BACKGROUND: Variceal bleeding is an important cause of mortality in patients with chronic liver disease (CLD). The gold standard for detection and grading of oesophageal varices (EV) is upper gastrointestinal endoscopy. However, it is expensive, time-consuming and invasive OBJECTIVES: This study aimed to find any association between splenic shear wave velocity (SWV) measured by acoustic radiation force imaging (ARFI) and the presence of EV. METHOD: The quasi-experimental study included 50 patients with CLD and 50 subjects without CLD as the control group. Both underwent upper abdominal ultrasonography followed by elastographic assessment on a Siemens Acuson S2000TM ultrasound system. A comparison of the findings was made between the control and patient groups. RESULTS: Both groups had similar hepatic size while patients with CLD had larger splenic size and area (p < 0.05). The CLD patients had higher mean hepatic and splenic SWV compared with the control group (p < 0.05). The mean splenic size and splenic SWV were higher in patients with varices than in those without varices (p < 0.05). CONCLUSION: Chronic liver disease causes significant increase in liver and splenic stiffness with splenic SWV values being higher for patients with varices emphasising the role of elastography as a non-invasive predictor for the presence of EVs. Splenic SWV had the highest sensitivity and specificity, which was augmented by a combination of hepatic and splenic SWV. Thus, splenic SWV alone or in combination with hepatic SWV is a useful technique for prediction of the presence of EVs. CONTRIBUTION: This study aims to find an alternative non-invasive and cost-effective technique for screening of EV.

Abstract Introduction: Aquasome is a self-assembled nanoparticulate carrier system with three layers. The system is made up of a polyhydroxy oligomer-coated inner nanocrystalline solid core. Adsorbed on the coated layer are drug molecules or biochemically active compounds. Self-assembly in this sense refers to the independent formation of molecules into organised, long-lasting, and non-covalently bonded patterns.This paper gives an overview of aquasome formation, covering structural properties, formulation methodologies, and the benefits and drawbacks of this novel drug delivery technology. The article primarily addresses the formulation processes used to create self-assembled nanostructures and their various possible applications. Method: Several online databases, including Science Direct, Medline, Web of Science, Google Scholar and Scopus, were used in the literature search. The datasets were searched for entries of studies up to July, 2023. The review paper especially addresses many elements of aquasome formation by various researchers employing methods/modified techniques such as co-precipitation, self-precipitation, sputtering, and and so forth. It also illustrates a variety of fields of therapy in which aquasome has been recognised to have a major influence, such as oxygen and extract carrier. Results: The solid core is responsible for providing structural stability, while the oligomeric coating is crucial for safeguarding against dehydration and stabilising the bioactive molecules. This biodegradable drug delivery vehicle at the nanoscale level exhibits a tendency to accumulate in the liver and muscles. The non-modification of drug adsorption onto the aquasome surface facilitates prompt pharmacological response by allowing unobstructed receptor recognition at the action site. Conclusions: Aquasome, a three-layered self-assembled molecule, is a simple yet new drug delivery system with promising carrier potentials to increase the solubility and bioavailability of poorly soluble drugs. Despite a host of challenges, such as time consumption, sophisticated processes, safety, and expensive research costs, aquasome may emerge as an alternative vesicular carrier in the future.

Resumen Introducción: Aquasome es un sistema portador de nanopartículas autoensamblado con tres capas. El sistema se compone de un núcleo sólido nanocristalino interno recubierto de oligómero polihidroxilado. Adsorbidas en la capa recubierta se encuentran moléculas de fármacos o compuestos bioquímicamente activos. El autoensamblaje en este sentido se refiere a la formación independiente de moléculas en patrones organizados, de larga duración y con enlaces no covalentes. nueva tecnología de administración de fármacos. El artículo aborda principalmente los procesos de formulación utilizados para crear nanoestructuras autoensambladas y sus diversas aplicaciones posibles. Método: En la búsqueda bibliográfica se utilizaron varias bases de datos en línea, incluidas Science Direct, Medline, Web of Science, Google Scholar y Scopus. Se realizaron búsquedas en los conjuntos de datos en busca de entradas de estudios hasta julio de 2023. El documento de revisión aborda especialmente muchos elementos de la formación de aquasomas por parte de varios investigadores que emplean métodos/técnicas modificadas como la coprecipitación, la autoprecipitación, la pulverización catódica, etc. También ilustra una variedad de campos de terapia en los que se ha reconocido que el aquasoma tiene una gran influencia, como el oxígeno y el transporte de extractos. Resultados: El núcleo sólido es responsable de brindar estabilidad estructural, mientras que el recubrimiento oligomérico es crucial para proteger contra la deshidratación y estabilizar las moléculas bioactivas. Este vehículo de administración de fármacos biodegradable a escala nanométrica muestra una tendencia a acumularse en el hígado y los músculos. La no modificación de la adsorción del fármaco en la superficie del aquasoma facilita una respuesta farmacológica rápida al permitir el reconocimiento sin obstrucciones del receptor en el sitio de acción. Conclusiones: Aquasome, una molécula autoensamblada de tres capas, es un sistema de administración de fármacos simple pero nuevo con un prometedor potencial de transporte para aumentar la solubilidad y la biodisponibilidad de fármacos poco solubles. A pesar de una serie de desafíos, como el consumo de tiempo, los procesos sofisticados, la seguridad y los altos costos de investigación, el aquasome puede surgir como un vehículo vesicular alternativo en el futuro.

ABSTRACT Introduction: The knowledge of clinicians regarding blood transfusion services may impact patient care and transfusion outcome. The wide variation in transfusion practices among clinicians leads to inappropriate blood product usage and jeopardizes patient safety. Hence, this survey study aimed to assess knowledge, attitude and practice among the residents and interns of safe blood transfusion. Methods: The online survey was based on self-administered questionnaires of three sections: 1. Demography; 2. Knowledge, and; 3. Attitude and Practice. One point was assigned for the correct response of each question in every section. The knowledge score was further categorized into three categories, depending on the points obtained. The participants were also divided into four groups, depending on their experience. The Kruskal-Wallis test was applied to determine the difference of knowledge and practice scores in three designated groups of residents and interns. A p-value of less than 0.05 was considered to be significant. Result: A total of 247 residents and interns participated in this study. Thirteen participants had an incomplete response. Out of 234 participants, Senior Residents (SR), Junior Residents (JR), and interns were 70, 96 and 68 participants, respectively. The knowledge scores of interns were significantly low, as compared to SRs and JRs. Practice scores of interns were also significantly low, compared to the JRs. However, most of the residents and interns (85%) were aware of the pre-transfusion testing. Conclusion: Therefore, the mandatory incorporation of the transfusion medicine subject in the undergraduate curriculum can help the young budding doctors to better implement the patient blood management.

Abstract: Mobile cloud computing is currently an encouraging field in the cyber-physical world. It is an amalgamation of mobile computing and cloud computing. Computational offloading is one feature in the mobile cloud application that offloads the task to the cloud server, processes it, and gets the results back on the mobile device. During offload, the job needs to be queued on the cloud servers and allocated to the virtual machines. Task scheduling is an important step where the mobile task is assigned to the servers and processed somehow. In the overall offloading process, energy conservation is a significant concern. The scheduling problem involves mapping the offloaded task to the cloud server while satisfying the energy and time constraints. This paper proposes a hybrid scheduling scheme based on Gaussian-based multi-objective particle swarm optimization(GMOPSO) and bacterial foraging optimization(BFO). This scheme performs better when compared to other variants of PSO in terms of makespan and energy efficiency.

ABSTRACT: Soil enzymes play a fundamental role in nutrient cycling in forest systems. The stoichiometry of C, N, and P–acquiring enzymes has been used to indicate nutrient limitation in the soil. However, the enzymatic stoichiometry remains poorly understood in pure and mixed eucalypt plantations. Thus, this study aims to assess the activity of enzymes in the soil to address the hypothesis that the introduction of N2-fixing trees could influence the enzymatic stoichiometry on C, N, and P cycling. The activity of β-glucosidase (BG), urease (U), and acid phosphatase (AP) was assessed in soil (0-20 cm depth) of pure Eucalyptus grandis without (E) and with N fertilization (E+N), and a mixed system with E. grandis and Acacia mangium (E+A), and a pure A. mangium (A) plantation at 27 and 39 months after planting. The activities of BG/U, BG/AP, and U/AP were used to calculate the enzyme C/N, C/P, and N/P ratios, respectively. Rates of N–acquiring enzymes were higher in E and E+N, while soil microorganisms invested in P–acquiring enzymes in A and E+A. The vector length and angle demonstrated that C demand by microorganisms does not change in relation to N and P, regardless of the treatment. However, N demand decreased in relation to P in A and E+A (mainly at 27 months). Our results suggest that enzymes activity in pure eucalypt systems is limited for their soil-litter nutrient contents. At the same time while acacia and mixed plantation seem to invest in P–acquiring enzymes to improve biological N2 fixation promoted by diazotrophic bacteria associated to acacia.

Abstract The current investigation presents the wear-worn surface analysis of a silicon carbide-reinforced brass-based composite synthesized by stir casting. Wear behavior of the brass composite pin was analyzed by disc tribometer. Wear characterization studies and confirmation of elemental composition are investigated through scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) respectively. The worn surface of the synthesized brass composite was analyzed using atomic force microscopy (AFM). The aim of the investigation is to examine the surface morphology of the worn specimen. Based on the input constraints, the wear rate ranges from 0.0135 to 0.0893 mm3/min. The applied load is the predominant factor in the wear rate (83.75%). Sliding velocity has a minor effect on wear rate (1.06%). The improved surface roughness of 15.27 nm was produced on the worn surface. The novelty of the research work is to study the various surface parameters of the worn surface, such as roughness average, root mean square roughness, maximum height of the roughness, skewness, and kurtosis. These parameters were analyzed at different wear-worn surfaces of the synthesized brass composite. The wear-worn surface was deeply investigated and incorporated with SEM and AFM analysis.

ABSTRACT In this research article, soil stabilisation is carried out by the latest method: nanotechnology. The stabilizer nano-aluminum oxide is used as a stabilising agent in concentrations of 0.2%, 0.4%, 0.6%, 0.8%, 1%, and 1.2%. Because it is 99% pure and nanoscale, it has a large surface area for analysing the properties and strength of soil tests such as Atterberg's limit, pycnometer, proctor compaction test, California bearing ratio test, and unconfined compressive strength. These tests are done for parent soil and soil with different percentages of nanomaterials. The nanostabilizer addition increases the unconfined compressive strength, California bearing ratio, liquid limit, and optimum moisture content value. One percentage of nano-aluminium oxide is considered an optimum dosage. Beyond the optimum amount, there is a change in soil property. The CBR value, liquid limit, and OMC of soil all go down, so it is recommended to use 1% nano-aluminum oxide to improve sub-grade clay soil.

ABSTRACT Diabetes is a life-threatening disease, and currently available synthetic medicines for treating diabetes are associated with various side effects. Therefore, there is an unmet need to develop herbal remedies against diabetes as an alternative to synthetic medicines. Although local healers use the roots of Spermadicyton suaveolens (SS) to manage diabetes, there is negligible research to validate its antidiabetic properties. The present investigation aims to the assess the antioxidant, antidiabetic, and antihyperlipidemic potential of the ethanolic extract of S. Suaveolen’s roots (EESS) on streptozotocin (STZ) induced diabetic rats. The extract was screened for in vitro antioxidant and antidiabetic activity. The in vivo antidiabetic potential of EESS (at 200 and 400 mg/kg) was studied on STZ-induced diabetic rats for 20 days. The EESS displayed significant (p<0.05) antidiabetic and antioxidant properties. The administration of 200 mg/kg and 400 mg/kg EESS in STZ-induced diabetic rats significantly reduced hyperglycemia, and restored antioxidant enzymes and lipid profile-a high density lipoprotein (HDL) increased by the administration of a single dose of streptozotocin. Thus, EESS could be a promising herbal medicine in the treatment of diabetes and hyperlipidemia.

Abstract The present study aimed to identify the bioactive constituents in the chloroform extract of H. spicatum rhizomes (HS-RCLE), further evaluated for its in-vitro pesticidal activities validating via molecular docking techniques. GC/MS analysis of HS-RCLE identified 14 compounds contributing 84.1 % of the total composition. The extract was dominated by oxygenated sesquiterpenes (43.1 %) with curcumenone (25.2 %) and coronarin E (14.8 %) as the major compounds. The extract recorded 89.4 % egg hatchability inhibition and 82.6 % immobility of Meloidogyne incognita, 66.7 % insecticidal activity on Spodoptera litura, 100 % phytotoxic activity on Raphanus raphanistrum seeds, and 74.7 % anti-fungal activity on Curvularia lunata at the respective highest dose studied. The biological activities were furthermore validated by using docking studies on certain proteins/enzymes namely acetylcholinesterase (PBD ID: IC2O), carboxylesterase (PDB ID: 1CI8), acetohydroxyacid synthase (PBD ID: 1YHZ) and trihydroxy naphthalene reductase (PBD ID: 3HNR). The bioactivity of the major constituents of the extract was predicted with the help of in silico PASS studies. HS-RCLE was observed to be a viable alternative source of natural pesticidal agents and paves the way for further studies on its mechanistic approaches and field trials to ascertain its pesticidal studies.

Abstract Direct oral anticoagulants (DOACs) have become the standard of care for acute and long-term therapy for venous thromboembolism (VTE) due to their efficacy and safety profiles. The 2021 International Society on Thrombosis and Haemostasis guidelines recommend using standard DOAC dosages in patients with BMI >40 kg/m2 or weight >120 kg. Use of DOACs remains uncertain in morbidly obese patients with VTE, including acute PE. A morbidly obese woman in her 30s who presented with acute worsening of dyspnea was diagnosed with acute intermediate-high risk acute pulmonary embolism and concomitant proximal deep vein thrombosis, constituting a clinically challenging scenario for treating her with rivaroxaban. Standard doses of rivaroxaban for acute and extended phase treatment of venous thromboembolism in individuals with morbid obesity at BMI>70 kg/m2 may be effective, and safe.

Resumo Devido à sua eficácia e aos seus perfis de segurança, os anticoagulantes orais diretos (DOACs) tornaram-se o padrão de cuidado para a terapia aguda e de longo prazo de tromboembolismo venoso (TEV). As diretrizes da Sociedade Internacional de Trombose e Hemostasia de 2021 recomendam o uso de dosagens padrão de DOACs em pacientes com índice de massa corporal (IMC) > 40 kg/m2 ou peso > 120 kg. O uso de DOACs em pacientes com obesidade mórbida e TEV, incluindo embolia pulmonar aguda, ainda não foi esclarecido. Uma mulher com obesidade mórbida na faixa dos 30 anos que apresentou piora aguda da dispneia foi diagnosticada com embolia pulmonar aguda de risco intermediário-alto e trombose venosa profunda proximal concomitante, com o cenário clínico desafiador de tratá-la com rivaroxabana. Doses padrão de rivaroxabana para tratamento e recorrência de tromboembolismo venoso em indivíduos com obesidade mórbida e IMC > 70 kg/m2 podem ser eficazes e seguras.

ABSTRACT Introduction: Malocclusion is presumed to have adverse effects on dental and facial attractiveness, leading to deleterious psychosocial impact and Quality of life(QoL) of the individual. The Psychosocial Impact of Dental Aesthetic Questionnaire (PIDAQ) has proved to be effective for assessment of psychosocial impact of malocclusion on dental aesthetics, but it’s effectiveness for assessing facial aesthetics is unknown. Objective: The aim of the present study was to assess the effectiveness of PIDAQ on its ability to reflect the psychosocial impact of malocclusion on facial attractiveness, using the Facial Aesthetic index (FAI) after its translation and validation in the regional language. Methods: The 23-item PIDAQ, after translation process, cross-cultural adaptation and pilot testing, was administered to 330 subjects (62.5 % females and 37.5 % males; age range 18-30 years) with varying degrees of severity of malocclusion, assessed by the two components of the Index of Orthodontic Treatment Need (Dental Health Component, IOTN-DHC, for normative need; and self-administered Aesthetic Component, IOTN-AC, for subjective need) and FAI. Results: The internal consistency and test-retest reliability were good (Cronbach’s alpha = 0.859 - 0.958; Intraclass correlation coefficient =0.984). FAI, IOTN-DHC and IOTN-AC scores showed highly significant correlation with PIDAQ scores, depicting strong convergent validity (p< 0.001). One-way analysis of variance (ANOVA) and Bonferroni post-hoc test showed highly significant correlations (p-value < 0.001) for all comparisons. There were no significant differences between responses of males and females. The regional version of PIDAQ had excellent reliability. Conclusions: PIDAQ showed good psychometric properties and was able to effectively reflect the psychosocial impact of malocclusion on altered facial aesthetics.

RESUMO Introdução: Acredita-se que a má oclusão tenha efeitos adversos na estética dentária e facial, levando a um impacto psicossocial e na qualidade de vida (QV) do indivíduo. O questionário PIDAQ (Psychosocial Impact of Dental Aesthetic Questionnaire) provou ser eficaz para avaliação do impacto psicossocial da má oclusão na estética dental, mas sua eficácia para avaliar a estética facial é desconhecida. Objetivo: O objetivo do presente estudo foi avaliar a eficácia do PIDAQ em refletir o impacto psicossocial da má oclusão na atratividade facial, usando o Índice de Estética Facial (FAI) após sua tradução e validação na linguagem regional. Métodos: O PIDAQ com 23 itens, após o processo de tradução, adaptação transcultural e teste piloto, foi administrado a 330 indivíduos (62,5% do sexo feminino e 37,5% do sexo masculino; faixa etária de 18 a 30 anos) com má oclusão de gravidade variada, avaliados pelos dois componentes do Índice de Necessidade de Tratamento Ortodôntico (Componente de Saúde Dentária, IOTN-DHC, para necessidade normativa; e Componente Estético auto-administrado, IOTN-AC, para necessidade subjetiva) e pelo FAI. Resultados: A consistência interna e a confiabilidade teste-reteste foram boas (alfa de Cronbach = 0,859-0,958; coeficiente de correlação intraclasse = 0,984). Os escores FAI, IOTN-DHC e IOTN-AC mostraram correlação altamente significativa com os escores do PIDAQ, representando forte validade convergente (p< 0.001). A análise de variância (ANOVA) de uma via e o teste post-hoc de Bonferroni mostraram correlações altamente significativas (p < 0,001) para todas as comparações. Não houve diferenças significativas entre as respostas de homens e mulheres. A versão regional do PIDAQ apresentou excelente confiabilidade. Conclusões: O PIDAQ mostrou boas propriedades psicométricas e foi capaz de refletir efetivamente o impacto psicossocial da má oclusão na estética facial alterada.

ABSTRACT This research is to replace natural coarse aggregate as 20%, 40%, 60%, 80%, and 100% respectively, by weight in an M20 grade geopolymer concrete. The geopolymer concrete with different mixes is subjected to fresh, hardened, and durability tests. Utilization of thermal ash aggregates increased the slump and compressive strength of geopolymer concrete by about 15% and 9% respectively. Whereas the slump and compressive strength of geopolymer concrete decreased by about 30% and 38% respectively by using 100% Lightweight Expanded Clay Aggregate (LECA). Density reduction in geopolymer concrete was found by using both thermal ash aggregate and lightweight expanded clay aggregate for about 9% and 28% respectively. Thermal ash aggregate decreased the density of geopolymer concrete up to 1850 kg/m3 and improved the strength up to 24.50 N/mm2, on the other side using lightweight expanded clay aggregate, the density of geopolymer concrete drastically decreased up to 1250 kg/m3 with a huge decrease in strength up to 14 N/mm2. Other mechanical test results showed similar variations with respect to the compression test results. To ensure the durability of lightweight geopolymer concrete for mixes of GPC, TM5, and LM2 conducted tests like acid resistance, sulphate resistance, salt resistance, water absorption, accelerated corrosion, and sorptivity test.

ABSTRACT This research mainly focuses on the nature of Fiber-Reinforced Polymers (FRP) wrapped piles for the axial compression load. Normally, the degradation of Reinforced Cement Concrete (RCC) structures occurred due to corrosion, inadequate quality materials, aging, live load increments, fatigue, damages and deterioration, and so forth. RCC pile foundations are commonly affected by the above reasons. So, these structures can be strengthened with suitable methods such as jacketing, stitching, overlaying, sealing, grouting, coating, Near Surface Mounted (NSM) systems, FRP wrapping, repairing, and blanketing. FRP wrapping is well suited for strengthening pile structures because of its easy application, and this method is done without using heavy tools and skilled labor. Due to its being non-metallic, FRP reinforcing has desirable properties such as high resistance to chemicals as well as heat, flexibility, large tensile strength, permeability, and also no oxidation. Thus, FRP wrapping was selected as the chosen approach for this ongoing research. In this study, we apply an axial compression load as well as a skin friction condition to a pile member that has been modified to assess its performance and behavior. FiberReinforced Fiber (FRP Normally (RCC corrosion materials aging increments fatigue deterioration forth reasons So jacketing stitching overlaying sealing grouting coating NSM (NSM systems repairing blanketing application labor nonmetallic, nonmetallic non metallic, metallic non-metallic heat flexibility strength permeability oxidation Thus study behavior

Abstract Background and objectives Several anthropometric measurements have been suggested to identify a potentially difficult airway. We studied thyromental height (TMH) as a predictor of difficult laryngoscopy and difficult intubation. We also compared TMH, ratio of height to thyromental distance (RHTMD), and thyromental distance (TMD) as predictors of difficult airway. Methods This cross-sectional observational study was conducted in 300 adult surgical patients requiring tracheal intubation. Preoperatively airway characteristics were assessed. Standard anesthesia was administered. Degree of difficulty with mask ventilation, laryngoscopic view, duration of laryngoscopy, and difficulty in tracheal intubation (intubation difficulty scale score) were noted. Multivariate logistics regression analysis was performed to identify independent predictors for difficult laryngoscopy. Results Laryngoscopy was difficult in 46 of 300 (15.3%) patients; all 46 patients had Cormack-Lehane grade 3 view. Duration of laryngoscopy was 27 ± 11 s in patients with difficult laryngoscopy and 12.7 ± 3.9 s in easy laryngoscopy; p= 0.001. Multivariate analysis identified that TMH, presence of short neck, and history of snoring were independently associated with difficult laryngoscopy. Incidence of difficult intubation was 17.0%. A shorter TMH was associated with higher IDS scores; r = -0.16, p= 0.001. TMH and duration of laryngoscopy were found to be negatively correlated; a shorter TMH was associated with a longer duration of laryngoscopy; r = -0.13, p= 0.03. The cut-off threshold value for TMH in our study is 4.4 cm with a sensitivity of 66% and a specificity of 54%. Conclusion Thyromental height predicts difficult laryngoscopy and difficult intubation. TMD and RHTMD did not prove to be useful as predictors of difficult airway.

Abstract Introduction Psychoeducational counselling and residual inhibition therapy (RIT) are traditional approaches used in many clinics to manage tinnitus. However, neurophysiological studies to evaluate posttreatment perceptual and functional cortical changes in humans are scarce. Objectives The present study aims to explore whether cortical auditory-evoked potentials (CAEPs; N1 and P3) reflect the effect of modified RIT and psychoeducational counselling, and whether there is a correlation between the behavioral and electrophysiological measures. Methods Ten participants with continuous and bothersome tinnitus underwent a session of psychoeducational counselling and modified RIT. Perceptual measures and CAEPs were recorded pre- and posttreatment. Further, the posttreatment measures were compared with age and gender-matched historical control groups. Results Subjectively, 80% of the participants reported a reduction in the loudness of their tinnitus. Objectively, there wasasignificant reductioninthe posttreatment amplitude of N1 and P3, with no alterations in latency. There was no correlation between the perceived difference in tinnitus loudness and the difference in P3 amplitude (at Pz). Conclusion The perceptual and functional (as evidenced by sensory, N1, and cognitive, P3 reduction) changes after a single session of RIT and psychoeducational counselling are suggestive of plastic changes at the cortical level. The current study serves as preliminary evidence that event-related potentials (ERPs) can be used to quantify the physiological changes that occur after the intervention for tinnitus.