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Abstract Background Postnatal care, crucial for preventing and assessing complications after birth, remains low in India. An interactive mHealth community-based postnatal intervention was implemented to promote healthy maternal behaviors through knowledge and social support in rural Northern India. However, there is limited information on how virtual health interventions in resource-constrained settings are perceived by the users and which elements influence their engagement and sustained participation. Objective We explored the user perceptions of acceptability and impact of a virtual interactive maternal and child health intervention pilot tested in Punjab State, India, including their perspectives on barriers and facilitators to engage with this intervention. Methods This qualitative study was embedded within extensive mixed-method research, and oriented by the Realist Evaluation approach. Sixteen participants were recruited from the parent study. They were identified by purposive sampling to cover diverse levels of attendance and engagement with the intervention. In-depth interviews were conducted by phone. Following translation, a framework analysis was completed to search for the main themes. Feedback was requested from intervention moderators during the process to prioritize local interpretation. Results Study participants reported overall satisfaction with the intervention. The mothers appreciated the educational material provided and the communication with other participants and health professionals. Across context, intervention, and actor domains, the barriers most commented on were network and connectivity challenges, lack of time due to household responsibilities, and feeling uncomfortable sharing personal experiences. Family buy-in and support were fundamental for overcoming the high domestic workload and baby care. Another facilitator mentioned was moderators’ guidance on using the different intervention modalities. Regarding perceived impact, participants shared that MeSSSSage increased their capability and motivation to breastfeed, seek care as needed, and use contraception according to their preferences. Finally, participants suggested adding more topics to the educational content and adjusting the dynamics within the group calls to improve the intervention. Conclusions This study identifies the high acceptability and perceived impact of a novel postnatal care program in a rural setting, including the users’ perceived barriers to engaging with the intervention and possible solutions to overcome them. These findings enable refinement of the ongoing intervention, providing a more robust framing for its scalability and long-term sustainability. On a larger scale, conclusions from this research provide new insights and encouragement to global stakeholders who aspire to improve maternal and neonatal outcomes in low-income and middle-income countries through mHealth. Trial Registration ClinicalTrials.gov NCT04693585 (Registration date: 05/01/21).

Abstract Black individuals have lower plasma natriuretic peptide (NP) concentrations than white individuals. However, race-based differences in the NP response to physiological perturbations are unknown. In this physiological trial (NCT#03070184), we measured the NP [mid-regional atrial NP (MR-proANP), N-terminal pro-B-type NP (NT-proBNP), and BNP] response to physiological perturbations among healthy, self-identified Black and white participants aged 18-40 years. The primary and secondary outcomes were the change in plasma NP concentrations at 6 weeks after metoprolol (initiated at 50 mg/day and doubled every 2 weeks) and standardized, aerobic exercise (70% of their maximal oxygen uptake on a salt-standardized background), respectively. Among 40 Black [median age: 27 (22, 32) years; 21 (52.5%) women] and 40 white [median age: 25 (20, 30) years; 19 (47.5%) women] participants, exercise increased MR-proANP (Black: 35%; white: 43%), NT-proBNP (Black: 11%; white: 23%), and BNP (Black: 59%; white: 61%) in both self-reported races. Exercise was associated with an increase in plasma MR-proANP (pinteraction: 0.25) and BNP (pinteraction: 0.87) concentrations which did not vary by self-reported race. However, the increase in plasma NT-proBNP concentrations were higher in white participants than in Black participants. (pinteraction: 0.04) Similarly, metoprolol therapy increased MR-proANP (Black: 18%; white: 16%), NT-proBNP (Black: 95%; white: 99%), and BNP (Black: 45%; white: 74%) in both self-reported races. The metoprolol-associated increase in plasma MR-proANP (pinteraction: 0.85), NT-proBNP (pinteraction: 0.94), and BNP (pinteraction: 0.21) concentrations were similar by self-reported race. In conclusion, the higher increase in plasma NT-proBNP concentrationsamong white patients after exercise suggests that exercise may induce significant physiological variations in NP levels. ClinicalTrials.gov ID: NCT03070184.

Abstract Background The purpose of this simulation study was to evaluate effect of different restorative design on stress concentration of endocrown. Different restorative materials were used on a mandibular molar using a finite element analysis. Methods A 3D FEA model of mandibular molar was constructed using the average values and was used in this analysis. 2 materials were used which were lithium disilicate and zirconia and 2 different margin design of knife edge and shoulder margins were used in various combinations of material and margin design. A constant 12° of internal wall angulation was considered for all the 4 models and a uniform cement thicknes of 100 μm was considered. A uniform 2 mm of bulk fill composite was used as a base beneath the endocrowns. 300 N load was applied on the cusps for each model and linear static analysis was carried out. Results Endocrowns of lithium disilicate was found to exert a greater stress concentration in comparison to zirconia endocrowns in both the margin designs of knife edge and shoulder. Knife edge margins were seen to yield greater stress concentration on the remaining tooth structure in comparison to shoulder margins in endocrowns of both the materials used. Conclusion There is a positive influence of margin design selection within the same material used for the fabrication of endocrown.

Background: Family planning is a critical aspect of reproductive health, influencing individuals and couples; decisions regarding contraception. This study explores the pattern of usage of contraceptives viz. condom, injectables, centchroman tablets, oral contraceptive pills and sterilization, including tubectomy and vasectomy. Understanding these associations is vital for improving the role of counselling in family planning services. Objective: To assess the magnitude and pattern of contraception usage in an urban health centre in East Delhi. Methodology: Data were collected and analysed from the family planning counselling register from November 2022 till October 2023 among the couples coming to the family planning clinic of UHTC located in East Delhi. Information about demographic details, live issues, contraceptive being used, contraceptive recommended, client choice and outcome (whether they accepted the recommended contraceptive or not). Responses of beneficiaries were analysed to determine the magnitude and pattern of contraceptive usage. Results: Among 764 couples, the mean age of females and males was 30.36 years (±5.6) and 34.32 years (±6.2), respectively. Among all participants, 38.32% of couples had two children. The usage of condoms was reported by 40.6% of the participants. Out of the total participants, 58.6% received counselling for permanent methods. The unmet need was identified in 25.2% of the participants. Conclusion: The study underscores the importance of counselling in shaping family planning decisions. Insights gained in this study can help healthcare providers tailor counselling approaches to better address the diverse needs of individuals and couples.

Background: Pregnant women and neonates are often considered as being a vulnerable group during the coronavirus disease 2019 (COVID-19) pandemic. Several studies have compared the impact of COVID-19 on pregnant and nonpregnant women. This study aimed to examine the reasons for severe acute maternal morbidity (SAMM) and “near-miss cases” and their effects on perinatal outcomes before and during the COVID-19 pandemic. Materials and Methods: All women admitted to our facility with pregnancy-related complications for birth or in the puerperium who required critical care unit (CCU) or high dependency unit (HDU) admission were included in the study. A modified version of the World Health Organization (WHO)’s Maternal Near-Miss Screening Tool was used to identify maternal near-miss cases and other obstetric emergencies requiring CCU admission. Results: The incidence of “near-miss” obstetric emergencies was -30.7 per 1000 live births. Over the 3 years of data obtained, 152 near-miss cases were found. Thirty-five cases were seen in the pre-COVID-19 period, whereas 117 near-miss cases were noted during the COVID-19 pandemic. The most common cause of near-miss cases in both groups was severe preeclampsia (65.8%). The rate of ICU admissions was 80.3% (94/117) during COVID-19, while only three cases required ICU before the COVID-19 pandemic. There were a total of 11 maternal deaths, and all were reported during the COVID-19 pandemic. Conclusion: There was a significant increase in ICU admission rates and “near-miss” obstetric emergencies during the COVID-19 pandemic. The COVID-19 infection indirectly led to higher maternal morbidity secondary to lockdown effects on antenatal care and delayed referrals. This study will contribute to the existing literature on the impact of the COVID-19 pandemic on maternal and child health. The results will help inform policy decisions and guide the development of interventions to improve the quality of care for pregnant women during the pandemic.

Abstract A novel geological framework is presented to address the origin of Orthopyroxene, Olivine, Mg-spinel (OOS) lithologies on the Moon, an emerging component of the lunar crust. The new framework can explain multiple remote sensing observations including the rare occurrence of OOS lithologies in close proximity, lack of mafic mineral association with Mg-spinel lithology and the contrasting observation of mafic mineral association with Mg-spinel in returned lunar samples. We further report new OOS exposures at Thomson crater and present the first remote-sensing-based evidence of mafic mixing among various OOS components. Collectively, the new framework and observations provide a testable set of geological scenarios to understand the origin and diversity of the OOS lithologies and their role in lunar crustal diversity. Future missions would directly benefit from this knowledge towards collecting the best OOS lithology samples, currently absent from the returned lunar sample collection.

Abstract Rising cases of type 2 diabetes (T2D) in India, especially in metropolitan cities is an increasing concern. The individuals that were most affected are young professionals working in the corporate sector. However, the corporate sector has remained the least explored for T2D risk predisposition. Considering corporate employees’ lifestyles and the role of gene-environment interaction in T2D susceptibility, the study aims to find genetic variants associated with T2D predisposition. In this first kind of study, 680 young professionals (284 T2D cases, and 396 controls) were diagnosed and screened for 2658 variants on an array designed explicitly for the CoGsI study. The variant filtering was done at Bonferroni p-value of 0.000028. The genetic data was analysed using PLINK v1.09, SPSS, R programming, VEP tool, and FUMA GWAS tool. Interestingly, 42 variants were associated with the T2D risk. Out of 42, three missense variants (rs1402467, rs6050, and rs713598) in Sulfotransferase family 1 C member 4 (SULT1C4), Fibrinogen Alpha Chain (FGA), and Taste 2 Receptor Member 38 (TAS2R38) and two untranslated region (UTR) variants (rs1063320 and rs6296) in Major Histocompatibility Complex, Class I, G (HLA-G) and 5-Hydroxytryptamine Receptor 1B (HTR1B) were associated with the T2D risk. CoGsI identified potential genomic markers increasing susceptibility to the early onset of T2D. Present findings provide insights into mechanisms underlying T2D manifestation in corporate professionals due to genetics interacting with occupational stress and urban lifestyles.

Background: Borderline ovarian tumors (BOTs) comprise 15%–20% of all ovarian epithelial malignancies. The majority of them are serous tumors followed by mucinous tumors. Pre-operative cytological diagnosis plays an important role with histopathology being the gold standard. The present study aimed to assess the sensitivity, specificity, and diagnostic accuracy of cytology in the diagnosis of epithelial ovarian tumors with special emphasis on the cytologically borderline category. Materials and Methods: The present study was conducted in our institute over five years from January 2017 to December 2022. This was a retrospective study and included 92 patients with ovarian masses who were subjected to ultrasound-guided fine needle aspiration (FNA) as a preliminary diagnostic procedure. Cytology smears were examined and categorized as benign, borderline, and malignant. The sensitivity, specificity, and diagnostic accuracy were assessed considering histopathology as the gold standard. Results: In the present study, 92 ovarian FNA cytology were performed. Aspirates were adequate in all but 10 cases. Out of 82 cases, 75 were epithelial tumors. Twelve cases of BOTs were compiled and cytological findings were assessed. Conclusion: To conclude, diagnosis of BOTs on cytology is difficult, however, aspiration from multiple sites from the lesion, critical cytomorphological assessment, and cell-block preparation with immunocytochemistry/immunohistochemistry can overcome the pitfalls.

Abstract Mycobacterium tuberculosis (M. tb) has a remarkable ability to persist inside host cells. Several studies showed that M. tb infects and survives inside bone marrow mesenchymal stem cells (BM-MSCs) escaping the host immune system. Here, we have identified various cellular pathways that are modulated in human BM-MSCs upon infection with virulent M. tb and the proteomic profile of these cells varies from that of avirulent M. tb infected cells. We found that virulent M. tb infection reshapes host pathways such as stem cell differentiation, alternative splicing, cytokine production, mitochondrial function etc., which might be modulated by M. tb to persist inside this unconventional niche of human BM-MSCs. Additionally, we observed that virulent M. tb infection suppresses various cellular processes. This study uncovers the differences in the host proteomic profiles resulting from the virulent versus avirulent M. tb infection that can pave the way to identify host-directed therapeutic targets for the treatment of tuberculosis.

The application of Geographic Information System (GIS) methodologies offers valuable insights into the hydrological behaviour of watersheds through the analysis of their morphometric attributes. This study focuses on the Goriganga River, a major tributary of the Ganga River system, by conducting a detailed morphometric analysis using Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) imagery with 30 m resolution, alongside survey of India topographic sheets. Thirty-two watersheds within the river basin were delineated to calculate linear, areal, and relief morphometric parameters, covering a total drainage area of 2,183.11 km2. The drainage pattern, primarily dendritic to sub-dendritic, is shaped by the region's topography, geological structure, and precipitation patterns. Classified as a 6th-order basin, the drainage density ranges from 1.21 km/km2 to 1.96 km/km2, underlining the significant influence of the regional physiography and lithological composition on the stream ordering. Relief analysis suggests the basin is in an early developmental stage, characterised by varying slope gradients and a low to moderate risk of soil erosion. The basin's hydrogeology is complex, with aquifer distribution primarily governed by lithological factors. Limestone, due to its high permeability and karst features, forms the principal aquifer, although it is susceptible to contamination. In contrast, groundwater potential in the Basement Gneissic Complex and Schist regions is limited to structurally controlled zones, while shale acts as an aquitard. The basin's heterogeneous aquifer characteristics emphasize the need for localized groundwater management strategies tailored to specific lithological units. The integration of remote sensing and GIS techniques effectively delineates the basin's morphometric and hydrogeological characteristics, providing critical information for the development of sustainable water resource management strategies.

Objective: Pelvic floor dysfunctions (pfds) such as urinary incontinence, pelvic organ prolapse, and vaginismus are very common and are affecting the quality of life of the female suffering through it. The pelvic floor muscles can be in spasm, thus resulting in the inability to relax or the pelvic floor muscles can be extremely weak or loose, resulting in the inability to contract strongly and completely. The spasmodic pelvic floor can result in vaginismus, dyspareunia, chronic pelvic pain, constipation, etc., Moreover, a weak pelvic floor can lead to issues such as urinary incontinence, pelvic organ prolapse, and sexual dysfunction. There is a scarcity of a valid and reliable scale that assesses both the components of pfd. Subjects and Methods: The present study was conducted on 1349 participants which were divided into three groups on the basis of their symptoms. Group A – No symptoms (n = 439), Group B – Hypotonus pfd (n = 658), and Group C – Hypertonus pfd (n = 252). Examination: Vaginal examination to assess the pelvic floor muscles relaxation and contraction was done by Het’s Manual Muscle Testing (MMT). Inter rater reliability was assessed by comparing the data of two independent examiners on the same day. The intra rater reliability was assessed by comparing the data of test and retest at an interval of 1 week. Results: The intra rater reliability at 95% confidence interval (CI) was 0.92 – Normal pelvic floor function, 0.96 – Hypotonus pfd, and 0.97 – Hypertonus pfd. Moreover, inter rater reliability at 95% CI was 0.93 – normal pelvic floor function, 0.95 for hypotonus pfd, and 0.98 – hypertonus pfd. Conclusions: This study concludes Het’s MMT is a highly reliable manual muscle testing tool to assess the pelvic floor muscles.

Background: Atopic dermatitis (AD) is a chronic relapsing dermatitis characterized by intense itching. Hanifin and Rajka criteria are the most commonly used diagnostic criteria in hospital setup, consisting of 4 major and 23 minor criteria. Objectives: The objective of the study was to estimate the frequency of distribution of Hanifin and Rajka minor criteria in the pediatric age group, to assess the association of age with minor criteria of AD, and to assess the association of gender with minor criteria of AD. Materials and Methods: A cross-sectional study of 150 pediatric patients (≤16 years) was conducted in the department of dermatology, who were diagnosed with AD based on history and clinical and ophthalmological examination. Serum immunoglobulin E (IgE) was also assessed. The age and gender analysis were done using a Chi-square test. Results: The most common clinical features were orbital darkening 133 (88.7%), Dennie–Morgan infraorbital fold 126 (84%), xerosis 102 (68%), keratosis pilaris 101 (67.3%), and hyperlinear palm 98 (65%). Serum IgE was elevated in 26%. The majority presented with high readings with no obvious keratoconus. Male children (88%) presented predominantly with orbital darkening (90.9%) and had an exacerbation in winters (18.2%) in comparison to females (62%) P ≤ 0.05. Children >1 year (141%) presented mostly with keratosis pilaris (71.6%), nonspecific hand-foot dermatitis (49.6%), and facial erythema (34.8%) than in infants (9%) P ≤ 0.05. Conclusion: Minor criteria are useful for the diagnosis of AD. Male children are more affected and manifest with orbital darkening with Dennie–Morgan infraorbital fold as the chief clinical finding in both the groups. Factors such as ethnic/racial, environmental, and diet have a role in AD.

Abstract The continuous evolution of SARS-CoV-2 has led to the emergence of several variants of concern (VOCs) that significantly affect global health. This study aims to investigate how these VOCs affect host cells at proteome level to better understand the mechanisms of disease. To achieve this, we first analyzed the (phospho)proteome changes of host cells infected with Alpha, Beta, Delta, and Omicron BA.1 and BA.5 variants over time frames extending from 1 to 36 h post infection. Our results revealed distinct temporal patterns of protein expression across the VOCs, with notable differences in the (phospho)proteome dynamics that suggest variant-specific adaptations. Specifically, we observed enhanced expression and activation of key components within crucial cellular pathways such as the RHO GTPase cycle, RNA splicing, and endoplasmic reticulum-associated degradation (ERAD)-related processes. We further utilized proximity biotinylation mass spectrometry (BioID-MS) to investigate how specific mutation of these VOCs influence viral–host protein interactions. Our comprehensive interactomics dataset uncovers distinct interaction profiles for each variant, illustrating how specific mutations can change viral protein functionality. Overall, our extensive analysis provides a detailed proteomic profile of host cells for each variant, offering valuable insights into how specific mutations may influence viral protein functionality and impact therapeutic target identification. These insights are crucial for the potential use and design of new antiviral substances, aiming to enhance the efficacy of treatments against evolving SARS-CoV-2 variants.

Background Persistent dyspnoea and pulmonary function impairment are common after coronavirus disease 2019 (COVID-19). However, long-term outcomes beyond 2 years of infection are unknown. Methods In this single-center study, we observed the trend of self-reported dyspnoea and pulmonary functions among subjects attending a post-COVID clinic in India after 2 years of COVID-19 illness. Using logistic regression, we explored the clinico-demographic factors associated with persistent dyspnoea and impaired lung functions beyond 2 years. Results Among 231 included subjects (68.8% male) with a mean [standard deviation (SD)] age of 44.8 (13.2) years, 119 (51.5%) had recovered from moderate-to-severe COVID-19. The median [inter-quartile range (IQR)] time intervals from COVID-19 diagnosis (T0) to clinical enrolment (T1) and final follow-up (T2) were 3.3 (1.9–5.5) months and 29.5 (27.2–32.2) months, respectively. Between T1 and T2, the prevalence of self-reported dyspnoea remained stable in the whole cohort (39.4% vs. 36.4%, P = 0.26) but declined in the sub-group with moderate-to-severe COVID-19 (63% vs. 54.6%, P = 0.03). Persistent dyspnoea at T2 was associated with female sex (P = 0.007), moderate-to-severe COVID-19 (P < 0.001), and infection during the delta wave (P < 0.001). At T2, impairment in forced vital capacity (FVC) was seen in 48.1% subjects. Persistently impaired FVC was associated with older age (P value = 0.047), female sex (P value

Endometrial carcinoma is one of the important health issues addressed globally. Therefore, understanding the molecular pathogenesis of endometrial carcinoma for the purpose of prognostic and predictive markers remains in the centre of research. It has been reported in recently published literature that loss of Phosphatase and Tensin Homolog (PTEN) expression, a tumour suppressor gene, is one of the key events in the pathogenesis of endometrial carcinoma. This review aims to study the data for loss of PTEN expression in literature. Based on the inclusion and exclusion criteria, eight studies were finally included in the review. Comparative statistics of various studies showed that loss of PTEN expression is a key molecular event in endometrial carcinoma. The detection of lost PTEN expression could help in knowing the progressive nature of Atypical Endometrial Hyperplasia (AEH) and in distinguishing AEH from endometrial carcinoma. This will facilitate the choice of targeted therapy.

Congenital vitiligo is a very rare entity, but cases in infancy have been reported. We are presenting the case of a 2-month-old male infant who came to us with complaints of multiple progressive white patches over the body since birth. The lesions showed white accentuation with fluorescence under a Wood’s lamp. There was a positive history of vitiligo in the maternal grandmother. The infant was successfully treated with topical pimecrolimus 1% cream. Our case in point contributes to the limited pool of studies on congenital vitiligo (nine cases reported till date) and lends credibility to the theory that, in genetically vulnerable individuals, the autoimmune process may begin in utero.

Background: Population-based research (PBR) plays a critical role in generating externally valid evidence and engaging local communities in health interventions. However, there is a lack of examples in the field of homeopathy. This study describes the transformation of a Homoeopathy Medical College and Hospital to initiate and sustain PBR. The focus was on Particularly Vulnerable Tribal Groups (PVTGs) of India, with a specific emphasis on sickle cell disorders (SCD), a significant health concern among tribal populations in Madhya Pradesh (MP). Aims and Objectives: The study aimed to estimate the burden of SCD among PVTGs in MP and evaluate the effectiveness of homeopathy as an adjuvant therapy. Materials and Methods: A sequential explanatory mixed methods design was used, incorporating document analysis, a structured literature review on PubMed, and a search of homeopathy journals and conference abstracts. A community-based cross-sectional survey was conducted using probability proportional to size (PPS) sampling in four districts of MP. Blood samples were collected for SCD diagnosis, and ethical clearance was obtained from the Government Homoeopathic Medical College and Hospital, Bhopal. Results: The study surveyed 27,892 individuals (mean age 27.71 ± 18.11 years) from the Baiga and Bhariya PVTGs across 346 villages. Out of these, 23,320 participants were deemed eligible for screening. Sickle cell solubility tests revealed that 9.4% (n = 2195) of participants were suspected to have SCD. A comprehensive module and Standard Operating Procedure (SOP) on PBR in homeopathy was developed for future researchers. Conclusion: This study provides a blueprint for implementing PBR in homeopathy, particularly with vulnerable populations. The use of mixed methods research in PBR, especially for assessing homeopathy’s role in managing SCD, is valuable for extending research in underrepresented populations.

Background and Objectives: Blood donation is a relatively safe procedure without any discomfort; however, if any unexpected or undesirable effects, i.e., an adverse donor reaction (ADR) does occur, it should be managed promptly and efficiently. The main aim of this study was to analyze the incidence of ADRs among blood donors. Methods: A prospective study was conducted from September 2020 to September 2022 at blood center. All ADRs in whole blood and apheresis donors were managed as per standard operating procedures. An ADR pro forma was filled, and the donor was given postdonation advice as per standard guidelines. The data collected were analyzed to find the incidence, risk factors, and causes of ADRs and to study its effect on repeat donation. Results: Among 83231 blood donations during the study period, ADRs were observed in 250 donors (0.30%). ADRs were most commonly noted in the age group of 18–30 years and were higher in first-time donors (69.6%) as compared to repeat donors (30.4%). The rate of ADR was higher in females (3.11/1000) as compared to males (3.00/1000) The most common type of ADR was vasovagal type (98%) followed by hematomas (2%). Conclusion: Younger, first-time, and female donors were more prone to ADRs in the present study. Better postdonation care and regular training of staff members in counseling, early identification, and management of ADR will aid in decreasing the severity and incidence of adverse reactions which further encourages repeat blood donations.

Objective: To evaluate and compare antimicrobial efficacy of Chlorhexidine and Chlorine dioxide mouthwashes on S.mutans biofilm created on metal and ceramic self-ligating brackets. Materials and methods: A total of 162 metal and ceramic self-ligating brackets (3M™ SmartClip™ & Clarity SL™) were randomly divided into 3 groups and 2 subgroups. Standard procedures were followed to coat all brackets with S.mutans biofilm. The biofilms were cultivated which were then subjected to the effects of the mouthwashes. Quantitative assessment was carried out by comparing the number of viable colonies of S.mutans. A Mann-Whitney U test was used to compare the data between the experimental and control groups. (p

Abstract Clinical biomedical applications of genomic technologies are extensive and provide possibilities to enhance healthcare covering the span of medical talents. Genome disorder prediction is an important issue in biomedical research. Genome disorders cause multivariate diseases such as cancer, dementia, diabetes, Leigh syndrome, etc. Existing machine and deep learning-based methods were introduced to forecast genome disorders. However, the genome prediction outcomes were not sufficient. To address this issue, propose a new method called Quadratic Feynman Polynomial Interpolated and Vector Nearest Centroid-based (QFPI-VNC) for acutely predicting the genome disorder with improved sensitivity and specificity. First, we utilized medical data about children from a public genomes dataset and applied it to Linear Quadratic and Feynman Kac Genome filtering to obtain computationally efficient filtered results. Next, the results are fed to the Concordance Correlated Polynomial Interpolation with the purpose of extracting genome wide data in an accurate manner. Finally, the features extracted are fused and fed to the Support Vector and Nearest Centroid model for genome disorder prediction. Experimental investigations of the proposed method employing the genome dataset confirm that the performance of the proposed method is prospective and in the scope of acceptance with relative to state-of-the-art methods in terms of convergence speed, recognition rate, sensitivity, and specificity. Results suggest that the QFPI-VNC method produces the best performance with a higher genome disease detection rate by 14%, accuracy by 11%, sensitivity by 14% specificity by 12%, and lesser convergence speed by 29% than compared to state-of-the-art methods.

Abstract Biological communication system for neurological disorder patients is similar to the Brain Computer Interface in a way that it facilitates the connection to the outside world in real time. The interdisciplinary field of Electroencephalogram based message depiction is gaining importance as it assists the paralysed person to communicate. In the proposed method a novel approach of feature extraction is done by Empirical Mode Decomposition on non- stationary & non-linear kind of EEG signal. EMD helps in the effective time frequency analysis by disintegrating the EEG signal in the form of six Intrinsic Mode Functions with help of the frequency components. In all nine features are extracted from the decomposed IMFs so as to predict the states or messages of the patient. The above computed features are then served to the Deep Neural Network to perform the classification. The performance of suggested method is studied through applying it to the acquired database generated by the designed hardware as well as also in real time message depiction. The maximum classification accuracy 97% for the acquired database & 85% in real time are obtained respectively by comparative analysis. The command messages generated from the proposed system helps the person suffering from neurological disorder to establish the communication link with the outside world in an efficient way. Thus, the proposed novel method shows better performance in real time message depiction purpose as related to other existing methods.

Introduction: Diabetes is increasingly becoming a significant health concern globally, including in India, where its prevalence continues to increase. Being overweight often acts as a catalyst for developing diabetes, exacerbating the condition and increasing the risk of other serious health complications such as heart disease, kidney problems, and nerve damage. Peptide-based molecules like semaglutide have proved their efficacy in controlling glycated hemoglobin (HbA1c) levels and body weight in diabetic patients. Objective: The present study aims to determine the effectiveness of oral semaglutide in a real-world setting. Materials and Methods: This retrospective study included patients ≥18 years of age prescribed oral semaglutide with a follow-up visit between 80 and 160 days post-prescription and had baseline body mass index (BMI) ≥ 30 kg/m2 and HbA1c levels ≤10.0%. The primary endpoints were to assess changes in HbA1c level, BMI, and body weight from the baseline. The secondary endpoints were to determine the changes in postprandial blood sugar (PPBS), fasting blood sugar (FBS), and blood pressure. The analysis also encompassed data on comorbid conditions and concomitant medications prescribed. Results: A total of 188 patients met the study eligibility criteria. At the follow-up visit, a statistically significant mean reduction of 0.34% in HbA1c levels and a weight loss of 1.83 kg were observed. The average duration between baseline and follow-up visit was 114.14 ± 21.5 days. The mean reduction in the BMI was 0.73 kg/m2 (P < 0.001). During the follow-up visit, the PPBS level decreased by 9.95 mg/dL and the FBS level decreased by 5.02 mg/dL. Additionally, the effect of semaglutide on blood pressure was evident, with a reduction in systolic blood pressure by 1.69 mm Hg and diastolic blood pressure by 1.30 mm Hg. The most common comorbid condition was dyslipidemia (66.49%), followed by hypertension (51.60%) and obesity (39.36%). Conclusion: Semaglutide demonstrated significant reductions in glycemic parameters, body weight, and blood pressure.

Abstract Lichen-forming fungi (LFF) are prolific producers of functionally and structurally diverse secondary metabolites, most of which are taxonomically exclusive and play lineage-specific roles. To date, widely distributed, evolutionarily conserved biosynthetic pathways in LFF are not known. However, this idea stems from polyketide derivatives, since most biochemical research on lichens has concentrated on polyketide synthases (PKSs). Here, we present the first systematic identification and comparison of terpene biosynthetic genes of LFF using all the available Lecanoromycete reference genomes and 22 de novo sequenced ones (111 in total, representing 60 genera and 23 families). We implemented genome mining and gene networking approaches to identify and group the biosynthetic gene clusters (BGCs) into networks of similar BGCs. Our large-scale analysis led to the identification of 724 terpene BGCs with varying degrees of pairwise similarity. Most BGCs in the dataset were unique with no similarity to a previously known fungal or bacterial BGC or among each other. Remarkably, we found two BGCs that were widely distributed in LFF. Interestingly, both conserved BGCs contain the same core gene, i.e., putatively a squalene/phytoene synthase (SQS), involved in sterol biosynthesis. This indicates that early gene duplications, followed by gene losses/gains and gene rearrangement are the major evolutionary factors shaping the composition of these widely distributed SQS BGCs across LFF. We provide an in-depth overview of these BGCs, including the transmembrane, conserved, variable and LFF-specific regions. Our study revealed that lichenized fungi do have a highly conserved BGC, providing the first evidence that a biosynthetic gene may constitute essential genes in lichens.

Abstract The widespread use of pesticides poses significant threats to both environmental and human health, primarily due to their potential toxic effects. The study investigated the cardiovascular toxicity of selected pesticides, focusing on their interactions with Toll-like receptor 4 (TLR4), an important part of the innate immune system. Using computational tools such as molecular docking, molecular dynamics (MD) simulations, principal component analysis (PCA), density functional theory (DFT) calculations, and ADME analysis, this study identified C160 as having the lowest binding affinity (-8.2 kcal/mol), followed by C107 and C165 (-8.0 kcal/mol). RMSD, RMSF, Rg, and hydrogen bond metrics indicated the formation of stable complexes between specific pesticides and TLR4. PCA revealed significant structural changes upon ligand binding, affecting stability and flexibility, while DFT calculations provided information about the stability, reactivity, and polarity of the compounds. ADME studies highlighted the solubility, permeability, and metabolic stability of C107, C160, and C165, suggesting their potential for bioavailability and impact on cardiovascular toxicity. C107 and C165 exhibit higher bioactivity scores, indicating favourable absorption, metabolism, and distribution properties. C165 also violated rule where molecular weight is greater than 500 g/mol. Further, DFT and NCI analysis of post MD conformations confirmed the binding of ligands at the binding pocket. The analysis shed light on the molecular mechanisms of pesticide-induced cardiovascular toxicity, aiding in the development of strategies to mitigate their harmful effects on human health.

Abstract Background The prostaglandin receptor PTGER4 facilitates homeostasis in the gut. Previous reports indicate that goblet cells, marked by SPINK4 expression, might be affected by PTGER4 activity. Current evidence suggests that prostaglandin E2 (PGE2) produced by mesenchymal stromal cells (MSC) stimulates PTGER4 in epithelial cells during inflammatory conditions. Here, we investigate the subcellular mechanisms and mRNA levels downstream of PTGER4 activity in epithelial cells. Methods Mucosal cells, organoids, and MSC were obtained from patient biopsies harvested by endoscopy. Using independent and co-cultures, we manipulated the activity of PTGER4, the downstream enzymes, and mRNA levels, by using PGE2, in combination with chemical inhibitors, L-161982, H89, LB100, DAPT, LMK-235, or with butyrate. Immunofluorescence, single cell sequencing, RNAscope, ELISA, real time PCR, and Western blotting were used to examine these samples. Results SPINK4 mRNA levels were increased in organoids by co-culture with MSC or exogenous stimulation with PGE2 that could be blocked by L-161982 or LMK-235, PTGER4 or HDAC4 inhibitors, respectively. Expression of PTGER4 was co-localized with JAM-A in the basolateral surfaces in rectal epithelial cells grown as organoids. PGE2 treatment of rectal organoids decreased HDAC4, 5, and 7 phosphorylation levels that could be blocked by L-161982 treatment. Butyrate treatment, or addition of L-161982, increased the phosphorylated levels of HDAC4, 5, and 7. Conclusions These findings suggest a mechanism during mucosal injury whereby MSC production of PGE2 increases HDAC4, 5, and 7 activities in epithelial cells by upregulating PTGER4 signaling, ultimately increasing SPINK4 mRNA levels and extracellular release of SPINK4.

Abstract Background Hypertensive disorders of pregnancy (HDP) pose significant risks to maternal and fetal health, with substantial mortality and morbidity rates globally, particularly in developing countries. Pre-eclampsia (PE) accounts for a notable portion of maternal morbidity and mortality, with varied prevalence across regions within countries like India. Despite advancements, disparities in healthcare access persist, influencing outcomes. PE not only affects maternal health during pregnancy but also predisposes women to long-term cardiovascular complications, emphasizing the need for early screening and preventive measures. Methods This prospective randomized double-blind clinical trial aims to compare the efficacy and safety of 75 mg versus 150 mg aspirin for preventing preterm pre-eclampsia in high-risk women. Screen-positive women aged 18–45 years with singleton pregnancies between 12 and 16 weeks of gestational age will be enrolled. They will be randomized in a 1:1 ratio to receive either 75 mg or 150 mg of aspirin nightly until 37 weeks of pregnancy or earlier if preterm pre-eclampsia develops. Feto-maternal outcomes, including preterm pre-eclampsia incidence and neonatal and maternal complications, will be assessed. The sample size calculation based on expected proportions of preterm pre-eclampsia in both groups indicates a total of 370 participants (185 per group) accounting for 20% attrition. Discussion This prospective randomized double-blind clinical trial aims to compare the effectiveness and safety of two doses of aspirin (75 mg vs 150 mg) in preventing preterm pre-eclampsia in high-risk women. The potential implications of this study are significant, including the optimization of aspirin prophylaxis, the development of evidence-based guidelines, and comprehensive assessment of maternal and fetal outcomes. In conclusion, the results of this study have the potential to significantly impact clinical practice by enhancing maternal and perinatal health outcomes and contributing to evidence-based obstetric care. Trial registration Clinical Trials Registry-India CTRI/2023/12/060983. Trial was registered prospectively on 29 December 2023. Acknowledgement Number REF/2023/12/076358. https://acrobat.adobe.com/id/urn:aaid:sc:AP:15870322-f1f4-4460-900c-6e056ab83a44 .

Introduction: The liver is the body’s largest solid organ and receives a dual blood supply, making it an easy target for metastases from both extra-abdominal and abdominal lesions. In adults, the most common sites of primary lesions are the breast, colon, lung and pancreas. Liver biopsies are pivotal for managing patients with metastatic diseases, aiding in diagnosis and treatment planning. When primary cancer sites are undetectable, the diagnosis often falls under Carcinoma of Unknown Primary (CUP), which carries a poor prognosis. Immunohistochemistry (IHC) is critical in such cases, using antibodies to identify the cancer’s origin when other methods fail. This technique is vital for confirming known malignancies and diagnosing elusive ones, thus informing treatment and improving patient outcomes. Aim: To study the role of IHC in the categorisation of metastatic tumours of the liver. Material and Methods: A cross-sectional observational study was conducted in the Department of Pathology, Sri Aurobindo Medical College and Postgraduate (PG) Institute, Indore, Madhya Pradesh, India, between March 2021 and April 2024. Core needle biopsy samples of 65 cases were processed and analysed for Haematoxylin and Eosin (H&E) stain and IHC markers. Data on demographics and lesion characteristics were entered into Microsoft Excel and analysed with a trial version of Statistical Package for the Social Sciences (SPSS). Significance was assessed using Pearson’s Chi-square test, with a p-value

Cellular angiofibroma (CA) is a relatively recently described, rare, benign soft tissue tumor that predominantly occurs in the vulvoperineal region. It was first described in 1997 as a mesenchymal-origin tumor composed of connective (fibrous) tissue and blood vessels. We report a case of vaginal CA in a 40-year-old woman who presented with pressure symptoms, incidentally diagnosed with a vaginal mass and clinically suspected as vaginal myoma. This case was diagnosed based on histomorphology and immunohistochemistry and underwent surgical treatment. This tumor was a diagnostic dilemma for other benign and aggressive spindle cell tumors in the same area, such as endometrial stromal nodule, spindle cell lipoma, solitary fibrous tumors, and mixed tumors of the vagina.

The researchers have presented a spatial database model for geometric path planning suitable for facilitating disaster management activities. The spatial queries executed using the proposed approach can reduce the computational time needed to find an optimal collision free path for network analysis. The framework is applicable to 2-dimensional and 3-dimensional workspaces. The strategy used decouples the motion planning problem into small tractable problems, which are solved using know path planning algorithm.

A novel adsorbent, GSCQD-FeFe2O4, combining groundnut shell-derived carbon quantum dots with magnetic iron oxide nanoparticles, was synthesized for efficient removal of Pb(II) from water. Characterization studies confirmed successful synthesis, with UV analysis showing absorption at 210 nm and green luminescence indicating carbon quantum dots. FT-IR identified characteristic functional groups, while XRD confirmed well-ordered structures. FE-SEM revealed clustered carbon nanoparticles with magnetic iron oxide, and TEM showed small-sized carbon dots suitable for adsorption. Batch adsorption studies revealed optimal conditions for Pb(II) removal, including a pH range of 5-6, temperature of 20°C, contact time of 20 minutes, and adsorbent dose of 0.2 g. Isotherm studies indicated that both Langmuir and Freundlich models provided a good fit, with a calculated adsorption capacity of 37.8 mg/g. Thermodynamic analysis suggested spontaneous, exothermic adsorption with increased disorder. GSCQD-FeFe2O4 displayed excellent potential for Pb(II) removal, but further research on reusability and stability in industrial settings is needed for broader applicability.

The high spatial resolution data presents a problem when it comes to mapping and identifying distinct tree species based on the characteristics of their canopies. The deep learning Semantic Segmentation approach based on U-Network (U-Net.) artificial intelligence model that we provide here can recognize, and map Azadirachta indica trees canopy cover. This method trains its model by making use of image chips and labels of the item being segmented. The new testing images processed for multiple stages of pixel level of convolution and pooling operations. The sampling methods allow increase to make complete to make the recognized object on the image. The model’s ability to identify items based on canopy shape, structure, and pixel data makes it very useful for mapping and recognizing a single tree species as well as several tree species. The model validation results indicated an accuracy of 84–89 percent, which is regarded to be rather good. Based on ground census data, the overall accuracy of identification is 89 percent, F1 score 0.91–0.94, while the complete tree canopy validation (Intersection to Union) for canopy matching area is 0.79–0.89. The method has the potential to be utilised for identification, mapping of tree canopy. The approach has the potential to be used for important research initiatives i.e tree censuses and the identification and mapping of crop plant identification. The deep learning model used as inferences for automatization of the identification of the tree species helps to resolve identification and mapping based complex problems in agro-forestry allied fields.

Abstract Background Individuals with spinal cord injury (SCI) often suffer from neuropathic pain which is often disabling and negatively affects function, participation, and quality of life (QoL). Pharmacological treatments lack efficacy in neuropathic pain reduction hence studying alternatives to drug treatment is necessary. Preclinical evidence of various aerobic exercises has shown positive effects on neuropathic pain but scientific studies investigating its effect in the SCI human population are limited. Methodology This study is a double-blind, parallel, two-group, randomized controlled trial with an interventional study design that aims to evaluate the effectiveness of aerobic exercise program on neuropathic pain and quality of life (QoL) in individuals with chronic paraplegia. Thirty individuals with chronic paraplegia with the neurological level of injury from T2 to L2 will be recruited from the rehabilitation department at a super specialty hospital based on the inclusion criteria. Using a 1:1 allocation ratio, the participants will be randomly assigned to one of the two groups. The intervention group will perform high-intensity interval training (HIIT) aerobic exercise using an arm ergometer based on their peak heart rate, and the control group will perform free-hand arm aerobic exercise. In both groups, the intervention will be delivered as 30-min sessions, four times a week for 6 weeks. Outcome measures International Spinal Cord Injury Pain Basic Data Set Version 3.0 will be used for diagnosing and assessing neuropathic pain and its interference with day-to-day activities, mood, and sleep. The International Spinal Cord Society (ISCoS) QoL basic data set will be used to assess QoL, and 6-min push test distance will be used to assess peak heart rate and aerobic capacity. Discussion The effectiveness of the aerobic exercise program will be assessed based on the changes in neuropathic pain score and its interference with day-to-day activities, mood, sleep, QoL, and aerobic capacity after 3 weeks mid-intervention and after 6 weeks post-intervention. The trial will provide new knowledge about the effectiveness of the aerobic exercise program in improving neuropathic pain and QoL in individuals with chronic paraplegia. Trial registration Clinical Trials Registry-India CTRI/2023/08/056257. Registered on 8 August 2023.

Purpose – The paper examines the recent trends in information technology for combating corruption and its impact on the Indian economy. It further explores how technology is being used to tackle corruption in India and the resulting economic benefits. Design/methodology/approach – The methodology encompasses qualitative analysis to investigate corruption comprehensively. It involves content analysis of corruption-related documents, case studies, and expert interviews. Recent information technological advancements are explored, including blockchain and AI, for their anti-corruption potential. Findings – This study reveals that the negative impacts of corruption on society include reduced economic growth, weakened institutions, and decreased public trust in government. Various technological advancements such as e-governance, blockchain, AI, and big data analytics have been implemented to enhance transparency and accountability in government processes. Special cases and examples of application of such technology tools and techniques adopted by the organizations to control corruption are discussed. Originality/value – This paper highlights the need for legal reforms, institutional strengthening, and awareness-raising campaigns to complement technological advancements in the fight against corruption.

Abstract Background The healthcare system in India is tiered and has primary, secondary and tertiary levels of facilities depending on the complexity and severity of health challenges at these facilities. Evidence suggests that emergency services in the country is fragmented. This study aims to identify the barriers and facilitators of emergency care delivery for patients with time-sensitive conditions, and develop and implement a contextually relevant model, and measure its impact using implementation research outcomes. Methods We will study 85 healthcare facilities across five zones of the country and focus on emergency care delivery for 11 time-sensitive conditions. This implementation research will include seven phases: the preparatory phase, formative assessment, co-design of Model “Zero”, co-implementation, model optimization, end-line evaluation and consolidation phase. The “preparatory phase” will involve stakeholder meetings, approval from health authorities and the establishment of a research ecosystem. The “formative assessment” will include quantitative and qualitative evaluations of the existing healthcare facilities and personnel to identify gaps, barriers and facilitators of emergency care services for time-sensitive conditions. On the basis of the results of the formative assessment, context-specific implementation strategies will be developed through meetings with stakeholders, providers and experts. The “co-design of Model ‘Zero’” phase will help develop the initial Model “Zero”, which will be pilot tested on a small scale (co-implementation). In the “model optimization” phase, iterative feedback loops of meetings and testing various strategies will help develop and implement the final context-specific model. End-line evaluation will assess implementation research outcomes such as acceptability, adoption, fidelity and penetration. The consolidation phase will include planning for the sustenance of the interventions. Discussion In a country such as India, where resources are scarce, this study will identify the barriers and facilitators to delivering emergency care services for time-sensitive conditions across five varied zones of the country. Stakeholder and provider participation in developing consensus-based implementation strategies, along with iterative cycles of meetings and testing, will help adapt these strategies to local needs. This approach will ensure that the developed models are practical, feasible and tailored to the specific challenges and requirements of each region.

Introduction: The purpose of the study was to calculate, tumor control probability (TCP) and normal tissue complication probability (NTCP) in cervical cancer patients and to clinically correlate the outcomes with a follow-up period of 24 months. Materials and Methods: One hundred and fifty patients were included in the present study who received 46 Gy/23 fractions/4½ weeks of external beam radiotherapy with concurrent cisplatin chemotherapy, followed by intracavitary brachytherapy of 3 different fractionations regimens, i.e., 9.5 Gy per fraction of two fractions (50 patients in Arm1), 7.5 Gy per fraction of three fractions (50 patients in Arm2), and 6.0 Gy per fraction of four fractions (50 patients in Arm3). Results: The median TCP value for Arm1, Arm2, and Arm3 was 99.6%, 94%, and 98.1%, respectively, (P < 0.01). The median NTCP value for bladder in Arm1, Arm2, and Arm3 was 0.17%, 0.04%, and 0.07%, respectively, (P = 0.05). The median NTCP value for rectum in Arm1, Arm2, and Arm3 was 4.73%, 4.35%, and 3.17%, respectively, (P = 0.052). The overall survival (OS) of 90%, 86%, and 84% was found for Arm1, Arm2, and Arm3, respectively, at 24 months of follow-up. Conclusion: TCP, NTCP, and OS rates were found higher in Arm1 as compared to the other two arms. The complications found in all arms were less, low grade, and manageable. Hence, Arm1, i.e., 9.5 Gy per fraction of two fractions can be concluded as the optimum fractionation regime in terms of radiobiological parameters as well as overall patient comfort.

Background: Uncomplicated crown fractures of maxillary anterior teeth are common dental injuries, and the bonding of fractured fragments is recommended for management. Rehydration of fragments improves bonding and fracture resistance. Therefore, the aim of this study was to compare the fracture resistance of the reattached tooth fragment of the incisor crown after rehydration using either a steamer or a humidifier. MATERIALS AND METHODS: Bovine teeth were used as a model. Fractured fragments were divided into three groups: Group I (no rehydration), Group II (rehydration by humidifier), and Group III (rehydration by steamer). Fragments were reattached using a standard bonding protocol. Fracture resistance was tested using a universal testing machine. Statistical analysis was performed using analysis of variance and Chi-square tests. Results: The force required to fracture the reattached fragments was significantly higher in Group II (humidifier) compared to Group I (no rehydration) (P = 0.005). Group III (steamer) had a force value similar to Group I, indicating no significant improvement in fracture resistance with steamer rehydration. The temperature inside the steam-based chamber reached an average of 95.7°C with 95% humidity, whereas the conventional humidification chamber had an average temperature of 39.2°C and 84% humidity. Conclusion: Within the limitations of the present study, the rehydration protocol using a steam-based chamber was found to have a significantly lower force required to fracture the reattached fragments as compared to humidifier-based chamber. This was not significantly different from the fragments which were reattached without rehydration.

Introduction COVID-19 is an infectious and contagious disease caused by the SARS-CoV-2 virus. Despite the availability of vaccines, there were reports of vaccine hesitancy among people, including healthcare workers. The study aims to assess the level of knowledge about vaccines available in India, the perception of people towards COVID-19 vaccine and the experiences of people who took the vaccine. Methods The study was carried out over a period of four months from 15th July 2021 to 15th November 2021. The sample size taken was 500. It was an institution-based cross-sectional, non-interventional study carried out among the people visiting the COVID-19 vaccination centre. The data collected using self-administered questionnaire was analysed using descriptive statistics and nonparametric statistics in SPSS version 29. Results It was observed that only 6.3% (30) participants had adequate knowledge about COVID-19 vaccination, and the majority (58.1%, 271) participants had poor knowledge. More than 60% of participants (61.6%, 294) reported having hesitancy to take up the COVID-19 vaccination. Besides hesitancy, many factors like access to vaccines, protection from COVID-19 disease, fear of increasing COVID-19 cases and deaths etc. were the facilitating factors reported by participants for COVID-19 vaccination uptake Conclusion More than half (61.6%) of the participants reported hesitancy towards uptake of vaccination owing to various side effects. However, people also believed that vaccination could prevent the disease, and its free availability facilitated people to get vaccinated. Various barriers leading to vaccine hesitancy and facilitators for a vaccination program should be identified and addressed for the successful implementation of the program.

Background There has been tremendous growth in internet usage globally, with an estimated 5 billion users around the world in 2022 (1). In India , there were 840 million internet users in 2022 (2). Internet addiction, defined as the inability to control one's use of the internet despite negative consequences, often persists over an extended period (3-5). While internet addiction has been widely studied in adolescents and young adults, there are limited studies to explore internet addiction among the elderly. Aims and Objectives The study aimed to estimate the prevalence of internet addiction among the elderly and to determine the various factors associated with internet addiction. Methods This community-based cross-sectional study was conducted among 200 study participants. A semi-structured interview schedule was used for data collection. It included the socio-demographic details of the study participants and a structured schedule for assessing internet addiction using Young's Internet Addiction Test (IAT). Statistical analysis was performed using descriptive statistics, chi-square test and logistic regression. Results The mean age of the study participants was 66.9 years (SD = 6.8), ranging from 60 to 92 years. The distribution of categories reveals that 49.5% of participants had no internet addiction, while 36.0% had mild internet addiction. Moderate internet addiction accounted for 9.5% of the total, and severe internet addiction was found in 5.0% of the individuals. On multivariable analyses, it was found that gender (adjusted OR = 2.35, 95% CI: 1.29-4.25), marital status (adjusted OR = 2.42, 95% CI: 1.23-4.76) and personal income (adjusted OR = 5.49, 95% CI: 2.45-12.32) were significantly associated with internet addiction. Conclusion The high prevalence of internet addiction, along with its significant associations with gender, marital status, and personal income, suggests a need for targeted interventions focusing on education about healthy internet use among older adults. It is also recommended to collaborate with local healthcare providers and youth volunteers to educate the elderly on internet addiction. Future research should consider longitudinal designs to better understand the causal pathways and the effectiveness of different intervention strategies.

This state-of-the-art review describes the potential etiologies, pathophysiology, and management of mixed shock in the context of a proposed novel classification system. Cardiogenic-vasodilatory shock occurs when cardiogenic shock is complicated by inappropriate vasodilation, impairing compensatory mechanisms, and contributing to worsening shock. Vasodilatory-cardiogenic shock occurs when vasodilatory shock is complicated by myocardial dysfunction, resulting in low cardiac output. Primary mixed shock occurs when a systemic insult triggers both myocardial dysfunction and vasoplegia. Regardless of the etiology of mixed shock, the hemodynamic profile can be similar, and outcomes tend to be poor. Identification and treatment of both the initial and complicating disease processes is essential along with invasive hemodynamic monitoring given the evolving nature of mixed shock states. Hemodynamic support typically involves a combination of inotropes and vasopressors, with few data available to guide the use of mechanical circulatory support. Consensus definitions and novel treatment strategies are needed for this dangerous condition.

Mental well-being has been a topic of concern in recent years. It is often assessed by measuring an individual's life satisfaction and mental health. However, gratitude also plays a vital role in a person's well-being. A noticeable reduction in students' mental well-being is characterized by increasing levels of stress, anxiety, and depression. Academic expectations and peer pressure about prospects badly affected students' mental and emotional well-being. To address these concerns, this study provides empirically supported insights and pragmatic suggestions for educators, counselors, and policymakers. The study used a cross-sectional survey, and participants were contacted through several online platforms for data collection. The findings revealed a positive and significant relationship between gratitude and life satisfaction. Gratitude further acts as a predictor of mental well-being, thus resulting in higher life satisfaction with the mediation of mental well-being.

This systematic review evaluates the long-term stability and retention of clear aligner treatment, focusing on factors like aligner compliance, attachment use, and treatment duration. Following PRISMA guidelines, we searched electronic databases and manual sources, identifying 112 records and narrowing down to six relevant studies. These studies compared clear aligners to traditional braces, highlighting their effectiveness, especially for mild crowding and anterior movements. Clear aligners, particularly Invisalign, showed benefits like shorter treatment times and higher patient satisfaction. However, variability in treatment accuracy and limited long-term follow-up indicate a need for further research. Overall, clear aligners offer a discreet, flexible, and effective orthodontic option.

Endophytes contribute to plant fitness and defence by producing bioactive secondary metabolites, which may be utilized in various industrial applications. We assessed the potential of bioactive compounds from the endophytes of Curcuma longa for therapeutic properties. We screened phytochemicals obtained from the C. longa endophytes for host-specific bioactive compounds which were also evaluated for their antimicrobial, anti-inflammatory and antioxidant potential. 59 endophytes were isolated from leaves and rhizome of C. longa, among which isolates Fusarium fujikuroi PCLCUT2 and Bacillus pacificus NCLALC2 showed significant antioxidant and anti-inflammatory properties. PCLCUT2 showed strong antioxidant potential (IC50 1.33 mg/mL) and the presence of compounds such as (-)-epicatechin and curcumin. B. pacificus NCLALC2 exhibited strong anti-inflammatory and antimicrobial potential (MIC 200 µg/L) against Mycobacterium smegmatis. NCLALC2 showed the presence of 12 potential bioactive compounds including Calicoferol D, terpinolene and alpha-phellandrene. With the presence of host-specific compounds, the two endophytes hold promising potential as cost-effective sources of bioactive metabolites for pharmacological applications.

The Ironwood tree (Casuarina equisetifolia) holds a significant ecological role in Guam where a decline in Ironwood trees was first documented in 2002. Studies have linked the Ironwood tree decline (IWTD) to bacteria from the Ralstonia solanacearum complex and wetwood bacteria, specifically Klebsiella oxytoca and Klebsiella variicola. Presence of termites was first found to be associated with IWTD in 2010; however, the role of termites in IWTD is still not clear. The Asian subterranean termite, Coptotermes gestroi (Wasmann) (Blattodea: Rhinotermitidae) frequently attacks Ironwood trees. As workers of this soil-dwelling species of the lower termites harbor a diverse microbial community in their bodies, we examined whether C. gestroi workers carry IWTD-associated bacteria and could, therefore, act as vectors. We described the bacterial community in C. gestroi workers using 16S rRNA gene sequencing and tested the impact of factors related to the location and health of the Ironwood tree the termites were collected from on termite bacterial diversity. Feeding assays were performed to assess if workers show preference in consumption depending on the amount of Ralstonia and wetwood bacteria in the food source. Health of Ironwood trees and level of site management impacted the bacterial composition of C. gestroi termite workers attacking the trees. Although C. gestroi workers equally consumed food sources with high and low Ralstonia and wetwood bacteria load in lab experiments, Ralstonia and other IWTD-related bacteria were not detected in considerable amounts in termite workers collected from trees. Thus, C. gestroi workers are not a vector for bacteria associated with IWTD in Guam.

The emergence of antibiotic-resistant Gram-negative bacteria necessitates the development of novel antibacterial agents. This study investigates the antibacterial activity of a reduced graphene oxide-silver (rGO-Ag) nanocomposite against Gram-negative bacterial strains, including Escherichia coli and Pseudomonas aeruginosa. The rGO-Ag nanocomposite was synthesized via a chemical reduction method, ensuring uniform dispersion of silver nanoparticles (AgNPs) on the reduced graphene oxide (rGO) sheets. Characterization techniques such as transmission electron microscopy (TEM), X-ray diffraction (XRD), and UV-Vis spectroscopy confirmed the successful reduction and functionalization of GO with AgNPs. The antibacterial activity was evaluated using the disk diffusion method and minimum inhibitory concentration (MIC) assays. Results showed that the rGO-Ag nanocomposite exhibited significantly enhanced antibacterial activity compared to pure AgNPs and rGO. The synergistic effect of AgNPs and rGO led to increased bacterial membrane disruption and reactive oxygen species (ROS) generation, contributing to higher antibacterial efficacy. Furthermore, the rGO matrix prevented the agglomeration of AgNPs, ensuring a sustained and controlled release of silver ions, which prolonged the antibacterial effect. The study highlights the potential of rGO-Ag nanocomposites as effective antibacterial agents against Gram-negative bacteria, offering a promising alternative to conventional antibiotics. The reduced agglomeration of silver nanoparticles in the composite also led to a more sustained release of antibacterial silver ions. Overall, the rGO-Ag nanocomposite shows great potential as an antibacterial agent against Gram-negative bacteria. The findings demonstrate that the antibacterial activities of Pseudomonas sp., and E. coli were improved by graphene-based nanomaterials, which may be used for various biomedical techniques.

Background and objective: Graft versus host disease (GVHD) is the common complication seen after allogeneic hematopoietic stem cell transplantation (HSCT) and a pleomorphic syndrome that resembles autoimmune and other immunologic disorders, leading to profound immune dysregulation and organ dysfunction. The most common targets of GVHD are skin, gastrointestinal tract and liver. GVHD is classified as acute graft versus host disease (aGvHD) if it occurs within the first 100 days after HSCT and chronic graft versus host disease(cGVHD) if it occurs after day 100. The skin is most frequently and earliest affected by aGvHD, followed by the gastrointestinal tract and liver. An ideal biomarker would predict the onset and severity of clinical acute GVHD and help to direct management, and this is an area of active research regarding the use of biomarkers for diagnosis and prognosis of acute GVHD. Recently, elafin has been identified as a potential plasma biomarker for aGVHD.Method: We searched the databases PubMed, Cochrane library, and medRxiv for all studies investigating the Diagnostic or prognostic role of elafin in GVHD. We set the search strategy incorporating the search terms, ‘elafin’, ‘graft versus host’, and ‘GVHD’, and operated using the Boolean operators ‘AND’, and ‘OR’. Thus, retrieved articles were then exported on an Excel® sheet, and duplicates were removed. The systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After selecting the study based on inclusion criteria, data on study characteristics and biomarker description was extracted on a pre-determined data extraction table on the Microsoft Excel version. The quality assessment of the included studies was determined using the QUIPS tool.Result: The search revealed 547 studies and 6 studies that met the eligibility criteria of this review have been included. The major finding of our study is the significant elevation of elafin in skin aGVHD.Conclusion: Elafin is a significant biomarker for diagnosis and prognosis of skin aGVHD and should be assessed within 2 weeks of the onset of the disease.

AbstractAmidst uncertain and disruptive environments, the significance of Organizational Resilience and Sustainability cannot be overstated, as they are crucial for businesses to thrive. By integrating sustainability and resilience practices into strategies, organizations can better navigate disruptive environments and position themselves for sustainable success. The aim of conducting a bibliometric study on organizational sustainability and resilience is to gather knowledge of the literature already written in these fields and spot trends, patterns, and research gaps. The present study sheds light on the four Organizational Resilience pillars: Preparedness, Responsiveness, Adaptability, and Learning. These pillars are crucial in enhancing an organization’s ability to withstand and recover from disruptive events. Using the Scopus Database, a comprehensive analysis was conducted on 120 documents that satisfied the inclusion criteria and were published between 2010 and 2022. Descriptive Statistical Analysis was employed to examine and comprehend the extent to which previous research has explored organizational resilience and sustainability within Business Management. The analysis focused on factors such as production productivity, country productivity, affiliation productivity, author productivity, and the most cited document.

The literature on overconfidence has witnessed prolific growth since the beginning of the century. This context underscores the necessity to comprehend and categorize an increasingly diverse body of overconfidence research within the financial domain. This study reviews existing literature on financial overconfidence from its inception to the present with a detailed review of 132 articles from 84 journals by examining theories, context, and methods (TCM) used in overconfidence research. Our review unpacks significant themes (i.e. determinants of overconfidence, overconfidence and risk-taking, overconfidence measures and type of investors, overconfidence in a volatile market, overconfidence, and personal financial behavior). We propose a pertinent research framework to investigate the less investigated aspects of financial overconfidence and suggest future research direction.

Promotion of altruistic behaviour in organisations to foster larger, socially responsible considerations to avoid the self-centred mentality is crucial nowadays. Examining how different factors work together to support a comprehensive solution that inspires self-transformation and leads to altruistic behaviour would be instructive. Altruistic behaviour built due to yoga-based practices was identified from the past literature and is finalised based on the Fuzzy Delphi method. The WINGS method has developed the contextual relationship between the identified behaviours. The results revealed that self-transcendence has a greater impact on others for altruistic behaviour followed by psychological capital and emotional intelligence which is found to be the prime causal factor. This study will assist management practitioners and institutions in identifying the behaviours and conducting the yoga-based practice in their organization. The study will also contribute to developing efficient, long-lasting, and successful training materials for encouraging altruistic conduct among management staff.