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Background: Competent clinical reasoning forms the foundation for effective and efficient clinical swallowing examination (CSE) and consequent dysphagia management decisions. While the nature of initial CSEs has been evaluated, it remains unclear how new information gathered by speech-language therapists (SLTs) throughout a patient's acute-care journey is integrated into their initial clinical reasoning and management processes and used to review and revise initial management recommendations. Aims: To understand how SLTs' clinical reasoning and decision-making regarding dysphagia assessment and management evolve as patients transition through acute hospital care from referral to discharge. Methods & Procedures: A longitudinal, qualitative approach was employed to gather information from two SLTs who managed six patients at a metropolitan acute-care hospital. A retrospective 'think-aloud' protocol was utilized to prompt SLTs regarding their clinical reasoning and decision-making processes during initial and subsequent CSEs and patient interactions. Three types of concept maps were created based on these interviews: a descriptive concept map, a reasoning map and a hypothesis map. All concept maps were evaluated regarding their overall structure, facts gathered, types of reasoning engaged in (inductive versus deductive), types of hypotheses generated, and the diagnosis and management recommendations made following initial CSE and during subsequent dysphagia management. Outcomes & Results: Initial CSEs involved a rich process of fact-gathering, that was predominantly led by inductive reasoning (hypothesis generation) and some application of deductive reasoning (hypothesis testing), with the primary aims of determining the presence of dysphagia and identifying the safest diet and fluid recommendations. During follow-up assessments, SLTs engaged in increasingly more deductive testing of initial hypotheses, including fact-gathering aimed at determining the tolerance of current diet and fluid recommendations or the suitability for diet and/or fluid upgrade and less inductive reasoning. Consistent with this aim, SLTs' hypotheses were focused primarily on airway protection and medical status during the follow-up phase. Overall, both initial and follow-up swallowing assessments were targeted primarily at identifying suitable management recommendations, and less so on identifying and formulating diagnoses. None of the patients presented with adverse respiratory and/or swallowing outcomes during admission and following discharge from speech pathology. Conclusions & Implications: Swallowing assessment and management across the acute-care journey was observed as a high-quality, patient-centred process characterized by iterative cycles of inductive and deductive reasoning. This approach appears to maximize efficiency without compromising the quality of care. The outcomes of this research encourage further investigation and translation to tertiary and post-professional education contexts as a clear understanding of the processes involved in reaching diagnoses and management recommendations can inform career-long refinement of clinical skills.

Nanoparticle-mediated mRNA delivery has emerged as a promising therapeutic modality, but its growth is still limited by the discovery and optimization of effective and well-tolerated delivery strategies. Lipid nanoparticles containing charged or ionizable lipids are an emerging standard for in vivo mRNA delivery, so creating facile, tunable strategies to synthesize these key lipid-like molecules is essential to advance the field. Here, we generate a library of N-substituted glycine oligomers, peptoids, and undertake a multistage down-selection process to identify lead candidate peptoids as the ionizable component in our Nutshell nanoparticle platform. First, we identify a promising peptoid structural motif by clustering a library of >200 molecules based on predicted physical properties and evaluate members of each cluster for reporter gene expression in vivo. Then, the lead peptoid motif is optimized using design of experiments methodology to explore variations on the charged and lipophilic portions of the peptoid, facilitating the discovery of trends between structural elements and nanoparticle properties. We further demonstrate that peptoid-based Nutshells leads to expression of therapeutically relevant levels of an anti-respiratory syncytial virus antibody in mice with minimal tolerability concerns or induced immune responses compared to benchmark ionizable lipid, DLin-MC3-DMA. Through this work, we present peptoid-based nanoparticles as a tunable delivery platform that can be optimized toward a range of therapeutic programs.

Abstract Pulses are essential components of vegetarian diet and play a pivotal role in addressing malnutrition by providing a vital source of dietary protein. However, weed competition remains as a significant obstacle to blackgram (Vigna mungo L) production, resulting in 25 to 35% yield losses. A field experiment was carried out at the National Pulses Research Centre, Tamil Nadu Agricultural University, Vamban, Pudukkottai, India during Kharif seasons of 2020 and 2021, to assess the suitable post-emergence herbicides for appropriate weed control in blackgram grown under irrigated conditions. The experimental field was observed to contain notable grass weed flora, specifically Dactyloctenium aegyptium and Chloris barbata, as well as broadleaved weeds, such as Flaveria australica, Cleome gynandra, Eclipta alba, Convolvulus arvensis, Digera arvensis, Vicia spp., and Celosia argentea. The results demonstrated that among the chemical weed management methods, spraying of Fomesafen @ 220 g + Fluzifop p-butyl @ 220 g ha−1 at 20 days after sowing (DAS) as a post-emergence herbicide treatment exhibited superior weed control efficiency, recording 66.80% and 68.53% at 30 and 45 DAS, respectively and recorded higher seed yield of 1088 kg ha−1. Additionally, this method generated 8.1% higher net income and 12.5% more benefit–cost ratio than hand weeding, making it an economically profitable strategy for maximizing blackgram yield and effective labour management.

In the past few years, there has been a considerable growth in the utilization of solar cells to produce electrical power to fulfil the growing worldwide energy demands. An optical loss is a crucial factor that impacts the performance of the photovoltaic conversion process. This loss occurs when incoming sunlight is reflected back on the outer layer of the photovoltaic cells. The application of antireflective materials on the photovoltaic substrates can enhance the absorption of sunlight and minimize the reflection. Currently, there is no ideal anti-reflective coating for solar cells that can allow the transmission of sunlight without any reflection. In this research, a transparent cyclic-olefin-copolymer (COC) was used to fabricate anti-reflection (AR) coversheet by fused deposition modelling process (3D printing). Further, the aluminium oxide Al2O3 powder was added at the proportions of 1 wt%, 2 wt%, 3 wt%, and 4 wt% to the COC polymer to increase the anti-reflection characteristics. The structural, morphological, mechanical (tear strength), electrical and temperature characteristics were studied. The performance of COC with aluminium oxide (COCA) coversheets was evaluated, and the findings revealed a considerable increment in power conversion efficiency (PCE) of 17.21% (sunlight exposure) and 18.34% (neodymium light) for COCA3 coversheets. As seen, the COCA3 sample exhibit lower electrical resistance of 3.88 × 10−3 Ω cm, carrier concentration (36.91 × 1020 cm−3) and higher hall mobility (13.67 cm2/Vs). The findings from the investigations demonstrated that the utilization of COC with Al2O3 powder (COCA) can be a suitable antireflective coversheet material for boosting the performance of polycrystalline silicon photovoltaic cells.

Abstract Background Long-term management of patients with hypothyroidism on thyroxine replacement requires thyroid function test (TFT) monitoring once every six–12 months as recommended by clinical practice guidelines. This study determined their thyroid function status during two-year follow-up visits in primary care, and the factors influencing their thyroid status, and assessed the optimal interval for TFTs. Methods A retrospective cohort study was conducted on adults with a clinical diagnosis code for hypothyroidism in their electronic health records taken from a group of polyclinics in Singapore between July 2017 and June 2020. The follow-up thyroid status was categorized as under-replacement (TSH ≥ 3.70mIU/L), over-replacement (TSH ≤ 0.65mIU/L) or euthyroid (TSH 0.65–3.70mIU/L). The patients’ demographic, clinical and TFT data were analyzed using appropriate statistical tests during the two-year follow-up. Stepwise logistic regression analysis identified the factors associated with suboptimal thyroid control. Kaplan–Meier analysis was used to compare their thyroid function status in association with the interval between TFT monitoring. Results Data from 5,749 eligible subjects (mean age 62.1 ± 13.29 years; 79% female; 79.7% Chinese) were analyzed. After a two-year follow-up, 61.9% (n = 3558) of all subjects were euthyroid, with 29.5% (n = 1694) being under-replaced and 8.6% (n = 497) over-replaced. However, thyroid status did not differ significantly with the various dose regimen (daily, segmented, or alternate days) (p = 0.193). Stepwise logistic regression showed that thyroxine under-replacement was significantly associated with the male gender (AOR = 1.25,95%CI = 1.03–1.51,p = 0.02) and obesity (AOR = 1.34,95%CI = 1.08–1.66,p = 0.008). Every unit (μg/kg body weight) increase in the mean daily thyroxine dose was associated with 2.72 times greater odds of over-replacement. When comparing thyroid function monitoring at intervals of 13-24 months, monitoring at shorter intervals (≤ 12 months) was less likely to detect thyroxine under-replacement (AOR = 0.57,95%CI = 0.44–0.74,p

India's education policies, including the National Education Policy (NEP) 2020, aim to empower human resources and reduce social disparities by improving access and relevance in education. Vocational education, despite its significant potential in producing skilled labor, often remains disconnected from mainstream academic education, receiving inadequate attention and integration. As a result, graduates often lack sufficient employability and entrepreneurial skills, limiting their opportunities in the job market and in starting their own businesses. This study analyzes national education policies from 1968, 1986, 1992, up to NEP 2020, and includes a case study of the Skill Enhancement Courses at the University of Delhi. Policy analysis methods were used to evaluate policy changes, while the case study aimed to assess the practical impact of these policies. The findings show that NEP 2020 has successfully promoted the integration of vocational education with academic education, and the Skill Enhancement Courses at the University of Delhi have been effective in improving students' employability skills. The novelty of this research lies in NEP 2020's priority to integrate vocational education into the mainstream curriculum, demonstrated to be effective through its implementation at the University of Delhi. This study recommends strengthening the synergy between vocational and academic education to address the skills gap among graduates, particularly in the context of social sciences and humanities development.