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Abstract The 2,2,2-trifluoroethoxy group increasingly features in drugs and potential tracers for biomedical imaging with positron emission tomography (PET). Herein, we describe a rapid and transition metal-free conversion of fluoroform with paraformaldehyde into highly reactive potassium 2,2,2-trifluoroethoxide (CF3CH2OK) and demonstrate robust applications of this synthon in one-pot, two-stage 2,2,2-trifluoroethoxylations of both aromatic and aliphatic precursors. Moreover, we show that these transformations translate easily to fluoroform that has been labeled with either carbon-11 (t 1/2 = 20.4 min) or fluorine-18 (t 1/2 = 109.8 min), so allowing the appendage of complex molecules with a no-carrier-added 11C- or 18F- 2,2,2-trifluoroethoxy group. This provides scope to create candidate PET tracers with radioactive and metabolically stable 2,2,2-trifluoroethoxy moieties. We also exemplify syntheses of isotopologues of potassium 2,2,2-trifluoroethoxide and show their utility for stable isotopic labeling which can be of further benefit for drug discovery and development.

Abstract Background Being older and having a migrant feature might cause a double risk of vulnerability in poor economic, social support, and health status at the place of destination. This study examines the association of migration on the social support and economic condition of older persons in India. Methods Longitudinal Ageing Study in India (LASI) wave-I (2017–2018) data with total samples of 66,156 older adults aged 45 + with 30,869 and 35,287 male and female samples, respectively, used in this study. Descriptive and bivariate analyses have been performed to examine the pattern of older migrants, and multinomial logistic regression analysis has been used to establish the associations between migration, social support, and economic condition. Results Over half (57.5%) of the population aged 45 + in India had migrant characteristics; 80% migrated before 25 years. Of all migrants, about 90% migrated within one state (Intrastate), and 9% migrated to another (Interstate). The association between social support and migration by distance and the adjusted result showed that immigrants were less likely to have medium [RRR = 0.56 (CI; 0.46–0.68)] and high [RRR = 0.39 (CI; 0.30–0.50)] social support. The interstate migrants were also less likely to have high [RRR = 0.90 (CI; 0.83–0.98)] social support. The migrants with 0–9 years of duration were less likely to have high social support, and the urban to rural stream migrants were more likely to have high social support. The association between economic status and migration by distance and the adjusted result showed that more affluent immigrants were likelier to have [RRR = 1.41 (CI; 1.14–1.73)] better economic conditions than affluent non-migrants. Migrants with 0–9-year duration and urban to rural stream were found to be likelier to have better economic conditions. Conclusions The findings of this study suggest that distance, duration, and migration stream have a significant association with social support and economic conditions in later life. In exploring migration’s effect on social and economic status, policymakers should prioritize migrants in their agenda to maintain socio-economic and social support for older persons in India to achieve the sustainable goal of active and healthy ageing.

Rectal foreign bodies require careful diagnosis amid patient embarrassment. Timely assessment is crucial to manage complications. Removal methods vary, including trans-anal, endoscopic, or surgical approaches. Our case highlights successful trans-anal extraction of health faucet from rectum, emphasizing the need for sensitive and efficient management.

Abstract Background Oil bodies or lipid droplets (LDs) in the cytosol are the subcellular storage compartments of seeds and the sites of lipid metabolism providing energy to the germinating seeds. Major LD-associated proteins are lipoxygenases, phospholipaseD, oleosins, TAG-lipases, steroleosins, caleosins and SEIPINs; involved in facilitating germination and enhancing peroxidation resulting in off-flavours. However, how natural selection is balancing contradictory processes in lipid-rich seeds remains evasive. The present study was aimed at the prediction of selection signatures among orthologous clades in major oilseeds and the correlation of selection effect with gene expression. Results The LD-associated genes from the major oil-bearing crops were analyzed to predict natural selection signatures in phylogenetically close-knit ortholog clusters to understand adaptive evolution. Positive selection was the major force driving the evolution and diversification of orthologs in a lineage-specific manner. Significant positive selection effects were found in 94 genes particularly in oleosin and TAG-lipases, purifying with excess of non-synonymous substitution in 44 genes while 35 genes were neutral to selection effects. No significant selection impact was noticed in Brassicaceae as against LOX genes of oil palm. A heavy load of deleterious mutations affecting selection signatures was detected in T-lineage oleosins and LOX genes of Arachis hypogaea. The T-lineage oleosin genes were involved in mainly anther, tapetum and anther wall morphogenesis. In Ricinus communis and Sesamum indicum > 85% of PLD genes were under selection whereas selection pressures were low in Brassica juncea and Helianthus annuus. Steroleosin, caleosin and SEIPINs with large roles in lipid droplet organization expressed mostly in seeds and were under considerable positive selection pressures. Expression divergence was evident among paralogs and homeologs with one gene attaining functional superiority compared to the other. The LOX gene Glyma.13g347500 associated with off-flavor was not expressed during germination, rather its paralog Glyma.13g347600 showed expression in Glycine max. PLD-α genes were expressed on all the tissues except the seed,δ genes in seed and meristem while β and γ genes expressed in the leaf. Conclusions The genes involved in seed germination and lipid metabolism were under strong positive selection, although species differences were discernable. The present study identifies suitable candidate genes enhancing seed oil content and germination wherein directional selection can become more fruitful.

Abstract Background Presently, the proper disposal of E-waste is a major challenge for all nations. Portland cement and aggregates continue to play a major role in the construction industry's operations. Meanwhile, natural resources like gravel (aggregates) are becoming scarce. Thus, E-waste is now offering the building industry a chance to replace traditional aggregates. The main goal of the current study is to determine the highest amount of E-waste that may be replaced with 10-mm coarse aggregates with a nano-silica associated ternary blend in M-60 grade high-strength concrete while still maintaining the designed concrete's mechanical, durability, microstructural and workability characteristics. Results When compared to normal concrete, concrete with 15% E-waste replacement maintained the design-required compressive, flexural and tensile strength properties. When the E-waste plastic component percentage is considerably high (15–30%), there is a significant decremental performance regarding the mechanical properties and the decremental rate is found to be in the range of 13–23%. Even the microstructure characteristics of concrete validate the mechanical performance of concrete. Nevertheless, the durability characteristics of E-waste incorporated concrete were found to be promising. Conclusions The overall outcome of the study recommends 15% as the optimal replacement percentage of E-waste for conventional concrete, and it is recommended to adopt for real-time practices.

Abstract Background Cardiac troponin is commonly raised in patients presenting with malignancy. The prognostic significance of raised troponin in these patients is unclear. Objectives We sought to investigate the relation between troponin and mortality in a large, well characterised cohort of patients with a routinely measured troponin and a primary diagnosis of malignancy. Methods We used the National Institute for Health Research (NIHR) Health Informatics Collaborative data of 5571 patients, who had troponin levels measured at 5 UK cardiac centres between 2010 and 2017 and had a primary diagnosis of malignancy. Patients were classified into solid tumour or haematological malignancy subgroups. Peak troponin levels were standardised as a multiple of each laboratory’s 99th -percentile upper limit of normal (xULN). Results 4649 patients were diagnosed with solid tumours and 922 patients with haematological malignancies. Raised troponin was an independent predictor of mortality in all patients (Troponin > 10 vs.

Introduction: Skin adnexal neoplasms are quite rare in routine pathology practice, yet the domain of Fine Needle Aspiration Cytology (FNAC) remains relatively unexplored. This current study explored different Adnexal Tumours (ATs) through FNAC, emphasising the efficacy of cytological diagnosis as a safe, simple, quick, and cost-effective tool with high sensitivity and specificity for diagnosing skin ATs. Aim: To diagnose various appendageal tumours through cytological examination, confirm and categorise them (benign/malignant) via histopathological examination, and identify any cytohistological discrepancies. Materials and Methods: This retrospective cross-sectional study was conducted over a five-year period (January 2016-December 2021) at the Department of Pathology, Nil Ratan Sircar Medical College and Hospital (NRSMCH) in Kolkata, West Bengal, India, following ethical approval. Patients underwent history and physical examination followed by FNAC. ATs were diagnosed cytologically in 78 out of 23,852 FNAC cases. The results were compared with histopathological diagnosis to assess concordance or discordance based on predefined criteria. Leishman-Giemsa (L&G) stain was used for cytological examination, and Haematoxylin and Eosin (H&E) stain for histopathology. Results: Cytologically, ATs were diagnosed in 78 cases (0.33%), with the majority being benign 69 (88.46%). There was a female preponderance (49, 62.82%) with a male-to-female ratio of 1:1.7. Nodular Hidradenoma (NH) was the most common diagnosis (16/48=33.33%). Out of 59 biopsy-confirmed lesions, 55 showed cytohistological concordance (93.22%), with only four discordant cases (6.78%). The sensitivity, specificity, positive predictive value, and negative predictive value for detecting malignancy in this series were 70%, 97.90%, 87.50%, and 94.10%, respectively. Conclusion: FNAC should be the primary choice for detecting skin ATs due to its safety, reliability, high predictive value, and low chance of discordance. Although occasional cytohistological discrepancies may occur, proper clinical correlation, aspiration from multiple sites, expert cytopathologists, and high-quality staining are essential to avoid misdiagnosis.

A 50-year-old male patient with cardiomyopathy (New York Heart Association Class IV, left ventricle ejection fraction of 15%, left bundle branch block, intermittent supraventricular tachycardia, tricuspid regurgitation, and mitral regurgitation) was qualified for a cardiac resynchronization therapy with defibrillator (CRT-D) procedure. CRT-D has become an integral part of systolic heart failure therapy. It can minimize rehospitalization, improve the exercise capacity and well-being of the patient, and potentially decrease mortality. After the CRT-D implantation, electrocardiographic changes were found to be reverted. No hospitalization was reported at 2-year follow-up. The patient survived and regained his quality of life.

Context: The Chandigarh Noncommunicable Disease (NCD) Registry was set up in 2018 to assess the burden of major NCDs and inform the planning of public health and clinical interventions. Aim: The aim of the present study was to assess the burden of NCDs in Chandigarh. Settings and Design: The cross-sectional study design includes data from government and private facilities, pathology laboratories, birth, and death registrar offices catering to urban and rural Chandigarh. Subjects and Methods: It collects data of young diabetes, stroke, acute cardiac events, aplastic anemia, and cancer patients using a structured questionnaire. Statistical Analysis Used: The study reports a descriptive analysis of case distribution, done using SPSS version 23. MS Excel 2016 was used to produce graphical illustrations and calculate age-adjusted rates using the world standard population. Results: During July 2018–December 2019, 3721 (incident and death) cases were recorded for cancer (n = 2414, 64.9%), acute cardiac events (n = 1034, 27.8%), stroke (n = 231, 6.2%), young diabetes (n = 28, 0.8%), and aplastic anemia (n = 14, 0.4%). The age-adjusted incidence and mortality rates (per 100,000 population) were calculated for cancer (males: 102.6 and 62.0; females: 100.8 and 52.9), acute cardiac events (males: 47.1; females: 21.7 and 28.8), and stroke (males: 7.5 and 8.5; females: 13.1 and 21.8). Study participants were exposed to tobacco and alcohol consumption. Positive family history was reported by 40% of the registered patients. Conclusions: An integrated model of the NCD registry is feasible and can yield evidence in low-resource settings for secondary prevention to achieve global targets for reducing risk factors and premature mortality due to NCDs.

Background: Goals of anesthesia in neurosurgery include stable cerebral hemodynamics and provide relaxed brain to surgeon. Dexmedetomidine and lignocaine as an adjuvant can fulfill these criteria but literature comparing the two are sparse. We compared the effects of intravenous infusion of dexmedetomidine or lignocaine on stress response, postoperative pain, and recovery in patients undergoing craniotomy for intracranial tumors. Methods: Approval was obtained from IEC, and the study was prospectively registered (CTRI/2022/11/047434). Written and informed consent was obtained from 105 patients fulfilling inclusion criteria, and they were divided into three groups. Group D received intravenous infusion of dexmedetomidine 1 mcg/kg over 15 minutes followed by infusion at rate of 0.5 mcg/kg/h, Group L received intravenous infusion of lignocaine 2 mg/kg over 15 minutes followed by infusion at rate of 1.5 mg/kg/h, and Group N received intravenous infusion of normal saline at the rate of 4–8 ml/h till skin suturing. SPSS v23 (IBM Corp.) was used for data analysis. Results: There was a significant difference between groups in terms of intraoperative hemodynamic variations, brain relaxation score, extubation criteria, postoperative pain, stress indicator response, and quality of recovery. Conclusions: Dexmedetomidine as an adjuvant to anesthetic drugs has a better profile than lignocaine in suppressing stress response and preventing hemodynamic variations at intubation, skull pin application, and surgical incision. Dexmedetomidine increases the duration of effective analgesia more than lignocaine, in postoperative period in patients undergoing craniotomy.

This study demonstrates the development of a unique hybrid thermoplastic composite using reduced Graphene oxide (rGO) content and Zirconia (ZrO2) nanoparticles into the Ultra-High Molecular Weight Polyethylene (UHMWPE) biomaterials for continuous loading conditions. Specimens with different loadings of rGO (0 to 1.5 wt.%) and ZrO2 (5 to 10 wt.%) were fabricated using liquid phase ultrasonication followed by the hot press moulding method. The samples were analyzed using Thermogravimetric Analysis (TGA), Impact (Izod) testing, and Dynamic Mechanical Analysis (DMA). The developed material feasibility was assessed using Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray (EDX) analyses. The findings revealed that the 1 wt.% rGO/5 wt.% ZrO2/UHMWPE sample improved the storage modulus by 66.15%, and the Impact absorbed energy by 11.33% compared to the pristine UHMWPE. The proposed nanocomposite could be endorsed for artificial joints, prostheses, and other Artificial Bio-Bearing (ABB) applications.

Abstract Low concentrations of circulating 25-hydroxy-vitamin D are observationally associated with an increased risk of subclinical atherosclerosis and cardiovascular disease. However, randomized controlled trials have not reported the beneficial effects of vitamin D supplementation on atherosclerotic cardiovascular disease (ASCVD) outcomes. Whether genetically predicted vitamin D status confers protection against the development of carotid artery plaque, a powerful predictor of subclinical atherosclerosis, remains unknown. We conducted a two-sample Mendelian randomization (MR) study to explore the association of genetically predicted vitamin D status and deficiency with the risk of developing carotid artery plaque. We leveraged three genome-wide association studies (GWAS) of vitamin D status and one GWAS of vitamin D deficiency. We used the inverse-variance weighted (IVW) approach as our main method, and MR-Egger, weighted-median, and radialMR as MR sensitivity analyses. We also conducted sensitivity analyses using biologically plausible genetic instruments located within genes encoding for vitamin D metabolism (GC, CYP2R1, DHCR7, CYP24A1). We did not find significant associations between genetically predicted vitamin D status (Odds ratio (OR) = 0.99, P = 0.91) and deficiency (OR = 1.00, P = 0.97) with the risk of carotid artery plaque. We additionally explored the potential causal effect of vitamin D status on coronary artery calcification (CAC) and carotid intima-media thickness (cIMT), two additional markers of subclinical atherosclerosis, and we did not find any significant association (βCAC = − 0.14, P = 0.23; βcIMT = 0.005, P = 0.19). These findings did not support the causal effects of vitamin D status and deficiency on the risk of developing subclinical atherosclerosis.

Abstract Centrin1 gene deleted Leishmania donovani parasite (LdCen1 −/− ) was developed and extensively tested experimentally as an intracellular stage-specific attenuated and immunoprotective live parasite vaccine candidate ex vivo using human PBMCs and in vivo in animals. Here we report manufacturing and pre-clinical evaluation of current Good-Laboratory Practice (cGLP) grade LdCen1 −/− parasites, as a prerequisite before proceeding with clinical trials. We screened three batches of LdCen1 −/− parasites manufactured in bioreactors under cGLP conditions, for their consistency in genetic stability, attenuation, and safety. One such batch was preclinically tested using human PBMCs and animals (hamsters and dogs) for its safety and protective immunogenicity. The immunogenicity of the CGLP grade LdCen1 −/− parasites was similar to one grown under laboratory conditions. The cGLP grade LdCen1 −/− parasites were found to be safe and non-toxic in hamsters and dogs even at 3 times the anticipated vaccine dose. When PBMCs from healed visceral leishmaniasis (VL) cases were infected with cGLP LdCen1 −/− , there was a significant increase in the stimulation of cytokines that contribute to protective responses against VL. This effect, measured by multiplex ELISA, was greater than that observed in PBMCs from healthy individuals. These results suggest that cGLP grade LdCen1 −/− manufactured under cGMP complaint conditions can be suitable for future clinical trials.

Abstract Background The escalating trend of obesity in Malaysia is surmounting, and the lack of evidence on the environmental influence on obesity is untenable. Obesogenic environmental factors often emerge as a result of shared environmental, demographic, or cultural effects among neighbouring regions that impact lifestyle. Employing spatial clustering can effectively elucidate the geographical distribution of obesity and pinpoint regions with potential obesogenic environments, thereby informing public health interventions and further exploration on the local environments. This study aimed to determine the spatial clustering of body mass index (BMI) among adults in Malaysia. Method This study utilized information of respondents aged 18 to 59 years old from the National Health and Morbidity Survey (NHMS) 2014 and 2015 at Peninsular Malaysia and East Malaysia. Fast food restaurant proximity, district population density, and district median household income were determined from other sources. The analysis was conducted for total respondents and stratified by sex. Multilevel regression was used to produce the BMI estimates on a set of variables, adjusted for data clustering at enumeration blocks. Global Moran’s I and Local Indicator of Spatial Association statistics were applied to assess the general clustering and location of spatial clusters of BMI, respectively using point locations of respondents and spatial weights of 8 km Euclidean radius or 5 nearest neighbours. Results Spatial clustering of BMI independent of individual sociodemographic was significant (p

Abstract Background In a sedated patient, airway compression by a large mediastinal mass can cause acute fatal cardiopulmonary arrest. Extracorporeal membrane oxygenation (ECMO) has been investigated to protect the airway and provided cardiopulmonary stability. The use of ECMO in the management of mediastinal masses was reported, however, the management complicated by cardiopulmonary arrest is poorly documented. Case presentation 32-year-old female presented with acute onset of left arm swelling and subacute onset of dry cough. Further investigation showed a deep venous thrombosis in left upper extremity as well as a large mediastinal mass. She underwent mediastinoscopy with biopsy of the mass which was complicated by cardiopulmonary arrest secondary to airway obstruction by the mediastinal mass. Venoarterial ECMO was initiated, while concurrently treating with a chemotherapy. The mediastinal mass responded to the chemotherapy and reduced in size during 2 days of ECMO support. She was extubated successfully and decannulated after 2 days of ECMO and discharged later. Conclusions Extracorporeal membrane oxygenation can serve as a viable strategy to facilitate cardiopulmonary support while concurrently treating the tumor with chemotherapy, ultimately allowing for the recovery of cardiopulmonary function, and achieving satisfactory outcomes.

Sarcoidosis is a multifaceted and multisystemic inflammatory disorder, the etiology of which remains unknown. However, it has been suggested that an intricate interplay between genetic, environmental, and inflammatory factors may contribute to the development and progression of sarcoidosis. Although 30–50% of patients demonstrate extra-pulmonary manifestations, cardiac involvement is rare, affecting only 2–5% of cases. Diagnosis is often challenging, relying on the careful application of clinical judgment, histopathological evidence, and imaging biomarkers. In this literature review, we aim to provide a comprehensive overview of the current understanding of the genetic basis of sarcoidosis, the contribution to the pathogenesis of the disorder, and discuss the potential link between certain genetic variants and the development of cardiac sarcoidosis.

Abstract The purpose of this study is to understand the impact of community mobilization initiatives on citizens’ health-seeking behavior through the lens of COVID-19 vaccination in the state of Madhya Pradesh, India. This study follows a case study approach to understand community mobilization initiatives that led to increased COVID-19 vaccination uptake. The study delineates the process to increase community mobilization to improve the uptake of COVID-19 vaccination. It highlights the key components of community mobilization that were adopted: the involvement of local leadership (at district, block, and village level), support of vaccination/mobilizer team, the role of in-person communication, involvement of influential community heads and social workers, localized strategies and IEC materials, and support from the state administration. Additionally, the key communication themes that played a crucial role in increasing COVID-19 vaccination coverage are identified. The findings of this study will help the policymakers and practitioners in the domains of Health and Medical Humanities, Health Policy and Services, and Social Sciences to clarify the roles of community mobilization activities and initiatives in increasing vaccination coverage. Furthermore, the study provides evidence for the adaptation, integration, and enhancement of these activities based on the four case studies discussed.

Abstract Introduction Respiratory Syncytial Virus (RSV) is a leading cause of acute lower respiratory infection in children worldwide. Understanding its prevalence, variations, and characteristics is vital, particularly in the context of the COVID-19 pandemic. Objective The study aimed to investigate the RSV positivity rate, subtype prevalence, age and gender distribution, symptomatology, and co-infection rates during pre-pandemic and pandemic periods. Methods We analyzed data from 15,381 patients tested for RSV between 2017 and 2023. Results Our analysis revealed a 7.2% average RSV positivity rate in the pre-pandemic period, with significant fluctuations during the pandemic (1.5% in 2020 to 32.0% in 2021). We observed variations in RSVA and RSVB detection rates. The 0–4 years’ age group was consistently the most affected, with a slight male predominance. Fever and cough were common symptoms. Therapeutic interventions, particularly antiviral usage and ventilation requirements, decreased during the pandemic. We also identified variations in co-infection rates with other respiratory viruses. Conclusion Our study offers critical insights into the impact of the COVID-19 pandemic on RSV prevalence, subtype distribution, patient characteristics, and clinical management. These findings underscore the need for ongoing surveillance and adaptive public health responses.

Abstract Graphene Quantum Dots (GQDs) are crucial in biomedicine for sensitive biosensing and high-resolution bioimaging and in photonics for their nonlinear optical properties. Integrating GQDs with photonic structures enhances optical properties by optimizing light-matter interactions and enabling precise control over their emission wavelengths. In this work, we explore a facile synthesis method for GQDs by pulsed laser irradiation in chlorobenzene and highlight the transformative potential of Tamm Plasmon Cavity (TPC) structures for tuning and amplifying the photoluminescence and nonlinear optical properties of GQDs. The characterization of GQDs revealed their exceptional properties, including efficient optical limiting and stable photoluminescence. The study demonstrated that the TPC structure significantly amplifies nonlinear optical effects due to the high light-matter interaction, indicating the potential for advanced optical systems, including optical limiters and nonlinear optical devices. Furthermore, introducing GQDs into the TPC structure leads to a significant enhancement and tuning of fluorescence emission. The Purcell effect, in combination with the confined electromagnetic fields within the TPC, increases the spontaneous emission rate of GQDs and subsequently enhances the fluorescence intensity. This enhanced and tunable fluorescence has exciting implications for high-sensitivity applications such as biosensing and single-molecule detection.

Abstract Intra-abdominal infections (IAIs) are an important cause of morbidity and mortality in hospital settings worldwide. The cornerstones of IAI management include rapid, accurate diagnostics; timely, adequate source control; appropriate, short-duration antimicrobial therapy administered according to the principles of pharmacokinetics/pharmacodynamics and antimicrobial stewardship; and hemodynamic and organ functional support with intravenous fluid and adjunctive vasopressor agents for critical illness (sepsis/organ dysfunction or septic shock after correction of hypovolemia). In patients with IAIs, a personalized approach is crucial to optimize outcomes and should be based on multiple aspects that require careful clinical assessment. The anatomic extent of infection, the presumed pathogens involved and risk factors for antimicrobial resistance, the origin and extent of the infection, the patient’s clinical condition, and the host’s immune status should be assessed continuously to optimize the management of patients with complicated IAIs.

Abstract The advent of the fourth industrial revolution, characterized by artificial intelligence (AI) as its central component, has resulted in the mechanization of numerous previously labor-intensive activities. The use of in silico tools has become prevalent in the design of biopharmaceuticals. Upon conducting a comprehensive analysis of the genomes of many organisms, it has been discovered that their tissues can generate specific peptides that confer protection against certain diseases. This study aims to identify a selected group of neuropeptides (NPs) possessing favorable characteristics that render them ideal for production as neurological biopharmaceuticals. Until now, the construction of NP classifiers has been the primary focus, neglecting to optimize these characteristics. Therefore, in this study, the task of creating ideal NPs has been formulated as a multi-objective optimization problem. The proposed framework, NPpred, comprises two distinct components: NSGA-NeuroPred and BERT-NeuroPred. The former employs the NSGA-II algorithm to explore and change a population of NPs, while the latter is an interpretable deep learning-based model. The utilization of explainable AI and motifs has led to the proposal of two novel operators, namely p-crossover and p-mutation. An online application has been deployed at https://neuropred.anvil.app for designing an ideal collection of synthesizable NPs from protein sequences.

Abstract Background The Life-Space Assessment (LSA) is an instrument that measures mobility in older adults as they reach different areas, defined as life-spaces extending from home to beyond towns or regions. The purpose of the study was to develop the Hindi version of the LSA (LSA- H) and to investigate the validity and reliability of the Hindi version as well as its cultural adaptation. Methods A cross-sectional study of two hundred forty-five older adults participated in the study from four different study practice areas. Following forward backwards translation, the LSA-H was developed, and the scores were correlated with those of the Activities-Specific Balance Confidence Scale Hindi (ABC- H), the Physical Health Subscale of the WHO-BREF Questionnaire and the Geriatric Depression Scale: Short Form Hindi (GDS-SFH) to test the criterion and concurrent validity. Results The mean score and standard deviation of the LSA-H questionnaire were 56.53 ± 35.99, those of the Physical Health Subscale of the WHO-BREF instrument were 18.54 ± 7.87, those of the GDS-SFH questionnaire were 6.95 ± 4.21 and those of the ABC- H questionnaire were 54.40 ± 28.96. The Pearson correlation coefficient (r) between the LSA-H score and ABC-H score was 0.707 (p value

Abstract Neuroleptic malignant syndrome is a rare, life-threatening neurologic emergency characterized by fever, rigidity, autonomic instability, mental status changes, and an elevated creatine kinase level. It often occurs shortly after the initiation of neuroleptic treatment, or after a dose increase. The management of patients with NMS is based upon clinical severity and includes supportive care and withdrawal of antipsychotic agents and agents like bromocriptine and dantrolene. Complications include acute renal failure associated with rhabdomyolysis, respiratory failure, electrolyte imbalance, hepatic failure, seizures from hyperthermia, metabolic derangements, etc.

Abstract Treatment-resistant depression (TRD) affects approximately 2.8 million people in the U.S. with estimated annual healthcare costs of $43.8 billion. Deep brain stimulation (DBS) is currently an investigational intervention for TRD. We used a decision-analytic model to compare cost-effectiveness of DBS to treatment-as-usual (TAU) for TRD. Because this therapy is not FDA approved or in common use, our goal was to establish an effectiveness threshold that trials would need to demonstrate for this therapy to be cost-effective. Remission and complication rates were determined from review of relevant studies. We used published utility scores to reflect quality of life after treatment. Medicare reimbursement rates and health economics data were used to approximate costs. We performed Monte Carlo (MC) simulations and probabilistic sensitivity analyses to estimate incremental cost-effectiveness ratios (ICER; USD/quality-adjusted life year [QALY]) at a 5-year time horizon. Cost-effectiveness was defined using willingness-to-pay (WTP) thresholds of $100,000/QALY and $50,000/QALY for moderate and definitive cost-effectiveness, respectively. We included 274 patients across 16 studies from 2009–2021 who underwent DBS for TRD and had ≥12 months follow-up in our model inputs. From a healthcare sector perspective, DBS using non-rechargeable devices (DBS-pc) would require 55% and 85% remission, while DBS using rechargeable devices (DBS-rc) would require 11% and 19% remission for moderate and definitive cost-effectiveness, respectively. From a societal perspective, DBS-pc would require 35% and 46% remission, while DBS-rc would require 8% and 10% remission for moderate and definitive cost-effectiveness, respectively. DBS-pc will unlikely be cost-effective at any time horizon without transformative improvements in battery longevity. If remission rates ≥8–19% are achieved, DBS-rc will likely be more cost-effective than TAU for TRD, with further increasing cost-effectiveness beyond 5 years.

Abstract Objective To assess asymptomatic rates and severity of SARS‐CoV‐2 infection in people with epilepsy and their healthcare workers in a long‐term care facility which had implemented weekly surveillance testing between April 2020 and June 2022. Methods Questionnaires focused on objective and subjective COVID‐19 symptoms for people with epilepsy residing in and their healthcare workers at the Chalfont Centre for Epilepsy in June 2022. Demographic information, comorbidities, and seizure frequency were gathered from medical records. We also collected responses on objective and subjective COVID‐19 symptoms from healthcare workers who participated in a prospective study assessing the reaction to COVID‐19 vaccinations (SAFER). Results Fifty‐five out of 89 (62%) residents tested positive at least once on weekly PCR testing for SARS‐CoV‐2 during the period of interest; 20 of those (37%) were asymptomatic. In comparison, of those 63 healthcare workers who tested positive at least once on weekly testing during the same period, only four (6%) were asymptomatic. Of the 159 healthcare workers who also participated in the SAFER study, 41 tested positive at least once, and seven (17%) were completely asymptomatic during infection with SARS‐CoV‐2. Significance People with epilepsy living in a long‐term care facility were more likely to present with asymptomatic SARS‐CoV‐2 infections than healthcare workers at the same facility. Despite possible bias in the reporting of subjective symptoms due to management‐by‐proxy, there is no evidence that vulnerable people living in an epilepsy long‐term care facility showed reduced resilience towards infections. Plain Language Summary People with epilepsy living in care home facilities had a surprisingly high degree of asymptomatic infections with SARS‐CoV‐2. Very few residents had severe or fatal outcomes. This is in stark contrast to the widely reported bad outcomes for people without epilepsy in other care homes. People with epilepsy reported significantly less symptoms than their healthcare workers. No changes in seizure frequency during or after infection were observed.

Introduction: Aspiration cytology has recently become the first-line of investigation during the initial assessment of any swelling. It is also an effective tool for the early diagnosis of malignancy. In this study, the feasibility of extending the benefits of this simple, cost-effective procedure to the community level has been assessed. Aim: In the present study, attempts were made to prove that most aspirations and subsequent interpretations of aspirated samples could be accomplished by Junior Residents (JRs) even in a tertiary care centre. Materials and Methods: This cross-sectional study was conducted at Bankura Sammilani Medical College (BSMC), West Bengal, India for a period of nine years (01/01/2014 to 31/12/2022). Conventional aspirations without guidance were included in the study group. The majority of aspirations were successfully conducted by JRs, and only 4.5% (823) of conventional aspirations needed the help and supervision of senior faculties. All adequate aspirations were then independently interpreted by two separate JRs, and the proportion of cases with similar and dissimilar interpretations was duly noted. Finally, all the smears were assessed by senior faculties and compared with the interpretations of JRs. Result: During this study period, a total of 19,743 aspirations were done of which 18,391 were conventional. JRs aspirated 17,568 (95.5%) of these cases. Data analysis revealed that JRs were successful in 16,570 (83.9%) of total aspirations and also correctly interpreted 13,381 (67.8%) of total cases. Conclusion: This study proved that one year of training could be sufficient to achieve a desirable level of competency in aspiration and interpretation of cytological samples. So, willing doctors with the necessary training could perform as Community Cytopathologists (CCPs) to extend the benefits of Fine Needle Aspiration Cytology (FNAC) up to the block level, thus escalating the fight against malignancy.

الملخص: مع التقدم في علوم طب الأسنان والحاجة المتزايدة لتحسين صحة الأسنان، أصبح من الضروري تطوير مواد زراعة جديدة تمتلك خصائص هندسية وميكانيكية وفيزيائية أفضل. البيئة الفموية هي بيئة أكالة، كما أن الحركة النسبية بين الأسنان تجعل البيئة أكثر عدائية. لذلك، يجب دراسة التآكل المشترك وعلم الاحتكاك المعروف باسم تآكل الغرسات. إن الأشكال المعقدة لزراعة الأسنان ومتطلبات الأداء العالي لهذه الغرسات تجعل التصنيع صعبا من خلال عمليات التصنيع التقليدية. مع ظهور التصنيع الإضافي أو الطباعة ثلاثية الأبعاد، أصبح تطوير الغرسات أمرا سهلا. ومع ذلك، فإن المتطلبات المختلفة مثل خشونة السطح، والقوة الميكانيكية، ومقاومة التآكل تزيد من صعوبة تصنيع الغرسات. تستعرض الورقة الحالية الدراسات المختلفة المتعلقة بالغرسات المطبوعة ثلاثية الأبعاد. كما تحاول الورقة تسليط الضوء على الدور الذي يمكن أن تلعبه الطباعة ثلاثية الأبعاد في مجال زراعة الأسنان. هناك حاجة إلى مزيد من الدراسات التجريبية والعددية لاستنباط الظروف المثلى لغرسات الطباعة ثلاثية الأبعاد لتطوير الغرسات ذات الخصائص الميكانيكية والتآكل والبيولوجية المحسنة. Abstract: With the advancements in dental science and the growing need for improved dental health, it has become imperative to develop new implant materials which possess better geometrical, mechanical, and physical properties. The oral environment is a corrosive environment and the relative motion between the teeth also makes the environment more hostile. Therefore, the combined corrosion and tribology commonly known as tribocorrosion of implants needs to be studied. The complex shapes of the dental implants and the high-performance requirements of these implants make manufacturing difficult by conventional manufacturing processes. With the advent of additive manufacturing or 3D-printing, the development of implants has become easy. However, the various requirements such as surface roughness, mechanical strength, and corrosion resistance further make the manufacturing of implants difficult. The current paper reviews the various studies related to3D-printed implants. Also, the paper tries to highlight the role of 3D-Printing can play in the area of dental implants. Further studies both experimental and numerical are needed to devise optimized conditions for 3D-printing implants to develop implants with improved mechanical, corrosion, and biological properties.

We assessed 160 patients who received imipenem/cilastatin/relebactam for ≥2 days. At treatment initiation, the median Charlson Comorbidity Index was 5, 45% were in the intensive care unit, and 19% required vasopressor support. The in-hospital mortality rate was 24%. These data advance our understanding of real-world indications and outcomes of imipenem/cilastatin/relebactam use.

Genetic variability in rice breeding programs plays a very crucial role. It provides an outstanding pool of superior alleles governing better agronomic and quality characters through association mapping. For a greater understanding of population structure, the genetic relationship among different rice lines is indispensable prior to the setting of a correlation among dynamic alleles and traits. In the present investigation, the genetic diversity and population structure of 116 rice accessions were studied to understand genetic relatedness and diversity among them using 64 polymorphic SSR markers. A genotyping assessment based on SSR markers revealed a total of 225 alleles, with an average PIC value of 0.755. The germplasm lines were classified into three distinct subgroups through population structure analysis, utilizing both model- and distance-based approaches. AMOVA analysis showed that 11% of the total variation could be attributed to differences between groups, while the remaining 89% was likely due to differences within groups. This study suggested that population structure and genetic relatedness should be considered to establish marker–trait associations for association mapping when working with the core collection of germplasm lines.

Background and Aims: Post-discharge nausea and vomiting (PDNV) is a pertinent problem in patients undergoing ambulatory surgery. The objective of this study was to assess the efficacy of the novel drug olanzapine, which has proved its efficiency in patients undergoing highly emetogenic chemotherapy for PDNV prevention. Methods: This randomised controlled trial recruited 106 adult patients (18–65 years) undergoing highly emetogenic daycare surgeries with propofol-based general anaesthesia (GA). Group O received preoperative oral olanzapine 10 mg, and Group C, acting as a control, received 8 mg of intravenous dexamethasone and 4 mg of ondansetron intraoperatively. The primary outcome was nausea (numeric rating scale >3) and/or vomiting 24 h after discharge. Secondary outcomes included nausea and vomiting in the post-anaesthesia care unit (PACU), severe nausea, vomiting and side effects. Normality was assessed using the Shapiro–Wilk test, and the independent samples t-test or the Mann–Whitney U test was used to compare continuous variables. Fisher’s exact test was used to assess any non-random associations between the categorical variables. Results: The incidence and severity of postoperative nausea and vomiting were similar in both groups within PACU (four patients experienced nausea and vomiting, three had severe symptoms in Group O, P = 0.057) and in the post-discharge period (three patients in Group O had nausea and vomiting compared to five patients in Group C, of which four were severe, P = 0.484). The side effects (sedation, dizziness, and light-headedness) were comparable between the two groups. Conclusion: A single preoperative oral olanzapine can be an effective alternative to standard antiemetic prophylaxis involving dexamethasone and ondansetron for preventing PDNV in highly emetogenic daycare surgeries with propofol-based GA.

The number of published literature on the effect of ultrasonic cavitation and advanced oxidation pretreatment on the dewatering performance of anaerobically digested sludge is very limited. This study aims at determining the optimum operating conditions of large-scale filtering centrifuges in wastewater treatment plants. The optimum dose of hydrogen peroxide, ultrasonic power, ultrasonic duration, ultrasonic pulse and particle size distribution for improved dewatering performance were determined in this study. In addition, shear stress–shear rate and viscosity–shear rate rheograms were developed to show the rheological flow properties for varying ultrasonic power and treatment duration. Optimum sonication power, time, pulse and amplitude were determined to be 14 W, 1 min, 55/5 and 20%, respectively. At a pH of 6.8, the optimum concentration of hydrogen peroxide was found to be 43.5 g/L. The optimum hydrogen peroxide dose in the combined conditioning experiments was determined to be 500 mg/L at a pH of 3. Under these optimum conditions, capillary suction time was reduced significantly by 71.1%. This study helps to reduce polymer consumption and provides the optimum pretreatment and dewatering operating conditions, and better monitoring and control in the dewatering unit has significant impact in the overall economy of wastewater treatment plants. HIGHLIGHTS Digested sludge dewatering is a cost-intensive operation in wastewater treatment plants.; The proposed ultrasonic and advanced oxidation pretreatment significantly improves the dewatering performance.; Rheological flow characteristics of digested sludge also improved after ultrasonic pretreatment.; Sonication and advanced oxidation can be used along with conventional dewatering polymers for better performance.;

Abstract The high energy (Regge) limit provides a playground for understanding all loop structures of scattering amplitudes, and plays an important role in the description of many phenomenologically relevant cross-sections. While well understood in the planar limit, the structure of non-planar corrections introduces many fascinating complexities, for which a general organizing principle is still lacking. We study the structure of multi-reggeon exchanges in the context of the effective field theory for forward scattering, and derive their factorization into collinear operators (impact factors) and soft operators. We derive the structure of the renormalization group consistency equations in the effective theory, showing how the anomalous dimensions of the soft operators are related to those of the collinear operators, allowing us to derive renormalization group equations in the Regge limit purely from a collinear perspective. The rigidity of the consistency equations provides considerable insight into the all orders organization of Regge amplitudes in the effective theory, as well as its relation to other approaches. Along the way we derive a number of technical results that improve the understanding of the effective theory. We illustrate this collinear perspective by re-deriving all the standard BFKL equations for two-Glauber exchange from purely collinear calculations, and we show that this perspective provides a number of conceptual and computational advantages as compared to the standard view from soft or Glauber physics. We anticipate that this formulation in terms of collinear operators will enable a better understanding of the relation between BFKL and DGLAP in gauge theories, and facilitate the analysis of renormalization group evolution equations describing Reggeization beyond next-to-leading order.

Abstract Perovskite solar cells promise to be part of the future portfolio of photovoltaic technologies, but their instability is slow down their commercialization. Major stability assessments have been recently achieved but reliable accelerated ageing tests on beyond small-area cells are still poor. Here, we report an industrial encapsulation process based on the lamination of highly viscoelastic semi-solid/highly viscous liquid adhesive atop the perovskite solar cells and modules. Our encapsulant reduces the thermomechanical stresses at the encapsulant/rear electrode interface. The addition of thermally conductive two-dimensional hexagonal boron nitride into the polymeric matrix improves the barrier and thermal management properties of the encapsulant. Without any edge sealant, encapsulated devices withstood multifaceted accelerated ageing tests, retaining >80% of their initial efficiency. Our encapsulation is applicable to the most established cell configurations (direct/inverted, mesoscopic/planar), even with temperature-sensitive materials, and extended to semi-transparent cells for building-integrated photovoltaics and Internet of Things systems.

Abstract Background HIV molecular epidemiology (HIV ME) can support the early detection of emerging clusters of new HIV infections by combining HIV sequence data routinely obtained during the clinical treatment of people living with HIV with behavioral, geographic, and sociodemographic information. While information about emerging clusters promises to facilitate HIV prevention and treatment efforts, the use of this data also raises several ethical concerns. We sought to assess how those working on the frontlines of HIV ME, specifically public health practitioners (PHPs) and researchers, prioritized these issues. Methods Ethical issues were identified through literature review, qualitative in-depth interviews, and stakeholder engagement. PHPs and researchers using HIV ME prioritized the issues using best–worst scaling (BWS). A balanced incomplete block design was used to generate 11 choice tasks each consisting of a sub-set of 5 ethical concerns. In each task, respondents were asked to assess the most and least concerning issue. Data were analyzed using conditional logit, with a Swait-Louviere test of poolability. Latent class analysis was then used to explore preference heterogeneity. Results In total, 57 respondents completed the BWS experiment May–June 2023 with the Swait-Louviere test indicating that researchers and PHPs could be pooled (p = 0.512). Latent class analysis identified two classes, those highlighting “Harms” (n = 29) (prioritizing concerns about potential risk of legal prosecution, individual harm, and group stigma) and those highlighting “Utility” (n = 28) (prioritizing concerns about limited evidence, resource allocation, non-disclosure of data use for HIV ME, and the potential to infer the directionality of HIV transmission). There were no differences in the characteristics of members across classes. Conclusions The ethical issues of HIV ME vary in importance among stakeholders, reflecting different perspectives on the potential impact and usefulness of the data. Knowing these differences exist can directly inform the focus of future deliberations about the policies and practices of HIV ME in the United States.

This study examines important aspects of lottery behavior in India using data from December 2001 to March 2021. We experiment with a new measure of lottery along with well-established measures. Our lottery measure focusing on more recent information is found to be appropriate for India. MAX has a unique role in predicting returns that is not subsumed by other risk measures. We find MAX, skewness, tail risk, and idiosyncratic volatility as relevant characteristics of lottery stocks. Using these, we construct a lottery factor representing investors’ risk-seeking behavior. This behavior is an outcome of mis-weighing probability of extreme gains or losses and leads to overreaction to attention-catching events. We augment the Fama-French five-factor model with our lottery factor. Our six-factor behavioral asset pricing framework is found to be an appropriate performance benchmark. Lottery behavior is mainly the result of retail investor actions and is linked to several behavioral biases.

Abstract Soybean is a rainfed crop grown across a wide range of environments in India. Its grain yield is a complex trait governed by many minor genes and influenced by environmental effects and genotype × environment interactions. In the current investigation, grain yield data of different sets of 41, 30 and 48 soybean genotypes evaluated during 2019, 2020 and 2021, respectively across 19 locations and twenty years’ data on 19 different climatic parameters at these locations was used to study the environmental effects on grain yield, to understand the genotype × environment interactions and to identify the mega-environments. Through analysis of variance (ANOVA), it was found that predominant portion of the variation was explained by environmental effects (E) (53.89, 54.86 and 60.56% during 2019, 2020 and 2021, respectively), followed by genotype × environment interactions (GEI) (31.29, 33.72 and 28.82% during 2019, 2020 and 2021, respectively). Principal Component Analysis (PCA) revealed that grain yield was positively associated with RH (Relative humidity at 2 m height), FRUE (Effect of temperature on radiation use efficiency), WSM (Wind speed at 2 m height) and RTA (Global solar radiation based on latitude and Julian day) and negatively associated with VPD (Deficit of vapour pressure), Trange (Daily temperature range), ETP (Evapotranspiration), SW (Insolation incident on a horizontal surface), n (Actual duration of sunshine) and N (Daylight hours). Identification of mega-environments is critical in enhancing the selection gain, productivity and varietal recommendation. Through envirotyping and genotype main effect plus genotype by environment interaction (GGE) biplot methods, nineteen locations across India were grouped into four mega-environments (MEs). ME1 included five locations viz., Bengaluru, Pune, Dharwad, Kasbe Digraj and Umiam. Eight locations—Anand, Amreli, Lokbharti, Bidar, Parbhani, Ranchi, Bhawanipatna and Raipur were included in ME2. Kota and Morena constitutes ME3, while Palampur, Imphal, Mojhera and Almora were included in ME4. Locations Imphal, Bidar and Raipur were found to be both discriminative and representative; these test locations can be utilized in developing wider adaptable soybean cultivars. Pune and Amreli were found to be high-yielding locations and can be used in large scale breeder seed production.

Abstract Limited data exist on viral hepatitis among migrant populations. This study investigated the prevalence of current hepatitis B virus (HBV) infection and lifetime hepatitis C virus (HCV) infection among Qatar's migrant craft and manual workers (CMWs), constituting 60% of the country's population. Sera collected during a nationwide COVID-19 population-based cross-sectional survey on CMWs between July 26 and September 9, 2020, underwent testing for HBsAg and HCV antibodies. Reactive samples underwent confirmatory testing, and logistic regression analyses were employed to explore associations with HBV and HCV infections. Among 2528 specimens tested for HBV infection, 15 were reactive, with 8 subsequently confirmed positive. Three samples lacked sufficient sera for confirmatory testing but were included in the analysis through multiple imputations. Prevalence of current HBV infection was 0.4% (95% CI 0.2–0.7%). Educational attainment and occupation were significantly associated with current HBV infection. For HCV infection, out of 2607 specimens tested, 46 were reactive, and 23 were subsequently confirmed positive. Prevalence of lifetime HCV infection was 0.8% (95% CI 0.5–1.2%). Egyptians exhibited the highest prevalence at 6.5% (95% CI 3.1–13.1%), followed by Pakistanis at 3.1% (95% CI 1.1–8.0%). Nationality, geographic location, and occupation were significantly associated with lifetime HCV infection. HBV infection is relatively low among CMWs, while HCV infection falls within the intermediate range, both compared to global and regional levels.

Abstract Whole-heart coronary calcium Agatston score is a well-established predictor of major adverse cardiovascular events (MACE), but it does not account for individual calcification features related to the pathophysiology of the disease (e.g., multiple-vessel disease, spread of the disease along the vessel, stable calcifications, numbers of lesions, and density). We used novel, hand-crafted calcification features (calcium-omics); Cox time-to-event modeling; elastic net; and up and down synthetic sampling methods for imbalanced data, to assess MACE risk. We used 2457 CT calcium score (CTCS) images enriched for MACE events from our large no-cost CLARIFY program (ClinicalTrials.gov Identifier: NCT04075162). Among calcium-omics features, numbers of calcifications, LAD mass, and diffusivity (a measure of spatial distribution) were especially important determinants of increased risk, with dense calcification (> 1000HU, stable calcifications) associated with reduced risk Our calcium-omics model with (training/testing, 80/20) gave C-index (80.5%/71.6%) and 2-year AUC (82.4%/74.8%). Although the C-index is notoriously impervious to model improvements, calcium-omics compared favorably to Agatston and gave a significant difference (P

Abstract Background Obstructive sleep apnea (OSA) increases risk for cognitive decline and Alzheimer’s disease (AD). While the underlying mechanisms remain unclear, hypoxemia during OSA has been implicated in cognitive impairment. OSA during rapid eye movement (REM) sleep is usually more severe than in non-rapid eye movement (NREM) sleep, but the relative effect of oxyhemoglobin desaturation during REM versus NREM sleep on memory is not completely characterized. Here, we examined the impact of OSA, as well as the moderating effects of AD risk factors, on verbal memory in a sample of middle-aged and older adults with heightened AD risk. Methods Eighty-one adults (mean age:61.7 ± 6.0 years, 62% females, 32% apolipoprotein E ε4 allele (APOE4) carriers, and 70% with parental history of AD) underwent clinical polysomnography including assessment of OSA. OSA features were derived in total, NREM, and REM sleep. REM-NREM ratios of OSA features were also calculated. Verbal memory was assessed with the Rey Auditory Verbal Learning Test (RAVLT). Multiple regression models evaluated the relationships between OSA features and RAVLT scores while adjusting for sex, age, time between assessments, education years, body mass index (BMI), and APOE4 status or parental history of AD. The significant main effects of OSA features on RAVLT performance and the moderating effects of AD risk factors (i.e., sex, age, APOE4 status, and parental history of AD) were examined. Results Apnea–hypopnea index (AHI), respiratory disturbance index (RDI), and oxyhemoglobin desaturation index (ODI) during REM sleep were negatively associated with RAVLT total learning and long-delay recall. Further, greater REM-NREM ratios of AHI, RDI, and ODI (i.e., more events in REM than NREM) were related to worse total learning and recall. We found specifically that the negative association between REM ODI and total learning was driven by adults 60 + years old. In addition, the negative relationships between REM-NREM ODI ratio and total learning, and REM-NREM RDI ratio and long-delay recall were driven by APOE4 carriers. Conclusion Greater OSA severity, particularly during REM sleep, negatively affects verbal memory, especially for people with greater AD risk. These findings underscore the potential importance of proactive screening and treatment of REM OSA even if overall AHI appears low.

Abstract Influenza Like Illness (ILI) and Severe Acute Respiratory Infection (SARI) cases are more prone to Influenza and SARS-CoV-2 infection. Accordingly, we genetically characterized Influenza and SARS-CoV-2 in 633 ILI and SARI cases by rRT-PCR and WGS. ILI and SARI cases showed H1N1pdm09 prevalence of 20.9% and 23.2% respectively. 135 (21.3%) H1N1pdm09 and 23 (3.6%) H3N2 and 5 coinfection (0.78%) of H1N1pdm09 and SARS-CoV-2 were detected. Phylogenetic analysis revealed H1N1pdm09 resemblance to clade 6B.1A.5a.2 and their genetic relatedness to InfA/Perth/34/2020, InfA/Victoria/88/2020 and InfA/Victoria/2570/2019. Pan 24 HA and 26 NA nonsynonymous mutations and novel HA (G6D, Y7F, Y78H, P212L, G339R, T508K and S523T) and NA (S229A) mutations were observed. S74R, N129D, N156K, S162N, K163Q and S164T alter HA Cb and Sa antibody recognizing site. Similarly, M19T, V13T substitution and multiple mutations in transmembrane and NA head domain drive antigenic drift. SARS-CoV-2 strains genetically characterized to Omicron BA.2.75 lineage containing thirty nonsynonymous spike mutations exhibited enhanced virulence and transmission rates. Coinfection although detected very minimal, the mutational changes in H1N1pdm09 and SARS-CoV-2 virus infected individuals could alter antibody receptor binding sites, allowing the viruses to escape immune response resulting in better adaptability and transmission. Thus continuous genomic surveillance is required to tackle any future outbreak.

Abstract Automated online cognitive assessments are set to revolutionise clinical research and healthcare. However, their applicability for Parkinson’s Disease (PD) and REM Sleep Behavioural Disorder (RBD), a strong PD precursor, is underexplored. Here, we developed an online battery to measure early cognitive changes in PD and RBD. Evaluating 19 candidate tasks showed significant global accuracy deficits in PD (0.65 SD, p = 0.003) and RBD (0.45 SD, p = 0.027), driven by memory, language, attention and executive underperformance, and global reaction time deficits in PD (0.61 SD, p = 0.001). We identified a brief 20-min battery that had sensitivity to deficits across these cognitive domains while being robust to the device used. This battery was more sensitive to early-stage and prodromal deficits than the supervised neuropsychological scales. It also diverged from those scales, capturing additional cognitive factors sensitive to PD and RBD. This technology offers an economical and scalable method for assessing these populations that can complement standard supervised practices.

Abstract Introduction The increasing ageing of the population with growth in NCD burden in India has put unprecedented pressure on India’s health care systems. Shortage of skilled human resources in health, particularly of specialists equipped to treat NCDs, is one of the major challenges faced in India. Keeping in view the shortage of healthcare professionals and the guidelines in NEP 2020, there is an urgent need for more health professionals who have received training in the diagnosis, prevention, and treatment of NCDs. This paper conducts a scoping review and aims to collate the existing evidence on the use of digital education of health professionals within NCD topics. Methods We searched four databases (Web of Science, PubMed, EBSCO Education Research Complete, and PsycINFO) using a three-element search string with terms related to digital education, health professions, and terms related to NCD. The inclusion criteria covered the studies to be empirical and NCD-related with the target population as health professionals rather than patients. Data was extracted from 28 included studies that reported on empirical research into digital education related to non-communicable diseases in health professionals in India. Data were analysed thematically. Results The target groups were mostly in-service health professionals, but a considerable number of studies also included pre-service students of medicine (n = 6) and nursing (n = 6). The majority of the studies included imparted online learning as self-study, while some imparted blended learning and online learning with the instructor. While a majority of the studies included were experimental or observational, randomized control trials and evaluations were also part of our study. Discussion Digital HPE related to NCDs has proven to be beneficial for learners, and simultaneously, offers an effective way to bypass geographical barriers. Despite these positive attributes, digital HPE faces many challenges for its successful implementation in the Indian context. Owing to the multi-lingual and diverse health professional ecosystem in India, there is a need for strong evidence and guidelines based on prior research in the Indian context.

Abstract Whole virus-based inactivated SARS-CoV-2 vaccines adjuvanted with aluminum hydroxide have been critical to the COVID-19 pandemic response. Although these vaccines are protective against homologous coronavirus infection, the emergence of novel variants and the presence of large zoonotic reservoirs harboring novel heterologous coronaviruses provide significant opportunities for vaccine breakthrough, which raises the risk of adverse outcomes like vaccine-associated enhanced respiratory disease. Here, we use a female mouse model of coronavirus disease to evaluate inactivated vaccine performance against either homologous challenge with SARS-CoV-2 or heterologous challenge with a bat-derived coronavirus that represents a potential emerging disease threat. We show that inactivated SARS-CoV-2 vaccines adjuvanted with aluminum hydroxide can cause enhanced respiratory disease during heterologous infection, while use of an alternative adjuvant does not drive disease and promotes heterologous viral clearance. In this work, we highlight the impact of adjuvant selection on inactivated vaccine safety and efficacy against heterologous coronavirus infection.

Perforation of the colon is frequently encountered in surgical emergencies and requires urgent intervention. Free colonic perforations are diagnosed early due to the development of signs of peritoneal irritation. However, perforation of the posterior wall of the colon into the retro-peritoneal space poses a diagnostic challenge because of the absence of signs of peritoneal irritation and its atypical clinical presentation. The authors reported an unusual case of 42 years old female patient with idiopathic perforation of the posterior wall of the ascending colon that presented as a large retroperitoneal abscess. The abscess was diagnosed based on clinical and Computed Tomography (CT) findings, and the patient underwent incision and drainage of the abscess through a flank incision. There was initial improvement in the patient’s general condition, but on the fourth day, there was faecal discharge through the wound, indicating colonic perforation. The patient was immediately taken for an emergency laparotomy. Intraoperatively, the peritoneal cavity was found to be clean; however, upon mobilisation of the ascending colon, two large perforations on its posterior wall were found with faecal soiling of the retroperitoneal tissues. Right hemicolectomy with end ileostomy and closure of the transverse colonic end were performed. Histopathology revealed the absence of any definite pathology, and a diagnosis of spontaneous perforation was made. This unusual case highlights that this rare possibility should be considered as a differential diagnosis of a retroperitoneal abscess to enable early intervention, which is likely to save the patient.

Performance of Photovoltaic-double skin façade (Photovoltaic-DSF) system in summer has been critical. Owing to high solar ingress, cooling requirement of a building significantly increases. Photovoltaic-DSF system provides a shield and controls the heat gain through fenestration in the interior spaces. In the present article, mathematical correlations are developed for energy characterization of forced-ventilated Photovoltaic-DSF system in India's hot summer zone i.e. Jaipur. The Photovoltaic-DSF system has been installed and monitored for Jaipur's summer months (May to July). L25 Orthogonal array of design parameters (air cavity thickness, air velocity, and PV panel's transparency) and their respective levels have been developed using Taguchi design to perform experiments. Based on experimental results, multiple linear regression has been used to forecast solar heat gain coefficient, PVs electrical power and daylighting illuminance indoors as function of design factors. The statistical significance of mathematical relationships is sorted by variance analysis, which is found to be in good accord with field measurements (R2 > 0.90). The proposed correlations are pragmatic in designing Photovoltaic-DSF systems for hot summer conditions. The Photovoltaic-DSF system with 30% transmittance and air velocity of 5 metres per second in 200 mm air cavity thickness achieved maximum energy performance in hot summers.

ABSTRACT: Objective: To evaluate the impact of the COVID-19 pandemic on the psychosocial functioning of individuals with cleft lip and/or palate (CL/P). Methods: Patients with CL/P ≥ 6 years old were prospectively recruited from the Cleft and Craniofacial Clinic of a tertiary children's hospital. From July-October 2021, eligible patients (or their parent/guardian) were sent a survey regarding their psychosocial functioning before and after the start of the pandemic. Main Outcome Measure: The difference between prepandemic and intrapandemic patient-reported outcome scores. Results: Thirty-six patients (20 female, age: 15.9 ± 9.8 years) responded. Most had cleft lip and palate (77.8%), responded online (69.4%), interacted remotely via both voice- and video-conferencing (62.9%), and wore masks routinely (77.1%). Similar numbers of patients responded independently (27.8%), responded with the help of a parent/guardian (36.1%), or had a parent/guardian respond on their behalf (36.1%). General social-emotional well-being (p = 0.004, rrb = 0.659) and satisfaction with facial appearance (p = 0.044, rrb = 0.610) significantly improved after the start of the pandemic. Compared to their general intrapandemic social-emotional well-being scores, patients reported higher scores while wearing a mask (rrb = 0.827) and lower scores while interacting remotely (rrb = 0.605), although all were still significantly improved compared to their prepandemic scores (p ≤ 0.010). Patients also reported significant improvement in social functioning while wearing a mask (p = 0.036, rrb = 0.519), whereas they did not when considering their general intrapandemic feelings/experiences (p = 0.269, rrb = 0.211). Conclusion: Patients with CL/P demonstrated significant improvement in overall social-emotional well-being, satisfaction with facial appearance, and social functioning after the start of the COVID-19 pandemic, particularly when wearing a mask.