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Background Hepatitis B virus (HBV) and Hepatitis C virus (HCV) show similarity in the transmission, distribution, hepatotropism, and leading to chronic asymptomatic infection. Coinfection of HBV and HCV can lead to more severe liver disease and an increased risk for progression to hepatocellular carcinoma (HCC). Most of the people with chronic infection are unaware of their HBV and HCV infections, hence facilitating these to go undiagnosed until these viruses have caused serious liver damage and they act as a potential source of infection for the community at large. Therefore, the present study aimed to find the prevalence of HBV and HCV along with incidences of coinfection of HBV and HCV in patients seeking hospital care in central India. Methods A five-year hospital-based study was carried out at the tertiary care hospital in Central India from 2018 to 2022. A total of 72402 patients attending the outdoor patients and admitted indoor patients who were advised for HBV and HCV for screening before any invasive/surgical procedure and patients who presented with symptoms of acute or chronic liver disease were included in this study. Screening was done by immunochromatography-based card test followed by the confirmation of all samples by enzyme immunoassay. Results Seroprevalence of HBV and HCV was found to be 3.71% and 1.91%, respectively. Coinfection with HBV/HCV was seen in 0.13% of the individuals. The overall prevalence of HBV, HCV, and HBV-HCV coinfection was significantly higher in the male population as compared to females. Conclusion The study findings of seroprevalence of HBV and HCV among the hospital-based population will help to get a baseline understanding of the disease burden in central India. The HBV/HCV coinfection rate also raises serious concerns owing to its high prevalence rate among the younger age.

Neurogenesis occurs in the adult brain in the hippocampal dentate gyrus, an area that contains neurons which are vulnerable to insults and injury, such as severe seizures. Previous studies showed that increasing adult neurogenesis reduced neuronal damage after these seizures. Because the damage typically is followed by chronic life-long seizures (epilepsy), we asked if increasing adult-born neurons would prevent epilepsy. Adult-born neurons were selectively increased by deleting the pro-apoptotic gene Bax from Nestin-expressing progenitors. Tamoxifen was administered at 6 weeks of age to conditionally delete Bax in Nestin-CreERT2Baxfl/fl mice. Six weeks after tamoxifen administration, severe seizures (status epilepticus; SE) were induced by injection of the convulsant pilocarpine. After mice developed epilepsy, seizure frequency was quantified for 3 weeks. Mice with increased adult-born neurons exhibited fewer chronic seizures. Postictal depression was reduced also. These results were primarily in female mice, possibly because they were more affected by Bax deletion than males, consistent with sex differences in Bax. The female mice with enhanced adult-born neurons also showed less neuronal loss of hilar mossy cells and hilar somatostatin-expressing neurons than wild-type females or males, which is notable because loss of these two hilar cell types is implicated in epileptogenesis. The results suggest that selective Bax deletion to increase adult-born neurons can reduce experimental epilepsy, and the effect shows a striking sex difference. The results are surprising in light of past studies showing that suppressing adult-born neurons can also reduce chronic seizures.

BackgroundPleomorphic xanthoastrocytoma (PXA) is a rare brain tumor that accounts for

Maternal choline supplementation (MCS) improves cognition in Alzheimer’s disease (AD) models. However, the effects of MCS on neuronal hyperexcitability in AD are unknown. We investigated the effects of MCS in a well-established mouse model of AD with hyperexcitability, the Tg2576 mouse. The most common type of hyperexcitability in Tg2576 mice are generalized EEG spikes (interictal spikes [IIS]). IIS also are common in other mouse models and occur in AD patients. In mouse models, hyperexcitability is also reflected by elevated expression of the transcription factor ∆FosB in the granule cells (GCs) of the dentate gyrus (DG), which are the principal cell type. Therefore, we studied ΔFosB expression in GCs. We also studied the neuronal marker NeuN within hilar neurons of the DG because reduced NeuN protein expression is a sign of oxidative stress or other pathology. This is potentially important because hilar neurons regulate GC excitability. Tg2576 breeding pairs received a diet with a relatively low, intermediate, or high concentration of choline. After weaning, all mice received the intermediate diet. In offspring of mice fed the high choline diet, IIS frequency declined, GC ∆FosB expression was reduced, and hilar NeuN expression was restored. Using the novel object location task, spatial memory improved. In contrast, offspring exposed to the relatively low choline diet had several adverse effects, such as increased mortality. They had the weakest hilar NeuN immunoreactivity and greatest GC ΔFosB protein expression. However, their IIS frequency was low, which was surprising. The results provide new evidence that a diet high in choline in early life can improve outcomes in a mouse model of AD, and relatively low choline can have mixed effects. This is the first study showing that dietary choline can regulate hyperexcitability, hilar neurons, ΔFosB, and spatial memory in an animal model of AD.

Background. Vascularized composite allograft transplantation is a treatment option for complex tissue injuries; however, ischemia reperfusion injury and high acute rejection rates remain a challenge. Hypothermic machine perfusion using acellular storage perfusate is a potential solution. This study evaluated the University of Wisconsin Kidney Preservation Solution-1 (KPS-1) compared with normal saline (NS) for preservation of donor rat hindlimbs subjected to 24 h of ex vivo perfusion cold storage. Methods. Hindlimbs were subjected to 24-h perfusion cold storage with heparinized KPS-1 (n = 6) or heparinized NS (n = 6). Flow, resistance, and pH were measured continuously. At the end of the 24-h period, tissue was collected for histological analysis of edema and apoptosis. Results. KPS-1 perfused limbs showed significantly less edema than the NS group, as evidenced by lower limb weight gain (P

Diuresis with loop diuretics is the mainstay treatment for volume optimization in patients with congestive heart failure, in which perfusion and volume expansion play a crucial role. There are robust guidelines with extensive evidence for the management of heart failure; however, clear guidance is needed for patients who do not respond to standard diuretic treatment. Diuretic resistance (DR) can be defined as an insufficient quantity of natriuresis with proper diuretic therapy. A combination of diuretic regimens is used to overcome DR and, more recently, SGLT2 inhibitors have been shown to improve diuresis. Despite DR being relatively common, it is challenging to treat and there remains a notable lack of substantial data guiding its management. Moreover, DR has been linked with poor prognosis. This review aims to expose the multiple approaches for treatment of patients with DR and the importance of intravascular volume expansion in the response to therapy.

A productive HIV-1 infection in humans is often established by transmission and propagation of a single transmitted/founder (T/F) virus, which then evolves into a complex mixture of variants during the lifetime of infection. An effective HIV-1 vaccine should elicit broad immune responses in order to block the entry of diverse T/F viruses. Currently, no such vaccine exists. An in-depth study of escape variants emerging under host immune pressure during very early stages of infection might provide insights into such a HIV-1 vaccine design. Here, in a rare longitudinal study involving HIV-1 infected individuals just days after infection in the absence of antiretroviral therapy, we discovered a remarkable genetic shift that resulted in near complete disappearance of the original T/F virus and appearance of a variant with H173Y mutation in the variable V2 domain of the HIV-1 envelope protein. This coincided with the disappearance of the first wave of strictly H173-specific antibodies and emergence of a second wave of Y173-specific antibodies with increased breadth. Structural analyses indicated conformational dynamism of the envelope protein which likely allowed selection of escape variants with a conformational switch in the V2 domain from an α-helix (H173) to a β-strand (Y173) and induction of broadly reactive antibody responses. This differential breadth due to a single mutational change was also recapitulated in a mouse model. Rationally designed combinatorial libraries containing 54 conformational variants of V2 domain around position 173 further demonstrated increased breadth of antibody responses elicited to diverse HIV-1 envelope proteins. These results offer new insights into designing broadly effective HIV-1 vaccines.

The association between hyperuricemia and cardiovascular diseases has been studied for many years. Research has shown a link between high uric acid levels and increased risk of including coronary artery disease hypertension and other cardiovascular conditions. Urate-lowering therapy, particularly with xanthine oxidase inhibitors like allopurinol, has shown promising results in reducing blood pressure in individuals with hyperuricemia and hypertension. Clinical trials and studies have demonstrated significant reductions in both systolic and diastolic blood pressure with urate-lowering treatment. Urate-lowering treatment has shown a favorable effect on reducing systolic blood pressure and major adverse cardiovascular events in patients with previous cardiovascular disease. In terms of cardiovascular safety, clinical trials have indicated that xanthine oxidase inhibitors such as febuxostat are non-inferior to allopurinol and do not increase the risk of death or serious adverse events. Overall, these findings highlight the importance of managing hyperuricemia and utilizing urate-lowering therapy to mitigate the adverse cardiovascular effects associated with elevated uric acid levels.

Summary: Background: The protection of fourth dose mRNA vaccination against SARS-CoV-2 is relevant to current global policy decisions regarding ongoing booster roll-out. We aimed to estimate the effect of fourth dose vaccination, prior infection, and duration of PCR positivity in a highly-vaccinated and largely prior-COVID-19 infected cohort of UK healthcare workers. Methods: Participants underwent fortnightly PCR and regular antibody testing for SARS-CoV-2 and completed symptoms questionnaires. A multi-state model was used to estimate vaccine effectiveness (VE) against infection from a fourth dose compared to a waned third dose, with protection from prior infection and duration of PCR positivity jointly estimated. Findings: 1298 infections were detected among 9560 individuals under active follow-up between September 2022 and March 2023. Compared to a waned third dose, fourth dose VE was 13.1% (95% CI 0.9 to 23.8) overall; 24.0% (95% CI 8.5 to 36.8) in the first 2 months post-vaccination, reducing to 10.3% (95% CI −11.4 to 27.8) and 1.7% (95% CI −17.0 to 17.4) at 2–4 and 4–6 months, respectively. Relative to an infection >2 years ago and controlling for vaccination, 63.6% (95% CI 46.9 to 75.0) and 29.1% (95% CI 3.8 to 43.1) greater protection against infection was estimated for an infection within the past 0–6, and 6–12 months, respectively. A fourth dose was associated with greater protection against asymptomatic infection than symptomatic infection, whilst prior infection independently provided more protection against symptomatic infection, particularly if the infection had occurred within the previous 6 months. Duration of PCR positivity was significantly lower for asymptomatic compared to symptomatic infection. Interpretation: Despite rapid waning of protection, vaccine boosters remain an important tool in responding to the dynamic COVID-19 landscape; boosting population immunity in advance of periods of anticipated pressure, such as surging infection rates or emerging variants of concern. Funding: UK Health Security Agency, Medical Research Council, NIHR HPRU Oxford, Bristol, and others.

Introduction Clopidogrel is a P2Y12 inhibitor that has become a mainstay treatment following percutaneous intervention with drug-eluting stent placement to decrease restenosis and its potential complications, including sudden cardiac death and ischaemic strokes in patients with significant vascular disease.Areas covered As a prodrug, the metabolism and efficacy of clopidogrel are contingent on the presence of wild-type CYP450 (CYP2C19) alleles. Genetic polymorphisms and variants are well known to impair its ability to prevent major adverse cardiovascular events in these patients, with inadequate response rates as high as 30% in previous publications. Patterns of allelic frequencies are expected to exhibit similarities between individuals of the same ancestry, ethnic group or geographic region. Accordingly, we seek to further elucidate worldwide prevalence rates for genetic polymorphisms in the CYP2C19-dependent metabolism of clopidogrel and review the potential of personalised CYP2C19 genotyping in clinical practice to mitigate this high treatment resistance and its associated burden on patients.Experts’ commentary Our findings support the consideration of genotyping before initiation of therapy to guide adequate dosage or substitutions of other P2Y12 inhibitors to promote personalised, precision medicine and to prevent adverse events when these therapies may inevitably fail in patients with variants of the CYP450 (CYP2C19) system.

Aim: This study investigated the efficacy of Endoactivator, Pro-agitator tip system (PATS) Vario, BF brush, and dual side-vented needle irrigation to remove double antibiotic paste (DAP) from the root canal. Methods: Biomechanical preparation till size #25 (F2) was carried out utilizing the Protaper Universal System on 92 extracted teeth with single root and root canal. All the canals were filled with DAP for 21 days, and the roots were split into two halves (n = 20) and divided into four groups randomly based on the irrigation method, using either dual side-vented needle irrigation, BF brush, Endoactivator, or PATS Vario. Under a stereomicroscope, the quantity of medication still present at every root half was assessed using a four-grade scoring system. Results: PATS Vario (0.46 ± 0.50) followed by Endoactivator (0.46 ± 0.52) groups were substantially more effective at eliminating DAP from the root canal than BF brush groups (0.98 ± 0.58) and dual side-vented irrigation tips (2.29 ± 0.53) (P < 0.05) However, none of the methods succeeded in entirely removing antibiotic paste from canal walls. Conclusion: PATS Vario Group was more efficient than Endoactivator at eliminating DAP from root canal walls, but the difference was not statistically significant (P > 0.05).

Background and Aims: Endotracheal intubation (ET) in infants is considered a challenging task over the decades. Infants have short safe apnoea time, and this difficulty has been vanquished to some extent by using the videolaryngoscopes (VLs), but there exists a dearth of research particularly in this vulnerable subset. Therefore, this trial was conducted to evaluate intubation times obtained with C-MAC VL and conventional Miller laryngoscopes in infants. Methods: A total of 80 infants aged between 1 month and 1 year with American Society of Anesthesiologists physical status I-II requiring ET were randomised in two groups; the C-MAC VL or Miller laryngoscope ML. Anaesthesia was induced with sevoflurane 1–8% and atracurium 0.5 mg/kg IV. The primary outcome was evaluated as the total time taken to intubate. Secondary outcomes were time to achieve best glottic view (TBGV), tube insertion time (TIT), percentage of glottic opening (POGO) score, number of attempts and intubation difficulty score (IDS). Results: The median (interquartile range) of time taken for ET was less in VL; 22.5 (20.75–26) compared to ML; 26 (21.75–31). TBGV was achieved early in VL group than the ML group (6.03 ± 1.33s/7.88 ± 2.44) respectively (P-value < 0.001). POGO was better in VL (99.12 ± 4.795s) compared to ML (85.50 ± 31.13s). IDS was less in the VL group (0.07 ± 0.27) than in ML (0.70 ± 1.14). Other parameters, such as the number of attempts, bougie usage, adverse effects and TIT, were comparable across the two groups. Conclusion: When compared to the ML group, the C-MAC VL group exhibited a decreased intubation time, early TBGV, better POGO score, reduced IDS and subjective intubation difficulty. As a result, we consider VL to be a more efficacious device for intubating the trachea in infants.

Introduction: COVID-19 pandemic has influenced health-care utilization globally accentuating oral disease burden. This has reinforced the role of telemedicine. However, being technologically sensitive; the concept is still not popular. Hence, the present study aims to assess the scope and feasibility of teledentistry services of a Mobile Dental Clinics. Methodology: Teledentistry services were provided to the old patients of Mobile Dental Clinic Project for follow-up care from May 2021 to June 2021. Contact details of the patients were retrieved and were contacted for teleconsultation services using smartphones. Data were recorded through a prestructured digital outpatient department and feedback form. Results: A total of 813 active calls were made to provide teledentistry services. The response rate was 26.33% (n = 214). Around 78.5% (n = 168) of the study respondents did not have any current chief complaint related to oral health. Those who suffered from some ailment (11.2%) complained majorly of “dental pain.” Around 34.6% (n = 74) still required further dental treatment. The majority (97.7%) were satisfied with the teledentistry services provided. Discussion: Mostly, the patients could not be contacted due to COVID-19-related lockdown and migration from the city. From the patients who were followed up, 21.5% reported having some dental complaint. This clearly showed that these patients had received dental treatment even during pandemic. Furthermore, the felt need in the community was quite high leading to health-seeking behavior previously. Conclusion: In the view of COVID-19 preventive measures, it is advocated that teledentistry services should be implemented to improve oral healthcare outreach.

Introduction: Quality healthcare is a multi-dimensional concept. Patient satisfaction is an important indicator for measuring the quality of health care. The evolution of digital feedback forms has gained momentum nowadays. The present study aims to evaluate patient satisfaction regarding community dental care services provided through mobile dental clinics using digital feedback forms and to assess various factors influencing oral health-seeking behavior. Methods: A descriptive cross-sectional study on randomly selected patients (n = 1228) reporting for dental treatment in Mobile Dental Clinics from January 2019 to December 2019 was considered for the study. The patients were interviewed about their satisfaction with the services provided and other factors which influence their health-seeking behavior in Mobile Dental Clinics. The responses were recorded in digital feedback form in software named Kobo Collect 1.2 RC1 (1006) toolbox. Results: Almost 80%–90% of the patients were completely satisfied based on various criteria with the treatment services given to them in Mobile Dental Clinics. Around 89.4% (n = 1098) of study participants responded that no dental services were available in nearby dispensaries which was the major factor influencing the health-seeking behavior in Mobile Dental Vans. The qualitative assessment of patient satisfaction showed that around 15.6% (192) of patients ”appreciated our project and staff members behavior and work.” Conclusion: Quality assessment of health-care services is essential. Digital feedback forms not only save time but are also safe to keep our environment green. The findings of this study could facilitate attending to the concerns of patients seeking treatments in Mobile Health Units.

Abstract Recognizing entities and their corresponding roles are important in human activity recognition. In light of recent advancements, the primary emphasis is recognizing the abstract activities involving person‐person interaction. The contribution of this work is proposing an architecture, which utilizes the knowledge of the human body parts coordinates in role detection of each individual. The network preprocesses the coordinates to build intra‐body and inter‐body features. The extracted features build the relationship between the interacting bodies and learn the temporal relation corresponding to each role using the human memory‐inspired hierarchical temporal memory. The model is tested on vague samples of mutual actions in the experimental work. The model is found robust in action and role recognition tasks and performed well per expectations.

BackgroundSpinal arachnoid cysts are relatively uncommon, cerebrospinal fluid-filled sacs formed by arachnoid membranes that can be either idiopathic or acquired. The neurological presentation of these cysts is varied. Advances in imaging techniques have allowed an improved characterization of these entities and excluded other possible causes of clinical manifestation. Their presentation remains varied, ranging from pain to progressive neurological deficits. Here, we present two cases of patients with thoracic arachnoid cysts that posed a diagnostic dilemma at initial presentation because of their acute neurological deficit, and their eventual recovery after surgical intervention.Case descriptionThe first case is of a patient with end-stage renal failure, which prevented the administration of contrast during the workup. The differential diagnosis ranged from intradural abscess to arachnoid cyst. The second patient presented with non-remitting back pain that progressed to an acute neurological deficit. Both patients recovered well after decompression of the cyst.ConclusionThe decision to intervene is still patient-dependent and based on the extent of neurological deterioration at the time of presentation due to the relatively benign nature and lack of understanding of the temporal presentation of neurological symptoms, which are rapidly and almost completely reversed after surgery. However, further studies need to be done to understand the acute presentation of these cysts, which are apparently long-standing.

Abstract Background Neuroleptic malignant syndrome is a clinical condition which has been studied and described well. But history of the patient and the medications he is on are very important to make this diagnosis. Case presentation We report the case of a young male who presented with the typical features but lacked the history of medication, hence delaying our diagnosis formation. In-depth history taking is very important in patients who present with unusual symptoms. Conclusions Patients on long-term medications, who may develop some side effects due to medication, should always carry a medical card stating their medical history and medication being taken.

Modeling the SARS-CoV-2 frameshifting RNA element (FSE), a drug target against Covid-19, the authors analyze the dynamics of three FSE conformations at different lengths to propose a conformational transition pathway and describe anti-viral strategies.

The purpose of the present paper is to study some properties of generalized MMZR(X,Y)⋅M~∗∗=0ηM~∗∗(X,Y)⋅S=0ψ=1

Infant feeding practices have a vital role to play in shaping the eating behaviour and overall health of individuals in both childhood as well as adulthood. A lesser-known advantage of breastfeeding in the global obesogenic environment, is its role in self-regulation of an infant’s appetite. Research demonstrates that children fed exclusively from the breast (that is, they are never bottle fed) develop the capacity for self-regulation of breastmilk intake – after all, mothers cannot possibly observe the quantity of milk the infant ingests. This encourages the infant to gain control, thus avoiding any overconsumption. On the other hand, bottle fed infants (whether mother’s milk or formula milk) are subjected to mother’s or other caregivers encouragement of bottle emptying. Since the regulation largely lies externally with the parent/caregiver on scheduled or timed feeding versus a cue feeding, this állows the possibility of such children being prevented from developing their own appetite responsiveness independently. Studies do find differences in satiety responses of children fed human milk with a bottle and those who were directly breastfed. Research has shown that directly breast-fed infants do not consume extra milk once their appetite stimulation phase ends. However, the teaching of bottle emptying during early infancy is positively associated with the weight gain. Such distinctions clearly emphasize the importance of breast feeding, but whether it is the milk composition (human or formula) or the mode of feeding (directly from breast or using bottle) that plays a bigger role in signalling appetite control warrants further examination. Considering that an infant’s weight gain or growth has a multifactorial causation, this review will highlight the association of direct breastfeeding with appetite signalling in infancy.

Background: Novel coronavirus pandemic has emerged as a grave global health crisis. The pandemic curve is still on the rise. Dental professionals face unique challenges and work pressure due to the fear of the spread of disease while coming in close contact with the potential carriers. Aim: The aim is to assess the knowledge and preparedness level toward novel coronavirus diseases among the dental professionals of India. Methodology: Online survey was carried out from May 2020 to June 2020 on dental health care professionals through snowball sampling. A 24-item structured closed-ended online questionnaire was used. Statistical Analysis Used: Frequency distribution and proportions of the responses were analyzed using the SPSS version 21. Results: A total of 154 dental professionals participated in the study. Majority of the respondents (72.72%) were aware about the correct genomic structure of the virus and aptly identified the early neurological symptom of novel coronavirus disease. 85.71% of the respondents were appropriately informed about the infection control protocol to be followed. However, regarding the protection level to be used while dealing COVID patients, only 24.03% of respondents correctly identified it as Level III. Regarding the amendments required in dental practice and level of preparedness, only 50% of the dental health-care workers were aware of the sequence of donning of personal protective equipment. Conclusions: In the present study, dentists were found to have good knowledge toward novel coronavirus disease with optimum preparedness level for dental practice modification. Dental fraternity is further advised to follow the standard guidelines overcoming this pandemic.

Abstract Acute kidney injury (AKI) after transplantation of human deceased donor kidneys is associated with upregulation of tubular toll like receptor 4 (TLR4), but whether TLR4 is required for AKI is unknown. We hypothesized that TLR4 knockout mice (TLR4KO) subjected to cold ischemia followed by kidney transplant (CI + Txp) would be protected from AKI. C57Bl/6J wild type or TLR4KO kidneys were subjected to CI + Txp into wild type recipients. Tubular cell apoptosis, tubular injury and cast formation were significantly improved in recipients of TLR4KO kidneys. TLR4KO kidneys also demonstrated significantly decreased expression of the effector caspase 8. Brush border injury scores and serum creatinine were not different in recipients of TLR4KO versus wild type kidneys. Phosphorylated RIP3 and MLKL through which TLR4 signals programmed necrosis were expressed in both recipient groups. In addition, TNF-α and TNFR1 expression were significantly increased in recipient serum and TLR4KO kidneys respectively after CI + Txp, suggesting continued activation of programmed necrosis despite TLR4 deletion. Our results suggest that TLR4 deletion decreases apoptosis via inhibition of the death receptor pathway and decreases tubular injury and cast formation.

ABSTRACT The U.S. Food and Drug Administration-authorized mRNA- and adenovirus-based SARS-CoV-2 vaccines are intramuscularly injected in two doses and effective in preventing COVID-19, but they do not induce efficient mucosal immunity or prevent viral transmission. Here, we report the first noninfectious, bacteriophage T4-based, multicomponent, needle- and adjuvant-free, mucosal vaccine harboring engineered Spike trimers on capsid exterior and nucleocapsid protein in the interior. Intranasal administration of two doses of this T4 SARS-CoV-2 vaccine 21 days apart induced robust mucosal immunity, in addition to strong systemic humoral and cellular immune responses. The intranasal vaccine induced broad virus neutralization antibody titers against multiple variants, Th1-biased cytokine responses, strong CD4+ and CD8+ T cell immunity, and high secretory IgA titers in sera and bronchoalveolar lavage specimens from vaccinated mice. All of these responses were much stronger in intranasally vaccinated mice than those induced by the injected vaccine. Furthermore, the nasal vaccine provided complete protection and sterilizing immunity against the mouse-adapted SARS-CoV-2 MA10 strain, the ancestral WA-1/2020 strain, and the most lethal Delta variant in both BALB/c and human angiotensin converting enzyme (hACE2) knock-in transgenic mouse models. In addition, the vaccine elicited virus-neutralizing antibodies against SARS-CoV-2 variants in bronchoalveolar lavage specimens, did not affect the gut microbiota, exhibited minimal lung lesions in vaccinated and challenged mice, and is completely stable at ambient temperature. This modular, needle-free, phage T4 mucosal vaccine delivery platform is therefore an excellent candidate for designing efficacious mucosal vaccines against other respiratory infections and for emergency preparedness against emerging epidemic and pandemic pathogens. IMPORTANCE According to the World Health Organization, COVID-19 may have caused ~15-million deaths across the globe and is still ravaging the world. Another wave of ~100 million infections is predicted in the United States due to the emergence of highly transmissible immune-escaped Omicron variants. The authorized vaccines would not prevent these transmissions since they do not trigger mucosal immunity. We circumvented this limitation by developing a needle-free, bacteriophage T4-based, mucosal vaccine. This intranasally administered vaccine generates superior mucosal immunity in mice, in addition to inducing robust humoral and cell-mediated immune responses, and provides complete protection and sterilizing immunity against SARS-CoV-2 variants. The vaccine is stable, adjuvant-free, and cost-effectively manufactured and distributed, making it a strategically important next-generation COVID vaccine for ending this pandemic.

Abstract This study presents a novel approach to predict a complete source to destination trajectory of a vehicle using a partial trajectory query. The proposed architecture is scalable to extremely large-scale data with respect to the dense road network. A deep learning model Long Short Term Memory (LSTM) has been used for analyzing the temporal data and predicting the complete trajectory. To handle a large amount of data, clustering of similar trajectory data is used that helps in reducing the search space. The clusters based on geographical locations and temporal values are used for training different LSTM models. The proposed approach is compared with the other published work on the parameters as Average distance error and one step prediction accuracy The one-step prediction accuracy is as good as 81% and Distance error are .33 Km. Our proposed approach termed Clustered LSTM is outperforming in both the parameters when compared with other reported results. The proposed solution is a clustering-based predictive model that effectively contributes to accurately handle the large scale data. The outcome of this study leads to improvise the navigation systems, route prediction, traffic management, and location-based recommendation systems.

The Coronavirus Disease 2019 (COVID-19) pandemic overwhelmed not just the resources in terms of infrastructure but also manpower. With many healthcare workers turning COVID-19 positive themselves, and the healthcare system being overburdened, we were short-staffed in most health Institutions across India. In anticipation of a similar crisis, at our tertiary care centre, we came up with certain measures to enhance the manpower should the need arise for not just hospitals, but also the society at large.

Background: Bloodstream infections (BSIs) remain a major cause of mortality in patients with malignancies. Up to 17% of patients who develop a nosocomial BSI in the hospital have an underlying malignancy. Gram-negative bacilli are the predominant etiologic agents of BSI, and their multidrug resistance rate is increasingly being recognized. This study attempts to identify the likely causative agents and their antibiotic susceptibility profile of BSI in cancer patients. Methodology: We conducted a prospective study for a period of 1 year and analyzed the spectrum of BSI and their antimicrobial susceptibility profile in cancer patients. Blood samples were collected aseptically and inoculated in BacT/ALERT (BioMerieux) blood culture bottles. Identification and antimicrobial susceptibility testing of the isolates including their methicillin resistance and β-lactamase and carbapenemase production were done by Vitek-2 (BioMerieux) method. Results: Of a total of 250 cancer patients, 60 (24%) were found to have BSI. The most common underlying malignancy associated with BSI was of gastrointestinal system (45%) followed by acute myeloid leukemia (21.7%). Most of the isolates belonged to Gram-negative bacteria (53.3%). Coagulase-negative Staphylococcus was the most common organism isolated followed by Escherichia coli. Conclusion: The treatment of infections in patients with malignancy relies on the use of established guidelines along with the consideration of local epidemiological data. The poor activity of primary empirical agents and the emergence of multidrug-resistance is alarming.

Cerebral embolism from a cardiac myxoma is a rare cause of ischaemic stroke. These emboli may later lead to the development of cerebral aneurysms. We report a case of delayed presentation of neurological manifestations in form of multiple intracranial aneurysms many years after treatment of a cardiac myxoma. Our patient, a 55-year-old right-handed female with a background history of hypertension, first presented at the age of 45 years with a sudden onset of right hemiplegia. A CT brain scan detected multiple infarcts in the territory of the left middle cerebral artery. Echocardiography revealed a cardiac myxoma for which she underwent immediate total surgical resection. Nearly 10 years after this diagnosis, she presented again with right-sided weakness and left ptosis. CT scan of the brain revealed bilateral acute superior cerebellar infarcts with interval evolution of previously known left cortical infarcts. MRI/MR angiogram showed multiple aneurysms arising from the bilateral middle, left anterior and left posterior cerebral arteries. She was managed conservatively. The management of multiple aneurysms with cardiac myxomas is highly debatable and dependent on the patient’s presentation. This case highlights the importance to follow up on potential late extra-cardiac manifestations of the myxomas despite adequate resection.

Introduction: Fungi are being increasingly implicated in the aetiopathology of Chronic Rhinosinusitis (CRS). Fungal Rhinosinusitis (FRS) is frequently seen in diabetic or immunocompromised patients, although it has also been reported in immunocompetent individuals. The spectrum of fungal involvement runs from benign colonisation to potentially life-threatening invasive disease. There are only a few landmark studies from India on FRS. Aim: To determine the prevalence of FRS and to analyse its clinicomycological profile. Materials and Methods: Thirty-nine patients with clinical suspicion of CRS during a period of one year were included in this prospective study. The sinonasal specimens were subjected to microscopy by potassium hydroxide (KOH) mount followed by fungal culture as per standard mycological technique. Specimens were also subjected to Histopathological Examination (HPE). The obtained data from the study was analysed by chi-square test using Statistical Package for the Social Sciences (SPSS) software. Results: The prevalence of FRS in this study was 41% (n=16) with a higher prevalence among third and fourth decades (n=10, 62.5%) of life, with a female predominance (n=11, 68.75%). Aspergillus spp. was the most prevalent organism (n=6) with A. flavus (4/6) being the commonest species. Allergic FRS (43.75%) was the most common presentation. The prevalence was higher among individuals who were immunocompetent (11/16). Conclusion: As FRS varies in presentation, perfect mycological identification plays a crucial role in diagnosing chronic sinusitis and also provides therapeutic guidance for the treatment of infection with unusual agents.

Background Dermatophytes are fungi parasitizing structures rich in keratin such as skin, hair, and nail, which leads to a dermal inflammatory response with intense itching and cosmetic disfigurement. The climatic condition of eastern India is predominantly hot and humid with severe rainfalls promoting fungal infection. This study was performed to determine the prevalence of dermatophytosis and to isolate and identify the dermatophyte from clinically suspected cases attending tertiary care center. Methodology This study was conducted from April 2018 to March 2019 and a total of 1,200 samples were included. Skin scrapings were collected and examined microscopically using 10% potassium hydroxide (KOH) mount. Culture was performed using Sabouraud dextrose agar and dermatophyte test medium. Speciation was done based on macroscopic and microscopic findings using lactophenol cotton blue staining and some special tests like urease test and slide culture. Results Of 1,200 cases, tinea corporis was the most common clinical presentation. Direct KOH positivity was 89.4% and culture positivity was 61.75%. Trichophyton mentagrophyte (77.5%) was the most common dermatophyte isolated followed by Trichophyton rubrum (13.3%). Conclusion Dermatophytic infections are not serious but their propensity to persist leading to chronicity and disfigurement may have personal and social implications.

(1) Background: Intra-operative neuronavigation is currently an essential component to most neurosurgical operations. Recent progress in mixed reality (MR) technology has attempted to overcome the disadvantages of the neuronavigation systems. We present our experience using the HoloLens 2 in neuro-oncology for both intra- and extra-axial tumours. (2) Results: We describe our experience with three patients who underwent tumour resection. We evaluated surgeon experience, accuracy of superimposed 3D image in tumour localisation with standard neuronavigation both pre- and intra-operatively. Surgeon training and usage for HoloLens 2 was short and easy. The process of image overlay was relatively straightforward for the three cases. Registration in prone position with a conventional neuronavigation system is often difficult, which was easily overcome during use of HoloLens 2. (3) Conclusion: Although certain limitations were identified, the authors feel that this system is a feasible alternative device for intra-operative visualization of neurosurgical pathology. Further studies are being planned to assess its accuracy and suitability across various surgical disciplines.

Abstract Background Venous air embolism (VAE) is a well-known entity in the field of neuroanesthesia, with established surgeries and positions where its occurrence is high. The insular cortex is a deep area within the lateral sulcus, and surgeries in this area are not reported to develop VAE. Case presentation A young male being operated on the insular cortex developed VAE, had cardiac arrest, was revived, and was extubated with no residual deficit due to the untoward event. Conclusions An anesthesiologist should always be prepared for this complication due to its rapid presentation and fatal consequences.

Introduction: Bloodstream infection (BSI) continues to be a significant cause of disease and death in hospitalized patients worldwide. These are among the most common healthcare-associated infections with a mortality rate of 20%–50%. The emergence of multidrug resistance among the organisms causing BSI is of great concern. Objectives: The study was undertaken in a medical intensive care unit of a tertiary care hospital in Eastern India to evaluate the spectrum of pathogens causing BSI, their antimicrobial resistance patterns and carbapenemase enzyme production using polymerase chain reaction (PCR). Materials and Methods: A total of 550 blood samples from clinically suspected cases of BSIs were studied from July 2016 to June 2018. Blood samples were inoculated and incubated in BacT/ALERT (BioMerieux) system. Identification and antibiotic susceptibility testing was conducted in Vitek-2 (BioMerieux) as per the Clinical Laboratory Standards Institute guidelines. Methicillin-resistant Staphylococcus aureus (MRSA) and β-lactamase production were also noted in the Vitek-2 method. All Gram-negative isolates were studied for carbapenemase production by the genotypic method using PCR. Results: Of 550 samples, 116 samples yielded the growth of various bacterial isolates. Of these, 54 (47%) were Gram-positive organisms and 62 (53%) were Gram-negative organisms. S. aureus was the most common organism isolated followed by Klebsiella pneumoniae. MRSA was observed in 66.7% of S. aureus isolates. Among Gram-negative isolates, 43.5% were found to be β-lactamase producers and 66.1% were carbapenemase producers. Most of the carbapenemase producers were encoded by the OXA gene (58%). Conclusion: This study emphasizes the importance of antibiotic policy and its stringent application, which will eventually help us to control the menacing rise in antimicrobial resistance.

Here, the authors present the structure of the HIV envelope (Env) protein from a transmitted founder virus and show that, while the overall structure of the Env trimer is similar to other closed trimers, the fusion peptide is buried in the hydrophobic core of the trimer, which is similar to open state trimers.

The present study was conducted to assess the usefulness of MUAC as a screening tool to assess nutritional status during pregnancy (>20 weeks). Pregnant women (>20 weeks of gestation, n=100) were enrolled from tertiary care ANC clinics in urban areas of Delhi. Data on socio-demographic profile was collected using pre-tested questionnaires. The blood pressure and anthropometric parameters (weight, height and MUAC) were recorded. The mean height, weight and MUAC of pregnant women were 152.15 ± 4.93cm, 56.7 ± 6.7Kgs and 25.5 ± 2.60cm respectively. Weight gain between trimesters and overall weight gain showed no correlation with blood pressure. Maternal weight was positively correlated with MUAC (p=0.00), SBP (p=0.006) and DBP (p=0.02). Maternal height was negatively correlated with MUAC (p=0.012). BMI and MUAC showed a significantly positive correlation (p=0.00), which indicates the versatility of this tool. However, no association was observed between MUAC and blood pressure during pregnancy in the present study.

Introduction: Onychomycosis is a common fungal infection of nail. It may be caused by dermatophytes, non-dermatophytic moulds or yeasts involving nail bed, nail plate or matrix of nail. As the fungi show variable susceptibility to antifungal drugs and treatment requires long duration of antifungal therapy, so it’s prevalence as well as proper laboratory diagnosis and antifungal susceptibility testing is essential for effective therapy. Aim: To find the prevalence of onychomycosis with demography along with various aetiology and the suitable antifungal drugs used for treatment. Materials and Methods: For this prospective study, over a period of two years a total of 300 nail samples were processed in the Department of Microbiology at IMS and SUM Hospital, Bhubaneswar, Odisha, India. The wet mount for microscopic examination was prepared using 20% Potassium Hydroxide (KOH) and examined after overnight incubation. Culture was done in duplicate in Sabouraud’s Dextrose Agar (SDA) tubes; one with actidione and another without it and both were incubated at 25°C in Biological Oxygen Demand (BOD) incubator. Culture tubes growing yeasts were further subjected to speciation by germ tube test, culture on Chromogenic (CHROM) agar and on cornmeal agar. In-vitro antifungal susceptibility testing was performed against Candida species using disc diffusion method on Muller Hinton agar. Chi-square test was used for statistical analysis of the results. Results: Onychomycosis can affect a wide age group though seen commonly at 31-40 years equally in both male and females. Fingernail infection was observed mostly in female cases. It was caused by Candida species (66%), moulds (24%) and dermatophytes (10%) and out of Candida sp. C.albicans was the main culprit. Although all the Candida strains were susceptible to amphotericin B, still some of them showed resistance to the commonly used antifungals like fluconazole and itraconazole. Conclusion: Candida albicans was the most common aetiological agent which contributed for onychomycosis and showed a variable resistance pattern to the commonly used antifungals. Proper laboratory diagnosis and selection of antifungal drug is essential prior to institution of therapy for successful treatment of this disease.

Dengue virus and Zika virus are mosquito-borne, single-stranded, positive-sense RNA viruses that belong to the Flaviviridae family. Both the viruses are closely related and have similarities with other flaviviruses. Dengue virus (DENV) causes a severe febrile illness with fever, joint pain, and rash leading to a life-threatening condition in severe cases. While Zika virus (ZIKV) primarily causes mild fever, it can be passed from a pregnant mother to her fetus, resulting in severe birth defect microcephaly and even causing a rare autoimmune disease—Guillain–Barre syndrome. To date, there are no approved DENV and ZIKA vaccines available, except a Dengue vaccine (Dengvaxia, Sanofi Pasteur Inc., Lyon, France) recently approved to be used only for 9–16 years of age groups living in endemic areas and having a previous record of confirmed dengue infection. There are several potential vaccine candidates in the clinical trials based on multiple vaccine platforms, such as live attenuated, subunit, nucleic acid, and viral vector-based vaccines. In the current review, we have focused exclusively on the nucleic acid vaccine platform and discussed the progress of all the DNA/RNA vaccine candidates under preclinical and clinical studies for DENV and ZIKA viruses. Additionally, we have described a brief history of the emergence of these flaviviruses, major structural similarities between them, prominent vaccine targets, and the mechanism of virus entry and infection.

Introduction: In an unanticipated difficult airway or in an emergency situation of cannot-intubate-cannot-ventilate scenario, Supraglottic Airway Devices (SGD) are recommended as rescue devices for establishing airway quickly to prevent hypoxia. Aim: To compare efficacy of i-gel airway and Laryngeal Mask Airway supreme (LMA supreme) as ventilatory devices and the time taken for their insertion in anaesthetised and paralysed patients with simulated difficult airway. Materials and Methods: One hundred and eighty adult patients with simulated difficult airway were randomly allocated to two groups of 90 patients each. In group I: i-gel and in group S: LMA supreme was inserted. Primary outcome studied was time taken for insertion of SGD. Secondary outcomes were the number of attempts taken for insertion of device, oropharyngeal leak pressure, ease of gastric catheter insertion, fibreoptic bronchoscopic view of anatomical alignment of device with glottic opening. Quantitative variables were compared using unpaired t-test/Mann-Whitney Test, between the two groups. Qualitative variable were compared using Chi-Square test/ Fisher’s-exact test. Results: Total time taken for successful insertion was significantly shorter with group i-gel as compared to group LMA supreme {median (IQR) {19 (18.25-21)} versus {24 (23-24)} with p-value ≤0.0001. Overall success rate of insertion (96.67% vs 97.78%, p=1.000) and oropharyngeal leak pressure (p-value=0.555) of i-gel and LMA-S were comparable. i-gel has better anatomic alignment with glottic opening as compared to LMA-S (p-value ≤0.0001). Gastric tube insertion was easy in all patients in both the groups. Conclusion: Shorter time for the insertion of i-gel was observed due to absence of inflatable cuff, although both LMA-S and i-gel are equally efficacious as ventilatory devices in patients with simulated difficult airway under general anaesthesia with controlled ventilation.

COVID-19 is a viral infectious disease caused by SARS-COV2. Its clinical signs and symptoms are on a broad spectrum ranging from asymptomatic to severe complications like multi-organ failure, thromboembolism, and severe pneumonia with respiratory failure. Worse outcomes and higher mortality rates have been reported in the elderly, people with co-morbidities, and malnourished individuals. Nutrition is fundamental to good health and immune function. It forms an integral component of treatment modalities for various acute and chronic diseases, especially where a causative treatment is not yet recognized. Taking into consideration the magnitude of demands this pandemic has posed on hospital resources, an orderly assessment of nutritional status and body composition may not be possible for critically ill and/or for patients with mild-moderate symptoms who are managing their illness at home. Adequate intake of various macro and micro-nutrients--energy, protein, fat, vitamins--A, B, C, D, E and minerals--iron, selenium, zinc, and copper, along with supportive health practices like hydration, meal consistency, frequency of meal consumption and physical activity, often ameliorate respiratory infections, in part by modulating the immune response. Though at present there is a lack of well-defined nutrition-based guidelines for COVID-19 patient care, this paper brings forward the existing relevant evidence base for caregivers and patients to use as a reference/guide.

Objective: Adipose tissue inflammation and fibrosis appear to contribute to insulin resistance in obesity. Vitamin D receptor (Vdr) genes are expressed by adipocytes, macrophages, and fibroblasts, all of which could potentially play a role in adipose tissue inflammation and fibrosis. As vitamin D has been shown to have direct anti-inflammatory effects on adipocytes, we determined whether specific vitamin D receptor-mediated effects on adipocytes could impact adipose tissue inflammation and fibrosis and ultimately insulin resistance. Methods: We examined the effects of repleting vitamin D in 25(OH)D-deficient, insulin resistant, overweight-to-obese human subjects (n = 19). A comprehensive assessment of whole-body insulin action was undertaken with stepped euglycemic (∼90 mg/dL) hyperinsulinemic clamp studies both before and after the administration of vitamin D or placebo. Adipose tissue fibrosis and inflammation were quantified by real-time rt-PCR and immunofluorescence in subcutaneous abdominal adipose tissue.To determine whether vitamin D's effects are mediated through adipocytes, we conducted hyperinsulinemic clamp studies (4 mU/kg/min) and adipose tissue analysis using an adipocyte-specific vitamin D receptor knockout (VDR-KO) mouse model (adiponectin-Cre + VDR+/fl) following high-fat diet feeding for 12 weeks. Results: 25(OH)D repletion was associated with reductions in adipose tissue expression of pro-inflammatory and pro-fibrotic genes, decreased collagen immunofluorescence, and improved hepatic insulin sensitivity in humans. Worsening trends after six months on placebo suggest progressive metabolic effects of 25(OH)D deficiency. Ad-VDR-KO mice mirrored the vitamin D-deficient humans, displaying increased adipose tissue fibrosis and inflammation and hepatic insulin resistance. Conclusions: These complementary human and rodent studies support a beneficial role of vitamin D repletion for improving hepatic insulin resistance and reducing adipose tissue inflammation and fibrosis in targeted individuals, likely via direct effects on adipocytes. These studies have far-reaching implications for understanding the role of adipocytes in mediating adipose tissue inflammation and fibrosis and ultimately impacting insulin sensitivity.

Entire world is battling the Novel Coronavirus Disease (COVID-19) pandemic. India too, has undertaken stringent containment measures to combat this disease. The country is in a state of national lockdown, which has inadvertently led more than a quarter of the Indian population to not use tobacco. This paper discusses the opportunity that surfaces with unavailability of tobacco products, and advocates the need for escalation of tobacco cessation services as well as strategic management of stress to stay tobacco-free.

Introduction: Globally, the incidence Blood Stream Infection (BSI) by Candida species is increasing. It is associated with high mortality rates especially in immunocompromised critically ill patients. The epidemiology has been shifted from Candida species to Non-albicans Candida (NAC) in recent decades. Speciation of Candida spp. can help to improve the outcome of patients as few Candida species are intrinsically resistant to antifungal agents. Aim: To identify the spectrum of Candida species causing BSI, study their sensitivity pattern to antifungal agents and comparison of conventional (germ tube test, Dalmau plate culture and Chromagar) and automated (Vitek-2) methods for the same. Materials and Methods: Blood specimens of the clinically suspected cases of septicaemic patients were cultured by BacT/ALERT before administration of antibiotics or antifungals during the study period of one and half year. The isolated Candida were identified to the species level along with antifungal susceptibility testing done by both conventional and automated (Vitek-2) methods. Statistical analysis was done using Chi-square test. Results: Of the total 100 Candida isolated, the most common Candida species was C.parapsilosis (26%), followed by C.tropicalis (23%), C.albicans (21%) and C.auris (15%). Total concordance between manual and Vitek-2 identification was 74%. Significant risk factors involved in patients with candidemia were malignancy, diabetes mellitus and chronic kidney disease. Antifungal susceptibility rate for amphotericin B, caspofungin, Fluconazole, Flucytosine, Micafungin and Voriconazole was 94%, 90.5%, 73.8%, 96.4%, 98.8% and 95.2%, respectively. Mortality rate was 45% due to sepsis and associated complications. Conclusion: Early isolation, speciation and antifungal susceptibility is the key for management of candidemia cases to get the better outcome as C.auris, the important multidrug resistant variant has caused a major epidemiologic shift in candidemia. Molecular studies are required for accurate speciation of Candida species like C. auris, C. haemulonii, C. famata, etc.

Aim: To assess the effect of orthodontic treatment needs on oral health-related quality of life among the young people of Delhi NCR. Methods: The study was conducted on 12–15 years of individuals attending dental clinic/hospital in Delhi NCR region. Data were collected using Index of Orthodontic Treatment Need -Dental Component and oral health impact profile 14 questionnaire. The Chi-square test was used to analyze the qualitative data. SPSS software version 20 was used for statistical analysis. Results: Orthodontic treatment needs had an almost similar impact on the daily activities of both males and females. The sense of taste was not significantly affected by the need for orthodontic treatment in either males or females. The proportions of orthodontic patients found to have the painful arch, embarrassment, tension, and self-conscious both in males and females. Conclusion: There is a significant correlation of orthodontic treatment needs among oral health-related quality of life.

Dietary diversity is a measure of the number of individual foods or food groups consumed in a given period of time. Consumption of more diverse diets is one of the many approaches to improve the nutrition situation. Malnutrition is linked with quality and quantity of dietary intake. A higher dietary diversity has been associated with better nutritional status in an individual. The present study was designed to assess the dietary diversity of the mother and her child, their nutritional status, and any association between these. The sample comprised of mothers (n=100) and their children aged, 2-5 years (n=100), residing in Shakurpur, an urban slum of Delhi, India. Data on background information, obstetric history, household characteristics, and hygienic practices followed by the mother for herself and for her child, morbidity profile of mother and child, immunization, child feeding practices, and birth information were collected. Anthropometric measurements were taken for both mother and child and were analysed using WHO- Anthro plus software (2010). Moderate wasting, underweight, and stunting were observed in 5%, 18%, and 20% of children respectively, as compared to severe wasting (4%), severe underweight (4%), and severe stunting (10%). No significant difference was observed in the height and weight of boys and girls. A greater proportion of mothers of pre-schoolers were either pre-obese (20%) or obese (9%) than underweight (3%) as per WHO classification, while a little over half (68%) the mothers were of normal weight. The mother’s nutritional status was significantly associated with all the indicators of her child’s nutritional status (p=0.00). The Minimum Dietary Diversity for Women questionnaire (MDD-W, 2016) was used to assess the diversity of the diets. A slight majority of the population, both mothers and children were consuming food from 5 or more food groups. Nearly half of both groups were not achieving adequate dietary diversity. An association between maternal dietary diversity and child dietary diversity (χ2= 14.577, p=0.000) was observed. However, no association was found between dietary diversity of either the child or the mother and the nutritional status of the children (p>0.05). Thus, the present study showed that the diet of the mother and her child as well as the nutritional status of a mother and her child are associated. This re- emphasizes the fact that a mother and child are very closely related.

Cryptococcus laurentii, one of the nonneoformans Cryptococcus is a known biopesticide to control fruit rot, previously considered to be nonpathogenic to humans, is now have been reported as a cause of opportunistic infections. Here, we present a case of pulmonary cryptococcosis due to C. laurentii in a patient with chronic lymphocytic leukemia and prolymphocytic leukemia. Sputum microscopy showed Gram-positive spherical capsulated budding yeast cells, culture of which revealed it as C. laurentii. The patient was promptly put on fluconazole, but he died on the subsequent day after initiation of therapy. A high index of suspicion and improvement of techniques of culture and identification is essential for early diagnosis and treatment of unusual fungal infections.

In this study, we report on a novel aptasensor based on an electrochemical paper-based analytical device (ePAD) that employs a tungsten disulfide (WS2)/aptamer hybrid for the detection of Listeria monocytogenes. Listeria is a well-known causative pathogen for foodborne diseases. The proposed aptasensor signifies many lucrative features which include simple, cost-effective, reliable, and disposable. Furthermore, the use of an aptamer added more advantageous features in the biosensor. The morphological, optical, elemental composition, and phase properties of the synthesized tungsten disulfide (WS2) nanostructures were characterized by field-emission scanning electron microscopy (FESEM), RAMAN spectroscopy, photoluminescence (PL), and X-ray diffraction (XRD), while electrochemical impedance spectroscopy was performed to corroborate the immobilization of aptamer and to assess the L. monocytogenes sensing performance. The limit of detection (LoD) and limit of quantification (LoQ) of the aptasensor was found to be 10 and 4.5 CFU/mL, respectively, within a linear range of 101–108 CFU/mL. The proposed sensor was found to be selective solely towards Listeria monocytogenes in the presence of various bacterial species such as Escherichia coli and Bacillus subtilis. Validation of the aptasensor operation was also evaluated in real samples by spiking them with fixed concentrations (101, 103, and 105) of Listeria monocytogenes, thereby, paving the way for its potential in a point-of-care scenario.

Background: The role of sugars on health and specifically on oral health is well evident in scientific literature. However, information regarding sugar portrayal in print media is quite limited. Objectives: To determine “Sugar Portrayal” in English newspapers (online version), a 1-year media content analysis of newspaper stories from Delhi (India) was conducted. Methods: Media content analysis was conducted by an online search for news stories in the two most popular Delhi English newspapers for daily and their Sunday equivalents. A total of 3648 newspaper articles and opinion pieces appearing over a period of 1 year (October 1, 2015, until September 30, 2016) were retrieved after entering selected “keywords.” The articles were reliably coded for overall frame and type of article. The data were entered in MS Excel and analyzed using SPSS version 21 (IBM Inc., Chicago, IL, USA). Results: It was inferred that the print media generally advertise sugar recipes and industry, invariably in state-wide context with either a negative or neutral slant. Although there was mention regarding benefits as well as harmful effects in the news stories, yet coverage often lacked detailed health information. Conclusions: The current study found out that there was relatively wider state-wide coverage of sugar, with very narrow focus on public health facts. More accurate information would permit the individuals to make more informed decisions regarding their own behavior.

Introduction: Urologists tend to prefer retroperitoneal approach for open nephrectomy and transperitoneal route for laparoscopic nephrectomy. Urologists consider retroperitoneal laparoscopic approach difficult to learn and perform. There is a need to objectively define predictors of difficulty during laparoscopic retroperitoneal simple nephrectomy (LRSN) for the proper preoperative selection. To the best of our knowledge, this is the first study to prospectively assess the factors associated with difficulty during LRSN. Materials and Methods: All adult patients of nonfunctioning kidneys (due to benign causes) planned for simple nephrectomies from November 2014 to January 2017 were included in the study. Various clinical and radiological parameters were noted along with intraoperative difficulty parameters (difficulty score, total operative time, and estimated blood loss). Renal and perirenal parameters were assessed and noted on computed tomography scan. Difficulty scale was calculated based on the three difficulty parameters and was used to objectively categorize the patients in easy and difficult group. Results: A total of 44 patients were included in the study. There were 23 patients in Group I (Easy) and 21 patients in Group II (Difficult). Various preoperative clinical and radiological parameters were analyzed and compared between these two groups. History of pyonephrosis and presence of nephrostomy tube were the only two statistically significant factors associated with difficult cases (Group II). None of the factors were statistically significant in multivariate analysis. Conclusion: Based on the findings of our study, history of pyonephrosis and presence of nephrostomy are the most significant factors predicting difficulty during LRSN.