Biological wastewater treatment: a comprehensive sustainability analysis using life cycle assessment

The research conducts a life cycle assessment (LCA) on wastewater treatment (WWT) methods-membrane bioreactor (MBR), soil biotechnology (SBT), and bio-electrochemical constructed wetlands (BCW)-in comparison with the conventional activated sludge process (ASP). Employing SimaPro v9.5 with a cradle-to-gate system boundary, the analysis utilizes the IMPACT 2002 + method, employing per cubic meter of treated wastewater as the functional unit. The analysis shows that SBT exhibits the lowest environmental impacts among the considered WWT methods. The global warming potential was 0.0996 kg CO2 eq. for SBT, 1.33 kg CO2 eq. for MBR, 0.131 kg CO2 eq. for BCW, and 0.544 kg CO2 eq. for ASP. BCW demonstrates a 75.91% decrease, while MBR exhibits a 144.48% increase compared to ASP. Notably, electricity consumption emerges as the primary contributor to environmental impact in MBR and ASP. The resource impact category varies with a 138.15% increase in MBR and an 83.41% decrease in SBT compared to ASP. Additionally, the research indicates that the high human health impact observed in MBR results mainly from increased carcinogens (0.00176 kg C2H3Cl eq.), non-carcinogens (0.01 kg C2H3Cl eq.), and ionizing radiation (3.34 Bq C-14 eq.). The findings underscore the importance of considering treatment efficiency and broader environmental implications in selecting WWT methods. As the world emphasizes sustainability, such LCA studies provide valuable insights for making informed decisions in wastewater management.

A comprehensive review of urban vegetation as a Nature-based Solution for sustainable management of particulate matter in ambient air

Air pollution is one of the most pressing environmental threats worldwide, resulting in several health issues such as cardiovascular and respiratory disorders, as well as premature mortality. The harmful effects of air pollution are particularly concerning in urban areas, where mismanaged anthropogenic activities, such as growth in the global population, increase in the number of vehicles, and industrial activities, have led to an increase in the concentration of pollutants in the ambient air. Among air pollutants, particulate matter is responsible for most adverse impacts. Several techniques have been implemented to reduce particulate matter concentrations in the ambient air. However, despite all the threats and awareness, efforts to improve air quality remain inadequate. In recent years, urban vegetation has emerged as an efficient Nature-based Solution for managing environmental air pollution due to its ability to filter air, thereby reducing the atmospheric concentrations of particulate matter. This review characterizes the various mitigation mechanisms for particulate matter by urban vegetation (deposition, dispersion, and modification) and identifies key areas for further improvements within each mechanism. Through a systematic assessment of existing literature, this review also highlights the existing gaps in the present literature that need to be addressed to maximize the utility of urban vegetation in reducing particulate matter levels. In conclusion, the review emphasizes the urgent need for proper air pollution management through urban vegetation by integrating different fields, multiple stakeholders, and policymakers to support better implementation.

Current perspective in research and industrial applications of microbial cellulases

The natural interactions between various bacteria, fungi, and other cellulolytic microorganisms destroy lignocellulosic polymers. The efficacy of this process is determined by the combined action of three main enzymes: endoglucanases, exo-glucanases, and β-glucosidase. The enzyme attacks the polymeric structure's β-1,4-linkages during the cellulose breakdown reaction. This mechanism is crucial for the environment as it recycles cellulose in the biosphere. However, there are problems with enzymatic cellulose breakdown, including complex cellulase structure, insufficient degradation efficacy, high production costs, and post-translational alterations, many of which are closely related to certain unidentified cellulase properties. These issues impede the practical use of cellulases. A developing area of research is the application of this similar paradigm for industrial objectives. Cellulase enzyme exhibits greater promise in many critical industries, including biofuel manufacture, textile smoothing and finishing, paper and pulp manufacturing, and farming. However, the study on cellulolytic enzymes must move forward in various directions, including increasing the activity of cellulase as well as designing peptides to give biocatalysts their desired attributes. This manuscript includes an overview of current research on different sources of cellulases, their production, and biochemical characterization.

Investigating Bacopa monnieri L. Therapeutic Potential for the Treatment of Neurological Diseases

The popular perennial creeping plant known as Bacopa monnieri (also known as Brahmi) is being utilized in the Indian Ayurvedic medicine practice. It has a variety of bioactive phytoconstituents that have been used therapeutically to treat a number of serious illnesses. Ancient Vedic scholars used this herb because of its pharmacological effects, particularly as a nerve booster and nootropic supporter. However, it is vital to comprehend the active phytochemical components of Bacopa monnieri extract (BME) and their molecular mechanisms in order to better grasp the effect of BME on neurological illnesses and diseases. Understanding its active phytochemical constituents and their molecular processes is essential. Numerous clinical investigations indicated that BME may have neuroprotective benefits, so it is worthwhile to re-evaluate this wellknown plant. Here, we focused on neurological problems as we examined the pharmacological and phytochemical characteristics of BME. For their effective usage in neuroprotection and cognition, many clinical concerns and the synergistic potential of Bacopa extract have been investigated. Alzheimer's disease is a neurological condition caused by the production of reactive oxygen species, which also causes amyloid-beta (A) and tau protein aggregation and increases neuro-inflammation and neurotoxicity. Our review offers a more indepth molecular understanding of the neuroprotective functions of BME, which can also be connected to its therapeutic management of neurological illnesses and cognitive-improving effects.

Enhancement of progesterone biosynthesis via kisspeptin stimulation: Upregulation of steroidogenic transcripts and phosphorylated extracellular signal-regulated kinase (p-ERK1/2) expression in the buffalo luteal cells

The presence of Kisspeptin (Kp) and its receptors in the corpus luteum (CL) of buffalo has recently been demonstrated. In this study, we investigated the role of Kp in the modulation of progesterone (P4) synthesis in vitro. The primary culture of bubaline luteal cells (LCs) was treated with 10, 50, and 100 nM of Kp and Kp antagonist (KpA) alongside a vehicle control. The combined effect of Kp and KpA was assessed at 100 nM concentration. Intracellular response to Kp treatment in the LCs was assessed by examining transcript profiles (LHR, STAR, CYP11A1, HSD3B1, and ERK1/2) using quantitative polymerase chain reaction (qPCR). In addition, the immunolocalization of ERK1/2 and phosphorylated ERK1/2 (p-ERK1/2) in the LCs was studied using immunocytochemistry. Accumulation of P4 from the culture supernatant was determined using enzyme-linked immunosorbent assay (ELISA). The results indicated that LCs had a greater p-ERK1/2 expression in the Kp treatment groups. A significant increase in the P4 concentration was recorded at 50 nM and 100 nM Kp, while KpA did not affect the basal concentration of P4. However, the addition of KpA to the Kp-treated group at 100 nM concentration suppressed the Kp-induced P4 accumulation into a concentration similar to the control. There was significant upregulation of ERK1/2 and CYP11A1 expressions in the Kp-treated LCs at 100 nM (18.1 and 37fold, respectively, p < 0.01). However, the addition of KpA to Kp-treated LCs modulated ERK1/2, LHR, STAR, CYP11A1, and HSD3B1 at 100 nM concentration. It can be concluded that Kp at 100 nM stimulated P4 production, while the addition of KpA suppressed Kp-induced P4 production in the buffalo LCs culture. Furthermore, an increment in p-ERK1/2 expression in the LCs indicated activation of the Kp signaling pathway was associated with luteal steroidogenesis.

Signatures of Correlated Defects in an Ultraclean Wigner Crystal in the Extreme Quantum Limit

Low-disorder two-dimensional electron systems in the presence of a strong, perpendicular magnetic field terminate at very small Landau level filling factors in a Wigner crystal (WC), where the electrons form an ordered array to minimize the Coulomb repulsion. The nature of this exotic, many-body, quantum phase is yet to be fully understood and experimentally revealed. Here we probe one of WC's most fundamental parameters, namely, the energy gap that determines its low-temperature conductivity, in record mobility, ultrahigh-purity, two-dimensional electrons confined to GaAs quantum wells. The WC domains in these samples contain ≃1000 electrons. The measured gaps are a factor of three larger than previously reported for lower quality samples, and agree remarkably well with values predicted for the lowest-energy, intrinsic, hypercorrelated bubble defects in a WC made of flux-electron composite fermions, rather than bare electrons. The agreement is particularly noteworthy, given that the calculations are done for disorder-free composite fermion WCs, and there are no adjustable parameters. The results reflect the exceptionally high quality of the samples, and suggest that composite fermion WCs are indeed more stable compared to their electron counterparts.

Soil carbon-nutrient cycling, energetics, and carbon footprint in calcareous soils with adoption of long-term conservation tillage practices and cropping systems diversification

Calcareous soils, comprising vast areas in northern and eastern parts of India, are characterized by low soil organic carbon (SOC) with high free CaCO3 that results in low nutrient bioavailability with poor soil structure. Improvement of this soil can be achieved with conservation tillage with residue retention coupled with diversification of cropping system including legumes, and oilseeds in the system. Concerning all these, a long-term experiment was carried out in the calcareous soils having low organic carbon and high free CaCO3 (∼33 %) with varied tillage practices, viz. permanent bed with residue (PB), zero tillage with residue (ZT), and conventional tillage without residue (CT); and cropping systems viz. maize-wheat-greengram (MWGg), rice-maize (RM), and maize-mustard-greengram (MMuGg) during 2015-2021. From this study, it was observed that PB and ZT resulted in ∼25-30 % increment in SOC compared to the initial SOC, while CT showed a 4 % decrease in the SOC. Conservation tillage practices also resulted in better soil aggregation and favourable bulk density of the soil. Furthermore, PB and ZT practice exhibited 10-13 %; 15-18 %; 11-15 %; 40-60 %, 20-36 %, and 23-45 % increments in the soil available N, P, K, soil microbial biomass carbon, dehydrogenase activity, and urease activity, respectively over those under CT. Crop diversification with the inclusion of legume and oilseed crops (MMuGg, and MWGg) over cereal-dominated RM systems resulted in better soil health. Maize equivalent yield and energy use efficiency (%) were also found to be the maximum under PB, and ZT, in combination with the MMuGg system. ZT and PB also reduced the carbon footprint by 465 and 822 %, respectively over CT by elevating SOC sequestration. Hence, conservation tillage practices with residue retention coupled with diversification in maize-based cropping systems with mustard and greengram can improve soil health, system productivity, and energetics, and reduce the carbon footprint in calcareous soils.

Study of wave motion on the emergence of veering, locking, and coupling in periodic composite panels

This research proposes the effect of micropolar-Cosserat (MC) parameters (length-scale parameters and Cosserat shear modulus) on the dispersion characteristics of propagating wave modes in periodic composite panels (PCPs). These inbuilt parameters are due to the assumption of the length-scale boundary conditions that allow for capturing the micro-rotational (MR) wave mode along with the flexural ones. A significant contribution of this study is the transformation of the two-dimensional (2-D) periodic composite problem into a series of one-dimensional (1-D) ones using the MC continuum theory. The analysis employs the transfer matrix method in the framework of the state-space approach to investigate periodic systems in the eigenvalue domain. Additionally, Bloch-Floquet's periodic boundary conditions (PBCs) are applied to the unit cell to ensure the periodicity of the system. The main innovation lies in observing veering, locking, and coupling phenomena, which occur due to alterations in lamina orientation and MC parameters. Moreover, the presence of inbuilt parameters renders the dispersion characteristics highly sensitive to even minor coefficient variations, with a mere 1% change significantly impacting eigenmode fluctuations. The sudden bandgap (BG) disappearing nature could be used to identify the accurate value of the coefficient for designing and analyzing PCPs.

Eco-safe composite edible coating of hydrocolloids with papaya leaf extract improves postharvest quality and shelf life of papaya fruit under ambient storage

Papaya postharvest management using low-temperature storage is discouraged as it is a tropical fruit. Extensive research is going on to preserve papaya quality at ambient storage using edible coatings and its composites. The present investigation examined the effects of an eco-safe composite edible coating consisting of hydrocolloid carboxymethyl cellulose (CMC) (1%), guar gum (1.5%), xanthan gum (0.3%), and Gum Arabic (10%) combined with papaya leaf extract (PLE) (1:1 ratio by volume) applied as dip treatment on "Red Lady" papaya fruit at ambient storage condition. Among all the attempted treatments, "PLE incorporated with CMC (1%)" was found to be the best, as the treated fruit exhibited the highest levels of biochemicals, whereas the lowest levels of physiological and enzymatic activity, which positively affected the shelf life. The "CMC + PLE" treatment enhanced the fruit gloss score by 70.1%, phenolics by 6.1%, ascorbic acid by 22.3%, total carotenoid content by 7.4%, and fruit predilection score by 22.0% over the control fruit. However, it lowered (controlling) the physiological loss in weight by 51.0%, decay incidence by 66.6%, and polygalacturonase and pectin methylesterase activity by 24.92% and 35.29%, respectively, over control. Moreover, this treatment exhibited the highest fruit purchase predilection score and prolonged the storage life for >3 days on the physiological loss standard basis (≤10%). This study indicates that "CMC (1%) with PLE (1:1)" composite coating application on papaya under ambient conditions might be an effective, environmentally friendly, and health-friendly way to retain the quality and extend the storage life.

Spontaneous Intracranial Hemorrhage and Acute Respiratory Distress Syndrome Associated with Dengue: A Case Report

BACKGROUND

Dengue is a major health burden worldwide, notably in tropical and subtropical countries, with symptoms ranging from asymptomatic infection to severe hemorrhagic or shock syndrome. The clinical and biochemical profile of dengue has been shown in the literature to be expanding as more atypical signs have been added over the past few decades. Most dengue-related symptoms are typically mild to moderate and self-limited. However, intracranial hemorrhage and acute respiratory distress syndrome in severe dengue is an event that has been encountered uncommonly.

CASE PRESENTATION

A 30-year-old female presented with complaints of fever, headache, cough, and altered sensorium. Later, she was diagnosed with severe dengue fever complicated by dengue hemorrhagic fever, which manifested as subarachnoid and subdural bleeding and acute respiratory distress syndrome. She was managed conservatively with a positive outcome.

CONCLUSION

Atypical manifestation, though rare, should be kept in mind while dealing with severe dengue patients, as early detection based on anticipated risk factors and timely treatment have the potential to save lives.

Reversing the damage: ecological restoration of polluted water bodies affected by pollutants due to anthropogenic activities

Aquatic ecosystems provide a large number of cultural, regulating, and supporting services to humans and play a pivotal role in sustaining freshwater-dependent ecosystems. However, an increase in human population coupled with economic growth in the last few decades has severely affected their functioning and ecological health. This has led to an increase in concentrations of pollutants originating from anthropogenic activities such as heavy metals, plastics, semi-volatile organic compounds, and endocrine disruptors. These pollutants provoke deleterious impacts on aquatic biodiversity and affect the water quality and functioning. In this paper, we discuss the sources and impacts of such pollutants as well as restoration techniques for reducing their impact on aquatic ecosystems. Several physical and chemical ecological restoration techniques, such as dredging, sediment capping, water diversion, adsorption, aeration, and flushing, can be employed to improve the water quality of water bodies. Additionally, biological techniques such as phytoremediation, phycoremediation, the use of biomembranes, and the construction of ecological floating beds can be employed to increase the population of aquatic organisms and improve the overall ecological health of aquatic ecosystems. Restoration techniques can effectively reduce the concentrations of suspended solids and dissolved phosphorus and increase the levels of dissolved oxygen. The restoration techniques for improving the ecological health of water bodies should not be limited to simply improving the water quality but should also focus on improving the biological processes and ecosystem functioning since it is essential to mitigate the adverse effects of pollutants and restore the vital ecosystem services provided by water bodies for future generations.

Fractional Quantum Hall State at Filling Factor ν=1/4 in Ultra-High-Quality GaAs Two-Dimensional Hole Systems

Single-component fractional quantum Hall states (FQHSs) at even-denominator filling factors may host non-Abelian quasiparticles that are considered to be building blocks of topological quantum computers. Such states, however, are rarely observed in the lowest-energy Landau level, namely at filling factors ν<1. Here, we report evidence for an even-denominator FQHS at ν=1/4 in ultra-high-quality two-dimensional hole systems confined to modulation-doped GaAs quantum wells. We observe a deep minimum in the longitudinal resistance at ν=1/4, superimposed on a highly insulating background, suggesting a close competition between the ν=1/4 FQHS and the magnetic-field-induced, pinned Wigner solid states. Our experimental observations are consistent with the very recent theoretical calculations that predict that substantial Landau level mixing, caused by the large hole effective mass, can induce composite fermion pairing and lead to a non-Abelian FQHS at ν=1/4. Our results demonstrate that Landau level mixing can provide a very potent means for tuning the interaction between composite fermions and creating new non-Abelian FQHSs.

Role of Pro-BNP in predicting outcome in acute heart failure patient presenting to a medical emergency: An observational study from North India

Background

Acute heart failure (AHF) is a clinical syndrome defined as the new onset or acutely decompensated heart failure (ADHF) leading to signs and symptoms of heart failure (HF). The critical cut-off values for these biomarkers that suggest high mortality are not clearly defined in previous studies. More studies are required to better understand the correlation of Pro- BNP and its association with HF. The primary objective is to study the role of Pro-BNP and critical factors in predicting outcomes in AHF patients presenting to a medical emergency.

Materials and Methods

The data from the patients presented with symptoms of HF in the Department of Medical Emergency at our hospital were recorded and analysed. AHF is a clinical syndrome defined as the new onset or ADHF leading to signs and symptoms of HF, as based on the European Society of Cardiology.

Results

The present study highlights the various risk factors of AHF in patients and their association with mortality. In the present study, mortality in patients with very high Pro-BNP levels ≥2000 pg/ml was significantly higher than in patients with moderately elevated Pro-BNP. The patients who survived after 5 days of hospitalization had Pro-BNP levels ≤2000 pg/ml, suggesting that very high Pro-BNP levels ≥2000 pg/ml are associated with fatal outcomes.

Conclusion

To conclude, diabetes and sepsis are critical factors for the hospitalization and mortality of patients with AHF in northern India. Very high Pro-BNP levels ≥2000 pg/ml in patients with AHF requiring hospitalization and associated with fatal outcomes.

Impact of secondary infections on dengue presentation: A cross-sectional study in a tertiary care hospital in Uttar Pradesh, India

BACKGROUND

Recently, a wide range variety of manifestations, including a self‑limiting to severe illness, has been increasingly reported in dengue. Few studies attract attention to severe dengue, mainly observed in secondary infection. With this background, this study aims to provide a comprehensive overview to differentiate primary from secondary dengue using serology (IgG) and the possible association of severity of illness in secondary dengue.

METHODS

Present retrospective cross-sectional study was conducted at a North Indian tertiary care center from September 2021 to January 2022. Clinical data of confirmed dengue patients from the medicine department were collected and assigned as primary and secondary dengue.

RESULTS

Of the 220 dengue patients, 22 (10 %) had secondary dengue infection. Hemorrhagic manifestations were reported in 58/220 (26.4 %) cases while 7/22 (31.8 %) in secondary dengue. Prevalent hemorrhagic manifestations in secondary dengue include purpura (27.3 %), vaginal bleeding (4.5 %), melaena (9.1 %), and epistaxis (4.5 %). In addition, 42 (19.1 %) patients had pancytopenia, and 8 (36.6 %) cases were of secondary dengue. Hepatic dysfunction was noted in 164 (74.5 %) cases. Notably, all secondary dengue cases (22;100 %) had hepatic dysfunction and severe in 9 (40.9 %) cases. In addition, in secondary dengue patients, evidence of plasma leakages such as hypoproteinemia 7 (31.8 %) and ascites (35 %) were statistically more frequent. Overall, two deaths (0.9 %) were reported, and were one in each group.

CONCLUSIONS

Many parameters, including hemorrhagic manifestation (melaena), hematological characteristic (pancytopenia), evidence of plasma leakage (hypoproteinemia and ascites), gastrointestinal (GB wall thickening and hepatic dysfunction) and reduction in mean hemoglobin and platelet count were found to be statistically significant in secondary dengue infection. Additionally, early classification of secondary dengue may help to anticipate its severity and allow for early strategic intervention/management to lower morbidity and mortality.

Friedelin: Structure, Biosynthesis, Extraction, and Its Potential Health Impact

Pharmaceutical companies are investigating more source matrices for natural bioactive chemicals. Friedelin (friedelan-3-one) is a pentacyclic triterpene isolated from various plant species from different families as well as mosses and lichen. The fundamental compounds of these friedelane triterpenoids are abundantly found in cork tissues and leaf materials of diverse plant genera such as Celastraceae, Asteraceae, Fabaceae, and Myrtaceae. They possess many pharmacological effects, including anti-inflammatory, antioxidant, anticancer, and antimicrobial activities. Friedelin also has an anti-insect effect and the ability to alter the soil microbial ecology, making it vital to agriculture. Ultrasound, microwave, supercritical fluid, ionic liquid, and acid hydrolysis extract friedelin with reduced environmental impact. Recently, the high demand for friedelin has led to the development of CRISPR/Cas9 technology and gene overexpression plasmids to produce friedelin using genetically engineered yeast. Friedelin with low cytotoxicity to normal cells can be the best phytochemical for the drug of choice. The review summarizes the structural interpretation, biosynthesis, physicochemical properties, quantification, and various forms of pharmacological significance.

Extracerebral choroid plexus papilloma in a newborn: a rare presentation

Choroid plexus papillomas (CPPs) are extremely rare lesions that originate in the central nervous system. Still rarely, these can occur in heterotopic locations. We report a case of aneonate who presented at fourth week of life with a small swelling in the left side of the oropharynx. There were no other symptoms. MRI scan revealed a cystic lesion with the possibility of lymphatic malformation or teratoma. Swelling which was gradually increasing in size was electively excised. Histopathological examination revealed it to be an extracerebral CPP. Postoperative period was uneventful, and baby had no further complications. CPP is a rare lesion and, almost always, cannot be anticipated before surgery. Imaging only helps in surgical planning. Complete excision is curative.

Changes in discourse on unmet need for family planning among married women in India: evidence from NFHS-5 (2019-2021)

Unmet needs for contraception in India have declined over time but the rate has not been uniform among women across geographies and socio-economic strata. Identifying the characteristics of women in communities where unmet need is still high is important to devise appropriate strategies to ensure access and uptake of modern contraceptive methods. The current study examined whether there was a national decline in unmet need over time and if regional disparities exist in unmet need. Demographic variations in unmet need based on factors such as maternal age, education, religion, caste, wealth index quintile, family size, and access to antenatal care (ANC) were also documented. Our approach was to document the prevalence of total unmet need for family planning and unmet need for spacing among married Indian women and quantify variability based on socio-economic and demographic drivers within a hierarchal framework, thus providing both macro and micro perspectives. We used data from the fourth and fifth rounds of the National Family Health Survey (NFHS) collected from all the States and Union Territories (UTs) in India. Quantile regression analysis and multilevel regression techniques were used to understand the predictors for the total unmet need for family planning and the unmet need for spacing. Results show a considerable decline in the prevalence of unmet need for family planning in India from NFHS-4 to 5 (from 12.9 to 9.3%) in the last six6 years. The north-eastern states show a significant reduction in unmet need for family planning in Manipur (17.8%), Nagaland (13.5%), and followed by Sikkim (9.1%). The predictors such as years of schooling, place of residence, caste, religion, wealth quintile, number of antenatal care (ANC) visits, and children ever born have a significant association with unmet needs for family planning and spacing among married women in India. There is a significant association between years of schooling with the total unmet needs for family planning at (q25) quantiles and the unmet need for spacing at (q25, q50) quantiles. Results reveal that the demand for unmet need for spacing and limiting was the highest among the women in the age categories 15-19 (17.8%) and 20-24 (17.3%). The demand for limiting was the highest (6.8%) among Muslim women. Across wealth quantile categories, the overall unmet demand (11.4%) for spacing and limiting was the highest among the women in the lowest socioeconomic groups. We conclude that greater access to frontline health workers among young wives, and significant investment in education in general, will continue to reduce the unmet needs for family planning in India.

The effect of paclitaxel- and fisetin-loaded PBM nanoparticles on apoptosis and reversal of drug resistance gene ABCG2 in ovarian cancer

BACKGROUND

High-grade serous ovarian cancer (OvCa) is the most common type of epithelial OvCa. It is usually diagnosed in advanced stages, leaving a woman's chance of survival below 50%. Despite traditional chemotherapeutic therapies, there is often a high recurrence rate following initial treatments. Hence, a targeted drug delivery system is needed to attack the cancer cells and induce apoptosis, overcome acquired drug resistance, and protect normal cells from cytotoxicity. The present study shows that targeting folate receptor alpha (FRα) through planetary ball milling (PBM) nanoparticles (NPs) induces apoptosis in OvCa cells.

RESULTS

Human tissue microarrays (TMAs) show overexpression of FRα in Stage IV OvCa tissues compared to matched normal tissues. They provide a focus for a targeted delivery system. We formulated PBM nanoparticles encapsulated with paclitaxel (PTX) or fisetin (Fis) and conjugated with folic acid (FA). The cytotoxic effect of these PBM NPs reduced the concentration of the toxic chemotherapy drug PTX by five-fold. The combined treatment of PTX-FA NPs and Fis-FA NPs inhibited cell proliferation and induced apoptosis more extensively than the individual drugs alone. Apoptosis of OvCa cells, determined by flow cytometry, showed an increase from 14.4 to 80.4% (OVCAR3 cells) and from 2.69 to 90.0% (CAOV3 cells) in the number of apoptotic cells. Also, expressions of the pro-apoptotic markers, BAK and active caspase-3, were increased after PTX-FA + Fis-FA PBM NP treatment. In addition to looking at targeted treatment effects on apoptosis, drug resistance was investigated. Drug resistance in OvCa cells was reversed by ABCG2, an ABC-transporter marker.

CONCLUSIONS

Our study shows that PTX-FA and Fis-FA PBM NPs directly target platinum-resistant OvCa cells, induce cytotoxic/apoptotic effects, and reverse multi-drug resistance (MDR). These findings allow us to create new clinical applications using PTX-FA and Fis-FA combination nanoparticles to treat drug-resistant cancers.

Soil microbes: a natural solution for mitigating the impact of climate change

Soil microbes are microscopic organisms that inhabit the soil and play a significant role in various ecological processes. They are essential for nutrient cycling, carbon sequestration, and maintaining soil health. Importantly, soil microbes have the potential to sequester carbon dioxide (CO2) from the atmosphere through processes like carbon fixation and storage in organic matter. Unlocking the potential of microbial-driven carbon storage holds the key to revolutionizing climate-smart agricultural practices, paving the way for sustainable productivity and environmental conservation. A fascinating tale of nature's unsung heroes is revealed by delving into the realm of soil microbes. The guardians of the Earth are these tiny creatures that live beneath our feet and discreetly work their magic to fend off the effects of climate change. These microbes are also essential for plant growth enhancement through their roles in nutrient uptake, nitrogen fixation, and synthesis of growth-promoting chemicals. By understanding and managing soil microbial communities, it is possible to improve soil health, soil water-holding capacity, and promote plant growth in agricultural and natural ecosystems. Added to it, these microbes play an important role in biodegradation, bioremediation of heavy metals, and phytoremediation, which in turn helps in treating the contaminated soils. Unfortunately, climate change events affect the diversity, composition, and metabolism of these microbes. Unlocking the microbial potential demands an interdisciplinary endeavor spanning microbiology, ecology, agronomy, and climate science. It is a call to arms for the scientific community to recognize soil microbes as invaluable partners in the fight against climate change. By implementing data-driven land management strategies and pioneering interventions, we possess the means to harness their capabilities, paving the way for climate mitigation, sustainable agriculture, and promote ecosystem resilience in the imminent future.

Hyperbaric Oxygen Therapy for Soft Tissue Injury in Open Musculoskeletal Trauma: A Prospective Study

Background Non-union, chronic pain, functional disability, and infection are all things that have been associated with open fractures with severe soft tissue damage leading to the need for additional hospitalization, and sometimes even subsequent surgeries and weeks or months of rehabilitation. Open fractures and severe musculoskeletal injuries are occasionally treated with hyperbaric oxygen therapy (HBOT) in an effort to reduce the risk of complications and increase the likelihood of a successful recovery. Methods A prospective randomized controlled study was done between January 2019 and August 2022 at a tertiary health care center including 60 patients with a severe soft tissue injury (Grade II and III) divided into two groups - group-CT (30 patients who received conventional treatment) and group HT (30 patients, who received HBOT in addition to conventional treatment). The outcome was measured according to the Bates-Jensen Wound Assessment Tool. Results The wound size, depth, and granulation were significantly reduced in group-HT patients. In the final session, the patient's severity of the wound in group-HT was significantly reduced (P = 0.0001) compared to group-CT. Conclusions Patients who received HBOT reported a significant improvement in their wounds.

The Comparative Analysis of Single Plating Versus Double Plating in the Treatment of Unstable Bicondylar Proximal Tibial Plateau Fractures

Introduction In the present study, we aimed to compare the clinical and radiological results of the single lateral locking plate fixation method to the dual plate (DP) fixation method in cases of unstable bicondylar proximal tibial plateau fractures. Materials and methods Fifty-six patients managed surgically with internal fixation for unstable bicondylar tibial plateau fractures (UBTF) (Schatzker type V and type VI or Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association {AO/OTA} type 41-C) over 36 months from January 2017 to December 2020 were included in this prospective study. All the fractures were fixed surgically either using dual locking plates through double incisions (DP group) or with a single lateral locking plate (single plate {SP} group). All intraoperative and postoperative complications were assessed and recorded. Oxford Knee Score (OKS), Rasmussen's functional grading system, and Rasmussen's radiological scoring system were used to evaluate the functional and radiological outcomes. Result All of the patients were followed for at least 12 months. Twenty-six patients were fixed with a single lateral locking plate, and 30 patients were fixed with a double-incision dual locking plate. The mean Oxford Knee Score (OKS) was 43.24 ± 4.46 in the DP group and 42.7 ± 2.57 in the SP group (P = 0.544). The mean Rasmussen's functional score (RFS) score in the present study was 26.6 ± 2.21 in the DP group and 24.97 ± 3.92 in the SP group (P = 0.056). At the final follow-up, the mean Rasmussen's radiological score (RRS) was 9.06 ± 1.01 in the DP group and 8.1 ± 0.81 in the SP group (P = 0.0003). Conclusion There are no statistically significant differences in the functional outcomes between the two groups, but higher benefits were found in the radiological outcomes in the dual plating group as compared to single lateral locking plate group.

Correction to "Green-Based Approach to Synthesize Silver Nanoparticles Using the Fungal Endophyte Penicillium oxalicum and Their Antimicrobial, Antioxidant, and In Vitro Anticancer Potential"

[This corrects the article DOI: 10.1021/acsomega.2c05605.].

Key drivers of reversal of trend in childhood anaemia in India: evidence from Indian demographic and health surveys, 2016-21

AIM

Recent National Family Health Survey results portray striking improvements in most population and health indicators, including fertility, family planning, maternal and child health, gender treatment, household environments, and health insurance coverage of the Pradhan Mantri Jan Arogya Yojana (PM-JAY), with all India resonance. However, the prevalence of any anaemia (< 11 g/dl) among children under age five has exhibited a reversed trajectory in recent years. Therefore, the present study explores key drivers of the reversal of the trend in the prevalence of childhood anaemia between 2015 and2021.

METHODS

Data of four rounds of the National Family Health Survey (NFHS) were used to show the overall trend of anaemia among children. However, for the analysis of key drivers of the reversal trend of childhood anaemia, only the recent two rounds (NFHS-4 & NFHS-5) were used. Descriptive, bivariate multivariable analysis and Fairlie decomposition model were used to explore the drivers of the reversal of the trend in childhood anaemia.

RESULTS

During the past two decades, India has seen a decline in the prevalence of childhood anaemia (NFHS-2 to NFHS-4). However, a reversal of trend was observed recently. The prevalence of anaemia among children aged 6-59 months increased from 59 percent in NFHS-4 to 67 percent in NFHS-5. In addition, the prevalence of mild anaemia increased from 23.3 percent in NFHS-2 to 28.7 percent in NFHS-5. However, the prevalence of moderate and severe anaemia declined considerably from NFHS-2 (40 percent and 4.1 percent) to NFHS-4 (28.7 percent and 1.6 percent), but showed an increase in the prevalence in NFHS-5 (36.3 percent and 2.2 percent). Among others, mothers' educational attainment, anaemia status and socio-economic status emerge as the key drivers of the change in the prevalence of childhood anaemia.

CONCLUSION

These findings may have vital implications for the ongoing Anaemia Mukt Bharat Programme, one of the government's dream projects in India.

Epigenetic manipulation for secondary metabolite activation in endophytic fungi: current progress and future directions

Fungal endophytes have emerged as a promising source of secondary metabolites with significant potential for various applications in the field of biomedicine. The biosynthetic gene clusters of endophytic fungi are responsible for encoding several enzymes and transcriptional factors that are involved in the biosynthesis of secondary metabolites. The investigation of fungal metabolic potential at genetic level faces certain challenges, including the synthesis of appropriate amounts of chemicals, and loss of the ability of fungal endophytes to produce secondary metabolites in an artificial culture medium. Therefore, there is a need to delve deeper into the field of fungal genomics and transcriptomics to explore the potential of fungal endophytes in generating secondary metabolites governed by biosynthetic gene clusters. The silent biosynthetic gene clusters can be activated by modulating the chromatin structure using chemical compounds. Epigenetic modification plays a significant role by inducing cryptic gene responsible for the production of secondary metabolites using DNA methyl transferase and histone deacetylase. CRISPR-Cas9-based genome editing emerges an effective tool to enhance the production of desired metabolites by modulating gene expression. This review primarily focuses on the significance of epigenetic elicitors and their capacity to boost the production of secondary metabolites from endophytes. This article holds the potential to rejuvenate the drug discovery pipeline by introducing new chemical compounds.

Perspective: The unexplored dimensions behind the foam formation in River Yamuna, India

For nearly two years, a persistent foam cover has been observed during the post-monsoon season in the Yamuna River beneath the barrage near Okhla in Delhi, India. This affair has been a matter of public concern now, after the gigantic appearance of foam in November 2021, as the visibility of foam has awakened people's environmental 'conscience' over the 'concealed' chemical pollution. The mechanisms of agents responsible for foaming in rivers, particularly surfactants and phosphates, have received wide attention in the dynamic community of river pollution. Many studies in the past, around the globe, have evidently provided different rationales behind the dense foam formation in rivers, yet the Concerned Govt. Authorities have highlighted the cause of foam formation in the river Yamuna is associated with the presence of detergents and phosphates as foaming agents. Despite this, an aperture with copious unaccounted factors or underlying agents still exists to rationalize the foam formation and persistence. In this article, we outline these unaccounted factors which might be responsible for the foam formation and stabilization and give indications for future research directives towards the emergence of studies regarding the dense foam formation in river Yamuna.

In Silico Insight to Identify Potential Inhibitors of BUB1B from Mushroom Bioactive Compounds to Prevent Breast Cancer Metastasis

BACKGROUND

Breast cancer is one of the most common types of cancer among women worldwide, and its metastasis is a significant cause of mortality. Therefore, identifying potential inhibitors of proteins involved in breast cancer metastasis is crucial for developing effective therapies. BUB1 mitotic checkpoint serine/threonine kinase B (BUB1B) is a key regulator of mitotic checkpoint control, which ensures the proper segregation of chromosomes during cell division. Dysregulation of BUB1B has been linked to a variety of human diseases, including breast cancer. Overexpression of BUB1B has been observed in various cancer types, and its inhibition has been shown to induce cancer cell death. Additionally, BUB1B inhibition has been suggested as a potential strategy for overcoming resistance to chemotherapy and radiation therapy. Given the importance of BUB1B in regulating cell division and its potential as a therapeutic target, the development of BUB1B inhibitors has been the focus of intense research efforts. Despite these efforts, few small molecule inhibitors of BUB1B have been identified, highlighting the need for further research in this area. In this study, the authors aimed to identify potential inhibitors of BUB1B from mushroom bioactive compounds using computational methods, which could ultimately lead to the development of new treatments for breast cancer metastasis.

METHODS

This study has incorporated 70 bioactive compounds (handpicked through literature mining) of distinct mushrooms that were considered and explored to identify a suitable drug candidate. Their absorption, distribution, metabolism and excretion (ADME) properties were obtained to predict the drug-likeness of these 70 mushroom compounds based on Lipinski's rule of 5 (RO5). Screening these bioactive compounds and subsequent molecular docking against BUB1B provided compounds with the best conformation-based binding affinity. The best two complexes, i.e., BUB1B-lepitaprocerin D and BUB1B-peptidoglycan, were subjected to molecular dynamic simulations. Both complexes were assessed for their affinity, stability, and flexibility in protein-ligand complex systems.

RESULTS

The molecular dynamic (MD) simulation studies revealed that lepitaprocerin D has an energetically favorable binding affinity with BUB1B. Results showed that the formation of a hydrogen bond between residues ASN123 and SER157, and lepitaprocerin D had strengthened the affinity of lepitaprocerin D with BUB1B.

CONCLUSIONS

This study identified lepitaprocerin D as a potential and novel inhibitor for BUB1B that could be a plausible drug candidate for identifying and controlling the spread of breast cancer metastasis.

Can adoption of climate resilient management practices achieve carbon neutrality in traditional green revolution states of Punjab and Haryana?

Decreasing greenhouse gas (GHG) emissions and enhancing soil carbon (C) sequestration in cropland are necessary to achieve carbon neutrality at national scale. The major objective of this study is to quantify the GHG mitigation potential of adopted climate resilient (CR) practices in CR villages using Ex-ACT tool developed by Food and Agriculture Organization (FAO). Intensively cultivated area of Punjab and Haryana was selected for carrying out this study. In both the states, villages were selected by considering the climate for past 30 years. In the selected villages, a set of CR practices were implemented in annuals, perennials, irrigated rice, fertilizer use, land use change and livestock and quantified the GHG mitigation potential in these villages for next twenty years. The tool predicted that the CR practices adopted were successful in enhancing the overall sink (carbon balance) in all the study villages. The villages of Punjab had recorded higher mitigation potential as compared to the villages of Haryana. The overall sink potential in these villages ranged from -354 to -38309 Mg CO₂-eq. The change in sink potential varied from 3.16 to 112% with lowest in Radauri and highest in Badhauchhi kalan village. The sink potential got doubled in Badhauchhi kalan village due to stopping rice straw burning and increase in area under perennials by 25%. The source potential varied from 6.33 to -7.44% across the study villages. Even with the implementation of NICRA, there was increase in source by 5.58 and 6.33% in Killi Nihal Singh Wala and Radauri due to irrigated rice, land use change and livestock. Majorly, rice straw burning was seen in most of the study villages, yet, with proper residue management and adoption of CR practices (mainly intermittent flooding) in rice cultivation resulted in emissions reduction up to 5-26% with enhanced productivity up to 15-18%, which can be considered for scaling up. Fertilizer management reduced the emissions by average of 13% across the study villages. Farm gate emission intensity per ton of milk and rice recorded highest emission intensity compared to annuals and perennials suggesting strict implementation of CR practices in rice cultivation and livestock sector. Implementation and scaling up of CR practices could potentially reduce the emissions and make the village C negative in intensive rice-wheat production system.

Is there a ubiquitous association between sleep disorder and frailty? findings from LASI (2017-18)

BACKGROUND

Relatively little is known about how sleep disorders affect frailty of seniors. The study uses Fried's frailty index, to investigate the relationship between sleep disorder and frailty among older Indian adults.

METHODS

The study analysed Longitudinal Ageing Study in India (2017-18) data which uses a multistage stratified area probability cluster sampling design. The association between frailty was studied for which the total sample size was 31,902. The principal dependent variable was frailty. Descriptive statistics and cross-tabulation were presented in the study. A binary logistic regression analysis was used to fulfil the study objectives to find the possible association.

RESULTS

The prevalence of frailty in India was 21.3 percent. Older adults with sleep disorder had 66 percent higher likelihood to be frail than their counterparts. The benefits of physical activity in containing frailty is huge, the association were quite high. Poor Self-rated health was significantly associated with higher frailty (OR = 1.73; CI = 1.47-2.04).

CONCLUSIONS

Frailty is an enormously growing public health issue and has bi-directional relation with sleep disorders. The study has clinical relevance since sleep complaints offer a means for identifying those who are vulnerable to frailty and through appropriate intervention, the causes of sleep disorder would help to delay and in some cases reverse frailty.

Management and outcome of EGFR mutant lung cancer with SARS-CoV-2 infection

The world and India, in particular, have been grappling with the coronavirus disease (COVID-19) pandemic for more than a year now. The simultaneous presence of active COVID-19 infection with lung cancer poses both a diagnostic and therapeutic dilemma, because of similar clinical, radiological features along with increased susceptibility to ICU admissions and death. We present the case of a metastatic EGFR mutant lung cancer patient who was started on Gefitinib during active COVID-19 infection. He had made a complete recovery from COVID-19 infection while achieving a partial response to therapy in terms of primary lung cancer. The case highlights the importance of active involvement of a medical oncologist in the care of all cancer patients with COVID-19 infection instead of the traditional holding of all therapy for cancer until COVID-19 recovery as suggested by the majority of guidelines.

Recent Advances in Nanomaterials-Based Targeted Drug Delivery for Preclinical Cancer Diagnosis and Therapeutics

Nano-oncology is a branch of biomedical research and engineering that focuses on using nanotechnology in cancer diagnosis and treatment. Nanomaterials are extensively employed in the field of oncology because of their minute size and ultra-specificity. A wide range of nanocarriers, such as dendrimers, micelles, PEGylated liposomes, and polymeric nanoparticles are used to facilitate the efficient transport of anti-cancer drugs at the target tumor site. Real-time labeling and monitoring of cancer cells using quantum dots is essential for determining the level of therapy needed for treatment. The drug is targeted to the tumor site either by passive or active means. Passive targeting makes use of the tumor microenvironment and enhanced permeability and retention effect, while active targeting involves the use of ligand-coated nanoparticles. Nanotechnology is being used to diagnose the early stage of cancer by detecting cancer-specific biomarkers using tumor imaging. The implication of nanotechnology in cancer therapy employs photoinduced nanosensitizers, reverse multidrug resistance, and enabling efficient delivery of CRISPR/Cas9 and RNA molecules for therapeutic applications. However, despite recent advancements in nano-oncology, there is a need to delve deeper into the domain of designing and applying nanoparticles for improved cancer diagnostics.

WNT-β Catenin Signaling as a Potential Therapeutic Target for Neurodegenerative Diseases: Current Status and Future Perspective

Wnt/β-catenin (WβC) signaling pathway is an important signaling pathway for the maintenance of cellular homeostasis from the embryonic developmental stages to adulthood. The canonical pathway of WβC signaling is essential for neurogenesis, cell proliferation, and neurogenesis, whereas the noncanonical pathway (WNT/Ca²⁺ and WNT/PCP) is responsible for cell polarity, calcium maintenance, and cell migration. Abnormal regulation of WβC signaling is involved in the pathogenesis of several neurodegenerative diseases such as Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), and spinal muscular atrophy (SMA). Hence, the alteration of WβC signaling is considered a potential therapeutic target for the treatment of neurodegenerative disease. In the present review, we have used the bibliographical information from PubMed, Google Scholar, and Scopus to address the current prospects of WβC signaling role in the abovementioned neurodegenerative diseases.

Hydrogeochemical characterisation and geospatial analysis of groundwater for drinking water quality in Ludhiana district of Punjab, India

This study characterises the quality of groundwater for the Ludhiana district of Punjab, India by analysing water samples collected from 152 locations spread across 3767 km². The samples were analysed for 18 parameters consisting of pH, EC, TDS, TA, TH, major anions and cations. The parameter values have been used to calculate the drinking water quality index of the study area which suggests that 2.6, 57.9, 32.9, 4 and 2.6% of the samples fall under the excellent, good, poor, very poor and unsuitable categories, respectively. The sequence of abundance for ions (in meq/l) as revealed from the laboratory tests is Na⁺ (37.1%) > Ca²⁺ (30.8%) > Mg²⁺ (29.1%) > K⁺ (2.8%) for cations and HCO₃^- (80%) > Cl^¯ (8.9%) > CO₃^2- (6.5%) > SO₄^2- (3.9%) > NO₃^-, F^-, PO₄^3- (< 1%) for anions. The spatial variability of these parameters has been depicted through the use of interpolation maps. Evaluation of different ionic ratios indicates that carbonate weathering and silicate weathering are both significantly affecting the groundwater chemistry with a slight dominance of carbonate weathering. Also, the ion exchange process is taking place in the area as confirmed by CAI index values. In terms of saturation index, the groundwater is undersaturated with respect to halite, fluorite and sylvite, whereas it is supersaturated for calcite, dolomite and aragonite minerals. The principal components in PCA explained 75.4% of the total variance with 29.1 and 28.3% contributions from PC1 and PC2. Both of these components indicate towards the geogenic and anthropogenic influence on groundwater mineralization of the area. The analysis suggests that groundwater for the study area is suitable for drinking in most of the region expect in a few places. Such a study could be used to understand the current status of groundwater quality in the area, the results of which can be used to prevent further contamination and sustain the resource for the future.

Quality of life, voiding & sexual dysfunction following robot-assisted vesicovaginal fistula repair: a tertiary care centre experience

Robot-assisted VVF (RA-VVF) repair has the advantage of small cystotomy, precise dissection and minimal surrounding tissue trauma. Translation of this to better functional outcomes is not studied so far. This study aims to evaluate the quality of life, voiding, and sexual dysfunction following robot-assisted VVF repair. Women with successful RA-VVF repair were screened using UDI-6, IIQ-7, FSFI, and WHOQOL-BREF questionnaires. The preoperative assessment was done in the prospective cohort only. Of the 75 women who underwent RA-VVF repair, 47 were enrolled, 33 in retrospective, and 14 in a prospective cohort. Overall, 28 (60%) women had urinary complaints with a median UDI-6 total score of 4 (0-100) and  IIQ-7 score (0-23) in 5 (10%) women. However, UDS (15 women) showed no DO with cystometric capacity (352 ± 98.12) ml and normal compliance in 14 (93%) women. Mean BOOI and DCI were 11.90 ± 7.01 and 44.25 ± 8.60 respectively, with PdetQmax ranging from 17 to 44. None had difficulty in voiding (Qmax 13.85 ± 4.90). Twenty (43%) women were sexually active, and 2 had sexual dysfunction (FSFI score < 26.55). Quality of life was "good" to "very good" in all domains (score > 90) except for the social domain. The prospective cohort showed significant improvement in UDI-6 score (p < 0.05), IIQ-7 score (p < 0.05), and quality of life (p < 0.05) postoperatively. RA-VVF repair results in minimal voiding dysfunction and significant improvement in overall quality of life. For sexual dysfunction assessment, a longer follow-up is required.

Predictors of mortality and nephrectomy in emphysematous pyelonephritis: a tertiary care centre study

INTRODUCTION

Emphysematous pyelonephritis (EPN) is a deadly disease due to its associated morbidity and mortality. Attempts have been made to identify predictors of severity, mortality and need for nephrectomy in EPN with little success.

METHODS

We conducted an ambispective study of EPN patients between March 2014 and September 2019. Retrospective data were collected which included age, sex, comorbidities, symptoms, signs, laboratory investigations including imaging, need for dialysis, management and any complications. All patients were then followed prospectively for renal dynamic scan, stone surgery or nephrectomy. Univariate analysis was performed to identify factors affecting mortality and need for elective nephrectomy.

RESULTS

In total, 112 patients were included. Mean patient age was 50.01 years, 55% were female and 5% had bilateral involvement. Fever and flank pain were the most common symptoms. Diabetes was seen in 75% of cases and 30% of cases required haemodialysis at initial presentation. About 60% of patients improved with pigtail drainage. Need for nephrectomy was greater in Huang-Tseng stage 3a (14.8%). Huang-Tseng stages 3b and 4 had higher mortality rates (25%) than the other stages (2.2%). Twelve of 99 patients had non functional kidney on follow-up and underwent elective nephrectomy. Low platelet counts, high body mass index, septic shock, dialysis and higher Huang-Tseng stage were found to be predictive of mortality and renal parenchymal thickness on computed tomography scan was predictive of follow-up nephrectomy.

CONCLUSIONS

Thrombocytopaenia, high body mass index, septic shock, haemodialysis and higher Huang-Tseng stage are predictors of mortality and renal parenchymal thickness <5mm is a predictor of poor salvage of affected kidney on follow-up.

Clinical Profile and Outcome of Children Admitted with Multisystem Inflammatory Syndrome (MIS-C) in a Tertiary Hospital

Background Most children infected with SARS-CoV-2 infection, are asymptomatic or develops mild to moderate symptoms. Few weeks later, few children develops delayed hyper inflammatory syndrome known as Multisystem inflammatory syndrome in children (MIS-C). Objective To describe various demographic features of children with Multisystem inflammatory syndrome in children. To analyze common clinical presentation, clinical and laboratory markers of severity and outcome of children with Multisystem inflammatory syndrome. Method This study was prospective observational study conducted on children with Multisystem inflammatory syndrome in children. This was conducted in Department of Pediatrics of Nobel Medical College during 12 months period from July 2021 to June 2022. Basic demographic features, common clinical presentation in children with Multisystem inflammatory syndrome in children and its severity and outcome were analyzed. Independent sample t-test and chi square test was used for comparison of means and categorical variables. Logistic regression was done to assess the relationship between clinical variables and outcome. Result A total of 36 children were included in our study. Maximum number of cases were male (61.11%) and age group > 10 years (58.33%). Fever, gastrointestinal symptoms, shock and renal dysfunction were common clinical features. Children requiring mechanical ventilation had higher C-reactive protein (CRP), lower platelets, higher d-Dimer and lower ejection fraction. Vasoactive Inotropic score (VIS > 10) was associated with higher chances of mechanical ventilation and prolonged pediatric intensive care unit (PICU) stay. Mortality rate in our study was 5.55% and three children developed coronary aneurysm.

Assessment of groundwater quality and human health risks of nitrate and fluoride contamination in a rapidly urbanizing region of India

Groundwater contamination studies are important to understand the risks to public health. In this study, groundwater quality, major ion chemistry, sources of contaminants, and related health risks were evaluated for North-West Delhi, India, a region with a rapidly growing urban population. Groundwater samples collected from the study area were analysed for physicochemical parameters - pH, electrical conductivity, total dissolved solids, total hardness, total alkalinity, carbonate, bicarbonate, chloride, nitrate, sulphate, fluoride, phosphate, calcium, magnesium, sodium and potassium. Investigation of hydrochemical facies revealed that bicarbonate was the dominant anion while magnesium was the dominant cation. Multivariate analysis using principal component analysis and Pearson correlation matrix indicated that major ion chemistry in the aquifer under study is primarily due to mineral dissolution, rock-water interactions and anthropogenic factors. Water quality index values showed that only 20% of the samples were acceptable for drinking. Due to high salinity, 54% of the samples were unfit for irrigation purposes. Nitrate and fluoride concentrations ranged from 0.24 to 380.19 mg/l and 0.05 to 7.90 mg/l, respectively due to fertilizer use, wastewater infiltration and geogenic processes. The health risks from high levels of nitrate and fluoride were calculated for males, females, and children. It was found that health risk from nitrate is more than fluoride in the study region. However, the spatial extent of risk from fluoride is more indicating that more people suffer from fluoride pollution in the study area. The total hazard index for children was found to be more than adults. Continuous monitoring of groundwater and application of remedial measures are recommended to improve the water quality and public health in the region.

Prevalence of Obesity in Newly Onset Diabetes Mellitus and Its Relationship with Uric Acid: An Indian Cross-Sectional Study

Introduction

Prevalence of obesity is high in diabetes mellitus (DM) and is associated with hyperuricemia (HU), hypertension, metabolic syndrome, cardiovascular disease and dyslipidemia. In obesity, elevated serum uric acid (SUA) has been shown to be associated in many studies from different countries, but data from India are lacking. The aim of the present study is to know the prevalence of obesity and to know the relationship between obesity and SUA in newly onset DM.

Methods

In this cross-sectional study from India, 402 consecutive newly onset diabetic patients (male: 284; female: 118) were enrolled. All patients were grouped into four based on BMI (body mass index): underweight (<18.5 kg/m²), normal weight (18.5-23 kg/m²⁾, overweight (>23-27.5 kg/m²), and obese (>27.5 kg/m²). All participants were grouped into four quartiles based on SUA (Q1: <4.23; Q2: ≥4.24-5.19; Q3: ≥5.20-6.16; Q4: >6.16).

Results

The mean age, BMI and SUA of the participants were 46.20±0.52 years, 26.35±0.21 kg/m² and 5.24±0.007 mg/dl, respectively. Overall prevalence of generalized obesity, central obesity and hyperuricemia (HU) were 35.07%, 85.82% and 13.43%, respectively. The prevalence of generalized obesity increased across the SUA quartile. A multinomial logistic regression analysis showed that serum uric acid level was independently associated with generalized obesity (p<0.001).

Conclusion

This first report from India shows a significant positive association between SUA and generalized obesity among newly onset DM. Therefore, routine estimation of SUA is recommended in newly onset DM to prevent and treat HU and its related complications.

Enhancement of immune surveillance in breast cancer by targeting hypoxic tumor endothelium: Can it be an immunological switch point?

Breast cancer ranks second among the causes of cancer-related deaths in women. In spite of the recent advances achieved in the diagnosis and treatment of breast cancer, further study is required to overcome the risk of cancer resistance to treatment and thereby improve the prognosis of individuals with advanced-stage breast cancer. The existence of a hypoxic microenvironment is a well-known event in the development of mutagenesis and rapid proliferation of cancer cells. Tumor cells, purposefully cause local hypoxia in order to induce angiogenesis and growth factors that promote tumor growth and metastatic characteristics, while healthy tissue surrounding the tumor suffers damage or mutate. It has been found that these settings with low oxygen levels cause immunosuppression and a lack of immune surveillance by reducing the activation and recruitment of tumor infiltrating leukocytes (TILs). The immune system is further suppressed by hypoxic tumor endothelium through a variety of ways, which creates an immunosuppressive milieu in the tumor microenvironment. Non responsiveness of tumor endothelium to inflammatory signals or endothelial anergy exclude effector T cells from the tumor milieu. Expression of endothelial specific antigens and immunoinhibitory molecules like Programmed death ligand 1,2 (PDL-1, 2) and T cell immunoglobulin and mucin-domain containing-3 (TIM-3) by tumor endothelium adds fuel to the fire by inhibiting T lymphocytes while promoting regulatory T cells. The hypoxic microenvironment in turn recruits Myeloid Derived Suppressor Cells (MDSCs), Tumor Associated Macrophages (TAMs) and T regulatory cells (Treg). The structure and function of newly generated blood vessels within tumors, on the other hand, are aberrant, lacking the specific organization of normal tissue vasculature. Vascular normalisation may work for a variety of tumour types and show to be an advantageous complement to immunotherapy for improving tumour access. By enhancing immune response in the hypoxic tumor microenvironment, via immune-herbal therapeutic and immune-nutraceuticals based approaches that leverage immunological evasion of tumor, will be briefly reviewed in this article. Whether these tactics may be the game changer for emerging immunological switch point to attenuate the breast cancer growth and prevent metastatic cell division, is the key concern of the current study.

Valley-Tunable Even-Denominator Fractional Quantum Hall State in the Lowest Landau Level of an Anisotropic System

Fractional quantum Hall states (FQHSs) at even-denominator Landau level filling factors (ν) are of prime interest as they are predicted to host exotic, topological states of matter. We report here the observation of a FQHS at ν=1/2 in a two-dimensional electron system of exceptionally high quality, confined to a wide AlAs quantum well, where the electrons can occupy multiple conduction-band valleys with an anisotropic effective mass. The anisotropy and multivalley degree of freedom offer an unprecedented tunability of the ν=1/2 FQHS as we can control both the valley occupancy via the application of in-plane strain, and the ratio between the strengths of the short- and long-range Coulomb interaction by tilting the sample in the magnetic field to change the electron charge distribution. Thanks to this tunability, we observe phase transitions from a compressible Fermi liquid to an incompressible FQHS and then to an insulating phase as a function of tilt angle. We find that this evolution and the energy gap of the ν=1/2 FQHS depend strongly on valley occupancy.

Isolation and characterization of N-(2-Hydroxyethyl)hexadecanamide from Colletotrichum gloeosporioides with apoptosis-inducing potential in breast cancer cells

Endophytic fungi are a well-established reservoir of bioactive compounds that are pharmaceutically valuable and therefore, contribute significantly to the biomedical field. The present study aims to identify the bioactive anticancer compound from ethyl acetate extract of fungal endophyte, Colletotrichum gloeosporioides associated with the leaf of the medicinal plant Oroxylum indicum. The fatty acid amide compound N-(2-Hydroxyethyl)hexadecanamide (Palmitoylethanolamide; PEA) was identified using antioxidant activity-guided fractionation assisted with tandem liquid chromatography coupled with quadrupole time of flight mass spectrometry, Fourier transform-infrared spectroscopy, time-of-flight mass spectrometry, and nuclear magnetic resonance. In-Silico molecular docking analysis showed that PEA potentially docked to the active sites of apoptosis-inducing proteins including BAX, BCL-2, P21, and P53. Further validation was done using in vitro study that showed PEA inhibitsthe proliferation, alters nuclear morphology and attenuates the wound closure ability of MDA-MB-231 and MCF-7 cells. PEA induces apoptosis via upregulating cell-cycle arrest (P21), tumor suppression (P53), pro-apoptotic (BAX, CASPASE-8, and FADD) genes, and downregulating anti-apoptotic gene BCL-2. The upregulation of the active form of Caspase-3 was also reported. This is the first-ever report for the isolation of PEA from C. gloeosporioides with anticancer activity against human breast cancer cells and therefore holds great potential for future therapeutics.

Integration of Pre-Treatment with UF/RO Membrane Process for Waste Water Recovery and Reuse in Agro-Based Pulp and Paper Industry

This recent study aims to evaluate the efficacy of membrane filtration on recovery of water resource from agro-waste such as bagasse, crop-based pulp and paper mill waste. A mini pilot scale membrane system having a combination of pre-treatment filter unit (pre-filter, sediment filter and pre-carbon filter), ultra-filtration and reverse osmosis with spiral wound configuration were employed to evaluate the water reuse efficacy of effluent coming from the secondary clarifier of the conventional treatment plant of the mill. The operational conditions were optimized using Taguchi method at pH 8, temperature 32 °C, and pressure 2 bar and a flow rate of 60 l/hr. The qualities of the effluent from the secondary clarifier, and the permeate from both the combination, viz. Combination 1 (pre-treatment + ultra-filtration) and Combination 2 (pre-treatment + ultra-filtration+ reverse osmosis) were analyzed and the percentage reduction in pH, TDS, TSS, BOD, COD, Color, Lignin, Potassium and Sodium were calculated. The elimination of TDS, COD and BOD with Combination 1 was not promising (<22%). However, the installation of a RO membrane greatly reduced (>88%) the contaminants in both paper mill effluents. The obtained qualities of water from all the combinations were compared with the tolerance standard for reuse as process water. The quality of effluent from the secondary clarifier did not agree with any class of water quality. The permeate from the combination of pre-treatment and UF sufficiently reduced the TSS to reach the requirement. However, the combination of (pre-treatment + UF + RO) adequately complied with the quality standard required for reuse in the making of all grades of paper.

Differential expression of inflammatory cytokines, prostaglandin synthases and secretory leukocyte protease inhibitor in the endometrium and circulation in different graded CEH-pyometra in bitch

Cystic endometrial hyperplasia (CEH)-pyometra (CEH-P) is one of the most common reproductive disorders in bitches, posing a risk to both future fertility and life. The aims of the current study were to elucidate the differential expression patterns of inflammatory mediators at transcript and protein levels in the endometrium and to assess the concentrations of key inflammatory mediators in the peripheral circulation of bitches with different graded CEH-P. A total of 25 client-owned intact mixed breed bitches of 3-10 years presented to the outpatient department of RVP-TVCC of the institute were considered for the study. Of which, 22 cases suggestive of pyometra and 3 cases of CEH obtained during routine elective ovariohysterectomy were subjected to histopathological examination. Uteri were categorized into CEH (n = 3), moderate CEH-P (mCEH-P, n = 9), severe CEH-P (sCEH-P, n = 6) and atrophic pyometra (AT-P, n = 7). A group of age matched (n = 12) bitches without pyometra served as control. Endometrial transcripts such as IL6, IL8, PTGS2, PGFS, and SLPI were expressed differentially in the CEH and CEH-P bitch. In addition, a strong immunoreactivity (IR) of IL6, IL8, PTGS2, and mPGES1 was recorded in the sCEH-P uterus, while expression of IL10 was noticed in AT-P. In circulation, serum IL6 was the most relevant marker with high sensitivity of 96.2% and specificity of 84.6% at a cut off concentration 8.5 pg/mL followed by SLPI with 95.2% sensitivity, and 84.6% specificity at cut off concentration of 1.3 ng/mL. Serum IL10, PGFM and SLPI concentration in the peripheral circulation were 1.5-2.23 fold higher in mCEH-P, 0.87-2.5 fold higher in sCEH-P and 2.9-3.5 fold higher in AT-P than that of control. It is concluded that monitoring the serum concentration of IL6, IL10 and SLPI would be useful adjunct to the established hematobiochemical parameters in the management of pyometra in the bitch with critical illness.

Ethyl Acetate Extract of Colletotrichum gloeosporioides Promotes Cytotoxicity and Apoptosis in Human Breast Cancer Cells

Fungal endophytes are known to be a paragon for producing bioactive compounds with a variety of pharmacological importance. The current study aims to elucidate the molecular alterations induced by the bioactive compounds produced by the fungal endophyte Colletotrichum gloeosporioides in the tumor microenvironment of human breast cancer cells. GC/MS analysis of the ethyl acetate (EA) extract of C. gloeosporioides revealed the presence of bioactive compounds with anticancer activity. The EA extract of C. gloeosporioides exerted potential plasmid DNA protective activity against hydroxyl radicals of Fenton's reagent. The cytotoxic activity further revealed that MDA-MB-231 cells exhibit more sensitivity toward the EA extract of C. gloeosporioides as compared to MCF-7 cells, whereas non-toxic to non-cancerous HEK293T cells. Furthermore, the anticancer activity demonstrated by the EA extract of C. gloeosporioides was studied by assessing nuclear morphometric analysis and induction of apoptosis in MDA-MB-231 and MCF-7 cells. The EA extract of C. gloeosporioides causes the alteration in cellular and nuclear morphologies, chromatin condensation, long-term colony inhibition, and inhibition of cell migration and proliferation ability of MDA-MB-231 and MCF-7 cells. The study also revealed that the EA extract of C. gloeosporioides treated cells undergoes apoptosis by increased production of reactive oxygen species and significant deficit in mitochondrial membrane potential. Our study also showed that the EA extract of C. gloeosporioides causes upregulation of pro-apoptotic (BAX, PARP, CASPASE-8, and FADD), cell cycle arrest (P21), and tumor suppressor (P53) related genes. Additionally, the downregulation of antiapoptotic genes (BCL-2 and SURVIVIN) and increased Caspase-3 activity suggest the induction of apoptosis in the EA extract of C. gloeosporioides treated MDA-MB-231 and MCF-7 cells. Overall, our findings suggest that the bioactive compounds present in the EA extract of C. gloeosporioides promotes apoptosis by altering the genes related to the extrinsic as well as the intrinsic pathway. Further in vivo study in breast cancer models is required to validate the in vitro observations.

Effect of Core Muscle Stabilisation Exercises on Disability Associated with Non Specific Low Back Pain in Postmenopausal Women: A Prospective Longitudinal Study

Introduction: Non Specific Low Back Pain (NSLBP) is a frequent problem faced by the majority of postmenopausal women at some stage of their lives, resulting in a significant level of disability. Aim: To evaluate the effectiveness of core stabilisation exercises compared to traditional physical treatment in postmenopausal women with NSLBP. Materials and Methods: A prospective longitudinal study was conducted from January 2022 to August 2022, including 50 postmenopausal women aged 45-60 years with NSLBP. They were placed into two groups. Conventional LBP physical therapy methods were administered to group 2. The identical traditional and Core muscle Stabilisation Exercises (CSE) were implemented in the group 1. The Modified Oswestry Disability Index (MODI) was used for the assessment of disability. The Mann-Whitney U test and Friedman Analysis of Variance (ANOVA) were conducted to analyse changes in disability scores across and among groups at the ends of the second, fourth, and sixth weeks of treatment. Results: Of 50 patients initially enrolled in the study, 33 patients were available for the final follow-up. Group 1 consisted of 16 patients, while group 2 had 17 patients. Significant reduction in disability was found across the two groups at the second, fourth, and sixth weeks of treatment (p-value<0.05). In the sixth week of treatment, group 1 had a statistically greater decrease in ODI score (41.16±13.53) than group 2 (30.74±13.28) (p-value =0.003). Conclusion: CSE were found to be more effective than conventional physical therapy in reducing disability associated with NSLBP in postmenopausal women.

Supplementary Posteromedial Plating for the Fixation of Complex Tibial Plateau Fractures: A Prospective Study

Introduction The management of complex tibial plateau fractures (CTPF) involving the posterior tibial plateau remains challenging and achieving maintenance of an axially stable construct with a single lateral locked plate is uncertain. Dual plating for such fractures via separate incisions can provide better fixation with superior clinical and radiological outcomes. This prospective study aimed to evaluate the results of the management of Schatzker type V and VI complex tibial plateau fractures using a conventional anterolateral plate along with a posteromedial buttress plate via two separate approaches and the potential complications associated with it. Methods Fifty-six patients presenting with tibial plateau fractures to the Department of Orthopaedics at a tertiary care center in the northern part of the state of Uttar Pradesh, India, between January 2018 and July 2022 were screened. Subsequently, 28 patients with CTPFs (AO/OTA types 41C1, 41C2, AND 41C3) were included in the study, managed with dual plating, and followed up for a duration of 12 months. The clinico-radiological outcome was assessed using Rasmussen's Functional Grading System (RFS), Oxford Knee Score (OKS), knee range of motion achieved, and Rasmussen's Radiological Scoring System (RRS), and statistical analysis of the data was performed. Results A total of 24 (85.71%) patients had excellent OKS and good to excellent RFS at the final follow-up. The average knee range of motion was 3.21° to 122°, with only two patients reporting an extensor lag of more than 10°. The final follow-up radiographs showed a mean medial proximal tibial angle (MPTA) of 83.98° ± 6.89 (75.44-89.21) and a mean posterior tibial plateau angle (PTPA) of 12.31 ± 4.69 (5.12 to 16.49) with the RRS showing excellent or good radiographic results with a mean score of 14.1 ± 1.7 (range 8-16). None of the patients showed signs of deep infection, whereas superficial infection was reported in two patients. A single case of secondary loss of particular reduction was seen. Conclusion Supplementary posterior buttress plating, along with the conventional anterolateral plate for the management of CTPF, achieves rigid fixation with superior articular reduction, a high knee score, a good range of motion, lower complication rates, and limited deformities with a good radiological outcome, with a few demerits of prolonged operative time, technically demanding procedure, increased blood loss, and a protracted hospital stay which can be minimized in most instances using minimally open reduction techniques and careful soft-tissue handling.

Nature, pattern, and changes in alcohol consumption among men in India: Insights from NFHS-4 and NFHS-5

The consumption pattern of alcohol varies between cultures and different communities. Moreover, alcohol consumption pattern depends on age, religion, education, type of drink, and other socio-economic parameters. Alcohol use has reportedly declined in most developed counties, but developing countries still witnessed an increasing trend. The study investigated socio-economic drivers, nature, and patterns of alcohol use among adult men in India. We have also investigated the state-level alcohol prevalence in India better to understand the impact of state-level alcohol prohibition policies. We have retrieved the data from the National Family Health survey's fourth and fifth-round, which was conducted in 2015-2016 and 2020-2021, respectively. We used the bi-variate technique to estimate that percentage of men who consume alcohol. Furthermore, a multivariate logistic regression model was applied to assess the association of each background characteristic with alcohol consumption. It is observed that 19 percent of men aged 15 and above currently drink alcohol, including 20 percent in rural and 17 percent in urban areas. The consumption of tadi/madi/country liquor/homemade liquor was high in rural areas than in urban areas in both rounds of the survey. Additionally, beer or wine consumption is higher in urban areas than in rural areas in NFHS-4 and NFHS-5. Among the 35-49 years of age group, around 6 and 8 times more likely to consume alcohol in NFHS-4 and NFHS-5, respectively. Rural men were 18 and one percent less likely to consume alcohol in NFHS-4 & 5 compared to urban (OR: 0.82 and 0.99 in NFHS-4 & 5 respectively). Despite an overall reduction in alcohol consumption among men, lowering alcohol consumption remains the main priority of policymakers. There is a need to target the most vulnerable socio-economic segments where alcohol consumption is still a problem, one of the primary reasons for violence against women.