Search

Abstract Background The Androgen Receptor (AR) has emerged as an endocrine therapy target in Breast Cancer, exhibiting up to 80% expression in clinical cases. AR-V7, a constitutively activated splice variant of AR with a truncated ligand-binding domain (LBD), demonstrates ligand-independent transcriptional activity and resistance to nonsteroidal antiandrogens like Bicalutamide or Enzalutamide, targeting the LBD. In metastatic prostate cancer, elevated AR-V7 levels lead to therapeutic resistance and increased metastasis. Methods In this study, we evaluated the expression of AR and AR-V7 in cell lines and a cohort of 89 patients undergoing surgical intervention for treatment-naïve breast cancer. Further clinicopathological correlations and survival analysis were performed to evaluate the relationship between the AR and AR-V7 expression and clinical outcomes. Results AR-V7/AR-FL ratio was elevated in the TNBC cell line and downregulation of AR-FL upon AR antagonists’ treatment led to a compensatory increase in AR-V7. Clinical samples showed significantly elevated expression of AR and AR-V7 in tumors compared to control cases. Further clinicopathological correlation revealed aggressive clinical traits, higher pathological grades, and poor survival with AR-V7 expression. Conclusions Our study unravels AR-V7 as a marker for poor clinical outcomes, predicting breast cancer aggressiveness, and encourages consideration of AR-V7 as a probable target for therapeutic intervention.

Background Breastfeeding is an important determinant of child survival. Breastfeeding practices vary throughout the nation. Objectives To assess the breastfeeding practices and the knowledge of recently delivered mothers regarding breastfeeding practices. Materials and Methods This community-based cross-sectional study was conducted among women who had delivered in the Moradabad region of Uttar Pradesh last year. A total of 423 households was divided between the six community health blocks according to probability sampling. A predesigned and pretested structured questionnaire was utilized to collect data. Knowledge scores were calculated. Results The majority of respondents had the correct knowledge about breastfeeding immediately after birth (76.6%), prelacteal foods should not be provided (82.2%), colostrum feeding (89.0%), adequate frequency of breastfeeding (99.1%), and exclusively breastfeeding (78.7%). The knowledge scores about breastfeeding were good (64.9%) for mothers. A higher proportion of respondents practiced breastfeeding only, or cup fed with breast milk only their babies for the first 2 days of life (62.3%), and the majority fed their baby with adequate frequency. Only (55.7%) put their baby to breast within an hour after birth. Colostrum was not squeezed and thrown by nearly (59.7%) of mothers. The breastfeeding practices scores were good among one-third of mothers. Age of mother, type of family, mother’s education, socioeconomic status, and type of delivery were significant determinants of good breastfeeding practices (

Abstract Breast cancer (BC) has emerged as the most common malignancy among females. The genomic profile of BC is diverse in nature and complex due to heterogeneity among various geographically different ethnic groups. The primary objective of this study was to carry out a comprehensive mutational analysis of Indian BC cases by performing whole exome sequencing. The cohort included patients with a median age of 48 years. TTN, TP53, MUC16, SYNE1, and OBSCN were the frequently altered genes found in our cohort. The PIK3CA and KLC3 genes are driver genes implicated in various cellular functions and cargo transportation through microtubules, respectively. Except for CCDC168 and PIK3CA, several gene pairings were found to be significantly linked with co-occurrence. Irrespective of their hormonal receptor status, RTK/RAS was observed with frequently altered signaling pathways. Further analysis of the mutational signature revealed that SBS13, SBS6, and SBS29 were mainly observed in our cohort. This study supplements the discovery of diagnostic biomarkers and provides new therapeutic options for the improved management of BC.

Abstract Breast cancer, a global health concern predominantly affecting women, recorded 2.3 million new cases and 685,000 deaths in 2020. Alarmingly, projections suggest that by 2040, there could be over 3 million new cases and 1 million deaths. To assess breast cancer prevalence in 24 rural villages within a 60 km radius of NIMS Hospital, Tala Mod, Jaipur, Rajasthan, North India 303,121. A study involving 2023 participants conducted initial screenings, and positive cases underwent further tests, including ultrasound, mammography, and biopsy. SPSSv28 analysed collected data. Among 2023 subjects, 3 screened positive for breast lumps. Subsequent clinical examination and biopsy identified 1 normal case and 2 with breast cancer, resulting in a prevalence proportion of 0.0009 or 98 per 100,000. This study helps fill gap in breast cancer prevalence data for rural Rajasthan. The results highlight a concerning prevalence of breast cancer in the rural area near NIMS hospital, emphasizing the urgent need for increased awareness, early detection, and better healthcare access. Challenges like limited resources, awareness programs, and delayed diagnosis contribute to this high incidence. To address this, comprehensive approach is necessary, including improved screening programs and healthcare facilities in rural areas. Prioritizing rural healthcare and evidence-based strategies can reduce the burden of breast cancer and improve health outcomes.

We utilized remote sensing and ground cover data to predict soil organic carbon (SOC) content across a vast geographic region. Employing a combination of machine learning and deep learning techniques, we developed a novel data fusion approach that integrated Digital Elevation Model (DEM) data, MODIS satellite imagery, WOSIS soil profile data, and CHELSA environmental data. This combined dataset, named GeoBlendMDWC, was specifically designed for SOC prediction. The primary aim of this research is to develop and evaluate a novel optimization algorithm for accurate SOC prediction by leveraging multi-source environmental data. Specifically, this study aims to (1) create an integrated dataset combining remote sensing and ground data for comprehensive SOC analysis, (2) develop a new optimization technique that enhances both machine learning and deep learning model performance, and (3) evaluate the algorithm’s efficiency and accuracy against established optimization methods like Jaya and GridSearchCV. This study focused on India, Australia, and South Africa, countries known for their significant agricultural activities. We introduced a novel optimization technique for both machine learning and deep neural networks, comparing its performance to established methods like the Jaya optimization technique and GridSearchCV. The models evaluated included XGBoost Regression, LightGBM, Gradient Boosting Regression (GBR), Random Forest Regression, Decision Tree Regression, and a Multilayer Perceptron (MLP) model. Our research demonstrated that the proposed optimization algorithm consistently outperformed existing methods in terms of execution time and performance. It achieved results comparable to GridSearchCV, reaching an R2 of 90.16, which was a significant improvement over the base XGBoost model’s R2 of 79.08. In deep learning optimization, it significantly outperformed the Jaya algorithm, achieving an R2 of 61.34 compared to Jaya’s 30.04. Moreover, it was 20–30 times faster than GridSearchCV. Given its speed and accuracy, this algorithm can be applied to real-time data processing in remote sensing satellites. This advanced methodology will greatly benefit the agriculture and farming sectors by providing precise SOC predictions.

Abstract Cyber‐Physical Systems (CPSs) are becoming more automated and aimed to be as efficient as possible by enabling integration between their operations and Information Technology (IT) resources. In combination with production automation, these systems need to identify their assets and the correlation between them; any potential threats or failures alert the relevant user/department and suggest the appropriate remediation plan. Moreover, identifying critical assets in these systems is essential. With numerous research and technologies available, assessing IT assets nowadays can be straightforward to implement. However, there is one significant issue of evaluating operational technology critical assets since they have different characteristics, and traditional solutions cannot work efficiently. This study presents the necessary background to attain the appropriate approach for monitoring critical assets in CPSs' Situational Awareness (SA). Additionally, the study presents a broad survey supported by an in‐depth review of previous works in three important aspects. First, it reviews the applicability of possible techniques, tools and solutions that can be used to collect detailed information from such systems. Secondly, it covers studies that were implemented to evaluate the criticality of assets in CPSs, demonstrates requirements for critical asset identification, explores different risks and failure techniques utilised in these systems and delves into approaches to evaluate such methods in energy systems. Finally, this paper highlights and analyses SA gaps based on existing solutions, provides future directions and discusses open research issues.

Abstract Background Vertigo and dizziness are frequent clinical symptoms. Peripheral vertigo and central vertigo are two different types of vertigo that result from a disrupted vestibular system. Imbalance and dizziness are frequent initial complaints. It is common for improper diagnosis and subpar treatment to result from a lack of a systematic approach to the examination and laboratory evaluation of the vestibular system. A correct diagnosis can be made with a fundamental knowledge of vestibular physiology and the right examination methods. Objectives The current study was done to evaluate and assess the roles of neuro-otological examinations, vestibular tests, and videonystagmography among patients with dizziness visiting a tertiary care centre. Methodology An analytical cross-sectional study was conducted among patients complaining of vertigo at a tertiary care centre for the duration of 18 months. A total of 64 patients were included according to inclusion and exclusion criteria. Various diagnostic tests were applied and correlated with the complaints of the patients. Result Forty-two percent of patients with dizziness had hearing loss, and 26.5% had tinnitus. 57.8% had the PTA test within the normal limit, and the head shake test (videonystagmography) was positive among 39.1%. Caloric test abnormality was seen in 53.1% of patients with dizziness. Neuro-otological examination of the head shake test was found positive in 29.7% of cases. 79.7% of cases show a positive Fukuda test. SP > AP is seen among 9.4% of cases in EchoG. 67.1% show a positive Romberg test. The Dix-Hallpike test was positive among 31.2% of dizziness patients. Conclusion In conclusion, history and neuro-otological testing can aid in the diagnosis of vertigo, but they cannot be relied on if the vertigo is complex. Only symptomatic history and neuro-otological tests are helpful in cases like a simple unilateral posterior canal BPPV, but in a complex case with tinnitus, aural fullness, Romberg positivity, or Fukuda positivity, we need the assistance of additional investigations such as vestibular tests such as ECochG and VNG.

Abstract The integration of distributed energy resources and advancement in information technology has enabled the transition of traditional power distribution systems to active cyber‐physical distribution systems. A growing amount of research has been done on the modelling, analysis, and optimisation of power distribution system behaviour. However, existing publicly available distribution test feeders are limited in numbers and have minimal features. Furthermore, these test feeders do not include cyber models and are not customisable. To bridge this gap, we propose and develop Cyber‐physical synthetic distribution system network (CP‐SyNet), a tool for generating customisable cyber‐physical synthetic distribution test feeders. CP‐SyNet generates three‐phase unbalanced test feeders according to users' requirements, while simultaneously considering both the cyber side and the physical side of the network for cyber‐physical analysis. The physical test network is developed using a graph‐theoretical approach that employs information from existing test feeders. The cyber side considers an equivalent communication network by transforming the physical topology into possible and feasible simulated network. Two examples are presented to demonstrate the feasibility of the proposed framework to generate cyber‐physical test feeders.

To ensure the sustainability of the future power grid, the rate of expansion of distributed energy resources (DERs) has introduced operational challenges. These include managing transmission constraints with DER power injection, dispatching DERs efficiently, managing system frequency, and ensuring sufficient reactive power for voltage support. Coupled with the intensification of wildfires, power infrastructures across the United States face challenges to minimize the impact of these factors and maintain system reliability and resiliency. This research embarked on a comprehensive evaluation, beginning with an in-depth historical analysis to delineate regions most susceptible to wildfires. Utilizing a multidimensional approach, the study assessed wildfire-induced risks to power grids by integrating historical wildfire occurrences, real-time wildfire proximities, Moderate-Resolution Imaging Spectroradiometer (MODIS)-derived vegetation metrics, and system parameters. Principal component analysis (PCA)-based optimal weights were then used, leading to the formulation of a novel risk factor model. This risk factor model has the potential to be the key to ensuring the resilience of a renewable-rich smart grid when faced with a severe weather event. Our model’s applicability was further verified through an empirical assessment, selecting representative networks from diverse regions, providing insights into the geographical variability of risk factors. Ultimately, this study offers stakeholders and policymakers a comprehensive toolset, empowering decisions regarding infrastructure investments, grid reinforcements, and strategic power rerouting to ensure consistent energy delivery during wildfires.

Abstract Patients with early breast cancer are affected by metastasis to axillary lymph nodes. Metastasis to these nodes is crucial for staging and quality of surgery. Sentinel Lymph Node Biopsy that is currently used to assess lymph node metastasis is not effective. This necessitates identification of biomarkers that can flag metastasis. Early stage breast cancer patients were recruited. Surgical resection of breast was followed by identification of sentinel lymph nodes. Fresh frozen section biopsy was used to assign metastatic and non-metastatic sentinel lymph nodes. Discovery phase included iTRAQ proteomics coupled with mass spectrometric analysis to identify differentially expressed proteins. Data is available via ProteomeXchange with identifier PXD027668. Validation was done by bioinformatic analysis and ELISA. There were 2398 unique protein groups and 109 differentially expressed proteins comparing metastatic and non-metastatic lymph nodes. Forty nine proteins were up-regulated, and sixty proteins that were down regulated in metastatic group. Bioinformatic analysis showed ECM-receptor interaction pathways to be implicated in lymph node metastasis. ELISA confirmed up-regulation of ECM proteins in metastatic lymph nodes. ECM proteins have requisite parameters to be developed as a diagnostic tool to assess status of sentinel lymph nodes to guide surgical intervention in early breast cancer.

Abstract Background The provision of health care services including maternal and newborn care is a dynamic system of entitlement and obligations among the community, the service providers, and the government. Thermal control remains poor in newborns owing to immaturity of the thermoregulatory center and newborn become vulnerable to hypothermia especially premature babies, intrauterine growth retardation and LBW babies, and even normal babies.This study aimed to assess the knowledge & practices regarding thermal protection their determinants. Methods Cross-sectional study was conducted in the Amroha district. The study population comprised women of reproductive age (15 to 49 years) who have delivered a live baby within the past 12 weeks before the conduct of the study. Out of 6 blocks, 2 most populous villages were selected. Total 61 villages from 6 blocks were covered under the study. Knowledge and practices regarding newborn thermal care were expressed in percentages and compared. Results The knowledge domain on thermal protection of baby, 60.9% of the respondents were well aware of how to keep baby warm after delivery, 71.4% of respondents knew that baby should be dried soon after birth, 64.9% of the respondents had an idea of time to dry the baby, 69.6% of the respondents knew that baby should be wrapped soon after birth. Conclusion The findings of the study provides an insight into the existing knowledge and necessitate a need for quantitative studies in the study area to access knowledge & practices related to thermal protection of newborns. The authors emphasize a need for improving community awareness for the promotion of newborn care and improve the health system to meet the demands of birthing mothers and the needs of newborns.

Background: Increased body mass index (BMI) is a known risk factor for respiratory infection and is being recognized as a predisposing factor in the COVID‐19 pandemic caused by the severe acute respiratory syndrome coronavirus‐2. Aims and Objectives: This study aimed to assess the association between different body mass index categories with severe COVID-19 patients leading to death. Materials and Methods: This retrospective study of six months included the laboratory-confirmed COVID-19 patients admitted to an ICU of a tertiary care academic health care organization. The medical records were reviewed at least 14 days after admission. Results: 484 patients were included, and BMI data were available for 306 patients. 40.19% had a normal weight, 26.79% were overweight, 17.97% had BMI 30-34.9 Kg/m2 and 15.03% had BMI ≥ 35 Kg/m2. Overall, 58 patients (18.95%) died within 14 days of ICU admission, 50.98% were discharged alive or referred from the hospital within 14 days, and 30.06% remained hospitalized at 14 days. After controlling for all covariates, there was a significantly increased risk of mortality in the patients with obesity class I (RR 2.03, 95% CI 1.07-3.85, P = 0.030) and patients with obesity class II & III (RR 2.83, 95% CI 1.54–5.22, P

Selective hydrogenation of CO2 to methanol over Pd nanoparticles supported on MgO promoted ZnO oxide catalyst was investigated in a fixed bed continuous downflow reactor at 3 MPa pressure and temperature between 200–280 °C. The synthesized catalyst showed exceptionally high selectivity (>90%) for methanol production via CO2 hydrogenation at low temperature (220 °C) and pressure (3 MPa). 2wt%Pd loaded on ZnO catalyst showed very less activity but the addition of MgO on the ZnO led to a higher dispersion of Pd, which directly influences catalyst activity and methanol production. The addition of 10 wt% MgO over 2wt%Pd/ZnO catalyst improved the catalyst activity, where we observed ∼ 8.2% CO2 conversion with ∼ 90.6% methanol selectivity. Density Functional Theory (DFT) calculation shows the addition of MgO at the Pd/ZnO catalyst promotes the adsorption of CO2, as well as reaction intermediates HCOO and COOH. The long-term stability of MgO-promoted Pd-ZnO was tested, and it was found that catalyst showed no deactivation even after 80 h time-on-stream.

Introduction: Anemia is a sign of serious disease at all ages; but in elderly population it is especially true. According to epidemiologic data, its prevalence rises with increasing age sharply after the age of 60years. Method: To evaluate the prevalence of anemia and its determinants among older age group in Uttarakhand, NFHS-IV (2015-16) data was used. For socio demographic analysis, study included 7056 individuals (After excluding missing information) aged 60 years and above. Results: The median age was 66.38years (range,60–95years). The mean levels of hemoglobin (Mean ± SD) were 14.23 ± 1.29 g/dL in men and13.75 ± 1.15 g/dL in women, and the overall prevalence of anemia was 36.42% (2502/6870):In men the prevalence was 36.86 % (2096/5687) and 34.32% (406/1183)in Women. The Prevalence in age group 60–69, 70–79 and ≥80 was 35.2%, 38.1% and 41.2% respectively. It was found that the prevalence of anemia differed significantly between those of age 60–69 and 70–79 years, those of age 60–69 and ≥80 years, and those of age 70–79 years and ≥80 years.Conclusions: The prevalence of anemia among elderly people of Uttarakhand was determined to be 35.9% and it increased with age. Male sex, older age, low BMI, low education and nuclear family were identified as independent risk factors of anemia among the elderly Indians.

Abstract Background and aim Globally, the ongoing pursuit in exploring an effective drug to combat severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus has not met with significant success to date. Indian traditional medicines, especially polyherbal formulations like Nilavembu Kudineer (NVK) and Kaba Sura Kudineer (KSK) of the Siddha system of medicine, have been used as public health interventions for controlling viral epidemics like dengue and Chikungunya. These traditional therapies have been found safe, effective, and widely accepted. The current study evaluates the comparative efficacy of NVK and KSK as opposed to the placebo, in the management of mild to moderate COVID-19 disease. Methods The study was a double-blind, placebo-controlled comparative clinical trial, with the primary objective of determining the efficacy of KSK and NVK. Patients (n=125) diagnosed with mild to moderate COVID-19 symptoms were enrolled in the study over a period of 4 months (Aug 2020—Dec 2020). Participants were randomized into 3 arms; placebo-decaffeinated tea in Arm I, NVK in Arm II, and KSK in Arm III. Each arm received 60 ml of the respective treatment twice a day, post morning and evening meals, along with standard allopathy treatment for a maximum of 10 days. The main outcome measures of the study were the reduction in SARS-CoV-2 viral load, hospital stay, and time taken by the patients to become asymptomatic from symptomatic. Efficacy assessments included clinical symptoms (fever, cough, and breathlessness) each day and real-time reverse transcription-polymerase chain reaction (RT-PCR), liver function test (LFT), renal function test (RFT), and electrolytes and electrocardiogram (ECG) at baseline (day 0) and days 3, 6, and 10. Post-treatment, participants were followed up for 30 days via phone for adverse effects if any. Effects of drugs on inflammatory markers (IL6) at the end of treatment were also recorded. Adverse events (AE) were monitored throughout the study. Results The results revealed that when compared to patients in the placebo arm, those in NVK and KSK arms showed a statistically significant reduction in hospital stay time, reduction in viral load of SARS-CoV-2, and the time taken to become symptomatic from asymptomatic. Out of 125 COVID-19 patients recruited, 120 completed the study; two from the placebo group developed severe symptoms and were shifted to the intensive care unit (ICU) and three patients from Arms II and III withdrew from the study. The mean age of females (n=60) and males (n=60) enrolled was between 40.2 and 44.3 years, respectively. Results were more promising for all the patients in NVK and KSK arms as all enrolled participants (100%) under this group got discharged by day 6 as compared to only 42.5% (n=17) from the placebo group on that day. The hospital stay time for patients in Arm I was significantly longer (mean [SD]=8.4 [2.0] days) as compared to the Arms II and III (mean [SD]=4.7 [1.5] and 4.2 [1.5] days, respectively (Kruskal-Wallis test, P=0.0001). Patients in the three groups took a significantly different number of days to become asymptomatic. While Arm II and III patients took mean of 2.5 and 1.7 days, respectively, Arm I, patients took a mean of 4.2 days (Kruskal-Wallis test, P=0.0001). In all, two adverse events were recorded, one for vomiting and one for diarrhea lasting a day in Arm I and Arm II, respectively. The mean value of interleukin-6 (IL6) was significantly different in comparison to the placebo-decaffeinated tea arm (NVK=2.6 and KSK=2.2, placebo=4.0, P=0.02). The other blood biochemical parameters like C-reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, and D-dimer that were analyzed at the baseline and at the time of discharge from the hospital, were not significantly different in the three arms. Conclusion NVK and KSK arms showed a statistically significant reduction in hospital stay time, reduction in viral load of SARS-CoV-2, and time taken for patients to become asymptomatic from symptomatic, when compared to the placebo (decaffeinated tea). The primary outcome measures of the KSK arm were significantly better than those in the NVK arm.

Carbon-based materials are the promising candidates for the design of multifunctional spintronic devices, owing to their fascinating inherent attributes such as the ballistic transport nature, long spin coherence time, etc. Here, we report the spin-dependent electron transport properties of a trans-polyacetylene channel sandwiched between two semi-infinite hydrogen-passivated zigzag graphene nanoribbon (ZGNR) electrodes within the framework of spin-polarized density functional theory (DFT) and non-equilibrium Green's function (NEGF) formalisms. The proposed device exhibits an excellent spin-dependent transport behavior within the bias window of [-0.5 V, 0.5 V]. In parallel configuration (PC), the device offers an ideal spin filtration efficiency of almost 100% within the bias range of [-0.4 V, 0.4 V], and in antiparallel configuration (APC), it exhibits negative differential resistance (NDR), dual-spin rectification, and dual-spin filtration effects. Also, a high tunnel magnetoresistance (TMR) of 1.2× 105% is achieved. To validate the aforementioned effects, the transmission spectra along with the area enclosed by the curve, eigenvalues, eigenstates, and quantum conductance have also been analyzed. In addition, the impact of hybridization and torsion defects on the spin-dependent transport phenomenon through trans-polyacetylene has been investigated. Furthermore, the modelled device is observed to exhibit the spin Seebeck effect in PC under the influence of temperature gradient. The proposed device may stand as a good contender for various spintronic and spin caloritronic applications.

Introduction: There is inadequate information on infections with the Severe Acute Respiratory Syndrome Virus 2 (SARS-CoV-2) in children. Their clinical, as well as pathological correlation, is poorly understood. In India, children and adolescents account for 12% of all Coronavirus Disease 2019 (COVID-19) cases reported. Children accounted for roughly 11% of those impacted globally last year. However, this year, we are seeing around 20-40% of youngsters in positive instances over the world. Even babies and infants are testing positive for COVID-19, although their illness is under control and seldom becomes fatal. Children aged 5 to 12 years, on the other hand, are at a higher risk. Aim: To study the clinical, pathological and genomic characteristics among children with SARS-CoV-2 infection. Materials and Methods: This cross-sectional study was conducted among 48 paediatric positive patients for SARS-CoV-2 at Government Institute of Medical Sciences, Noida, Uttar Pradesh, and CSIR-Institute of Genomics and Integrative Biology, New Delhi, India, from 1st April 2021 to 31st May 2021. The laboratory testing was done by the real-time Reverse Transcription-Polymerase Chain Reaction (RT-PCR) method. The patients were classified as mild, moderate, severe, or asymptomatic. Their clinical and pathological findings were recorded in the case sheet. Genomic analyses were done for identifying the genetic variant in the nine selected samples. Data entry and analysis were performed using Statistical Package for Social Sciences (SPSS) version 26.0. Chi-square test was used for categorical variables and the t-test was used for continuous variables. Results: The study group has median age of 12 years. Male:Female ratio was 2:3. Most children had acquired infection from the community and 30% had the moderate illness and were admitted. Serum Glutamic-Oxalacetic Transaminase (SGOT) and Glutamic-Pyruvic Transaminase (SGPT) were raised in six patients. Alkaline Phosphatase (ALP) was raised in 21 patients and bilirubin was raised in two patients. The average duration of hospitalisation was six days (range 2-13 days). No mortality among the 48 paediatric patients studied was identified in the hospital. Delta variant (B.1.617.2) was identified in seven patients with D614, P681R, L452R mutations and B.1.617.2 was identified in two patients. Delta variant was present in the paediatric patients, but it did not prolong the hospital stay or cause mortality. Conclusion: The findings of the study suggest that children may be a potential source of infection in the SARS-CoV-2 pandemic while having an asymptomatic to mild illness.

Abstract The present study reports the upcycling process of waste plastics into value-added product graphene nanosheets (GNs) and their subsequent applications in dye sensitized solar cells (DSSCs) and supercapacitors. Bentonite nanoclay has been used as an agent for the degradation of waste plastics with two step pyrolysis processes at 450 °C and 945 °C in an inert atmosphere of N2 gas to obtain GNs. The GNs with few layers were confirmed by the RAMAN spectroscopy, XRD and HRTEM analyses. Further, FT-IR and EDX analyses also performed for the identification and quantitative analysis of functional groups in GNs. The GNs thus synthesized from plastic waste have been used for the fabrication of DSSCs and supercapacitors. The DSSC fabrication with GNs as part of photo-anode with polymeric electrolyte showed a high fill factor of 86.4% and high Voc of 0.77 V, which were also supported by the computational findings. On the other hand, the utilization of GNs as an active layer material of supercapacitor electrodes offered a high specific capacitance of 398 F/g with a scan rate of 0.005 V/s. The supercapacitor also exhibited significant energy density (Ed) and power density (Pd) of 38 Wh/kg and 1009.74 W/kg, respectively. Thus, the process illustrated the utility of waste plastics upcycling for conservation of EEE i.e., ecology, economy and energy for better tomorrow.

Introduction: Endoscopic thyroidectomy is an advanced procedure and has a long learning curve. Most commonly employed approach is combined axillary-breast approach (ABA). Recently, transoral endoscopic thyroidectomy vestibular approach (TOETVA) is being popularised as a scarless procedure. However, it is not established whether TOETVA or ABA approach is better to begin with. Purpose: The purpose of the study was to compare the initial experience of TOETVA and ABA with respect to difficulties and outcomes. Methodology: A prospective non-randomised interventional study was conducted including the initial ten patients in each group who underwent hemithyroidectomy for benign solitary thyroid nodule. Sigma plot version 12.3 was used for the statistical analysis. Results: All the patients were female and comparable with respect to age (33.2 vs. 28.2 years) and size of nodule (2.7 vs. 3 cm) (TOETVA vs. ABA). The operative time (121 vs. 138.5 min, P = 0.34) and blood loss (50 vs. 60 ml, P = 0.9) were similar in both the groups. Even though the flap raising time was significantly less with TOETVA group (29.3 vs. 47.2 min, P < 0.001), it was associated with more difficulty in approaching upper pole (P = 0.02) and lower pole (P < 0.001), more intra-operative events (30% vs. 10%, P = 0.58) and conversions to open (20% vs. 10%, P = 1). Similarly, post-operative pain scoring was more with TOETVA (3 vs. 2, P = 0.04). Hospital stay was similar in both the groups (2.5 vs. 3 days, P = 1). Patients in both the groups had both overall and cosmetic satisfaction. Conclusions: Axillary-breast approach should be preferred to start learning the endoscopic thyroidectomy, as it is easier and safer than transoral endoscopic vestibular approach.

The WEPPcloud interface is a new online decision-support tool for the Water Erosion Prediction Project (WEPP) model that facilitates data preparation and model runs, and summarizes model outputs into tables and maps that are easily interpretable by users. The interface can be used by land and water managers in the United States, Europe, and Australia interested in simulating streamflow, sediment and pollutant loads from both undisturbed and disturbed (e.g. post-wildfire or post-treatment such as thinning or prescribed fires) forested watersheds. This article contains full hydrologic model runs for 28 forested watersheds in the U.S. Pacific Northwest with the WEPPcloud online interface. It also includes links to repositories with the individual model runs, a table containing default model parameters for disturbed conditions, and figures with model outputs as compared to observed data. The data in the repositories include all the raw data input and output from the model as well as the processed data, which can be accessed through tables and shapefiles to provide additional insights into the model outputs. Lastly, the article describes how the data are organized and the content of each folder containing the data. These model runs are useful for anyone interested in modeling forested watersheds with the WEPPcloud interface.

The proliferation of inverter-based distributed energy resources (IBDERs) has increased the number of control variables and dynamic interactions, leading to new grid control challenges. For stability analysis and designing appropriate protection controls, it is important that IBDER models are accurate. This paper focuses on the accurate estimation and parameter calibration of DER_A, a recently proposed aggregated IBDER model. In particular, we focus on the parameters of the reactive power–voltage regulation module. We formulate the problem of parameter tuning as a non-linear least square minimization problem and solve it using the Levenberg–Marquardt (LM) method. The LM method is primarily chosen due to its flexibility in adaptively selecting between the steepest descent and Gauss–Newton methods through a damping parameter. The LM approach is used to minimize the error between the actual measurements and the estimated response of the model. Further, the computational challenges posed by the numerical calculation of the Jacobian are tackled using a quasi-Newton root-finding approach. The proposed method is validated on a real feeder model in the northeastern part of the United States. The feeder is modeled in OpenDSS and the measurements thus obtained are fed to the DER_A model for calibration. The simulation results indicate that our approach is able to successfully calibrate the relevant model parameters quickly and with high accuracy, with a total sum of square error of 3.57×10−7.

Objectives. This is a diagnostic test research study to evaluate the various existing methods of thyroid examination and their comparison with the novel modified Rose method. It also aims to measure inter-examiner variation in clinical findings based on the level of education and training, as compared to ultrasonography. Methodology. This cross-sectional study was conducted at a tertiary care hospital with eighty-three patients presenting to surgery OPD with neck swelling. Each patient was examined by one trained Junior Resident and a Surgery Consultant with all the four methods and with ultrasonography. Data was analysed by Stata-14, agreement between the two categorical variables was assessed by Kappa. In case of continuous variable agreement was assessed by Intra class correlation and Bland-Altman plot. Results. Modified Rose method by the consultant has the highest sensitivity (98%) and diagnostic odds (210) as compared to others but its specificity ranges from 46.7- 91.1% to diagnose retro-sternal extension of a goiter. It has 93.98% agreement for identification of nodules. It has a high specificity (Consultant -100%, Resident – 95.5%) with relatively lower sensitivity (Consultant -94%, Resident – 86.8%) to diagnose solitary thyroid nodule (STN) but the sensitivity and specificity for diagnosing a multinodular goitre (MNG) was high. However, the highest sensitivity to diagnose STN was highest with Crile’s method, but specificity was low. Lahey’s method was a better clinical method to palpate lymph nodes compared to the other three. Conclusion. Examination in modified Rose’s position is a better method of clinical examination of thyroid especially in patients with occult substernal extension. Lahey’s method is a better method to examine cervical lymph nodes.

Introduction: Satisfaction of the patient play a very important decisive factor for pay-for-performance metrics and it also replicates the type of care being provided. One of the major parameters to establish patient satisfaction is to measure success of services provided in hospital. Aim: To assess the quality of care in terms of patient’s satisfaction in a tertiary care hospital of Uttar Pradesh. Materials and Methods: A community based cross-sectional study was carried out among patients attending the Outpatient Department (OPD) at Varunarjun Medical College and Rohilkhand Hospital, Uttar Pradesh, India. Total 88 people (patients or attendants) were interviewed by using a predesigned and pretested semi-structured proforma, in Hindi language. The questionnaire contained questions related to an individual’s experience with the staff and environment of health system at the end of their outpatient visit. Data were analysed using Statistical Package for the Social Sciences (SPSS) version 20.0. Result: The majority 37 (42.0%) belonged to age group of 34-49 years, 58 (66%) were males, 36 (40.9%) educated upto high school and 45 (51.2%) belonged to general category. In the present study, regarding hospital informatory, 28 (31.8%) respondent found good direction indicators. Waiting period was less than half-an-hour reported by 47 (53.4%) patients. Sixty-three (71.5%) patients had opportunity to ask questions about their disease and treatment. Most of the respondent 50 (56.8%) said that hospital staff listened to their questions and problems. Statistically significant association was found inbetween patient satisfaction and socio-demographic variable like age, gender, education and socio-economic status (p-value

Abstract Objectives The primary objectives of the study are to determine the effectiveness of the Kaba Sura Kudineer (KSK) & Nilavembu Kudineer (NVK) along with standard Allopathy Treatment to compared with Placebo (Decaffeinated Tea) with standard Allopathy Treatment in the management of Symptomatic COVID 19 patients and also in reduction of Hospital Stay Time & Changes in Immunological (IL6) and Bio Chemical Markers (Ferritin, CRP, D-Dimer and LDH). The secondary objectives are to evaluate the safety of the trial medicines and their effects in the reduce the risks of the disease. In addition, to document the profile of Symptomatic COVID 19 patients as per Siddha Principles. Trial Design A Double Blinded, Three arm, Single Centre, Placebo Controlled, Exploratory and comparative Randomized Controlled Trial Participants Patients who were admitted to the COVID Care Centre at Govt. Institute of Medical Sciences. Noida in India will be recruited. These will be patients with Mild and Moderate symptoms with laboratory confirmed COVID 19 (RT – PCR Tested Positive) aged 18-65, willing and consenting to participate. Intervention and comparator Arm I: Decaffeinated Tea (Placebo – similar in taste and appearance to the other Two Decoctions), 60 Ml Morning and Night after Food, along with standard Allopathy Treatment for 10 days. Arm II: Nilavembu Kudineer (The Siddha Medicines which is used as a standard Anti-Viral drug for the past Pandemics by Siddha Physicians) 60 Ml Morning and Night after Food, along with standard Allopathy Treatment for 10 days. Arm III: Kaba Sura Kudineer (The Siddha Medicine which is proposed to be used as a Treatment for COVID 19 based on Siddha Literature) 60 Ml Morning and Night after Food, along with standard Allopathy Treatment for 10 days. The investigational drugs are registered products under the Govt.of India and bought from GMP Certified Manufacturing Units. Main Outcomes Primary outcomes: 1. Reduction in Viral load of SARS-CoV-2 at the end of treatment (10 days). 2. Time taken to convert Patient from symptomatic to Asymptomatic based on Reduction in clinical symptoms (10 days). 3. Effect of drugs inflammatory markers (IL6,) at the end of treatment (10 days). 4. Reduction in hospital stay time (20 days follow up). (Based on RT PCR CT Value 3rd, 6th if needed 10th day). (Based on IL 6 Value needed 10th day or IL6 value on turning negative. (entry level/exit level). Secondary outcomes (10 days): 1. Reduction in use of Intensive Supportive Care. 2. Reduction in incidence of complications (Acute Respiratory Distress Syndrome, other systemic complications). 3. MuLBSTA score for viral pneumonia (multinodular infiltration, hypo-lymphocytosis, bacterial co infection, Total Leucocyte Count (TLC ≤ 0.8 x 109/L), smoking history, hyper-tension and age) score. 4. Laboratory markers (Haematological & Biochemical Markers). 5. Adverse events/effects Siddha-based measurements. 6. Siddha Udaliyal assessment by using Yakkai Ilakkanam (YI) Tool to diagnose body condition for covid-19 patients. Randomisation The assignment of the participants into 3 Groups will be allocated in 1:1:1 Ratio through randomization Blocks in Microsoft Excel by a Statistician who is not involved in the study. The allocation scheme will be made by another statistician by using a closed envelope after the assessment of eligibility and Informed consent procedures. The groups will be balanced for age and sex with 3:1 Ratio in each group for mild: severe COVID-19 symptoms. Blinding The Study is Double Blinded. Participants and Investigators were blinded. Numbers to be randomized (Sample size) Sample size could not be calculated, Since there are no prior trials on KSK and NVK as a comparative trial. In addition, there are no prior trials on KSK and NVK in this region. A total Number of 120 Patients, 40 each in 3 groups will be recruited in 1:1:1 Ratio. Trial Status Protocol Number : SCRUND GIMS Noida Study 1,Version: 2.0 Protocol Date : 20.08.2020 The recruitment period is completed for the trial. The Trial started its recruitment on 22.8.2020. We anticipate study including data analysis will finish in January 2021. This is to state that it was a late submission from authors for publication of the protocol to the BMC, after enrolment in the study was over. Trial Registration The trial protocol was registered with CTRI (Clinical Trial Registry of India) and number is CTRI/2020/08/027286 on 21.08.2020 Full Protocol The full Protocol is attached as an additional file, Accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated. This letter serves as a summary of the key elements of the full protocol. The Study protocol has been reported in accordance with the SPIRIT guidelines.

Background: Infantile hemangioma is the most common tumor of infancy. Currently, propranolol is a preferred drug for treating hemangioma. The exact mechanism of action of propranolol is not known. In this study, we attempted to assess whether propranolol has any effect on vascular endothelial growth factor (VEGF) and tissue inhibitor of metalloproteinase-2 (TIMP-2) over a period of time, and if it is there, how long it affects it. Materials and Methods: Propranolol was administered in the dosage of 2–3 mg/kg. The first serum sample was collected before starting the propranolol treatment. Thereafter, samples were collected at monthly intervals up to a total of six samples. The samples were assessed for TIMP-2 and VEGF using enzyme-linked immunosorbent assay kit. Results: The duration of this study was from June 2016 to November 2017. The total number of patients in this study was 15. Thirteen patients responded to treatment. The mean age of patients was 7.1 months. The mean value of baseline VEGF was 0.234 ± 0.059 and that of TIMP-2 was 1.338 ± 0.679. As compared to baseline value, the P value was statistically not significant in any of sequential values. In category-wise analysis, apart from statistically significant value in the 6th month in excellent category and good response category in the 1st month, all other values did not reveal any significant change in VEGF analysis. The analysis of TIMP-2 revealed a significant change in the levels from Sample 2 to Sample 6 in the excellent response group; however, the levels did not show a specific trend either increasing or decreasing. Conclusion: Despite its beneficial action in regression of hemangioma, the exact mechanism is yet to be identified. The exact duration of treatment needs further evaluation.

Background: Thoracic paravertebral block (TPVB) has become the gold standard to provide postoperative analgesia in breast surgery. Recently, ultrasound-guided (USG) pectoralis (PECS) block and serratus anterior plane (SAP) block have been described as an alternative to TPVB. The objectives were to compare TPVB, PECS, and SAP block in terms of analgesic efficacy and the spread of local anesthetic by ultrasound imaging, correlating it with the sensory blockade. Materials and Methods: Prospective randomized interventional study conducted in 45 ASA grades I–II patients scheduled for the elective breast surgery. Patients were randomly allocated into three groups, i.e., Gr.1 (USG –TPVB) (ropivacaine 0.375% 20 ml), Gr.2 (USG-PECS II) block (ropivacaine 0.375% 30 ml), and Gr.3 (USG-SAP) (ropivacaine 0.375% 30 ml). Spread of the local anesthetics was seen with ultrasound imaging. Onset of sensory blockade, postoperative fentanyl consumption, and pain scores was measured. Results: TPVB and SAP group had comparatively higher spread and sensory block compared to PECS group. Postoperative fentanyl requirement (mean ± SD) was 428.33 ± 243.1 μg, 644.67 ± 260.15 μg, and 415 ± 182.44 μg in the TPVB group, PECS II group, and SAP group, respectively. SAP group had significantly lesser requirement than PECS II group (P = 0.028) but similar requirement as in TPVB group (P = 1.0). Pain scores were not significantly different among the group in the postoperative period. Conclusion: TPVB and SAP group result in a greater spread of the drug and provide equivalent analgesia and are superior to the PECS II block in providing analgesia for breast surgeries. SAP block is easier to perform than TPVB with lesser chances of complications and results in faster onset.

In this paper we propose a distribution-level retail electricity market operated by a Distribution System Operator (DSO), to permit participation for small-scale distributed energy resources (DERs) in a real-time energy market. The retail market is built upon a distributed Proximal Atomic Coordination algorithm, which solves the optimal power flow using the convex nonlinear Branch Flow model, rendering spatially and temporally varying distribution-level Locational Marginal Prices. A numerical study of the market structure is carried out via simulations of the IEEE-123 node network using data from ISO-NE and Eversource in Massachusetts, US. The market performance is compared to existing retail practices, including demand response with no-export rules and net metering. Results show the DSO-centric market increases DER utilization, resulting in lower electricity rates for customers, from $0.114/kWh to $0.0291/kWh. Further, we discuss the policy implications of such a market, including DER participation models at the wholesale level in light of FERC Order 2222, and the evolving business model of the modern utility which is moving from commoditized markets towards performance-based ratemaking.

Objectives of this Trial: The objectives of this trial were to compare the treatment of lymphedema by creating artificial pathways along with standard compressive therapy versus standard therapy alone in Stage 2 and 3 lymphedema. Materials and Methods: A total of 18 patients were randomized into two groups. Silicone group (n = 8) received the placement of fenestrated silicone tubes subcutaneously from the hand to scapular region along with standard compression therapy, and the control group (n = 10) received standard compression therapy only. Follow-up was for 6 months. Results: A mean reduction of limb volume in the silicone group was 887 ml (25%), whereas in the control group, it was 250 ml (8%) (P = 0.01). All patients, 8 (100%) of silicone group and only 4 (40%) of control group, had ≥10% limb volume reduction at the end of 24 weeks with P = 0.013. More number of patients in the silicone group had a mean reduction in limb circumference of ≥2 cm as compared to the control group at almost all points of measurements along the limb with P < 0.05. There was a significant improvement in the quality of life, especially the functional domain in the silicone group with a P = 0.01. Improvement in pain-free range of motion in all major joints was observed in both the groups. No serious complications were reported. Postoperative ultrasonography and lymphoscintigraphy have shown patency of tubes, lymphatic fluid flow in silicone tubes. Postoperative indocyanine green lymphography showed decreased dermal backflow compared to preoperative. Conclusion: Combination of artificial lymphatics in the form of silicone tubes and standard care leads to a more significant reduction in the limb volume and limb circumference with improved quality of life with no serious complications.

Context: Mammography in dense breasts is challenging due to lesion obscuration by tissue overlap. Does tomosynthesis offers a solution? Aims: To study the impact of digital breast tomosynthesis (DBT) in characterizing lesions in breasts of different mammographic densities. Settings and Design: Prospective blinded study comparing mammography in two views with Mammography + Tomosynthesis. Methods and Material: Tomosynthesis was performed in 199 patients who were assigned Breast imaging reporting and data system (BIRADS) categories 0, 3, 4, or 5 on two-dimensional (2D) mammogram. Mammograms were first categorized into one of 4 mammographic breast densities in accordance with the American College of Radiology (ACR). Three radiologists independently analyzed these images and assigned a BIRADS category first based on 2D mammogram alone, and then assigned a fresh BIRADS category after taking mammography and tomosynthesis into consideration. A composite gold-standard was used in the study (histopathology, ultrasound, follow-up mammogram, magnetic resonance imaging). Each lesion was categorized into 3 groups—superior categorization with DBT, no change in BIRADS, or inferior BIRADS category based on comparison with the gold-standard. The percentage of lesions in each group was calculated for different breast densities. Results: There were 260 lesions (ages 28–85). Overall, superior categorization was seen in 21.2% of our readings on addition of DBT to mammography. DBT was most useful in ACR Densities 3 and 4 breasts where it led to more appropriate categorization in 27 and 42% of lesions, respectively. DBT also increased diagnostic confidence in 54.5 and 63.6% of lesions in ACR Densities 3 and 4, respectively. Conclusions: In a diagnostic setting, the utility of tomosynthesis increases with increasing breast density. This helps in identifying the sub category of patients where DBT can actually change management.

Due to the increasing penetration of distributed energy resources (DERs) required for the sustainable distribution system, new voltage control strategy is needed by utilities. Traditional voltage control strategy can not support the increasing number of DERs in a coordinated and scalable manner to meet the operational voltage regulation requirement. Supported by the power electronics converter, the energy storage system can provide fast, smooth, and flexible voltage control services. In this paper, an effective and easy to implement sensitivity-based voltage control strategy is developed for the energy storage system. The developed control strategy is validated using an industrial feeder data in Northwest Washington. The proposed strategy can mitigate the voltage unbalance issue, improve the voltage profile, and correct power factors while supporting sustainable distribution system operation.

This study presents a tool to study the cyber-physical resiliency (CyPhyR) of critical energy infrastructure system, in particular the effect of cyber attacks on the microgrid's resiliency. The developed tool enables measuring resiliency using data from cyber and physical systems and suggests control decisions for resilient planning and operation of the microgrid. The microgrid resiliency is formulated based on graph theory based indices and cyber-power system characteristics. A Common Vulnerability Scoring System based metric called the Cyber Asset Impact Potential is developed and used in the planning phase, and another metric, Cyber Impact Severity is introduced to study the system performance in the operational phase. The information from these two phases is provided to the operator to make informed and proactive decisions to ensure the resilient operation of the microgrid. The performance of the developed tool has been tested using comprehensive real-time cyber-power testbed for a Consortium for Electric Reliability Technology Solutions microgrid test system.

Not available

Nanowire are the one-dimensional nanostructure with the diameter order of one to few hundred nanometre. These structure shows unique properties other than their bulk structures. In this article, a qualitative first principle discussion of TiC nanowire is reported, indicating the impact of DFT based GGA relativistic corrections on its electronic properties. Here, we analyse the Titanium Carbide (TiC) nanowire of hexagonal structure periodic in Z-direction with the density functional theory (DFT). The GGA with RBBE Correlation analysis of this material shows the metallic characteristics in its bulk but the electronic density of state shows that the hybridization state are different from their bulk when the material is analysed in nanostructure form. Three structures of hexagonal TiC nanowire directed in (1,1,1) plane were analysed to explore diameter (4-18) Å dependent comparative study of electronic, stabilizing and optical property which shows unique different result counterparts to its bulk. Hexagonal TiC nanowire were found to be semiconducting with narrow band gap (0.21-0.34) eV in small diameter while metallic in higher diameter. They are comparable stables as their bulk for higher structure. Similarly, for the same investigation, the structures are cross checked by surface atom passivation to verify the reliability of the result that we found. BIBECHANA 16 (2019) 7-14

In this study, the authors introduce ARCADES (Analysis of Risk from Cyberattack against DEfensive Strategy), a technique to systematically explore the cybersecurity defence strategies based on contingency rankings in power systems. While cybersecurity defensive standards exist, these approaches are primarily based on expert opinions, rather than systematic studies of risk. ARCADES presents an approach to identify improved cybersecurity defensive strategies based on a graph-based cyber-physical security model that is evaluated by resistance-distance metrics and then prioritised based on contingency analysis studies of the system. This study also proposed a technique that identifies the most critical cybersecurity mechanisms to protect the power grid. Planning and operation: those two applications for cybersecurity on power grid mainly explored in this study. For planning, a systematic method is developed to verify the effectiveness of security strategies and for operation, prioritised the security mechanism for auditing and monitoring purpose. As a case study, they analyse the IEEE-14 bus, IEEE-30 bus, and IEEE-118 bus systems, observe the defensive strategies, and calculate substation criticality ranking by using the authors’ proposed method.

Breast cancer (BC) is the most common cancer diagnosed in women and the second most common cancer overall, ranking as the fifth cause of death from cancer. The chronicity of the disease produces long-term physiological and psychological manifestations, which adversely affect the quality of life of the individual. The primary treatment while managing cancer presents with various debilitating side effects. With the recent advances in treatment techniques that have improved the survival rate, patients suffer from continuing posttreatment complications. Patients seem to cope well with the stress of treatment of BC and sustain a normal life; however, the deterioration in physical well-being makes the patient functionally inefficient. Exercise has been proven to be an effective, safe, and feasible tool in combating the adverse effects of treatment, prevents complications and decreases the risk of BC-specific mortality. This review briefly presents an overview of the burden of the disease and its management strategies. Owing to the heterogeneity of the population and the multitude of therapies they receive, the response of each patient to treatment is different and so is the magnitude of adverse effects. The review discusses the late sequelae following treatment and evidence supporting the role of physical activity in their management. In conclusion, there is a need for personalized physical activity plans to be developed to suit the individual and their circumstances.

Background: Suicide is a social burden and 3rd leading cause of death among the youth worldwide. A few studies have shown that Borderline personality disorder and Histrionic personality disorder are the most likely amongst the personality disorders to predispose patients to suicide. Not many studies have been focussed on the issues of deliberate self harm and the personality factors which predispose to these attempts, which seem to be more common than suicide attempts. Objective: To study personality factors and the incidence of depression as well as the stressors in patients with suicidal attempt. Results and Discussion: The subjects tended to be married, employed, and educated, with no female preponderance. There is low prevalence of depression (8/30, 26.6%) in the subjects in this study. Though all of were referred to the psychiatry unit for a “suicide attempt”, the majority (26/30, 86.6%) of them did not show severe suicidal ideation on Columbia Suicide Severity Rating scale (CSSR). Conclusion: Most of the patients referred from the Emergency Medical Department (EMD) tended not to be depressed and had low suicidal ideation and only scored averagely on the life events stress scale. This study also did not find any significant difference in the Personality traits as assessed on Clinical Analysis Questionnaire (CAQ) in the depressed and non-depressed groups, or between the severe ideation and not-severe ideation groups on CSSR.

The modelling and geometry optimisation of metal-organic complexes of dibenzothiophene have been done to analyse their electronic, optoelectronic, and thermodynamic properties in the gas phase and in solvent phase (Heptane, Chloroform, Dichloroethane, Ethanol, Acetonitrile, Water). The Density functional theory (DFT) has been used to deduce the properties like polarizability ( α ), dipole moment ( μ ), first hyperpolarizability ( β ), second hyperpolarizability ( γ ), susceptibility ( χ ), dielectric constant (ϵ), refractive index (n), and thermodynamic properties, using the B3LYP functional and LANL2DZ basis function. The high values of n, χ , β , and α , and the small values of HOMO-LUMO energy gap, and ϵ affirm good optoelectronic and electronic applications for the studied molecules.

Background: There are many techniques being followed in marital or couples therapy for the resolution of marital discord. In the particular module of Conjoint collaborative therapy where joint sessions with the couple run concurrently with individual sessions for each partner, an additional issue crops up which may influence the outcome independently of the marital therapy: resolution of individual psychopathology may have beneficial effects in strengthening the marriage, but may also have the opposite effect. Individual ego strengthening may disturb the homeostasis which has kept the dysfunctional marriage together. Objective: To study individual ego strengthening as a dynamic factor that influences the course and outcome of marital therapy. Discussion: It may be that many marriages which are held together because of the pressures from without rather than the desire from within may find the dynamics changed by therapy. If the individual sessions are going well, it may be that the benefits there may outpace those in the joint sessions or the progress in the relationship. Conclusion: With the resolution of individual crisis, one or both partners may no longer be willing to carry the relationship forward and a separation is the result. The individual may benefit from the ego strengthening, but it proves deleterious for the relationship. This paper explores the dynamics that may be involved in this event.

INTRODUCTION:Duct ectasia (DE) and periductal mastitis (PDM) are the most common benign breast conditions seen in women. The etiopathogenesis of these entities is still not clear and most of the theories regarding the causation are based on the histological features as seen on light microscopy. The ultramicroscopic features associated with these conditions that may give more insight to the etiopathogenesis are unknown. AIM:To study the ultrastructural changes occurring in mammary duct cones in patients with DE and PDM using Transmission Electron Microscopic (TEM). METHOD:Major ducts removed by radical duct excision from 21 patients with final histopathological diagnosis of DE and PDM were subjected to TEM study with 2 normal duct samples as controls. RESULTS:The TEM features of DE were denudation of the epithelial cells with focal loss of microvilli, widening of the inter-epithelial junctions with focal disruption of the T bars, periductal collagenisation without inflammation, and features suggestive of Epithelial Mesenchymal Transition (EMT). PDM features are intact epithelial lining with proliferative epithelium and periductal collagenisation with inflammation. CONCLUSIONS:Based on the TEM findings, we suggest that DE and PDM are two different entities. EMT a novel finding observed in DE in this study.

Introduction: Diabetes dramatically increases the risk of lower extremity amputation because of infected, non-healing foot ulcers. The objective was to assess the knowledge of diabetic foot practices and find association with socio-demographic variables in patients visiting a tertiary care hospital in Uttar Pradesh. Methods: Hospital based cross-sectional study involving clinically diagnosed adult (>18 years) patients of Diabetic Foot. Results: Maximum knowledge score was found in the age group 40-50 years, females, rural residence, semi-skilled/ skilled occupation, higher education, religion other than Hindu or Muslim, living alone and belonging to socio-economic class IV. The maximum attitude score in age>60 years, females, urban area, semi-skilled/ skilled workers, higher education, Hindu religion and living in a joint family. Among the practices, maximum score was seen in age>60 years, females, urban areas, semi-professional/ professional occupation and higher education. Significant association was seen with duration of Diabetes, prior receipt of information, treatment compliance and type of foot wear used. Conclusion: This study highlights the importance of variables like compliance to treatment, barefoot walking, choice of footwear and grade of ulcer. Regular inculcation of health education and boosting self-care management during treatment will reduce the burden of this disease and reduce long term complications.

Background : Breastfeeding is one of the most important determinants of child survival, birth spacing, and the prevention of childhood infections. The beneficial effects of breastfeeding depend on its initiation, duration, and the age at which the breastfed child is weaned. Breastfeeding practices vary among different regions and communities. Objectives: To assess the pattern of infant feeding and its relation to certain practices of maternity and newborn care, and to assess the knowledge of mothers on the advantages of exclusive breastfeeding. Materials and Methods: The cross-sectional study was carried out in randomly selected villages of the Bhojipura Block of Bareilly district, Uttar Pradesh. A total of 123 women who had delivered within the last year were interviewed in a house-to-house survey. A study instrument was used to collect data. Chi- square test and regression analysis were used to analyze the data. Results: Most of the mothers were aged less than 30 years (78.04%) and were Hindus (73.9%). Most were illiterate (69.9%) and belonged to the lower socioeconomic class (97.5%). The majority were housewives (99.1%) and multiparous (68.2%). Most had initiated breastfeeding (78.8%) within 24 hours of delivery. About 15.4% of the infants did not receive colostrum and 22.8% of the infants were not exclusively breastfed. Ghutti (water mixed with honey and herbs), boiled water, tea, and animal milk were commonly used pre-lacteal feeds. About 47.2% of the respondents were not aware of the benefits of exclusive breastfeeding. About one quarter of the mothers started complementary feeding before the child was six months old. About half the deliveries had taken place at home and only a quarter of the females had had three or more antenatal visits during pregnancy. The birth weight of the majority (78%) of newborns was not measured. A majority (69.9%) of the mothers did not receive advice on child feeding. Multivariate logistic regression analysis showed that maternity and newborn care variables had no significant association with exclusive breastfeeding. Conclusions: Despite higher rates of early initiation of breastfeeding and exclusive breastfeeding, awareness of the benefits of exclusive breastfeeding was low. This indicates the need to promote awareness of the correct method of infant feeding and care of the newborn. Creating an awareness of the advantages of exclusive breastfeeding will further strengthen and support this common practice in rural communities and avoid an early introduction to complementary foods for sociocultural reasons.

Objective: There is a lack of consensus among surgeons over interrupted versus continuous methods of abdominal wound closure. The objective of this study was to perform a meta-analysis to estimate the pooled odds ratio (OR) for dehiscence and incisional hernia in the interrupted technique of laparotomy wound closure as compared to the continuous technique. Methods: All randomized, controlled trials comparing continuous and interrupted methods of laparotomy wound closure, with burst abdomen and/or incisional hernia as the outcomes, were included in the meta-analysis. MEDLINE, Clinical Evidence and the Cochrane Library were searched. Burst abdomen and incisional hernia were the two primary outcomes. Results: Twenty-three studies were identified, with a total of 10,900 patients. The interrupted method of closure was associated with significantly less dehiscence as compared with the continuous method (OR, 0.576; p =0.014; relative risk reduction, 39.8%; number needed to treat, 143). The interrupted technique was also found to be better in the nonabsorbable suture, vertical incision and mass closure subgroups. However, no difference in the hernia risk was found between the two methods. Conclusion: Interrupted laparotomy wound closure reduces the odds of dehiscence by half compared with continuous wound closure.

Chronic wound management is a difficult area in surgical practice. A wide range of dressings have been recommended for the management of chronic wounds. The present meta-analysis was undertaken to determine the effectiveness of hydrocolloid dressing (HCD) in the healing of chronic wounds compared with conventional gauze dressing. All available controlled clinical trials published before December 2001 that compared HCD to conventional gauze dressing in the healing of chronic wounds were systematically reviewed. We identified and analysed 12 randomized trials (11 published; 1 unpublished) comprising 693 patients with 819 ulcers. The overall odds ratio under the fixed effect model was 1.72, that is, 72% more ulcers healed completely with HCD than with conventional gauze dressing. This result was both clinically and statistically significant.

Background: Tuberculosis is a disease as old as the history of mankind. Nothing substantial could be done by the National Tuberculosis Control Program, launched in our country about 6 decades back. According to a report in India, only 30% TB cases are diagnosed and of them only 35% take treatment for adequate duration. This study was conducted to know sputum conversion of supervised short course chemotherapy for pulmonary tuberculosis. Methods: The study was carried out on rural patients of Bareilly district. The patients were divided in two groups. Group A received drugs under supervision and Group B took conventional domiciliary treatment. In this study supervision was done by a ‘designated’ person who was usually parents, spouse, sibling or children and if no one was available or not found intelligent enough to do this job, a friend of patient living in the village was considered. Result: The sputum conversion was significantly faster in group A as compared to group B; but at 10th week the difference between the two groups became non-significant. The significance was further lost at 3 months, as 100% patients in both groups converted to negative and remained sputum negative at the end of 6 months. Conclusion: The sputum conversion was significantly faster in patient received anti-tuberculosis drugs under supervision as compared to patient who took conventional domiciliary treatment. The present study further supports the fact that DOTS with daily supervision is an effective treatment for tuberculosis.

The present paper discusses the effect of manganese doping on the structural stability and electronic band gap of chiral (2, 1), armchair (3, 3), and zigzag ((6, 0) and (10, 0)) single walled GaN nanotube by using density functional theory based Atomistix Toolkit (ATK) Virtual NanoLab (VNL). The structural stability has been analyzed in terms of minimum ground state total energy, binding, and formation energy. As an effect of Mn doping (1–4 atoms), all the GaN nanotubes taken into consideration show semiconducting to metallic transition first and after certain level of Mn doping changes its trend.

Background: The most common cause of mortality in geriatric patients is cardiovascular disease (CVD). Hypertension (HTN), a risk factor for CVD and the number one reason for primary care visits in the India, affects 20-50% of geriatric population. Methodology: A community based cross sectional study was carried out in the field practice area of Urban health training center (UHTC), dept. Of community medicine, NKP Salve Institute of Medical Sciences and Research Center, Nagpur. A total of 400 subjects aged ≥ 60 years were screened for hypertension. Diagnosis of hypertension was based on the JNC-VII. Results: Author observed that prevalence of hypertension was 34.75%. Family history of Hypertension, BMI ≥ 25 & Stress as risk factors were highly significant with hypertension (p

Background: Non-communicable diseases (NCDs) are the leading causes of death globally, out of 57 million global deaths in year 2008, 63%, were due to NCDs. Over 80% of cardiovascular and diabetes deaths, and almost 90% of deaths from chronic obstructive pulmonary disease, occur in low-and middle-income countries. A large percentage of NCDs are preventable through the reduction of their four main behavioural risk factors: tobacco use, physical inactivity, harmful use of alcohol and unhealthy diet. Thus, there is a need to carryout rigorously implemented surveys that estimate the risk factors of NCDs among Medical students. Objective: This study was undertaken to estimate the Load of lifestyle associated risk factors& their correlates in apparently healthy medical students. Materials and Methods: The cross sectional study will be carried out among students of Medical Institute in Western Uttar Pradesh, India. Student’s interview will be done through an age appropriate modified Global school based student health survey structured self-administrated questionnaire on life style associated risk factors. The statistical analysis will be done using SPSS 17- Chi-square test, t-test and ANOVA. Result: This study documented a prevalence rate of active smoking among the study population 6.4% as against 84.2% for non-smoking. Drinking of alcohol as one of the behavioural risk factors for NCDs was also documented by this present study is 1.8% for binge drinking status and 3.8% for heavy drinking status. Conclusion: The study shows a high prevalence of NCD related risk factors in medical students. Primary prevention may be one way to lower the risk burden of NCDs.

Perturbations in cell adhesion molecules are linked to alterations in cadherin-catenin complexes and likely play major roles in invasion and metastasis; their impact on early precancerous stages remains yet unknown. We showed ALCAM overexpression in early oral lesions and its cytoplasmic accumulation in oral squamous cell carcinoma (OSCC) to be a predictor of disease progression and poor prognosis. This study tested the hypothesis that alterations in E-cadherin and β -catenin expressions are early events in oral tumorigenesis, associated with disease prognosis, and correlate with perturbations in ALCAM expression.Expressions of E-cadherin and β-catenin were analyzed in the same cohort of 105 OSCCs, 76 oral lesions and 30 normal oral tissues by immunohistochemistry and correlated with clinicopathological parameters and prognosis. The effect of siRNA mediated ALCAM knockdown on E-cadherin and β -catenin was determined using western blot, confocal microscopy and RT-PCR analysis in oral cancer cells.Significant loss of membranous E-cadherin and β-catenin expression was observed from normal, hyperplasia, dysplasia to OSCCs (p(trend)

Background: Breast feeding is the safest, least allergic and best infant feeding method. It has nutritional, immunological, behavioral and economic benefits and also provide desirable mother infant bonding. Despite the demonstrated benefits of breastfeeding, breastfeeding prevalence and duration in many countries are still lower than the international recommendation of exclusive breastfeeding for the first six months of life . Objective: To know breast feeding practices of mothers with a view to strengthen these practices for improving the health of infants. Materials & methods: Community Based Cross sectional study was conducted in the field practice area of Rural Health Training Centre. 500 mothers having children between 0-3years age group were included in the study .Self administered questionnaire was used to collect information on breastfeeding practices in the initial six months of birth of the child. Results: The study findings revealed that majority of children were breastfed (93.6%). Initiation of breastfeeding within an hour was practiced by only a few mothers (21.37%). Only 5.13% babies were exclusively breastfed till six months. Prelacteal feeds & colostrum was given to most of them i.e. 66.03% & 87.18%. Conclusion: This shows that undesirable cultural practices such as giving pre-lacteals, late initiation of breast feeding are still prevalent among the community & these should be discouraged by proper BCC activities. For successful feeding, mothers need active support, care & privacy during pregnancy & following birth, not only of their families & communities but also of the entire health system.

Tumor hypoxia is a known driver of angiogenesis that also facilitates tumor growth. Moreover, poorly oxygenated central tumor area remains relatively radio or chemo resistant. HBO therapy is known to elevate the levels of dissolved oxygen and eliminates tumor hypoxia. It has been one of the modalities in cancer treatment; therefore its optimization is important. In this experimental study, no cancer enhancing effect was seen during the course of HBO therapy; however, post therapy there was an accelerated growth and progression of tumor. HBO treated mice lived shorter and the response to therapy was dose & tumor volume dependent. HBO therapy probably exert its effect on the cancer proliferating cells through multiple pathways such as increased DNA damage, apoptosis & geno-toxicity leading to slow cancer progression while post therapy tumorigenic effect could be due to impaired DNA repair mechanism, mutagenic effect & aneuploidy as well as altered blood supply & nutrients. Tumor growth reached plateau with time and this finding validated theoretical model predicting tumor reaching an asymptotic limit. While, marked asymmetry observed in tumor volume progression or cancer cell proliferation rate in each of the experimental C3H mouse suggested a need for an alternate small animal pre-clinical cancer therapeutic model.