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Contagious infections cause over 17 million human deaths in a year among which diseases caused by bacteria are the most prominent ones. Additionally, in the last few years, the haphazard usage of antibiotics has provoked the condition of multifarious defiance in the bacterial strains against these chemical drugs thus contributing to an upsurge towards severe economic and communal welfare-related uncertainties. Thus, to annihilate such situations there is a compelling demand to explore novel substitutes to overcome these concerns. Hence, such problematic situations bring up the limelight towards plant-derived proteins/peptides possessing antimicrobial activity which prove to be excellent alternatives against bacterial pathogens causing serious maladies in humans. Therefore, in this context the current study investigated the antibacterial potential of the Ethanol, Methanol and Chloroform peptides/protein isolate obtained from pods of Acacia nilotica by Disc-Diffusion Assay and MIC (Minimum Inhibitory Concentration) against E. coli and B. subtilis bacterial strains. The antibacterial activity of all three solvent peptide isolates was found to be exhibiting antimicrobial activity at a concentration of 100μg/ml against B. subtilis with Disc-Diffusion as well as MIC with Chloroform isolate displaying the highest activity against gram-positive Bacillus species. Therefore, such plant-derived antibacterial proteins/peptides in the future can be used as a therapeutic drug to combat various severe bacterial maladies thus providing a better alternative than antibiotics both in terms of safety against unwanted secondary effects as well as will also help in bringing down the graphs of Antimicrobial Resistance (AMR) posing a serious threat to the human health. As a result, the study concludes that peptide isolates obtained from Acacia nilotica pods are effective against gram-positive Bacillus species, making them an important antibacterial compound.

Microorganisms in human gastrointestinal tract have profound influence on the transformation of food into metabolites which can impact human health. Along with playing crucial roles in regulating and modulating various metabolic reactions and life processes, dysbiosis of gut microbiota also affects the permeability of gut and blood-brain barrier. This increases the chance of age-related neurological disorders’ like Alzheimer’s and Parkinson’s diseases. Withania somnifera (W. somnifera) has been proclaimed as a virtuous plant for the treatment of neurodegenerative diseases and many other problems. We have studied the bioactive components of W. somnifera for combined treatment of gut-dysbiosis led bowel diseases (Inflammatory Bowel Disease, Irritable Bowel Syndrome) and the most common neurodegenerative diseases through common potential targets. This approach can solve along with curing the neurodegenerative diseases, the factors causing these diseases would also be obstructed from entering the brain, consonantly curing Inflammatory Bowel Disease and Irritable Bowel Syndrome. Our work on GPCR receptors common to gut inflammatory diseases and neuronal disorders through Network Pharmacology, Molecular docking and Dynamic Simulation approach has shown that modulation of these receptors with bioactive compounds present in W. somnifera can result in effective control of these diseases. We have found five proteins (HTR1A, HTR1B, HTR2A, HTR2B & HTR7) and five best lead compounds (Withanolide A, B, E, Q & Anahygrine) against these targets after molecular docking analysis. Our simulation studies have finally shown that amongst these five HTR1A and HTR7 proteins are the best targets with the leads Withanolide E and Withanolide A against them, respectively. Communicated by Ramaswamy H. Sarma

This study examines the impact of R&D spillover and firm size on the R&D intensity of electronic firms operating in India for the time period 2000–2015. The study finds that firms benefitting from R&D spillover in their line of business are spending more on in-house R&D, indicating complementarity between R&D spillover and R&D efforts. When we consider possible R&D spillover with firm size, the positive association between R&D spillover and in-house R&D activity holds after a certain threshold of firm size is reached. A probable implication for the moderating influence of firm size suggests that large-sized firms have financial resources and the capability to assimilate technological knowledge in their product designs and processes. An inverted-U relationship between firm size and R&D suggests that support and assistance with the cost of research and development can spur the innovation incentive of small- and medium-sized firms. The empirical finding indicates that fringe firms in the electronics sector aim at developing new technology. The import of intermediate inputs appears to be negatively associated with in-house R&D. This suggests substitutability between imported intermediaries and R&D activity. In the case of R&D reporting firms, the coefficient of embodied technology and capital intensity turns out to be positive and significant. As it remains, an increase in the import of capital goods promotes in-house R&D of electronic firms. At the same time undertaking R&D activity in a high-tech sector is capital intensive. Hence, firms require capital reserves to engage in innovative activities and remain competitive.

Mycobacterial pathogens, including nontuberculous mycobacteria (NTM) and Mycobacterium tuberculosis, are pathogens of significant worldwide interest owing to their inherent drug resistance to a wide variety of FDA-approved drugs as well as causing a broad range of serious infections. Identifying new antibiotics active against mycobacterial pathogens is an urgent unmet need, especially those antibiotics that can bypass existing resistance mechanisms. In this study, we demonstrate that gepotidacin, a first-in-class triazaacenapthylene topoisomerase inhibitor, demonstrates potent activity against M. tuberculosis and M. fortuitum, as well as against other clinically relevant NTM species, including fluoroquinolone-resistant M. abscessus. Furthermore, gepotidacin exhibits concentration-dependent bactericidal activity against various mycobacterial pathogens, synergizes with several drugs utilized for their treatment, and reduces bacterial load in macrophages in intracellular killing assays comparably to amikacin. Additionally, M. fortuitum ATCC 6841 was unable to generate resistance to gepotidacin in vitro. When tested in a murine neutropenic M. fortuitum infection model, gepotidacin caused a significant reduction in bacterial load in various organs at a 10-fold lower concentration than amikacin. Taken together, these findings show that gepotidacin possesses a potentially new mechanism of action that enables it to escape existing resistance mechanisms. Thus, it can be projected as a potent novel lead for the treatment of mycobacterial infections, particularly for NTM, where present therapeutic interventions are extremely limited.

Body parts and their Pramana are specially described in Ayurveda which is an important part of Rachana Sharir. Description of Angula Pramana was found in Vedic Kala, Purana-Upanishad Kala. Samhita Kala like Vrahtai (Charaka Samhita, Sushruta Samhita, Ashtanga Sangraha, Astanga Hridya) Kashyapa Samhita, Bhela Samhita, Sharangadhara Samhita, Vangsena Samhita, and Kautilya Arthashastra. Pramanas are not useful only in Rog and Rogi Pariksha but also useful to know about his/her Ayu such as Hitaayu, Ahitaayu, Sukhayu and Dukhaayu. At the time of Acharya Charaka, the length and breadth of different Anga-Pratyanga was measured by using their own fingers. This technique of measurement is known as Anguli Pramana. Anguli Pramana which is based on Swa-Angula Pramana is used for measuring the dimensions (Ayam, Vistara and Parinaha etc.) of the different Anga Pratyanga of the body. The study was conducted on 200 volunteers in the age group of 16-40 years. One Angula as a unit of Angula Pramana was obtained by measuring the width of Madhyamparva of middle finger of working hand. The measurements were taken in centimetres for standardization as per metric system and then converted into Anguli Pramana based on individual. This article summarizes the facts related to Anguli Pramana from classical literature, Ayurvedic literature and modern literature along with result of our research work to identify the anatomical landmark of Shadanga to measure through Anguli Pramana and its impact on physical health in present era. At present, there are many physical anomalies either they are genetic disorders, endocrine disorders, traumatic injury which results as anatomical disfiguration of body parts that can distinguish from their Anguli pramana or anthropometry.

Women in medicine have made substantial strides throughout the years, but continue to face inequities throughout their careers that ultimately limit their ability to achieve personal and profession success. This is particularly true in male dominated fields like gastroenterology. In this article, we explore the various challenges and offer a review of strategies to overcome these challenges at each training and career milestone.

The risk and determinants of HCC in patients with primary biliary cholangitis (PBC) are unclear. We conducted a systematic review and meta-analysis of the incidence of HCC and risk factors associated with HCC risk among patients with PBC. We searched PubMed, EMBASE, MEDLINE, Cochrane databases and reference lists from relevant articles to identify cohort studies that examined incidence of HCC in patients with PBC from inception through November 2019. A total of 29 studies including 22,615 patients met the eligibility criteria. The median cohort size was 292 patients followed for an average of 76 months. The pooled incidence rate for patients with PBC was 4.17 per 1000 patient-years (95% CI 3.17–5.47). On subgroup analysis, the incidence of HCC in patients with PBC cirrhosis was 15.7 per 1000 patient-years (95% CI 8.73–28.24). The HCC incidence rate was 9.82 per 1000 person-years (95% CI 5.92–16.28) in men and 3.82 per 1000 person-years (95% CI 2.85–5.11) in women. Cirrhosis is the strongest risk factor for HCC in patients with PBC. Male gender was also a risk factor. Our meta-analysis supports current recommendations of HCC surveillance in patients with PBC cirrhosis. Further studies are needed to evaluate risk factors in this population.

A collection of 84 author's testimonies and workspace photographs between 18 March and 5 May 2020

Background Clinically, melatonin (MLT) has variable oral absorption and extensive first-pass effect, making its oral mode less preferable. Ethosomes are able to permeate intact through the human skin due to its high deformability. Aim Present study assessed topical potential of ethosomes loaded with MLT for the prevention of UV radiation. Methods Melatonin was encapsulated using different ratios of ethanol, soya lecithin, and cholesterol. Prepared ethosomes were characterized for scanning electron microscopy (SEM), zeta potential, % entrapment efficiency (%EE), in vitro drug release kinetics. Then, optimized formulation was incorporated in gel and evaluated for viscosity, pH, extrudability, homogeneity, skin irritation study, spreadability, in vitro skin permeation study, flux, and stability. Results Ethosomes were spherical in structure as confirmed by SEM, and zeta potential was in range of -12.4 mV to -27.4 mV. %EE of the vesicles was in the range of 49.61%-78.047%. Cumulative percentage drug release from various ethosomal formulations was ranged from 64.82%-81.01%. F3 was selected as optimized formulation on the basis of highest %EE, zeta potential, and in vitro drug release. An ethosomal gel of optimized formulation F3 was prepared by using carbopol 934 and compared with plain gel formulation. G3 formulation showed pseudoplastic rheological behavior, optimum pH, spreadability and also showed maximum % in vitro drug permeation with flux 13.85 μg/cm2 /hr and followed zero-order release kinetics which was good for topical drug delivery system. Conclusion This research suggested that MLT loaded ethosomes can be potentially used as a topically drug delivery system.

The inability of neural cells to regenerate themselves after an injury represents the major difference between neural cells and other cells of the body. Various factors are responsible for this, as the expression of myelin-derived inhibitors of axonal outgrowth such as neurite outgrowth inhibitor (Nogo), myelin-associated growth factor, and oligodendrocyte-myelin glycoprotein (OMgp) hinder the central nervous system (CNS) axons to recover properly and inhibit the neuron regeneration. The patient with spinal cord injury can even permanently lose their function due to the inability of axons to regenerate. However, their role in neural regeneration in vivo is not known completely. During the study, we found that once CNS gets injured, the axon growth inhibitor OMgp binds to the Nogo-66 Receptor 1 (NgR1) which in turn restricts the normal functioning of CNS. Considering the OMgp as the target protein, two flavonoid libraries (curcumin and piperine) were screened against it to get potential inhibitors. The effectiveness of the ligands was first screened by three-tier structure-based virtual screening by Glide, Schrodinger. Based on the docking score, the best-docked compounds were taken for absorption, distribution, metabolism, and excretion analysis and the top two complexes from each library were chosen for simulation studies. Flavonoid ligands showed a much better binding affinity when compared with already known inhibitors Riluzole and Minocycline. To date, no natural inhibitors are known for OMgp. Hence, this study can provide novel insight for upcoming research in this area. Communicated by Ramaswamy H. Sarma.

Patients with opioid use disorder (OUD) have a significant problem in psychosocial functioning domains, which are not systematically studied in India. This study aimed to evaluate the psychosocial functioning in current noninjecting opioid users on Methadone Maintenance Treatment (MMT) versus Treatment as Usual (TaU:It is a cross-sectional study on patients of current noninjecting OUD on MMT or TaU for at least in the past month. Comorbidities and illness severity were assessed with the help of Mini-International Neuropsychiatric Interview 7.0.2 and World Health Organization-The Alcohol, Smoking, and Substance Involvement Screening Test 3.0, respectively. Social and occupational functioning assessment scale (SOFAS), WHO Quality of Life (WHOQoL-BREF), and Client Satisfaction Questionnaire (CSQ-8) assessed the sociooccupational functioning and QoL and client satisfaction. A total of 67 participants (37 on MMT and 30 on TaU) were included in the study.A significant difference between the two groups (MMT better than TaU) was based on SOFAS scores, CSQ-8, and WHOQoL-BREF. In the TaU group, there was a significant negative correlation between risk of addiction severity with sociooccupational functioning (Sociooccupational Functioning, Client Satisfaction, and QoL of patients maintained on MMT are better than those on TaU.

An uncommon deadly genetic situation symbolized by the presence of rapid maturation in infants is called as the Hutchinson–Gilford Progeria Syndrome. The term basically is meant as ‘prematurely old’ taken from the Greek meanings. The selective cause behind this syndrome is usually a mutation in a gene called LMNA. The product of this LMNA gene which is a protein i.e. Lamin-A is considered to be responsible for anatomical framing which clasps the nuclei of the cell, well organized and together. But, the recent investigations prove a deformity in the protein i.e. Lamin-A that leads to the non-stability of the nuclei an thus gives rise to the deadly situation of untimely ageing in the children popularly known as Progeria. The literature review investigation provided pivotal information about the therapeutic researches related to the syndrome, the mutational causes and the basic information including the major and minor symptoms generally shown by the patients affected with Hutchinson–Gilford Progeria Syndrome. Investigations on this rare, uncommon disease i.e. Progeria had begun a couple of years back and in some of the researches many important aspects about the causes and possible curative drugs related to the disease which can help the patients in leading a normal life with lesser side effects and symptoms have also been discussed. Further studies will more clearly clarify the possible curative agents and unrevealed mechanisms of the disease which will help the scientists to develop measures which can provide more beneficial and healthy life to the patients with lesser complications.

This study examines the role of market structure and entry barrier factors on firm-level R&D activity of firms operating in the electronics sector in India. R&D efforts of a firm are distinguished in terms of (a) decision to undertake R&D activities, and (b) firm-level R&D intensity. To analyse (a) we use a Probit model, while the Tobit model is used to explain the inter-firm differences in (b). Using the data from the Prowess database provided by the Centre for Monitoring Indian Economy (CMIE), the analysis was carried out for the time period of 16 years, from 2000 to 2015. The trends point out a large inter-industry variation within this sector in R&D intensity and concentration ratio. For a pooled cross-sectional data of 353 electronic firms, the study finds that lower levels of industry concentration and high set-up cost induce firm-level R&D activity. Further, the study highlights the role of industry size in which the firm operates in decisions related to R&D activities.

The present study aims to explore the alternative way to improve the quality and productivity of rice grown under CO2 stress through an external supplement of Trichoderma as a biofertilizer (BF). The impact of BF-treated rice under elevated CO2 (eCO2) was examined by different plant growth parameters, physiological observations, scanning electron microscopy, microbial community profiling and expression levels of stress-related genes. The effect of eCO2 on percent change in yielding attributes of rice (Heena and Kiran) was found higher in control, whereas it was reduced in the presence of BF. Photosynthetic rate, stomatal conductance and transpiration rate were higher in BF-treated rice under eCO2 condition. SEM analysis of BF-treated roots exhibits an increase in the number of metaxylem along with its diameter with thicker and rigid sclerenchymatous cells. Expression analysis of stress-related genes showed an increase in their mRNA transcripts under eCO2 condition. A significant change in the microbial community was found in the rhizospheric region of Heena treated with BF under eCO2. The current study demonstrates the potential of BF in ameliorating the stress generated as a result of CO2 enrichment.

AimsAn increasing proportion of patients presenting in crisis to Newham Home Treatment Team (NHTT) had been noted to exhibit clinical signs and symptoms of neurodiversity. The aim of our project was to identify the number of confirmed and suspected autism and ADHD cases over a 12 month period. We also collated data on gender, age, presenting complaint, medication, and use of screening tools.MethodsThe project involved a retrospective case note review of the NHTT (South) caseload from November 1st 2020-October 31st 2021. This involved searching caseload and electronic patient records on RiO for keywords: “autism”, “ADHD”, “ASD”, “Asperger”, “Attention Deficit Hyperactivity Disorder”, “AQ10”. Patients were included if neurodiversity was suspected or already diagnosed. Data were collected on age at presentation, gender, presenting complaint, NHTT diagnosis, other diagnoses, Autism Spectrum Quotient (AQ-10) score, whether screening for attention deficit hyperactivity disorder (ADHD) was completed, age at first presentation to services, and medications at discharge.ResultsOver a 12 month period 49 patients (out of 258) presenting to NHTT South raised clinical suspicion of neurodiversity, representing 19% of the caseload and on average one new patient per week. The majority of these (47) related to autism, 13 of which had confirmed diagnosis (M = 26, F = 23). Of the 36 for whom there was clinical suspicion of autism, an AQ10 score was recorded for 18. 14 patients were suspected to have ADHD, 6 of which were confirmed (M = 5, F = 9). There was not a significant impact of gender. The majority of patients included (33) presented with a mood disorder (M = 15, F = 18), and a minority (13) with psychotic disorders (M = 7, F = 6). Over half of patients included presented with suicidality (M = 11, F = 14), and just under half had received a diagnosis of personality disorder (M = 7, F = 16). 21 patients were prescribed anti-psychotic medication (M = 13, F = 8), and 24 were prescribed an antidepressant (M = 9, F = 15).ConclusionOur findings demonstrate that neurodiversity may currently be under-diagnosed and is often mis-diagnosed, with suspicion frequently raised in previously undiagnosed adult psychiatric patients presenting in crisis. There is need for increased awareness of presenting features of neurodiversity within secondary mental health care services, and particular screening for patients experiencing suicidality may be beneficial. The AQ10 is under-utilised as an independent screening tool, and should be promoted to aid in identifying neurodiversity. Patients who may be neurodiverse are frequently prescribed antipsychotic and antidepressant medication, and further studies exploring prescribing practices in this patient sub-set may be useful.

In the year 2019, the potent zoonotic virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began to rage globally, which resulted in the World Health Organization (WHO) declaring it as a pandemic on March 11th, 2020. Although extensive research is currently ongoing worldwide to understand the molecular mechanism and disease pathogenicity of SARS-CoV-2, there are still many nuances to elucidate. Therefore, developing an appropriate vaccine or therapeutic drug to combat coronavirus 2019 (COVID-19) is exceedingly challenging. Such scenarios require multifaceted approaches to identify suitable contenders for drugs against COVID-19. In this context, investigating natural compounds found in food, spices, and beverages can lead to the discovery of lead molecules that could be repurposed to treat COVID-19. Sixteen cucurbitacin analogues were investigated for activity against the SARS-CoV-2 main protease protein (Mpro), angiotensin-converting enzyme 2 (ACE2) binding receptor, nonstructural protein 12 (NSP12) RNA-dependent RNA polymerase (RdRp), NSP13 helicase, and Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) pathway using several relevant tools and simulated screening methods. All key proteins were found to bind efficiently only with cucurbitacin G 2-glucoside and cucurbitacin H with the lowest global energy. Further, the absorption, distribution, metabolism, and excretion (ADME) of all the cucurbitacins were analysed to explore their drug profiles. Cucurbitacin G 2-glucoside and H showed the best hits and all the analogues showed no adverse properties that would diminish their drug-likeness abilities. The encouraging results of the current study may lay the foundation for future research and development of effective measures and preventive medications against SARS-CoV-2., Graphical abstract Image 1

Health, productivity, and reproductive success of plants as primary producer are dependent on soil mineral nutrients, among many other biotic and abiotic factors. Mineral nutrients have been categorized into major and minor nutrients. Both deficiency and excess of nutrient availability cause deficiency stress and nutrient toxicity, respectively; “sufficiency range” being the amount needed for optimal growth and productivity. Plants deploy a variety of developmental and adaptive mechanisms, root architecture being one, to maximize its chances of acquiring mineral nutrition in the sufficiency range. Past approaches to maximize crop yield and productivity relied on abundant application of mineral nutrition as chemical fertilizers and formed the basis of green revolution. The degradation of environment became an unintended collateral damage. The present strategy, therefore, is to unravel the molecular basis of nutrient uptake by plant roots, mobilization, assimilation within the plant, and the source–sink relationship in order to improve nutrient uptake efficiency, and nutrient utilization efficiency (NUE). Given the vastness of the subject involving developmental and adaptive traits, complicated and interconnected nature of the various factors that regulate mineral nutrition, the present endeavor is limited to providing an overview of key transporters that are involved in uptake of the sixteen soil-derived mineral nutrients. The roles of transcriptional regulators such as microRNAs are just beginning to be unraveled. Together with transporters, small RNAs and transcription factors hold the key to future crop breeding and improvement programs through improved root system architecture and nutrient uptake, mobilization, and assimilation.

The management of colorectal cancer has undergone a paradigm shift from previously proctectomy alone being standard of care to present-day multimodality treatment. The multimodality management involves the interplay between different specialty care providers in isolation or in combination, which often includes colorectal surgery, medical oncology, radiation oncology, Wound, ostomy, continence nursing (WOCN), radiology, pathology, pain and palliative care physician and genetics. The present multimodality treatment is aimed to increase the survival and reduce the recurrence and improve the quality of life.

The present paper aims to bring out the influence of Hegel's work in Beauvoir's philosophy. It tries to understand the philosophical relationship between Beauvoir and Hegel where their texts act as a mediator in order to establish this invisible philosophical link.

The present paper aims to read Beauvoir through the diaries that she has written in 1926–1927. Firstly, by reading these diaries I endeavor to understand the philosophical culmination of her thoughts which begin from her diaries. Secondly, after elucidating her philosophical views on self and other from her diaries I would like to make a larger philosophical argument in relation to the originality and ingenuity of Beauvoir as a philosopher and a thinker. She stands independent of Sartre and her diaries bear the originality of her philosophical concepts.

Prior studies have demonstrated the efficacy of non-selective beta-blockers (NSBB) in preventing first variceal bleeding in patients with cirrhosis. However, little is known about the overall effectiveness of NSBB in routine clinical care.We conducted a retrospective cohort study of cirrhotic patients without prior bleeding who initiated a NSBB (propranolol, nadolol) at any Veterans Administration facility between 2008 and 2013. The primary outcome was variceal bleeding within 12 months. We conducted Cox-proportional hazards analyses to identify demographic, clinical, and NSBB-related (type of NSBB, mean dose, dose change, and heart rate response) factors associated with variceal bleeding.Of 5,775 patients, 678 (11.7%) developed variceal bleeding. Mean daily dose of NSBB was40 mg in 58.8%, 18.1% had either upward or downward titration in NSBB dose, and 9.8% had hemodynamic response. Patients who were younger, with ascites, greater medical comorbidity, and higher MELD (Model for end-stage liver disease) scores had a higher risk of variceal bleeding. Patients on a higher daily dose (60 vs.40 mg, adjusted hazard ratio (HR) 0.64; 95% confidence interval (CI): 0.51-0.81), who had either upward or downward dose titration (adjusted HR 0.69; 95% CI: 0.52-0.90 and 0.64; 95% CI 0.45-0.90, respectively), and those who achieved hemodynamic response (adjusted HR 0.75; 95% CI=0.57-1.0) had lower risk.Approximately 12% of patients bled while being on NSBB for primary prophylaxis. A higher NSBB dose and dose titration were protective; yet most patients did not have the NSBB dose titrated to the recommended levels. Our data highlight the need for careful monitoring of cirrhotic patients on NSBB.

Purpose This phase II study evaluated the utility of magnetic resonance imaging (MRI) and positron emission tomography for planning radiation and brachytherapy in patients with postsurgical recurrence of cervical cancer. Methods and Materials The study (NCT 01391065) recruited patients with residual or recurrent disease after hysterectomy. Patients underwent baseline T2 weighted (T2W) MRI, 18F-flouro-deoxyglucose (18F-FDG), 18F-flouro thymidine (18F-FLT) and 18F-flouromisonidazole (18F-F Miso) positron emission tomography (PET) and received external radiation (50 Gy/25 fractions for 5 weeks) and weekly cisplatin (40 mg/m2). MRI was performed at brachytherapy and used for delineation of clinical target volume (CTV). Patients with parametrial disease at baseline received interstitial brachytherapy (16-20 Gy/4-5 fractions) and those with vaginal disease received intracavitary brachytherapy (12-14 Gy/2-4 fractions). Kaplan-Meier analysis was performed to evaluate locoregional relapse, disease free survival, and overall survival. Common Toxicity Criteria for adverse event reporting (CTCAE) v4.1 was used for toxicity scoring and European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questtionaire Core 30 (QLQC-30) and Cx 24 for quality-of-life reporting. Results Between January 2011 and February 2016, 60 patients were included, of which 50 received study treatment. The mean gross tumor volume on T2 W MR was 20 (IQR 3.6-90) cc. The metabolic tumor volume was 15 (interquartile range [IQR] 2.1-56.1) cc. The median FLT volume was 10 (IQR 0-48) cc. A total of 8 patients had 18-F F Miso uptake. The median CTV at brachytherapy was 38 (12-85) cc. The median CTVD90 and D 98 was 71 (53-74) and 74 (53-74) Gy. At a median follow-up of 60 (5-93) months, the 5-year local control, disease free survival, and overall survival were 84%, 73%, and 74.5%, respectively. Grade III and IV proctitis and cystitis were observed in 4% and 2% of patients. On multivariate analysis baseline tumor volume, on T2 W MR impacted disease free (91% vs 65%, P = .03) and overall survival (96% vs 77%, P = .06). Conclusions Image-guided assisted radiation and brachytherapy are associated with good to excellent local control and survival in patients with vaginal recurrences of cervical cancer.

The risk and determinants of HCC in patients with primary biliary cholangitis (PBC) are unclear. We conducted a systematic review and meta-analysis of the incidence of HCC and risk factors associated with HCC risk among patients with PBC.We searched PubMed, EMBASE, MEDLINE, Cochrane databases and reference lists from relevant articles to identify cohort studies that examined incidence of HCC in patients with PBC from inception through November 2019.A total of 29 studies including 22,615 patients met the eligibility criteria. The median cohort size was 292 patients followed for an average of 76 months. The pooled incidence rate for patients with PBC was 4.17 per 1000 patient-years (95% CI 3.17-5.47). On subgroup analysis, the incidence of HCC in patients with PBC cirrhosis was 15.7 per 1000 patient-years (95% CI 8.73-28.24). The HCC incidence rate was 9.82 per 1000 person-years (95% CI 5.92-16.28) in men and 3.82 per 1000 person-years (95% CI 2.85-5.11) in women.Cirrhosis is the strongest risk factor for HCC in patients with PBC. Male gender was also a risk factor. Our meta-analysis supports current recommendations of HCC surveillance in patients with PBC cirrhosis. Further studies are needed to evaluate risk factors in this population.

Introduction SARS-CoV-2 a new virus of the zoonotic coronavirus family causes the disease COVID-19, which has become a global pandemic. One of the ways for prevention of COVID-19 is by disabling its spike protein which results in inhibiting its binding with angiotensin-converting enzyme 2 (ACE-2). The other alternative is to inhibit its replication once inside the body. The aim of this study was to explore the literature to identify whether there were any Ayurvedic remedies which contained ingredients which demonstrated this dual effect. Methods In silico studies were carried out to find the structures of the targets i.e. spike protein of the virus and its main protease (Mpro). Databases were searched to identify the composition of Ayurvedic decoctions used for respiratory ailments. Results We have found that two components out of 26 active ingredients of Ayurvedic decoctions are strong binders for spike protein as well as corresponding Mpro (3CL protease) which plays an essential role in mediating viral replication and transcription, making it an attractive antiviral drug target. Out of 26 components of Ayurvedic herbal decoction used for influenza, one compound was found to be most active. It is a well-known antioxidant, antinflammatory and hepatoprotective molecule. Conclusion The resultant compound could act as a repurposed drug or like other methoxyphenols, could be a good lead molecule for a potent drug for COVID-19.

Reversible logic is gaining importance in the context of upcoming fields such as nanotechnology, cellular automata, quantum level computation and low power VLSI design. The most attractive feature in reversible circuits is that there is one to one correspondence between input and output vectors. Therefore these circuits do not lose any information during computation. In this work we have improved the performance of reversible logic adder by modifying its structure. A delay and power efficient vedic multiplier has been implemented using proposed adder. All the circuits have been designed at 90 nm CMOS technology using Cadence Virtuoso software. Based on the results, it is concluded that the performance of a carry look ahead (CLA) adder gives best performance by changing the type of reversible gate used in its structure. The performance improvement is in terms of reduced number of gates by almost 60% reduced ancillary inputs by 46% and reduced number of garbage outputs by almost 48%. The proposed CLA adder may also find many applications in multiply and accumulate units.

This article explores the possibility of associating firm size vis-à-vis industry size with firm-level R&D led-innovation and the resultant impact(s) on industry level output and price. We consider an oligopolistic industry having one dominant firm and some fringes. Innovation by the dominant firm is viewed both as a technological breakthrough and as (cost) augmenting monetary expenditure. When innovation is considered as technological breakthrough, then for the benevolent industry leader, its scope for output expansion is more if R&D is induced by the industry size vis-à-vis firm size. However, when R&D led innovation is seen as cost augmenting, then the industry size induced innovation yields greater output if the dominant firm acts as a Stackelberg leader. Therefore, we show that exploiting the industry size renders a higher incentive to innovate for the industry leader in terms of capacity expansion.