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Abstract Adult Neural Stem Cells (aNSCs) in the ventricular-subventricular zone (V-SVZ) are largely quiescent. Here, we characterize the mechanism underlying the functional role of a cell-signalling inhibitory protein, LRIG1, in the control of aNSCs proliferation. Using Lrig1 knockout models, we show that Lrig1 ablation results in increased aNSCs proliferation with no change in neuronal progeny and that this hyperproliferation likely does not result solely from activation of the epidermal growth factor receptor (EGFR). Loss of LRIG1, however, also leads to impaired activation of transforming growth factor beta (TGFβ) and bone morphogenic protein (BMP) signalling. Biochemically, we show that LRIG1 binds TGFβ/BMP receptors and the TGFβ1 ligand. Finally, we show that the consequences of these interactions are to facilitate SMAD phosphorylation. Collectively, these data suggest that unlike in embryonic NSCs where EGFR may be the primary mechanism of action, in aNSCs, LRIG1 and TGFβ pathways function together to fulfill their inhibitory roles.

Abstract Background This qualitative study aims to assess perspectives of clinicians and clinic staff on mail-order pharmacy dispensing for medication abortion. Methods Participants included clinicians and staff involved in implementing a mail-order dispensing model for medication abortion at eleven clinics in seven states as part of a prospective cohort study, which began in January 2020 (before the FDA removed the in-person dispensing requirement for mifepristone). From June 2021 to July 2022, we invited participants at the participating clinics, including six primary care and five abortion clinics, to complete a semi-structured video interview about their experiences. We then conducted qualitative thematic analysis of interview data, summarizing themes related to perceived benefits and concerns about the mail-order model, perceived patient interest, and potential barriers to larger-scale implementation. Results We conducted 24 interviews in total with clinicians (13 physicians and one nurse practitioner) and clinic staff (n = 10). Participants highlighted perceived benefits of the mail-order model, including its potential to expand abortion services into primary care, increase patient autonomy and privacy, and to normalize abortion services. They also highlighted key logistical, clinical, and feasibility concerns about the mail-order model, and specific challenges related to integrating abortion into primary care. Conclusion Clinicians and clinic staff working in primary care and abortion clinics were optimistic that mail-order dispensing of medication abortion can improve the ability of some providers to provide abortion and enable more patients to access services. The feasibility of mail-order pharmacy dispensing of medication abortion following the Supreme Court Dobbs decision is to be determined. Trial registration Registry: Clinicaltrials.gov. Trial registration number: NCT03913104. Date of registration: first submitted on April 3, 2019 and first posted on April 12, 2019.

Abstract Dental calculus is a microbial biofilm that contains biomolecules from oral commensals and pathogens, including those potentially related to cause of death (CoD). To assess the utility of calculus as a diagnostically informative substrate, in conjunction with paleopathological analysis, calculus samples from 39 individuals in the Smithsonian Institution’s Robert J. Terry Collection with CoDs of either syphilis or tuberculosis were assessed via shotgun metagenomic sequencing for the presence of Treponema pallidum subsp. pallidum and Mycobacterium tuberculosis complex (MTBC) DNA. Paleopathological analysis revealed that frequencies of skeletal lesions associated with these diseases were partially inconsistent with diagnostic criteria. Although recovery of T. p. pallidum DNA from individuals with a syphilis CoD was elusive, MTBC DNA was identified in at least one individual with a tuberculosis CoD. The authenticity of MTBC DNA was confirmed using targeted quantitative PCR assays, MTBC genome enrichment, and in silico bioinformatic analyses; however, the lineage of the MTBC strain present could not be determined. Overall, our study highlights the utility of dental calculus for molecular detection of tuberculosis in the archaeological record and underscores the effect of museum preparation techniques and extensive handling on pathogen DNA preservation in skeletal collections.

Background Older patients are particularly vulnerable to age-related respiratory changes. This prospective randomized controlled trial studied the effects of high and low fractions of inspired oxygen (FiO2) with the recruitment maneuver (RM) during extubation on lung atelectasis postoperatively in older patients undergoing major abdominal surgery. Methods We randomized a total of 126 patients aged >60 years who underwent both elective and emergency major abdominal surgeries and met the inclusion criteria into three groups (H, HR, and LR) using computer-generated block randomization. Group H received high FiO2 (1), Group HR received high FiO2 (1) with RM followed by a positive end-expiratory pressure of 5 cm H2O, and Group LR received low FiO2 (0.4) with RM followed by a positive end-expiratory pressure of 5 cm H2O 10 minutes before extubation. Oxygenation and atelectasis were measured using the arterial partial pressure of oxygen (PaO2)/FiO2 ratios and lung ultrasound score. Postoperative pulmonary complications were recorded up to 24 hours postoperatively. Results The mean PaO2/FiO2 at 30 minutes post-extubation was significantly higher in Groups LR and HR compared to that in Group H (390.71±29.55, 381.97±24.97, and 355.37±31.70; p

Introduction: Febrile Neutropenia (FN), a common side effect of chemotherapy, is regarded as an oncologic emergency necessitating prompt treatment. A delay in door-to-antibiotic administration time is associated with poor patient outcomes. Aim: To assess the time lag in the administration of antibiotics after arrival at the hospital in patients with solid/haematological malignancy presenting with post-chemotherapy FN. Materials and Methods: This was a cohort study conducted in the Department of Medical Oncology at Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, Rajasthan, India, over a period of one year from December 2019 to November 2020 among 80 patients with solid or haematological malignancy who presented with fever and Absolute Neutrophil Count (ANC)

Abstract The anatomy of furcation favours the bacterial retention and makes periodontal debridement as well as oral hygiene procedures difficult. Teeth that have lost attachment to a level of the furcation are said to have a furcal invasion or furcation involved. Involvement of furcation in a multi-rooted tooth poses a very different type of clinical situation in terms of establishment of diagnosis, determination of prognosis and of course planning the treatment modality.The present study was carried out on 200 selected extracted human first and second permanent molar teeth based on a predefined criteria. Teeth with prosthetic crowns, fused or fractured roots, those not fully developed, grossly carious or heavily restored at the cementoenamel junction (CEJ) were excluded from the study. The morphology of the root trunk was recorded by measuring various dimensions of the root trunk,including furcal angle and root trunk volume was calculated by using a custom made special apparatus. The furcation areas were debrided with different types of curettes in the market in order to see how best the instrument could be maneuvered in the furcation area. The data so obtained was statistically analysed using SPSS version 22. The highest root trunk volume and the longest root trunk length were found to be in the maxillary second molar. 48.60% furcations didn’t allow instrument engagementof furcation area with standard area specific curettes. The proposal of inclusion of root trunk length (mm) is suggested in addition to classification of FI to have assess prognosis and appropriate treatment for of the involved tooth.

Introduction: Tissue Microarray (TMA) is a novel technique that is now integral in pre-clinical and translational research. In resource-limited settings, automated microarrayers and molds are out of reach, and manual TMA construction may be done instead. Aim: To explore the pitfalls encountered while constructing manual TMAs and to troubleshoot these problems using the available resources. Materials and Methods: A cross-sectional study was done between September 2019 and March 2021 in the Department of Pathology at a tertiary healthcare center in New Delhi using 60 mastectomy specimens. Five manual TMAs were constructed using simple, cheap, and readily available resources. Problems encountered during the construction were identified and documented. Solutions attempted to troubleshoot the common problems were documented, and their outcomes were evaluated. Results: Difficulty in core extraction, cracking of TMAs during core insertion, loss of cores, misalignment of cores, bulging of blocks, difficulty in sectioning due to non-uniform cores, and loss of cores during sectioning were major problems identified. Simple measures such as prior warming of both donor and recipient blocks, use of punch biopsy needles with a plunger, maintaining a margin around the cores, using wax cores to align cores, and adequate cooling prior to sectioning helped in overcoming these problems. Other solutions that were attempted but did not yield satisfying results included the use of agarose in paraffin blocks and the use of liquid wax to seal cracks and gaps. Conclusion: Manual TMA is not only feasible, it is easy to construct once the technique is learned and the problems that commonly arise in its construction are tackled. The modifications suggested in the present study can aid in constructing these microarrays faster and avoid both wastage of time and resources. TMAs can thus be used as an alternative to traditional paraffin-based techniques for research applications in resource-limited centers with high patient loads.

Abstract Biotechnology has revolutionized plant propagation by providing plant tissue culture as a rising alternative platform to conventional methods. In the present scenario, plant tissue culture becomes the key technique for the large-scale production and conservation of germplasm, maintenance of genetic stability, and meets out the economic demands of plant and plant products. It is the science of artificially growing test tube plantlets under optimized microclimatic conditions isolated from the external environment. This micro-scale environment resembles the natural environment consisting of culture vessels, humidity, gases, light irradiation, spectrum, temperature, nutritional media, and its constituents as major growth-affecting factors. The efficient architectural development of any genotype depends on these factors and requires a specifically optimized climate. Here, we are reviewing the interaction of physical factors of in vitro artificial climate including culture vessel, light, and temperature with the developing plantlets. The outcomes can increase the understanding of the developmental response of plants toward their environment in the recently changing climatic conditions. Further, this can also eliminate the challenges of cost, labor, and timings and introduce the advancements of efficient large-scale production of plant and plant products which will be effective in fulfilling the population demands.

Activity-based training and lumbosacral spinal cord epidural stimulation (scES) have the potential to restore standing and walking with self-balance assistance after motor complete spinal cord injury (SCI). However, improvements in upright postural control have not previously been addressed in this population. Here, we implemented a novel robotic postural training with scES, performed with free hands, to restore upright postural control in individuals with chronic, cervical (n?=?5) or high-thoracic (n?=?1) motor complete SCI, who had previously undergone stand training with scES using a walker or a standing frame for self-balance assistance. Robotic postural training re-enabled and/or largely improved the participants' ability to control steady standing, self-initiated trunk movements and upper limb reaching movements while standing with free hands, receiving only external assistance for pelvic control. These improvements were associated with neuromuscular activation pattern adaptations above and below the lesion. These findings suggest that the human spinal cord below the level of injury can generate meaningful postural responses when its excitability is modulated by scES, and can learn to improve these responses. Upright postural control improvements can enhance functional motor recovery promoted by scES after severe SCI.

Background & Objective: At emergency department (ED) at different point of time different teams are involved in management of patients as per their posting/duty roster. So, a robust system should be in place to avoid major mishaps. The current study was an attempt to improve pediatric care at our Emergency Department through third-level Kirkpatrick’s evaluation model after training of pediatric resident doctors to use newly developed structured proforma while doing initial assessment of sick children at ED. Materials & Methods: This Quasi-experimental study included all departmental pediatric resident doctors and as per sample size calculation, 36 (pre-intervention) and 36 (post-intervention) computer-generated random selection records were reviewed from the total of serially arranged admissions of pediatric patients. The intervention was the implementation of a Structured proforma, and training of all departmental residents. All raters scored the records of patients on 47 & 51 items of documentation pre-and post-intervention periods respectively on a scale 0-2, 0 meaning ‘no mention’, 1-incomplete/improper mention and 2-complete/proper mention. Mean, standard deviation (SD) of scores were calculated item-wise, raters-wise and overall. Bland Altman analysis was done to find agreement in scoring among raters both in pre-and post-intervention. Results: The mean (SD) and percentage of mean score were 32.93 (4.50) and 35.03% before intervention whereas 89.64 (4.35) and 87.88% post-intervention. This indicated 53.5% improvement post-intervention. Bland Altman analysis found good agreement post-intervention. Conclusion: The introduction of Educational tool along with the training of pediatric resident doctors to implement it, has improved documentation process significantly.

Over the past decade, copper (Cu) has been recognized as a crucial metal in the differential expression of soluble (sMMO) and particulate (pMMO) forms of methane monooxygenase (MMO) through a mechanism referred to as the “Cu switch”. In this study, we used Methylosinus trichosporium OB3b as a model bacterium to investigate the range of Cu concentrations that trigger the expression of sMMO to pMMO and its effect on growth and methane oxidation. The Cu switch was found to be regulated within Cu concentrations from 3 to 5 µM, with a strict increase in the methane consumption rates from 3.09 to 3.85 µM occurring on the 6th day. Our findings indicate that there was a decrease in the fold changes in the expression of methanobactin (Mbn) synthesis gene (mbnA) with a higher Cu concentration, whereas the Ton-B siderophore receptor gene (mbnT) showed upregulation at all Cu concentrations. Furthermore, the upregulation of the di-heme enzyme at concentrations above 5 µM Cu may play a crucial role in the copper switch by increasing oxygen consumption; however, the role has yet not been elucidated. We developed a quantitative assay based on the naphthalene–Molisch principle to distinguish between the sMMO- and pMMO-expressing cells, which coincided with the regulation profile of the sMMO and pMMO genes. At 0 and 3 µM Cu, the naphthol concentration was higher (8.1 and 4.2 µM, respectively) and gradually decreased to 0 µM naphthol when pMMO was expressed and acted as the sole methane oxidizer at concentrations above 5 µM Cu. Using physical protein–protein interaction, we identified seven transporters, three cell wall biosynthesis or degradation proteins, Cu resistance operon proteins, and 18 hypothetical proteins that may be involved in Cu toxicity and homeostasis. These findings shed light on the key regulatory genes of the Cu switch that will have potential implications for bioremediation and biotechnology applications.

Abstract Recombinant adeno-associated virus (rAAV) has been developed as a safe and effective gene delivery vehicle to treat rare genetic diseases. This study aimed to establish a novel biomanufacturing process to achieve high production and purification of various AAV serotypes (AAV2, 5, DJ, DJ8). First, a robust suspensive production process was developed and optimized using Gibco Viral Production Cell 2.0 in 30–60 mL shaker flask cultures by evaluating host cells, cell density at the time of transfection and plasmid amount, adapted to 60–100 mL spinner flask production, and scaled up to 1.2–2.0-L stirred-tank bioreactor production at 37 °C, pH 7.0, 210 rpm and DO 40%. The optimal process generated AAV titer of 7.52–8.14 × 1010 vg/mL. Second, a new AAV purification using liquid chromatography was developed and optimized to reach recovery rate of 85–95% of all four serotypes. Post-purification desalting and concentration procedures were also investigated. Then the generated AAVs were evaluated in vitro using Western blotting, transmission electron microscope, confocal microscope and bioluminescence detection. Finally, the in vivo infection and functional gene expression of AAV were confirmed in tumor xenografted mouse model. In conclusion, this study reported a robust, scalable, and universal biomanufacturing platform of AAV production, clarification and purification.

IntroductionAs the body’s first line of defense against disease and infection, neutrophils must efficiently navigate to sites of inflammation; however, neutrophil dysregulation contributes to the pathogenesis of numerous diseases that leave people susceptible to infections. Many of these diseases are also associated with changes to the protein composition of the extracellular matrix. While it is known that neutrophils and endothelial cells, which play a key role in neutrophil activation, are sensitive to the mechanical and structural properties of the extracellular matrix, our understanding of how protein composition in the matrix affects the neutrophil response to infection is incomplete.MethodsTo investigate the effects of extracellular matrix composition on the neutrophil response to infection, we used an infection-on-a-chip microfluidic device that replicates a portion of a blood vessel endothelium surrounded by a model extracellular matrix. Model blood vessels were fabricated by seeding human umbilical vein endothelial cells on 2, 4, or 6 mg/mL type I collagen hydrogels. Primary human neutrophils were loaded into the endothelial lumens and stimulated by adding the bacterial pathogen Pseudomonas aeruginosa to the surrounding matrix.ResultsCollagen concentration did not affect the cell density or barrier function of the endothelial lumens. Upon infectious challenge, we found greater neutrophil extravasation into the 4 mg/mL collagen gels compared to the 6 mg/mL collagen gels. We further found that extravasated neutrophils had the highest migration speed and distance in 2mg/mL gels and that these values decreased with increasing collagen concentration. However, these phenomena were not observed in the absence of an endothelial lumen. Lastly, no differences in the percent of extravasated neutrophils producing reactive oxygen species were observed across the various collagen concentrations.DiscussionOur study suggests that neutrophil extravasation and migration in response to an infectious challenge are regulated by collagen concentration in an endothelial cell-dependent manner. The results demonstrate how the mechanical and structural aspects of the tissue microenvironment affect the neutrophil response to infection. Additionally, these findings underscore the importance of developing and using microphysiological systems for studying the regulatory factors that govern the neutrophil response.

BackgroundLimited interventions exist on reducing unwanted screen time (ST) among children from low- and middle-income countries (LMICs), so we developed and assessed the effectiveness of the program to lower unwanted media screen time (PLUMS) among children aged 2–5 years in Chandigarh, Union Territory, North India.MethodsAn open-label randomized control parallel group trial per CONSORT guidelines was conducted among randomly selected 340 families with children aged 2–5 (±3 months) years in Chandigarh, India. PLUMS was implemented at the family level with a focus on modifying the home media environment and targeted individual-level interventions using parent and child modules for 2 months. A post-intervention (immediately) and a follow-up assessment after 6 months was done. During the follow-up period, the interaction was done passively via WhatsApp groups. The control group received routine healthcare services. Validated and standardized tools, including a digital screen exposure questionnaire with a physical activity component, preschool child behavior checklist, and sleep disturbance scale for children, were used to collect data at baseline, post-intervention, and follow-up periods. The primary outcome was the mean difference in ST (minutes/day) among children in the intervention group versus the control group. Generalized estimating equation (GEE) analysis was performed to adjust for clustering.ResultsAn equal number of families (n = 170) were randomly assigned to the intervention and control arms. In the post-intervention assessment, 161 and 166 families continued while, at the follow-up assessment, 154 and 147 were in the intervention and control arm, respectively. The mean difference in ST on a typical day [27.7 min, 95% Confidence Interval (CI) 5.1, 50.3] at the post-intervention assessment significantly (p

Abstract The Ta/CoFeB/Pt/MgO/HfO2 system is investigated, whose magnetic anisotropy can be controlled through magneto‐ionic gating, using both ionic liquid and solid state gating, via a non‐oxidative mechanism combining reversible and irreversible gating effects. Analysis of X‐ray absorption spectroscopy at the Co and Fe edges reveals no indications of oxidation after gating, while a reversible change at the oxygen K edge suggests the involvement of oxygen species in the magneto‐ionic process. In addition, X‐ray diffraction measurements reveal that gating can irreversibly increase the crystalline volume of MgO, through an increase in the MgO/Mg(OH)2 ratio. This is in line with measurements in solid state devices showing that in a series of 150 gating cycles a reversible effect combines with a progressive increase in the strength of the perpendicular magnetic anisotropy contribution that saturates after extensive cycling. Consequently, the observed gate‐induced changes in magnetic anisotropy can be attributed to the combined effects of Mg(OH)2 dehydration into MgO (irreversible) and most likely a gentle reordering of oxygen species at the CoFeB interface (reversible) leading to a non‐oxidative magneto‐ionic mechanism. This study provides valuable insights into the underlying mechanisms governing the complex magneto‐ionic phenomena, including the coexistence of both reversible and irreversible effects, and a pathway to voltage‐control of crystalline order in spintronics materials.

BackgroundDual tasking (i.e., concurrent performance of motor and cognitive task) is significantly impaired in older adults with mild cognitive impairment (OAwMCI) compared to cognitively intact older adults (CIOA) and has been associated with increased fall risk. Dual task studies have primarily examined volitionally driven events, and the effects of mild cognitive impairment on reactive balance control (i.e., the ability to recover from unexpected balance threats) are unexplored. We examined the effect of cognitive tasks on reactive balance control in OAwMCI compared to CIOA.MethodsAdults >55 years were included and completed the Montreal Cognitive Assessment (MoCA) to categorize them as OAwMCI (MoCA: 18–24, n = 15) or CIOA (MoCA: ≥25, n = 15). Both OAwMCI [MoCA: 22.4 (2.2), 65.4 (6.1) years, 3 females] and CIOA [MoCA: 28.4 (1.3), 68.2 (5.5) years, 10 females] responded to large magnitude stance slip-like perturbations alone (single task) and while performing perceptual cognitive tasks targeting the visuomotor domain (target and tracking game). In these tasks, participants rotated their head horizontally to control a motion mouse and catch a falling target (target game) or track a moving object (track). Margin of stability (MOS) and fall outcome (harness load cell >30% body weight) were used to quantify reactive balance control. Cognitive performance was determined using performance error (target) and sum of errors (tracking). A 3 × 2 repeated measures ANOVA examined the effect of group and task on MOS, and generalized estimating equations (GEE) model was used to determine changes in fall outcome between groups and tasks. 2 × 2 repeated measures ANOVAs examined the effect of group and task on cognitive performance.ResultsCompared to CIOA, OAwMCI exhibited significantly deteriorated MOS and greater number of falls during both single task and dual task (p

Background: Perinatal asphyxia (PA) is a neonatal emergency causing multi-organ dysfunction, and neurological insult called hypoxic-ischemic encephalopathy (HIE). The traditional focus is on neuroprotection. However, the immature cardiovascular system simultaneously undergoes tremendous hypoxic-ischemic insult especially during the secondary phase of HIE. The hemodynamic consequences, comprehensive cardiac assessment, and care are often overlooked in bedside practice. Objective: The objective is to quantitatively document myocardial dysfunction in neonates with PA using electrocardiography (ECG), echocardiography, and cardiac enzymes (creatinine kinase-MB [CK-MB], B-type natriuretic peptide [BNP], and troponin I). Design and Methods: This was a single center, case–control prospective study. Sixty-four neonates with PA were enrolled. Myocardial function was assessed by clinical, ECG, echocardiography, and biomarkers assay. The same number of healthy neonates was taken as control. Results: 15 (23.4%) had mild, 28 (43.7%) moderate, and 21 (32.8%) severe HIE in the case arm. Abnormal ECG was observed in 42 (65.6%), of which 20 (47.6%) had Grade I, 13 (30.9%) Grade II, 8 (19.04%) Grade III, and 1 (2.38%) had Grade IV changes. Serum levels of CK-MB, BNP and Troponin I were raised in 29 (45.3%), 30 (46.8%) and 10 (15.6%) neonates, respectively. Echocardiographic parameters such as ductal shunting pattern, mitral and tricuspid regurgitation, pulmonary hypertension, and systolic and diastolic ventricular function were significantly abnormal in cases versus controls as demonstrated by P value. Conclusion: Abnormal ECG, echocardiography, and cardiac enzymes in PA are markers and prognosticators of cardiac injury affecting overall outcomes in neonates with PA. Early detection can help in better management and survival of these neonates.

Abstract The phase changes of soil water or porous media have a crucial influence on the performance of natural and man-made infrastructures in cold regions. While various methods have been explored to address the impacts of frost-action arising from these phase changes, conventional approaches often rely on chemicals, mechanical techniques, and the reuse of waste materials, which often exhibit certain limitations and environmental concerns. In contrast, certain organisms produce ice-binding proteins (IBPs) or antifreeze proteins (AFPs) to adapt to low temperatures, which can inhibit ice crystal growth by lowering the freezing point and preventing ice crystallization without the need for external intervention. This study explores the potential of three psychrophilic microbes: Sporosarcina psychrophile, Sporosarcina globispora, and Polaromonas hydrogenivorans, to induce non-equilibrium freezing point depression and thermal hysteresis in order to control ice lens growth in frost-susceptible soils. We hypothesize that the AFPs produced by psychrophiles will alter the phase changes of porous media in frost-susceptible soils. The growth profiles of the microbes, the concentration of released proteins in the extracellular solution, and the thermal properties of the protein-mixed soils are monitored at an interval of three days. The controlled soil showed a freezing point of − 4.59 °C and thermal hysteresis of 4.62 °C, whereas protein-treated soil showed a maximum freezing point depression of − 8.54 °C and thermal hysteresis of 7.71 °C. Interestingly, except for the controlled sample, all the protein-treated soil samples were thawed at a negative temperature (minimum recorded at − 0.85 °C). Further analysis showed that the treated soils compared to porous media mixed soil freeze (1.25 °C vs. 0.51 °C) and thaw (2.75 °C vs. 1.72 °C) at extensive temperature gap. This freezing and thawing temperature gap is the temperature difference between the beginning of ice core formation and completed frozen, and the beginning of ice core thawing and completed thawed for the treated soil samples selected from different incubation days. Overall, this study presents a novel bio-mediated approach using psychrophilic microbes to control ice formation in frost-susceptible soils.

Abstract Background The World Health Organization (WHO) recommends that women with HIV breastfeed for a minimum of one year. In contrast, United Kingdom (UK) guidelines encourage formula feeding, but breastfeeding can be supported under certain circumstances. Infant-feeding decisions often involve personal and social networks. Currently, little research addresses how individuals with HIV in high-income countries navigate infant-feeding decisions with the father of their children. Methods Semi-structured remote interviews were conducted with UK-based individuals with a confirmed HIV positive diagnosis who were pregnant or one-year postpartum, and two partners. Using purposive sampling, pregnant and postpartum participants were recruited through HIV NHS clinics and community-based organisations, and where possible, fathers were recruited via them. Data were analysed using thematic analysis and organised using NVivo 12. Results Of the 36 women interviewed, 28 were postpartum. The majority were of Black African descent (n = 22) and born outside the UK. The key factors in women navigating HIV and infant-feeding discussions with respect to their baby’s father were the latter’s: (1) awareness of woman’s HIV status; (2) relationship with the woman; (3) confidence in infant-feeding decision; (4) support and opinion about woman’s infant-feeding intentions. Most women made a joint decision with biological fathers when in a long-term (> one year) relationship with them. Single women tended not to discuss their infant-feeding decision with the father of their child, often for safety reasons. Conclusion Women in ongoing relationships with the father of their child valued their support and opinions regarding infant-feeding. In contrast, single women chose not to involve the father for reasons of privacy and safety. Clinical teams and community-based organisations should support mothers in discussing infant-feeding decisions regardless of relationship status. When appropriate, they should also support discussions with their partners, but remain sensitive to circumstances where this may put women at risk.

This case report documents the trauma and follow-up care of lateral luxation injury of upper central incisors in a 3½-year-old boy. Traumatic dental injuries in children occur very frequently and lateral luxation is a kind of injury in which the tooth is displaced in either labial or palatal/lingual direction. Lateral luxation injuries are one of the most severe periodontal injuries in dental trauma. A correct diagnosis followed by repositioning of the tooth in the right position is fundamental to the periodontal ligament healing. A 3½-year-old boy reported with a fall on his upper front tooth while laying at home and his upper central incisors got laterally luxated. The teeth were repositioned by digital pressure subsequently, on finding necrotic changes pulpectomy was performed in 51 and 61. Clinical and radiographic follow-up of 7 months is presented showing uneventful healing. Immediate repositioning along with occlusal relief, endodontic management, and proper follow-up with adequate patient engagement can be considered for treating lateral luxation injury.

Introduction: Respiratory illness caused by a novel coronavirus was first noted in December 2019 in Wuhan, Hubei Province, China. Later, the novel coronavirus was referred to as Severe and critical Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) by the International Committee on Taxonomy of Viruses (ICTV). However, the types of co-infected pathogens and the proportion of co-infection in SARS-CoV-2-positive patients were unclear. Co-infection with certain pathogens may also hinder accurate disease diagnosis. Aim: To determine the most suitable sample type for a better culture outcome and to identify the various opportunistic fungal infections related to Coronavirus Disease 2019 (COVID-19) patients. Materials and Methods: This retrospective observational study was conducted between November 2021 to January 2022 at Department of Microbiology, Government Medical College, Surat, Gujarat, India. The data collection was done in the month of November 2021 followed by data analysis in December 2021 to January 2022. A total of 252 suspected cases of fungal co-infection were sampled (including swabs, tissues, skin scrapings, Cerebrospinal fluid (CSF), sputum, pus, and drain) from different wards for fungal wet mount Potassium Hydroxide (KOH) and culture. The data was entered into Microsoft Excel (Windows 10), and analysis was performed using Microsoft Excel, including frequency distribution and percentage. Results: A total of 252 samples were received. Demographic details showed that individuals aged 41-50 years were more commonly affected, and males were affected more than females. Among the sample types, tissue samples showed the highest positivity 43 (17%), followed by scraping materials 14 (6%). Out of the total 252 cultures performed, 70 were positive. In terms of fungal speciation, Mucor species accounted for 24 (34.28%) isolates, while Aspergillus flavus accounted for 26 (37.14%), followed by other isolated fungal species. Conclusion: Fungal co-infection is observed in COVID-19 positive patients, which not only contributes to morbidity but also increases mortality. Tissue samples demonstrated the highest culture positivity. The culture results showed a higher frequency of Mucor species isolates and Aspergillus flavus compared to other isolates.

Background: Cytopathology is defined as a branch of pathology which involves studying diseases and their diagnosis. The conventional method involves fixing the cells in alcohol, but its poor availability in ill-equipped areas can pose problems. One solution to this problem is air-drying of smears followed by rehydration. In this study, we intend to assess the cytomorphologic changes in air-dried smears rehydrated using various agents and to correlate them with the smears prepared using conventional wet technique. Also, we attempt to find the alternative to alcohol which can be used in less equipped areas. Materials and Methods: Three smears each were prepared from 24 patients (12 healthy and 12 with habits). A total of 72 smears were prepared. One smear from each patient was used as control group (alcohol fixation - total number: 24 smears). The remaining two smears were air-dried and rehydrated and were taken as the test group (test group A - rehydrated with aq. glycerine; total number: 24 smears, test group B - rehydrated with coconut oil; total number: 24 smears) for 5–10 minutes. Then, all 72 slides were stained by standard Papanicolaou stain. The slides were examined for cytomorphologic changes and a score was assigned from 0 to 3. Conclusion: Our study proved aq. glycerine to be a superior rehydrant in comparison to conventional wet fixed smears or coconut oil. Also, in studies where cytoplasmic evaluation is required, coconut oil can be used due to its superior quality.

Context: Acute cholecystitis (AC) is one of the most common afflictions of the gastrointestinal system presenting to hospitals whose delayed diagnosis can lead to severe complications. Neutrophil-to-lymphocyte ratio (NLR) is a new and inexpensive predictor of severe AC that can be used as prognostic biomarker for the stratification of patients for appropriate management. Aims: The aims of the study are to determine the usefulness of the NLR as a prognostic marker and to find range that distinguishes between grades of AC and to compare NLR use with white blood cell, high sensitivity C-reactive protein, and radiological modalities in the diagnosis of severe AC. Settings and Design: This is a 1-year prospective observational study in tertiary care center. Subjects and Methods: Demographic data, investigations, and management of 110 patients diagnosed with AC were collected. Categorization in mild, moderate, or severe AC group was based on Tokyo guidelines and NLR was calculated as absolute neutrophil count/absolute lymphocyte count. Statistical Analysis Used: One-way analysis of variance. Results: Sixty-four were male and 46 were female. 23.64% had severe AC, 30.91% had moderate, and 45.45% had mild AC. Mean hospital stay and intensive care unit stay were more in severe cholecystitis group. Diabetes mellitus was commonly associated comorbidity in severe cholecystitis (35.48%). As per the study, NLR ranges 10 in severe AC (sensitivity of 97% and specificity of 88%). The cardiovascular system was most commonly affected in severe AC, followed by renal derangement. Conclusions: NLR has proved to be a prognostic marker to determine disease severity in patients with AC which will help in appropriate management and better patient outcome.

Abstract Background and objectives To enable an accurate assessment of vaccine hesitancy among adults, a validated Hindi vaccine hesitancy questionnaire, encompassing multiple sub-domains of vaccine hesitancy, is a pre-requisite. The following study was conducted to translate and determine the reliability, content, construct, and concurrent validity of the Hindi Adult Vaccine Hesitancy scale (5C) among adults in Northern India. Methods Translation-back translation of the 5C tool (which comprises five domains of vaccine hesitancy: confidence, calculation, complacency, constraint, and collective responsibility) to Hindi, followed by cognitive interviews among the target population, was done. Item-wise (I-CVI) and full-scale Content Validity Index (S-CVI) were determined through a panel of experts. The robust econometric approach of Confirmatory Factor Analysis (CFA) was employed and construct validity were tested among 150 participants. Discriminant and Convergent validity were examined using the Average Variance Extracted (AVE). The reliability of the domains was assessed through Composite Reliability (CR). Results The I-CVI and Kappa statistics of all tool items ranged from 0.8 to 1.0. The S-CVI/AVE was calculated to be 0.97. The composite reliability (CR ≥ 0.70) and convergent validity (AVE ≥ 0.50) coefficients were found to be adequate. AVE of the latent variables was greater than the squared values of the latent variable correlations, indicating adequate discriminant validity. 5C tool in the Indian setting demonstrated a ‘good fit’ established through confirmatory factor analysis. Interpretation and conclusions Hindi version of the 5C scale is a valid tool to assess vaccine hesitancy among the Hindi-speaking population North Indian Population. Willingness to take the recommended vaccines was positively correlated with ‘confidence,’ ‘calculation,’ and ‘collective responsibility’ and negatively correlated with ‘complacency’ and ‘constraint’ domains.

Introduction: The quality of Gutta-percha (GP) filling techniques depends on canal dimensions and anatomy. Thermoplasticised GP obturation techniques need to be modified in accordance to the root canal space anatomy. Aim: To evaluate the efficacy of continuous wave and modified continuous-wave compaction GP techniques in obturating ovoid canals. Materials and Methods: The present in-vitro study was carried out in the Department of Conservative Dentistry and Endodontics in MGMDCH, Navi Mumbai, Maharashtra, India, from October 2019 to December 2019 on 45 single rooted human teeth were selected and mounted in Eppendorf tubes. The canals were cleaned and shaped using the Protaper Next rotary system. The specimens were divided into three groups based on the obturation technique: Group 1-Lateral Compaction (LC), Group 2-Continuous Wave Compaction (CWC), and Group 3-modified continuous-wave compaction. After obturation, the specimens were radiographed in labial and distal views. Subsequently, the specimens were removed from the Eppendorf tubes, and the extrusion of filling materials was assessed. The radiographic images were analysed using image analysis software, and the void area was measured. The obtained data was tabulated and statistically analysed using the Kruskal-Wallis test, followed by Post-hoc Dunn’s test. Results: The warm compaction techniques showed denser obturations compared to LC and were statistically significant (p

Abstract Background Eagle’s syndrome or stylalgia is a relatively rare condition that usually presents with throat pain and dysphagia. Most cases are asymptomatic, and diagnosis is difficult owing to the vague nature of the symptoms. There is a female preponderance. In most cases, the bony tip of the styloid process (SP) is palpable upon careful palpation of the ipsilateral tonsillar fossa. X-ray (Towne’s view) or an orthopantomogram indicates the length of the styloid process or the ossified stylohyoid complex (OSHC). Computerized tomography (CT) of the skull base, apart from measuring length, provides additional details such as medial or ventral angulation and relation to the surrounding neurovascular structures. Case presentation A 40-year-old female patient who presented to our hospital with left-sided throat pain and pricking sensation. After workup, she was diagnosed with left-sided stylalgia. X-ray (Towne’s view) showed that the left styloid process was 27 mm long, and the right styloid process was 24 mm long. CT of the skull base measured the length and angulation of the styloid process on both sides (sagittal and transverse angles), which were found to be 60° and 61° on the left and 64° and 60° on the right side, respectively. The patient underwent left styloidectomy under general anesthesia. Postoperatively, the symptoms were completely relieved by day 7. Conclusion Stylalgia is usually diagnosed on the basis of the elongated styloid process. Solely using the length of the styloid process as a parameter for diagnosis leads to misdiagnosis of cases that present with normal length of the styloid process. This article highlights the importance of CT scans in measuring the angulation of the ossified stylohyoid complex in such cases for accurate diagnosis.

Introduction: Dengue, a common mosquito-borne arboviral infection in tropical countries, presents cyclical epidemics and seasonal variations with diverse clinical outcomes. Over the past three decades, it has become endemic in India, leading to a rising mortality trend, primarily due to its severity and antibody-dependent enhancement in secondary dengue cases. Therefore, understanding the trend of dengue infection in specific geographical areas is crucial for more efficient prophylaxis. Aim: To provide a comprehensive overview of the seroprevalence of dengue virus infection in Surat district, including the trends in gender, age distribution, and seasonal variations of dengue infection from 2014 to 2021. Materials and Methods: The present retrospective observational analysis was conducted in the Department of Microbiology, Government Medical College (tertiary care teaching New Civil Hospital), Surat, Gujarat, India. A total of 31,683 blood samples were received from patients with clinical suspicion of dengue-like illness from January 2014 to December 2021. Data collection took place from March 2022 to May 2022, and the analysis was conducted in June and July 2022. All samples underwent dengue infection detection using the Enzyme-linked Immunosorbent Assay (ELISA) method by Non structural 1 (NS1) antigen detection and Immunoglobulin M (IgM) antibody detection by Mac capture ELISA. Demographic and clinical details were obtained and recorded from laboratory request forms using a structured data sheet in using Microsoft Excel software version 2013. The data were entered and analysed using EpiInfo software version 3.5.1. Results: Among the 31,683 blood samples tested, 5,994 (18.91%) cases were confirmed for dengue infection through ELISA testing. The highest number of positive cases (33.6%) was observed in the 20-29 years age group, with males outnumbering females in terms of dengue positivity at a ratio of 1.37:1. The maximum number of dengue cases occurred during the postmonsoon and early winter periods, with 96.5% of cases reported from Surat district, India. Conclusion: The rising trend of dengue infection in different age groups over the years underscores the need for continued implementation of surveillance and preventive strategies before the monsoon, aiming to reduce severe dengue infections in the future.

The mechanism of ballas-like nanodiamond formation still remains elusive, and this work attempts to analyze its formation in the framework of activation energy (Ea) of nanodiamond films grown from a H2/CH4 plasma in a 2.45 GHz chemical vapor deposition system. The Ea was calculated from the Arrhenius equation corresponding to the thickness growth rate using substrate temperature (∼1000−1300 K) in all the calculations. While the calculated values matched with the Ea for nanodiamond formation throughout the literature, these values of ∼10 kcal/mol were lower compared to ∼15–25 kcal/mol for standard single crystal diamond (SCD) formation, concluding thus far that the energetics and processes involved were different. Further, the substrate preparation and sample collection method were modified while keeping the growth parameters constant. Unseeded Si substrate was physically separated from the plasma discharge by a molybdenum disk with a pinhole drilled in it. Small quantity of a sample substance was collected on the substrate. The sample was characterized by electron microscopy and Raman spectroscopy, confirming it to be nanodiamond, thus suggesting that nanodiamond self-nucleated in the plasma and flowed to the substrate that acted as a mere collection plate. It is hypothesized then, if nanodiamond nucleates in gas phase, gas temperature has to be used in the Arrhenius analysis. The Ea values for all the nanodiamond films were re-calculated using the simulated gas temperature (∼1500−2000 K) obtained from a simple H2/CH4 plasma model, giving new values within the range characteristic to SCD formation. Based on these findings, a unified growth mechanism for nanodiamond and SCD is proposed, concluding that the rate-limiting reactions for nanodiamond and SCD formation are the same.

We describe the case of a 62-year-old man presenting 2 months after a reversed great saphenous vein femoropopliteal bypass performed for critical limb ischemia. He was found to have early, high-grade bypass graft stenosis on duplex ultrasound. Subsequent angiography demonstrated flow limitations secondary to two areas of retained venous valves in the proximal and mid-portions of the vein graft. The culprit valve lesions were successfully lysed endovascularly with a HawkOne (Medtronic) directional atherectomy device. This case demonstrates a safe, novel use of a directional atherectomy device for treatment of remnant valves causing hemodynamically significant flow problems in peripheral vein grafts.

The COVID-19 pandemic presented an unparalleled challenge to global healthcare systems. A central issue revolves around the urgent need to swiftly amass critical biological and medical knowledge concerning the disease, its treatment, and containment. Remarkably, text data remains an underutilized resource in this context. In this paper, we delve into the extraction of COVID-related relations using transformer-based language models, including Bidirectional Encoder Representations from Transformers (BERT) and DistilBERT. Our analysis scrutinizes the performance of five language models, comparing information from both PubMed and Reddit, and assessing their ability to make novel predictions, including the detection of “misinformation.” Key findings reveal that, despite inherent differences, both PubMed and Reddit data contain remarkably similar information, suggesting that Reddit can serve as a valuable resource for rapidly acquiring information during times of crisis. Furthermore, our results demonstrate that language models can unveil previously unseen entities and relations, a crucial aspect in identifying instances of misinformation.

Summary: Actin cytoskeleton remodeling sustains the ability of cytotoxic T cells to search for target cells and eliminate them. We here investigated the relationship between energetic status, actin remodeling, and functional fitness in human CD8+ effector T cells. Cell spreading during migration or immunological synapse assembly mirrored cytotoxic activity. Morphological and functional fitness were boosted by interleukin-2 (IL-2), which also stimulated the transcription of glycolytic enzymes, actin isoforms, and actin-related protein (ARP)2/3 complex subunits. This molecular program scaled with F-actin content and cell spreading. Inhibiting glycolysis impaired F-actin remodeling at the lamellipodium, chemokine-driven motility, and adhesion, while mitochondrial oxidative phosphorylation blockade impacted cell elongation during confined migration. The severe morphological and functional defects of ARPC1B-deficient T cells were only partially corrected by IL-2, emphasizing ARP2/3-mediated actin polymerization as a crucial energy state integrator. The study therefore underscores the tight coordination between metabolic and actin remodeling programs to sustain the cytotoxic activity of CD8+ T cells.

Mild traumatic brain injury (mTBI) may be caused by occupational hazards military personnel encounter, such as falls, shocks, exposure to blast overpressure events, and recoil from weapon firing. While it is important to protect against injurious head impacts, the repeated exposure of Canadian Armed Forces (CAF) service members to sub-concussive events during the course of their service may lead to a significant reduction in quality of life. Symptoms may include headaches, difficulty concentrating, and noise sensitivity, impacting how personnel complete their duties and causing chronic health issues. This study investigates how the exposure to the recoil force of long-range rifles results in head motion and brain deformation. Direct measurements of head kinematics of a controlled population of military personnel during firing events were obtained using instrumented mouthguards. The experimentally measured head kinematics were then used as inputs to a finite element (FE) head model to quantify the brain strains observed during each firing event. The efficacy of a concept recoil mitigation system (RMS), designed to mitigate loads applied to the operators was quantified, and the RMS resulted in lower loading to the operators. The outcomes of this study provide valuable insights into the magnitudes of head kinematics observed when firing long-range rifles, and a methodology to quantify effects, which in turn will help craft exposure guidelines, guide training to mitigate the risk of injury, and improve the quality of lives of current and future CAF service members and veterans.

The present study was carried out during 2018–19 and 2019–20 at Chaudhary Charan Singh Haryana Agricultural University, Hisar, Haryana to examine the impact of salt stress on physiological parameters of 9 distinct rootstocks of citrus (Citrus spp.) The experimental design followed a completely randomized design (CRD) accompanied with 3 replications, enclosing 45 combinations with 9 citrus rootstocks (Pectinifera, Cleopatra mandarin, Rangpur lime, Alemow, Rough lemon, NRCC-4, Volkamer lemon, CRH-12 and NRCC-3) exposed to 5 NaCl salt stress levels, viz. control (0.07), 2.5, 4.0, 5.5 and 7.0 dS/m. Among the different rootstocks, Rangpur lime exhibited the highest leaf (12.65 mg/g DW) and root (12.42 mg/g DW) total soluble carbohydrates at the 7.0 dS/m salinity level. Additionally, Rangpur lime showcased minimal reduction in chlorophyll stability index (17.2%), leaf and root relative water content (18.7 and 18.9%, respectively), relative stress injury (32.0 and 33.0%, respectively) and leaf and root (Malondialdehyde) MDA content (8.46 and 8.12 µmoles/g DW, respectively) at the same salinity level. Overall, Rangpur lime, Volkamer lemon and CRH-12 demonstrated superior performance by exhibiting relatively higher buildup of total soluble carbohydrates and less drop in CSI, RWC, RSI and MDA content at 7.0 dS/m as compared to control. Conversely, Cleopatra mandarin, Rough lemon and NRCC-3 displayed a relative moderate response, while Pectinifera, Alemow, and NRCC-4 showcased substandard performance, exhibiting contrasting behaviour at 7.0 dS/m as compared to control, particularly concerning physiological parameters at the seedling stage.

Lymphangiomas are rare benign tumors that mainly involve the head and neck region in pediatric patients. Lymphangiomas of the small bowel mesentery in adults are rarer. We present two cases of mesenteric lymphangioma with acute abdominal pain on presentation. Case 1: A 38-year-old female presented with abdominal pain, vomiting, fever, and difficult evacuation. On abdominal examination, she had an ill-defined, tender lump, and radiological findings raised a possibility of perforation peritonitis. Thus, exploratory laparotomy was planned. Per-operatively, a mesenteric mass was found, which, on histopathological evaluation, was found to be a mesenteric lymphangioma involving the bowel. Case 2: A 27-year-old male presented with abdominal pain and difficult evacuation. Radiological evaluation revealed a multilobulated lesion involving the mesentery and with differential diagnoses of mesenteric fibromatoses and inflammatory pseudotumor. Histopathological assessment of the resected mass revealed a lymphangioma that was limited to the mesentery. Owing to their rarity and non-specific presentation, mesenteric lymphangiomas are often misdiagnosed on clinical examination and imaging. Thus, histopathological examination is the gold standard to reach a definitive diagnosis.

Background: Fluctuations in beat-to-beat blood pressure variability (BPV) encode untapped information of clinical utility. A need exists for developing new methods to quantify the dynamical properties of these fluctuations beyond their mean and variance.Objectives: Introduction of a new beat-to-beat BPV measure, termed blood pressure fragmentation (BPF), and testing of whether increased preoperative BPF is associated with (i) older age; (ii) higher cardiac surgical risk, assessed using the Society of Thoracic Surgeons’ (STS) Risk of Morbidity and Mortality index and the European System for Cardiac Operative Risk Evaluation Score (EuroSCORE II); and (iii) longer ICU length of stay (LOS) following cardiac surgery. The secondary objective was to use standard BPV measures, specifically, mean, SD, coefficient of variation (CV), average real variability (ARV), as well a short-term scaling index, the detrended fluctuation analysis (DFA) ⍺1 exponent, in the same type of analyses to compare the results with those obtained using BPF.Methods: Consecutive sample of 497 adult patients (72% male; age, median [inter-quartile range]: 67 [59–75] years) undergoing cardiac surgery with cardiopulmonary bypass. Fragmentation, standard BPV and DFA ⍺1 measures were derived from preoperative systolic blood pressure (SBP) time series obtained from radial artery recordings.Results: Increased preoperative systolic BPF was associated with older age, higher STS Risk of Morbidity and Mortality and EuroSCORE II values, and longer ICU LOS in all models. Specifically, a one-SD increase in systolic BPF (9%) was associated with a 26% (13%–40%) higher likelihood of longer ICU LOS (>2 days). Among the other measures, only ARV and DFA ⍺1 tended to be associated with longer ICU LOS. However, the associations did not reach significance in the most adjusted models.Conclusion: Preoperative BPF was significantly associated with preoperative predictors of cardiac surgical outcomes as well as with ICU LOS. Our findings encourage future studies of preoperative BPF for assessment of health status and risk stratification of surgical and non-surgical patients.

Objectives: To ascertain whether a link exists between vitamin D insufficiency and early childhood caries or not. Method: From the out patient department (OPD) of the Pedodontics Department at Vyas Dental College, a random sample of 40 kids between the ages of 8 months and 5 years old was chosen. Each kid had blood drawn to check their serum 25(OH) vitamin D levels. All of the data was collated and given the necessary statistical analysis. Result: The case group's mean serum 25(OH) vitamin D level was 10.19 ng/mL (with a standard deviation of 3.46), while the control group's was 20.84 ng/mL (2.54 SD). Conclusion: A significant modifiable risk factor for childhood dental caries is a vitamin D deficiency. Therefore, cavities in teeth can be avoided by giving youngsters vitamin D supplements and avoiding vitamin D insufficiency.

Premature loss of primary teeth due to early childhood caries could be treated with different options. Presented cases discuss the clinical sequence of rehabilitation of maxillary anterior primary teeth. Endodontic treatment was followed by composite resin restoration reinforced with fiberglass post. Two case reports present a treatment option for severely mutilated primary maxillary incisors due to early childhood caries.

Granulomatous inflammation is a distinctive variant of the chronic inflammatory response. The orofacial tissues may be affected by a wide range of granulomatous diseases. The lesions range from infections, immunological, and reactive, to foreign body granulomas. As is common knowledge, tuberculosis (TB) is a chronic infectious disease that can affect any region of the body, including the mouth. It may involve the tongue in the mouth and have quite peculiar features and forms. Therefore, while uncommon, oral lesions are crucial for the early detection and treatment of primary TB. We discuss a possible instance of gingival TB that manifested as an enlarged gingiva. The patient received a test dose of antituberculous therapy for one month. The antituberculous therapy was completed for the following five months after one month of treatment showed progress. This case report for dentists emphasizes how crucial it is to consider TB in the differential diagnosis of various types of gingival enlargements.

Pyogenic granuloma is an inflammatory non-neoplastic lesion of the oral cavity. Chronic, mild, local irritation, trauma, hormonal variables, and certain medications are typical causes of pyogenic granulomas. Women have a higher prevalence than men. The risk is greatest in the second to fifth decades of life. Clinically, the lesion appears smooth, with soft to firm consistency and nontender with a pedunculated or sessile base. Various modalities have been proposed for the treatment of lesion, which include the conventional approach, the use of laser, cryotherapy, and electrocauterization. This case series discusses three cases of pyogenic granuloma in female patients at different locations in the oral cavity. The lesion was subsequently treated with electrosurgery and surgical convention methods. No recurrence of the lesion has been seen in either of the cases.

The importance of esthetics is increasing for the patients as well as for the dentist. With a high incidence that rises with age and a complicated soft-tissue pathology caused by a wide variety of factors, gingival recessions are a common but troublesome dental problem. They are characterized by the exposure of the root surface of the teeth due to the apical migration of the gingival border beyond the cemento-enamel junction, and they cause both functional and cosmetic disruptions. Many different surgical approaches have been offered over the years to address gingival recession, all with the goal of providing enough root coverage and achieving aesthetically pleasing results. No matter the amount of defects, Zucchelli's method is beneficial in terms of root coverage and keratinized tissue gain when treating many neighboring recessions. In this case study, Zucchelli's coronally advanced flap is used to treat numerous neighboring gingival recessions.

Abstract Background India is hyperendemic to dengue and over 50% of adults are seropositive. There is limited information on the association between neutralizing antibody profiles from prior exposure and viral RNA levels during subsequent infection. Methods Samples collected from patients with febrile illness was used to assess seropositivity by indirect ELISA. Dengue virus (DENV) RNA copy numbers were estimated by quantitative RT-PCR and serotype of the infecting DENV was determined by nested PCR. Focus reduction neutralizing antibody titer (FRNT) assay was established using Indian isolates to measure the levels of neutralizing antibodies and also to assess the cross-reactivity to related flaviviruses namely Zika virus (ZIKV), Japanese encephalitis virus (JEV) and West Nile virus (WNV). Results In this cross-sectional study, we show that dengue seropositivity increased from 52% in the 0–15 years group to 89% in >45 years group. Antibody levels negatively correlate with dengue RNAemia on the day of sample collection and higher RNAemia is observed in primary dengue as compared to secondary dengue. The geometric mean FRNT50 titers for DENV-2 is significantly higher as compared to the other three DENV serotypes. We observe cross-reactivity with ZIKV and significantly lower or no neutralizing antibodies against JEV and WNV. The FRNT50 values for international isolates of DENV-1, DENV-3 and DENV-4 is significantly lower as compared to Indian isolates. Conclusions Majority of the adult population in India have neutralizing antibodies to all the four DENV serotypes which correlates with reduced RNAemia during subsequent infection suggesting that antibodies can be considered as a good correlate of protection.

Background: Both valvular heart disease (VHD) and atrial fibrillation (AF) frequently coexist. AF is an important cause of arrhythmias with a definitive cardiovascular morbidity. The use of either vitamin K antagonists (VKAs/warfarin) or direct oral anticoagulants (DOACs) (also known as new oral anticoagulants (NOACs)) has been the mainstay for preventing stroke and systemic embolism in patients with VHD and/or AF, and this has been broadly discussed. However, there are limited studies on anticoagulation therapy for patients with valvular atrial fibrillation (VAF). The main aim of this meta-analysis was to evaluate the outcomes (stroke–vascular events and intracranial bleeding) following DOAC and VKA treatment amongst patients with VAF. Methods: We identified clinical trials and observational studies published in the last 10 years. A systematic review and a meta-analysis were performed to evaluate the outcomes of patients with valvular atrial fibrillation following DOAC vs. VKA treatment. Data evaluation was performed using Review Manager 5.4; the endpoints were stroke–vascular events and intracranial bleeding following DOAC and VKA treatment amongst VAF patients. Risk ratios (RR) were evaluated with 95% confidence intervals. Using random effects models, forest plots were obtained. Heterogeneity was assessed by using the I2 statistic. Results: Eight studies were included in this metanalysis, and a total of fifteen thousand two hundred and fifteen patients (DOAC (8732) and VKA (6483)) were pooled. We found a significant risk reduction in stroke–vascular events when using DOACs in comparison with using VKAs (pooled RR: 0.76; 95% CI: 0.64–0.90, p = 0.002). A total of 14862 patients (DOAC (8561) and VKA (6301)) were pooled from a total of six studies for intracranial bleeding. We found a significant risk reduction in terms of intracranial bleeding when using DOACs in comparison with using VKAs (pooled RR: 0.43; 95% CI: 0.24–0.77, p ≤ 0.05). Conclusions: When compared to VKAs, DOAC agents were found to have less risk of stroke–vascular events and intracranial bleeding. Further prospective studies are essential to establish the efficacy and safety of DOAC agents in patients with various subtypes of VAF.

Abstract Modeling electronic systems is an important application for quantum computers. In the context of materials science, an important open problem is the computational description of chemical reactions on surfaces. In this work, we outline a workflow to model the adsorption and reaction of molecules on surfaces using quantum computing algorithms. We develop and compare two local embedding methods for the systematic determination of active spaces. These methods are automated and based on the physics of molecule-surface interactions and yield systematically improvable active spaces. Furthermore, to reduce the quantum resources required for the simulation of the selected active spaces using quantum algorithms, we introduce a technique for exact and automated circuit simplification. This technique is applicable to a broad class of quantum circuits and critical to enable demonstration on near-term quantum devices. We apply the proposed combination of active-space selection and circuit simplification to the dissociation of water on a magnesium surface using classical simulators and quantum hardware. Our study identifies reactions of molecules on surfaces, in conjunction with the proposed algorithmic workflow, as a promising research direction in the field of quantum computing applied to materials science.

Introduction: Food availability is essential for addressing malnutrition. However, nutritional adequacy, which includes both the quantity and quality of food, is equally important. In India, the household serves as the fundamental unit of food consumption, and the health of all household members reflects the nutrient adequacy at this level. Aim: To assess the quantity and quality of food prepared in household kitchens in rural India. Materials and Methods: A community-based cross-sectional study was conducted from July 2021 to June 2022 in village Juan, Haryana, India. Ninety households were selected using systematic random sampling. A dietary assessment was conducted to evaluate the food consumed at the household level. Additionally, a general physical examination was performed on all household members (n=405). The data were analysed using Statistical Package for Social Sciences (SPSS) version 20.0, and the Chi-square test was applied to identify associations between micronutrients (iron, calcium, and folic acid) and socio-demographic variables (social caste, socioeconomic status, and household size). Results: Out of the 90 households, the majority (52.2%) followed a lacto-vegetarian diet and had adequate calorie intake (more than the Recommended Daily Allowance (RDA)) (80%), protein intake (97.8%), and fat intake (86.7%). However, only 34.4% (n=31) and 20% (n=18) of households had sufficient iron and folic acid intake, respectively, resulting in over half (51.1%) of the household members being clinically anaemic. Approximately one-third (31%) of the household members were found to be overweight. Conclusion: Despite the majority of households having an adequate quantity of food, there was a high prevalence of anaemia and malnutrition. Therefore, it is not only the quantity of food that is crucial for an individual’s health but also the quality and source of food.

Adding mulberry fruit extract (MFE) to carbohydrate-rich meals can reduce postprandial glucose (PPG) and insulin (PPI) responses in healthy individuals. This pilot study assessed the acute postprandial effects of low doses of MFE in individuals with type 2 diabetes. In a randomized cross-over (within-subjects) design, 24 unmedicated adult males and females with type 2 diabetes (mean [SD] age 51.0 [9.3] yr, BMI 27.5 [3.9] kg/m2) consumed meals with 0 (control), 0.37, and 0.75 g of MFE added to ~50 g of available carbohydrates from rice. Primary and secondary outcomes were the PPG 2 hr positive incremental area under the curve and the corresponding PPI. Results were reported as mean differences from the control meal with 95% CI. Relative to control, 0.37 and 0.75 g of MFE reduced the mean 2 hr PPG by 8.2% (−20.8 to 6.6%) and 22.4% (−38.6 to −1.9%), respectively, and reduced PPI by 9.6% (−20.7 to 3.0%) and 17.5% (−27.9 to −5.7%). There were no indications of adverse events or gastrointestinal discomfort. MFE additions also led to dose-related reductions in glucose peak and glucose swing. At these levels, MFE appears to dose-dependently reduce acute PPG and PPI in individuals with type 2 diabetes and may be a feasible dietary approach to help attenuate glycemic exposures.

Cross-lingual transfer learning using multilingual models has shown promise for improving performance on natural language processing tasks with limited training data. However, translation can introduce superficial patterns that negatively impact model generalization. This paper evaluates two state-of-the-art multilingual models, Cross-Lingual Model-Robustly Optimized BERT Pretraining Approach (XLM-Roberta) and Multilingual Bi-directional Auto-Regressive Transformer (mBART), on the cross-lingual natural language inference (XNLI) natural language inference task using both original and machine-translated evaluation sets. Our analysis demonstrates that translation can facilitate cross-lingual transfer learning, but maintaining linguistic patterns is critical. The results provide insights into the strengths and limitations of state-of-the-art multilingual natural language processing architectures for cross-lingual understanding.

Sickle cell disease is an orphan disease affecting ethnic minorities and characterized by profound systemic manifestations. Although around 100,000 individuals with SCD are living in the US, the exact number of individuals is unknown, and it is considered an orphan disease. This single-gene disorder leads to red blood cell sickling and the deoxygenation of hemoglobin, resulting in hemolysis. SCD is associated with acute complications such as vaso-occlusive crisis, infections, and chronic target organ complications such as pulmonary disease and renal failure. While genetic therapy holds promise to alter the fundamental disease process, the major challenge in the field remains the target end organ damage and ways to mitigate or reverse it. Here, we provide an overview of the clinical manifestations and pathogenesis with a focus on end-organ damage and current therapeutic options, including recent FDA-approved stem cell and gene editing therapies.