Practice Trends in (C)APD Assessment and Management: A Survey of Audiologists in Kerala.

Aims Present study investigates the current trends in (Central) Auditory Processing Disorder [(C)APD] assessment and management practices among Audiologists practicing in Kerala, India. Materials and Methods The questionnaire for the survey was developed based on the Knowledge, Attitude, and Practices (KAP) model and underwent validation by experts in Audiology. Online survey was conducted to collect data from Audiologists practicing in Kerala, with a valid RCI-CRR number. Descriptive statistics were used to analyze the responses. Results The majority of participants held bachelor's degrees and completed training modules on the assessment of (C)APD during their undergraduate studies. However, clinical exposure was very low. Even though 59.2% of participants reported that they were performing screening for (C)APD, the use of standardized screening tools was limited. Only 35% of participants reported that they were performing diagnostic evaluation. However, the rest of the participants used only speech-in-noise tests for (C)APD evaluation. The participants who performed management of (C)APD were even fewer, at only 13.4%. Lack of facilities, inadequate patient load, and lack of practical exposure were major obstacles to (C)APD assessment and management. The majority of participants strongly agreed that Audiologists are the most qualified persons to deal with (C)APD; however, the practice trends obtained from the study suggest that Audiologists have a really poor practice in this area. Conclusion The study highlights the need for standardized assessment tools, improved training opportunities, and increased awareness among Audiologists regarding (C)APD. Multidisciplinary collaboration and further research are essential for enhancing (C)APD assessment and management practices in Kerala.

Enhancing COVID-19 Risk Mitigation in Bisha City Primary Schools: Investigating Teacher and Administrative Staff Awareness Through a Comprehensive Survey.

Background and aims This research investigates COVID-19 awareness among primary school teachers and staff in Bisha City. It aims to enhance safety protocols by examining knowledge, awareness levels, and demographic associations. Despite school reopening, concerns linger. The study promotes informed decision-making, fostering a safer school environment and contributing to the well-being of the educational community. Methods In an institutional-based cross-sectional study among primary school teachers and administrative staff in Bisha City, our research aimed to comprehensively evaluate awareness regarding specific measures for minimizing COVID-19 risks. With a sample size of 348 participants, we employed a robust methodology, including online questionnaires addressing sociodemographic characteristics and knowledge about COVID-19 risks. The data collection period spanned from March 2022 to December 2023, providing a temporal context for responses. A pilot test ensured questionnaire clarity, and efforts were made to enhance reliability and validity, incorporating validated scales and iterative adjustments based on feedback. Non-response or incomplete responses were handled transparently, with sensitivity analyses to assess potential impact. The awareness level was measured using 17 Likert scale questions, and predefined categories (poor, moderate, and good) facilitated result interpretation. Researcher influence was minimized through training and inter-rater reliability checks. Confidentiality and anonymity were rigorously maintained, adhering to ethical considerations. Statistical analyses employed frequency tables, percentages, mean, standard deviations, and the chi-square test. Dissemination included academic publications, reports to the educational directorate, and presentations at conferences. This holistic approach contributes to the robustness and societal impact of our study, offering insights into COVID-19 awareness among educators in Bisha City. Results In this study assessing awareness among teachers and administrative staff in Bisha City regarding COVID-19 risk minimization, data from 348 respondents revealed key bio-demographic characteristics. The majority demonstrated good knowledge of environmental (83%) and personal hygiene risks (84%). The chi-square test indicated no significant associations between bio-demographic factors and awareness levels. Specifically, for age groups, χ²(4, N = 348) = 5.46, p = 0.707; for gender, χ²(1, N = 348) = 1.95, p = 0.744; for educational levels, χ²(4, N = 348) = 2.13, p = 0.995; for residency, χ²(1, N = 348) = 1.11, p = 0.892; and for job types, χ²(3, N = 348) = 8.30, p = 0.404. The absence of significant associations underscores the potential universality of successful awareness campaigns, suggesting that future efforts can maintain an inclusive approach without tailoring messages. These results emphasize the importance of sustained awareness efforts across the diverse demographic spectrum of the educational community. Conclusion This study reveals robust COVID-19 awareness among primary school teachers and staff in Bisha City, with no significant demographic associations. Successful, inclusive awareness campaigns can further enhance safety measures and promote well-being in the educational community.

Geochemical and Organic Petrological Characteristics of the Bituminous Carbonate Succession (Upper Cretaceous Shu'ayb Formation) in Northern Jordan: Implications for Organic Matter Input and Paleosalinity, Paleoredox, and Paleoclimatic Conditions.

Bituminous carbonate rocks of the Upper Cretaceous Shu'ayb Formation from the Ajloun outcrop in Northern Jordan were geochemically and petrologically analyzed in this study. This study integrates kerogen microscopy results with geochemical results (i.e., biomarker, stable carbon isotope, and major elemental compositions) to understand the organic matter (OM) inputs and to reveal the dispositional setting and its effect on the occurrence of OM. The Shu'ayb bituminous carbonate rocks have high total organic carbon (TOC) and sulfur (S) contents, with average values of 12.3 and 4.59 wt %, respectively, indicating redox conditions during their precipitation. The high abundance of alginite (i.e., lamalginite) in the Shu'ayb bituminous carbonate sediments is a further evidence for redox conditions. The finding of mainly marine-derived OM was also demonstrated by the biomarker distribution and carbon isotope composition. The biomarkers are represented by a narrow Pr/Ph ratio of up to 0.97, abundance of tricyclic terpanes, and high C27 regular sterane, indicating that the OM was primarily derived from phytoplankton algae, along with small amounts of land plant-derived materials, and were accumulated under reducing conditions. The studied Shu'ayb bituminous carbonate facies is composed of mainly calcium (CaO; average, 45.10 wt %), with significant amounts of silicon (Si2O3; avg., 9.35 wt %), aluminum (Al2O3; avg., 6.91 wt %), and phosphorus (P2O3; avg., 1.47 wt %) and low amounts of iron (Fe2O3) and titanium (TiO2) of less than 1 wt %, indicating that the detrital influx was low in an open water depth system with higher primary bioproductivity. The geochemical proxy suggests that the Shu'ayb bituminous carbonate facies was established in a saline water environment, with Ca/Ca + Fe and S/TOC values of more than 0.9 and 0.50, respectively, which could be attributed to the increase in reducing conditions of the water column. The chemical index of alteration values of more than 0.8 also indicate that the Shu'ayb bituminous carbonate facies formed during warm and humid climatic conditions, thereby resulting in intense subaerial weathering.

Definitive engineering strength and fracture toughness of graphene through on-chip nanomechanics.

Fail-safe design of devices requires robust integrity assessment procedures which are still absent for 2D materials, hence affecting transfer to applications. Here, a combined on-chip tension and cracking method, and associated data reduction scheme have been developed to determine the fracture toughness and strength of monolayer-monodomain-freestanding graphene. Myriads of specimens are generated providing statistical data. The crack arrest tests provide a definitive fracture toughness of 4.4 MPa m . Tension on-chip provides Young's modulus of 950 GPa, fracture strain of 11%, and tensile strength up to 110 GPa, reaching a record of stored elastic energy ~6 GJ m-3 as confirmed by thermodynamics and quantized fracture mechanics. A ~ 1.4 nm crack size is often found responsible for graphene failure, connected to 5-7 pair defects. Micron-sized graphene membranes and smaller can be produced defect-free, and design rules can be based on 110 GPa strength. For larger areas, a fail-safe design should be based on a maximum 57 GPa strength.

The effect of brain training video games on improving visuospatial working memory and executive function in children with dyscalculia.

The aim was to investigate the effect of brain training video games on improving visuospatial working memory and executive function in children with dyscalculia. This study employed a quasi-experimental, within-subjects design. Pre- post- and follow up test scores on visuospatial working memory and executive function were used. Sixty children from a primary education public school in Taif were selected. This study employed simple random method for selecting participants. Children assigned to the experimental group completed 18, 30 ms training sessions at the technology room in the presence of the researcher over a period of six weeks. The analyses were conducted using SPSS by performing a repeated-measures analysis of variance with a between-group factor and a with-group factor (pretest and posttest). Scheffé's post hoc test was also applied. The training helped the intervention group gain better scores in visuospatial working memory and executive function in post test compared to control one. There were significant differences in visuospatial working memory and executive function across different measurements(pre-post-and follow up).

Number sense deficits in children with developmental dyscalculia, dyslexia, co-occurring disorder and their typically developing peers.

The aim of this study was to explore a number sense deficits in children with developmental dyscalculia, dyslexia, co-occurring disorder and their typically developing peers. A non-symbolic quantity comparison task was used in this study to examine whether children with dyscalculia have number sense deficits. Children aged 10-11 years old from nine primary schools in Taif city, Saudi Arabia, were selected to participate in this study. The children were divided into the dyscalculia group (n = 62), the dyslexia group (n = 60), and co-occurring disorder group (n = 65), and the typically developing peers group (n = 100).4 groups (dyscalculia, dyslexia, co-occurring disorder and typically developing peers group) × 2 stimulus ratio (6:7; 8:12). There were significant differences in non-symbolic quantity comparison tasks between children with dyslexia, co-occurring disorder, and typically developing peers. These results indicate that children with dyscalculia do have number sense deficiencies, but number sense deficiencies are not specific to children with dyscalculia.

Vibrational spectroscopy of dynamic interactions and relaxation processes in ionic systems.

In recent years, there has been a boom in the publication of research results on ionic (electrolyte) systems used in the creation of electrochemical energy systems (batteries, supercapacitors, etc.). One of the alternative ways to obtain dynamic information in ionic systems is spectroscopic experiments, and the most valuable information on the behavior of condensed systems at picosecond and adjacent time intervals is provided by vibrational spectroscopy. The source of this information is the analysis of the shape and width of the lines in the vibrational spectra of ion systems. This review aims to systematize the theoretical and methodological aspects of the study of the dynamics of ion systems by vibrational spectroscopy.

In silico analysis of the use of solanine derivatives as a treatment for Alzheimer's disease.

Alzheimer's disease (AD) is a brain illness that causes cognitive impairment in the elderly, especially females, as a result of genetics, hormones, and life experiences. It becomes more severe with age and is associated with cardiovascular disease, hypertension, and diabetes. Beta-amyloid plaques and hyper phosphorylated Tau protein buildup are common clinical findings. Misfiling of amyloid precursor protein (APP) and Amyloid beta peptide (Aß) proteins contributes to Alzheimer's disease. Enzyme Acetylcholinesterase enzyme interacts with amyloid-beta, enhancing its accumulation in insoluble plaques, leading to successful treatment for Alzheimer's disease primarily based on lowering this enzyme. Treatments include using the Rivastigmine for mild, moderate, or severe Alzheimer's disease, which inhibits acetylcholinesterase, but may cause side effects; Solanine derivatives, nightshade toxin, it is cholinesterase inhibitory, may mitigate Alzheimer's illness is progressing. In this research utilized a molecular docking program, which is a computer's computational ability to determine the optimal position for a specific compound to bind to a protein or target, forming a target-ligand complex and displaying biological activity and aiding in the development of effective anti-AD treatments and understanding AD pathological mechanisms. The study examined complexes of 3LII (Acetylcholinesterase receptor) in the A and B chain with Solanine and Rivastigmine derivatives, using an in-silico approach. PyRx default sorter was used to improve docking accuracy. Four compounds were selected based on their higher binding affinities in chain A and B. The results showed that Solanine derivatives (alpha-Solanine, Beta1-Solanine and Beta2-Solanine) have higher binding strength (-9.0,-9.3 and -8.6) than Rivastigmine (-7.2) in chain A, and also the binding strength was high for the Solanine derivatives (alpha-Solanine, Beta1-Solanine, and Beta2-Solanine) (-9.0,-8.8 and -8.9) is higher than Rivastigmine (-6.0) in the chain B. Solanine derivatives showed higher binding strength with acetylcholinesterase, potentially for to reduce the progression of the disease.

Study on Regio- and Diastereoselectivity of the 1,3-Dipolar Cycloaddition Reaction of Azomethine Ylide with 2-(Benzo[d]thiazol-2-yl)-3-(aryl)acrylonitrile: Synthesis, Spectroscopic, and Computational Approach.

An unprecedented and efficient three-component 1,3-dipolar cycloaddition reaction using (E)-2-(benzo[d]thiazol-2-yl)-3-(aryl)acrylonitriles 4a-g and an in situ generated azomethine ylide 3 from isatin and N-methylglycine is described. The reaction exhibits exclusive regioselectivity, resulting in the formation of 3'-(benzo[d]thiazol-2-yl)-1'-methyl-2-oxo-4'-(aryl)spiro[indoline-3,2'-pyrrolidine]-3'-carbonitriles regioisomers through exo/endo approaches. The diastereoselectivity of the reaction is highly dependent on the substitution pattern of the phenyl ring in dipolarophiles 4a-g, leading to the formation of exo-/endo-cycloadducts in varying ratios. To understand the stereoselectivity, the transition state structures were optimized using the TS guess geometry with the QST3-based method. The reaction mechanism and regioselectivity were elucidated by evaluating global and local electrophilicity and nucleophilicity descriptors at the B3LYP/cc-pVTZ level of theory, along with considerations based on the HSAB principle. The analysis of global electron density transfer (GEDT) showed that the reactions are polar and electron density fluxes from azomethine ylide 3 toward dipolarophile 4a-g. It was found from the molecular electrostatic potential map (MESP) that at the more favorable transition state, approach of reactants locates the oppositely charged regions over each other resulting in attractive forces between the two fragments. The computational results are consistent with the experimental observations, confirming that the reactions proceed through an asynchronous one-step mechanism.

Efficacy and Safety of Radiation Segmentectomy with 90Y Resin Microspheres for Hepatocellular Carcinoma.

Background Limited data are available on radiation segmentectomy (RS) for treatment of hepatocellular carcinoma (HCC) using yttrium 90 (90Y) resin microsphere doses determined by using a single-compartment medical internal radiation dosimetry (MIRD) model. Purpose To evaluate the efficacy and safety of RS treatment of HCC with 90Y resin microspheres using a single-compartment MIRD model and correlate posttreatment dose with outcomes. Materials and Methods This retrospective single-center study included adult patients with HCC who underwent RS with 90Y resin microspheres between July 2014 and December 2022. Posttreatment PET/CT and dosimetry were performed. Adverse events were assessed using the Common Terminology Criteria for Adverse Events, version 5.0. Per-lesion and overall response rates (ie, complete response [CR], objective response, disease control, and duration of response) were assessed at imaging using the Modified Response Evaluation Criteria in Solid Tumors, and overall survival (OS) was assessed using Kaplan-Meier analysis. Results Among 67 patients (median age, 69 years [IQR, 63-78 years]; 54 male patients) with HCC, median tumor absorbed dose was 232 Gy (IQR, 163-405 Gy). At 3 months, per-lesion and overall (per-patient) CR was achieved in 47 (70%) and 41 (61%) of 67 patients, respectively. At 6 months (n = 46), per-lesion rates of objective response and disease control were both 94%, and per-patient rates were both 78%. A total of 88% (95% CI: 79 99) and 72% (95% CI: 58, 90) of patients had a per-lesion and overall duration of response of 1 year or greater. At 1 month, a grade 3 clinical adverse event (abdominal pain) occurred in one of 67 (1.5%) patients. Median posttreatment OS was 26 months (95% CI: 20, not reached). Disease progression at 2 years was lower in the group that received 300 Gy or more than in the group that received less than 300 Gy (17% vs 61%; P = .047), with no local progression in the former group through the end of follow-up. Conclusion Among patients with HCC who underwent RS with 90Y resin microspheres, 88% and 72% achieved a per-lesion and overall duration of response of 1 year or greater, respectively, with one grade 3 adverse event. In patients whose tumors received 300 Gy or more according to posttreatment dosimetry, a disease progression benefit was noted. © RSNA, 2024 Supplemental material is available for this article.

Exploring chemical space, scaffold diversity, and activity landscape of spleen tyrosine kinase active inhibitors.

This study aims to comprehensively characterize 576 inhibitors targeting Spleen Tyrosine Kinase (SYK), a non-receptor tyrosine kinase primarily found in haematopoietic cells, with significant relevance to B-cell receptor function. The objective is to gain insights into the structural requirements essential for potent activity, with implications for various therapeutic applications. Through chemoinformatic analyses, we focus on exploring the chemical space, scaffold diversity, and structure-activity relationships (SAR). By leveraging ECFP4 and MACCS fingerprints, we elucidate the relationship between chemical compounds and visualize the network using RDKit and NetworkX platforms. Additionally, compound clustering and visualization of the associated chemical space aid in understanding overall diversity. The outcomes include identifying consensus diversity patterns to assess global chemical space diversity. Furthermore, incorporating pairwise activity differences enhances the activity landscape visualization, revealing heterogeneous SAR patterns. The dataset analysed in this work has three activity cliff generators, CHEMBL3415598, CHEMBL4780257, and CHEMBL3265037, compounds with high affinity to SYK are very similar to compounds analogues with reasonable potency differences. Overall, this study provides a critical analysis of SYK inhibitors, uncovering potential scaffolds and chemical moieties crucial for their activity, thereby advancing the understanding of their therapeutic potential.

Development and Validation of a Questionnaire to Assess the Effect of Vestibular Rehabilitation Therapy.

Vestibular rehabilitation therapy (VRT) is an effective treatment for individuals experiencing imbalance and dizziness, helps to improve the quality of life. Lack of culturally valid questionnaires to assess the outcome from VRT necessitates the development of reliable and culturally valid questionnaire to measure the outcomes of VRT. Hence, the current study aimed to develop a culturally valid and reliable questionnaire for measuring the outcome of VRT in Indian population and to translate it into Malayalam and Kannada. This cross-sectional study was conducted at the department of Audiology and Speech Language Pathology of a tertiary care hospital. The questionnaire was constructed based on thorough literature search of existing questionnaires related to dizziness and vestibular disorders in relevant to the Indian context. Content validity was assessed by expert reviewers using a rating scale, and the questionnaire was translated into two south Indian languages (Malayalam and Kannada). The questionnaire was then administered on 12 patients undergoing VRT to assess its initial validation. The questionnaire was named as 'Effect of Vestibular Rehabilitation Therapy Questionnaire (EVRT-Q)', consisted of 25 questions divided into three domains: symptom, function, and emotion. The questionnaire demonstrated good content validity with a Content Validity Index greater than 0.8 for each question in all domains. The questionnaire possesses a high internal consistency when measured using Cronbach's alpha. Hence, the EVRT-Q appears to be a valid and reliable tool to assess the outcome from VRT in Indian population.

Neutral Sphingomyelinase 2 Inhibition Limits Hepatic Steatosis and Inflammation.

Non-alcoholic fatty liver disease (NAFLD) is manifested by hepatic steatosis, insulin resistance, hepatocyte death, and systemic inflammation. Obesity induces steatosis and chronic inflammation in the liver. However, the precise mechanism underlying hepatic steatosis in the setting of obesity remains unclear. Here, we report studies that address this question. After 14 weeks on a high-fat diet (HFD) with high sucrose, C57BL/6 mice revealed a phenotype of liver steatosis. Transcriptional profiling analysis of the liver tissues was performed using RNA sequencing (RNA-seq). Our RNA-seq data revealed 692 differentially expressed genes involved in processes of lipid metabolism, oxidative stress, immune responses, and cell proliferation. Notably, the gene encoding neutral sphingomyelinase, SMPD3, was predominantly upregulated in the liver tissues of the mice displaying a phenotype of steatosis. Moreover, nSMase2 activity was elevated in these tissues of the liver. Pharmacological and genetic inhibition of nSMase2 prevented intracellular lipid accumulation and TNFα-induced inflammation in in-vitro HepG2-steatosis cellular model. Furthermore, nSMase2 inhibition ameliorates oxidative damage by rescuing PPARα and preventing cell death associated with high glucose/oleic acid-induced fat accumulation in HepG2 cells. Collectively, our findings highlight the prominent role of nSMase2 in hepatic steatosis, which could serve as a potential therapeutic target for NAFLD and other hepatic steatosis-linked disorders.

Late lesion growth following endovascular therapy: is 24 hours too early to assess acute infarct size including the effects of secondary injury?

Introduction Stroke lesion volume on MRI or CT provides objective evidence of tissue injury as a consequence of ischemic stroke. Measurement of "final" lesion volume at 24hr following endovascular therapy (post-EVT) has been used in multiple studies as a surrogate for clinical outcome. However, despite successful recanalization, a significant proportion of patients do not experience favorable clinical outcome. The goals of this study were to quantify lesion growth during the first week after treatment, identify early predictors, and explore the association with clinical outcome. Methods This is a prospective study of stroke patients at two centers who met the following criteria: i) anterior large vessel occlusion (LVO) acute ischemic stroke, ii) attempted EVT, and iii) had 3T MRI post-EVT at 24hr and 5-day. We defined "Early" and "Late" lesion growth as ≥10mL lesion growth between baseline and 24hr DWI, and between 24hr DWI and 5-day FLAIR, respectively. Complete reperfusion was defined as >90% reduction of the volume of tissue with perfusion delay (Tmax>6sec) between pre-EVT and 24hr post-EVT. Favorable clinical outcome was defined as modified Rankin scale (mRS) of 0-2 at 30 or 90 days. Results One hundred twelve patients met study criteria with median age 67 years, 56% female, median admit NIHSS 19, 54% received IV or IA thrombolysis, 66% with M1 occlusion, and median baseline DWI volume 21.2mL. Successful recanalization was achieved in 87% and 68% had complete reperfusion, with an overall favorable clinical outcome rate of 53%. Nearly two thirds (65%) of the patients did not have Late lesion growth with a median volume change of -0.3mL between 24hr and 5-days and an associated high rate of favorable clinical outcome (64%). However, ~1/3 of patients (35%) did have significant Late lesion growth despite successful recanalization (87%: 46% mTICI 2b/ 41% mTICI 3). Late lesion growth patients had a 27.4mL change in Late lesion volume and 30.1mL change in Early lesion volume. These patients had an increased hemorrhagic transformation rate of 68% with only 1 in 3 patients having favorable clinical outcome. Late lesion growth was independently associated with incomplete reperfusion, hemorrhagic transformation, and unfavorable outcome. Conclusion Approximately 1 out of 3 patients had Late lesion growth following EVT, with a favorable clinical outcome occurring in only 1 out of 3 of these patients. Most patients with no Early lesion growth had no Late lesion growth. Identification of patients with Late lesion growth could be critical to guide clinical management and inform prognosis post-EVT. Additionally, it can serve as an imaging biomarker for the development of adjunctive therapies to mitigate reperfusion injury.

Effects of phytase enzyme supplementation on growth performance, intestinal morphology and metabolism in Nile tilapia (Oreochromis niloticus).

Phytase is crucial in enhancing the bioavailability and release of phosphorus and other nutrients bound to phytic acid, making them more bioavailable for animal absorption. This study was carried out to inspect the effect of supplementing low phosphorus (P) diet with di-calcium phosphate (DCP) and liquid phytase enzyme (LP), which contains 1500 FTU/kg, on growth performance, intestinal morphometry, proximate body chemical composition, blood profile, immunity status, liver mitochondrial enzyme activities, the expression response and economic returns of Nile tilapia (Oreochromis niloticus). Three triplicate groups of fish (initial weight 5.405 ± 0.045 g, N = 90) were fed on three different diets for 90 days. The first was a control diet with zero DCP; the second was a control diet supplemented with 0.71% DCP; the third was a control diet supplemented with 0.03% LP. The groups were designated as CG, DCP and LP, respectively. Results showed that LP induced considerable improvements (p < 0.05) in FBW, body weight gain, weight gain rate, specific growth rate, HIS, viscero-somatic index, spleen-somatic index, feed conversion ratio, blood parameters and the histomorphometry assessment of intestinal villi absorptive capacity, compared with the other groups. Also, whole-body protein and lipid contents pointedly (p < 0.05) increased by LP, compared with the DCP group. A positive response (p < 0.05) to the phytase enzyme was noted in complexes I, III and IV of the mitochondrial liver complex enzyme activity. Likewise, the relative gene expression levels of (GHr-1, IGF-1, FAS and LPL) were notably (p < 0.05) upregulated by phytase enzyme, associated with DCP and control groups. Further, phytase recorded the highest total return and profit percentage. It can be concluded that Nile tilapia benefits from using phytase enzyme 1500 FTU/kg at 0.03% without adding DCP in terms of good performance and profits.

Carbon sequestration and credit potential of gamhar (Gmelina arborea Roxb.) based agroforestry system for zero carbon emission of India.

The agroforestry system is the best option to achieve the net zero carbon emissions target for India. Keeping this view, carbon sequestration and credit potential of gamhar based agroforestry system has been assessed. The experiment was carried out in randomized block design in seven different treatments with five replications. Gamhar tree biomass accumulation was higher in gamhar based agroforestry system compared to sole gamhar. Among different tree components, stem contributed a maximum to total gamhar tree biomass followed by roots, leaves and branches. The average contributions of stems, roots, leaves and branches in total tree biomass in two annual cycles (2016-17 and 2017-18) varied between 50 and 60, 19.8 and 20, 19.2 and 20, and 10.7 and 12.7 percent, respectively. In case of crops, above ground, below ground and total biomass was significantly higher in sole intercrops than gamhar based agroforestry system. Total (Tree + interrops + Soil) carbon stock, carbon sequestration, carbon credit and carbon price were significantly affected by treatments, and was maximum in Sole Greengram-Mustard. Net carbon emission was also recorded lowest in Sole Greengram-Mustard for which the values were 811.55% and 725.24% and 760.69% lower than Sole Gamhar in 2016-17, 2017-18 and in pooled data, respectively.

Component separation repair of incisional hernia: evolution of practice and review of long-term outcomes in a single center.

PURPOSE: To review the long-term outcomes of complex abdominal wall reconstruction using anterior and posterior component separation (CS) techniques in our center. METHODS: This was a descriptive analytical study. Analysis of data from a prospectively collected database of patients who had undergone Component Separation (CS) repair of incisional hernias was performed. Two techniques were used. Anterior component separation (ACS) and posterior component separation with transversus abdominis release (PCS/TAR). Follow-up was clinical review at 6 weeks, 6 months, and 12 months with direct access telephone review thereafter. Long-term outcome data was obtained from electronic records and based on either clinical or CT assessment. Minimum physical follow-up was 6 months for all patients. RESULTS: 89 patients with large incisional hernias underwent CS repair. 29 patients had ACS while 60 underwent PCS/TAR. Mean follow-up was 60 months (range 6-140 months) in the ACS group and 20 months (range 6-72 months) in the PCS group. Twenty-five patients (28%) had simultaneous major procedures including 21 intestinal anastomoses. Twenty-six (29%) of patients had associated stomas. Twenty-seven (30.3%) of the patients had undergone previous hernia repairs. Seromas occurred in 24 (26.97%) patients. Wound infections were more common after ACS. There have been 10 (11.2%) recurrences to date. CONCLUSION: Component separation repair techniques result in good long-term outcomes with acceptable complication rates. They can be performed simultaneously with gastrointestinal procedures with low morbidity. Appropriate patient selection and use of appropriate mesh are important.

Hospital outbreak of Carbapenem-resistant acinetobacter baumannii in the context of local facility transmission.

Carbapenem-resistant Acinetobacter baumannii are of increasing concern in the health care setting. We describe a cluster of 9 cases in hospitalized patients over a 3-month period that reflected ongoing community transmission from high-risk facilities. Robust surveillance and knowledge of local epidemiology are critical to mitigating onward transmission in the health care setting.

Perspectives on Ensifentrine and Its Therapeutic Potential in the Treatment of COPD: Evidence to Date.

Ensifentrine is a novel inhalational phosphodiesterase (PDE)3 and PDE4 inhibitor which improves bronchodilation and decreases inflammatory markers by acting locally on the bronchial tissue, with minimal systemic effects. Both preclinical and clinical trials have demonstrated benefits of this therapy, including improvement in lung function and reduction in exacerbations. This therapy is currently under review by the US Food and Drug Administration with a decision expected in 2024.

Exploring the untapped pharmacological potential of imidazopyridazines.

Imidazopyridazines are fused heterocycles, like purines, with a pyridazine ring replacing the pyrimidine ring in purines. Imidazopyridazines have been primarily studied for their kinase inhibition activity in the development of new anticancer and antimalarial agents. In addition to this, they have also been investigated for their anticonvulsant, antiallergic, antihistamine, antiviral, and antitubercular properties. Herein, we review the background and development of different imidazopyridazines as potential pharmacological agents. Moreover, the scope of this relatively less charted heterocyclic scaffold is also highlighted.