Cobalt-Catalyzed Enantioselective Hydroboration of α-Substituted Acrylates.

Even though metal-catalyzed enantioselective hydroborations of alkenes have attracted enormous attention, few preparatively useful reactions of α-alkyl acrylic acid derivatives are known, and most use rhodium catalysts. No examples of asymmetric hydroboration of the corresponding α-arylacrylic acid esters are known. In our continuing efforts to search for new applications of earth-abundant cobalt catalysts for broadly applicable organic transformations, we have identified 2-(2-diarylphosphinophenyl)oxazoline ligands and mild reaction conditions for efficient and highly regio- and enantioselective hydroboration of α-alkyl- and α-aryl- acrylates, giving ß-borylated propionates. Since the C-B bonds in these compounds can be readily replaced by C-O, C-N, and C-C bonds, these intermediates could serve as valuable chiral synthons, some from feedstock carbon sources, for the synthesis of propionate-bearing motifs including polyketides and related molecules. Two-step syntheses of "Roche" ester from methyl methacrylate (79%; er 99:1), arguably the most widely used chiral fragment in polyketide synthesis, and tropic acid esters (∼80% yield; er ∼93:7), which are potential intermediates for several medicinally important classes of compounds, illustrate the power of the new methods. Mechanistic studies confirm the requirement of a cationic Co(I) species [(L)Co]+as the viable catalyst in these reactions and rule out the possibility of a [L]Co-H-initiated route, which has been well-established in related hydroborations of other classes of alkenes. A mechanism involving an oxidative migration of a boryl group to the ß-carbon of an η4-coordinated acrylate-cobalt complex is proposed as a plausible route.

Genetic diversity assessment and biotechnological aspects in Aristolochia spp.

Aristolochia, belonging to the family Aristolochiaceae, has immense ecological significance due to its large size and huge geographic distribution. In the context of dealing with a genus with a huge number of species like Aristolochia, these markers come in handy to precisely identify a particular species and enumerate the genetic diversity. Also, certain species of Aristolochia are economically important due to the presence of secondary metabolites and vast use in traditional and modern medicine. But, the presence of profitable biochemical constituents in Aristolochia is very low and the breeding process of the plant is highly dependable on pollinators. Hence, identifying different biotechnological approaches to fasten the reproductive cycle of Aristolochia and increase the secondary metabolites is of great interest to the researchers. In this study, a comprehensive review has been established on different types of morphological/anatomical markers (starch grains with "Maltese cross"), phytochemical markers (aristolochic acid, triterpenoid, aristolactam etc.) and genetic markers (ISSR, SSR, DNA bar-coding) for various Aristolochia spp. We have also discussed the applications of different biotechnological tools in Aristolochia spp. which include discrete approaches to promote in vitro germination, in vitro shooting, root induction, somatic embryogenesis, synthetic seed production, acclimatization and hardening and sustainable production of secondary metabolites. In a nutshell, the present review is a first of kind approach to comprehensively demonstrate the genetic diversity studies and biotechnological aspects in Aristolochia spp. KEY POINTS: • Insights into the in vitro propagation of Aristolochia spp. • In vitro production and optimization of secondary metabolites. • Assessment of genetic diversity by molecular markers.

Piper longum L.: A comprehensive review on traditional uses, phytochemistry, pharmacology, and health-promoting activities.

Piper longum (family Piperaceae), commonly known as "long-pepper" or "Pippali" grows as a perennial shrub or as an herbaceous vine. It is native to the Indo-Malaya region and widely distributed in the tropical and subtropical world including the Indian subcontinent, Sri Lanka, Middle-East, and America. The fruits are mostly used as culinary spice and preservatives and are also a potent remedy in various traditional medicinal systems against bronchitis, cough, cold, snakebite, and scorpion-sting and are also used as a contraceptive. Various bioactive-phytochemicals including alkaloids, flavonoids, esters, and steroids were identified from the plant extracts and essential oils from the roots and fruits were reported as antimicrobial, antiparasitic, anthelminthic, mosquito-larvicidal, antiinflammatory, analgesic, antioxidant, anticancer, neuro-pharmacological, antihyperglycaemic, hepato-protective, antihyperlipidaemic, antiangiogenic, immunomodulatory, antiarthritic, antiulcer, antiasthmatic, cardioprotective, and anti-snake-venom agents. Many of its pharmacological properties were attributed to its antioxidative and antiinflammatory effects and its ability to modulate a number of signalling pathways and enzymes. This review comprehensively encompasses information on habit, distribution, ethnobotany, phytochemistry, and pharmacology of P. longum in relation to its medicinal importance and health benefits to validate the traditional claims supported by specific scientific experiments. In addition, it also discusses the safety and toxicity studies, application of green synthesis and nanotechnology as well as clinical trials performed with the plant also elucidating research gaps and future perspectives of its multifaceted uses.

Direct access to benzofuro[2,3-b]quinoline and 6H-chromeno[3,4-b]quinoline cores through gold-catalyzed annulation of anthranils with arenoxyethynes and aryl propargyl ethers.

This work reports a facile annulation of anthranils with aryloxyethynes or aryl propargyl ethers to construct useful benzofuro[2,3-b]quinoline and 6H-chromeno[3,4-b]quinoline frameworks, respectively; these heterocycles are not readily available from literature methods despite their biological significance. This high atom- and step-economy strategy is highlighted by a broad substrate scope. The reaction mechanism is proposed to proceed through sequential cyclizations among the oxyaryl group, gold carbene and benzaldehyde of the α-imino gold carbene intermediates.

Scar site metastasis of renal cell carcinoma diagnosed on-site cytology: a case report.

BACKGROUND: Renal cell carcinomas (RCCs) have a propensity for widespread metastases and a wide range of survival rates. They can spread into adjacent organs by direct extension and can invade local or distant sites by lymphatic, hematogenous or lympho-hematogeneous pathways. Scar site metastasis is very rare. CASE PRESENTATION: We report a rare case of scar site RCC metastasis in a patient who underwent left radical nephrectomy 10 months ago. CONCLUSION: FNAC is a simple and easy technique that can help in the definitive diagnosis of subcutaneous lesions. A correct early stage diagnosis of metastatic RCC can considerably improve the survival rates.

Catalytic Transformations of Alkynes into either α-Alkoxy or α-Aryl Enolates: Mannich Reactions by Cooperative Catalysis and Evidence for Nucleophile-Directed Chemoselectivity.

The catalytic formation of gold enolates from alkynes, nitrones, and nucleophiles is described, and their Mannich reactions result in nucleophile-directed chemoselectivity through cooperative catalysis. For 1-alkyn-4-ols and 2-ethynylphenols, their gold-catalyzed nitrone oxidations afforded N-containing dihydrofuran-3(2H)-ones with syn selectivity. The mechanism involves the Mannich reactions of gold enolates with imines through an O-H-N hydrogen-bonding motif. For aryloxyethynes, their gold enolates react selectively with nitrones to deliver 3-alkylidenebenzofuran-2-ones, as controlled by a C-H-O hydrogen-bonding motif.

Exploring the Interplay of Socioeconomic and Behavioral Factors: Unraveling Gender Disparities in Glycemic Control Among Adult Type 2 Diabetic Patients in Outpatient Care.

Background Diabetes mellitus (DM) presents global challenges, with optimal glycemic control being pivotal in managing complications, notably in type 2 diabetes mellitus (T2DM). Yet, achieving sustained control faces barriers stemming from socioeconomic and gender-specific disparities. This study addresses these gaps by examining socioeconomic determinants and gender disparities in diabetes management, particularly in Maharashtra, India. Methodology This cross-sectional study involved 302 T2DM patients aged 20 to 79 years. Data on sociodemographic, behavioral, and clinical factors were collected through interviews, and records were analyzed via logistic regression to identify predictors of glycemic control. Results Significant associations emerged between gender and education, occupation, and religion. Glycemic control, with a mean HbA1c of 8.45%, remained suboptimal. Logistic regression identified gender, average family income, diabetes duration, treatment nature, comorbidities, complications, and medication adherence as glycemic control predictors. Conclusions Addressing socioeconomic and gender-specific factors is paramount in diabetes management, especially in rural areas where sociocultural influences shape health behaviors. Tailored interventions, including gender-sensitive health education, are vital for improving diabetes care and outcomes. This study provides crucial insights into gender-specific influences on glycemic control among T2DM patients in Maharashtra, advocating for personalized interventions to enhance overall diabetes management.

Estimation of the Parasitic Burden of Soil-Transmitted Helminths Among Pregnant Women in the Maharashtra State of India Using qPCR: A Community-Based Study.

Background: Soil-transmitted helminth (STH) infections are widespread in developing countries with inadequate sanitation facilities. These infections can lead to malnutrition, anemia, and other complications that can negatively impact both the mother's and fetus's health during pregnancy. This study aimed to estimate the burden of STH by Kato-Katz microscopy and quantitative polymerase chain reaction (qPCR) in pregnant women from rural India. The diagnostic accuracy of these two methods was also compared. Material and Methods: A community-based cross-sectional study was conducted in rural areas of Wardha district of Maharashtra state. We randomly selected and interviewed 688 pregnant women. A total of 534 (77.61%) participants gave stool samples. Two containers (60 mL) labeled with a unique identification number were given to pregnant women to collect stool samples for Kato-Katz microscopy and qPCR. Stool specimens were transported to an accredited lab and examined within 24 hours. Suitable examinations were conducted to compare sensitivity between two tests. Results: The results are presented for 534 participants who gave stool samples. The prevalence of any STH by Kato-Katz stool microscopy was 6.55% (95%CI 4.46-12.19), and that by qPCR was 20.41 (95%CI 17.53-29.40). The sensitivity of Kato-Katz microscopy was 29.17% compared to sensitivity of 90.83% by qPCR (P = 0.001). Pregnant women with STH infection have a significantly lower weight gain during pregnancy, and the majority were either mild or moderate anemic compared to those without STH. Conclusion: The study highlighted significant differences in prevalence of STH among pregnant women by Kato-Katz microscopy and qPCR. The sensitivity of qPCR for detecting STH was higher than that of Kato-Katz microscopy.

Mucous Extravasation Cyst Associated With the Lower Lip and Its Management: A Case Report.

A 15-year-old female patient was reported with swelling on the right side of the lower lip for 15 days. A provisional diagnosis of mucocele was obtained based on the patient's history and clinical examination. Under all aseptic conditions and administration of local anesthetic, surgical mucocele removal was done using a scalpel. An excised soft tissue specimen was given for histopathological examination, confirming the final diagnosis of mucous extravasation phenomena or mucocele. Recall examination after seven days reveals satisfactory lesion healing and no discomfort. This case report demonstrates that surgical excision is a simple, efficient, and affordable method for treating mucoceles and giving aesthetic and functional clearance.

Barriers and Facilitators of COVID-19 Vaccination Outreach Program in Rural India: A Qualitative Study.

Background Primary health centres are in charge of effectively implementing the COVID-19 vaccination program in rural areas. So, the study was planned to seek insight into the challenges faced by health personnel in the effective implementation of the COVID-19 vaccination program. Methodology The study was conducted in a rural area of Akola district which lies in the western parts of Maharashtra State and belongs to the Vidarbha region and is said to be one of the progressive districts in the region. A qualitative study was planned to understand the barriers and facilitators of the COVID-19 vaccine implementation program at rural and tribal areas. The study participants were medical officers from rural and tribal areas who actively planned and implemented COVID-19 vaccination at the primary health centre. A total of 30 medical officers were interviewed. Interview questions were focussed on the planning of COVID-19 vaccination in their area. Other questions were the problem faced during the implementation of the COVID-19 vaccination program and how it has been tackled. Results The factors identified were grouped into three groups: Health system factors, Human resource factors and Community level factors. Health system factors like shortage of vaccines and syringes, tablet paracetamol, online digital method of vaccination registration, overcrowding at the initial stage, and inadequate infrastructure were barriers to vaccination. Fear about vaccine adverse events, even in healthcare workers (HCWs), and overburdened healthcare workers were also factors affecting vaccination. At the community level, high resistance initially and misconception about the vaccine, and also the fear about post-vaccination side effects have an impact on the COVID-19 vaccination program in rural and tribal areas. Conclusion The successful vaccination rate among the population needs community leadership and a community-centred approach when conducting outreach and strengthening primary health care in terms of infrastructure, manpower, and capacity building of healthcare staff.

Design-redesign, implementation, and evaluation of effectiveness of maternal nutrition and responsive parenting program on child development at 2 years of age from rural India: a cluster RCT.

Background: To promote early childhood development (ECD), we require information not only on what needs to be addressed and on what effects can be achieved but also on effective delivery methods that can be adapted to local context. We describe design, implementation, and evaluation of a complex intervention to strengthen nurturing environment for young children. Methods: Study participants were pregnant women and their children from birth to 2 years. We used design and redesign, implementation, and evaluation approaches for the study. We co-created curriculum and delivery plan with stakeholders, based on the theoretical framework, findings from formative research, and our preliminary work. We recruited 656 pregnant women and newborns, 326 (49.69%) from intervention and 330 (50.30%) from the control group. We conducted a cluster randomized controlled trial to evaluate the program's effectiveness. The outcomes of children were assessed at 12 and 24 months. Findings: At recruitment, study participants from both the study arms were similar in sociodemographic characteristics. We conducted 6,665 home visits, 25 toy-making workshops, and 65 caregiver-meetings. The initial examination of program data revealed gaps in quality and coverage of interventions. The intervention was redesigned based on feedback from stakeholders in community meetings. At recruitment, participants in both study groups had similar socio-demographics. We conducted 6,665 home visits, 25 toy workshops, and 65 caregiver meetings. Initial program data showed intervention quality and coverage gaps, leading to a redesign program based on community and stakeholder feedback. Post-re-designing, session quality improved, with program coverage rising from 32 to 98%. Male participation in home visits increased from 4.3 to 32.65%, and data errors reduced from 270 to 140 per month on average. At 24 months, program showed moderate-mild impact on ECD - cognitive (0.31, 95%CI: 0.13-0.48), language (0.2, 95%CI: 0.01-0.39), and socioemotional-development (0.19, 95%CI: 0.01-0.37), moderate effect on home-environment and mother-child interaction. 96% of women initiated breastfeed within one-hour of delivery, and exclusive-breastfeeding rate of 89.80%. Interpretations: The study provides an evidence-based community centered ECD curriculum and implementation strategies to enhance service providers, and caregivers' knowledge and skills for promoting ECD in low-resource settings with the potential to scale within existing Government Program. Funding: The trial was funded by the Saving Brains Round 5 Initiative of Grand Challenges Canada (Grant no. SB-1707-05084), and we are grateful for their ongoing support through online sessions and orientation workshops. The trial was also supported by the Indian Council of Medical Research (File No: 5/7/1693/CH/Adhoc/RBMCH-2020).

Rapid-cycle evaluation and learning for the effective delivery of integrated interventions in early childhood in rural India.

Background: Effective and real-time data analytics plays an essential role in understanding gaps and improving the quality and coverage of complex public health interventions. Studies of public health information systems identify problems with data quality, such as incomplete records and untimely reporting. Effective data collection and real-time analysis systems for rapid-cycle learning are necessary to monitor public health programs and take timely evidence-based decisions. Early childhood development (ECD) programs are very diverse. Rapid-cycle evaluation and learning (REAL) guides the implementation process of such complex interventions in real time. Stepping stones was one such early childhood development program implemented in Central India. Objective: The objective was to improve the delivery of complex, integrated public health interventions for early childhood development in remote areas of rural India. Methodology: The program was developed according to the principles of inclusion and community-centeredness, which can be tested quickly and iteratively. To enhance the decision-making process and improve delivery and coverage, the core team implemented an information system for rapid-cycle learning. We developed performance indicators and a performance measurement matrix after defining the specific needs. Following that, we trained staff to collect complete data using electronic data collection tools and transfer it the same day to the server for quality review and further analysis. A variety of data/information was triangulated to address the gaps in intervention delivery, and those decisions were subsequently implemented. Results: We observed that the quality of data collection improved, and errors were reduced by 50% in the third quarter. The quality of the narrative was also enhanced; it became more elaborate and reflective. Sharing their field output in meetings and improving the quality of the narrative enhanced the self-reflection skills of field staff and consequently improved the quality of the intervention delivery. Refresher training and mentoring by supervisors helped to improve the data quality over time. Conclusion: Rapid-cycle evaluation and learning (REAL) can be implemented in resource-limited settings to improve the quality and coverage of integrated intervention in early childhood. It nurtures a reinforcing ecosystem that integrates providers, community, and family perspectives and guides interactions among stakeholders by integrating data from all available sources.

Study of anaemia in pregnancy and low birth weight in fluoride endemic area of Western Rajasthan: a cohort study.

Background: Fluoride is a noxious element known to destroy gastrointestinal mucosa, leading to erythrocytes' destruction and causing anaemia. The birth weight of newborn babies is a significant indicator of a child's vulnerability to the risk of childhood diseases and chances of existence. Methods: This prospective cohort study was planned to find linkages between fluorosis and the low-birth weight of newborn babies with anaemic mothers. Antenatal mothers until the 20th week of gestation were followed up till delivery in the Antenatal Clinic of a District Hospital in one of the known fluoride-endemic districts (Nagaur) and the other not-so-endemic district (Jodhpur) of Western Rajasthan. Results: Around 19% of the newborn in Jodhpur and around 22% in Nagaur had low birth weight. Mean fluoride values in water samples were measured to be 0.57 (range from 0.0 to 2.7 PPM) in Jodhpur and 0.7 (range from 0.0 to 3.4 PPM) in Nagaur. Conclusions: Thus, in fluoride endemic areas, other factors should be included besides iron and folic acid supplementation for improving anaemia in pregnant women. This calls for assessing the effectiveness of de-fluoridation activities along with the area's most common indigenous food practices.

Are paid tools worth the cost? A prospective cross-over study to find the right tool for plagiarism detection.

Background: The increasing pressure to publish research has led to a rise in plagiarism incidents, creating a need for effective plagiarism detection software. The importance of this study lies in the high cost variation amongst the available options for plagiarism detection. By uncovering the advantages of these low-cost or free alternatives, researchers could access the appropriate tools for plagiarism detection. This is the first study to compare four plagiarism detection tools and assess factors impacting their effectiveness in identifying plagiarism in AI-generated articles. Methodology: A prospective cross-over study was conducted with the primary objective to compare Overall Similarity Index(OSI) of four plagiarism detection software(iThenticate, Grammarly, Small SEO Tools, and DupliChecker) on AI-generated articles. ChatGPT was used to generate 100 articles, ten from each of ten general domains affecting various aspects of life. These were run through four software, recording the OSI. Flesch Reading Ease Score(FRES), Gunning Fog Index(GFI), and Flesch-Kincaid Grade Level(FKGL) were used to assess how factors, such as article length and language complexity, impact plagiarism detection. Results: The study found significant variation in OSI(p < 0.001) among the four software, with Grammarly having the highest mean rank(3.56) and Small SEO Tools having the lowest(1.67). Pairwise analyses revealed significant differences(p < 0.001) between all pairs except for Small SEO Tools-DupliChecker. Number of words showed a significant correlation with OSI for iThenticate(p < 0.05) but not for the other three. FRES had a positive correlation, and GFI had a negative correlation with OSI by DupliChecker. FKGL negatively correlated with OSI by Small SEO Tools and DupliChecker. Conclusion: Grammarly is unexpectedly most effective in detecting plagiarism in AI-generated articles compared to the other tools. This could be due to different softwares using diverse data sources. This highlights the potential for lower-cost plagiarism detection tools to be utilized by researchers.

Fatal polymorphic ventricular tachycardia in a primary health center setting: A case report.

Polymorphic ventricular tachycardia (PVT) is a lethal cardiac arrhythmia. It requires medical intervention, including defibrillation, or imminent death may result. A 26-year-old male patient presented to the emergency department with complaints of syncope while working on the farm; later diagnostic testing indicated PVT. As cardiovascular disorders are becoming increasingly prevalent in urban as well as rural areas, it is a need of time to make our facilities well equipped for resuscitation measures by implementing advanced cardiac life support.

Importance of Maternal Nutrition in the First 1,000 Days of Life and Its Effects on Child Development: A Narrative Review.

Maternal nutrition needs to be addressed during pregnancy for the child's first 1,000 days of life, or roughly between conception and a child's second birthday. The infant requires just breast milk for the first six months of life. The production of breastmilk and its nutritional value is essentially unaffected by maternal privation. The child's health suffers when the mother's diet and health are impaired. This review aims to discuss the importance of pregnant women's nutrition and how it impacts the development and expansion of a child during this critical period of development, which is supported by the most recent literature. Throughout the child's growth in the mother's womb and outside, four distinct stages have been identified: (1) nine months to zero months: pregnancy; (2) zero to six months: breastfeeding; (3) six to 12 months: introduction of solid food; and (4) >12 months: transition to family diet, appreciation of nutritious food offered within each period for the child's development. Moreover, there is a strong link between nutrition, well-being, and learning. The nutritional intake of infants, children, and adolescents maintains the body weight and is sufficient to sustain their normal growth and development. One of the crucial factors influencing a child's development is nutrition. Rapid growth occurs during infancy. Compared to other growth phases, this phase has the largest relative energy and food needs for body size.

Prevalence of thyroid disorder among young adults in the rural areas of Wardha district: A cross-sectional study.

Background and Aim: Recently, it has been revealed that most thyroid disorders occur among females and that the factors contributing to this are infertility and sex hormone imbalance. Other research studies showed both genders are equally affected. Therefore, this study aims to estimate the prevalence rate of thyroid disorder among young adults in the rural areas of Wardha district and correlate the results with demographic variables. Materials and Methods: A cross-sectional research design was used in this study. One thousand males and females were involved in the study. The Calbiotech Thyroxine Elisa kit was used to check the prevalence rate of thyroid disorder. Data were analysed using the Statistical Package for Social Sciences (SPSS) and released in 2016. Results: Among the rural villages of Wardha district, Seloo, Salod (Hirapur) and Kelzar were included in the study. It was found that in Seloo, 154 (49.04%) young adults had normal thyroid function, 105 (33.44%) had hyperthyroidism and 55 (17.52%) participants had hypothyroidism. Salod (Hirapur) showed 210 (47.95%) with normal thyroid function, 149 (34.02%) with hyperthyroidism and 79 (18.04%) with hypothyroidism. In Kelzar, there were 121 (48.79%) with normal thyroid function, 80 (32.26%) with hyperthyroidism and 47 (18.95%) with hypothyroidism. Conclusion: Prevalence of thyroid disorder revealed that majority of the thyroid problems were found among females in the rural areas of Wardha district. There are various problems in rural areas, such as lack of medical facilities and laboratory facilities to diagnose thyroid dysfunction early. It is recommended that health check-up camps be conducted in rural areas and health education be given to young adults about thyroid disorders and their prevention measures for promotion of health free from a thyroid disorder.

Nutritional Status of Children Under Two Years of Age in the Devbhumi Dwarka District, Gujarat: A Descriptive Cross-Sectional Study.

Improvements in the analysis of child nutrition status can be helpful in increasing the understanding of the magnitude and critical causes of undernutrition. The present study aimed to assess the nutritional status and related factors in children under two years of age in the Devbhumi Dwarka District of Gujarat, India. A descriptive cross-sectional study was conducted for which the sample size was calculated using Open Epi and considering a 20% non-response rate. The sample size for the study was 1200, but the achieved sample size was 1301. Statistical analysis was performed to identify significant determinants of under-nutrition separately for stunting, wasting, and underweight. The prevalence of wasting, underweight, and stunting was 14%, 17%, and 32%, respectively. Prevalence of low birth weight was recorded as 14% in the district. The overall prevalence of overweight was 20% and 6% as per weight for height and weight for age criteria, respectively. The proportion of children with exclusive breastfeeding was observed to be decreasing with increasing age from birth to six months. About 70% of children were exclusively breastfed at the age of six months. Chi-square analyses revealed that parity and spacing are significant determinants of under-nutrition in children under two years in the Devbhumi Dwarka District. A multipronged and convergence approach is needed to combat the menace of child malnutrition.

Fatal outcome of non-Hodgkin B cell lymphoblastic lymphoma: A case report.

B-lymphoblastic lymphoma is more slow-growing than T-LL and can be found in the skin, bone, or lymph nodes. Lymphoblastic lymphoma can be spread all over the body parts, including the brain and spinal cord (cerebrospinal fluid), in a male to the testes. It is a type of non-Hodgkin lymphoma (NHL). Children are most affected by lymphoblastic lymphoma and about 35% of all NHLs in children. Here, we report a 2-year and 6-month-old male child was brought with complaints of swelling in the right testicular region in the last 6 days. The patient was alright 6 months back when he developed swelling in the temporal region, sudden in onset and not associated with pain. The further clinical investigation with hematological and radiological aids confirmed a final diagnosis of non-Hodgkin B cell lymphoblastic lymphoma.