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Abstract Type III interferons (λ1, λ2, and λ3) are potent antiviral cytokines in the lung. However, their roles in nonviral lung injuries are less well understood. This study investigates the activation of type III interferon signaling in three distinct models of lung injuries caused by diverse stimuli: the bacterial pathogen Pseudomonas aeruginosa, bacterial endotoxin LPS, and the chemotherapeutic agent bleomycin. Our data show that, despite inducing a potent inflammatory response, Pseudomonas and LPS did not increase IFNλ secretion. In contrast, bleomycin instillation increased secretion of IFNλ in the airways at both early and late time points. Consistent with limited secretion, type III interferon signaling had a minimal role in the host response to both Pseudomonas and LPS, as measured by pathogen burden, inflammatory response, and lung injury. Conversely, a deficiency in type III interferon signaling led to increased inflammatory signaling and elevated acute lung injury in the bleomycin model on day 3. This elevated early injury resulted in impaired recovery in IFNLR1 knockout mice, as evidenced by their recovery from bleomycin‐induced weight loss. Taken together, these data suggest a context‐specific activation of type III interferon signaling, where it plays an anti‐inflammatory role in the lung.

Summary: Increased cases of sepsis during COVID-19 in the absence of known bacterial pathogens highlighted role of viruses as causative agents of sepsis. In this study, we investigated clinical, laboratory, proteomic, and metabolomic characteristics of viral sepsis patients (n = 45) and compared them to non-sepsis patients with COVID-19 (n = 186) to identify molecular mechanisms underlying the pathology of viral sepsis in COVID-19. We identified unique metabolomic and proteomic signatures that suggest a substantial perturbation in the coagulation, complement, and platelet activation pathways in viral sepsis. Our proteomic data indicated elevated coagulation pathway protein (fibrinogen), whereas a decrease in many of the complement proteins was observed. These alterations were associated with the functional consequences such as susceptibility to secondary bacterial infections and potentially contributing to both local and systemic disease phenotypes. Our data provide novel aspect of COVID-19 pathology that is centered around presence of sepsis phenotype in COVID-19.

The 5G Heterogeneous Network (HetNet) enables massive connections and diverse applications for User Equipments (UEs), leading to an exponential increase in data traffic. This surge results in extensive overloading at co-tier and inter-tier levels, inefficiencies in UE power usage at the cell edge, and complexities in Quality of Service (QoS) support. In this paper, we propose a scheme to address load balancing among Base Stations (BSs), while simultaneously improving power efficiency and ensuring QoS for UEs. The proposed heuristic scheme comprises three phases. The first phase optimizes the Discontinuous Reception (DRX) configuration parameters for UEs, the second phase evaluates overloading, and the third phase offloads data from overloaded BSs to other BSs. We categorize performance indicators into 1) User Performance Parameters (UPP), including DRX power saving, packet drop rate, and end-to-end delay, and 2) Network Performance Parameters (NPP), such as system throughput. To validate our scheme, we design an analytical model based on a two-dimensional continuous-time Markov chain (2D-CTMC) and a semi-Markov process. In addition, we implement a simulator to validate the scheme’s performance. The results demonstrate that the proposed scheme significantly enhances performance in terms of UPP and NPP.

Objectives To boost COVID-19 vaccine uptake, an innovative ‘vaccinate my village’ (VMV) strategy using door-to-door vaccination by Health Surveillance Assistants (HSA) was adopted. In this study, we assessed the impact of the ‘vaccinate my village’ strategy on COVID-19 vaccine uptake. Methods This was a cross-sectional review of the data on COVID-19 vaccination obtained from the Ministry of Health, Malawi, from 11 March 2021 to September 2022. Results From March 2021–4 September 2022,091,551 COVID-19 vaccine doses were administered, out of which 2,253,546 were administered over just six months as a part of VMV as compared to 1,838,005 doses were administered over 13 months as a part of other strategies. The proportion of Malawi’s population receiving at least one dose of the COVID-19 vaccine increased substantially from 4.66 to 15.4 with the implementation of the VMV strategy (p = 0.0001). District-wise coverage of the COVID-19 vaccine also increased significantly after its implementation (p = 0.0001). Conclusions Door-to-door vaccination involving HSAs benefitted the COVID-19 vaccination program in Malawi by ensuring accessibility, availability, and acceptability.

Abstract Background Furnishing an opinion about the manner may be challenging for a forensic pathologist in cases of spot deaths with isolated cut-throat injury. Case presentation This fatality in a young male is elucidated for it to be found markedly deviant with reference to the factors described for suicidal cut-throat injuries, including (1) medical history; (2) death circumstances (non-home); (3) type of object that produced injury; (4) injury pattern in relation to dexterity, lack of old and fresh hesitation cuts at neck and elsewhere, predisposition (horizontal), and extent (superficiality); (5) autopsy findings (non-pale organs); (6) scene evidence/s; (7) findings at viscera examination; and (8) cause of death (choking). The deceased was a cannabis addict, practiced black magic, and lived separated from his wife. There was no lead of the event, and thus an inquest proceeding was initiated. Conclusion The possibility of suicide by cut throat by razor blade was considered in the light of the pragmatic comprehension of the post-mortem and scene findings. A case of suicide cut-throat without hesitation cuts, but with venous outpour, and not-so-deep injuries caused by a razor blade, has not been reported. This unprecedented review aims to add to the virtually non-existent literature about medico-legal masquerades rarely seen in suicide cut-throat injuries. It is an endeavor to guide the deduction of the most qualified opinion with a guide to analyzing often undermined and neglected variables in cases of isolated cut-throat injuries. The causative association of marital conflicts that put young males at an increased risk of suicide is highlighted here.

Abstract Background The emergence of COVID-19 and the implementation of preventive measures and behavioral changes have led to a significant decrease in the prevalence of other respiratory viruses. However, the manner in which seasonal viruses will reemerge in the absence of COVID-19-related restrictions remains unknown. Methods Patients presenting with influenza-like illness in two hospitals in Beijing were subjected to testing for COVID-19, influenza A, and influenza B to determine the causative agent for viral infections. The prevalence of influenza B across China was confirmed using data from the Centers for Disease Control, China (China CDC). Clinical characteristics, laboratory findings, imaging results, and mortality data were collected for a cohort of 70 hospitalized patients with confirmed influenza B from 9 hospitals across China. Results Starting from October 2021, a substantial increase in the number of patients visiting the designated fever clinics in Beijing was observed, with this trend continuing until January 2022. COVID-19 tests conducted on these patients yielded negative results, while the positivity rate for influenza rose from approximately 8% in October 2021 to over 40% by late January 2022. The cases started to decline after this peak. Data from China CDC confirmed that influenza B is a major pathogen during the season. Sequencing of the viral strain revealed the presence of the Victoria-like lineage of the influenza B strain, with minor variations from the Florida/39/2018 strain. Analysis of the hospitalized patients' characteristics indicated that severe cases were relatively more prevalent among younger individuals, with an average age of 40.9 ± 24.1 years. Among the seven patients who succumbed to influenza, the average age was 30 ± 30.1 years. These patients exhibited secondary infections involving either bacterial or fungal pathogens and displayed elevated levels of cell death markers (such as LDH) and coagulation pathway markers (D-dimer). Conclusion Influenza B represents a significant infection threat and can lead to substantial morbidity and mortality, particularly among young patients. To mitigate morbidity and mortality rates, it is imperative to implement appropriate vaccination and other preventive strategies.

Acid phosphatases (EC 3.1.3.2) are the enzymes that catalyse transphosphorylation reactions and promotes the hydrolysis of numerous orthophosphate esters in acidic media, as a crucial element for the metabolism of phosphate in tissues. Inorganic phosphate (Pi) utilisation and scavenging, as well as the turnover of Pi-rich sources found in plant vacuoles, are major processes in which intracellular and secretory acid phosphatases function. Therefore, a thorough understanding of these enzymes’ structural characteristics, specificity, and physiochemical properties is required to comprehend the function of acid phosphatases in plant energy metabolism. Furthermore, acid phosphatases are gaining increasing importance in industrial biotechnology due to their involvement in transphosphorylation processes and their ability to reduce phosphate levels in food products. Hence, this review aims to provide a comprehensive overview of the purification methods employed for isolating acid phosphatases from diverse plant sources, as well as their structural and functional properties. Additionally, the review explores the potential applications of these enzymes in various fields.

Abstract Intracellular infiltration of bacteria into host cells complicates medical and surgical treatment of bacterial joint infections. Unlike soft tissue infections, septic arthritis and infection‐associated inflammation destroy cartilage that does not regenerate once damaged. Herein, we show that glycolytic pathways are shared by methicillin‐resistant Staphylococcus aureus (MRSA) proliferation and host inflammatory machinery in septic arthritis. MRSA readily penetrates host cells and induces proinflammatory cascades that persist after conventional antibiotic treatment. The glycolysis‐targeting drug dimethyl fumarate (DMF) showed both bacteriostatic and anti‐inflammatory effects by hindering the proliferation of intracellular MRSA and dampening excessive intraarticular inflammation. Combinatorial treatment with DMF and vancomycin further reduced the proliferation and re‐emergence of intracellular MRSA. Combinatorial adjuvant administration of DMF with antibiotics alleviated clinical symptoms of septic arthritis by suppressing bacterial burden and curbing inflammation to protect cartilage and bone. Our results provide mechanistic insight into the regulation of glycolysis in the context of infection and host inflammation toward development of a novel therapeutic paradigm to ameliorate joint bioburden and destruction in septic arthritis.

An unprecedented global pandemic caused by a novel coronavirus named SARS-CoV-2 has created a severe healthcare threat and become one of the biggest challenges to human health and the global economy. As of July 2023, over 767 million confirmed cases of COVID-19 have been diagnosed, including more than 6.95 million deaths. The S protein of this novel coronavirus binds to the ACE2 receptor to enter the host cells with the help of another transmembrane protease TMPRSS2. Infected subjects that can mount an appropriate host immune response can quickly inhibit the spread of infection into the lower respiratory system and the disease may remain asymptomatic or a mild infection. The inability to mount a strong initial response can allow the virus to replicate unchecked and manifest as severe acute pneumonia or prolonged disease that may manifest as systemic disease manifested as viremia, excessive inflammation, multiple organ failure, and secondary bacterial infection among others, leading to delayed recovery, hospitalization, and even life-threatening consequences. The clinical management should be targeted to specific pathogenic mechanisms present at the specific phase of the disease. Here we summarize distinct phases of COVID-19 pathogenesis and appropriate therapeutic paradigms associated with the specific phase of COVID-19.

Cytokines are signaling molecules that play a role in myriad processes, including those occurring during diseases and homeostasis. Their homeostatic function begins during embryogenesis and persists throughout life, including appropriate signaling for the cell and organism death. During viral infections, antiviral cytokines such as interferons and inflammatory cytokines are upregulated. Despite the well-known benefits of these cytokines, their levels often correlate with disease severity, linking them to unfavorable outcomes. In this review, we discuss both the beneficial and pathological functions of cytokines and the potential challenges in separating these two roles. Further, we discuss challenges in targeting these cytokines during disease and propose a new method for quantifying the cytokine effect to limit the pathological consequences while preserving their beneficial effects.

Background: Effective immunization supply chain (iSC) is crucial for safe and timely transport of potent vaccines to the beneficiary. India's iSC, with a network of ~29,000 cold chain points (CCP), measures its quality standards using the World Health Organization–United Nations International Children's Emergency Fund (WHO–UNICEF) global tool on effective vaccine management (EVM). The two national EVM assessments (EVMA) were conducted in 2013 and 2018. This study helps to see the impact of policies and practices through EVMA in maintaining an efficient iSC for effective implementation of immunization program. Materials and Methods: We conducted a desk analysis using EVMA reports to summarize and compare the findings of the two studies. Cut-off of 80% was considered ideal for each category/criteria score. Results: Both EVMA 2013 and 2018 were conducted using Android-based global EVM tool, though across a wider sample of CCP. Maximum and minimum changes in scores were sub-national and lowest distribution (16% each) and national buffer stores (7%), respectively. Maximum and minimum improvements were seen in vaccine management (29%) and MIS and supportive functions (3%), respectively. The improvement was statistically significant for the overall scores (P = 0.02), primary (P = 0.01), subnational (P = 0.02), and lowest distribution stores (P = 0.03). Among the 36 recommendations of 2013 assessment, 78% and 22% were fully and partially implemented (or ongoing), respectively. Conclusion: Implementation of EVM recommendations has significantly led to improvement and continues to provide a benchmark for iSC and its processes. Follow-up assessments every 3–5 years can further help to evaluate iSC and ascertain the impact of recommendations.

SARS-CoV-2 infection can lead to progressive pathology in patients with COVID-19, but information for this disease progression is sparse. Here the authors use multi-omics approach to profile the immune responses of patients, assessing immune repertoire and effects of tocilizumab treatments, to find a dyssynchrony between innate and adaptive immunity in progressive COVID-19.

Introduction: Oral diseases are considered a public health problem due to their high prevalence. It is the primary concern of oral health educators to impart positive oral health knowledge and behavior in the society. Health workers' knowledge, attitude, and practices (KAP) toward oral health to a great extent influence the community as they can extend health education at the first contact in the community. Thus, the aim of the study was to assess the knowledge, attitude, and practices of health care workers. Material and Methods: A descriptive cross-sectional survey was designed to assess the knowledge, attitude, and practices towards oral health among health care workers. The study was conducted among health care workers aged between 20 and 60 years working in Primary Healthcare Centres and Community Healthcare Centres of Lucknow district. Informed consent was obtained from health care workers before the start of the study. The data were collected via a predesigned and pretested questionnaire. The data were analyzed using IBM SPSS Statistics-version 21. Results: The results of the study showed that 70.2% of the respondents ever visited the dentist due to somereason of which 19.2% visited once in a year. In addition, 38.9% of the respondents were daily smokers of which the majority belonged to the age group 20–40 years. A total of 63.9% of the respondents were daily chewable tobacco users, and 12.4% were routine users of alcohol. Conclusion: The present study gives a brief insight into the oral health knowledge, attitude, and practices of health care workers which were of fair degree.

Idiopathic pulmonary fibrosis (IPF) is a progressive and ultimately fatal disease. Recent findings have shown a marked metabolic reprogramming associated with changes in mitochondrial homeostasis and autophagy during pulmonary fibrosis. The microRNA-33 (miR-33) family of microRNAs (miRNAs) encoded within the introns of sterol regulatory element binding protein (SREBP) genes are master regulators of sterol and fatty acid (FA) metabolism. miR-33 controls macrophage immunometabolic response and enhances mitochondrial biogenesis, FA oxidation, and cholesterol efflux. Here, we show that miR-33 levels are increased in bronchoalveolar lavage (BAL) cells isolated from patients with IPF compared with healthy controls. We demonstrate that specific genetic ablation of miR-33 in macrophages protects against bleomycin-induced pulmonary fibrosis. The absence of miR-33 in macrophages improves mitochondrial homeostasis and increases autophagy while decreasing inflammatory response after bleomycin injury. Notably, pharmacological inhibition of miR-33 in macrophages via administration of anti–miR-33 peptide nucleic acids (PNA-33) attenuates fibrosis in different in vivo and ex vivo mice and human models of pulmonary fibrosis. These studies elucidate a major role of miR-33 in macrophages in the regulation of pulmonary fibrosis and uncover a potentially novel therapeutic approach to treat this disease.

Objectives: A country’s immunization system's effectiveness depends on its supply chain's efficacy. To assess the challenges of maintaining an efficient vaccine supply chain, Malawi conducted its assessment using The EVM2.0 tool (Effective Vaccine Management). Methods: It is a cross-sectional study in which all EVM requirements were assessed between September and October 2021. Data were collected from eighty-two randomly selected sites using the site selection tool of the EVM. Data were entered into the EVM assessment tool 2.0 version 1.12 for analysis. This tool generates performance indicators and criteria scores for assessed sites, compared with a WHO minimum score of 80%. Results: Overall criteria scores across all levels of the immunization supply chain showed a statistically significant mean difference of 5.92 (t = 2.58, P = 0.02). Comparative overall mean criteria scores across different levels of the immunization supply chain showed no statistically significant difference for primary (p = 0.76), sub-national (p = 0.69), and lowest distribution stores (p = 0.12). However, a substantial gap was found in the overall mean scores of the health facility’s service point (SP) (t = 4.12, P = 0.001). The overall category scores across all immunization supply chain levels did not show a statistically significant difference. However, among individual category scores, Infrastructure (76 %), Equipment (67 %), Policies and procedures (62 %), Financial (47 %), and Resources (64 %) were found to be below the WHO minimum score. Conclusion: Though the 2021 Malawi EVM assessment findings are promising, they still identified the gaps to be improved to ensure the vaccine availability in the right amount, at the right time, and at the right cost.

Electronic Vaccine Intelligence Network (eVIN) is an indigenously developed technology which strives to digitise vaccine stocks and monitor the temperature of the cold chain through a smartphone based application. The platform supports the central government’s Universal Immunization Programme by providing real-time information on vaccine stocks, flows and storage temperatures across all cold chain points of the country.This vaccine logistics system has been introduced by the Ministry of Health and Family Welfare and implemented by the United Nations Development programmers. In terms of functionality, eVIN aims to provide an integrated solution to address constraints of infrastructure, monitoring and human resource, inadequate vaccine stocks and related challenges.

A 52-year-old woman presented with respiratory symptoms of productive cough and shortness of breath. She had suffered from repeated pneumonia. The CT scans revealed chronic sinusitis, tree bud signs in pulmonary imaging, and situs inversus. She received a primary diagnosis of Kartagener syndrome of primary ciliary dyskinesia (PCD) and a genetic examination was performed. Compound heterozygous mutations in dynein axonemal heavy chain 9 (DNAH9) were identified, which encoded outer dynein arms (ODAs) components. DNAH9 mutations are relatively rare events in PCD, and this is the first report of PCD patients with DNAH9 mutations in the Chinese population. Further, a literature review of mutations in PCD was conducted.

Pseudomonas aeruginosa (PsA) is an opportunistic bacterial pathogen that causes life-threatening infections in individuals with compromised immune systems and exacerbates health concerns for those with cystic fibrosis (CF). PsA rapidly develops antibiotic resistance; thus, novel therapeutics are urgently needed to effectively combat this pathogen. Previously, we have shown that a novel cationic Zinc (II) porphyrin (ZnPor) has potent bactericidal activity against planktonic and biofilm-associated PsA cells, and disassembles the biofilm matrix via interactions with eDNA In the present study, we report that ZnPor caused a significant decrease in PsA populations in mouse lungs within an in vivo model of PsA pulmonary infection. Additionally, when combined with an obligately lytic phage PEV2, ZnPor at its minimum inhibitory concentration (MIC) displayed synergy against PsA in an established in vitro lung model resulting in greater protection of H441 lung cells versus either treatment alone. Concentrations above the minimum bactericidal concentration (MBC) of ZnPor were not toxic to H441 cells; however, no synergy was observed. This dose-dependent response is likely due to ZnPor’s antiviral activity, reported herein. Together, these findings show the utility of ZnPor alone, and its synergy with PEV2, which could be a tunable combination used in the treatment of antibiotic-resistant infections.

Background: Oral submucous fibrosis (OSMF) is a chronic insidious disease that affects oral cavity, may also involve pharynx or esophagus, and may be associated with vesicle formation. The present study aimed to determine prevalence of oral submucous fibrosis among school children in Kanpur city through cross-sectional study and its association with various type of quid and areca nut chewing habit. Materials and Methods: In different urban and rural educational areas of the Kanpur district of Uttar Pradesh, a school-based cross-sectional study was carried out. Data on consumption of areca nut were obtained by a self-administered questionnaire based on demographic characteristics, areca nut use, daily frequency of areca nut chewing, other ingredients mixed with nut, tobacco use (smoking and/or chewing), age of initiation of nut chewing, reasons for use, social influence factors, and risk perceptions. All oral examinations were done by specialist examiners who were familiar with oral mucosal lesions in the local population. Results: The results from this study shows that the areca nut chewing habit is significant among school children of rural areas as compare to urban areas in Kanpur district. No female subject was found to be suffering from OSMF in both the urban as well as rural areas however 27 (3.41%) male subjects were found to be suffering from OSMF. Conclusion: In order to spread awareness through educational programs, newspapers, and mass media in neighborhoods and classrooms, steps should be taken at the public health level.

Abstract Background The spread of a highly pathogenic, novel coronavirus (SARS-CoV-2) has emerged as a once-in-a-century pandemic, having already infected over 63 million people worldwide. Novel therapies are urgently needed. Janus kinase-inhibitors and Type I interferons have emerged as potential antiviral candidates for COVID-19 patients due to their proven efficacy against diseases with excessive cytokine release and their direct antiviral ability against viruses including coronaviruses, respectively. Methods A search of MEDLINE and MedRxiv was conducted by three investigators from inception until July 30th 2020 and included any study type that compared treatment outcomes of humans treated with Janus kinase-inhibitor or Type I interferon against controls. Inclusion necessitated data with clearly indicated risk estimates or those that permitted their back-calculation. Outcomes were synthesized using RevMan. Results Of 733 searched studies, we included four randomized and eleven non-randomized trials. Five of the studies were unpublished. Those who received Janus kinase-inhibitor had significantly reduced odds of mortality (OR, 0.12; 95% CI, 0.03–0.39, p

The ongoing pandemic of COVID-19 is a threat to various routine healthcare services. India's routine immunization (RI) campaign is one of largest ever known. In this review, we discuss the magnitude of disruption of RI activities due to COVID-19 pandemic, various causes of it and recommend ways to reduce the disruptions. Prominent literature databases were searched till April 30, 2021 for articles reporting disruptions of RI due to COVID-19. One study from India and numerous from outside India reported significant declines in the vaccine coverage rates during the lockdown period, which ranged from March 2020 till August 2020 in different regions of the world. Some reported disruptions for all vaccines, while a few reported sparing of birth doses. Shortage of healthcare workers due for them being diverted to patient care services and their reduced movement due to lockdowns and non-availability of public transport were prominent causes. Parents avoided RI sessions as they feared them or their children getting infected. They also faced travel restrictions, just like the healthcare workers. Children of school entry age and those from poorer socio-demographic profile appeared to miss the doses more frequently. Ministry of Health and Family Welfare, India has issued guidelines for conducting fixed and outreach RI sessions while following COVID-appropriate behavior. Promptly identifying missed out children and scheduling catch-up sessions is required to sustain the gains made over the decades by the immunization program of India.

Lili Ren et al. investigate antibody response from 176 COVID-19 patients who presented different stages of their disease. This study suggests the late onset of antibody response as a risk factor for disease severity and a limited role of antibody titers in predicting the disease severity of COVID-19.

Objective:With the increasing popularity of minimally-invasive surgery, laparoscopic pyeloplasty has become a staple in the armamentarium of urologists. However, the surgery has a steep learning curve and longer operative time. In this study, we aimed to evaluate the results of initial 53 cases of laparoscopic dismembered pyeloplasty in our institute.Materials and Methods:A total 52 of patients with pelvi-ureteric junction (PUJ) obstruction, 30 male and 22 female, with the mean age of 23.5 years were managed by transperitoneal laparoscopic dismembered pyeloplasty. The patients were placed in full lateral position and surgery was done using a minimum of three ports, retrograde pyelography was done in all; initial access was done by using a Veress needle. The ureter was spatulated first, first suture taken and then the PUJ was dismembered to avoid rotation of the ureter. Antegrade DJ stenting was done in all patients and one drain was left in the retroperitoneum after surgery. DJ stent was removed six weeks after surgery.Results:Fifty two patients were managed by dismembered pyeloplasty. Six patients required preoperative urinary diversion. Intrarenal pelvis was seen in seven, crossing vessel in ten, high insertion of ureter in six and associated calculus in five patients. Conversion to open surgery was required in six patients. Initially, the operative time was more than three hours but after sufficient experience of 25 cases, it reduced drastically and in last 28 cases, the mean operative time was 123 minutes, with shortest time reported 97 minutes. Reintervention was required in eight patients and overall success rate was 87%.Conclusion:Laparoscopic pyeloplasty is a safe, minimally-invasive and viable alternative to open pyeloplasty for the management of PUJ obstruction.

Background: Internet addiction is defined as any online-related, compulsive behavior which interferes with normal living and causes severe stress on family, friends, loved ones, and one's work environment. The adolescents are most vulnerable to the numerous addictive temptations offered by the Internet during the transition phase. The present study aims to evaluate the prevalence of Internet addiction in adolescents of urban areas of Kanpur district and assess the association of Internet addiction with stress, anxiety, and depression. Materials and Methods: A cross-sectional study was conducted among students of higher secondary schools/colleges in the urban areas of Kanpur district in Uttar Pradesh. Out of 105 colleges, 10%, i.e., 10 colleges, were selected randomly and a total of 900 students were enrolled in the study. A pretested, predesigned questionnaire, Young's Internet Addiction Scale, and Depression Anxiety Stress Scales 21 were used in the study. Data distribution was assessed for normality using the Shapiro–Wilk test. Categorical data were compared using the Chi-square test. All values were considered statistically significant for a value of P ≤ 0.05. Results: Majority (61.1%) of the respondents were females, and the mean age was 17.20 years. The prevalence of Internet addiction was 89.78%. The main purpose of using Internet was social networking (54.89%), followed by online gaming/gambling (19.67%) and study (12.89%). About 60.44% of the respondents used Internet for 3–6 h/day and 28.67% of the respondents used Internet for

Aim: To assess the oral health status and inflammatory markers in end stage chronic kidney disease (CKD) patients. Objectives: To study and compare oral health status of end stage CKD patients with the control group (matched health individuals) and to study and compare inflammatory biomarkers in study and control groups. Materials and Methods: A cross-sectional study was conducted among 50 patients of end stage CKD and 50 matched healthy individual, who were taken as control in the study. Convenience sampling technique was used. Oral health status was recorded by using WHO proforma (2013). Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP ) were also measured in the both groups. These are inflammatory markers which show systemic inflammation. Statistical analysis was done by using IBM SPSS Statistics-version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) Results: The study revealed that patients on dialysis going for transplantation have evidence of increased inflammation as indicated by raised CRP values. Conclusion: The present study concludes that the oral hygiene of the patients is deteriorated who are having chronic kidney disease. Good oral and dental care in CKD patients can improve the transplant outcomes.

Background: Numerous triggers have been implicated in adult female acne including endogenous (hormonal dysfunction and genetic predisposition) and exogenous causes (drugs, cosmetics, sunscreens, stress, and smoking). Aims: To evaluate the role of various trigger factors in adult female acne and to analyze the androgenic hormone pattern including anti-Mullerian hormone (AMH) in these patients. Materials and Methods: Patients having acne of age ≥25 years were analyzed using a pre devised proforma to elicit trigger factors while the severity was graded using the Global Acne Grading System (GAGS). A detailed hormonal assessment was undertaken that assessed total testosterone (TT), sex hormone-binding globulin (SHBG), free androgen index (FAI), AMH, 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone sulfate (DHEAS), follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), and prolactin. Results: Out of the 165 cases seen and sub-analyzed for triggers, premenstrual flare, diet, cosmetics, and stress were the most commonly implicated causes. Among cosmetics, fairness creams and foundations were implicated.The hormonal analysis revealed deranged values of all hormones with the most common being 17-OHP and AMH. Almost 42.8% patients with DHEAS derangement and 58.75% females with raised 17-OHP suffered from moderate to severe stress. Limitations: A prospective cohort correlation study of the implicated triggers is needed to confirm the association with adult female acne. Conclusions: Adult female acne may be triggered by diet, stress, and cosmetics and there is a distinct hormonal milieu that accounts for hyperandrogenemia. We noted high levels of adrenal androgens which have been known to be associated with stress and sleep deprivation. Our study shows the value of counseling adult female acne patients about various acne triggers.

Background: Oral health is fundamental to general health and well-being. Schools may serve as the best platform for the promotion of oral health. Thus, it is essential to promote oral health in schoolchildren as they are the future of our nation. Aim: The aim of this study was to assess the impact of oral health education (OHE) on the knowledge, attitude, and practice of 13–15-year-old schoolchildren. Materials and Methods: A quasi-experimental study was conducted on a total of 876 schoolchildren aged 13–15 years of age. They were assessed for their oral health knowledge, attitude, and practice at the start of the study using a specially designed questionnaire. OHE was imparted to the children at baseline, 2 months, 4 months, and 6 months. All the children were later reassessed for their oral health knowledge, attitude, and practice using the same specially designed questionnaire after 6 months. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 21. Chi-square test was used for comparing the categorical data. Results: The schoolchildren in the study group showed higher levels of knowledge, attitude, and oral hygiene practices after OHE at the end of 6 months. Before and after the intervention, the scores were found to be statistically significant (P < 0.001). Conclusion: The OHE imparted proved to be effective in improving the oral health knowledge, attitude, and practices of schoolchildren.

Background: The habit of smoking and chewing tobacco is associated with various types of oral mucosal lesions and conditions, many of which pose a potential threat to cancer growth. The present study aims to evaluate the prevalence of potentially malignant lesions (PML) and oral cancer in North India and to identify the associated risk factors. Materials and Methods: A cross-sectional study was carried out in the Department of Oral Medicine and Radiology Rama Dental College Hospital and research center Kanpur over a period of 5 years with1,10,625 patients. Participants were divided into study group with a positive history of the chewing habit as well as oral lesions and control group who had a positive history of habits with no oral lesions. Detailed case history and clinical examination were carried out under visible light by trained professionals to assess any oral mucosal changes. Results: The study group consisted of 76.31% males and 23.69% females. In total, 84.34% participants in the study group were literate. However, 57.56% subjects were having oral submucous fibrosis, 23.7% were having leukoplakia, 13.12% were having Lichen planus, and 5.62% were having oral cancer. Conclusion: Results from the present study indicate that tobacco smoking, chewing of betel quid with and/or without tobacco chewing are the major risk factors for PML and oral cancer.

Background: The Swachh Bharat Abhiyan (SBA) is the most significant cleanliness campaign by the Government of India. Youth are the strong pillars of the development of any country. There is a need to bring a big change to the youth about the cleanliness drive. This study aims to assess the perception of SBA and attitude towards cleanliness among dental students of Kanpur city. Materials and Methods: This study is a descriptive, cross-sectional survey, which comprised of 390 undergraduate and postgraduate students. A pretested, self-administered, close-ended questionnaire consisting of 11 questions were included to evaluate the perceptions and attitudes regarding SBA among the dental students. Data were analyzed using IBM Statistical Package for the Social Sciences (SPSS) version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.). Categorical data were compared using the Chi-square test. All values were considered statistically significant for a value of P ≤ 0.05. Results: The results of the study revealed that there is a positive attitude among study participants towards cleanliness, but efforts are still required to emphasize the importance of cleanliness among the many inhabitants. To implement SBA effectively, it is important to highlight the urgent need for public awareness. Conclusion: This study found that the majority of the participants was having positive attitude and perception towards SBA, yet initiatives and approaches are still needed to help bring positive actions among those who are reluctant to follow proper cleanliness, sanitation, and hygiene practices.

Aim: To examine the significance of cigarette prices, statuary warning, anti-tobacco camp or advertisement in influencing smoking cessation and the motivation to quit tobacco use.Tobacco use is highly prevalent all over the world. Tobacco smoking and chewing affects almost all the systems of the body. Subjects: Tobacco (smokeless and smoking) male participants aged between 18 and 50 years were recruited. Materials and Methods: Participants were asked to complete a questionnaire related to smoking habits, the Fagerstrom test for nicotine dependence questionnaire, and effect of price hike, statuary warning, anti-tobacco camp or advertisement. Results: Tobacco user with moderate and high dependent showed no effect in use of tobacco of price hike, statuary warning, anti-tobacco camp or advertisement. Conclusion: This study provides a unique opportunity to study tobacco cessation among tobacco user and their response to tobacco prices, statuary warning, anti-tobacco camp or advertisement. Higher tobacco prices appear to be associated with greater motivation to stop tobacco habit.

Introduction: Gingivitis is codified as the most familiar oral disease in children and teenagers. Several studies reported that most of the children and adolescents have negative impact on quality of life (QoL) due to gingivitis or destructive periodontal disease or poor oral health status. Existing literature in this context on Indian population is sparse. Hence, this study has been shouldered to find out possible coalition between gingivitis and COHRQoL. Objective: This study desires to evaluate the confederation of gingivitis and child oral health-related quality of life (COHRQoL) among school children of Lucknow. Methods: A cross-sectional survey was conducted in school going children with the age group of 11–14 years, with a representative sample of 400 students in Lucknow city. For data on oral health-related quality of life (OHRQoL), a predesigned questionnaire (CPQ11-14) was used for demographic information and questions on oral symptoms, functional limitations, emotional, and social well-being. Gingival status was evaluated by Gingival index (Loe and Silness 1963). Results: QoL was found to be moderately affected in children with severe gingivitis as compared with children with no gingivitis, mild, and moderate gingivitis, but this difference was found to be statistically nonsignificant (P = 0.896). Conclusion: The present findings indicated that the existence of substantial levels of gingivitis might be fatalistically related with how children perceive their oral health and daily life.

Automation of Postal systems has the major research scope in the field of automation. To create Postal Automation set-up for countries like India is a tedious task if compared with other countries because of India’s multiscript and multilingual behavior. This work will help in recognizing the “Gurmukhi” handwritten district names of the State Punjab. To recognize the district names, a CNN-based architecture is proposed by employing a Holistic approach. For this, an image database of 22000 samples is prepared having 1000 sample images for every district name which is collected from 500 different writers. Maximum accuracy on validation data achieved by the proposed Model is 99%.

Klebsiella species cause infections at multiple sites, including lung, urinary tract, bloodstream, wound or surgical site, and brain. These infections are more likely to occur in people with preexisting health conditions. Klebsiella pneumoniae (K. pneumoniae) has emerged as a major pathogen of international concern due to the increasing incidences of hypervirulent and carbapenem-resistant strains. It is imperative to understand risk factors, prevention strategies, and therapeutic avenues to treat multidrug-resistant Klebsiella infections. Here, we highlight the epidemiology, risk factors, and control strategies against K. pneumoniae infections to highlight the grave risk posed by this pathogen and currently available options to treat Klebsiella-associated diseases.

Abstract Background There is a pressing need for systematic approaches for monitoring how much TB treatment is ongoing in the private sector in India: both to cast light on the true scale of the problem, and to help monitor the progress of interventions currently being planned to address this problem. Methods We used commercially available data on the sales of rifampicin-containing drugs in the private sector, adjusted for data coverage and indication of use. We examined temporal, statewise trends in volumes (patient-months) of TB treatment from 2013 to 2016. We additionally analysed the proportion of drugs that were sold in combination packaging (designed to simplify TB treatment), or as loose pills. Results Drug sales suggest a steady trend of TB treatment dispensed by the private sector, from 18.4 million patient-months (95% CI 17.3–20.5) in 2013 to 16.8 patient-months (95% CI 15.5–19.0) in 2016. Overall, seven of 29 states in India accounted for more than 70% of national-level TB treatment volumes, including Uttar Pradesh, Maharashtra and Bihar. The overwhelming majority of TB treatment was dispensed not as loose pills, but in combination packaging with other TB drugs, accounting for over 96% of private sector TB treatment in 2017. Conclusions Our findings suggest consistent levels of TB treatment in the private sector over the past 4 years, while highlighting specific states that should be prioritized for intervention. Drug sales data can be helpful for monitoring a system as large, disorganised and opaque as India’s private sector.

Background: Green tea (Camellia sinensis) is one of the most popularly consumed beverages worldwide containing a number of bioactive chemicals, and it is particularly rich in flavonoids which include catechin. It is linked to a lower incidence of some pathological conditions including oral cancer, dental caries, stroke, cardiovascular diseases, and obesity. Aim: The aim of the study was to compare and evaluate the effects of commercially available green tea mouthwash with chlorhexidine mouthwash on gingivitis. Materials and Methods: A 3-week, double-blinded study was conducted on thirty nursing students aged between 18 and 25 years. Plaque status was assessed by plaque index (Silness and Loe 1964) and gingival status was assessed by gingival index (Loe and Silness 1963) at the 14th day and at the 21st day. Statistical analysis was done using the Statistical Package for the Social Sciences version 21. The test used was one-way analysis of variance and repeated measures. The level of significance was kept as P < 0.05. Results: There was a reduction in the gingivitis scores of the participants using green tea mouthwash as compared to chlorhexidine mouthwash and distilled water. Statistically significant differences were observed between distilled water and green tea groups (P = 0.04). Conclusion: The present study showed that green tea mouthwash was found to be more effective than the chlorhexidine mouthwash in reducing extensive levels of gingivitis.

Background: The COVID-19 pandemic is a significant health threat. Health care worker (HCWs) are at a significant risk of infection which may cause high levels of psychological distress. The aim of this study was to investigate the psychological impact of the COVID-19 on HCWs and factors which were associated with these stresses during the first outbreak in Shanghai.Methods: Between February 9 and 21, 2020, a total of 3,114 frontline HCWs from 26 hospitals in Shanghai completed an online survey. The questionnaire included questions on their sociodemographic characteristics, 15 stress-related questions, and General Health Questionnaire-12 (GHQ-12). Exploratory factor analysis was applied to the 15 stress-related questions which produced four distinct factors for evaluation. Multiple linear regression models were performed to explore the association of personal characteristics with each score of the four factors. Binary logistic analysis was used to explain the association of personal characteristics and these four factors with the GHQ-12.Results: There were 2,691 valid surveys received. The prevalence of emotional distress (defined as GHQ-12 ≥ 12) was noted in 47.7% (95%CI:45.7–49.6%) HCWs. Females (OR = 1.43, 95%CI:1.09–1.86) were more likely to have a psychological distress than males. However, HCWs who work in secondary hospitals (OR = 0.71, 95% CI:0.58–0.87) or had a no contact history (OR = 0.45, 95%CI: 0.35–0.58) were less likely to suffer psychological distress. HCWs who were nurses, married, and had a known contact history were highly likely to have anxiety. HCWs working at tertiary hospitals felt an elevated anxiety regarding the infection, a lack of knowledge, and less protected compared to those who worked at secondary hospitals.Conclusions: Our study shows that the frontline HCWs had a significant psychosocial distress during the COVID-19 outbreak in Shanghai. HCWs felt a lack of knowledge and had feelings of being not protected. It is necessary for hospitals and governments to provide additional trainings and psychological counseling to support the first-line HCWs.

COVID-19 pandemic has infected millions of people with mortality exceeding >1 million. There is an urgent need to find therapeutic agents that can help clear the virus to prevent severe disease and death. Identifying effective and safer drugs can provide more options to treat COVID-19 infections either alone or in combination. Here, we performed a high throughput screening of approximately 1,700 US FDA-approved compounds to identify novel therapeutic agents that can effectively inhibit replication of coronaviruses including SARS-CoV-2. Our two-step screen first used a human coronavirus strain OC43 to identify compounds with anti-coronaviral activities. The effective compounds were then screened for their effectiveness in inhibiting SARS-CoV-2. These screens have identified 20 anti-SARS-CoV-2 drugs including previously reported compounds such as hydroxychloroquine, amlodipine besylate, arbidol hydrochloride, tilorone 2HCl, dronedarone hydrochloride, mefloquine, and thioridazine hydrochloride. Five of the newly identified drugs had a safety index (cytotoxic/effective concentration) of >600, indicating a wide therapeutic window compared to hydroxychloroquine which had a safety index of 22 in similar experiments. Mechanistically, five of the effective compounds (fendiline HCl, monensin sodium salt, vortioxetine, sertraline HCl, and salifungin) were found to block SARS-CoV-2 S protein-mediated cell fusion. These FDA-approved compounds can provide much needed therapeutic options that we urgently need during the midst of the pandemic.

Host response to lung infection includes coordinated efforts of multiple cell types, including the lung epithelium and macrophages. Importantly, both the lung epithelium and macrophages can internalize and clear invading pathogens. However, the mechanisms and their ability to internalize or phagocytose differ. Akt is a key cellular pathway that controls cell proliferation and survival, in addition to its role in host defense. The role of the Akt pathway was assessed using pharmacological Akt modulators in lung epithelial (A549) and macrophage (RAW 264.7) cell lines during Klebsiella bacterial infection. Our data show that the inhibition of the Akt pathway using specific Akt inhibitor MK2206 increased the phagocytic ability of lung epithelial cells but not of macrophages. In contrast, the activation of Akt using specific activator SC-79 decreased the phagocytic ability of epithelial cells, while it increased the phagocytic ability of macrophages. The altered phagocytic ability in both cell types using Akt modulators was not due to changes in bacterial adhesion to the host cell. The clinical usefulness of these Akt modulators may vary based on the type of infection and on the relative contribution of epithelial cells and macrophages in clearing the particular bacterial infection. The Akt pathway has differential roles in the internalization of Klebsiella bacteria by respiratory epithelial cells and immune cells.

Chitotriosidase (CHIT1) is a highly conserved and regulated chitinase secreted by activated macrophages; it is a member of the 18-glycosylase family (GH18). CHIT1 is the most prominent chitinase in humans, can cleave chitin and participates in the body's immune response and is associated with inflammation, infection, tissue damage and remodelling processes. Recently, CHIT1 has been reported to be involved in the molecular pathogenesis of pulmonary fibrosis, bronchial asthma, COPD and pulmonary infections, shedding new light on the role of these proteins in lung pathophysiology. The potential roles of CHIT1 in lung diseases are reviewed in this article.

Bacterial lung infections are major healthcare challenges killing millions of people worldwide and resulting in a huge economic burden. Both basic and clinical research have elucidated host mechanisms that contribute to the bacterial clearance where an indispensable role of immune cells has been established. However, the role of respiratory epithelial cells in bacterial clearance has garnered limited attention due to their weak inflammatory or phagocytic ability compared to immune cells such as macrophages and neutrophils. These studies often underappreciate the fact that epithelial cells are the most abundant cells in the lung, not only serving as building blocks but also providing immune protection throughout the lung. Epithelial cells function either independently to eradicate the pathogen or communicate with immune cells to orchestrate pathogen clearance. The epithelial cells have multiple mechanisms that include mucus production, antimicrobial peptide production, muco-ciliary clearance, and phagocytosis, all of which contribute to their direct antibacterial function. Secretion of cytokines to recruit immune cells and potentiate their antimicrobial activities is a pathway by which the epithelium contributes to bacterial clearance. Successful pathogens outsmart epithelial resistance and find a way to replicate in sufficient numbers to establish infections in the airway or lung epithelial surfaces. In this mini-review, we discuss evidences that establish important roles for epithelial host defense against invading respiratory bacterial pathogens and demonstrate how pathogens outsmart these epithelial immune mechanisms to successfully establish infection. Finally, we discuss briefly how to boost epithelial immunity to improve outcomes in bacterial lung infections.

For the future-generation wireless communications, the carrier aggregation (CA) of third generation partnership project (3GPP) long-term evolution-advanced (LTE-A) is one of the most promising technologies, which can support significant high data rates over wide frequency bandwidths for various real-time services/applications. To reduce the energy consumption, the LTE-A standard defines the discontinuous reception (DRX) mechanism that allows user equipments (UEs) to turn off radio interfaces when no data is expected to be received. However, how to allocate resource optimally within the DRX cycle for UEs with the CA technology is still an open issue. In this paper, we address the resource scheduling with CA within the DRX cycle, with an objective that maximizes the spectrum utilization while minimizes UE wake-up time. We formulate this problem and propose an energy-efficient iterative heuristic. Our scheme consists of two phases; the first phase determines the scheduling order of component carriers (CCs) to improve the resource efficiency, whereas the second phase minimizes UEs' unnecessary wake-up periods by optimizing their resource intervals from different CCs. Extensive simulation results show that our scheduling achieves better performance than the existing schemes.

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s10020-020-00265-0

Older people are very likely to fall, which is a significant threat to the health. However, falls are preventable and are not necessarily an inevitable part of aging. Many different fall detection systems have been developed to help people avoid falling. However, traditional systems based on wearable devices or image recognition-based have many disadvantages, such as user-unfriendly, privacy issues. Recently, WiFi-based fall detection systems try to solve the above problems. However, there is a common problem of reduced accuracy. Since the system is trained at the original signal collecting/training place, however, the application is at a different place. The proposed solution only extracts the features of the changed signal, which is caused by a specific human action. To implement this, we used Channel State Information (CSI) to train Convolutional Neural Networks (CNNs) and further classify the action. We have designed a prototype to test the performance of our proposed method. Our simulation results show an average accuracy of same place and different place is 93.2% and 90.3%, respectively.

Chitinase 3-like 1 regulates cell death, inflammation and tissue remodelling via IL-13receptorα2. Here, the authors show that TMEM219 is a IL-13Rα2 co-receptor and modulates oxidant-induced apoptosis and lung injury, melanoma metastasis and TGF-β1 signalling, downstream of Chi3l1-IL-13Rα2.