of Ireland (ROI), a one-day workshop was held in Cambridge, United Kingdom in October 2022. Methods Following a series of talks, delegates participated in open, round-table discussions to outline local and broader challenges limiting routine WGS for diagnostic work-up for children with cancer in their Principal Treatment Centres (PTCs) and Genomic Laboratory Hubs (GLHs). Within smaller groups, delegates answered structured questions regarding clinical capability, education and training needs, and workforce competence and requirements. Data was recorded, centrally collated, and analysed following the event using thematic analysis. Results Sixty participants attended the workshop with broad representation from the 20 PTCs across the UK and ROI and the seven GLHs in England. All healthcare professionals involved in the WGS pathway were represented, including paediatric oncologists, clinical geneticists, clinical scientists, and histopathologists. The main themes highlighted by the group in ensuring equitable access to WGS identified were: lack of knowledge equity between NHS trusts, with a perception of WGS being for research only; and perception of lack of financial support for the clinical process surrounding WGS, including lack of time to take informed consent from patients. The latter also included limited trained staff available for data interpretation, affecting the turnaround time for reporting. Finally, the need for an integrated digital pathway to order, track, and return data to clinicians was highlighted. Conclusion At the workshop, the general motivation for including WGS in the diagnostic work up for children with cancer was high throughout the UK, however a perceived lack of resources and education opportunities limit the widespread use of this commissioned assay. This workshop has led to some recommendations to increase access to WGS in this population in England and more widely in the devolved national of the UK and the ROI.