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Abstract Globally, the prevalence of breast cancer (BC) is increasing at an alarming level, despite early detection and technological improvements. Alkaloids are diverse chemical groups, and many within this class have been reported as potential anticancer compounds. Chabamide F (F) and chabamide G (G) are two dimeric amide alkaloids found in a traditional medicinal plant, Piper chaba, and possess significant cytotoxic effects. However, their scientific rationalization in BC remains unknown. Here, we aimed to investigate their potential and molecular mechanisms for BC through in silico approaches. From network pharmacology, we identified 64 BC-related genes as targets. GO and KEGG studies showed that they were involved in various biological processes and mostly expressed in BC-related pathways such as RAS, PI3K-AKT, estrogen, MAPK, and FoxO pathways. However, PPI analysis revealed SRC and AKT1 as hub genes, which play key roles in BC tumorigenesis and metastasis. Molecular docking revealed the strong binding affinity of F (− 10.7 kcal/mol) and G (− 9.4 and − 11.7 kcal/mol) for SRC and AKT1, respectively, as well as the acquisition of vital residues to inhibit them. Their long-term stability was evaluated using 200 ns molecular dynamics simulation. The RMSD, RMSF, Rg, and SASA analyses showed that the G-SRC and G-AKT1 complexes were excellently stable compared to the control, dasatinib, and capivasertib, respectively. Additionally, the PCA and DCCM analyses revealed a significant reduction in the residual correlation and motions. By contrast, the stability of the F-SRC complex was greater than that of the control, whereas it was moderately stable in complex with AKT1. The MMPBSA analysis demonstrated higher binding energies for both compounds than the controls. In particular, the binding energy of G for SRC and AKT1 was − 120.671 ± 16.997 and − 130.437 ± 19.111 kJ/mol, respectively, which was approximately twice as high as the control molecules. Van der Waal and polar solvation energies significantly contributed to this energy. Furthermore, both of them exhibited significant interactions with the binding site residues of both proteins. In summary, this study indicates that these two molecules could be a potential ATP-competitive inhibitor of SRC and an allosteric inhibitor of AKT1.

The study aims to identify the effect of corporate governance factors on financial institution performance in Bangladesh. This study employs annual data for 20 financial institutions, including banks, NBFIs, and insurance companies, data is collected from 2011 to 2022. Here, three corporate governance indicators are utilized – board size, board independence, and director’s ownership. The performance of the financial institutions is measured using return on assets (ROA), return on equity (ROE), and net asset value (NAV). Apart from the corporate governance variables, three company-specific factors, i.e., firm age, financial leverage, and firm size, are used as the control variables. Panel data analysis is conducted through the dynamic Feasible Generalize Least Square (FGLS) method, and the robustness is performed using the random effect model. The results show that corporate governance parameter such as board size has a significant positive influence on financial institution performance in Bangladesh, where board independence and director ownership do not have a significant influence on the performance of financial institutions. Thus, the performance of financial institutions increases when board size increases. This indicates that board members are actively engaged in strategic decision-making and ensure the rights of all stakeholders, which helps improve financial institutions’ overall performance. Therefore, financial institutions may increase their board size to the maximum level to ensure better corporate governance practices in the organizations, which ultimately increases performance.

Abstract The study pertains to preparing value added frozen yoghurt through use of orange peel powder (OPP). The quality aspects of medium-fat (6.0% fat) frozen yoghurt prepared using OPP at three levels (1.5, 2.5, 3.5% as T1, T2 and T3 respectively) was studied. Frozen yoghurt was prepared by freezing blend of fermented yoghurt base with ice cream mix (25:75 w/w); other ingredients were sugar, stabilizer-emulsifier and orange crush. Inclusion of OPP in frozen yoghurt impacted the orange flavour favorably and enriched product with β-carotene and dietary fiber. The control product (TC) was prepared in similar manner, avoiding OPP. As the level of OPP was raised in formulation, there was a marked increase in the protein, carbohydrate, ash and total solids when compared with TC. Presence of OPP markedly affected the acidity, viscosity, overrun and melting resistance of the product; maximum overrun was associated with TC. Product T3 had the maximum acidity and viscosity; T2 had maximum total sensory score. It is recommended to prepare medium-fat frozen yoghurt utilizing 2.5% OPP along with orange crush as flavouring. Such inclusion of peel solids enriched the product with β-carotene and dietary fiber, contributed to stabilization of product and enhanced the products sensory acceptance.

Abstract Background Lead, a potent neurotoxin, causes irreversible damage to the nervous system, and low- and middle-income countries face huge health and economic productivity losses due to childhood lead exposure. In Bangladesh, informal Used Lead Acid Battery (ULAB) recycling sites are an important source of lead pollution. Little is known about lead awareness among communities exposed to ULAB recycling. Therefore, this study aims to assess knowledge, attitudes, and practices related to lead pollution among caregivers of young children and adolescents living adjacent to informal ULAB sites. Methods A cross-sectional study was conducted among 732 mothers of young children and adolescents in 4 districts of Bangladesh (survey and observation). Simple and multiple linear regression was conducted to describe patterns and predictors of lead-related knowledge and practices. Results 60% of respondents had heard the name ‘lead’ (“shisha”). The mean knowledge score was low (19 out of 44). Residents of high-risk districts, male respondents, and those with more than 5 years of schooling were significantly more likely to have higher knowledge scores than others. In terms of attitude, 52% of respondents perceived lead to be risky for human health but 43% thought lead pollution was controllable. Observation of households for lead exposure revealed that 63% of children and adolescents play or pass by ULAB sites, 29% ate non-food items, 41% of households had visible paint chips on the walls, 59% households used polished turmeric and 15% used lead-soldered cans to store foods. Among protective practices, 70% reported cleaning floors, 84% consumed iron-rich foods, and 48% consumed calcium-rich foods. Conclusions The population had a high potential for lead exposure. Their knowledge about lead was limited, and risk perception was moderate. To reduce lead exposure and increase knowledge and awareness among the at-risk population, it is crucial to take measures such as mass awareness campaigns through media and schools. It is important to strengthen the implementation of existing policies, such as policies on leaded gasoline, paints, and lead-acid batteries, that can address the sources of lead exposure for the community.

Introduction The patient experience (PX) is central to improving the quality of healthcare services. We launched a PX capacity- and capability-building program at the Armed Forces Hospitals Taif Region, which is integral to our regional healthcare cluster transformation plans and is an initial step toward developing a culture of improvement in human experience in healthcare. Methods A multidisciplinary PX committee recruited five frontline interprofessional PX heads, one from each of our regional healthcare hospitals. The Kirkpatrick model for program evaluation was used to assess the impact on four key levels: reaction, learning, behavior, and results. A pre-program competency assessment was conducted to evaluate the level of expertise across various PX competencies, and a program curriculum was developed accordingly. Participants underwent an intensive workshop-based PX capacity-building training program. A post-program competency assessment was performed along with a post-program survey. The PX-related activities led by interprofessional frontline PX heads at their respective hospitals’ post-programs were tracked. The impact on the regional PX mean score across various settings, including inpatient, outpatient, and emergency settings, was measured using Press Ganey PX surveys. Our work is reported in accordance with the SQUIRE-EDU guidelines of the EQUATOR network. Results The PX capacity-building program led to a significant improvement in participants’ expertise across various PX competencies. Significant improvements beyond the strategic targets were observed in the PX mean score in inpatient departments pre-program (83.31) vs. post-program (86.34), with a p-value of < 0.001 across the regional healthcare system. Conclusion The PX capacity-building program is a first step toward major cultural change amid the healthcare cluster transformation in our regional healthcare system. The Kirkpatrick model helps evaluate the impact of PX capacity- and capability-building training programs comprehensively through an organizational approach. Sustainable improvements in PX over a long period through a capacity-building program alone remain challenging.

The occurrence of testicular dislocation resulting from blunt trauma to the scrotum or abdominopelvic region is infrequent. Due to the presence of significant associated injuries, the diagnosis of this condition can often be missed. This case study presents a case of an adult male who experienced bilateral testicular dislocation following a motorbike accident. Additionally, a concise review of relevant literature is included.

Abstract Knee osteoarthritis (OA) significantly impacts the quality of life of individuals globally. However, the interconnections between Achilles tendon thickness, knee symptoms/functions, and foot alignment remain understudied in knee OA patients. This study determines the relationships between Achilles tendon thickness (ATT), knee symptoms/functions, and foot alignment in knee OA patients, considering their interconnected biomechanical nature. In a cross-sectional analysis involving 122 knee OA patients, Knee injury and Osteoarthritis Outcome Score (KOOS) assessed knee function and symptoms. Forefoot, midfoot, and rearfoot alignment were measured using hallux valgus angle, navicular/foot ratio, and rearfoot angle. The navicular/foot ratio represented the ratio of navicular height to total foot length. ATT was measured using a digital calliper. Pearson correlations and stepwise multiple linear regression models were employed to explore relationships and determinants. Out of 122 participants, 88 (72.1%) were females. ATT correlated significantly with ankle range of motion, forefoot alignment, and midfoot alignment. In stepwise multivariable regression, ankle range of motion, navicular/foot ratio, and age were significantly associated with ATT (adjusted R2 = 0.44). Similarly, KOOS-Symptoms scores were linked to the OA severity, navicular/foot ratio, ankle range of motion, gastrocnemius strength, and age (adjusted R2 = 0.22). KOOS-Function scores were significantly associated with knee OA severity, gastrocnemius strength, ankle range of motion, and age (adjusted R2 = 0.19). Midfoot alignment was significantly associated with ATT and knee symptoms in patients with Knee OA. This suggests potential benefits of interventions targeting both Achilles tendon properties and foot alignment for improved knee OA outcomes.

Ben Li,1– 4,&ast; Farah Shaikh,2,&ast; Abdelrahman Zamzam,2 Ravel Raphael,2 Muzammil H Syed,2 Houssam K Younes,5 Rawand Abdin,6 Mohammad Qadura1– 3,7 1Department of Surgery, University of Toronto, Toronto, Ontario, Canada; 2Division of Vascular Surgery, St. Michael’s Hospital, Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada; 3Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; 4Temerty Centre for Artificial Intelligence Research and Education in Medicine (T-CAIREM), University of Toronto, Toronto, Ontario, Canada; 5Heart, Vascular, & Thoracic Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates; 6Department of Medicine, McMaster University, Hamilton, Ontario, Canada; 7Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada&ast;These authors contributed equally to this workCorrespondence: Mohammad Qadura, University of Toronto, Division of Vascular Surgery, St. Michael’s Hospital, Unity Health Toronto, 30 Bond Street, Suite 7-076, Toronto, Ontario, M5B 1W8, Canada, Tel +1 416-864-5154, Email mohammad.qadura@utoronto.caPurpose: Inflammatory biomarkers associated with peripheral artery disease (PAD) have been examined separately; however, an algorithm that includes a panel of inflammatory proteins to inform prognosis of PAD could improve predictive accuracy. We developed predictive models for 2-year PAD-related major adverse limb events (MALE) using clinical/inflammatory biomarker data.Methods: We conducted a prognostic study using 2 phases (discovery/validation models). The discovery cohort included 100 PAD patients that were propensity-score matched to 100 non-PAD patients. The validation cohort included 365 patients with PAD and 144 patients without PAD (non-matched). Plasma concentrations of 29 inflammatory proteins were determined at recruitment and the cohorts were followed for 2 years. The outcome of interest was 2-year MALE (composite of major amputation, vascular intervention, or acute limb ischemia). A random forest model was trained with 10-fold cross-validation to predict 2-year MALE using the following input features: 1) clinical characteristics, 2) inflammatory biomarkers that were expressed differentially in PAD vs non-PAD patients, and 3) clinical characteristics and inflammatory biomarkers.Results: The model discovery cohort was well-matched on age, sex, and comorbidities. Of the 29 proteins tested, 5 were elevated in PAD vs non-PAD patients (MMP-7, MMP-10, IL-6, CCL2/MCP-1, and TFPI). For prognosis of 2-year MALE on the validation cohort, our model achieved AUROC 0.63 using clinical features alone and adding inflammatory biomarker levels improved performance to AUROC 0.84.Conclusion: Using clinical characteristics and inflammatory biomarker data, we developed an accurate predictive model for PAD prognosis.Plain Language Summary: Inflammatory biomarkers associated with peripheral artery disease (PAD) have been examined separately; however, an algorithm that includes an inflammatory protein panel to inform prognosis of PAD may improve predictive accuracy. We developed predictive models for 2-year major adverse limb events (MALE) using clinical characteristics (demographics, comorbidities, and medications) and a panel of 5 PAD-specific inflammatory biomarkers (MMP-7, MMP-10, IL-6, CCL2/MCP-1, and TFPI) that achieved excellent performance on an independent validation cohort (AUROC 0.84). The models developed through this study may support PAD risk-stratification and targeted management strategies.Keywords: inflammatory biomarkers, predictive model, prognosis, peripheral artery disease

Microalgae cultivation in photobioreactors (PBRs) has emerged as a promising and sustainable approach to address various environmental and energy challenges, offering a multitude of benefits across diverse applications. Recent developments in microalgae cultivation in photobioreactors have contributed substantially to the development and optimization of sustainable bioprocesses. This review presents a comprehensive analysis of recent innovations and breakthroughs in the field of microalgae cultivation, with a specific focus on their application in photobioreactors, aimed at paving the way for a greener future. This study in-depth examines the advantages of microalgae cultivation in photobioreactors, concentrating on its effectiveness in wastewater treatment, CO2 bioremediation, and the production of biofuels and high-value products. The review evaluates the effects of light, solar irradiation, temperature, nitrogen and phosphorus concentrations in culture media, CO2 concentrations, and pH on microalgae growth performance, including specific growth and biomass productivity. The study also examines open systems like unstirred ponds, raceway ponds, and circular ponds and closed systems like horizontal tubular, vertical bubble-column, airlift, flat panel, and plastic-bag photobioreactors, comparing their pros and cons. To optimize microalgae cultivation, key factors in photobioreactor design, including photosynthetic efficiencies, light/dark (L/D) cycles, CO2 concentrations, mass transfer, hydrodynamics behavior, and pH, are extensively investigated. In addition, the review outlines recent developments in large-scale photobioreactors and highlights the challenges and opportunities associated with photobioreactor scale-up and design parameter optimization, including genetic engineering and economic feasibility. This article is a vital resource for researchers, engineers, and industry professionals seeking sustainable bioprocesses and the application of microalgae-based technologies.

As the environment is severely harmed by tobacco (like growing, processing, production, and disposal), the study was set forth to determine the tobacco cultivation status and perceptions of the tobacco farmers toward the environmental and health hazards of tobacco farmers due to tobacco cultivation. We conducted the study in Lama Upazila, Bandarban Hill District, Bangladesh. The survey method was applied to collect the necessary data, utilizing a pre-structured interview schedule, from 242 tobacco farmers who were selected randomly. The study’s results portrayed that the average tobacco cultivation farming experience of the farmers was about 10 years, and the farmers occupied about 0.97 acres of land for cultivating tobacco, while 81% of the tobacco farmers utilized the plain lands for cultivating tobacco, although the study area was a hilly one. A huge amount of fuel wood (average 5390 kg) was required for the curing of tobacco leaves. The farmers produced about 2 MT of tobacco per year and earned about BDT 89,066 (USD 810) from this production. Given that 77% of the tobacco farmers in the research area felt that tobacco production increased the risks to the environment and tobacco farmers health, their opinions ranged from somewhat to highly favorable, which meant they were concerned about the environment and health hazards. The research’s findings provide useful background knowledge on the detrimental effects of Bangladesh’s tobacco farming.

The Haors in Bangladesh are saucer-shaped, low-lying land depressions that form deep basins; they remain submerged for approximately half of the year, typically from June onwards. This fragile ecosystem spans over 2.0 million hectares in the northeastern region of the country, accounting for roughly 14% of the total areas, where approximately 19.4 million people reside. Factors including floods, flash floods, and low winter temperatures constrain agricultural productivity in the haor areas. It is a great challenge to change the haor areas from less productive to more productive land. This is a comprehensive analysis of the biophysical and socioeconomic characteristics of haors which also highlights the constraints and opportunities in agricultural production. It explores strategies for significantly increasing crop, livestock, and fish production within the haor ecosystem, in alignment with government policies. Some of the proposed agricultural development strategies for the haor areas include the development of short-duration, cold-tolerant crop varieties, such as Boro rice, utilizing relatively flood-free elevated lands and homesteads for vegetable production and promoting agricultural mechanization, livestock rearing, fisheries, and agribusiness development. The recommendations presented in this paper focus on enhancing crop yields, increasing cropping intensity, and boosting livestock and fish production; ultimately, they contribute to food security, poverty reduction, and improved livelihoods for the inhabitants of the haor areas.

Abstract Background Knee osteoarthritis (KOA) progression is often influenced by biomechanical factors. Biomechanical interventions, such as Trunk stabilization exercise (TSE) and Mulligan joint mobilization (MWM), may offer relief from KOA symptoms and potentially slow disease progression. However, the comparative efficacy of these therapies remains uncertain. This study aimed to compare the efficacy of TSE, Mulligan joint mobilization, and isometric knee strengthening (KSE) on disability, pain severity, and aerobic exercise capacity in patients with KOA. Methodology A randomized controlled trial (RCT) with three intervention groups was conducted between September 2020 to February 2021. The study enrolled adults aged between 40 and 60 years with a confirmed KOA diagnosis recruited from the physical therapy clinic of the Sindh Institute of Physical Medicine and Rehabilitation, Pakistan. Participants were randomly assigned to receive 24 sessions of either TSE, MWM, or KSE. The knee’s functionality was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS), pain on a visual analogue scale (VAS), and two objective functional tests—the 6-minute walk test (6MWT) and the 11-stair climb test (SCT). These assessments were conducted at baseline, the third week, and the sixth week. Changes in outcome measures were analyzed using a mixed-design ANOVA with Bonferroni post-hoc analysis, with statistical significance set at a p-value

This paper carried out an empirical study on Return on Assets (ROA), total assets turnover, financial leverage, working capital, and debt-to-equity ratio. This study investigated commercial banks operating in Turkey. A secondary data collection method is used for the data collected from fifteen commercial banks. These banks' financial reports were examined from 2011 to 2022. A line graph is presented for each balance that tells us the volatility ratio in the variables, the unit root test applied to resolve the unit root problem, and the cointegration test used for long-term relationships among variables. The Autoregressive Distributed Lag (ARDL) bound test was performed to measure the short-run and long-run effects. Financial leverage, debt-to-equity ratio, and working capital have short- and long-run effects on ROA. Total asset turnover has only long-run effects on ROA in the Turkish banking industry. This study will be beneficial for investment managers, financial specialists, treasurers, and controllers of the banking industry.

Microorganisms offer a sustainable way to increase crop production and promote eco-friendly farming. The endophytic fungus Metarhizium anisopliae is known for its multiple roles in plant ecosystems, including plant protection, symbiosis, and abiotic stress mitigation. In this study, we evaluated the potential of seed priming with M. anisopliae isolate MetA1 (MA) to enhance germination, photosynthetic efficiency, growth, and yield of two wheat varieties, BARI Gom 26 (BG26) and BARI Gom 33 (BG33) under field conditions. The study demonstrated that MA seed priming significantly improved wheat germination (by 13% and 26.04%) of BG26 and BG33, respectively. Overall, photosynthetic performance, indicated by increased leaf angle, leaf thickness, relative chlorophyll content, and linear electron flow (LEF), quantum yield of Photo System II (Phi2) was increased in MA primed wheat plants, while reducing non-photochemical quenching like NPQt, PhiNO, PhiNPQ of both varieties. These enhancements were attributed to increased shoot biomass (by 215.64% for BG26 and 280.38% for BG33), root biomass (by 141.79% for BG26 and 207.4% for BG33), effective tiller percentage (by 9.17% for BG26 and 5.7% for BG33), spike length (by 25.05% for BG26 and 25.42% for BG33), grain yield parameters such as filled grain percentage (by 23.8% for BG26 and 12.5% for BG33), and grain weight per plant (by 168.62% for BG26 and 119.62% for BG33). The findings of the research demonstrated the potential of M. anisopliae for field use in an agricultural setting, providing a sustainable means of increasing food production.

Under the assumption that the recent pulsar timing array evidence for a stochastic gravitational wave (GW) background at nanohertz frequencies is generated by metastable cosmic strings, we analyze the potential of present and future GW observatories for probing the change of particle degrees of freedom caused, e.g., by a supersymmetric (SUSY) extension of the Standard Model (SM). We find that signs of the characteristic doubling of degrees of freedom predicted by SUSY could be detected at Einstein Telescope and Cosmic Explorer even if the masses of the SUSY partner particles are as high as about 104 TeV, far above the reach of any currently envisioned particle collider. We also discuss the detection prospects for the case that some entropy production, e.g. from a late decaying modulus field inducing a temporary matter domination phase in the evolution of the universe, somewhat dilutes the GW spectrum, delaying discovery of the stochastic GW background at LIGO-Virgo-KAGRA. In our analysis we focus on SUSY, but any theory beyond the SM predicting a significant increase of particle degrees of freedom could be probed this way.

Objective: There is growing evidence that anemic patients suffer more severe strokes. We evaluated the relationship between anemia and stroke severity in our patient population. Methods: This descriptive cross-sectional study was carried out over six months in Dow University Hospital which is a tertiary care hospital in Karachi. Patients admitted with acute ischemic stroke, with symptoms duration of up to 72 hours and age more than 20 and less than 80 years were recruited. Patients were divided into two categories, anemic and non-anemic. The stroke severity was classified according to the National Institute of Health Stroke Scores (NIHSS) into three categories, i.e. mild, moderate, and severe. The demographic details, NIHSS scores at admission, symptom du- ration, and hemoglobin concentration were entered into spreadsheets and later transferred to SPSS software for statistical analyses Results: A total of 104 patients were recruited after applying inclusion and exclusion criteria, out of which 55 patients were anemic. The mean age was 54.6 (±13) years. The mean hemoglobin concentration was 10 (±2) g/dl among anemic patients while in non-anemic patients it was 13.9 (±1.2) g/dl. Anemic stroke patients were more likely to have severe strokes, compared to non-anemic patients 41 (74.5%) vs 18 (36.7%), P-value 0.001. The mean NIHSS was higher in anemic compared to non- anemic stroke patients 18.3 (±6.7) vs 13.5 (±6.6), P-value .00, (95 % CI, 2.2, 7.3). Patients with severe anemia had higher stroke severity but did not reach statistical significance (11/13,84.6% vs 48/ 91, 52.7%, P-value .02). Conclusion: Ischemic stroke patients with anemia have more severe strokes when compared to non- anemic patients. The level of hemoglobin may also be associated with stroke severity. These findings should be evaluated by more studies in stroke patients.

Background Boswellin® Super is a standardized extract of Boswellia serrata Roxb gum resin, standardized to contain 30% 3-acetyl-11-keto-β-boswellic acid along with other β-boswellic acids (BSE). A randomized, double-blind, placebo-controlled clinical trial was conducted at two doses of BSE to understand its safety and efficacy in supporting joint health and improving mobility and symptoms of osteoarthritis (OA) of the knee.MethodsBased on the inclusion/exclusion criteria, 105 newly diagnosed participants with degenerative hypertrophy OA were recruited and randomized into Placebo, BSE-150 mg or BSE-300 mg (n = 35 in each group) to receive either 150 mg or 300 mg BSE or a placebo tablet twice a day for 90 days. All the participants were evaluated for pain and physical function using the standard tools including the Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequesne Functional Index (LFI), EuroQol- 5 Dimension (EQ-5D) quality of life, 6-min walk test at day 0, days 5, 30, 60 and 90 of treatment. Additionally, the circulating levels of inflammatory biomarkers, tumor necrosis factor-α (TNFα), high-sensitive C-reactive protein (hs-CRP), and interleukin-6 (IL-6) were evaluated. Safety was evaluated by blood biochemical, hematological analysis, urinary analyses and by monitoring adverse events throughout the study.ResultsNinety-eight subjects completed the study. Improvements in pain scores were observed as early as 5 days after the start of the supplement in the BSE-150 and BSE-300 groups. By 90 days, the VAS pain score reduced by 45.3% and 61.9%, WOMAC- total score improved by 68.5% and 73.6% in the BSE-150 and BSE-300 groups respectively. WOMAC pain (70.2%, 73.9%, WOMAC stiffness (65.6%,68.9%), WOMAC function (68.8%,74.2%), LFI severity (50%,53.3%), decreased and EQ5D (56.9%, 62.9%) and distance walked in 6 minutes (21.2%, 21.9%) improved in the BSE-150 and BSE-300 groups in 90 days. Further, the levels of TNFα, hs-CRP, and IL-6 were found to decrease in the serum in BSE-supplemented participants. No significant adverse events were recorded during the study.ConclusionThe study confirms that Boswellin® Super can be used as a safe and effective supplement to support joint health and mobility in the management of osteoarthritis.Clinical Trial Registration:https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=NzU2Nzc=&Enc=&userName=CTRI, identifier CTRI/2022/11/047397

Pulp therapy has been emerged as a one of the efficient therapies in the field of endodontics. Among different types of new endodontic materials, pulpotec has been materialized as a recognized material for vital pulp therapy. However, its efficacy has been challenged due to lack of information about its cellular biocompatibility. This study evaluates the mechanistic biocompatibility of pulpotec cement with macrophage cells (RAW 264.7) at cellular and molecular level. The biocompatibility was evaluated using experimental and computational techniques like MTT assay, oxidative stress analysis and apoptosis analysis through flow cytometry and fluorescent microscopy. The results showed concentration-dependent cytotoxicity of pulpotec cement extract to RAW 264.7 cells with an LC 50 of X/10-X/20. The computational analysis depicted the molecular interaction of pulpotec cement extract components with metabolic proteins like Sod1 and p53. The study revealed the effects of Pulpotec cement's extract, showing a concentration-dependent induction of oxidative stress and apoptosis. These effects were due to influential structural and functional abnormalities in the Sod1 and p53 proteins, caused by their molecular interaction with internalized components of Pulpotec cement. The study provided a detailed view on the utility of Pulpotec in endodontic applications, highlighting its biomedical aspects.

With advancements in nanotechnology and innovative materials, Graphene Oxide nanoparticles (GONP) have attracted lots of attention among the diverse types of nanomaterials owing to their distinctive physicochemical characteristics. However, the usage at scientific and industrial level has also raised concern to their toxicological interaction with biological system. Understanding these interactions is crucial for developing guidelines and recommendations for applications of GONP in various sectors, like biomedicine and environmental technologies. This review offers crucial insights and an in-depth analysis to the biological processes associated with GONP immunotoxicity with multiple cell lines including human whole blood cultures, dendritic cells, macrophages, and multiple cancer cell lines. The complicated interactions between graphene oxide nanoparticles and the immune system, are highlighted in this work, which reveals a range of immunotoxic consequences like inflammation, immunosuppression, immunostimulation, hypersensitivity, autoimmunity, and cellular malfunction. Moreover, the immunotoxic effects are also highlighted with respect to in vivo models like mice and zebrafish, insighting GO Nanoparticles' cytotoxicity. The study provides invaluable review for researchers, policymakers, and industrialist to understand and exploit the beneficial applications of GONP with a controlled measure to human health and the environment.

Scalar leptoquarks naturally arise within unified theories, offering a promising avenue for addressing one of the most significant challenges of the Standard Model–the existence of non-zero neutrino masses. In this work, we present a unified theory based on the SU(5) gauge group, where neutrino mass appears at the two-loop level via the propagation of scalar leptoquarks. Due to the unified framework, the charged fermion and neutrino masses and mixings are entangled and determined by a common set of Yukawa couplings. These exotic particles not only shed light on the neutrino mass generation mechanism but also help to achieve the unification of gauge couplings and are expected to lead to substantial lepton flavor violating rates, offering tangible opportunities for experimental verification. Reproducing the observed neutrino mass scale necessitates that a set of leptoquarks reside a few orders of magnitude below the unification scale–a specific feature of the proposed scenario. Moreover, maximizing the unification scale implies TeV scale new physics states, making them accessible at colliders. The diverse roles that leptoquarks play highlight the elegance and predictive ability of the proposed unified model.

Plagiarism defines as the act of using another person work or ideas without giving proper crediton, is a widespread problem in both academic and professional settings. This abstract investigates the many facets of plagiarism, including its numerous ramifications and the potential preventative steps. Plagiarism can manifest itself in a variety of ways, including the outright copying of content or the paraphrasing the text without correct or lack of referencing. Plagiarism brings about a wide range of consequences from academic penalties such as failing grades to legal repercussions in professional contexts. In addition to this, it is detrimental to the principles of intellectual honesty and stifles the development of skills in critical thinking. Lack of awareness about citation procedures is one of the cause. Both employers and educational institutions have a responsibility to adopt preventative actions in order to solve this problem. implementation of instructional programs on appropriate ways of citation, the cultivation of a culture of academic integrity, and the utilization of systems that detect instances of plagiarism are the solution.

Artificial intelligence, specifically advanced language models such as ChatGPT, have the potential to revolutionize various aspects of healthcare, medical education, and research. In this review, we evaluate the myriad applications of artificial intelligence in diverse healthcare domains. We discuss its potential role in clinical decision-making, exploring how it can assist physicians by providing rapid, data-driven insights for diagnosis and treatment. We review the benefits of artificial intelligence such as ChatGPT in personalized patient care, particularly in geriatric care, medication management, weight loss and nutrition, and physical activity guidance. We further delve into its potential to enhance medical research, through the analysis of large datasets, and the development of novel methodologies. In the realm of medical education, we investigate the utility of artificial intelligence as an information retrieval tool and personalized learning resource for medical students and professionals.

Abstract Introduction People with Xeroderma Pigmentosum (XP) have a heightened sensitivity to ultraviolet radiation (UVR) and are advised to wear photoprotective clothing including a visor covering the face and neck. Photoprotective visors are homemade and predominately worn by children with decreasing frequency as age increases. To improve upon the current design and efficacy we were tasked with developing a prototype visor to meet patients’ needs. Methods Adopting a codesign methodology, patients’ experiences of wearing a visor and patient and carer views of emerging prototypes were explored during interviews. A thematic analysis was conducted in parallel with data collection and themes were interpreted into design cues; desirable attributes of a visor that would counteract the negative user experiences and meet the requirements described by patients and carers. The design cues guided the iterative development of prototypes by academic engineers. Results Twenty-four interviews were conducted with patients and carers. Thematic analysis resulted in the following five themes: Being safe from UVR exposure; self-consciousness; temperature effects; acoustic difficulties; and material properties. The following design cues were developed from the themes respectively; materials and design with high UVR protection; ability to customise with own headwear; ventilation to reduce steaming up; acoustic functionality to enable hearing and speech; foldable, portable, and easy to put on and take off. Conclusions It is important to understand people’s experiences of using medical devices to improve their safety, efficiency and user satisfaction. The user experience themes and design cues, informed the iterative development of low fidelity visor prototypes as part of a codesign process. These design cues and responses to the prototypes are guiding commercial manufacturing and regulatory approval. The visor can then be prescribed to patients, providing an equitable service of care.

Abstract Background The lack of appropriate prognostic biomarkers remains a significant obstacle in the early detection of Head and Neck Squamous Cell Carcinoma (HNSCC), a cancer type with a high mortality rate. Despite considerable advancements in treatment, the success in diagnosing HNSCC at an early stage still needs to be improved. Nuclear factor erythroid 2-related factor 2 (Nrf2) and Sonic Hedgehog (Shh) are overexpressed in various cancers, including HNSCC, and have recently been proposed as possible therapeutic targets for HNSCC. Circulating Tumor Cell (CTC) is a novel concept used for the early detection of cancers, and studies have suggested that a higher CTC count is associated with the aggressiveness of HNSCC and poor survival rates. Therefore, we aimed to establish molecular markers for the early diagnosis of HNSCC considering Shh/Nrf2 overexpression in the background. In addition, the relation between Shh/Nrf2 and CTCs is still unexplored in HNSCC patients. Methods In the present study, we selected a cohort of 151 HNSCC patients and categorized them as CTC positive or negative based on the presence or absence of CTCs in their peripheral blood. Data on demographic and clinicopathological features with the survival of the patients were analyzed to select the patient cohort to study Shh/Nrf2 expression. Shh and Nrf2 expression was measured by qRT-PCR. Results Considering significant demographic [smoking, betel leaf (p-value

The identification and restoration of ancient watermarks have long been a major topic in codicology and history. Classifying historical documents based on watermarks is challenging due to their diversity, noisy samples, multiple representation modes, and minor distinctions between classes and intra-class variations. This paper proposes a modified U-net-based conditional generative adversarial network (GAN) named Npix2Cpix to translate noisy raw historical watermarked images into clean, handwriting-free watermarked images by performing image translation from degraded (noisy) pixels to clean pixels. Using image-to-image translation and adversarial learning, the network creates clutter-free images for watermark restoration and categorization. The generator and discriminator of the proposed GAN are trained using two separate loss functions, each based on the distance between images, to learn the mapping from the input noisy image to the output clean image. After using the proposed GAN to pre-process noisy watermarked images, Siamese-based one-shot learning is employed for watermark classification. Experimental results on a large-scale historical watermark dataset demonstrate that cleaning the noisy watermarked images can help to achieve high one-shot classification accuracy. The qualitative and quantitative evaluation of the retrieved watermarked image highlights the effectiveness of the proposed approach.

Bruxism is a sleep disorder which is manifested by unintentional grinding and clenching of teeth during sleep. An automated sleep bruxism recognition system using single channel EEG data is proposed in this paper which is based on Inverse Discrete Wavelet Transformed Reconstructed Band Limited (IDWT-RBL) signals. These band limited EEG signals are used for extracting various features. Instead of using handcrafted features, feature reduction is done by ranking using statistical test scoring combined with classifier testing. This technique finds optimal features, reduces model complexity, lowers computational burden and increases model interpretability. Abundant features from time, frequency and statistical domains are used primarily so that no significant feature is ignored. Choosing a good subset of features from a larger set is a challenge for data with low sample size. To meet this challenge, a Group wise Feature Ranking (GFR) technique is introduced to reduce feature dimension. After statistical ranking and group wise averaging the scores, most significant groups of features are chosen. The proposed scheme is validated on a publicly available dataset. This process is examined for both unlabeled and labeled sleep stage. For segments with unlabeled sleep stage, cubic Support Vector Machine (SVM) performed best for F3C3 channel using 6 features with an accuracy of 97.83%. For segments with labeled sleep stage, F3C3 and REM sleep stage using 10 features performed best with 98.39% accuracy. The accuracy of proposed method is superior to most recent bruxism detection techniques. Finally, the GFR technique is applied to detect sleep disordered breathing (SDB). The outstanding performance to detect SDB clearly demonstrates the versatility of the proposed GFR technique to solve binary classification problem using EEG signals. Moreover, the introduced GFR technique enhances confidence and pellucidity of the system as it is more explainable.

Abstract Background Despite growing evidence of the potential of arts-based modalities to translate knowledge and spark discussion on complex issues, applications to health policy are rare. This study explored the potential of a research-based theatrical video to increase public capacity and motivation to engage with the complex issues that make Emergency Department wait times such an intractable problem. Methods Larry Saves the Canadian Healthcare System is a digital musical micro-series developed from extensive research examining system-level causes of Emergency crowding and the ineffectiveness of prevailing approaches. We released individual episodes and a revised full-length version on YouTube, using organic promotion strategies and paid advertising. We used YouTube Analytics to track views, engagement and viewer demographics, and content-analyzed viewer comments. We also conducted five university-based screenings; 92 students completed questionnaires, rating Larry on 16 descriptors using a 7-point Likert scale. Results From June 2022 through May 2023, Larry garnered over 100,000 views (76,752 of the full-length version, 35,535 of episodes), 1329 likes, 2780 shares, and 139 comments. Views and watch time were higher among women and positively associated with age. Among YouTube comments, the predominating themes were praise for the video and criticism of the healthcare system. Many commenters applauded the show’s accuracy, humor, and/or resonance with their experience; several shared healthcare horror stories. Students overwhelmingly agreed with all positive and disagreed with all negative descriptors, and nearly unanimously deemed the video informative, thought-provoking, and entertaining. Most also affirmed that it had increased their knowledge, interest, and confidence to participate in discussions about healthcare issues. Neither gender, primary language, nor employment in healthcare predicted ratings, but graduate students and those 25+ years old evaluated the video most positively. Discussion These findings highlight the promise of research-informed musical satire to inform and invigorate discourse on an urgent health policy problem. Larry has reached tens of thousands of viewers, garnered excellent feedback, and received high student ratings. Further research should directly assess educational and behavioural outcomes and explore what facilitative strategies could maximize this knowledge translation product’s potential to foster informed, impactful policy dialogue.

Abstract Objectives Functional retentive overflow incontinence (retentive FI) is the most common cause of fecal soiling in children. Based on the clinical experiences, the treatment of retentive FI in patients with comorbid psychiatric disorders was accelerated when Risperidone was used as treatment for their psychiatric comorbidities; therefore, this study was conducted to evaluate the effect of risperidone in the treatment of retentive FI in children and adolescents. Methods In this double-blind, randomized, placebo-controlled trial, 140 patients aged 4–16 years eligible for the study were randomized into two groups, receiving either 0.25–0.5 mg of Risperidone syrup (n = 70) or maltodextrin syrup (placebo group, n = 70) every 12 h daily for 12 weeks. Sociodemographic data, including age, sex, weight, height, BMI, BMI z-score, and socioeconomic status, was recorded, and the number of nocturnal FI, diurnal FI, and painful defecations was measured. Results 136 participants (69 on Risperidone and 67 on placebo) were included in the study. Mean age of participants in the intervention and placebo groups were 7.2 ± 2.4 years and 8.0 ± 3.1 years, respectively. The mean number of nocturnal FI (Ptrend=0.39) and diurnal FI (Ptrend=0.48) in patients without psychiatric comorbidities, and the number of painful defecations for participants with and without psychiatric comorbidities (P = 0.49, P = 0.47, respectively) were not significantly different between the groups, but a significant effect was observed in diurnal FI after Risperidone treatment in patients with psychiatric comorbidities (P

In this paper, we designed and implemented a multi-antenna configured secure millimeter-wave (mmWave) CP-less multi-user orthogonal chirp division multiplexing (OCDM) transceiver. The proposed simulated system emphasizes more applicable performance metrics for a typically assumed case of four users and a passive eavesdropper for audio data transmission. We introduce a four-dimensional hyperchaotic system-based encryption algorithm to enhance physical layer security (PLS). In addition, low-density parity check (LDPC), TURBO, ( $3, 2$ ) single parity check (SPC), and repeat and accumulate (RA) channel coding with Cholesky decomposition-based zero-forcing (CD-ZF) and minimum mean square error (MMSE) signal detection techniques for a better bit error rate (BER) were also implemented. The simulation results signify the effectiveness of the proposed system in terms of PLS enhancement with low correlation coefficients (14.62%, 7.61%, 13.61%, and 15.39% for users 1, 2, 3, and 4, respectively), an achievable secrecy rate with a low signal-to-interference and noise ratio (SINR) of the passive eavesdropper, an achievable out-of-band (OOB) power emission of 341 dB, an estimated average short-time Fourier transform (STFT) spectral power difference of 7.68 dB and estimated peak-to-average power ratios (PAPRs) ranging from 7 to 7.5 dB at a complementary cumulative distribution function (CCDF) of $1\times 10^{-3}$ for different ground transmitting channels. At an identical signal-to-noise ratio (SNR) of 17 dB, all four users achieved a bit error rate of $1\times 10^{-4}$ under RA channel coding, CD-ZF, and 16-QAM (quadrature amplitude modulation) digital modulation.

Introduction: Considering the inherent vulnerability of immunoassays for heterophilic interference and the potential of Rheumatoid Factor (RF) to act as a heterophile-like antibody, we conducted this study to investigate if RF leads to any such heterophilic interference in seropositive rheumatoid arthritis (RA) patients. The study was done on the TSH assay as it is a noncompetitive, double antibody sandwich assay, which is known to be vulnerable to heterophilic interference. Methods: In this cross-sectional observational study, eighty-four consecutive newly diagnosed RF-positive RA patients underwent TSH, Free T4, and anti-TPO estimation using the chemiluminescence technique (CLIA) on Siemens Immulite 1000 platform. The samples were screened for TSH interference using four methods: 1) analysis on a different platform, 2) assessment of linearity using doubling dilutions, 3) polyethylene glycol (PEG) precipitation, and 4) addition of a commercial blocker. Results: Ten samples had a loss of linearity on serial dilution, indicating potential interference. After heterophile blocker treatment, five cases exhibited interference. One patient had diagnostic interpretation discordance on the second platform. No sample on PEG precipitation suggested the influence of antibodies. It is worth noting that even in cases where interference was suspected, the clinical interpretation was largely unaffected by the correction of TSH values based on mean dilution or measurement after heterophile blocker treatment. Conclusion: RF can cause heterophilic interference in TSH immunoassays used commercially. However, in most cases, this interference does not affect clinical decision-making.

Osama Mosalem,1 Tanmayi Pai,1 Mohammed Alqawasma,2 Marwan Shaikh,1 K David Li,3 Muhamad Alhaj Moustafa1 1Department of Hematology/Oncology, Mayo Clinic, Jacksonville, FL, USA; 2Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA; 3Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USACorrespondence: Tanmayi Pai, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, USA, Tel +1 904 953 2000, Email pai.tanmayi@mayo.eduAbstract: Brentuximab vedotin (BV) and nivolumab are increasingly utilized as a novel regimen in patients with relapsed/refractory classical Hodgkin lymphoma (cHL). A 26-year-old male presented to the hospital with refractory diabetic ketoacidosis and multiple electrolyte abnormalities, 9 days after the first dose of brentuximab vedotin and nivolumab for recurrent classical Hodgkin lymphoma. During his hospitalization, he developed multi-organ failure. His workup showed elevated cytokine levels concerning severe cytokine release syndrome (CRS) and hemophagocytic lymphohistiocytosis (HLH)-like syndrome. Despite treatment with CRS- and HLH-directed therapies, his clinical status deteriorated due to ongoing multifactorial shock and worsening multi-organ dysfunction, and comfort care measures were eventually pursued. To our knowledge, there have been no other cases reported of HLH-like syndrome after the combination of BV and nivolumab in patients with cHL. This case of a fatal adverse event following one dose of BV and nivolumab underscores the vital need for close monitoring of patients receiving this treatment regimen.Keywords: immunotherapy, immune-related adverse event, antibody drug conjugate, CRS

Somina Shaikh Dow Medical College, Karachi, PakistanCorrespondence: Somina Shaikh, Dow Medical College, Karachi, Pakistan, Email somina.sh16@gmail.com

The mobile phone is one of the most accessible and transformative communication technologies globally and a staple in modern life. This study explores the impact of mobile phone usage among women on developing agricultural farm enterprises. Data were collected from 150 rural women involved in agricultural enterprise development. Descriptive statistics, chi-square test, multiple linear regression, step-wise regression, and path analysis were used for quantitative data analysis. The study found that a large proportion (70.0% and 64.0%) of the respondents in crop and fisheries enterprises had a medium extent of mobile phone usage. In contrast, more than half (56.0%) of the rural women in livestock enterprises fell under the low usage category. Factors such as reduced transportation costs, time-saving, easy contact with stakeholders, and frequent contact with fellow entrepreneurs were identified as significant influences on rural women’s mobile phone usage. Multiple regression analysis revealed that 14 selected characteristics explained 66.0% of the total variation. Among them, membership in an organization, distance of residence from the nearest market, training received on mobile phone usage, skill in using mobile phones, attitude towards mobile phones, amount of money spent, and perceived ease of use had a significant positive contribution. The attitude towards mobile phones had the highest contribution, explaining 36.0% of the variation. The path analysis showed that attitude towards mobile phones had a positive direct effect (0.30) on the extent of mobile phone usage. Perceived ease of use had the highest total indirect effect (0.413), primarily channeled positively through attitudes towards mobile phones.

The presence of metformin (MTN) and erythromycin (ETM) in groundwater is a growing global concern due to their persistence and toxicity. This study addresses a critical gap in understanding the fate and transport of these pharmaceutical and personal care products in saturated sandy soil columns at environmentally relevant concentrations, an underexplored area. The results show that MTN, due to its high mobility, appeared earlier in the soil column with a recovery rate exceeding 90 % and an adsorption coefficient (Kd) of 1.063 Lkg−1. In contrast, ETM, with a higher Kd value of 5.426 Lkg−1, exhibited delayed breakthrough and recovery of less than 15 %, indicating stronger adsorption potential. Desorption studies indicated a greater risk of MTN leaching into groundwater, while ETM remained strongly adsorbed to soil particles. Despite the limited organic matter content in sandy soil, a significant amount of ETM was adsorbed, suggesting sands' high adsorption capacity and potential for natural remediation. This research fills a knowledge gap regarding the adsorption capacity of sandy soils at environmentally relevant concentrations, providing essential insights for environmental risk assessments and groundwater contamination mitigation strategies, directly supporting Sustainable Development Goals 3 (Health and Well-being), 6 (Clean Water and Sanitation), and 14 (Life Below Water).

The prevalence of premature atherosclerotic cardiovascular disease (ASCVD) ranges from 7% to 30%, but the incidence in young patients is increasing. Traditional risk factors, such as hypertension, hyperlipidemia, obesity, and diabetes, have an increasing prevalence in young patients and especially in young women. A 32-year-old woman presented with dyspnea and exertional chest pain. She had a history of familial hypercholesterolemia and unidentified aortic valve disease status after a pulmonary autograft at the age of 20. Due to insurance changes with the onset of the COVID-19 pandemic, she lost access to specialty care. She was not on any cholesterol-lowering agents prior to admission. An electrocardiogram demonstrated no ST changes with elevated high-sensitivity troponin-I concerning for non-ST elevation myocardial infarction. Laboratory data also revealed elevated LDL-C greater than 400. Due to concern for multivessel disease and complex anatomy, she underwent coronary computerized tomography angiography, which verified her multivessel coronary artery disease. An echocardiogram demonstrated a preserved ejection fraction and moderate aortic regurgitation. Her coronary artery bypass graft was deferred due to possible future valvular surgery. She underwent percutaneous coronary intervention with drug-eluting stents to left circumflex and left anterior descending arteries. Familial hypercholesterolemia is a prevalent but under-recognized and under-treated risk factor for premature ASCVD, which can be adequately identified through improved risk assessment and managed with aggressive combination anti-hyperlipidemia therapy.

Autoimmune Thyroiditis (AIT) is a prevalent autoimmune disorder characterized by an immune response targeting the thyroid gland. Genetic factors play a significant role in AIT susceptibility, with immune-related genes, especially the vitamin D receptor (VDR) gene, potentially influencing AIT development. This comprehensive review delves into the intricate association between VDR gene polymorphisms, particularly rs2228570 (FokI), and AIT susceptibility, exploring various populations. Research has unveiled contrasting outcomes regarding the link between the VDR rs2228570 polymorphism and AIT risk across diverse ethnic groups. Certain populations have exhibited a noteworthy correlation, suggesting that population-specific genetic factors contribute to AIT risk. A recurring observation of vitamin D deficiency in AIT patients has correlated with elevated anti-thyroid antibodies, abnormal thyroid function, and thyroid volume. The results emphasize the possible role of vitamin D in the development of AIT, suggesting the importance of vitamin D supplementation to address deficiencies associated with AIT. In addition to VDR rs2228570, other genetic variants have also shown associations with AIT susceptibility, displaying varying results across different populations. Ethnicity emerges as a pivotal factor influencing these associations, underscoring the need to consider genetic variations in diverse populations. We emphasize the intricate interplay between VDR gene polymorphisms, vitamin D, and AIT susceptibility. Extensive research is essential to unveil the clinical significance of these genetic variations, offering prospects for enhanced diagnostic and therapeutic strategies for individuals with AIT.

Bangladesh Agricultural Research Institute (BARI) released two beautiful Lilium varieties in 2020. In the same year the farmers in Gazipur district reported a set of disease symptoms on these flowers and alerted the Plant Pathology Division of BARI. Subsequent investigation confirmed the symptoms as Botrytis gray mold (BGM), caused by Botrytis cinerea. The pathogen identity was confirmed through ITS gene sequencing. A series of in vitro and in planta experiments conducted to understand the symptoms, the optimal growth condition for the pathogen, potential resistant Lilium genotypes, effective chemical treatments and potential of biological control agents to combat the disease. B. cinerea exhibited the highest growth in V8 media (88.55 mm) at pH6 (85.32 mm) and temperature between 20 and 25 °C (89.56 mm), and pH6 (85.32 mm). Screening revealed that five oriental-originated genotypes provided lower disease incidence (31.66–41.66 %), and were categorized as moderately resistant to resistant in disease reaction. Six fungicides successfully reduced mycelial growth in vitro. Moreover, Ipridione provided the lowest % disease incidence (27.11) and % disease severity (5.33) in the in planta nethouse experiment. Therefore, this fungicide was recommended to the farmers initially. Additionally, two fungal biocontrol agents Epicoccum nigrum EJS002 and Trichoderma ThC003, demonstrated effectiveness in reducing leaf lesion size over control in a detach leaf assessment technique. In conclusion, this study presents BGM of Lilium as a farmers issue for the first time in Bangladesh. It also provides valuable insights into its management, recommending specific chemical fungicides for farmers to use, and two fungal antagonists (E. nigrum EJS002 and Trichoderma ThC003) as potential disease control agent.

Objective To examine the effectiveness of rivaroxaban compared to enoxaparin in patients diagnosed with cancer and venous thromboembolism. Methods A search of Pub Med, Scopus, and Google Scholar, from inception through April 2023 was conducted. Articles comparing rivaroxaban with enoxaparin in patients with cancer and VTE/PE/DVT were included. Review Manager Version 5.2 was utilised for the analysis of the following outcomes; VTE, PE, DVT, major bleeding, and mortality. Results A total of 8 articles and 2276 patients were included in the final analysis. Pooled analysis showed that rivaroxaban had a statistically insignificant reduced association with VTE occurrence (RR:0.83, 95% CI:0.58–1.18, P:0.3) as well as a statically insignificant reduction in major bleeding (RR:0.79, 95% CI:0.53–1.18, P:0.25). Analysis showcased that there was an insignificant reduction of mortality rivaroxaban as compared to enoxaparin (RR:0.74, 95% CI: 0.46–1.20, P:0.23). Conclusion Rivaroxaban can serve as a viable alternative to enoxaparin, with no appreciable drawbacks, for preventing and managing VTE in patients with malignancy.