Longitudinal outcomes of COVID-19 in solid organ transplant recipients from 2020 to 2023.

Data regarding coronavirus disease 2019 (COVID-19) outcomes in solid organ transplant recipients (SOTr) across severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) waves, including the impact of different measures, are lacking. This cohort study, conducted from March 2020 to May 2023 in Toronto, Canada, aimed to analyze COVID-19 outcomes in 1975 SOTr across various SARS-CoV-2 waves and assess the impact of preventive and treatment measures. The primary outcome was severe COVID-19, defined as requiring supplemental oxygen, with secondary outcomes including hospitalization, length of stay, intensive care unit (ICU) admission, and 30-day and 1-year all-cause mortality. SARS-CoV-2 waves were categorized as Wildtype/Alpha/Delta (318 cases, 16.1%), Omicron BA.1 (268, 26.2%), Omicron BA.2 (268, 13.6%), Omicron BA.5 (561, 28.4%), Omicron BQ.1.1 (188, 9.5%), and Omicron XBB.1.5 (123, 6.2%). Severe COVID-19 rate was highest during the Wildtype/Alpha/Delta wave (44.6%), and lower in Omicron waves (5.7%-16.1%). Lung transplantation was associated with severe COVID-19 (OR: 4.62, 95% CI: 2.71-7.89), along with rituximab treatment (OR: 4.24, 95% CI: 1.04-17.3), long-term corticosteroid use (OR: 3.11, 95% CI: 1.46-6.62), older age (OR: 1.51, 95% CI: 1.30-1.76), chronic lung disease (OR: 2.11, 95% CI: 1.36-3.30), chronic kidney disease (OR: 2.18, 95% CI: 1.17-4.07), and diabetes (OR: 1.97, 95% CI: 1.37-2.83). Early treatment and ≥3 vaccine doses were associated with reduced severity (OR: 0.29, 95% CI: 0.19-0.46, and 0.35, 95% CI: 0.21-0.60, respectively). Tixagevimab/cilgavimab and bivalent boosters did not show a significant impact. The study concludes that COVID-19 severity decreased across different variants in SOTr. Lung transplantation was associated with worse outcomes and may benefit more from preventive and early therapeutic interventions.

Improving adolescents' dietary behavior through teacher-delivered cancer prevention education: a school-based cluster randomized intervention trial in urban Rajasthan.

BACKGROUND: Dietary practices are one of the most common modifiable risk factors for cancers. Foods rich in dietary fibers are considered protective, meanwhile fast & junk foods are risk for common cancers. Adolescence period is marked by habit formation and is thus suited for delivering behavioral intervention. Schools offer an optimal setting for planning and executing these interventions to a large number of adolescents. OBJECTIVE: To assess the effectiveness of a teacher-delivered cancer-prevention education in changing dietary behaviors of school going adolescents. METHODS: A cluster randomized trial was conducted in government secondary and senior secondary schools with schools as clusters. A minimum required sample of 1032 students was estimated from 16 schools with 1:1 allocation in intervention and non-intervention groups. Dietary behaviors were recorded as dichotomous variable. The determinants were recorded as per theory of planned behavior framework using Likert-scale. Two teachers from each intervention school were trained to deliver cancer prevention education with focus on role of dietary behavior. Pre-post training assessment of teachers' knowledge towards common cancers was done using a self-administered questionnaire. Gender adjusted difference-in-difference analysis was done to assess intervention effect on both healthy and unhealthy behaviors. RESULTS: In selected schools all students from classes 8 to 10 were approached and a total of 1224 students were enrolled, of whom 1096 completed the study. The study recorded significant improvement in scores of students from intervention group compared to non-intervention group for their attitude, subjective norms, perceived behavioral control and intention towards consuming healthy and avoiding unhealthy foods. The intervention was effective in significantly improving the proportion of students limiting fried/fast/packed food & sugar sweetened beverages (OR:1.51, 95%CI:1.08,2.12,p:0.017), and consuming fruits & vegetables daily (OR:1.55, 95%CI:1.08,2.22, p:0.017) while adjusting effect of gender. CONCLUSION: Classroom-based cancer prevention education delivered through teachers during regular working hours is effective in improving dietary behaviors and its determinants among adolescent students. Thus, we recommend integrating a section focusing on the role of diet in cancer prevention and other lifestyle diseases in the existing school curriculum. TRIAL REGISTRATION: The trial was registered under Clinical Trial Registry-India with registration number CTRI/2018/12/016586, dated-10/12/2018.

COVID-19 Reinfection Has Better Outcomes Than the First Infection in Solid Organ Transplant Recipients.

BACKGROUND: Solid organ transplant recipients face an increased risk of severe coronavirus disease 2019 (COVID-19) and are vulnerable to repeat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. In nonimmunocompromised individuals, SARS-CoV-2 reinfections are milder likely because of cross-protective immunity. We sought to determine whether SARS-CoV-2 reinfection exhibits milder manifestations than primary infection in transplant recipients. METHODS: Using a large, prospective cohort of adult transplant patients with COVID-19, we identified patients with SARS-CoV-2 reinfections. We performed a 1:1 nearest neighbor propensity score matching to control potential confounders, including the COVID-19 variant. We compared outcomes including oxygen requirement, hospitalization, and intensive care unit admission within 30 d after diagnosis between patients with reinfection and those with the first episode of COVID-19. RESULTS: Between 2020 and 2023, 103 reinfections were identified in a cohort of 1869 transplant recipients infected with SARS-CoV-2 (incidence of 2.7% per year). These included 50 kidney (48.5%), 27 lung (26.2%), 7 heart (6.8%), 6 liver (5.8%), and 13 multiorgan (12.6%) transplants. The median age was 54.5 y (interquartile range [IQR], 40.5-65.5) and the median time from transplant to first infection was 6.6 y (IQR, 2.8-11.2). The time between the primary COVID-19 and reinfection was 326 d (IQR, 226-434). Three doses or more of SARS-CoV-2 vaccine are received by 87.4% of patients. After propensity score matching, reinfections were associated with significantly lower hospitalization (5.8% versus 19.4%; risk ratio, 0.3; 95% CI, 0.12-0.71) and oxygen requirement (3.9% versus 13.6%; risk ratio, 0.29; 95% CI, 0.10-0.84). In a within-patient analysis only in the reinfection group, the second infection was milder than the first (3.9% required oxygen versus 19.4%, P < 0.0001), and severe first COVID-19 was the only predictor of severe reinfection. CONCLUSIONS: Transplant recipients with COVID-19 reinfection present better outcomes than those with the first infection, providing clinical evidence for the development of cross-protective immunity.

Stereoselective analysis of chiral pesticides: a review.

Chiral organic pollutants, including pesticides, herbicides, medicines, flame retardants, and polycyclic musk, represent a significant threat to both the environment and human health. The presence of asymmetric centers in the structure of chiral pesticides introduces stereoisomers with distinct distributions, fates, biomagnification capacities, and cytotoxicities. In aquatic environments, pesticides, as persistent/pseudo-persistent compounds, have been detected in substantial quantities, posing severe risks to non-target species and, ultimately, public health through water supply and food exposures. In response to this environmental challenge, stereoselective analytical methods have gained prominence for the identification of pesticide/drug enantiomers in recent years. This review examines the environmental impact of chiral pesticides, emphasizing the distinct biological activities and distribution patterns of their stereoisomers. By highlighting the advancements in liquid chromatography for enantiomeric analysis, the review aims to underscore the urgent need for a comprehensive understanding of these pollutants to facilitate informed remediation strategies and ensure the safer dispersal of chiral organic pollutants in the environment, thereby addressing the potential risks they pose to ecosystems and human health. Future research should focus on developing sustainable and efficient methodologies for the precise analysis of stereoisomers in complex matrices, particularly in sewage water, emphasizing the importance of sewage processing plants in ensuring water quality.

Recent advances in the antioxidant activity of metal-curcumin complexes: a combined computational and experimental review.

Curcumin, an extensively studied phytochemical compound, has gained attention for its potential therapeutic applications across a spectrum of diseases. Its notable attributes include its relatively high tolerability within the human body and its perceived absence of adverse side effects. This review article presents a comprehensive overview of the antioxidant effects exhibited by complexes formed by curcumin and curcumin derived ligands with metals like Mn, Cu, Fe, Zn, Ga and In, which leads to toxic effects beyond a certain limit, based on both experimental and theoretical findings. Additionally, the discussion delves into metal-curcumin complexes characterized by stoichiometries of 1:1 and 1:2, exploring their geometric arrangements and corresponding antioxidant activity, as highlighted in recent studies. These complexes hold the promise of improving curcumin's solubility, stability, and bioavailability, potentially augmenting its overall therapeutic potential and expanding its scope for medical applications.

Untapped potential of commercial drivers in providing post-crash care to road traffic accident victims: A cross-sectional study from fast urbanizing city of Jodhpur, India.

Objectives: Most road traffic accident (RTA) deaths occur before victim reaches a definitive trauma care facility. The aim of the study was to determine the role of commercial drivers toward providing post-crash care to RTA victims in Jodhpur, Rajasthan. Materials and Methods: This cross-sectional study assessed the role of commercial auto-rickshaw and cab drivers for providing post-crash care in urban Jodhpur during 2019-2020. Eligible participants volunteering for the study were included from taxi and auto stands in urban Jodhpur. A pre-tested questionnaire was administered by a trained interviewer. Data analysis was done using SPSS v23.0. Summary measures in terms of frequencies, means, and range are reported. Chi-square test, Fisher's Exact test, and Multivariate Logistic Regression analysis were done for statistical associations. Results: Two hundred male participants completed the study with a mean age of 37.74 (8.96) years having an average work experience as commercial drivers of more than 10 years. Over 70% of participants witnessed RTA in the past year and 52% provided care to victims. The knowledge of post-crash care was most affected by their education level (adjusted odds ratio [aOR]: 1.778, 95% confidence interval [CI]: 0.958, 3.301), whereas the intended post-crash care practices were significantly better among participants with previous training (aOR: 15.376, 95% CI: 2.149, 110.017). Conclusion: The current study establishes the role of commercial drivers as first responders at accident sites in the fast urbanizing city of Jodhpur, Rajasthan. Systematic capacity building initiatives of commercial drivers to salvage RTA victims have potential to strengthen pre-hospital trauma care continuum in non-metro districts of India experiencing high burden of accidents.

Diagnosis and Management of Latent Tuberculosis Infection: Updates.

India has the largest problem of tuberculosis (TB) infection globally (estimated at about 35-40 crores cases), and around 18-36 lakh develop active tuberculosis annually. Latent TB is defined as a state of persistent immune response to stimulation by Mycobacterium tuberculosis antigens with no evidence of clinically manifested active TB. The progression of a latent infection to active tuberculosis increases several-fold in children < 5 years of age and in people with some or the other form of an immunocompromising condition. Therefore, to cater to this gigantic problem of tuberculosis, it is necessary to have awareness about latent tuberculosis infection (LTBI) amongst clinicians and to prioritise its diagnosis and treatment in high-risk groups. India plans to end TB well before the deadline set by the World Health organisation (WHO). However, this can only be achieved with effective strategies targeting LTBI. Multiple treatment regimens have been approved for LTBI treatment, and all have comparable efficacy. The selection of one regimen over the other depends on various factors, such as availability, risk of adverse events, age, and drug interactions. Recently, the WHO, as well as the Revised National TB Control Programme (RNTCP), have updated their guidelines on TB preventive treatment in 2020 and 2021, respectively. This review has been especially prepared to acknowledge the differences in approach to LTBI in developed and developing countries.

Circuit-Level Modeling and Simulation of Wireless Sensing and Energy Harvesting With Hybrid Magnetoelectric Antennas for Implantable Neural Devices.

A magnetoelectric antenna (ME) can exhibit the dual capabilities of wireless energy harvesting and sensing at different frequencies. In this article, a behavioral circuit model for hybrid ME antennas is described to emulate the radio frequency (RF) energy harvesting and sensing operations during circuit simulations. The ME antenna of this work is interfaced with a CMOS energy harvester chip towards the goal of developing a wireless communication link for fully integrated implantable devices. One role of the integrated system is to receive pulse-modulated power from a nearby transmitter, and another role is to sense and transmit low-magnitude neural signals. The measurements reported in this paper are the first results that demonstrate simultaneous low-frequency wireless magnetic sensing and high-frequency wireless energy harvesting at two different frequencies with one dual-mode ME antenna. The proposed behavioral ME antenna model can be utilized during design optimizations of energy harvesting circuits. Measurements were performed to validate the wireless power transfer link with an ME antenna having a 2.57 GHz resonance frequency connected to an energy harvester chip designed in 65nm CMOS technology. Furthermore, this dual-mode ME antenna enables concurrent sensing using a carrier signal with a frequency that matches the second 63.63 MHz resonance mode. A wireless test platform has been developed for evaluation of ME antennas as a tool for neural implant design, and this prototype system was utilized to provide first experimental results with the transmission of magnetically modulated action potential waveforms.

Correlation Between Synovial Fluid Levels of Matrix Metalloproteinase's (MMP-1, MMP-3, and MMP-9) and TNF-α with the Severity of Osteoarthritis Knee in Rural Indian Population.

Background: In India, 22% to 39% of the ageing population suffers from degenerative knee osteoarthritis (OA), making it the most prevalent joint disorder in the knee. MMP-1, MMP-3, and MMP-9 protein expression levels have all been associated with OA. The aim of the present study was to establish a relationship between synovial fluid levels of matrix metalloproteinases (MMP-1, MMP-3, and MMP-9), and tumour necrosis factor-alpha (TNF-α) with different Kellgren-Lawrence Grading scale as per the severity of knee osteoarthritis (OA). Methods: This hospital-based observational study included 87 individuals with knee osteoarthritis examined at the orthopaedics department outpatient clinic at the tertiary care teaching hospital in rural area of north India. In-person interviews were conducted to gather data, through a semi-structured, pretested interview schedule. To determine the degree and severity of OA, the levels of the enzymes matrix metalloproteinase MMP-1, MMP-3, and MMP-9 as well as tumour necrosis factor (TNF-α) were assessed in the synovial fluid of knee of each study participant. Results: The levels of MMP-1, MMP-3, MMP-9, and TNF-α in synovial fluid were significantly correlated with the severity of osteoarthritis as determined by the Kellgren-Lawrence Grading Scale. Age, duration of symptoms and BMI showed a strong positive and significant correlation with biochemical markers (MMP-1, MMP-3, MMP-9, and TNF-α) in synovial fluid of Knee. Conclusion: Level of biochemical markers (MMP-1, -3, -9, and TNF-α) in synovial fluid act as diagnostic markers and have a positive correlation with the severity of osteoarthritis knee, age, weight/BMI and duration of disease. However, no significant correlation was found between the level of aforementioned biochemical markers with sex, height, inflammation of the knee, morning stiffness, and age of onset of disease.

Anterolateral and Medial Locking Compression Plates for the Management of Distal Tibial Fractures: A Comparative Prospective Study.

INTRODUCTION: Open/close reduction (OR/CR) and internal fixation (IF) of displaced fractures of distal tibia with either a medial or anterolateral plate is a commonly performed procedure. Anterolateral plating avoids an incision along the medial subcutaneous border of tibia and has been shown to have reduced risk of wound complications. The aim of our study was to determine the functional outcome of these fractures treated with anterolateral and medial distal tibial locking compression plates. METHODS: This was a prospective study that included 60 patients with distal tibial fractures (close or grade I open injury) divided into two groups with 30 patients in each where one group was treated with OR/CR and IF using an anterolateral distal tibial locking plate (Group A) and the other using a medial distal tibial locking plate (Group B). The duration of surgery and intraoperative blood loss and time to union were recorded for all the patients. Functional evaluation was done at one year in terms of pain, function and alignment using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, and complications, if any, were noted. RESULTS: Both the groups were comparable in terms of age, gender, time of presentation, AO classification and presence of wound. The mean duration of surgery as well as the intraoperative blood loss were more in the anterolateral plate group than in the medial plate group, but the difference was statistically insignificant. Ten patients (33%) with medial plates had symptomatic hardware and 7 (23.3%) underwent removal while only 3 (10%) patients in the anterolateral plate group had similar complaints and none had to undergo removal. Two patients with anterolateral plate and one with medial plate had malunion. The mean time to fracture union as well as the rate of infection was less and the functional outcome at one year was better in the group treated with anterolateral plates as compared to the one with medial plates, but the difference again was not statistically significant for all the parameters. CONCLUSION: With reduced risk of soft tissue complications and by obviating the need for implant removal, anterolateral plates can prove to be a better alternative to the medial plates especially in elderly patients in the management of these fractures.

Immunogenicity and Safety of Booster SARS-CoV-2 mRNA Vaccine Dose in Allogeneic Hematopoietic Stem Cell Transplantation Recipients.

Allogeneic hematopoietic stem cell transplantation (HSCT) recipients are susceptible to severe outcomes of Coronavirus disease 2019 (COVID-19). Most guidelines recommend a fourth dose (ie, booster) of COVID-19 vaccine to reduce the infection risk, and observational studies are needed to determine the immunogenicity and safety of the booster dose in this population. The primary outcome was to determine the quantitative anti-receptor-binding domain (RBD) antibody titers after the fourth dose of the COVID-19 vaccine. The secondary outcomes included adverse effects and all-cause mortality. This single-group prospective cohort included allogeneic HSCT recipients age ≥18 years who received their fourth dose of COVID-19 mRNA vaccine between December 15, 2021, and August 2, 2022. We excluded patients with a history of COVID-19 diagnosis and those who received i.v. Ig within 21 days of antibody testing or rituximab within 6 months before study entry. We used regression models to determine the contributing factors significantly associated with post-fourth dose anti-RBD titer. Sixty-seven patients (median age, 59.5 years; IQR, 53.5 to 65.5 years; 33 males [61%]) received the fourth dose of vaccine, and 54 were included in the anti-RBD titer analysis. The median anti-RBD titers at 4 to 6 weeks after the third and fourth doses differed significantly (13,350 U/mL [IQR, 2618 to 34,740 U/mL] and 44,500 U/mL [IQR, 11,163 to 84,330 U/mL], respectively; P < .0001). In univariate analysis, the post-third dose anti-RBD titer (ß = .70; 95% CI, .54 to .87; P < .001) and treatment with mycophenolate compounds (ß = -1.05; 95% CI, -1.97 to -1.12; P = .03) significantly predicted the antibody response to the fourth dose. In multivariate analysis, the inverse association between treatment with mycophenolate compounds and the post-fourth dose anti-RBD antibody titer was not significant (ß = -.57; 95% CI, -1.32 to .19; P = .14), whereas the significant association between the anti-RBD titers following the third and fourth doses did not change considerably (ß = .66; 95% CI, .47 to .86; P < .001). The most frequent adverse event was vaccination site soreness (44%), followed by fatigue (16%), myalgia (4%), and headache (2%). No recipient experienced new or worsened preexisting graft-versus-host disease within 40 days of vaccination, and no patient died. Six patients (11%) developed breakthrough severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection not associated with hospitalization or severe outcomes. The fourth dose of the COVID-19 vaccine appears to be highly immunogenic and safe in allogeneic HSCT recipients. Further studies are needed to determine the neutralizing antibody titers against SARS-CoV-2 subvariants and the effectiveness and immunogenicity of bivalent vaccines in allogeneic HSCT recipients.

Highly Scalable and Inherently Safer Preparation of Di, Tri and Tetra Nitrate Esters Using Continuous Flow Chemistry.

Nitrate esters are important organic compounds having wide application in energetic materials, medicines and fuel additives. They are synthesized through nitration of aliphatic polyols. But the process safety challenges associated with nitration reaction makes the production process complicated and economically unviable. Herein, we have developed a continuous flow process wherein polyol and nitric acid are reacted in a microreactor to produce nitrate ester continuously. Our developed process is inherently safer and efficient. The process was optimized for industrially important nitrate esters containing two, three and four nitro groups. Substrates include glycol dinitrates: 1,2-propylene glycol dinitrate (PGDN), ethylene glycol dinitrate (EGDN), diethylene glycol dinitrate (DEGDN), triethylene glycol dinitrate (TEGDN); trinitrates: trimethylolethane trinitrate (TMETN), 1,2,4-butanetriol trinitrate (BTTN); and tetranitrates: erythritol tetranitrate (ETN). The optimized process for each molecule provided yield >90 % in a short residence time of 1 min corresponding to a space time yield of >18 g/h/mL of reactor volume.

Free radical scavenging activity of gallic acid toward various reactive oxygen, nitrogen, and sulfur species: a DFT approach.

Gallic acid is a well-recognized naturally occurring compound possessing antioxidant activities. The free radical scavenging ability of gallic acid for fifty reactive species, such as oxygen, nitrogen, and sulfur-containing species, has been studied using the formal hydrogen atom transfer mechanism. The theoretical studies have been conducted in the gas phase and aqueous solution at M05-2X/6-311++G** level using the density functional theory (DFT) calculations. The relative damaging potential of all the reactive species has been compared by investigating their hydrogen atom and electron affinity. Furthermore, a comparison of their relative reactivity was made by evaluating several global chemical reactivity descriptors. Additionally, the feasibility of scavenging the species by gallic acid has been studied by computing the redox potentials and equilibrium constants for the overall process in the aqueous solution.

Synthesis of Picramide Using Nitration and Ammonolysis in Continuous Flow.

This paper describes a safer, scalable and continuous process for synthesis of picramide. The process consists of two steps: step-1. nitration of p-nitroanisole (PNAN) to 2,4,6-trinitrianisole (TNAN); step-2. ammonolysis of TNAN to picramide. Both the steps were optimized in flow, with yield of 90% and 98% in step-1 and step-2 respectively. Picramide with HPLC purity greater than 99% was obtained. When compared with batch, in step-1, flow process provided significant advantage in selectivity and yield. The optimized flow process was scaled to 25 g/hr production rate in a laboratory flow reactor. The method can be considered fit for the safe production of picramide at commercial scale.

Role of tigecycline in the treatment of urinary tract infections: a systematic review of published case reports.

Introduction: The emergence of multi-drug resistance has forced clinicians to occasionally use drugs that are not approved to treat urinary tract infections (UTIs). This systematic review aimed to evaluate the utility of tigecycline in patients with UTIs. Methodology: A systematic review of case studies was used to retrieve articles between 1.1.1999 to 1.1.2021 from two databases, PubMed and Embase. The title-abstract screening was done for 198 articles, out of which 69 articles were included for full-text screening. A total of 18 articles with 27 cases were included for final analysis. Results: Of the 27 cases, there were 13 cases with complicated UTI and five had catheter-associated UTI. The most common organisms were Klebsiella pneumoniae (n=11), Acinetobacter baumannii (n=9), and Escherichia coli (n=6). Tigecycline was used as monotherapy in 19 patients and as a combination therapy in 8 patients. The median duration of tigecycline was 13 (10-15) days. A favourable clinical or microbiological response at varying intervals was seen in 24/27 (88.9%). Within three months of a favourable response, recurrence of symptoms was seen in four patients. Conclusion: In a small analysis of published case reports, tigecycline appeared to be a relatively effective treatment in patients with UTIs, caused by multidrug-resistant organisms. Where tigecycline is the only susceptible drug, it can be used for treatment. Further research, such as randomized controlled trials, is needed to fully assess the drug's efficacy in this context.

A 30% Efficient High-Output Voltage Fully Integrated Self-Biased Gate RF Rectifier Topology for Neural Implants.

This paper presents a fully integrated RF energy harvester (EH) with 30% end-to-end power harvesting efficiency (PHE) and supports high output voltage operation, up to 9.3V, with a 1.07 GHz input and under the electrode model for neural applications. The EH is composed of a novel 10-stage self-biased gate (SBG) rectifier with an on-chip matching network. The SBG topology elevates the gate-bias of transistors in a non-linear manner to enable higher conductivity. The design also achieves >20% PHE range of 12-dB. The design was fabricated in 65 nm CMOS technology and occupies an area of 0.0732-mm2 with on-chip matching network. In addition to standalone EH characterization measurement results, animal tissue stimulation test was performed to evaluate its performance in a realistic neural implant application.

Gradual Elastic Suture (Shoelace Technique) Approximation and Platelet-Rich Plasma Infiltration Technique in the Closure of Open Fracture Wound and Infected Wound With Significant Skin Loss.

Infected wounds can be really hard to manage in cases of open fractures, chronic osteomyelitis, and superficial infection. When the skin is damaged, bacteria can quickly enter the underlying tissue and cause a potentially fatal infection. Regular wound dressing with antimicrobial agents has become available in vials as a way to decrease the chance of bacterial colonization and infection and speed up the healing of wounds. In this report, we discuss the shoelace suture technique and platelet-rich plasma (PRP) infiltration in the wound. Due to its ability to stimulate and fasten the healing of wounds, PRP is becoming more and more popular. The progressive suture approximation (the shoelace technique) is an easy and effective technique for gently approximating the skin borders. The cytokines and growth factors in PRP play a critical role in the healing process. Hence, the combination of these two techniques will reduce the need for hospitalization, lead to better aesthetic outcomes, and reduce healthcare costs.

Recent advances in the antioxidant activity and mechanisms of chalcone derivatives: a computational review.

In this review, we have reported the antioxidant mechanisms and structure-antioxidant activity relationship of several chalcone derivatives, investigated in the recent past, based on the density functional theory (DFT) calculations, considering free radical scavenging and metal chelation ability. The antioxidant mechanisms include hydrogen atom transfer (HAT), sequential proton loss electron transfer (SPLET), single electron transfer followed by proton transfer (SET-PT), sequential proton loss hydrogen atom transfer (SPLHAT), sequential double proton loss electron transfer (SdPLET), sequential triple proton loss double electron transfer (StPLdET), sequential triple proton loss triple electron transfer (StPLtET), double HAT, double SPLET, double SET-PT, triple HAT, triple SET-PT, triple SPLET, proton-coupled electron transfer (PCET), single electron transfer (SET), radical adduct formation (RAF) and radical adduct formation followed by hydrogen atom abstraction (RAF-HAA). Furthermore, solvent effects have also been considered using different solvation models. The feasibility of scavenging different reactive oxygen and nitrogen species (ROS/RNS) has been discussed considering various factors such as the number and position of hydroxyl as well as methoxy groups present in the antioxidant molecule, stability of the species formed after scavenging reactive species, nature of substituent, steric effects, etc. This review opens new perspectives for designing new compounds with better antioxidant potential.

A ±0.5dB, 6nW RSSI Circuit with RF Power-to-Digital Conversion Technique for Ultra-low Power IoT Radio Applications.

This paper presents a new technique of radio frequency (RF) signal strength detection with a received signal strength indicator (RSSI) circuit which can be deployed in an internet-of-things (IoT) network. The proposed RSSI circuit is based on a direct conversion of RF to digital code indicating the signal strength. The direct conversion is achieved by the repeated switching of a rectifier's output voltage using an ultra-low power comparator. A 5-bit programmable feedback circuit is used to correct detection inaccuracies. The RSSI circuit is implemented in a 65-nm CMOS process and consumes 6nW power. It has a linear dynamic range of 26dB and exhibits an error of ±0.5dB with a wide bandwidth of 750MHz. A detailed analysis of the RSSI circuit is presented and verified with simulation and measurement results. The high detection accuracy with ultra-low power consumption of our RSSI circuit is favourable for IoT applications including localization, beamforming, hardware security and other low-power applications.

Effect of environment and season on acute decompensated heart failure: Data from low-to middle-income country.

OBJECTIVES: The environmental effect in heart failure (HF) patients is well established. However, the data is limited from low-to middle-income countries like India. This study determined the impact of environment on acute decompensated HF (ADHF) admissions and mortality in India. METHODS: Retrospectively, the data of all HF patients admitted between April 2017 and March 2019 was accessed through electronic hospital records. Simultaneously, the environmental-related data was collected from the central pollution control board. RESULTS: The study included 4561 patients of ADHF. The peak of monthly ADHF events (admission and mortality) was observed during the chilly month (January) while the lowest rates were observed in summer months (May-June). The most significant factor correlating inversely with the monthly ADHF admission (r = -0.78, p = 0.003) and mortality (r = -0.65, p = 0.004) was the maximum air temperature, and it was found to be the independent predictor for both ADHF mortality [t = -2.78, ß = -0.84; 95%CI(-6.0 to -0.6), p = 0.021] and admission [t = -4.83, ß = -0.91; 95%CI(-19.8 to -6.9), p = 0.001]. The above correlation was better seen in the elderly subset and male gender. Humidity and the air pollution attributes did not have a significant correlation with ADHF admission or mortality. CONCLUSION: In conclusion, even in low-to middle-income country like India, a periodic effect of season was demonstrated for ADHF mortality and admission, with a peak in ADHF events noted during winter months especially in the regions having extremes of seasons. Air pollution could not affect the ADHF outcome for which further studies are needed.