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Dental cements are in a constant state of evolution, adapting to better align with the intricacies of tooth structure and the dynamic movements within the oral cavity. This study aims to evaluate the efficacy of zirconia-reinforced glass ionomer cement—an innovative variant of modified glass ionomer cements—in terms of its ability to withstand compressive forces and prevent microleakage during dental caries reconstruction. An extensive search was conducted across various databases, encompassing PubMed-MEDLINE, Scopus, Embase, Google Scholar, prominent journals, unpublished studies, conference proceedings, and cross-referenced sources. The selected studies underwent meticulous scrutiny according to predetermined criteria, followed by the assessment of quality and the determination of evidence levels. In total, 16 studies were incorporated into this systematic review and network meta-analysis (NMA). The findings suggest that both compomer and giomer cements exhibit greater compressive strength and reduced microleakage values than zirconia-reinforced glass ionomer cement. In contrast, resin-modified glass ionomer cement (RMGIC) and high-viscosity glass ionomer cement (GIC) demonstrate less favorable performance in these regards when compared with zirconia-reinforced glass ionomer cement.

Background: Knowledge on distribution and burden of diseases in a community is essential for planning of public health services. In the absence of information on morbidity profile through community based surveys, facility based data provide a good alternative.The aim of this study was to describe the morbidity profile of patients attending the Primary Health Centre (PHC). Methods: A record based descriptive study was carried out in a rural PHC of Puducherry, South India. Information on age, sex, residence, new or old case and principal diagnosis were extracted from the outpatient registers for the period between January, 2011 and December, 2011.Only newly registered patients for the study year (2011) were included. Descriptive analysis was done. Results: A totalof 68,818 episodes of illnesses were treated. Adults (>15 years) constituted about 84%. Overall respiratory disorders (26.2%) and musculoskeletal disorders (26.0%) were the most common illnesses followed by circulatory disorders (10.9%), digestive disorders (9.5%) and external causes of morbidity (7.6%). Conclusion:This study gives a brief description of the morbidity profile of patients attending a primary health care centre over a period of one year. This knowledge would help in planning health services to meet the patients’ needs and also help in training health staff.

This research presents a comprehensive investigation to enhance understanding of subsurface structural complexities within the Upper Cretaceous Pab Sandstone reservoir level in a gas-producing field within the Kirthar Fold Belt of the Southern Indus Basin, Pakistan. The seismic interpretation for accurate structural delineation and characterization of intricate fault systems is often challenging in Fold and Thrust Belt settings. The 3D structural maps of Upper Cretaceous Pab Sandstone at the reservoir level and the application of the ant-tracking attribute for fault extraction improve the structural understanding of the gas-producing field in the Kirthar Fold Belt in the Southern Indus Basin, Pakistan. Attribute-assisted 3D seismic interpretation has revealed several subsurface structure elements, including a large thrusted anticline extended towards the north-south, the pattern of north-south oblique ramp thrusts on the southeastern flank, and a combination of easterly vergent thrusts with a counter-back thrust creating a local pop-up structure in the area. A 3D structural model at the reservoir level was generated using horizon and fault framework volume-based modeling approach, serving as a structural model for Pab sandstone. The structural smoothing, variance and ant-tracking attribute were applied iteratively to get the best results and correlated with manual interpretation. 3D seismic interpretation and application of ant-tracking for fault extraction identifies discrete structural styles and revealed that all thrusting occurred due to compressional tectonics of the Plio-Pleistocene period. The apparent different styles result from the reactivation of earlier extensional fault systems and probably during phased periods of compression. The resulting 3D reservoir model can be used as an input to populate petrophysical properties and results can be extended for future field development plans. Integration of well and 3D seismic data interpretation and the application of automatic fault extraction techniques are highly recommended in structurally complex areas and have an equal implication for worldwide basins with similar conditions for reliable structural interpretation in Fold and Thrust Belts with structural complexity.

The application of Machine Learning (ML) in healthcare has opened unprecedented avenues for predictive analytics, diagnostics, and personalized medicine. However, the sensitivity of healthcare data and the ethical dilemmas associated with automated decision-making necessitate a rigorous ethical framework. This review paper aims to provide a comprehensive overview of the existing ethical frameworks that guide ML in healthcare and evaluates their adequacy in ad-dressing ethical challenges. Specifically, this article offers an in-depth examination of prevailing ethical constructs that oversee healthcare ML, spotlighting pivotal concerns: data protection, in-formed assent, equity, and patient autonomy. Various analytical approaches including quantitative metrics, statistical methods for bias detection, and qualitative thematic analyses are applied to address these challenges. Insights are further enriched through case studies of Clinical Decision Support Systems, Remote Patient Monitoring, and Telemedicine Applications. Each case is evaluated against existing ethical frameworks to identify limitations and gaps. Based on our com-prehensive review and evaluation, we propose actionable recommendations for evolving ethical guidelines. The paper concludes by summarizing key findings and underscoring the urgent need for robust ethical frameworks to guide ML applications in sensitive healthcare environments. Future work should focus on the development and empirical validation of new ethical frameworks that can adapt to emerging technologies and ethical dilemmas in healthcare ML.

Unexpected accidents and events in industrial chemical processes have resulted in a considerable number of causalities and property damage. Safety process management in industrial chemical processes is critical to avoid and ensure casualties and property damage. However, due to the immense scope and high complexity of current industrial chemical processes, the traditional safety process management approaches cannot address these challenges to attain adequate fault detection accuracy. To address this issue, an innovative machine learning-based distributed canonical correlation analysis-dynamic independent component analysis (DICA-DCCA) approach is needed to improve the fault detection effectiveness of complicated systems. The (DICA-DCCA) model could potentially detect anomalies and faults in industrial chemical data by utilizing three essential statistics:Id2,Ie2and squared prediction error (SPE). The practical effectiveness of the proposed frameworks is evaluated and compared using a continuous stirred tank reactor (CSTR) framework as a standard benchmark study. The research findings present that the suggested (DICA-DCCA) approach is more resilient and effective in detecting abnormalities and faults than the ICA and DICA approaches with FDR 100 % and FAR 0 %. The implied research approach is robust, operational, and productive.

The Sohnari Member of the Early Eocene Laki Formation is massively deposited in the Southern Indus Basin of Pakistan and is considered a potential source rock to generate hydrocarbons. However, the detailed paleoclimatic, paleoweathering, and depositional conditions of the Sohnari Member have not been studied earlier. This research mainly discusses the detailed mineralogical (bulk and clay) and elemental geochemistry of the Laki Formation from two outcrop sections (Jhimpir and Lakhra) in the Southern Indus Basin, Pakistan. The bulk minerals, including quartz (low), hematite, calcite, halite, gypsum, and clay minerals such as kaolinite, chlorite, smectite and illite have been discussed here. These results demonstrate the paleo-environment of studied area was arid with enhanced saline and weak to strong oxidizing depositional conditions. The chemical index of alteration (CIA) values in Jhimpir and Lakhra sections are in the ranges of 41.30–97.93 and 22.30–96.19, respectively, indicating that the Sohnari sediments experienced weak to intense chemical weathering in the source area. The interpretation of the A–CN–K ternary diagram is consistent with the clay mineral contents in the studied sediments, which is characterized by the predominance of kaolinite, gibbsite and chlorite, demonstrating the weak to strong weathering state under warm and humid climatic conditions. The chemical indices such as Sr/Ba, δU, V/Cr, Ni/Co, and Cu/Zn, U/Th and Ba/Ga show that Sohnari rocks of Early Eocene Laki Formation underwent strong evaporation, oxic water column with warm to humid and minor contact of cold climatic conditions. Based on our present data, it can be concluded that the sediments of Sohnari Member of Laki Formation from Jhimpir and Lakhra areas of Southern Indus Basin in Pakistan are related to Indio-Eurasian collision and came from the Indian shield rocks that were deposited in a brackish water body with a minor contact of the freshwater oxidizing paleo-environment depositional conditions.

Social media can play an important role in current-day disaster management. Images shared from the disaster areas may include objects relevant to operations. If these objects are identified correctly, they can offer a preliminary damage assessment report and situational awareness for response and recovery. This research is carried out in collaboration with a Community Emergency Response Team (CERT) to understand the state-of-the-art object detection model’s capability to detect objects in multi-hazard disaster scenes posted on social media. Specifically, 946 images were collected from social media during major earthquake and hurricane disasters. All the images were inspected by trained volunteers from CERT and, 4,843 objects were analyzed for applicability to specific functions in disaster operations. The feedback provided by the volunteers helped determine the existing model’s key strengths and weaknesses and led to the development of a disaster object taxonomy relevant to specific disaster support functions. Lastly, using a subset of classes from the taxonomy, an instance segmentation dataset is developed to fine-tune state-of-the-art models for damage object detection. Empirical analysis demonstrates promising applications of transfer learning for disaster object detection.

The Lower Indus Basin is the leading hydrocarbon-bearing sedimentary basin in Pakistan. This study has been conducted on the Sawan gas field located in the Lower Indus Basin, adjacent to a few other well-known gas fields of Pakistan like Kadanwari, Qadirpur, and Miano gas fields. This research aims to present the spatial distribution and reservoir potential of the productive zones of the Lower Goru Formation. The present study utilized various two-dimensional (2D) seismic lines and well-log data (Sawan-01 and Sawan-02) to investigate the structural and stratigraphic features of the area. The stratigraphic layers are mildly deepening in the southeast direction. The 2D seismic interpretation of the research area identifies the existence of extensional remanents, i.e., normal faults. These extensional structures are associated with horst and graben geometry that acts as a trapping mechanism for hydrocarbons. Wireline logs are used to identify the reservoir's diverse lithology and petrophysical properties. Petrophysical results indicate fair to good effective porosities, low shale volume, and high hydrocarbon saturation (>55%), signifying good reservoir potential in C interval of the Lower Goru Formation.

For generations, Muslims have engaged in daily life in the West—what this study identifies as Muslim social activity. Through social activity in Western societies, Muslims transform spaces into places by seeking to belong, feel at home, care, materialise religious and ethno-cultural values, and live meaningfully. The concept of place has not been used to explain Muslim social activity in the West. This study addresses this lacuna by explaining it in Australia as placemaking.

This study is aimed to delineate the subsurface structural elements using geophysical techniques in the Haraza area of Pakistan. We investigated the Oghi and Battal thrust faults, sedimentary and metasedimentary wedge, and the absolute crustal thickness based on terrestrial gravity data. Unlike seismic survey relying on wave propagation, magnetic survey is based on both attraction and repulsion, and electrical and electromagnetics on induction. The attractive gravity field produces relatively simpler patterns of anomalies, like a series of highs and lows over regions with undulating basements and buried structures. A qualitative interpretation of gravity data reveals a good deal of information. During the collision of Indian and Eurasian Plates, compressional structures were developed in the Lesser Himalayas or northwest of the Hazara Kashmir Syntaxis. The study mainly focuses on the western limb of the Hazara Kashmir Syntaxis. The regional and local Bouguer anomalies were incorporated to delineate the regional structural units. The gravity model is computed through geophysical technique along with profile A-A' from Mansehra to the Battal area that demarcates the blind Oghi Thrust and emergent Battal Thrust. Tanol Formation of Precambrian age demarcates the Oghi Thrust near Kotli Pine while the Battal Thrust is demarcated within the Mansehra Granite of Cambrian to Ordovician age near Battal. Along with the Battal Thrust, fault gouge and breccias have been observed during the field studies. The total thickness of the sedimentary/metasedimentary wedge in the Mansehra and Battal areas was estimated to be 13.6 km and 14.2 km. In comparison, the total thickness of crust in the Mansehra and Battal areas was 51.6 km and 52.2 km, respectively.

COVID-19 has emerged as a disaster for people around the globe. Consequently, it has changed the way we live and do things in our everyday lives. This study analyzes the experiences of online education of university students during COVID-19 pandemic. It further explores the ways in which gender effects the online education of the students. The study was conducted in four conveniently selected universities of Lahore, Punjab. In-depths interviews were conducted with 16 research participants and data were analyzed by employing thematic analysis approach. The study found that students, particularly females, were facing loads of hurdles in attending online classes, including non-availability or frequent disconnection of internet, electricity load shading, lack of knowledge about using technology for online education, and time management. This study not only presents lived experiences of students but also suggests some constructive measures to address and curtail the challenges that are being faced by students during online education.

Abstract Background This is the first comprehensive report on the traditional and novel uses of medicinal plants practiced by the indigenous communities of the Sudhnoti district of Azad Jammu and Kashmir (AJK), Pakistan. The area is rich in folklore and indigenous medicinal knowledge due to a unique tribal composition and socioeconomic conditions. This study aimed to document traditional knowledge of native plant use by the local communities, particularly those used for therapeutic purposes. Methods Field surveys were conducted from September 2015 to March 2017. Interviews with 125 local inhabitants of different tribes, age groups, genders, and occupations were conducted using structured and semi-structured questions along with group discussions. Data gathered on plant uses, local names, and modes of application of each plant species were organized in tables. Ethnobotanical indices such as use value (UV) and cultural significance index (CSI) were used to produce quantitative information on the plant use category, frequency, and cultural preference of species. Reports on therapeutic uses of medicinal plants were compared with previous studies. Results In all, 88 plant species from 45 families were reported, out of which 67 (77%) were used in ethnomedical applications. Asteraceae, Rosaceae, Fabaceae, and Lamiaceae were the dominant families. Berberis lycium was the most valued plant species, followed by Zanthoxylum armatum and Taraxacum officinale. Mentha arvensis had the highest cultural significance, followed by Mentha longifolia, Punica granatum, and Zanthoxylum armatum. Leaves were the most preferred plant parts in the preparation of medicine exclusively or mixed with other parts. The most frequently used process of crude preparation of medicinal plants was cooking. Oral intake was the predominant route of administration. Conclusions Our comparative analysis confirmed that most of the plants documented have uses that match those previously reported for the region and other parts of the world, with the exception of novel medicinal uses for 11 plant species, including Verbascum thapsus for earache, Elaeagnus umbellata for hepatitis, Achillea millefolium for oral care, Dicliptera roxburghiana to prevent sunstroke in cattle, Rumex hastatus for allergy antidote, Pyrus pashia for hepatitis, and Nerium oleander for diabetes.

This paper aims to numerically investigate the thermal-hydraulic performance of dimpled tubes having various geometric pitches under a constant external heat flux of 10 kW/m2 for a wide range of Reynolds numbers (Re). The performance of enhanced tubes consisting of ellipsoidal 0°, teardrop, and ellipsoidal 45° dimples of equivalent volumes are compared using steady-state Reynolds-Averaged Navier-Stokes simulations. It is observed that the performance of dimpled tubes vary significantly with dimple pitch (P) and Re variation. Therefore, optimum pitches and working ranges of Re are identified for all dimpled tube configurations by varying 3.2mm≤P≤13.2mm and 9000≤Re≤40000. The ellipsoidal 45° and teardrop dimpled tubes have been found to have an optimum pitch of 3.2 mm, and suitable working ranges of 9000≤Re≤30000 and 14000≤Re≤40000. The ellipsoidal 45° and teardrop dimpled tubes with optimum pitch enhanced thermal-hydraulic performance up to 45.7% and 31.2%, respectively. However, ellipsoidal 0° tubes have relatively short working ranges with limited thermal-hydraulic performance improvement. An in-depth analysis of local drag and heat transfer characteristics of individual dimples along with their effects on the overall performance of the tubes are also carried out. Lastly, new correlations of Nusselt number and friction factor are proposed for optimum dimpled tubes.

A main tenet of discourse theory, as derived from the original scholarship of Laclau and Mouffe, is that any social order is the contingent outcome of a political project. Such project is itself a consequence of material discursive practice, the pervasiveness of which is measurable in part by the extent to which its verbal articulations get disseminated with the help of news media. Thus, investigating news media agents which initiate, further, counter and discontinue the discursive process can be effective in mapping the political constitution of the social. But the question is: how to operationalize discourse theory for in-depth analysis of news media artifacts? Glynos and Howarth’s (2007) logics approach is a major step forward, but their account is too generalized to pass as an instructive account of their method. Others who have attempted to operationalize this approach have also left data analysis underspecified, particularly regarding the method of identifying the self-interpretations of social actors, on which the uncovering of logics initially depends. This article offers a more comprehensive methodological account. Through a sample analysis of one news report, we demonstrate that discourse theory’s analytical resources can be bolstered by subjecting the textual data to an approach derived from the literature on frame analysis. In the course of this illustration, we additionally hope to contribute to framing theory’s analytical repertoire.

AbstractTight sandstone reservoirs are widely distributed worldwide. The Upper Triassic Chang 6 member of the Yanchang Formation is characterized by low permeability and porosity. The facies model offers a unique approach for understanding the characteristics of various environments also heterogeneity, scale, and control of physical processes. The role of subsurface facies features and petrophysical properties was unclear. Notable insufficient research has been conducted based on facies and petrophysical modeling and that demands to refine the role of reservoir properties. To tackle this problem, a reservoir model is to be estimated using various combinations of property modeling algorithms for discrete (facies) and continuous (petrophysical) properties. Chang 6 member consists of three main facies, i.e., channel, lobe main body, and lobe margin facies. The current research is aimed at comparing the applicability and competitiveness of various facies and petrophysical modeling methods. Further, well-log data was utilized to interpret unique facies and petrophysical models to better understand the reservoir architecture. Methods for facies modeling include indicator kriging, multiple-point geostatistics, surface-based method, and sequential indicator simulation. Overall, the indicator kriging method preserved the local variability and accuracy, but some facies are smoothed out. The surface-based method showed far better results by showing the ability to reproduce the geometry, extent, connectivity, and facies association. The multiple-point geostatistics (MPG) model accurately presented the facies profiles, contacts, geometry, and geomorphological features. Sequential indicator simulation (SIS) honored the facies spatial distribution and input statistical parameters. The porosity model built using sequential Gaussian simulation (SGS) showed low porosity (74% values

Hydraulic fracturing (HF) has been used for years to enhance oil and gas production from conventional and unconventional reservoirs. HF in enhanced geothermal systems (EGS) has become increasingly common in recent years. In EGS, hydraulic fracturing creates a geothermal collector in impermeable or low-permeable hot dry rocks. Artificial fracture networks in the collector allow for a continuous flow of fluid in a loop connecting at least two wells (injector and producer). However, it is challenging to assess the fracability of geothermal reservoirs for EGS. Consequently, it is necessary to design a method that considers multiple parameters when evaluating the potential of geothermal development. This study proposes an improved fracability index model (FI) based on the influences of fracability-related geomechanical and petrophysical properties. These include brittle minerals composition, fracture toughness, minimum horizontal in-situ stress, a brittleness index model, and temperature effect to quantify the rock’s fracability. The hierarchical analytic framework was designed based on the correlation between the influencing factors and rock fracability. The results of the qualitative and quantitative approaches were integrated into a mathematical evaluation model. The improved fracability index model’s reliability was evaluated using well logs and 3D seismic data on low-permeable carbonate geothermal reservoirs and shale gas horizontal wells. The results reveal that the improved FI model effectively demonstrates brittle regions in the low-permeable carbonate geothermal reservoir and long horizontal section of shale reservoir. We divide the rock fracability into three levels: FI > 0.59 (the rock fracability is good); 0.59 > FI > 0.32 (the rock fracability is medium); and FI < 0.32, (the rock fracability is poor). The improved FI model can assist in resolving the uncertainties associated with fracability interpretation in determining the optimum location of perforation clusters for hydraulic fracture initiation and propagation in enhanced geothermal systems.

This study examines the emotional dynamics of the written and oral texts of Tabligh Jama’at—respectively, Faza’il-e-A’maal (Virtues of Good Deeds) and bayan (religious sermon). In them, the study identifies emotion work—the attempt to generate certain emotions. The study discusses how the texts’ emotion work relates to Tablighi discursive ideology (framing) and also posits several emotions that the emotion work might generate. From these findings, the study offers the idea that Tablighi emotion work contributes to transforming Muslims’ emotional sphere by attaching them emotionally to ultimate religious concerns. By enchanting Muslims’ emotional sphere and attaching Muslims to Islamic social actors, values, practices, and Islamic revivalist goals, Tablighi emotion work contributes to the social transformation of individuals and society.

Sudden cardiac death (SCD) in an athlete is a rare but tragic event. In view of this, pre-participation cardiac screening is mandatory across many sporting disciplines to identify those athletes at risk. Echocardiography is a primary investigation utilized in the pre-participation setting and in 2013 the British Society of Echocardiography and Cardiac Risk in the Young produced a joint policy document providing guidance on the role of echocardiography in this setting. Recent developments in our understanding of the athlete’s heart and the application of echocardiography have prompted this 2018 update.

A cross-sectional study was carried out at the Animal Bite Management (ABM) clinic in a primary health centre in the Faridabad district of Haryana. Information about socio-demographic characteristics, animal bite exposure and pre-treatment practices was obtained. Clinical examination determined the severity of the bite. All 619 patients who reported to the ABM clinic during January 2011 to December 2012 were included. Out of the total, 38% had applied chilli-oil paste, and 4% antiseptics to the wound as pre-treatment; only 30.6% had washed the wound with water. There was a direct association between traditional pre-treatment practices and delay in seeking treatment for animal bites which was statistically significant (P = 0.01). Health education of the general population with culturally appropriate Information, Education and Communication material is therefore a necessary strategy to reduce delay in seeking appropriate treatment. [ABSTRACT FROM AUTHOR]

The online learning has broadened the teaching spectrum from Face-to-Face to virtual environment, and this move has brought traditional teacher-centered instruction to learner-centered instruction. This paradigm shift appears to place demands on faculty to modify faculty’s instruction roles that are different from those encountered in Face-to-Face teaching. This study explores the role of faculty development forum in improving the virtual teaching skills of academic staff members in an online university. The study has used single holistic case study approach, and the data from nine respondents have been collected through an interview schedule divided into four sections of 1) Basic Information, 2) Presentation Skills, 3) Subject Knowledge and 4) Research Orientation as per the objectives of the study. It can be theorized from the findings of the study that in virtual environments where faculty members lack the learning opportunities and exposure available in the conventional environments such forums prove to be very effective in capacity building of the faculty.

This article presents a q-generalized linear operator in Geometric Function Theory (GFT) and investigates its application to classes of analytic bounded functions of complex order S q ( c ; M ) and C q ( c ; M ) where 0 < q < 1 , 0 ≠ c ∈ C , and M > 1 2 . Integral inclusion of the classes related to the q-Bernardi operator is also proven.

In order to document stomatal characters which are significant in taxonomy, a detailed microscopic study on leaf epidermis of the selected taxa from Asteraceae was carried out. The plant species were Sonchus oleraceus, Bidens bipinnata, Centaurea iberica, Conyza bonariensis, Helianthus annuus, Lectuca serriola, Parthenium hysterophorus, Tagetes erecta, Cosmos sulphureus, Launaea procumbens, Zinnia elegan, Galinsoga parviflora and Conyza canadensis. All the species were amphistomatic and four types of stomata i.e., tetracytic, anomocytic, anisocytic and tricytic were recognized. Tetracytic stomatal type was dominant followed by anomocytic. Stomatal density was high on abaxial epidermis than adaxial epidermis except in Conyza bonariensis and Conyza canadensis. Highest stomatal density was in Tagetes erecta while lowest in Conyza canadensis. In lower epidermis stomatal index was higher in Sonchus oleraceus followed by Bidens bipinnata and Tagetes erecta while in upper epidermis highest index was shown by Cosmos sulphureus. Stomatal aperture and guard cell size and density were also significant features in these species.

The present study investigates the impact of social media on political efficacy and vote intention in university of Gujrat. In this study, a structured questionnaire was used to collect the data by targeting those 320 Master and B.S students who have maintained at least one personal profile on Facebook, Twitter, LinkedIn, Blogs, MySpace or any other social networking sites. These respondents were taken through using purposive sampling technique. In analytical portion, independent sample t-test, Pearson correlation, and Kendall’s tau b-c were used to test the hypothesis of current study. It is found that the majority of the respondents agreed that social media has a very strong impact in developing, modifying and changing the political affiliation and ultimately vote casting intention. Results of the present study have also highlighted that males have more political efficacy as compared to females (male=56.39 and female=52.84). However, there is no or very little impact of the family system (nucleus =55.21 and joint=54.82) and area of residence (urban=55.49 and rural=54.50) upon the political efficacy and vote casting. Moreover, it is investigated that the majority of the respondents (mean vaule is 55.56) have used their right and cast their vote in the recent elections 2013. According to Pearson Correlation and Kendall tau b-c's results, political efficacy (p-value: 0.00) is affecting vote casting status of the respondents.

The majority of expression quantitative trait locus (eQTL) studies have been carried out in single tissues or cell types, using methods that ignore information shared across tissues. Although global analysis of RNA expression in multiple tissues is now feasible, few integrated statistical frameworks for joint analysis of gene expression across tissues combined with simultaneous analysis of multiple genetic variants have been developed to date. Here, we propose Sparse Bayesian Regression models for mapping eQTLs within individual tissues and simultaneously across tissues. Testing these on a set of 2,000 genes in four tissues, we demonstrate that our methods are more powerful than traditional approaches in revealing the true complexity of the eQTL landscape at the systems-level. Highlighting the power of our method, we identified a two-eQTL model (cis/trans) for the Hopx gene that was experimentally validated and was not detected by conventional approaches. We showed common genetic regulation of gene expression across four tissues for approximately 27% of transcripts, providing >5 fold increase in eQTLs detection when compared with single tissue analyses at 5% FDR level. These findings provide a new opportunity to uncover complex genetic regulatory mechanisms controlling global gene expression while the generality of our modelling approach makes it adaptable to other model systems and humans, with broad application to analysis of multiple intermediate and whole-body phenotypes.

Introduction: Non-tobacco products (NTP) are increasingly popular as an alternative to traditional tobacco use, raising concerns about potential health risks. This systematic review and meta-analysis examine the association of NTP use with oral, esophageal, & pharyngeal cancer, and oral potentially malignant disorders (OPMD) in adults., Methods: A comprehensive electronic search was conducted in PubMed, Embase, and Google Scholar, for observational studies that evaluated the association between NTP use, and oral, esophageal, & pharyngeal cancer and OPMD, published till December 2023 in the English language. The quality of the included studies was assessed using the Newcastle-Ottawa scale. Pooled odds ratio (OR) with a 95% Confidence Interval (CI) was obtained using a random effects model, heterogeneity was assessed using I2 statistic. Sub-group analysis was conducted based on the year of publication, a comparator for association, type of NTP user, and country., Results: Forty-nine studies were included in the meta-analysis with a combined total of 1,32,390 participants, revealing a significant association between NTP use and increased risk of cancers- oral (OR:5.0, 95% CI 3.3-7.7), esophageal (OR:3.0, 95%CI 1.2-7.5), and OPMD (OR:15.3, 95%CI 8.8-26.7). The proportion of the annual burden of oral and esophageal cancers attributable to NTP was 33% (30,667 cancers), and 19% (8,025 cases) respectively in India., Conclusion: This review provides strong evidence for the association between NTP use and increased risk of oral, and esophageal cancer and OPMD. The findings highlight the need for targeted interventions, firmer regulations, and awareness campaigns addressing NTP. Incorporating NTP as a separate category in national surveys can help reduce their burden, particularly in high-risk populations.

Aims: Given the high prevalence of oral health problems among prisoners, the goal of this systematic review is to provide a better knowledge of the scope of this problem., Methods: Electronic searches of PubMed/MEDLINE, Embase, Scopus, and Google Scholar were performed. Studies that investigated inmates aged 18 or older with oral health problems were eligible. Variables reported in four or less studies were described narratively. Conversely, for variables reported in more than four studies, a meta-analysis was performed using random effect model. Furthermore, meta-regression and sensitivity analysis is also performed to evaluate moderator effect on outcome. Doi and LFT index is applied to assess publication bias., Results: Out of 494 results, 12 studies were included. The pooled prevalence of caries among prisoners is 78.42% (59.48%-92.58%). On meta-regression, the prevalence of caries appears to be lower in studies with a higher male percentage; however, non-significant (p = .079) due to small sample size. Community periodontal index (CPI) scores revealed periodontal disease, with scores of 3 and 4. Moreover, a significant need for oral hygiene instruction, prosthesis, extraction, and tooth ache, periodontal disease, oral mucosal lesions, leucoplakia, attrition, abrasion, bruxism, and smoking behaviors were also reported., Conclusion: Poor oral health status in the incarcerated population highlights the urgent need for comprehensive oral health intervention in prisons., (© 2024 Special Care Dentistry Association and Wiley Periodicals LLC.)

Background: Oral cancer screening reduces mortality associated with oral cancer. The current study evaluated the cost-effectiveness of commonly used screening techniques, namely conventional oral examination (COE), toluidine blue staining (TBS), oral cytology (OC), and light-based detection (LBD) in the Indian scenario., Methods: The study used a Markov modelling approach to estimate the cost and health outcomes of four different approaches (COE, TBS, OC, and LBD) for screening oral cancer over time from a societal perspective. The discount rate was assumed as 3%. The outcomes estimated were oral cancer incident cases, deaths averted, and quality-adjusted life years (QALYs). To address the high burden of risk factors (tobacco and/or alcohol) in India, two Markov models were developed: Model A adopted a mass-screening strategy, whereas Model B adopted a high-risk screening strategy versus no screening. Probabilistic sensitivity analysis (PSA) was undertaken to address any parameter uncertainty., Findings: Mass-screening using LBD at three years had the least incident cases (3271.68) and averted the maximum number of oral cancer deaths (459.76). High-risk screening using COE at ten years interval incurred the least lifetime cost of 2,292,816.21 US$ (182,794,468.26 INR). The high-risk strategies (US$/QALY), namely COE 5 years (-29.21), COE 10 years (-90.68), TBS 10 years (-60.54), and LBD 10 years (-13.51), were dominant over no-screening., Interpretation: The most cost-saving approach was the conventional oral examination at an interval of 10 years for oral screening in high-risk populations above 30 years of age., Funding: Department of Health Research, Ministry of Health & Family Welfare, Government of India., Competing Interests: None. The current study was supported by funding from Department of Health Research, Ministry of Health & Family Welfare, Government of India., (© 2023 The Author(s).)

Background: Oral cancer screening strategies help reduce associated mortality and could be performed by a trained frontline health worker (FHW). The present review aims to assess the diagnostic accuracy of commonly used screening modalities for oral cancer performed by FHW in apparently healthy individuals., Methods: Electronic databases PubMed, Scopus, Embase, Cochrane Library, and Google Scholar, were searched. The review included studies conducted where apparently healthy adult individuals were screened by the FHW for cancer or PMD of the lip and oral cavity by any of the four commonly used techniques - Conventional Oral Examination (COE), toluidine blue staining (TBS), Oral Cytology (OC), and Chemiluminescent Illumination (CLI)., Findings: A total of 2,413 potentially relevant articles were retrieved from the search, among which five studies for COE were included in the review. Four out of those five studies were done before the year 2000. None of the studies fitted the inclusion criteria for TBS, OC, and CLI. Pooled sensitivity of oral screening by COE performed by an FHW (n=5) was 88.8% (95% CI: 71.6-96.1), whereas pooled specificity was 91.9% (95% CI: 78.3-97.3). On subgroup analysis, the pooled sensitivity and specificity of studies where the prevalence of disease was <50% (n=4) was 84.5% (95% CI: 62.6 - 94.7) and 94.1% (95% CI: 82.2 - 98.2), respectively., Interpretation: COE by trained FHW had high pooled sensitivity and specificity for screening of oral cancer and PMDs. The screening techniques TBS, OC, and CLI, were not studied for mass screening by trained FHW. COE by trained FHW could be utilized for oral screening in limited-resource settings. However, the FHW should be sufficiently trained to get the desired benefits of early detection., Funding: Department of Health Research, Ministry of Health & Family Welfare, Government of India.

Background: In the ongoing COVID-19 pandemic, an increased incidence of ROCM was noted in India among those infected with COVID. We determined risk factors for rhino-orbito-cerebral mucormycosis (ROCM) post Coronavirus disease 2019 (COVID-19) among those never and ever hospitalized for COVID-19 separately through a multicentric, hospital-based, unmatched case-control study across India., Methods: We defined cases and controls as those with and without post-COVID ROCM, respectively. We compared their socio-demographics, co-morbidities, steroid use, glycaemic status, and practices. We calculated crude and adjusted odds ratio (AOR) with 95% confidence intervals (CI) through logistic regression. The covariates with a p-value for crude OR of less than 0·20 were considered for the regression model., Results: Among hospitalised, we recruited 267 cases and 256 controls and 116 cases and 231 controls among never hospitalised. Risk factors (AOR; 95% CI) for post-COVID ROCM among the hospitalised were age 45-59 years (2·1; 1·4 to 3·1), having diabetes mellitus (4·9; 3·4 to 7·1), elevated plasma glucose (6·4; 2·4 to 17·2), steroid use (3·2; 2 to 5·2) and frequent nasal washing (4·8; 1·4 to 17). Among those never hospitalised, age ≥ 60 years (6·6; 3·3 to 13·3), having diabetes mellitus (6·7; 3·8 to 11·6), elevated plasma glucose (13·7; 2·2 to 84), steroid use (9·8; 5·8 to 16·6), and cloth facemask use (2·6; 1·5 to 4·5) were associated with increased risk of post-COVID ROCM., Conclusions: Hyperglycemia, irrespective of having diabetes mellitus and steroid use, was associated with an increased risk of ROCM independent of COVID-19 hospitalisation. Rational steroid usage and glucose monitoring may reduce the risk of post-COVID., Competing Interests: The authors have declared that no competing interests exist.

This paper assesses the mechanical and structural behavior of self-consolidating lightweight concrete (SCLWC) incorporating bloated shale aggregate (BSA). BSA was manufactured by expanding shale pellets of varying sizes by heating them up to a temperature of 1200 °C using natural gas as fuel in the rotary kiln. Fly ash (FA) and limestone powder (LSP) were used as supplementary cementing materials (10% replacement of cement, each for LSP and FA) for improved properties of the resulting concrete. The main parameters studied in this experimental study were compressive strength, elastic modulus, and microstructure. The fresh-state properties (Slump flow, V-funnel, J-Ring, and L-box) showed adequate rheological behavior of SCLWC in comparison with self-consolidating normal weight concrete (SCNWC). There was meager (2-4%) compressive strength reduction of SCLWC. Lightweight aggregate tended to shift concrete behavior from ductile to brittle, causing reduced strain capacity and flexural toughness. FA and LSP addition significantly improved the strength and microstructure at all ages. The study is encouraging for the structural use of lightweight concrete, which could reduce the overall construction cost.

Objective: The aim of this study was to review literature on the effects of herbal dentifrice compared to conventional dentifrice on plaque and gingival inflammation., Materials and Methods: MEDLINE, Cochrane Central Register of Controlled Trials, and major journals were explored for studies up to September 30, 2017. A comprehensive search was designed and the articles were independently screened for eligibility by two reviewers. Randomized controlled clinical trials, in which oral prophylaxis was undertaken before the intervention was introduced into the oral cavity using toothbrush were included. Where appropriate, a meta-analysis (MA) was performed and standardized mean differences (SMDs) were calculated., Results: Ten articles out of 1378 titles were found to meet the eligibility criteria. A MA showed that for plaque intervention the SMD was 2.14; 95% confidence interval (CI): 0.88-3.41, P = 0.0009; test for heterogeneity: P < 0.00001, I 2 = 96% in favor of conventional dentifrice; and for gingival inflammation, the SMD was 1.37; 95% CI: 0.49-2.26, P = 0.002; test for heterogeneity: P < 0.00001, I 2 = 94% which also was in favor of conventional dentifrice. Subgroup analysis for plaque intervention and gingival inflammation in case of long-term (more than 4 weeks and up to 6 months) and short-term effects (minimum of 4 weeks) of herbal dentifrice showed no difference when compared to conventional dentifrice., Conclusion: Currently, there is no high-quality evidence to support or abnegate the anti-plaque and anti-gingivitis effects of the herbal dentifrice., Competing Interests: There are no conflicts of interest.

Objectives: The purpose of this study was to conduct a systematic review and if appropriate a meta-analysis of the efficacy of daily rinsing with green tea-based mouthwashes in terms of plaque index (PI) and/or gingival index (GI) as compared to other mouthwashes in plaque-induced gingivitis patients., Materials and Methods: MEDLINE, Cochrane Central Register of Controlled Trials, IndMed, Google Scholar, and major journals were searched for studies up to December 2016. A comprehensive search strategy was designed, and the eligible articles were independently screened for eligibility by two reviewers. Randomized controlled trials in which individuals were intervened with oral mouthwashes of interest were included. Where appropriate, a meta-analysis was performed and standardized mean differences (SMDs) for GI and PI were calculated., Results: A total of 9 articles out of the 311 titles met the eligibility criteria. A meta-analysis was performed for five studies that compared green tea-based mouthwashes with chlorhexidine (CHX). The SMD for PI was -0.14 (95% CI: -1.70, 1.43; P = 0.86 and I 2 = 94%), while that for GI was 0.43 ((95% CI: -0.63, 1.49; P = 0.43, I 2 = 89%). Both these estimates suffered from significant heterogeneity. For both PI and GI, two studies were in favor of green tea while three studies were in favor of CHX., Conclusions: Green tea-based mouthwashes can be considered an alternative to CHX mouthwashes in sustaining oral hygiene, especially because of the added advantages provided by such herbal preparations., Competing Interests: There are no conflicts of interest

Background: Major Depressive Disorder (MDD) is a broad heterogeneous construct resolving into several symptom-clusters by factor analysis. The aim was to find the factor structures of MDD as per Montgomery and Asberg Depression Rating Scale (MADRS) and whether they predict escitalopram response., Methods: In a longitudinal study at a tertiary institute in north India, 116 adult out-patients with non-psychotic unipolar MDD were assessed with MADRS before and after treatment with escitalopram (10-20mg) over 6-8 weeks for drug response., Results: For total 116 patients pre-treatment four factor structures of MADRS extracted by principal component analysis with varimax rotation altogether explained a variance of 57%: first factor 'detachment' (concentration difficulty, lassitude, inability to feel); second factor 'psychic anxiety' (suicidal thoughts and inner tension); third 'mood-pessimism' (apparent sadness, reported sadness, pessimistic thoughts) and fourth 'vegetative' (decreased sleep, appetite). Eighty patients (68.9%) who completed the study had mean age 35.37±10.9 yrs, majority were male (57.5%), with mean pre-treatment MADRS score 28.77±5.18 and majority (65%) having moderate severity (MADRS <30). Among them 56 (70%) responded to escitalopram. At the end of the treatment there were significant changes in all the 4 factor structures (p<0.01). Vegetative function was an important predictor of response (p<0.01, odd's ratio: 1.3 [1.1-1.6] 95% CI). Melancholia significantly predicted non-response (p=0.04)., Conclusions: Non-psychotic unipolar major depression having moderate severity in north Indian patients as per MADRS resolved into four factor-structures all significantly improved with adequate escitalopram treatment. Understanding the factor structure is important as they can be important predictor of escitalopram response., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Objectives: To compare pulse oximetry and Ankle-Brachial Index (ABI) with duplex ultrasonography as reference standard to determine the diagnostic accuracy for screening asymptomatic PVD in type 2 diabetes mellitus., Methods: This cross-sectional study was conducted in 2012 at tertiary hospital in Madurai among diabetic patients attending the medicine outpatient department (OPD). Type 2 Diabetes Mellitus patients, asymptomatic with regards to symptoms and signs of PVD, aged above 40 years were included. Pulse Oximetry was performed using a pulse oximeter and ABI using sphygmomanometer cuffs and duplex ultrasonography of femoral, popliteal, tibial, posterior tibial and dorsalis pedis arteries. A diagnosis of PVD was based on: monophasic waveforms in any artery by duplex ultrasonography, toe saturation being less than finger saturation by >2% or if foot saturation decreased by >2% in an elevated position and an ABI <0.9., Results: Among 120 patients included in the study, prevalence of PVD was 22.5% (95% CI: 15.9, 30.8). The PVD group had a higher proportion of elderly, males, current smokers, long-standing diabetics and comorbidities. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of pulse oximetry were 74.1% (95% CI: 55.3, 86.8), 95.7% (89.4, 98.3), 83.3% (64.1, 93.3) and 92.7% (85.7, 96.4) respectively, while those of ABI were 70.3% (51.5, 84.2), 87.1 (78.8, 92.5), 61.3% (43.8, 76.3) and 91.0% (83.3, 95.4) respectively. Parallel testing had net sensitivity increased to 92.3% and net specificity decreased to 83.3%. Performances did not differ across the subgroups., Conclusions: Pulse oximetry was atleast as good as ABI for the screening for asymptomatic PVD among diabetics.

Introduction: Disorders of menstruation are common problems among women. They have several psychological effects on women's health., Aim: This study aimed to estimate prevalence of menstrual disorders, usage of sanitary pads and their determinants among married women in selected villages of rural Haryana., Materials and Methods: A cross-sectional study was conducted during September 2011 in 10 villages of PHC (Primary Health Centre) Mandi, Haryana, using a systematic random sampling technique. Currently married women in the age group of 18-45 years living in study area for more than 1 year were included in the study while those who were pregnant and unable to understand questions were excluded. Informed verbal consent was obtained from all participants., Results: A total of 344 women were interviewed. The mean (SD) age of participants was 28.0 (5.4) years. Majority of women were housewives (78.8%) and most had education up to middle school (22.7%). Mean (SD) age at menarche was 14.3 (1.2) years. Nearly one-tenth of women had married before 18 years of age. Prevalence of all menstrual disorders was 20.3% and most common disorder was excessive pain. About one fifth reported irregularity of menstrual cycles. Almost half were not using sanitary pads during menses. Menstrual disorders were more common among non-users of contraception (OR=1.7, p = 0.04) and housewives (OR = 2.4, p= 0.03)., Conclusion: Disorders of menstruation were fairly common among women surveyed. Usage of sanitary pads was quiet low. Awareness generation among women regarding menstrual problems and Behaviour Change Communication to promote usage of sanitary pads are important measures to reduce related morbidity.

Context: About 490 million cases of curable Reproductive Tract Infections (RTI) occur throughout the world, of which 79 million cases occur in India annually. Sexually Transmitted Infections/Reproductive Tract Infections (STI/RTI) confers a huge economic burden on the individual and the health system. Complications of RTI/STI are many, ranging from chronic pain syndrome to infertility. Most of these complications can be prevented by early diagnosis and treatment., Aims: To assess knowledge, attitude and practices on STI/RTIs among married women aged 15-45 years in rural Haryana., Setting and Design: Cross-sectional study, conducted in selected villages under the primary health centre Mandi, Sonepat, Haryana., Subjects and Methods: Systematic sampling was used to cover 10 villages. In each village, every tenth house was sampled, taking first house from the center of the village. Face-to-face interview was conducted using pretested questionnaire., Statistical Analysis Used: Descriptive statistics and results were described in percentages., Results: A total of 344 women were interviewed. About 44% women had never heard of STI/RTI. The prevalence of self-reported symptoms of STI/RTI was very high (60%). Only 40% of them opted for treatment and most common cause for not opting for treatment was that they considered it as a minor problem. Advice for use of condom during the treatment was received by only 20% of patients and only 26.5% of their husbands also received treatment., Conclusions: Overall knowledge, attitude and practices relating to STI/RTI among married women in rural Haryana was poor. The prevalence of self-reported STI/RTI was found to be high and treatment seeking behavior was poor.

Background: Household air pollution (HAP) due to biomass cooking fuel use is an important risk factor for a range of diseases, especially among adult women who are primary cooks, in India. About 80% of rural households in India use biomass fuel for cooking. The aim of this study is to estimate the attributable cases (AC) for four major diseases/conditions associated with biomass cooking fuel use among adult Indian women., Methods: We used the population attributable fraction (PAF) method to calculate the AC of chronic bronchitis, tuberculosis (TB), cataract, and stillbirths due to exposure to biomass cooking fuel. A number of data sources were accessed to obtain population totals and disease prevalence rates. A meta-analysis was conducted to obtain adjusted pooled odds ratios (ORs) for strength of association. Using this, PAF and AC were calculated using a standard formula. Results were presented as number of AC and 95% confidence intervals (CI)., Results: The fixed effects pooled OR obtained from the meta-analysis were 2.37 (95% CI: 1.59, 3.54) for chronic bronchitis, 2.33 (1.65, 3.28) for TB, 2.16 (1.42, 3.26) for cataract, and 1.26 (1.12, 1.43) for stillbirths. PAF varied across conditions being maximum (53%) for chronic bronchitis in rural areas and least (1%) for cataract in older age and urban areas. About 2.4 (95% CI: 1.4, 3.1) of 5.6 m cases of chronic bronchitis, 0.3 (0.2, 0.4) of 0.76 m cases of TB, 5.0 (2.8, 6.7) of 51.4 m cases of cataract among adult Indian women and 0.02 (0.01, 0.03) of 0.15 m stillbirths across India are attributable to HAP due to biomass cooking fuel. These estimates should be cautiously interpreted in the light of limitations discussed which relate to exposure assessment, exposure characterization, and age-specific prevalence of disease., Conclusions: HAP due to biomass fuel has diverse and major impacts on women's health in India. Although challenging, incorporating the agenda of universal clean fuel access or cleaner technology within the broader framework of rural development will go a long way in reducing disease burden.