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

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

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

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

Topological phase transition and tunable surface states in YBi.

A unique co-existence of extremely large magnetoresistance (XMR) and topological characteristics in non-magnetic rare-earth monopnictides has stimulated intensive research on these materials. Yttrium monobismuthide (YBi) has been reported to exhibit XMR up to 105% but its Topological properties still need clarification. Here we use the hybrid density functional theory to probe the structural, electronic, and topological properties of YBi in detail. We observe that YBi is topologically trivial semimetal at ambient pressure which is in accordance with reported experimental results. The topological phase transitions i.e., trivial to non-trivial are obtained with volumetric pressure of 6.5 GPa and 3% of epitaxial strain. This topological phase transitions are well within the structural phase transition of YBi (24.5 GPa). The topological non-trivial state is characterized by band inversions among Y-d band and Bi-p band at Γ- and X-point which is further verified with the help of surface band structure along (001) plane. The Z2 topological invariants are calculated with the help of product of parities and evolution of Wannier charge centers. The occurrence of non-trivial phase in YBi with a relatively small epitaxial strain, which a thin film geometry can naturally has, make it an ideal candidate to probe inter-relationship between XMR and non-trivial topology.

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

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

Definitions, etiologies and outcomes of acute on chronic liver failure: A systematic review and meta-analysis.

BACKGROUND AND AIMS: Acute-on-chronic liver failure (ACLF) is a major public health concern. We aimed to assess the definitions, etiological spectrum, organ failure (OF), and outcomes of ACLF globally. METHODS: Three databases were searched for studies on ACLF from 1990 till September 2022. Information regarding definitions, acute precipitants, underlying chronic liver disease (CLD), OF, and mortality were extracted. Meta-analyses were performed for pooled prevalence rates (95% confidence interval, CI) using random effects model for each definition of ACLF. RESULTS: Of the 11,451 studies identified, 114 articles (142 cohorts encompassing 210,239 patients) met the eligibility criteria. Most studies (53.2%) used the European Association for the Study of the Liver (EASL) definition, followed by Asia-Pacific Association for the Study of the Liver (APASL) (33.3%). Systemic infection was the major acute precipitant and alcohol use was the major cause of CLD in EASL-defined studies while alcohol was both, the major acute precipitant and cause of CLD in APASL-defined studies. Liver failure was the major OF in APASL-based studies, while renal failure was predominant in EASL-based studies. Thirty-day mortality varied across definitions: APASL: 38.9% [95%CI 31.2-46.9], EASL: 47.9% [95%CI 42.2-53.5] and NACSELD: 52.2% [95%CI 51.9-52.5]. Diagnostic overlap between definitions ranged from 7.7% to 80.2%. Meta-regression suggested that the WHO region influenced 30-day mortality in studies using EASL definition. CONCLUSION: Heterogeneity in the definition of ACLF proposed by different expert societies and regional preferences in its use result in differences in clinical phenotype and outcomes. A uniform definition would enhance the comparability and interpretation of global data.

Clinical profile and outcomes of hepatocellular carcinoma in primary Budd-Chiari syndrome.

BACKGROUND: There is scant literature on hepatocellular carcinoma (HCC) in patients with Budd-Chiari syndrome (BCS). AIM: To assess the magnitude, clinical characteristics, feasibility, and outcomes of treatment in BCS-HCC. METHODS: A total of 904 BCS patients from New Delhi, India and 1140 from Mumbai, India were included. The prevalence and incidence of HCC were determined, and among patients with BCS-HCC, the viability and outcomes of interventional therapy were evaluated. RESULTS: In the New Delhi cohort of 35 BCS-HCC patients, 18 had HCC at index presentation (prevalence 1.99%), and 17 developed HCC over a follow-up of 4601 person-years, [incidence 0.36 (0.22-0.57) per 100 person-years]. BCS-HCC patients were older when compared to patients with BCS alone (P = 0.001) and had a higher proportion of inferior vena cava block, cirrhosis, and long-segment vascular obstruction. The median alpha-fetoprotein level was higher in patients with BCS-HCC at first presentation than those who developed HCC at follow-up (13029 ng/mL vs 500 ng/mL, P = 0.01). Of the 35 BCS-HCC, 26 (74.3%) underwent radiological interventions for BCS, and 22 (62.8%) patients underwent treatment for HCC [transarterial chemoembolization in 18 (81.8%), oral tyrosine kinase inhibitor in 3 (13.6%), and transarterial radioembolization in 1 (4.5%)]. The median survival among patients who underwent interventions for HCC compared with those who did not was 3.5 years vs 3.1 mo (P = 0.0001). In contrast to the New Delhi cohort, the Mumbai cohort of BCS-HCC patients were predominantly males, presented with a more advanced HCC [Barcelona Clinic Liver Cancer C and D], and 2 patients underwent liver transplantation. CONCLUSION: HCC is not uncommon in patients with BCS. Radiological interventions and liver transplantation are feasible in select primary BCS-HCC patients and may improve outcomes.

Amebic liver abscess: An update.

Amebic liver abscess (ALA) is still a common problem in the tropical world, where it affects over three-quarters of patients with liver abscess. It is caused by an anaerobic protozoan Entamoeba hystolytica, which primarily colonises the cecum. It is a non-suppurative infection of the liver consisting primarily of dead hepatocytes and cellular debris. People of the male gender, during their reproductive years, are most prone to ALA, and this appears to be due to a poorly mounted immune response linked to serum testosterone levels. ALA is more common in the right lobe of the liver, is strongly associated with alcohol consumption, and can heal without the need for drainage. While majority of ALA patients have an uncomplicated course, a number of complications have been described, including rupture into abdomino-thoracic structures, biliary fistula, vascular thrombosis, bilio-vascular compression, and secondary bacterial infection. Based on clinico-radiological findings, a classification system for ALA has emerged recently, which can assist clinicians in making treatment decisions. Recent research has revealed the role of venous thrombosis-related ischemia in the severity of ALA. Recent years have seen the development and refinement of newer molecular diagnostic techniques that can greatly aid in overcoming the diagnostic challenge in endemic area where serology-based tests have limited accuracy. Metronidazole has been the drug of choice for ALA patients for many years. However, concerns over the resistance and adverse effects necessitate the creation of new, safe, and potent antiamebic medications. Although the indication of the drainage of uncomplicated ALA has become more clear, high-quality randomised trials are still necessary for robust conclusions. Percutaneous drainage appears to be a viable option for patients with ruptured ALA and diffuse peritonitis, for whom surgery represents a significant risk of mortality. With regard to all of the aforementioned issues, this article intends to present an updated review of ALA.

Isolation, Characterization, and Expression Analysis of NAC Transcription Factor from Andrographis paniculata (Burm. f.) Nees and Their Role in Andrographolide Production.

Andrographis paniculata (Burm. f.) Nees is an important medicinal plant known for its bioactive compound andrographolide. NAC transcription factors (NAM, ATAF1/2, and CUC2) play a crucial role in secondary metabolite production, stress responses, and plant development through hormonal signaling. In this study, a putative partial transcript of three NAC family genes (ApNAC83, ApNAC21 22 and ApNAC02) was used to isolate full length genes using RACE. Bioinformatics analyses such as protein structure prediction, cis-acting regulatory elements, and gene ontology analysis were performed. Based on in silico predictions, the diterpenoid profiling of the plant's leaves (five-week-old) and the real-time PCR-based expression analysis of isolated NAC genes under abscisic acid (ABA) treatment were performed. Additionally, the expression analysis of isolated NAC genes under MeJA treatment and transient expression in Nicotiana tabacum was performed. Full-length sequences of three members of the NAC transcription factor family, ApNAC83 (1102 bp), ApNAC21 22 (996 bp), and ApNAC02 (1011 bp), were isolated and subjected to the promoter and gene ontology analysis, which indicated their role in transcriptional regulation, DNA binding, ABA-activated signaling, and stress management. It was observed that ABA treatment leads to a higher accumulation of andrographolide and 14-deoxyandrographolide content, along with the upregulation of ApNAC02 (9.6-fold) and the downregulation of ApNAC83 and ApNAC21 22 in the leaves. With methyl jasmonate treatment, ApNAC21 22 expression decreased, while ApNAC02 increased (1.9-fold), with no significant change being observed in ApNAC83. The transient expression of the isolated NAC genes in a heterologous system (Nicotiana benthamiana) demonstrated their functional transcriptional activity, leading to the upregulation of the NtHMGR gene, which is related to the terpene pathway in tobacco. The expression analysis and heterologous expression of ApNAC21 22 and ApNAC02 indicated their role in andrographolide biosynthesis.

Prevalence of breast cancer in rural population of Jaipur: a survey-based observational study.

Breast cancer, a global health concern predominantly affecting women, recorded 2.3 million new cases and 685,000 deaths in 2020. Alarmingly, projections suggest that by 2040, there could be over 3 million new cases and 1 million deaths. To assess breast cancer prevalence in 24 rural villages within a 60 km radius of NIMS Hospital, Tala Mod, Jaipur, Rajasthan, North India 303,121. A study involving 2023 participants conducted initial screenings, and positive cases underwent further tests, including ultrasound, mammography, and biopsy. SPSSv28 analysed collected data. Among 2023 subjects, 3 screened positive for breast lumps. Subsequent clinical examination and biopsy identified 1 normal case and 2 with breast cancer, resulting in a prevalence proportion of 0.0009 or 98 per 100,000. This study helps fill gap in breast cancer prevalence data for rural Rajasthan. The results highlight a concerning prevalence of breast cancer in the rural area near NIMS hospital, emphasizing the urgent need for increased awareness, early detection, and better healthcare access. Challenges like limited resources, awareness programs, and delayed diagnosis contribute to this high incidence. To address this, comprehensive approach is necessary, including improved screening programs and healthcare facilities in rural areas. Prioritizing rural healthcare and evidence-based strategies can reduce the burden of breast cancer and improve health outcomes.

Optimizing methanol synthesis from CO2 using graphene-based heterogeneous photocatalyst under RSM and ANN-driven parametric optimization for achieving better suitability.

Assessment of the performance of linear and nonlinear regression-based methods for estimating in situ catalytic CO2 transformations employing TiO2/Cu coupled with hydrogen exfoliation graphene (HEG) has been investigated. The yield of methanol was thoroughly optimized and predicted using response surface methodology (RSM) and artificial neural network (ANN) model after rigorous experimentation and comparison. Amongst the different types of HEG loading from 10 to 40 wt%, the 30 wt% in the HEG-TiO2/Cu assisted photosynthetic catalyst was found to be successful in providing the highest conversion efficiency of methanol from CO2. The most influencing parameters, HEG dosing and inflow rate of CO2, were found to affect the conversion rate in the acidic reaction regime (at pH of 3). According to RSM and ANN, the optimum methanol yields were 36.3 mg g-1 of catalyst and 37.3 mg g-1 of catalyst, respectively. Through the comparison of performances using the least squared error analysis, the nonlinear regression-based ANN showed a better determination coefficient (overall R2 > 0.985) than the linear regression-based RSM model (overall R2 ∼ 0.97). Even though both models performed well, ANN, consisting of 9 neurons in the input and 1 hidden layer, could predict optimum results closer to RSM in terms of agreement with the experimental outcome.

Hippo Signaling at the Hallmarks of Cancer and Drug Resistance.

Originally identified in Drosophila melanogaster in 1995, the Hippo signaling pathway plays a pivotal role in organ size control and tumor suppression by inhibiting proliferation and promoting apoptosis. Large tumor suppressors 1 and 2 (LATS1/2) directly phosphorylate the Yki orthologs YAP (yes-associated protein) and its paralog TAZ (also known as WW domain-containing transcription regulator 1 [WWTR1]), thereby inhibiting their nuclear localization and pairing with transcriptional coactivators TEAD1-4. Earnest efforts from many research laboratories have established the role of mis-regulated Hippo signaling in tumorigenesis, epithelial mesenchymal transition (EMT), oncogenic stemness, and, more recently, development of drug resistances. Hippo signaling components at the heart of oncogenic adaptations fuel the development of drug resistance in many cancers for targeted therapies including KRAS and EGFR mutants. The first U.S. food and drug administration (US FDA) approval of the imatinib tyrosine kinase inhibitor in 2001 paved the way for nearly 100 small-molecule anti-cancer drugs approved by the US FDA and the national medical products administration (NMPA). However, the low response rate and development of drug resistance have posed a major hurdle to improving the progression-free survival (PFS) and overall survival (OS) of cancer patients. Accumulating evidence has enabled scientists and clinicians to strategize the therapeutic approaches of targeting cancer cells and to navigate the development of drug resistance through the continuous monitoring of tumor evolution and oncogenic adaptations. In this review, we highlight the emerging aspects of Hippo signaling in cross-talk with other oncogenic drivers and how this information can be translated into combination therapy to target a broad range of aggressive tumors and the development of drug resistance.

Viral hepatitis-induced acute liver failure.

Viral hepatitis-induced acute liver failure (ALF) is a preventable cause for liver-related mortality worldwide. Viruses are the most common cause for ALF in developing nations in contrast to the west, where acetaminophen is largely responsible. Viruses may be hepatotropic or affect the liver secondary to a systemic infection. In tropical countries, infections such as leptospirosis, scrub typhus and malaria can mimic the symptoms of ALF. Differentiating these ALF mimics is crucial because they require etiology-specific therapy. Treatment of viral hepatitis-induced ALF is two-pronged and directed towards providing supportive care to prevent organ failures and antiviral drugs for some viruses. Liver transplantation (LT) is an effective modality for patients deteriorating despite adequate supportive care. Early referral and correct identification of patients who require a transplant are important. Liver support devices and plasma exchange have evolved into "bridging modalities" for LT. Preventive strategies such as hand hygiene, use of clean and potable water and inclusion of vaccines against viral hepatitis in the national program are simple yet very effective methods focusing on the preventive aspect of this disease.

Erratum: Antibacterial Efficacy of ZnO/Bentonite (Clay) Nanocomposites against Multidrug-Resistant Escherichia coli.

[This corrects the article DOI: 10.1021/acsomega.3c07950.].

Evaluation of immunogenicity and protective efficacy of bacteriophage conjugated haemagglutinin based subunit vaccine against equine influenza virus in a murine model.

Equine influenza (EI) is a highly contagious acute respiratory disease of equines caused by the H3N8 subtype of Influenza A virus i.e. equine influenza virus (EIV). Vaccination is an important and effective tool for the control of EI in equines. Most of the commercial influenza vaccines are produced in embryonated hen's eggs which has several inherent disadvantages. Hence, subunit vaccine based on recombinant haemagglutinin (HA) antigen, being the most important envelope glycoprotein has been extensively exploited for generating protective immune responses, against influenza A and B viruses. We hypothesized that novel vaccine formulation using baculovirus expressed recombinant HA1 (rHA1) protein coupled with bacteriophage will generate strong protective immune response against EIV. In the present study, the recombinant HA1 protein was produced in insect cells using recombinant baculovirus having cloned HA gene of EIV (Florida clade 2 sublineage) and the purified rHA1 was chemically coupled with bacteriophage using a crosslinker to produce rHA1-phage vaccine candidate. The protective efficacy of vaccine preparations of rHA1-phage conjugate and only rHA1 proteins were evaluated in mouse model through assessing serology, cytokine profiling, clinical signs, gross and histopathological changes, immunohistochemistry, and virus quantification. Immunization of vaccine preparations have stimulated moderate antibody response (ELISA titres-5760 ± 640 and 11,520 ± 1280 for rHA1 and rHA1-phage, respectively at 42 dpi) and elicited strong interferon (IFN)-γ expression levels after three immunizations of vaccine candidates. The immunized BALB/c mice were protected against challenge with wild EIV and resulted in reduced clinical signs and body weight loss, reduced pathological changes, decreased EIV antigen distribution, and restricted EIV replication in lungs and nasopharynx. In conclusion, the immune responses with moderate antibody titer and significantly higher cytokine responses generated by the rHA1-phage vaccine preparation without any adjuvant could be a novel vaccine candidate for quick vaccine preparation through further trials of vaccine in the natural host.

Etiological Spectrum of Cirrhosis in India: A Systematic Review and Meta-analysis.

Background: Cirrhosis is a significant cause of morbidity and mortality globally and in India. This systematic review and meta-analysis aimed to ascertain the etiological spectrum and changing trends of cirrhosis in India. Methods: We searched electronic databases, including Pubmed/Medline, Scopus, and Embase. We included original studies that reported the etiology of cirrhosis in the Indian population. Results: We included 158 studies (adults: 147, children: 11). The overall pooled estimate of alcohol as a cause of cirrhosis in adults was 43.2% (95% confidence interval (CI) 39.8-46.6%; I2 = 97.8%), followed by nonalcoholic fatty liver disease (NAFLD)/cryptogenic in 14.4%, 95% CI (11.7-17.3%; I2 = 98.4%), hepatitis B virus (HBV) in 11.5%, 95% CI (9.8-13.3%; I2 = 96.6%), and hepatitis C virus (HCV) in 6.2%, 95% CI (4.8-7.8%; I2 = 97.2%) of the included patients. The most common cause of cirrhosis in all zones was alcohol-related. Comparison of etiologies over time revealed a reduction in the viral hepatitis-related and an increase in the proportion of alcohol-related and NAFLD/cryptogenic-related cirrhosis. The overall pooled estimates of various etiologies in children were: HBV in 10.7%, 95% CI (4.6-18.7%; I2 = 91.0%), NAFLD/Cryptogenic in 22.3%, 95% CI (9.0-39.2%; I2 = 96.7%), and HCV in 2.0%, 95% CI (0.0-8.5%; I2 = 94.6%). Conclusions: Alcohol is the most common etiology of cirrhosis in adults in India. The proportions of alcohol and NAFLD-related cirrhosis are increasing, and those of viral hepatitis-related cirrhosis are reducing. The results of our meta-analysis will help formulate health policies and the allocation of resources.

Development of high-yielding white maize hybrids with better chapatti-making quality compared to traditionally used local landraces.

Introduction: The present research focuses on the chapatti making quality of high-yielding white maize hybrids compared to available low-yielding local yellow and white landraces in India. Materials and methods: In this study, the top nine superior hybrids were selected for testing the physical properties of the maize kernels, proximate composition of flours and chapattis, physical parameters of chapatti, textural properties, sensory evaluation of chapattis and pasting properties of maize flour. Results and discussion: The results revealed the superiority of white maize hybrids (WMH), viz., WHM 1, WHM 2, and WHM 8 over the local yellow and white landraces for most of the parameters studied. In sensory analysis, though, the yellow landrace was considered superior by the panellists in terms of colour but the white maize hybrids outperformed in overall sensory analysis and were more acceptable than the yellow and white maize landraces. These high yielding white maize hybrids with good consumer acceptance may cater for the needs of rural and tribal populations in India who prefer white maize as a staple food.

Two-Phase Crude Oil-Water Flow Through Different Pipes: An Experimental Investigation Coupled with Computational Fluid Dynamics Approach.

The present study deals with two-phase non-Newtonian pseudoplastic crude oil and water flow inside horizontal pipes simulated by ANSYS. The study helps predict velocity and velocity profiles, as well as pressure drop during two-phase crude-oil-water flow, without complex calculations. Computational fluid dynamics (CFD) analysis will be very important in reducing the experimental cost and the effort of data acquisition. Three independent horizontal stainless steel pipes (SS-304) with inner diameters of 1 in., 1.5 in., and 2 in. were used to circulate crude oil with 5, 10, and 15% v/v water for simulation purposes. The entire length of the pipes, along with their surfaces, were insulated to reduce heat loss. A grid size of 221,365 was selected as the optimal grid. Two-phase flow phenomena, pressure drop calculations, shear stress on the walls, along with the rate of shear strain, and phase analysis were studied. Moreover, velocity changes from the wall to the center, causing a velocity gradient and shear strain rate, but at the center, no velocity variation (velocity gradient) was observed between the layers of the fluid. The precision of the simulation was investigated using three error parameters, such as mean square error, Nash-Sutcliffe efficiency, and RMSE-standard deviation of observation ratio. From the simulation, it was found that CFD analysis holds good agreement with experimental results. The uncertainty analysis demonstrated that our CFD model is helpful in predicting the rheological parameters very accurately. The study aids in identifying and predicting fluid flow phenomena inside horizontal straight pipes in a very effective way.

Postharvest handling of ethylene with oxidative and absorptive means.

Fruit ripening is an unfolding of a series of genetically-programmed modifications and tend to be highly orchestrated irrevocable phenomenon mediated by ethylene. Phytohormone ethylene also leads to over-ripening, senescence, loss of texture, microbial attack, reduced post-harvest life and other associated problems during storage and transportation of fruits. Its harmful impacts on fresh fruits, vegetables, and ornamentals result in substantial product losses even up to 80%. Curbing of this inevitable menace is therefore need of the hour. Accrual of ethylene in packaging system should fundamentally be ducked to extend the shelf-life and uphold an adequate superiority of perishables in visual and organoleptic terms. The current review discusses about properties, factors affecting and impact of ethylene, intimidation of its impact at gene vis-à-vis activity level using gene-modification/inhibition techniques, chemical/physical in conjunction with other suitable approaches. It also entails the most commercially cultivated approaches worldwide viz. KMnO4-based oxidation together with adsorption-based scrubbing of ethylene in thorough details. Future ethylene removal strategies should focus on systematic evaluation of KMnO4-based scavenging, exploring the mechanism of adsorption, adsorbent(s) behavior in the presence of other gases and their partial pressures, volatiles, temperature, relative humidity, development of hydrophobic adsorbents to turn-up under high RH, regeneration of adsorbent by desorption, improvement in photocatalytic oxidation etc. and further improvements thereof. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-023-05777-1.

Ammonia is associated with liver-related complications and predicts mortality in acute-on-chronic liver failure patients.

The relationship between ammonia and liver-related complications (LRCs) in acute-on-chronic liver failure (ACLF) patients is not clearly established. This study aimed to evaluate the association between ammonia levels and LRCs in patients with ACLF. The study also evaluated the ability of ammonia in predicting mortality and progression of LRCs. The study prospectively recruited ACLF patients based on the APASL definition from the ACLF Research Consortium (AARC) from 2009 to 2019. LRCs were a composite endpoint of bacterial infection, overt hepatic encephalopathy (HE), and ascites. A total of 3871 cases were screened. Of these, 701 ACLF patients were enrolled. Patients with LRCs had significantly higher ammonia levels than those without. Ammonia was significantly higher in patients with overt HE and ascites, but not in those with bacterial infection. Multivariate analysis found that ammonia was associated with LRCs. Additionally, baseline arterial ammonia was an independent predictor of 30-day mortality, but it was not associated with the development of new LRCs within 30 days. In summary, baseline arterial ammonia levels are associated with 30-day mortality and LRCs, mainly overt HE and ascites in ACLF patients.

Minimum dietary diversity and associated determinants among children aged 6-23 months in Pakistan.

Pakistan is facing a high prevalence of malnutrition and Minimum Dietary Diversity (MDD) is one of the core indicators that remain below the recommended level. This study assesses MDD and its associated factors among children aged 6 to 23 months in Pakistan. The study uses a cross-sectional study using the dataset of the latest available Multiple Indicators Cluster Survey (MICS) for all provinces of Pakistan. Multistage sampling is used to select 18,699 children aged 6 to 23 months. The empirical method is the Logistic Regression Analysis and Chi-Square Test. The dataset is freely and publicly available with all identifier information removed, and no ethics approvals are required. About one-fifth (20%) of infants and young children aged 6 to 23 months had met MDD, this number varies from 17 to 29%, highest in Baluchistan and lowest in Punjab province of Pakistan. The age group (18-23) indicates a 2.45 times greater chance of having MDD. Age (< 0.001), diarrhea (0.01), prenatal care (0.06), mother's education (< 0.001), computer access (< 0.001), wealth quantile (< 0.001), and residence (< 0.001) were significantly associated with meeting MDD. However, gender (0.6) and mother's age (0.4) both were statistically insignificant in meeting MDD. Regarding mothers' education, compared to no education, the chance of MDD is 1.45 times greater for highly educated mothers in the Punjab province. Dietary diversity among children aged 6 to 23 months in Pakistan is low. It is recommended that mothers should be aware and encouraged to use dietary diverse food for infants and younger children.