Epidemiology, genetic characterization and population structure analysis of lumpy skin disease virus from North India.

Lumpy skin disease (LSD) is a transboundary, viral disease of cattle with a significant economic impact on the livestock industry. This study describes the epidemiological investigations of outbreaks of LSD that occurred in 2022 in three Indian states viz., Haryana, Himachal Pradesh and Rajasthan and the genetic characterization of Lumpy skin disease viruses (LSDVs). Also, the population structure analysis of LSDVs was carried out. Out of 138 scab samples tested from suspected cattle for LSDV, 106 were found positive. Of these, nine representative scab samples were further genetically characterized. Phylogenetic analysis based on the P32 and EEV gene sequences depicted that the LSDV strains of the present study had nucleotide identity of 100% and 99.10-99.45%, respectively with the LSDV/2019 field strains of India. Multiple sequence alignment of the EEV glycoprotein gene sequences revealed nucleotide polymorphisms at three positions viz., G178A, G253A and A459G in circulating LSDV/2022 field strains. Based on the median joining network analysis of the EEV gene, 12 haplotypes were identified among the LSDV populations. Population structure analysis corresponding to the EEV gene revealed high haplotype (0.8486 ± 0.026) and low nucleotide diversities (0.00636 ± 0.0006) and negative values for neutrality indices, indicating a high number of closely related haplotypes and the studied population may have undergone a recent expansion. The findings will help in understanding the distribution and dynamics of LSDV populations, which will prove pivotal in designing and implementing effective management and control strategies.

Profiling of autoantibodies in the sera of glioblastoma patients.

Aim: This study aimed to determine the expression pattern of autoantibody proteins from the serum of grade IV glioblastoma patients.Materials & methods: We performed high throughput antibody profiling via the Sengenics i-Ome® Protein Array to determine the differentially expressed autoantibodies.Results: The results portrayed that anti-COL4A3BP and anti-HSP90AA1 were among the upregulated autoantibodies in glioblastoma sera.Conclusion: The selected autoantibodies offer promising targets for future glioblastoma pathogenesis. However, further validation is required to elucidate the autoantibody signature in glioblastoma patients.

Glioblastoma is a disease affecting many people. Herein we have identified several proteins called autoantibodies that are abundant in the serum of glioblastoma patients and can be used as targets to treat or diagnose this disease.

Incidence and risk factors of antituberculosis drug-induced liver injury in India: A systematic review and meta-analysis.

BACKGROUND: Antituberculosis drug-induced liver injury (ATDILI) is a significant problem of tuberculosis treatment. This systematic review and meta­analysis aimed at evaluating the incidence and risk factors of ATDILI in adult patients with tuberculosis in India. METHODS: Five electronic databases were searched comprehensively for studies on Indian adult patients with tuberculosis investigating the incidence and/or risk factors of ATDILI. The relevant data was pooled in a random or fixed-effect model to calculate the pooled incidence with a 95% confidence interval (CI), standardized mean difference (MD) or odds ratio (OR). RESULTS: Following the screening of 3221 records, 43 studies with 12,041 tuberculosis patients were finally included. Based on the random effect model, the pooled incidence of ATDILI was 12.6% (95% CI, 9.9-15.3%, p < 0.001, I2 = 95.1%). The pooled incidence was higher in patients with daily treatment regimen compared to the thrice weekly regimen (16.5% vs. 3.5%). The concurrent hepatitis B or C infection, alcohol consumption and underlying chronic liver disease were associated with high incidence of ATDILI. The pooled incidence of acute liver failure (ALF) among ATDILI patients was 6.78% (95% CI 3.9-9.5%). Female gender (OR 1.24), older age (MD 0.26), lean body mass index (OR 3.8), hypoalbuminemia (OR 3.09), N-acetyltransferase slow acetylator genotypes (OR 2.3) and glutathione S-transferases M null mutation (OR 1.6) were found to be associated with an increased risk of ATDILI. The pooled mortality rate of ATDILI patients was 1.72% (95% CI 0.4-3.0%) overall and 71.8% (95% CI 49.3-94.2%) in case of ALF. CONCLUSION: Overall, 12.6% patients of tuberculosis in India developed ATDILI when combination of first-line antituberculosis drugs was used. An average of 7% of ATDILI patients progressed to ALF which had a high mortality rate. Older age, female, poor nutritional status and some genetic polymorphisms were identified as significant risk factors.

Synthesis, kinetics, mechanisms, and bioactivity evaluations of a novel Zn(ii) complex.

Zn(ii)-based anticancer drugs can be suitable alternatives to conventional Pt(ii)-based drugs because of the unique chemical properties of Zn(ii) and low toxicity. In this study, a new hexadentate and heteroleptic Zn(ii) complex ([Zn(bpy)2(OAc)2], 1) was prepared with a conventional N,N-donor ligand (2,2'-bipyridine) and a leaving group (OAc) and characterized via ESI-MS, UV-Vis, and FT-IR spectroscopy. Kinetic and mechanistic investigations of 1 were performed using two biologically relevant ligands (dl-penicillamine and l-cysteine) to understand its selectivity and reactivity. Substitution reactions were determined to be two-step processes in the associative activation mode. Bioactivity studies of 1 revealed moderate to strong DNA-binding, cleaving ability, and antimicrobial properties.

A review on e-waste contamination, toxicity, and sustainable clean-up approaches for its management.

Ecosystems and human health are being negatively impacted by the growing problem of electrical waste, especially in developing countries. E-waste poses a significant risk to ecological systems because it can release a variety of hazardous substances into the environment, containing polybrominated diphenyl ethers and heavy metals, brominated flame retardants, polychlorinated dibenzofurans and polycyclic aromatic hydrocarbons, and dioxins. This review article provides a critical assessment of the toxicological consequences of e-waste on ecosystems and human health and data analyses from scientific journals and grey literature on metals, BFRs, PBDEs, PCDFs, and PAHs in several environmental compartments of commercial significance in informal electronic trash recycling. The currently available techniques and tools employed for treating e-waste are sustainable techniques such as bioremediation, chemical leaching, biological leaching, and pyrometallurgy have been also discussed along with the necessity of implementing strong legislation to address the issue of unregulated exports of electronic trash in recycling practices. Despite the ongoing hurdles, implementing environmentally sustainable recycling methods have the potential to address the detrimental impacts of e-waste and foster positive economic development.

Experience of Gamma Knife radiosurgery for treatment of brain metastases in pregnancy with literature review.

Brain metastases during pregnancy poses complex conundrum in management. Stereotactic radiosurgery (SRS) offers valuable option to clinicians in this scenario. We reviewed and described the safety and effectiveness of Gamma Knife (GK) SRS in treating a solitary cerebellar metastasis in a patient with recurrent breast cancer at 28 weeks of gestation. Following multidisciplinary discussion, she consented for urgent single session GK SRS to the brain metastasis with 2 cycles of 3-weekly paclitaxel chemotherapy prior to planned delivery at term. Prior to the frame-based treatment, a trial run with dosimeters placed on the superior and inferior parts of foam knee support showed radiation exposure of 3.12 mSv and 1.06 mSv respectively. A prescription dose of 16 Gy at the 50% isodose was delivered using 24 isocentres over 39.7' of beam on time. The treatment plan had 98% coverage, 89% selectivity and a gradient index of 2.98. Dosimeters placed near the uterine fundus and suprapubic region (consistent with location of fetal head) during the actual treatment recorded 2.83 mSv and 0.27 mSv, which is lower than the trial dosimeter readings. The patient successfully completed SRS treatment and gave birth to a healthy baby two months later. Follow-up MRI at three months interval showed total resolution of the lesion. GK SRS is known for the lowest extracranial dose compared to other SRS modalities. This report and literature review confirmed that GK is a sharp and effective, yet gentle and safe treatment for pregnant patients with brain metastases.

Microbial contributions to sustainable paddy straw utilization for economic gain and environmental conservation.

Paddy straw is a versatile and valuable resource with multifaceted benefits for nutrient cycling, soil health, and climate mitigation. Its role as a rich nutrient source and organic matter significantly enhances soil vitality while improving soil structure and moisture retention. The impact of paddy straw extends beyond traditional agricultural benefits, encompassing the promotion of microbial activity, erosion control, and carbon sequestration, highlighting its crucial role in maintaining ecological balance. Furthermore, the potential of paddy straw in bioenergy is explored, encompassing its conversion into biogas, biofuels, and thermal energy. The inherent characteristics of paddy straw, including its high cellulose, hemicellulose, and lignin content, position it as a viable candidate for bioenergy production through innovative processes like pyrolysis, gasification, anaerobic digestion, and combustion. Recent research has uncovered state-of-the-art techniques and innovative technologies capable of converting paddy straw into valuable products, including sugar, ethanol, paper, and fiber, broadening its potential applications. This paper aims to underscore the possibilities for value creation through paddy straw, emphasizing its potential use in bioenergy, bio-products, and other environmental applications. Therefore, by recognizing and harnessing the value of paddy straw, we can advocate for sustainable farming practices, reduce waste, and pave the way for a resource-efficient circular economy. Incorporating paddy straw utilization into agricultural systems can pave the way for enhanced resource efficiency and a more sustainable circular economy.

NeuroAiDTM-II (MLC901) Promoted Neurogenesis by Activating the PI3K/AKT/GSK-3ß Signaling Pathway in Rat Spinal Cord Injury Models.

Traumatic damage to the spinal cord (SCI) frequently leads to irreversible neurological deficits, which may be related to apoptotic neurodegeneration in nerve tissue. The MLC901 treatment possesses neuroprotective and neuroregenerative activity. This study aimed to explore the regenerative potential of MLC901 and the molecular mechanisms promoting neurogenesis and functional recovery after SCI in rats. A calibrated forceps compression injury for 15 s was used to induce SCI in rats, followed by an examination of the impacts of MLC901 on functional recovery. The Basso, Beattie, and Bresnahan (BBB) scores were utilized to assess neuronal functional recovery; H&E and immunohistochemistry (IHC) staining were also used to observe pathological changes in the lesion area. Somatosensory Evoked Potentials (SEPs) were measured using the Nicolet® Viking Quest™ apparatus. Additionally, we employed the Western blot assay to identify PI3K/AKT/GSK-3ß pathway-related proteins and to assess the levels of GAP-43 and GFAP through immunohistochemistry staining. The study findings revealed that MLC901 improved hind-limb motor function recovery, alleviating the pathological damage induced by SCI. Moreover, MLC901 significantly enhanced locomotor activity, SEPs waveform, latency, amplitude, and nerve conduction velocity. The treatment also promoted GAP-43 expression and reduced reactive astrocytes (GFAP). MLC901 treatment activated p-AKT reduced p-GSK-3ß expression levels and showed a normalized ratio (fold changes) relative to ß-tubulin. Specifically, p-AKT exhibited a 4-fold increase, while p-GSK-3ß showed a 2-fold decrease in T rats compared to UT rats. In conclusion, these results suggest that the treatment mitigates pathological tissue damage and effectively improves neural functional recovery following SCI, primarily by alleviating apoptosis and promoting neurogenesis. The underlying molecular mechanism of this treatment mainly involves the activation of the PI3K/AKT/GSK-3ß pathway.

In vitro larvicidal efficacy of Lantana camara essential oil and its nanoemulsion and enzyme inhibition kinetics against Anopheles culicifacies.

Mosquitoes are important vectors for the transmission of several infectious diseases that lead to huge morbidity and mortality. The exhaustive use of synthetic insecticides has led to widespread resistance and environmental pollution. Using essential oils and nano-emulsions as novel insecticides is a promising alternative approach for controlling vector borne diseases. In the current study, Lantana camara EO and NE were evaluated for their larvicidal and pupicidal activities against Anopheles culicifacies. The inhibitory effect of EO and NE on AChE, NSE (α/ß), and GST was also evaluated and compared. GC-MS analysis of oil displayed 61 major peaks. The stable nano-emulsion with an observed hydrodynamic diameter of 147.62 nm was formed using the o/w method. The nano-emulsion exhibited good larvicidal (LC50 50.35 ppm and LC90 222.84 ppm) and pupicidal (LC50 54.82 ppm and LC90 174.58 ppm) activities. Biochemical evaluations revealed that LCEO and LCNE inhibited AChE, NSE (α/ß), and GST, displaying LCNE to be a potent binder to AChE and NSE enzyme, whereas LCEO showed higher binding potency towards GST. The nano-emulsion provides us with novel opportunities to target different mosquito enzymes with improved insecticidal efficacy. Due to its natural origin, it can be further developed as a safer and more potent larvicide/insecticide capable of combating emerging insecticide resistance.

Intestinal lymphangiectasia: Understanding the bigger picture.

Intestinal lymphangiectasia (IL) is characterized by the dilation of intestinal lymphatic vessels, which can rupture and cause loss of lymph into the intestine. Due to the high content of proteins, lipoproteins, and lymphocytes in the intestinal lymph, loss of lymph might result in hypoproteinemia, hypoalbuminemia, hypogammaglobulinemia, and lymphocytopenia. In addition, there may be a depletion of minerals, lipids, and fat-soluble vitamins. IL can be primary due to inherent malfunctioning of the lymphatic system, or secondly, a result of various factors that may hinder lymphatic drainage either directly or indirectly. This condition has emerged as a subject of significant clinical interest. Given that the intestinal lymphatic system plays an important role in the body's fluid homeostasis, adaptive immunity, nutrient and drug absorption, intestinal transport, and systemic metabolism, its dysfunction may have wider implications. Although primary IL is rare, with varied clinical features, complications, treatment response, and outcomes, secondary IL is more common than previously believed. The definitive diagnosis of IL requires endoscopic demonstration of whitish villi (which frequently resemble snowflakes) and histological confirmation of dilated lacteals in the small intestinal mucosa. Treatment of IL is challenging and involves dietary modifications, managing underlying medical conditions, and using medications such as sirolimus and octreotide. Recognizing its prevalence and diverse etiology is crucial for targeted management of this challenging medical condition. This article provides a comprehensive exploration of the clinical implications associated with IL. In addition, it offers valuable insights into critical knowledge gaps in the existing diagnostic and management landscape.

Renal resistive index measurements by ultrasound in patients with liver cirrhosis: Magnitude and associations with renal dysfunction.

BACKGROUND: The hemodynamic alterations seen in liver cirrhosis lead to renal vasoconstriction, ultimately causing acute kidney injury (AKI). The renal resistive index (RRI) is the most common Doppler ultrasound variable for measuring intrarenal vascular resistance. AIM: To evaluate the association of the RRI with AKI in patients with liver cirrhosis and to identify risk factors for high RRI. METHODS: This was a prospective observational study, where RRI was measured using Doppler ultrasound in 200 consecutive hospitalized patients with cirrhosis. The association of RRI with AKI was studied. The receiver operating characteristic (ROC) curve analysis was utilized to determine discriminatory cut-offs of RRI for various AKI phenotypes. Multivariate analysis was conducted to determine the predictors of high RRI. RESULTS: The mean patient age was 49.08 ± 11.68 years, with the majority (79.5%) being male; the predominant etiology of cirrhosis was alcohol (39%). The mean RRI for the study cohort was 0.68 ± 0.09, showing a progressive increase with higher Child-Pugh class of cirrhosis. Overall, AKI was present in 129 (64.5%) patients. The mean RRI was significantly higher in patients with AKI compared to those without it (0.72 ± 0.06 vs 0.60 ± 0.08; P < 0.001). A total of 82 patients (41%) had hepatorenal syndrome (HRS)-AKI, 29 (22.4%) had prerenal AKI (PRA), and 18 (13.9%) had acute tubular necrosis (ATN)-AKI. The mean RRI was significantly higher in the ATN-AKI (0.80 ± 0.02) and HRS-AKI (0.73 ± 0.03) groups than in the PRA (0.63 ± 0.07) and non-AKI (0.60 ± 0.07) groups. RRI demonstrated excellent discriminatory ability in distinguishing ATN-AKI from non-ATN-AKI (area under ROC curve: 93.9%). AKI emerged as an independent predictor of high RRI (adjusted odds ratio [OR]: 11.52), and high RRI independently predicted mortality among AKI patients (adjusted OR: 3.18). CONCLUSION: In cirrhosis patients, RRI exhibited a significant association with AKI, effectively differentiated between AKI phenotypes, and predicted AKI mortality.

Evaluating Yoga-Based Intervention Versus the American Diabetes Association Exercise Regimen in Conjunction With Standard Care for Autonomic Neuropathy in Diabetes Mellitus: An Exploratory Clinical Trial.

INTRODUCTION: Diabetic autonomic neuropathy (DAN) is a prevalent yet often overlooked complication of diabetes mellitus (DM), impacting multiple organs and substantially elevating the risk of morbidity and mortality. This study aimed to assess the effectiveness of yoga-based intervention (YBI) compared to the American Diabetes Association exercise regimen (ADA Ex. Regime) and standard care for treating autonomic neuropathy in type 2 DM. METHODS: This open-label exploratory clinical trial featured two parallel study arms: Group A (Intervention), which received YBI alongside standard care, and Group B, which adhered to the ADA Ex. Regime in conjunction with standard care. A total of 80 participants aged 35-60, diagnosed with type 2 DM and autonomic neuropathy, were equally allocated to both groups. Data collection included nerve conduction velocity (NCV) tests, autonomic function tests (AFTs), as well as evaluations of depression and quality of life. RESULTS: YBI demonstrated a drop in parasympathetic tone compared to the ADA Ex. Regime. Following a six-month intervention, the sympathetic activity indicator (SD2) exhibited a significantly lower value in the YBI group than in the ADA Ex. Regime group, indicating a positive effect (p < 0.05), while the ADA Ex. Regime showed more improvement in certain areas of NCV (e.g., left and right peroneal NCV, right and left peroneal F-latency), notable differences were observed in alkaline phosphatase levels, depression scores, and WHO-5 wellness, all reaching statistical significance at p < 0.05. CONCLUSIONS: The study findings observed that a 24-week YBI significantly reduced in symptoms of diabetic neuropathy and stress. Although the ADA Ex. Regime demonstrated greater improvement in specific aspects of NCV compared to YBI, YBI outperformed the ADA Ex. Regime in enhancing WHO-5 wellness and reducing depression symptoms.

Bedside assessment of sarcopenia in hospitalized patients with liver cirrhosis: Magnitude and clinical implications.

BACKGROUND: Sarcopenia is associated with many adverse outcomes in patients with cirrhosis. The tools currently in use for assessing sarcopenia have numerous flaws. We evaluated the utility of portable ultrasonography and a dynamometer for the bedside assessment of sarcopenia and its implications in hospitalized cirrhosis patients. METHODS: A dynamometer was used to test the hand-grip strength (HGS) and ultrasound was used to measure the thickness of the forearm and quadriceps muscles. HGS value < 27 kg for men and < 16 kg for women was taken as significant according to the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria. The lower normal limit of muscle mass (5th percentile) was determined on 100 matched healthy controls. RESULTS: According to the EWGSOP2 criteria and HGS values, the prevalence of sarcopenia and probable sarcopenia among 300 cirrhosis patients were 56% and 62.3%, respectively. HGS alone identified sarcopenia in 88.9% of patients, while overestimated it in 6.3% of cases. The prevalence rate of sarcopenic obesity was 11%. Compared to patients without sarcopenia, sarcopenic patients had more complications of cirrhosis such as ascites, variceal bleeding, hepatic encephalopathy, spontaneous bacterial peritonitis, sepsis, hepatorenal syndrome and refractory ascites. In-hospital (p = 0.037), three-month (p < 0.001), and six-month (p < 0.001) mortality rates were all higher among sarcopenic patients. On cox regression survival analysis, overall six-month mortality was significantly higher in sarcopenic patients compared to patients without sarcopenia (hazard ratio, 6.37; 95% confidence interval, 3.15-12.8, p < 0.001). CONCLUSION: Bedside assessment of sarcopenia using a portable ultrasound machine and a dynamometer detects liver cirrhosis patients with high risk of complications and mortality.

Snakebite Management: The Need of Reassessment, International Relations, and Effective Economic Measures to Reduce the Considerable SBE Burden.

The sole treatment for snakebite envenomation (SBE), the anti-snake venom (ASV), suffers from considerable drawbacks, including side effects and limited species specificity. Additionally, despite its existence for more than a century, uniform availability of good quality ASV does not yet exist. The present review describes the journey of a SBE victim and highlights the global crisis of SBE management. A detailed analysis of the current ASV market has also been presented along with the worldwide snake distribution. The current production of country specific licensed ASV throughout the globe along with their manufacturers has been examined at the snake species level. Furthermore, a detailed analysis of on-ground situation of SBE management in antivenom manufacturing countries has been done using the most recent literature. Additionally, the export and import of different ASVs have been discussed in terms of procurement policies of individual countries, their shortcomings, along with the possible solution at the species level. It is interesting to note that in most countries, the existence of ASV is really either neglected or overstated, implying that it is there but unsuitable for use, or that it is not present but can be obtained from other countries. This highlights the urgent need of significant reassessment and international collaborations not just for development and production, but also for procurement, distribution, availability, and awareness. A PROMISE (Practical ROutes for Managing Indigenous Snakebite Envenoming) approach has also been introduced, offering simple, economical, and easy to adopt steps to efficiently alleviate the worldwide SBE burden.

Realization of a green-emitting pyrosilicate-structured Er3+-activated Y2Si2O7 phosphor: a systematic study of opto-electronic characteristics and thermal stability for lighting applications.

A series of green-emitting Y2-x Si2O7:xEr3+ phosphors (x = 1-7 mol%) have been successfully synthesized using a straightforward gel-combustion method facilitated by urea. X-ray diffraction analysis provided specific patterns for samples, confirming a consistent triclinic phase across erbium-doped structures compared to undoped structures. Studies using TEM and EDX were conducted to identify the surface-related characteristics and chemical composition of the synthesized nanophosphor, respectively. The band gap was determined to be 5.55 eV and 5.80 eV for the host material and optimal sample, respectively. The primary peak of excitation, observed at 379 nm, represents the highly sensitive electric dipole transition from the 4I15/2 state to the 4G11/2 level, suggesting that the prepared phosphors could effectively absorb NUV light for activation. The PL profiles of Y2-x Si2O7:xEr3+ (x = 1-7 mol%) phosphors demonstrate characteristic emissions at 409 nm (2H9/2 → 4I15/2), 522 nm (2H11/2 → 4I15/2), 553 nm (4S3/2 → 4I15/2) and 662 nm (4F9/2 → 4I15/2). In accordance with Dexter's theory, luminescence quenching observed at a concentration of 4 mol% Er3+ is attributed to dipole-quadrupole interactions. The optimal sample demonstrates excellent thermal stability, indicated by its luminescence at different temperatures and activation energy of 0.2641 eV. Additionally, the CIE, color purity and CCT values of the fabricated nanomaterials make it ideal for use in lighting applications.

Correction: Psychological impact of COVID-19 and lock down measures: An online cross-sectional multicounty study on Asian university students.

[This corrects the article DOI: 10.1371/journal.pone.0253059.].

Geochemical evaluation and the mechanism controlling groundwater chemistry using chemometric approach and groundwater pollution index (GPI) in the Kishangarh city of Rajasthan, India.

This study is primarily focused on delving into the geochemistry of groundwater in the Kishangarh area, located in the Ajmer district of Rajasthan, India. In pursuit of this research goal, the sampling locations were divided into three parts within the Kishangarh region: Badgaon Rural (KSGR), Kishangarh Urban (KSGU), and the Kishangarh RIICO marble industrial area (KSGI). Various analytical methods have been executed to assess the suitability of groundwater for various purposes based on pH, electric conductivity, total dissolved solids, hardness, salinity, major anions, and cations. The ionic trend of anions and cations was found as HCO3- > Cl- > SO42- > NO3- > Br- > NO2- > F- and Na+ > Ca2+ > Mg2+ > K+, respectively. Applying statistical techniques such as principal component analysis (PCA) and Pearson correlation matrix analysis (PCMA) makes it evident that the physicochemical attributes of water sourced from the aquifers in the study area result from a blend of diverse origins. In addition, Gibbs, Piper, Durov, and scatter plots were used to assess groundwater's geochemical evolution. Piper plot demonstrated the two types of groundwater facies, Na-HCO3- and Na-Cl, implying significant contributions from evaporitic dissolution and silicate weathering. Also, the scatter plots have evaluated the impression of mine acid leachate, evaporitic dissolution, and silicate weathering to upsurge salt formation in the groundwater. The pollution risk evaluation within the study area was conducted using the groundwater pollution index (GPI). This index revealed a prominent concern for pollution, particularly in the northern segment of the study region. As a result, it can be inferred that the fine aeolian sand and silt formations in the northern part are relatively more vulnerable to contamination.

Hepatogenous Diabetes as Compared to Type-2 Diabetes Mellitus and Non-diabetes in Patients With Liver Cirrhosis: Magnitude, Characteristics, and Implications.

Aim: Hepatogenous diabetes (HD) is frequently underestimated among cirrhosis patients. The current study assessed the magnitude, clinical characteristics, and implications of HD in cirrhosis patients as compared to the patients with type-2 diabetes mellitus (T2DM) and non-diabetes (ND) cirrhosis. Methods: In a prospective observational study, 338 consecutive eligible cirrhosis patients were screened for diabetes mellitus. A 2-hour oral glucose tolerance test (OGTT) was used to detect HD. The clinical characteristics, complications, and outcomes were ascertained and compared amongst HD, T2DM, and ND patients. Results: In the final study cohort of 316 patients, the proportion of HD, T2DM, and ND was 22.5% (n = 71), 26.3% (n = 83), and 51.3% (n = 162), respectively. HD was the predominant form of diabetes (68.9%) in Child-Pugh class-C cirrhosis. The majority (73%) of HD patients had abnormal OGTT without fasting hyperglycaemia. A lower cut-off of 98.5 mg/dl for fasting blood glucose had a modest sensitivity (72%) and specificity (75%) for predicting HD. In comparison to T2DM patients, HD patients were younger, leaner, and had more advanced cirrhosis. In comparison to ND patients, HD patients were leaner but had higher glycemic indices, serum cholesterol, and arterial ammonia levels. During a median follow-up period of 12 (03-21) months, the frequency of hepatic encephalopathy and variceal haemorrhage were higher in HD and T2DM patients compared to that in the ND group. Conclusions: HD is prevalent in about one fifth of cirrhosis patients. It differs from T2DM and ND in a number of ways, and has association with complications of cirrhosis.

Topological phase transition and tunable surface states in YBi.

A unique co-existence of extremely large magnetoresistance (XMR) and topological characteristics in non-magnetic rare-earth monopnictides has stimulated intensive research on these materials. Yttrium monobismuthide (YBi) has been reported to exhibit XMR up to 105% but its topological properties still need clarification. Here we use the hybrid density functional theory to probe the structural, electronic, and topological properties of YBi in detail. We observe that YBi is topologically trivial semimetal at ambient pressure which is in accordance with reported experimental results. The topological phase transitions i.e. trivial to non-trivial are obtained with volumetric pressure of 6.5 GPa and 3% of epitaxial strain. These topological phase transitions are well within the structural phase transition of YBi (24.5 GPa). The topological non-trivial state is characterized by band inversions amongY-dband andBi-pband atΓ-andX-pointwhich is further verified with the help of surface band structure along (001) plane. The Z2topological invariants are calculated with the help of product of parities and evolution of Wannier charge centers. The occurrence of non-trivial phase in YBi with a relatively small epitaxial strain, which a thin film geometry can naturally have, make it an ideal candidate to probe inter-relationship between XMR and non-trivial topology.

Gender Difference of Burnout in Physicians Working in Tertiary Care Hospital: A Cross-Sectional Study.

Burnout and emotional exhaustion are becoming common among health workers in the busy teaching hospitals due to increased workload and the dearth of human resource. This study aimed to determine the causes of burnout among doctors and across gender differences. This was a descriptive cross-sectional study conducted in the Fauji Foundation Hospital, Rawalpindi, Pakistan, from 1st July to 30th September 2022. Two hundred and forty-five randomly recruited doctors who filled out self-administered questionnaires were included in the study. Independent samples t-test was used for comparison of the mean emotional burnout score. Female doctors felt more emotionally drained, more fatigued, and more worn out from work than male doctors (p < 0.05). Overall emotional exhaustion was also higher in female doctors (p < 0.05). This situation was more serious during the COVID-19 pandemic. Gender-sensitive environments, workplace policies, and necessary interventions will save physicians' burnout and brain drain. Emotional burnout is greater in female doctors as compared to their male counterparts. This evidence not only calls for prevention and treatment but also certain service-related reforms to facilitate female physicians to balance out their work and family lives more effectively. Key Words: Physicians, Emotional exhaustion, Burnout, Gender difference, Pakistan.