Protocol change improves live birth and recurrent cycle cancellation rates after a previous IVF cycle cancellation: an analysis of 13 000 autologous cycles reported to SART CORS.

STUDY QUESTION: After an IVF cycle cancellation, does changing the stimulation protocol affect the odds of live birth and recurrent cancellation in the subsequent cycle? SUMMARY ANSWER: After IVF cycle cancellation, compared to those who repeated the same stimulation protocol, those who changed their protocol had higher odds of live birth and lower odds of recurrent cycle cancellation. WHAT IS KNOWN ALREADY: There is limited data addressing the effect of changing the stimulation protocol after an IVF cycle is cancelled during initial stimulation. The odds of live birth outcomes are not known so far in studies addressing the effect of changing the protocol. STUDY DESIGN, SIZE, DURATION: Retrospective Cohort Study using the 2014-2017 Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) database. PARTICIPANTS/MATERIALS, SETTING, METHODS: The data included 13 135 patients with a first autologous IVF cycle that resulted in a cycle cancellation and was followed by a second autologous cycle within the study period. We excluded fertility preservation cycles, supernumerary cycle attempts after the second IVF cycle attempt, and cycles with more than one stimulation protocol documented per cycle start. Patients who received the same protocol for both cycles (n = 6434) were compared to those who changed their protocol in the second cycle (n = 6701). Multivariable logistic regression analyses were performed to estimate the adjusted odds of live birth and recurrent cancellation. MAIN RESULTS AND THE ROLE OF CHANCE: Changing the protocol in the second cycle resulted 14% lower odds of recurrent cycle cancellation (P = 0.01) and 17% higher odds of live birth after fresh transfers (P = 0.04). When stratifying the data by specific combinations of protocol change (agonist flare, agonist suppression, antagonist), there was an increase in live birth when switching from antagonist to agonist suppression (odds ratio (OR) = 1.36, P = 0.03) and from agonist suppression to antagonist (OR = 1.73, P = 0.01) compared to those who repeated their same stimulation protocol. Specifically in poor responders, outcomes were worse when using the agonist flare protocol and significantly improved with the agonist suppression protocol. LIMITATIONS, REASONS FOR CAUTION: Comparison of response to stimulation between first and second cycles cannot be made in this study because the index IVF cycle was cancelled during ovarian stimulation, and thus there is no reportable outcome data for that cycle. Additionally, SART only tracks the three stimulation protocols addressed in this study and does not have data on more contemporary protocols that are used in poor responders thus limiting the generalizability of our findings. WIDER IMPLICATIONS OF THE FINDINGS: Using the SART CORS database, which includes >90% of all reported IVF cycles in the USA, provides generalizability to the demographically diverse IVF populations found here. In agreement with prior studies assessing change in IVF protocols, the agonist flare protocol seems to result in worse IVF outcomes, and based on our results, we believe that there is no role for the agonist flare protocol in patients with a prior poor response to stimulation. STUDY FUNDING/COMPETING INTEREST(S): None declared. TRIAL REGISTRATION NUMBER: N/A.

Serious Failure Modes After EVAR Are Device Specific.

OBJECTIVES: Type I and III endoleaks following endovascular aneurysm repair (EVAR) can lead to catastrophic events that require major re-interventions. We reviewed our experience with aortic endograft re-interventions for type I and III endoleaks and other serious failures among different devices. METHODS: We retrospectively reviewed patients with a prior EVAR who underwent open conversion (OC) or major endovascular intervention (MEI) (re-lining, cuff/limb extension, parallel graft) for type I/III endoleaks at our institution from 2002 to 2019. Baseline characteristics, procedural details, re-interventions, and outcomes were collected. RESULTS: A total of 229 patients (194 men) underwent re-interventions for type I and III endoleaks after EVAR (90 OC, 139 MEI) for devices implanted between 1997 and 2019. Average age at re-intervention was 78±8.5 years. A total of 135 (59%) were implanted at our institution, whereas 93 (41%) were referred. Median time to re-intervention was 4 years with 25% to 75% interquartile range (IQR) of 2.2-6.6 years. There was no significant difference in baseline demographics or type of re-interventions (OC/MEI) between device types. 42/229 (18%) presented with ruptured aneurysms, 20/229 (9%) were symptomatic, whereas the rest presented with asymptomatic radiographic findings. Type 1A endoleak was present in 146/229 (63.8%-72 with proximal migration), type IB in 46/229 (20.1%), type IIIA in 37/229 (16.6%), type IIIB in 15/229 (6.5%), and persistent aneurysm sac growth with no radiographic evidence of an endoleak in 6/229 (2.6%). Devices included most commercial products: AFX, Excluder, AneuRx, Ancure, Endurant, and Zenith. A smaller number of investigational devices accounted for the rest. Type 1A endoleak was the most common indication for re-intervention among all devices except for AFX and ancure devices, proximal migration was a frequent presentation with AneuRx. AFX devices more frequently presented with a type III and ancure devices more frequently presented with a type IB endoleak. CONCLUSIONS: Serious failure modes after EVAR differ between endografts and occur throughout the follow-up period. This is important to guide targeted interrogation of surveillance studies and follow-up schedules, even for discontinued devices, as well as comparisons between various series and estimation of EVAR failure rates. CLINICAL IMPACT: Surveillance after EVAR is critical for long term success of the repair, understanding of the differential modes of failure of every graft available is important in the longitudinal evaluation of these endografts. Equally important is the understanding of the modes of failure of legacy endografts that are no longer on the market but still being followed, in order to be able to tailor a surveillance regiemn and the evntual repair if needed.

Efficacy of Eating Disorder Focused Family Therapy for Adolescents With Anorexia Nervosa: A Systematic Review and Meta-Analysis.

OBJECTIVE: To systematically review and evaluate the efficacy of eating disorder focused family therapy (FT-ED) in comparison to all other forms of psychotherapy for children and adolescents with anorexia nervosa. A secondary aim is to assess the relative efficacy of different variations of FT-ED (e.g., shorter vs. longer dose, parent-focused). METHODS: A search with relevant terms was systematically conducted on four databases. Twenty-three publications across 18 randomized controlled trials met inclusion criteria. Outcomes of interest included variables related to weight, eating psychopathology, and remission status. Study quality was assessed, and data were extracted by two independent researchers. RESULTS: Adolescents receiving FT-ED gained significantly more weight by the end of treatment in comparison to those receiving individual psychotherapy. FT-ED that was delivered just to parents or to parents and child separately offered preferable weight outcomes and rates of recovery at the end of treatment in comparison to conjoint FT-ED. No other outcomes tested in the meta-analysis were statistically significant at the end of treatment or follow-up. DISCUSSION: Currently available data suggest the use of FT-ED in its conjoint or separated/parent focused format is the best outpatient treatment option for adolescents with anorexia nervosa when immediate weight gain is paramount. The variability of outcome measurement, including the tools used and timepoints chosen, limit comparison among no more than a handful of studies. The field would benefit from the standardization of measurement and reporting guidelines for future clinical trials. TRIAL REGISTRATION: PROSPERO number: CRD42023396263.

OBJETIVO: Revisar y evaluar sistemáticamente la eficacia de la terapia familiar centrada en el trastorno de conducta alimentaria (TF­TCA; FT­ED por sus siglas en inglés) en comparación con todas las demás formas de psicoterapia para niños y adolescentes que padecen anorexia nerviosa. Un objetivo secundario es evaluar la eficacia relativa de diferentes variaciones de la TF­TCA (por ejemplo, dosis más corta vs. más larga, centrada en los padres). MÉTODOS: Se realizó una búsqueda sistemática con términos relevantes en cuatro bases de datos. Veintitrés publicaciones de 18 ensayos controlados aleatorios cumplieron con los criterios de inclusión. Los resultados de interés incluyeron variables relacionadas con el peso, la psicopatología alimentaria y el estado de remisión. La calidad del estudio fue evaluada y los datos fueron extraídos por dos investigadores independientes. RESULTADOS: Los adolescentes que recibieron TF­TCA ganaron significativamente más peso al final del tratamiento en comparación con aquellos que recibieron psicoterapia individual. La TF­TCA que se administró solo a los padres o a padres e hijos por separado ofreció mejores resultados en el peso y tasas de recuperación al final del tratamiento en comparación con la TF­TCA conjunta. Ningún otro resultado probado en el metaanálisis fue estadísticamente significativo al final del tratamiento o durante el seguimiento. DISCUSIÓN: Los datos disponibles actualmente sugieren que el uso de la TF­TCA en su formato conjunto o separado/centrado en los padres es la mejor opción de tratamiento ambulatorio para adolescentes que padecen anorexia nerviosa cuando la ganancia de peso inmediata es primordial. La variabilidad en la medición de los resultados, incluyendo las herramientas utilizadas y los puntos temporales elegidos, limita la comparación entre no más de un puñado de estudios. El campo se beneficiaría de la estandarización de la medición y las directrices de reporte para futuros ensayos clínicos.

Effect of prostaglandin alone and in combination with trace minerals on the follicular and luteal dynamics, estrus response and pregnancy in sub-estrus buffaloes (Bubalus bubalis).

Sub-estrus is a condition when buffaloes do not display behavioural estrus signs, despite being in estrus and causes a delay in conception and increases the service period. The present study describes the effect of synthetic prostaglandin (PGF2α) alone and in combination with trace minerals on the follicular and corpus luteum (CL) dynamics, serum estradiol (E2) and progesterone (P4) concentration correlating estrus response and pregnancy outcome in sub-estrus buffaloes during the breeding season. A total of 50 sub-estrus buffaloes, identified through ultrasonography (USG) examination, were randomly allocated into three groups, viz. T1 (Synthetic PGF2α, Inj. Cloprostenol 500 µg, i.m, n = 17), T2 (Synthetic PGF2α + Trace mineral supplementation, Inj. Stimvet 1 mL/100 kg body weight, i.m., n = 17) and control (untreated; n = 16). Following treatment, 100% of sub-estrus buffaloes were induced estrus in the T1 and T2 groups, while only 18.75% were induced in the control. The CL diameter and serum P4 concentration were significantly lower at post-treatment, whereas the pre-ovulatory follicle (POF) size and serum E2 concentration were significantly higher in the T1 and T2 groups as compared to the control (p < .05). The buffaloes of the T2 group had a greater proportion of moderate intensities estrus than those of T1. Moreover, the proportion of buffaloes conceived in the T1 and T2 were 41.2% and 52.95%, respectively. The larger POF diameter and higher serum E2 concentration were associated with intense intensity estrus and higher conception rate (66.7%) in sub-estrus buffaloes. Similarly, CL regression rate, POF size and serum E2 concentration were relatively higher in the buffaloes conceived as compared to those not conceived. It is concluded that synthetic PGF2α in combination with trace minerals induces moderate to intense intensities estrus in a greater proportion of sub-estrus buffaloes and increases the conception rate during the breeding season. Moreover, behavioural estrus attributes correlating follicle and luteal morphometry, serum E2 and P4 concentration could be used to optimise the breeding time for augmenting the conception rate in sub-estrus buffaloes.

Next-generation hybrid technologies for the treatment of pharmaceutical industry effluents.

Water and industries are intangible units of the globe that are always set to meet the population's demand. The global population depends on one-third of freshwater increasing the demand. The increase in population along with urbanization has polluted the fresh water resources. The pharmaceutical industry is marked as an emerging contaminant of water pollution. The most common type of pharmaceutical drugs that are detected in the environment includes antibiotics, analgesics, NSAIDs, and pain-relieving drugs. These drugs alter the food chain of the organisms causing chaos mainly in the marine ecosystem. Pharmaceutical drugs are found only in shallow amounts (ng/mg) they have a huge impact on the living system. The consumption of water contaminated with pharmaceutical ingredients can disrupt reproduction, hormonal imbalance, cancer, and respiratory problems. Various methods are used to remove these chemicals from the environment. In this review, we mainly focused on the emerging hybrid technologies and their significance in the effective treatment of pharmaceutical wastewater. This review paper primarily elaborates on the merits and demerits of existing conventional technologies helpful in developing integrated technologies for the modern era of pharmaceutical effluent treatment. This review paper further in detail discusses the various strategies of eco-friendly bioremediation techniques namely biostimulation, bioaugmentation, bacterial degradation, mycoremediation, phytoremediation, and others for the ultimate removal of pharmaceutical contaminants in wastewater. The review makes clear that targeted and hybrid solutions are what the world will require in the future to get rid of these pharmacological prints.

IGF-1 stabilizes goat sperm mitochondrial transmembrane potential and reduces dna fragmentation.

BACKGROUND: Antioxidant present in sperm cells protects them from oxidative damage. However, sperm are more susceptible to peroxidative damages due to the loss of these enzymes during cryopreservation and their survival and fertility may be compromised. Insulin like growth factor-1 (IGF-1) has an antioxidant effect and could maintain sperm motility. OBJECTIVE: To improve seminal parameters, mitochondrial membrane potential (MMP), oxidative status and DNA integrity of buck semen after freeze-thawing by fortification of goat semen diluent with various concentrations of IGF-1. MATERIALS AND METHODS: Fifty ejaculates were collected and were extended with tris- citric acid- fructose diluent with 10% egg yolk and 6% glycerol with sperm concentrations of 1×108 mL-1. Post-cryopreserved sperm were assessed for motility and a range of other functional parameters. RESULTS: In post-thaw semen sperm motility, live sperm count, acrosome integrity, hypo-osmotic swelling positive spermatozoa, malondialdehyde (MDA), protein carbonyl content (PCC), TUNEL positive sperm differed significantly (P<0.05) with the various concentrations of IGF-1 used. Sperm functional parameters post-thawing were significantly (P<0.05) better in 250 ng/mL IGF-1. IGF-1 protects against lipid peroxidation by lowering MDA and PCC production, thus reducing the harmful effect of reactive oxygen species. The kidding percentage using the artificial insemination technique was significantly higher ( i.e., 40%) in the group supplemented with 250 ng/mL of IGF-1 than in the non-supplemented group (i.e., 30%). CONCLUSION: IGF-1 may be used to improve post-thaw semen quality and fertility as measured by actual kidding rate. Doi.org/10.54680/fr23610110312.

Design and Rationale of a Two-Armed Randomized Controlled Trial on Yoga/Brisk Walking-Based Lifestyle Modification on Dementia Risk Reduction, and Influence of ApoE Genotypes on the Intervention.

Background/Introduction: Though considered a late-onset disease, the 2020 report of the Lancet Commission emphasizes the necessity of conducting primary prevention trials with an approach of never too early in the life course for dementia prevention. Driven by the same notion, we hereby aim to compare the dementia risk reduction potential of two potential interventions, 48 weeks (12 months) of yoga and brisk walking, in middle-aged high-risk subjects. Design: A randomized controlled trial. Setting: Community in India. Participants: In total, 323 at-risk dementia subjects will be recruited from community settings through health awareness camps and door-to-door surveys across Delhi, India. Participants will be randomized into yoga or brisk-walking groups (1:1). The yoga intervention group will receive 60 contact yoga sessions per 60-min/day at the community parks, followed by continued tele-supervised home practice, further followed by at-home self-practice, and will be tested at 3-time points (baseline, 24-week and 48-week, post-randomization) to test the efficacy of the intervention. The control group will be asked to do brisk walking daily for 45 minutes at their convenience, followed by weekly telephone follow-ups. Applying the intention-to-treat principle, the primary endpoint will be the change from baseline at the 12th month in the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) Scores. Secondary outcomes will include the composite scores derived from a comprehensive neuropsychology battery, comprising the Trail Making Test, Digit Span Test, N Back, Color Trail, Animal Fluency Test, COWA (Controlled Oral Word Association Test), and Digit Symbol Substitution. The primary outcome will be analyzed using mixed-effect models for repeated measures, adjusted for covariates as fixed effects. The study has been prospectively registered (CTRI/2023/02/049746) on February 15, 2023. The protocol was conceptualized in 2021 and approved by the Institutional Ethics Committee of SVYASA. Recruitment began in February 2023 and is underway with patient enrollment. Conclusion: To our knowledge, this is the first controlled trial to investigate the longitudinal effects of a yoga-based intervention on dementia risk reduction using the CAIDE risk score. The findings of this trial will also provide insight into a better understanding of genotype-dependent responses to yoga intervention and open up avenues for understanding the implications of gene-intervention interactions for precision prevention using yoga.

Let it go, let it go: Stop measuring child maltreatment as a binary yes/no.

Numerous methods are used in the measurement of child maltreatment (CM) exposure. As a science, it is necessary that the field of CM research evaluate its measurement approaches periodically to ensure that the common approaches are the best approaches. A prominent method for measuring CM in research as a predictor variable is to conceptualize CM as a two-level, yes/no binary variable (e.g., 0 = No CM exposure, 1 = CM exposure). While there is no consensus on what method is the best approach for measuring CM, empirical evidence suggests that the binary measurement approach to CM has significant limitations. The current paper sought to progress the field of CM and trauma research forward by reviewing several lines of research demonstrating why the use of a binary yes/no CM measurement approach is problematic. As evidence for why a binary measurement of CM should be halted, this paper reviews research on: why the characteristics or details of CM exposure matter, risk of CM "contamination," and CM's relation with environmental or systemic factors. The ethical and clinical implications of a CM binary measurement approach are also discussed. Several recommendations for the field are provided on how researchers can improve the measurement of CM and ensure accurate and replicable studies are being published.

Quality control performance evaluation of uMI550 digital PET-CT by utilising LYSO crystal natural radioactivity of 176Lu.

PURPOSE: Quality Control (QC) of the Positron Emission Tomography-Computed Tomography (PET-CT) system must be performed prior to the PET-CT acquisition to ensure the reproducibility as per the manufacturer recommendation. In this study we have evaluated the performance of daily PET QC test by utilising lutetium yttrium oxyorthosilicate (LYSO) scintillation crystal natural radioactivity of 176Lu as a source of radiation to perform the PET uCare.iQC with uMI550 digital PET-CT system. This was also compared with existing radioactive external source-based QC test with other manufacturer PET-CT systems. METHOD: This radioactive source free daily QC study was performed on uMI550 digital PET-CT system. The daily QC data report was captured and interpreted. This PET-CT system has unique feature that utilises the inherent property of LYSO crystal that is 176Lu with natural radioactivity abundance of 2.6%. The Lutetium-176 (176Lu) radioactivity is used to perform the daily QC in PET in place of external radioactive source of Germanium-68 (68Ge). This feature work automatically in preschedule manner to complete the daily QC at preset time in the morning and system get ready after the QC test. RESULTS: Over 120 automatic PET daily uCare.iQC test were performed. The daily PET QC test was prescheduling setup for 6:00 am in every morning. No failure on daily QC test were observed. The QC parameters and system parameters consistency was observed. CONCLUSION: It was concluded that the daily PET QC can be performed by utilising LYSO crystal inherent natural radioactivity of 176Lu as a source of radiation to perform the test as replacement of external 68Ge radioactive source. IMPLICATION FOR PRACTICE: PET-CT daily QC by utilizing the 176Lu radioactivity of LYSO crystal results in reducing the radiation exposure to operation staff and reducing operational cost by elimination 68Ge shield source Phantom.

Patterns of Failure After Prostate-Only Radiotherapy in High-Risk Prostate Cancer: Implications for Refining Pelvic Nodal Contouring Guidelines.

PURPOSE: To study prostate specific membrane antigen - positron emission tomography (Ga68PSMA-PETCT) based patterns of relapse at biochemical failure (BCF) after prostate-only radiotherapy (PORT) in high-risk (HR) prostate cancer and its implications on pelvic contouring recommendations. METHODS AND MATERIALS: Patients with clinico-radiological high-risk node-negative prostate cancer treated with curative PORT and androgen deprivation therapy (ADT), either within the POP-RT randomised trial or off trial, who underwent a Ga68PSMA-PETCT upon BCF were included. Patterns of regional and distant recurrence on Ga68PSMA-PETCT were studied. Pelvic nodal recurrences were mapped with reference to the superior border of pubic symphysis. Pelvic lymph nodal caudal border (PLNcb) recommendations in the published contouring guidelines (RTOGcb, GETUGcb, PIVOTALcb, NRGcb, GFRUcb) were evaluated. RESULTS: Of the total 262 patients screened, 68 eligible patients were included (POP-RT trial 35 patients; off-trial 33 patients). Median follow-up was 91 months (IQR, 72-117) and median time to BCF was 65 months (IQR, 49-83). Regional and distant recurrence was seen in 31 (46%) and 31 (46%) patients, respectively. Of the nodal recurrences, nearly half (46%, 14/31) had no distant metastases and 64% (20/31) had a failure in the common iliac nodal region. The lower-most nodal recurrence was 20 mm cranial to the top of pubic symphysis (RTOGcb, GETUGcb, GFRUcb) and 10 mm cranial to the PIVOTALcb. The PLNcb recommended by NRG guideline (NRGcb) had an inter-patient variability of 32 mm, ranging from 16 mm above to 16 mm below the top of pubic symphysis, and the lower most nodal recurrence ranged from 4 mm to 36 mm cranial to NRGcb. CONCLUSION: Pelvic failures accounted for a major proportion of recurrences after prostate-only radiotherapy, with the caudal most nodal recurrence being 20 mm cranial to the top of pubic symphysis. This could have implications in defining the caudal border of contouring recommendations.

Relative resistance of Salmonella serotypes (Typhimurium, Infantis, and Reading) to peroxyacetic acid on chicken wings.

Peroxyacetic acid (PAA) is widely used as an antimicrobial in poultry processing. Recent salmonellosis outbreaks caused by Salmonella Infantis (SI) from chicken products and Salmonella Reading (SR) from turkey products have raised concerns about their enhanced resistance (compared to Salmonella Typhimurium [ST]) to commonly used antimicrobial interventions such as PAA. The objective of this research was to evaluate the efficacy of PAA against Salmonella serotypes (Typhimurium, Infantis and Reading), effect on product color and decomposition of PAA at different pH levels. Fresh chicken wings (0.45 kg) were inoculated with a cocktail (ca. 6 log CFU/mL) of nalidixic acid resistant ST, rifampicin resistant SI and kanamycin resistant SR. Inoculated chicken wings were immersed in PAA solutions (100 or 500 ppm; adjusted to either pH 8.5 or unadjusted natural pH) for either 10 s or 60 min to replicate treatments for chicken parts or whole carcasses, respectively. Treated chicken wings were rinsed in buffered peptone water (100 mL) containing sodium thiosulfate (0.1 %), serially diluted in peptone water supplemented with 200 ppm of nalidixic acid, rifampicin or kanamycin for enumeration of ST, SI, and SR respectively, and plated on APC Petrifilm. Immersion of chicken wings in 500 ppm PAA for 60 min resulted in greater microbial reductions (P ≤ 0.05) of ST, SI, SR of ca. Two log CFU/mL each, compared to 10 s treatment. Regardless of concentration and pH of PAA, increased exposure time (60 min vs. 10 s) resulted in greater reductions (P ≤ 0.05) of ST, SI, SR. ST was slightly more resistant to PAA solutions than S. Infantis and S. Reading (P ≤ 0.05) for all experimental conditions (PAA conc, pH, and exposure times). Faster decomposition of PAA (100 and 500 ppm) was observed at pH 8.5 compared to unadjusted, natural pH (P ≤ 0.05). Product color (lightness, L*) was not affected regardless of the PAA concentration, exposure time or the pH.

An Integrated Machine Learning Approach for Congestive Heart Failure Prediction.

Congestive heart failure (CHF) is one of the primary sources of mortality and morbidity among the global population. Over 26 million individuals globally are affected by heart disease, and its prevalence is rising by 2% yearly. With advances in healthcare technologies, if we predict CHF in the early stages, one of the leading global mortality factors can be reduced. Therefore, the main objective of this study is to use machine learning applications to enhance the diagnosis of CHF and to reduce the cost of diagnosis by employing minimum features to forecast the possibility of a CHF occurring. We employ a deep neural network (DNN) classifier for CHF classification and compare the performance of DNN with various machine learning classifiers. In this research, we use a very challenging dataset, called the Cardiovascular Health Study (CHS) dataset, and a unique pre-processing technique by integrating C4.5 and K-nearest neighbor (KNN). While the C4.5 technique is used to find significant features and remove the outlier data from the dataset, the KNN algorithm is employed for missing data imputation. For classification, we compare six state-of-the-art machine learning (ML) algorithms (KNN, logistic regression (LR), naive Bayes (NB), random forest (RF), support vector machine (SVM), and decision tree (DT)) with DNN. To evaluate the performance, we use seven statistical measurements (i.e., accuracy, specificity, sensitivity, F1-score, precision, Matthew's correlation coefficient, and false positive rate). Overall, our results reflect our proposed integrated approach, which outperformed other machine learning algorithms in terms of CHF prediction, reducing patient expenses by reducing the number of medical tests. The proposed model obtained 97.03% F1-score, 95.30% accuracy, 96.49% sensitivity, and 97.58% precision.

Metabolic syndrome burden, determinants and treatment status in an urban slum resettlement colony in Delhi, India.

BACKGROUND: Metabolic syndrome (MetS) in low-resource settings contributes to accentuated risk of cardiovascular disease, including stroke. The study objective was to estimate the prevalence, determinants and treatment status of MetS in an urban slum resettlement population in Delhi, India. METHODS: This study was conducted from February to May 2023. Multiphase sampling was conducted with 1910 individuals screened for abdominal obesity (AO), with 996 detected as having AO, of which, 400 were selected by simple random sampling and further evaluated for triglycerides (TGs), high-density lipoprotein (HDL) and fasting glucose levels. RESULTS: Among the 400 participants detected as having AO, 211 had evidence of MetS (52.75% [95% confidence interval 47.83 to 57.62]). The most prevalent combination of MetS clustering was for all five components (AO, diabetes mellitus [DM], hypertension [HTN], low HDL and high TGs; 14.69%), followed by AO, DM and HTN (12.32%). On adjusted analysis, the odds of having MetS was found to be independently associated with increasing age (≥40 y) but not sex. CONCLUSIONS: A high burden of MetS and suboptimal treatment status is prevalent in urban slum populations. Screening of individuals with AO, especially in those >40 y of age, can be an effective programmatic strategy for early diagnosis and management of MetS and its underlying components.

Unravelling groundwater contamination and health-related implications in semi-arid and cold regions of India.

Groundwater, a vital global resource, is essential for sustaining life and various human activities. However, its quality and availability face increasing threats from both natural and human-induced factors. Widespread contamination, arising from both natural origins and human activities such as agriculture, industry, mining, improper waste disposal, and wastewater release, poses significant risks to human health and water security. India, known for its dense population and pronounced groundwater challenges, serves as a prominent case study. Notably, in most of its regions, groundwater resources have been found to be severely contaminated by various chemical, biological, and radioactive contaminants. This review presents an examination of contamination disparities across various states of semi-arid and cold regions, encompassing diverse assessment methods. The studies conducted in semi-arid regions of North, South, West, and East India highlight the consistent presence of fluorides and nitrates majorly, as well as heavy metals in some areas, with values exceeding the permissible limits recommended by both the Bureau of Indian Standards (BIS) and the World Health Organization (WHO). These contaminants pose skeletal and dental threats, methemoglobinemia, and even cancer. Similarly, in cold regions, nitrate exposure and pesticide residues, reportedly exceeding BIS and WHO parameters, pose gastrointestinal and other waterborne health concerns. The findings also indicated that the recommended limits of several quality parameters, including pH, electrical conductivity, total dissolved solids (TDS), total hardness, and total alkalinity majorly surpassed. Emphasising the reported values of the various contaminant levels simultaneously with addressing the challenges and future perspectives, the review unravels the complex landscape of groundwater contamination and its health-related implications in semi-arid and cold regions of India.

Development and validation of a gel wax phantom to evaluate geometric accuracy and measurement of a hyperechoic target diameter in diagnostic ultrasound imaging.

Diagnostic ultrasound (US) scanners are generally evaluated using proprietary quality assurance (QA) phantoms, but their prohibitively high cost may prevent organizations to perform the necessary tests. This study aimed to develop a low-cost gel wax phantom with targets to determine the lateral and axial resolution and diameter of a hyperechoic target in an US scanner. The acoustic property (AP) of gel wax, which includes the speed of sound (cus), acoustic impedance (Z), and attenuation coefficient (µ), were determined for multiple transducers operating at 2.25, 5, 10, 15, and 30 MHz. These results were compared to the AP of soft tissue. Two polytetrafluoroethylene (PTFE) rectangular frames with holes separated by 5, 10, and 20 mm were constructed. Nylon filaments and stainless-steel disc (SS disc) (diameter = 16.8 mm) were threaded through the frames and suitably placed in gel wax to obtain orthogonal targets in the phantom. The target dimensions obtained from computerized tomography (CT) and US images of the phantom were compared for phantom validation. The average cus=1431.4 m/s, mass density ρ = 0.87 g/cm3, Z = 1.24 MRayls, and µ ranged from 0.7 to 0.98 dB/cm/MHz for gel wax at 22 °C. The US image measurement exhibited a maximum error in determining the diameter of the SS disc, resulting in a value of 18 mm instead of its actual value of 16.8 mm. The phantom volume decreased by 1.8% in 62 weeks. The present phantom is affordable, stable, customizable, and can be used to evaluate diagnostic US scanners across multiple centers.

Recent advances in sensing toxic nerve agents through DMMP model simulant using diverse nanomaterials-based chemical sensors.

Recent terrorist assaults have demonstrated the need for the exploration and design of sustainable and stable chemical sensors with quick reaction times combined with great sensitivity. Among several classes of chemical warfare agents, nerve agents have been proven to be the most hazardous. Even short-term exposure to them can result in severe toxic effects. Human beings inadvertently face the after-effects of these chemicals even several years after these chemicals were used. Due to the extreme toxicity and difficulty in handling, dimethyl methylphosphonate (DMMP), a simulant of nerve agents with much lesser toxicity, is frequently used in laboratories as a substitute. Having a chemical structure almost identical to those of nerve agents, DMMP can mimic the properties of nerve agents. Through this paper, authors have attempted to introduce the evolution of several chemical sensors used to detect DMMP in recent years, including field-effect transistors, chemicapacitors, chemiresistors, and mass-sensitive sensors. A detailed discussion of the role of nanomaterials as chemical sensors in the detection of DMMP has been the main focus of the work through a comprehensive overview of the research on gas sensors that have been reported making use of the properties of a wide range of nanomaterials.

Comparative Analysis of the Efficacy of Intrathecal Fentanyl and Magnesium Sulphate as an Adjuvant to Bupivacaine: A Double-Blinded Randomized Controlled Trial.

BACKGROUNDS: The duration and potency of the subarachnoid block (SAB) can be enhanced by incorporating spinal additives into local anesthetics. In this study, the effectiveness of intrathecal fentanyl and magnesium sulphate as adjuvant anesthetics to 0.5% hyperbaric bupivacaine is compared in regard to the onset and duration of sensory and motor block, along with circulatory variables. METHODS: After authorization of ethical committee , 100 patients belonging to American Society of Anesthesiologists grades I and II, were chosen and split into two groups with 50 patients each. A SAB was administered; Group 1 was given 2.5 mL of 0.5% hyperbaric bupivacaine + 0.5 mL of fentanyl (25 µg), and Group 2 received 2.5 mL of 0.5% hyperbaric bupivacaine + 0.2 mL of magnesium sulphate (100 mg). 0.3 mL of distilled water was added to both groups making an intrathecal drug volume of 3.0 mL. Perioperative circulatory parameters and sensory and motor block features are noted and compared. Version 21.0 of Statistical Package for the Social for Windows was used for all statistical calculations. RESULTS: Group 1 had a faster onset of sensory and motor block in comparison to Group 2. However, both groups were statistically similar with regard to the duration of sensory and motor blockade, visual analog scale scores, intra and postoperative hemodynamic parameters. CONCLUSION: 0.5 mL fentanyl functions as a better spinal adjuvant to 0.5% hyperbaric bupivacaine compared to magnesium sulphate, block but both the agents had similar duration of block, postoperative analgesia and hemodynamic parameters.

Understanding mammary activity in red-rumped agouti and implications for management and conservation of this Neotropical game species / Compreendendo a atividade mamária na cutia e as implicações para o manejo e a conservação desta espécie cinegética Neotropical

Abstract The red-rumped agouti (Dasyprocta leporina) produces precocial young and is the most hunted and farmed game species in several Neotropical countries. An understanding of the reproductive biology, including the relationship between litter size and teat functionality is crucial for conservation management of this animal. In precocial mammals, as the red-rumped agouti, maintaining maternal contact to learn foraging patterns may be more important than the energy demands and nutritional constraints during lactation and suckling may not play important roles when compared to altricial mammals. Therefore, in this study we evaluated the relationship between mammary functionality with litter size, litter birth weight, and parturition number in captive red-rumped agouti. Functionality was assessed by manual palpation of teats from un-sedated females (N=43). We compared the average birth weight of all newborns, male newborns and female newborns among agoutis with different litter sizes and different parturitions by one way ANOVA's, while Pearson's Chi-squared tests were used to detect relationships between teat functionality, litter size, and parturition number. Parturition number had no effect on the mean birth weight of all young (F0.822, P > 0.05), male young (F0.80, P > 0.05) or female young (F0.66, P > 0.05) in the litters. We found (i) no significant correlations (P > 0.05) between teat functionality and litter size and (ii) no significant correlations (P > 0.05) between teat functionality and parturition number. This suggests that whilst all teat pairs were functional, functionality was a poor indicator of litter size; suggesting that female agouti young may not have a high dependency on maternal nutrition; an possible evolutionary strategy resulting in large wild populations; hence its popularity as a game species.

Resumo A cutia (Dasyprocta leporina) produz filhotes precoces, e é a espécie cinegética mais caçada e criada em muitos países neotropicais. O entendimento da biologia reprodutiva, incluindo a relação entre o tamanho da ninhada e a funcionalidade das glândulas mamárias é crucial para o manejo conservacionista deste animal. Nos mamíferos precoces, como a cutia, manter o contato materno para a aprendizagem de padrões de forrageamento pode ser mais importante do que a demanda energética e de restrição nutricional durante a lactação, e a amamentação pode não desempenhar um papel importante quando comparado aos mamíferos altriciais. Portanto, neste estudo nós avaliamos a relação entre a funcionalidade mamária com o tamanho da ninhada, peso ao nascer da ninhada, e o número de partos em cutias cativas. A funcionalidade foi avaliada por meio de palpação manual das glândulas mamárias em fêmeas não sedadas (N=43). Nós comparamos a média do peso ao nascer de todos os recém-nascidos, macho e fêmeas recém-nascidos entre cutias com diferentes tamanhos de ninhadas e diferentes parturições, por meio da análise one-way ANOVA unifatorial; enquanto o teste do chi-quadrado de Pearson foi utilizado para detectar as relações entre a funcionalidade da glândula mamária, o tamanho da ninhada e o número de partos. O número de partos teve efeito na média de peso ao nascer dos filhotes (F0,822, P > 0,05), filhotes machos (F0,80, P > 0,05) ou filhotes fêmeas (F0,66, P > 0,05) nas ninhadas. A análise bivariada de Pearson (i) não mostrou correlação (P > 0,05) entre a funcionalidade da glândula mamária e o tamanho da ninhada e (ii) nenhuma correlação significativa (P > 0,05) entre a funcionalidade da glândula mamária e o número de parições. Os resultados sugerem que, embora todos os pares de tetas fossem funcionais, as cutias recém-nascidas podem não depender da nutrição materna para sobreviver; .embora todos os pares de tetas sejam funcionais, as cutias recém nascidas aparentemente não dependem da nutrição materna para sua sobrevivência; esta é, provavelmente, uma estratégia evolutiva que resulta em grandes populações da cutia em vida livre; e que pode explicar sua popularidade como espécie cinegética

Understanding mammary activity in red-rumped agouti and implications for management and conservation of this Neotropical game species

Abstract The red-rumped agouti (Dasyprocta leporina) produces precocial young and is the most hunted and farmed game species in several Neotropical countries. An understanding of the reproductive biology, including the relationship between litter size and teat functionality is crucial for conservation management of this animal. In precocial mammals, as the red-rumped agouti, maintaining maternal contact to learn foraging patterns may be more important than the energy demands and nutritional constraints during lactation and suckling may not play important roles when compared to altricial mammals. Therefore, in this study we evaluated the relationship between mammary functionality with litter size, litter birth weight, and parturition number in captive red-rumped agouti. Functionality was assessed by manual palpation of teats from un-sedated females (N=43). We compared the average birth weight of all newborns, male newborns and female newborns among agoutis with different litter sizes and different parturitions by one way ANOVAs, while Pearsons Chi-squared tests were used to detect relationships between teat functionality, litter size, and parturition number. Parturition number had no effect on the mean birth weight of all young (F0.822, P > 0.05), male young (F0.80, P > 0.05) or female young (F0.66, P > 0.05) in the litters. We found (i) no significant correlations (P > 0.05) between teat functionality and litter size and (ii) no significant correlations (P > 0.05) between teat functionality and parturition number. This suggests that whilst all teat pairs were functional, functionality was a poor indicator of litter size; suggesting that female agouti young may not have a high dependency on maternal nutrition; an possible evolutionary strategy resulting in large wild populations; hence its popularity as a game species.

Resumo A cutia (Dasyprocta leporina) produz filhotes precoces, e é a espécie cinegética mais caçada e criada em muitos países neotropicais. O entendimento da biologia reprodutiva, incluindo a relação entre o tamanho da ninhada e a funcionalidade das glândulas mamárias é crucial para o manejo conservacionista deste animal. Nos mamíferos precoces, como a cutia, manter o contato materno para a aprendizagem de padrões de forrageamento pode ser mais importante do que a demanda energética e de restrição nutricional durante a lactação, e a amamentação pode não desempenhar um papel importante quando comparado aos mamíferos altriciais. Portanto, neste estudo nós avaliamos a relação entre a funcionalidade mamária com o tamanho da ninhada, peso ao nascer da ninhada, e o número de partos em cutias cativas. A funcionalidade foi avaliada por meio de palpação manual das glândulas mamárias em fêmeas não sedadas (N=43). Nós comparamos a média do peso ao nascer de todos os recém-nascidos, macho e fêmeas recém-nascidos entre cutias com diferentes tamanhos de ninhadas e diferentes parturições, por meio da análise oneway ANOVA unifatorial; enquanto o teste do chi-quadrado de Pearson foi utilizado para detectar as relações entre a funcionalidade da glândula mamária, o tamanho da ninhada e o número de partos. O número de partos teve efeito na média de peso ao nascer dos filhotes (F0,822, P > 0,05), filhotes machos (F0,80, P > 0,05) ou filhotes fêmeas (F0,66, P > 0,05) nas ninhadas. A análise bivariada de Pearson (i) não mostrou correlação (P > 0,05) entre a funcionalidade da glândula mamária e o tamanho da ninhada e (ii) nenhuma correlação significativa (P > 0,05) entre a funcionalidade da glândula mamária e o número de parições. Os resultados sugerem que, embora todos os pares de tetas fossem funcionais, as cutias recém-nascidas podem não depender da nutrição materna para sobreviver; .embora todos os pares de tetas sejam funcionais, as cutias recém nascidas aparentemente não dependem da nutrição materna para sua sobrevivência; esta é, provavelmente, uma estratégia evolutiva que resulta em grandes populações da cutia em vida livre; e que pode explicar sua popularidade como espécie cinegética