The impact of topical tranexamic acid on drain duration and seroma volume in axillary lymph node dissection for breast cancer: A randomized controlled trial.

BACKGROUND: Seroma is the most common complication after breast surgery. Some studies showed that tranexamic acid (TA) can be used in breast surgery to reduce seroma formation and drain volume. We studied the effect of intra-operative and postoperative topical TA on the duration of drain and volume of seroma in patients undergoing axillary lymph node dissection (ALND) for breast cancer. PATIENTS AND METHODS: Breast cancer patients planned for ALND were enrolled in the study between July 2020 and July 2021. Patients were randomized into three groups where one group (n = 50) received a single intraoperative dose of diluted topical TA, the second group, in addition, received daily postoperative doses till day 5 through the suction drain, and the third group (n = 50) did not receive any dose. Chi-square tests and ANOVA were used to analyze the primary outcomes-the total volume of drain fluid and total drain duration, and secondary outcomes-daily drain output till postoperative-day-5, wound infection, and seroma rates. RESULTS: Patients receiving multiple doses of topical TA had a decreasing trend in total drain volume, although this was not statistically significant (1597 vs. 1763 vs. 1773 mL: p = 0.269). There was no significant change in the duration of the postoperative drain (21.6 vs. 19.2 vs. 19.55 days: p = 0.54). There was no statistically significant difference in complications between the groups. CONCLUSION: There is no significant reduction in drain duration, total drain volume, or the rate of complications with the use of single or multiple doses of topical TA.

In-plane thermal conductivity measurements of Si µ-cantilevers using the suspended thermo-reflectance (STR) technique.

The Suspended Thermoreflectance (STR) technique is described in this paper. This optoelectronic measurement tool performs thermal characterization of freestanding micro-/nanoscale materials. STR performs thermal mapping at the submicron level and produces unconstrained thermal conductivity unlike other optical measurement techniques where independent conductivity measurement is not possible due to their reliance on heat capacity. STR works by changing the temperature of a material and collecting the associated change in light reflection from multiple points on the sample surface. Reflection is a function of the material being tested, the wavelength of the probe light, geometry, and the composition of the specimen for transparent and quasi-transparent materials. In this article, Si µ-cantilevers are studied. In addition, a thermal analytical model is developed and incorporated with optical equations to characterize the conductivity of the Si µ-cantilevers. The analytical model is compared with a finite element model to check its applicability in the STR experiment and data analysis. To validate the technique, the thermal conductivity of 2 and 3 µm thick Si µ-cantilevers was determined using STR at a temperature range of 20-350 K and compared to simulations using the equation of phonon radiative transfer and literature values.

Self-microemulsifying drug delivery system-based gastroretentive in situ raft of pazopanib with enhanced solubility and bioavailability.

Pazopanib hydrochloride (PZH) is a Biopharmaceutics Classification System class II drug that faces challenges at the formulation forefront including low aqueous solubility (0.043 mg/mL) and poor oral bioavailability (14-39%). The present investigation aimed to develop a self-microemulsifying drug delivery system (SMEDDS) of PZH using a blend of Capryol® 90, Labrasol®, and propylene glycol to improve its solubility. Furthermore, a sustained-release SMEDDS-based gastroretentive floating system was developed and optimized using the Central Composite Design approach of DoE. The optimized SMEDDS-based in situ gelling raft, R-SM-PZH, exhibited minimal floating lag time (3.09 ± 0.8 s), optimal viscosity (1229.4 ± 20.9 cP) and density (0.327 ± 0.15 g/mL) as compared to other formulations under study. Additionally, R-SM-PZH was evaluated for its in vitro dissolution in FaSSGF and FeSSGF, pharmacokinetic profile, and MTT assay (against NCI-H460 lung cancer cells) compared to pure PZH. A 12 h sustained release, three-fold augmentation in dissolution rate and bioavailability, and 15-fold enhancement in cytotoxicity were observed in comparison to pure PZH. Thus, the SMEDDS-based in situ gelling raft presents a promising approach to advancing the developability potential of PZH.

Comparative Analysis of Bariatric Surgery and Non-surgical Therapies: Impact on Obesity-Related Comorbidities.

Obesity is associated with a broad spectrum of comorbidities, including metabolic dysregulation, cardiovascular complications, and socioeconomic impacts. Traditional lifestyle interventions often yield transient results in weight management, while bariatric surgery offers a promising alternative. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and focused on randomized controlled trials comparing bariatric surgery (e.g., Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB), and sleeve gastrectomy (SG)) with non-surgical therapies (drug therapy and lifestyle modifications) in the management of obesity-related comorbidities, particularly hypertension and type 2 diabetes mellitus (T2DM). We comprehensively searched databases like PubMed, PMC, and EBSCO using Medical Subject Headings (MeSH) terms related to obesity, bariatric surgery, and non-surgical treatments. We included seven studies involving participants aged 18-64 published within the last six years. We rigorously assessed these studies for quality and extracted data to evaluate outcomes such as weight loss, diabetes remission rates, hypertension management, and renal function. The review found that bariatric surgery consistently resulted in substantial and sustained weight loss compared to non-surgical therapies. Surgical interventions significantly improved hypertension control, reduced cardiovascular risks, and enhanced glycemic control in diabetic patients. The effectiveness of bariatric surgery in promoting diabetes remission was attributed not only to weight loss but also to physiological changes in gastrointestinal anatomy, gut hormones, and energy balance regulation. Limitations identified in the literature included variations in study methodologies, follow-up durations, and patient characteristics, which limited direct comparisons and generalizations. Future research should incorporate more extended follow-up periods and standardized methods to further validate these findings' durability and broad applicability across diverse patient populations. In conclusion, bariatric surgery emerges as an effective treatment option for managing obesity-related comorbidities, particularly hypertension and T2DM. While acknowledging the inherent risks and complexities associated with surgical interventions, ongoing research and clinical innovations are crucial to optimizing patient outcomes and reducing the global burden of obesity-related diseases.

Dietary Interventions and Supplements for Managing Attention-Deficit/Hyperactivity Disorder (ADHD): A Systematic Review of Efficacy and Recommendations.

Attention-deficit/hyperactivity disorder (ADHD) significantly impacts children's neurological development, behaviour, and overall well-being, affecting academic performance and social interactions. This systematic review investigates the effectiveness of dietary interventions (DASH (Dietary Approaches to Stop Hypertension) diet, Vitamin D3 supplementation, magnesium, and impact of artificial food colors and marine oils) and supplements alongside standard pharmacotherapy in managing ADHD symptoms. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, we extensively searched various databases for studies published from 2016 to 2022. Out of an initial pool of 7873 records, 14 randomized controlled trials met our inclusion criteria following rigorous screening. Our findings suggest that gluten-free diets may alleviate ADHD symptoms despite negative celiac serology, highlighting the role of non-celiac gluten sensitivity. Moreover, vitamin and mineral supplements like vitamin D and magnesium showed varying degrees of effectiveness in improving behavioural and emotional symptoms. Innovative treatments, such as combining saffron with methylphenidate and using marine oil extracts, also demonstrated potential in enhancing behaviours associated with ADHD. The review underscores the importance of dietary approaches, such as the DASH diet and specific exclusions (e.g., a few foods diet and an oligoantigenic diet), in managing symptoms by addressing nutritional factors. Studies on probiotics and interventions targeting gut microbiota composition yielded mixed results, necessitating further exploration. Limitations include study diversity and short-term outcome assessments, cautioning against broad generalizations. Integrating personalized dietary assessments and interventions into ADHD treatment strategies could optimize therapeutic outcomes and potentially reduce reliance on pharmacotherapy alone. In summary, this systematic review highlights the potential benefits of dietary modifications and supplements in managing ADHD symptoms. Future research should prioritize long-term efficacy, interactions with conventional medications, and personalized dietary approaches to refine ADHD treatment strategies.

Clinical and echocardiographic parameters associated with outcomes in patients with moderate secondary mitral regurgitation.

BACKGROUND: Significant secondary mitral regurgitation (SMR) is known to be associated with worse prognosis. However, data focusing specifically on moderate SMR and associated risk factors are lacking. In the present study, clinical and echocardiographic parameters associated with outcomes were evaluated in a large cohort of patients with moderate SMR. METHODS: Patients with moderate SMR were retrospectively included and stratified by New York Heart Association (NYHA) class and specific aetiology (atrial SMR (aSMR) or ventricular SMR (vSMR)) with a further classification of vSMR based on left ventricular ejection fraction (LVEF) ≥40% or <40%. The primary endpoint was all-cause mortality and the secondary endpoint was the composite of all-cause mortality and heart failure (HF) events. RESULTS: Of the total 1061 patients with moderate SMR (age 69±11 years, 59% male) included, 854 (80%) were in NYHA class I-II and 207 (20%) were in NYHA class III-IV. Regarding the aetiology, 352 (33%) had aSMR and 709 (67%) had vSMR, of which 329 (46%) had LVEF ≥40% and 380 (54%) had LVEF <40%. During a median follow-up of 82 (IQR 55-115) months, 397 (37%) died and 539 (51%) patients had HF events or died. On multivariable analysis, NYHA class III-IV (HR 1.578; 95% CI 1.244 to 2.002, p<0.001) and SMR aetiology were independently associated with both endpoints. Specifically, compared to aSMR, vSMR with LVEF ≥40% had a HR of 1.528 (95% CI 1.108 to 2.106, p=0.010) and vSMR with LVEF <40% had a HR of 1.960 (95% CI 1.434 to 2.679, p<0.001). To further support these findings, patients were matched for (1) NYHA class and (2) SMR aetiology by propensity scores including age, sex, diabetes, chronic obstructive pulmonary disease, renal function, left atrial volume index, NYHA class (only for SMR aetiology matching), LVEF, SMR aetiology (only for NYHA class matching), tricuspid regurgitation severity and right ventricular pulmonary artery coupling index. After matching, NYHA class and SMR aetiology remained associated with both outcomes (for both: log rank p<0.050). CONCLUSION: In patients with moderate SMR, distinction in SMR aetiology and assessment of symptoms are important independent determinants of outcome.

Parental assigned chromosomes for cultivated cacao provides insights into genetic architecture underlying resistance to vascular streak dieback.

Diseases of Theobroma cacao L. (Malvaceae) disrupt cocoa bean supply and economically impact growers. Vascular streak dieback (VSD), caused by Ceratobasidium theobromae, is a new encounter disease of cacao currently contained to southeast Asia and Melanesia. Resistance to VSD has been tested with large progeny trials in Sulawesi, Indonesia, and in Papua New Guinea with the identification of informative quantitative trait loci (QTLs). Using a VSD susceptible progeny tree (clone 26), derived from a resistant and susceptible parental cross, we assembled the genome to chromosome-level and discriminated alleles inherited from either resistant or susceptible parents. The parentally phased genomes were annotated for all predicted genes and then specifically for resistance genes of the nucleotide-binding site leucine-rich repeat class (NLR). On investigation, we determined the presence of NLR clusters and other potential disease response gene candidates in proximity to informative QTLs. We identified structural variants within NLRs inherited from parentals. We present the first diploid, fully scaffolded, and parentally phased genome resource for T. cacao L. and provide insights into the genetics underlying resistance and susceptibility to VSD.

Rationally designed febuxostat-based hydroxamic acid and its pH-Responsive nanoformulation elicits anti-tumor activity.

Attempts to furnish antitumor structural templates that can prevent the occurrence of drug-induced hyperuricemia spurred us to generate xanthine oxidase inhibitor-based hydroxamic acids and anilides. Specifically, the design strategy involved the insertion of febuxostat (xanthine oxidase inhibitor) as a surface recognition part of the HDAC inhibitor pharmacophore model. Investigation outcomes revealed that hydroxamic acid 4 elicited remarkable antileukemic effects mediated via HDAC isoform inhibition. Delightfully, the adduct retained xanthine oxidase inhibitory activity, though xanthine oxidase inhibition was not the underlying mechanism of its cell growth inhibitory effects. Also, compound 4 demonstrated significant in-vivo anti-hyperuricemic (PO-induced hyperuricemia model) and antitumor activity in an HL-60 xenograft mice model. Compound 4 was conjugated with poly (ethylene glycol) poly(aspartic acid) block copolymer to furnish pH-responsive nanoparticles (NPs) in pursuit of circumventing its cytotoxicity towards the normal cell lines. SEM analysis revealed that NPs had uniform size distributions, while TEM analysis ascertained the spherical shape of NPs, indicating their ability to undergo self-assembly. HDAC inhibitor 4 was liberated from the matrix due to the polymeric nanoformulation's pH-responsiveness, and the NPs demonstrated selective cancer cell targeting ability.

The Effect of a Synthetic-Grass Sport Surface on Physiology and Perception During Intermittent Exercise in Hot Conditions.

PURPOSE: The current study aimed to determine the effect of a synthetic-grass sport surface on core body temperature, skin temperature, heart rate, thermal sensation, thermal comfort, and rating of perceived exertion (RPE) during intermittent exercise in hot conditions. METHODS: Using a randomized crossover design, 13 trained/developmental team-sport athletes completed two 50-minute standardized intermittent running protocols on a synthetic and a natural-grass surface, on separate days (control-condition air temperature 32.6 °C [1.3 °C], relative humidity 43.2% [5.3%]). RESULTS: Final skin temperature was significantly higher on synthetic compared with natural grass at the calf (40.1 °C [2.5 °C] vs 33.4 °C [0.6 °C]; P < .001), shoulder (36.6 °C [1.7 °C] vs 33.7 °C [0.7 °C]; P < .001), and chest (33.2 °C [1.1 °C] vs 31.8 °C [1.2 °C]; P = .02). Thermal sensation (median: 2.3; interquartile range [0.5] vs 2.2 [0.5], P = .03) and sweat rate (1.5 [0.4] L·h-1 vs 1.2 [0.3] L·h-1; P = .02) were also significantly higher on synthetic grass. While final core body temperature was significantly higher on the natural than synthetic grass (38.4 °C [0.3 °C] vs 38.2 °C [0.4 °C]), there were no significant differences in delta core temperature, as well as heart rate, thermal comfort, or RPE. CONCLUSIONS: Higher skin temperatures, thermal sensation, and sweat rates suggest that exercising on synthetic grass in hot conditions may increase some markers of heat strain during exercise. However, delta core body temperature, heart rate, thermal comfort, and RPE remained unaffected.

C60 Fullerene-Reinforced Silicon Oxycarbide Composite Fiber Mats: Performance as Li-Ion Battery Electrodes.

Precursor-derived silicon oxycarbide (SiOC) has emerged as a potential high-capacity anode material for rechargeable Li-ion batteries. The polymer processing and pyrolysis route, a hallmark of polymer-derived ceramics, allows chemical interfacing with a variety of nanoprecursors and nanofiller phases to produce composites with low-dimensional structures such as fibers and coatings not readily attained in traditional sintered ceramics. Here, buckminsterfullerene or C60 was introduced as a filler phase in a hybrid precursor of 1,3,5,7-tetramethyl-1,3,5,7-tetravinyl-cyclotetrasiloxane (TTCS) along with polyvinylpyrrolidone or PVP as a spinning agent to fabricate electrospun fiber mats, which upon a high-heat treatment transformed to a C60-reinforced SiOC ceramic composite. Tested as the self-supporting working electrode in a Li-ion half-cell, C60-reinforced fiber mats show a much-improved reversible capacity (825 mA h g-1), nearly 100% Coulombic efficiency, and superior rate capability with low-capacity decay at high currents (only 25.5% decay at 800 mA g-1) compared to neat C60 and neat carbonized fiber electrodes.

Sigmoid Volvulus in the Setting of Type 4 Hiatal Hernia: An Uncommon Presentation and Literature Review.

Hiatal hernias occur when intra-abdominal contents protrude into the diaphragmatic opening. Of the four classifications, Type 4 hiatal hernias are the most rare and severe. They develop from herniation of the gastroesophageal junction and abdominal viscera other than the stomach into the thoracic cavity. The resulting increase in intrathoracic pressure can cause a wide variety of symptoms on presentation and potentially lead to misdiagnosis. We present a rare case in which a 78-year-old woman presented with nonspecific symptoms and was diagnosed with incarcerated Type 4 hiatal hernia with sigmoid volvulus. We also report a literature review from 2015 to emphasize the importance of recognizing diverse symptomatic presentations in complex Type 4 hiatal hernias and the need for a comprehensive evaluation, as early detection and prompt intervention are essential in preventing life-threatening complications.

Thiazolidine-2,4-dione hybrids as dual alpha-amylase and alpha-glucosidase inhibitors: design, synthesis, in vitro and in vivo anti-diabetic evaluation.

Twelve 3,5-disubstituted-thiazolidine-2,4-dione (TZD) hybrids were synthesized using solution phase chemistry. Continuing our previous work, nine O-modified ethyl vanillin (8a-i) derivatives were synthesized and reacted with the TZD core via Knoevenagel condensation under primary reaction conditions to obtain final derivatives 9a-i. Additionally, three isatin-TZD hybrids (11a-c) were synthesized. The intermediates and final derivatives were characterized using 1H and 13C NMR spectroscopy, and the observed chemical shifts agreed with the proposed structures. The in vitro alpha-amylase and alpha-glucosidase inhibitory evaluation of newly synthesized derivatives revealed compounds 9F and 9G as the best dual inhibitors, with IC50 values of 9.8 ± 0.047 µM for alpha-glucosidase (9F) and 5.15 ± 0.0017 µM for alpha-glucosidase (9G), 17.10 ± 0.015 µM for alpha-amylase (9F), and 9.2 ± 0.092 µM for alpha-amylase (9G). The docking analysis of synthesized compounds indicated that compounds have a higher binding affinity for alpha-glucosidase as compared to alpha-amylase, as seen from docking scores ranging from -1.202 to -5.467 (for alpha-amylase) and -4.373 to -7.300 (for alpha-glucosidase). Further, the molecules possess a high LD50 value, typically ranging from 1000 to 1600 mg kg-1 of body weight, and exhibit non-toxic properties. The in vitro cytotoxicity assay results on PANC-1 and INS-1 cells demonstrated that the compounds were devoid of significant toxicity against the tested cells. Compounds 9F and 9G showed high oral absorption, i.e., oral absorption >96%, and their molecular dynamics simulation yielded results closely aligned with the observed docking outcomes. Finally, compounds 9F and 9G were evaluated for in vivo antidiabetic assessment by the induction of diabetes in Wistar rats using streptozotocin. Molecule 9G has been identified as the most effective anti-diabetic molecule due to its ability to modulate several biochemical markers in blood plasma and tissue homogenates. The results were further confirmed by histology investigations conducted on isolated pancreas, liver, and kidney.

Global geoepidemiology of gastrointestinal surgery rates in Crohn's disease.

BACKGROUND: Data regarding the worldwide gastrointestinal surgery rates in patients with Crohn's disease (CD) remains limited. AIM: To systematically review the global variation in the rates of surgery in CD. METHODS: A comprehensive search analysis was performed using multiple electronic databases from inception through July 1, 2020, to identify all full text, randomized controlled trials and cohort studies pertaining to gastrointestinal surgery rates in adult patients with CD. Outcomes included continent based demographic data, CD surgery rates over time, as well as the geoepidemiologic variation in CD surgery rates. Statistical analyses were conducted using R. RESULTS: Twenty-three studies spanning four continents were included. The median proportion of persons with CD who underwent gastrointestinal surgery in studies from North America, Europe, Asia, and Oceania were 30% (range: 1.7%-62.0%), 40% (range: 0.6%-74.0%), 17% (range: 16.0%-43.0%), and 38% respectively. No clear association was found regarding the proportion of patients undergoing gastrointestinal surgery over time in North America (R 2 = 0.035) and Europe (R 2 = 0.100). A moderate, negative association was seen regarding the proportion of patients undergoing gastrointestinal surgery over time (R 2 = 0.520) in Asia. CONCLUSION: There appears to be significant inter-continental variation regarding surgery rates in CD. Homogenous evidence-based guidelines accounting for the geographic differences in managing patients with CD is prudent. Moreover, as a paucity of data on surgery rates in CD exists outside the North American and European continents, future studies, particularly in less studied locales, are warranted.

Investigating extrusion impact on functional, textural properties, morphological structure, and molecular interactions in hulless barley-based extruded snacks supplemented with mung bean.

The effect of varying extrusion conditions on the functional properties of hulless barley-mung bean (70:30) extruded snacks was investigated using response surface methodology with feed moisture (FM), barrel temperature (BT), and screw speed (SS) as process variables. Results revealed significant impacts on functional characteristics with varying extrusion conditions. Bulk density (BD) of extruded snacks ranged from 0.24 to 0.42 g/cm3, showing that lower FM and higher BT results in lower BD while it increased with increasing FM, SS, and BT. The expansion ratio (ER) of extruded snacks ranged between 2.03 and 2.33, showing BT and SS had a desirable positive effect, whereas increasing FM led to decreased ER. Increasing BT and SS depicted a negative effect on water absorption index, whereas FM showed positive effect, which ranged between 4.21 and 4.82 g/g. A positive effect on water solubility index was depicted by BT and SS, which ranges between 9.01% and 13.45%, as higher SS and BT led to starch degradation and increased solubility suggesting better digestibility. The hardness of extruded snacks ranged from 32.56 to 66.88 Newton (N), showing increasing FM increased hardness, whereas higher SS and BT resulted in lowering the hardness. Scanning electronic microscope (SEM) analysis revealed structural changes in extrudates in comparison with nonextruded flour, indicating starch gelatinization and pore formation affected by varying processing parameters. Shifts in absorption bands were observed in Fourier transform infrared spectroscopy (FT-IR), suggesting structural changes in starch and protein. Understanding the effects of extrusion parameters on product properties can help tailored production to meet consumers' preferences and the development of functional snacks with improved nutritional quality.

Mild Cognitive Impairment: Clinical Presentation and Short-Term Comparative Outcome of Patients With Potentially Modifiable and Nonmodifiable Risk Factors.

Objective: To estimate the prevalence and study the clinical presentation of mild cognitive impairment (MCI), assess its outcome in terms of cognition and quality of life, identify factors for reversion to baseline, and compare these factors in the modifiable and nonmodifiable risk factor groups.Methods: Individuals aged >50 years with memory/cognitive complaint(s) were screened using the Mini-Cog over 1 year (August 2018-August 2019). Those meeting the DSM-5 criteria for MCI were enrolled, and risk factors (modifiable and nonmodifiable) were noted. Assessments were done using the Hindi version of the Montreal Cognitive Assessment (H-MoCA), the Clinical Dementia Rating (CDR)-Hindi version, and the World Health Organization Quality of Life-Brief Hindi version. Treatment outcome was assessed at 6 months and compared between the risk factor groups. Factors for reversion of MCI were assessed.Results: A total of 124 patients (22.1% of 561 with cognitive complaints) had MCI, and 100 patients (50 patients from the modifiable group and 50 patients from the nonmodifiable group) completed the study. Depression (52%) and hypertension (48%) were common risk factors. End point cognition scores were similar in both groups, with quality of life better in the modifiable group (P = .023). Age was negatively correlated with cognition in total patients and the nonmodifiable group (r =0.283-0.420; P = .002-.004). In total patients, cognition moderately correlated with education and somewhat with quality of life; 31% and 57% reverted to normal on the MoCA and CDR scales, respectively, while 1 progressed to dementia. Reverters had higher baseline H-MoCA scores (odds ratio [OR] = 6.996; P < .001) and were treated with cholinesterase inhibitors + vitamin E (OR = 28.999; P = .007).Conclusion: Short-term outcome for both the modifiable and nonmodifiable risk factor groups was favorable. Higher education positively correlated with cognition, which itself predicted a better quality of life. Reverters of MCI had better baseline cognition and were treated with cholinesterase inhibitors + vitamin E.Prim Care Companion CNS Disord 2024;26(4):24m03708. Author affiliations are listed at the end of this article.

Factors associated with treatment adherence among pulmonary tuberculosis patients in New Delhi.

BACKGROUND: TB is treated with a six-month course of four antimicrobial drugs, and nearly all cases of TB can be cured if the medications are given and taken correctly. Due to its prolong treatment plans, there can be reasons associated with non-adherence to treatment by TB patients. Hence, the present study aimed to explore the factors associated with medication adherence among TB patients. METHOD: A cross-sectional descriptive survey was conducted among adult pulmonary tuberculosis patients enrolled under RNTCP (now NTEP) in New Delhi among 27 functional RNTCP districts. Around 200 TB patients who are enrolled in the Nikshay App and are also on treatment were considered. A structured questionnaire was prepared for the interview guide. Analysis was done using bivariate analysis, chi-square tests, and Fisher's exact tests. RESULTS: Among the total participants, 173 (86.5%) were adherent and the remaining 27 (13.5%) participants were non-adherent. The majority of the participants (91%) said they were able to follow the routine to the DOTS center, and 9% said they find it difficult to report to the DOTS center as per their schedule. Only 12.35% of non-adherent participants were seen among those who get regular reminders from their families to take medicines, as compared to 18.42% among those who did not get regular reminders from their families. More than one-fourth of the participants (25.9%) who report not getting necessary motivation from healthcare providers were non-adherent. Motivation by healthcare workers to follow drug schedules was found statistically significant to treatment compliance with a P-value of 0.0422. CONCLUSION: TB is a curable disease; this belief has turned out to be a motivational factor for patients suffering from this disease. Studies have shown that faith in the efficacy of treatment helps adherence to TB treatment while other studies describe how patient adherence was adversely affected by the belief that TB is incurable or the treatment is inefficient or that alternative treatment such as traditional medicine is better.

Narrow-linewidth Fano microcavities with resonant subwavelength grating mirror.

We report on the theoretical and experimental investigations of optical microcavities consisting in the plane-plane arrangement of a broadband high-reflectivity mirror and a suspended one-dimensional grating mirror possessing a high-quality factor Fano resonance. By varying the length of these cavities from the millimeter to the few-micron range, we observe at short lengths the reduction of the spectral linewidth predicted to occur for such a Fano cavity as compared to a conventional broadband mirror cavity with the same length and internal losses. Such narrow linewidth and small modevolume microcavities with high-mechanical quality ultrathin mirrors will be attractive for a wide range of applications within optomechanics and sensing.

MoS2, WS2, and MoWS2 Flakes as Reversible Host Materials for Sodium-Ion and Potassium-Ion Batteries.

Transition-metal dichalcogenides (TMDs) and their alloys are vital for the development of sustainable and economical energy storage alternatives due to their large interlayer spacing and hosting ability for alkali-metal ions. Although the Li-ion chemically correlates with the Na-ion and K-ion, research on batteries with TMD anodes for K+ is still in its infancy. This research explores TMDs such as molybdenum disulfide (MoS2) and tungsten disulfide (WS2) and TMD alloys such as molybdenum tungsten disulfide (MoWS2) for both sodium-ion batteries (NIBs) and potassium-ion batteries (KIBs). The cyclic stability test analysis indicates that in the initial cycle, the MoS2 NIB demonstrates exceptional performance, with a peak charge capacity of 1056 mAh g-1, while retaining high Coulombic efficiency. However, the WS2 KIB underperforms, with the least charge capacity of 130 mAh g-1 in the first cycle and exceptionally low retention at a current density of 100 mA g-1. The MoWS2 TMD alloy exhibits a moderate charge capacity and cyclic efficiency for both NIBs and KIBs. This comparison study shows that decreasing sizes of alkali-metal ions and constituent elements in TMDs or TMD alloys leads to decreased resistance and slower degradation processes as indicated by cyclic voltammetry and electrochemical impedance spectroscopy after 10 cycles. Furthermore, the study of probable electrochemical intercalation and removal processes of Na-ions and K-ions demonstrates that large geometrically shaped TMD flakes are more responsive to intercalation for Na-ions than K-ions. These performance comparisons of different TMD materials for NIBs and KIBs may promote the future development of these batteries.

The effect of synthetic grass sports surfaces on the thermal environment: A systematic review.

There are concerns regarding high surface temperatures on synthetic grass sports surfaces influencing the surrounding thermal environment, potentially increasing heat stress and impacting athlete safety. As such, studies have investigated changes to the thermal environment surrounding synthetic grass surfaces in comparison to both natural grass, and synthetic surfaces with different features, but this body of research has not been systematically reviewed. Therefore, this systematic review aimed to (i) determine if there are differences in the thermal environment surrounding synthetic grass surfaces compared with natural grass surfaces, and (ii) determine if there are differences in the thermal environment between different types of synthetic grass surfaces. A systematic review adhering to the PRISMA guidelines was performed. The eligibility criteria required investigations to report at least one of the following environmental parameters on or directly above both a synthetic surface and a comparator group of either natural grass or an alternative synthetic grass surface used in sport: Air temperature, mean radiant temperature, humidity, wind velocity, unified heat stress indices (i.e. wet-bulb-globe temperature and heat index) and/or surface temperature. Twenty-three studies were identified. The only parameters that were consistently higher on synthetic grass compared to natural grass were the air temperature (range: 0.5-1.2 °C) and surface temperature (range: 9.4-33.7 °C), while the mean radiant temperature, humidity, wind velocity and wet-bulb-globe temperature remained similar or required more data to determine if any differences exist. Synthetic grass surfaces consisting of styrene butadiene rubber infill or a shock pad had increased surface temperatures, whereas surfaces with thermoplastic elastomer infill, Cool climate turf fibres or HydroChill had lower surface temperatures. This systematic review has demonstrated that air and surface temperatures can be increased on synthetic sports surfaces, compared to natural grass surfaces. However, it is uncertain whether the differences are enough to increase an individual's heat stress risk and cause concern for athlete safety. While modifications to the turf infill or fibres can reduce synthetic surface temperatures, the effect of these features on the thermal environment as a whole is unclear. This review was prospectively registered with the Open Science Framework (Open Science Framework registration   https://doi.org/10.17605/OSF.IO/BTKGE ).

Biodiversity of endosymbiont fungi associated with a marine sponge Lamellodysidea herbacea and their potential as antioxidant producers.

This study aims to isolate endosymbiontic fungi from the marine sponge Lamellodysidea herbacea and to explore their antioxidant potential. Marine-derived fungi, with their vast biodiversity, are considered a promising source of novel antioxidants which can replace synthetic ones. Marine sponges have previously reported bioactive properties that could ameliorate oxidative stress, particularly their associated fungi, producing high-frequency bioactive molecules (adaptogenic molecules) in response to stressors. 19 endosymbiont fungi associated with marine sponges were isolated, and their extracts were evaluated for their antioxidant capacities. Extract of an endosymbiont fungus, isolate SPG6, identified as Alternaria destruens, through surface electron microscopy (SEM) and ITS gene sequencing, showed broad range antioxidant activities (EC50 values) (free radical scavenging 32.54 mg L-1, Hydroxyl radical scavenging activity < 0.078 g L-1, total reducing power 0.114 g L-1, Chelating power 0.262 g L-1, H2O2 scavenging activity < 0.078 g L-1, and Superoxide radical scavenging activity > 5.0 g L-1). The extract of isolate SPG6 was fractioned and analyzed through GC-MS. Marine sponge-associated endosymbiont fungi are a rich source of antioxidant molecules. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-024-03972-1.