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Rheumatoid arthritis (RA) is linked to various signs of advanced aging, such as premature immunosenescence which occurs due to decline in regenerative ability of T cells. RA T cells develop a unique aggressive inflammatory senescent phenotype with an imbalance of Th17/T regulatory (Treg) cell homeostasis and presence of CD28- T cells. The phenotypic analysis and characterization of T cell subsets become necessary to ascertain if any functional deficiencies exist within with the help of transcription factor (TF) analysis. These subset-specific TFs dictate the functional characteristics of T-cell populations, leading to the production of distinct effector cytokines and functions. Examining the expression, activity, regulation, and genetic sequence of TFs not only aids researchers in determining their importance in disease processes but also aids in immunological monitoring of patients enrolled in clinical trials, particularly in evaluating various T-cell subsets [Th17 (CD3+CD4+IL17+RORγt+) cells and T regulatory (Treg) (CD3+CD4+CD25+CD127-FOXP3+) cells], markers of T-cell aging [aged Th17 cells (CD3+CD4+IL17+RORγt+CD28-), and aged Treg cells (CD3+CD4+CD25+CD127-FOXP3+CD28-)]. In this context, we propose and outline the protocols for assessing the expression of TFs in aged Th17 and Treg cells, highlighting the crucial aspects of this cytometric approach.

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Artificial Intelligence and Natural Language Processing technology have demonstrated significant promise across several domains within the medical and healthcare sectors. This technique has numerous uses in the field of healthcare. One of the primary challenges in implementing ChatGPT in healthcare is the requirement for precise and up-to-date data. In the case of the involvement of sensitive medical information, it is imperative to carefully address concerns regarding privacy and security when using GPT in the healthcare sector. This paper outlines ChatGPT and its relevance in the healthcare industry. It discusses the important aspects of ChatGPT's workflow and highlights the usual features of ChatGPT specifically designed for the healthcare domain. The present review uses the ChatGPT model within the research domain to investigate disorders associated with the hepatic system. This review demonstrates the possible use of ChatGPT in supporting researchers and clinicians in analyzing and interpreting liver-related data, thereby improving disease diagnosis, prognosis, and patient care.

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Potassium, a pivotal macronutrient essential for growth, development, and crop yield, serves as a critical determinant of soil productivity. Its depletion disrupts the equilibrium of soil nutrients, prompting an investigation into integrated potassium management strategies to address this challenge. A field experiment was conducted during the winter season of 2020 using a randomized complete block design, with eight treatments, each replicated three times in Chinese cabbage (Brassica rapa L. subsp. chinensis). These treatments comprised standard (100 %) and reduced (75 % and 50 %) rates of the recommended dose of potassium (RDK) via muriate of potash (MOP). Variations in the inclusion and exclusion of plant growth-promoting rhizobacteria (PGPR), farmyard manure (FYM) as 25 % of the potassium recommendation, and foliar spray of nano potash were systematically implemented. Findings unequivocally demonstrated that the treatmentT8, involving 100 % RDK +25 % K through FYM + PGPR + nano K fertilizer spray at 25 and 40 DAS, yielded significant improvements in both green fodder (64.0 t ha-1) and dry fodder (7.87 t ha-1).Moreover, T8 exhibited the highest values for total ash (8.75 %), total ash yield (68.9 ± 2.88 kg ha-1), ether extract (2.85 %), ether extract yield (22.4 ± 0.88 kg ha-1), crude protein (9.71 %), and total crude protein yield (76.4 ± 3.21 kg ha-1). Conversely, a marked reduction was observed in various fiber components and carbohydrate fractions upon application of the T8 treatment. The lowest values of yield, crude protein content, total ash ether extract were recorded in treatment T1 (control) applied with no potassium. This investigation underscores the inadequacy of the recommended potassium dose in achieving optimal productivity, necessitating a re-evaluation of potassium fertilization levels. The integrated approach involving FYM, PGPR, and nano potash, coupled with the recommended potassium dose through MOP, emerges as a promising avenue for augmenting both yield and quality parameters in Chinese cabbage.

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Pesticides have health consequences for humans, living organisms, and ecosystems. Research on biological management, with a primary focus on entomopathogens, has been accelerated by the rise in issues such as pesticide residue, soil degradation, and pest resistance. Entomopathogenic nematodes (EPNs) are among the most frequently used and commercialised biopesticides. However, they are restricted in their infectivity, persistence, storage, and cost of production. The nematodes, along with their endosymbiotic bacteria, combine to form a nemato-bacterial complex. This complex is responsible for causing mortality in insect pests due to the production of insecticidal compounds. The adaptation of EPNs is an eco-friendly method, economical, and safer for the environment as well as non-target organisms. Moreover, it's a better alternative to synthetic chemical pesticides, as it can be helpful in overcoming pest resistance and resurgence issues. Application of nematode juveniles is a cost-effective method, but the necessity of refrigeration and transportation may enhance their cost. This review emphasised the diversity of entomopathogenic nematodes and their endosymbiotic bacteria, the exploration of the biocontrol potential of insect pests by under-utilisation of nematodes, the development of nematode-based formulations, and the discussion of critical issues and required research in the future.

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Background: The overall aim of this study was to assess the effectiveness of endoscopic decompression for outcomes in patients with lumbar spinal stenosis (LSS). Methods: We conducted a retrospective cohort, single-institution study of n = 139 patients from 2019 to 2022 who underwent endoscopic decompression for LSS. The primary outcome was improvement of Oswestry Disability Index (ODI) between baseline and 12-month follow-up. Results: In the present sample (n = 139) the average age was 57.6 years (SD = 17.4, with even distribution of men (49%) vs. women (51%). In patients with LSS, lumbar disc herniation was the most common diagnosis in 49 patients followed by lumbar radiculopathy in 25 patients. Lumbar radicular pain was the 3rd most common diagnosis in 21 patients with all other diagnosis listed in Table S1. There was a significant improvement (i.e., decrease) in ODI following endoscopic decompression (mean change: -8.3, 95% CI: -9.4, -7.2, P < 0.001, Fig. 1). Prior lumbar spine surgery (P = 0.048), BMI (P = 0.053), and age (P = 0.022) were associated with changes in ODI. Nearly half (47%) of the sample had prior lumbar spine surgery. Those with prior lumbar spine surgery (-7.5, 95% CI: -8.3, -6.6) showed less improvement than those without prior lumbar spine surgery (-9.1, 95% CI: -10.9, -7.2, Fig. 2). For BMI, 23% had normal BMI while 24% were overweight and 53% were obese. Patients with normal BMI (-10.3, 95% CI: -13.4, -7.2) showed greater improvements compared to overweight (-7.9, 95% CI: -9.4, -6.4) and obese (-7.6, 95% CI: -9.0, -6.3, Fig. 3) patients. Patients under 40 years old (-10.2, 95% CI: -13.6, -6.8) showed greater improvements in ODI compared to those 40 years and older (-7.8, 95% CI: -8.6, -6.8, Fig. 4). Conclusions: In patients with lumbar spinal stenosis, endoscopic decompression was associated with reduced disability. Patients with no prior lumbar spine surgery, normal BMI, and who were under 40 years old showed greater improvements.

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Endoscopic decompression continues to expand its therapeutic scope in alleviating chronic back pain. Endoscopic decompressions are minimally invasive and have rare complications. This case details a unique occurrence of a subdural collection following an interlaminar endoscopic laminotomy, facetectomy, lateral recess, and left L5 decompression. The subdural collection manifested above the operative site, despite the absence of dural puncture during the intervention. Subsequent to the procedure, the patient reported significant pain relief and presented for a follow-up appointment, disclosing new symptoms which included new weakness in his hamstrings and burning pain in his bilateral feet. A repeat MRI revealed a subdural collection, the etiology of which remains unclear given the intact dura during the surgical procedure. The MRI showed no new herniation and had objective improvement where his decompression took place. While previous cases have documented subdural collections primarily in association with dural puncture, this instance is distinctive in that regard. An intriguing aspect specific to endoscopic procedures is the potential for injury related to irrigation pressure. This scenario raises the hypothesis of a hematoma formation within the subdural space, possibly due to trauma to bridging vessels between the dura and arachnoid membrane. Alternatively, an unexpected increase in intra-abdominal or thoracic pressure may have led to elevated spinal vessel pressure, particularly affecting radiculomedullary veins traversing both the subdural and subarachnoid spaces. Further investigation and clinical monitoring are warranted to elucidate the precise mechanism underlying this subdural collection and its implications for postoperative management.

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Vertebral artery (VA) lusoria is an unusual variation of the VA origin and course, characterised by the direct origin of the right VA (RVA) from the aortic arch (AoA) instead of the right subclavian artery (RSCA). Generally, this condition remains asymptomatic and is diagnosed during computed tomography angiography (CTA) or catheter angiography performed for evaluation of other cardiac or extracardiac pathology. The surgeon and physician must be aware of this VA-origin anomaly before undergoing surgery or angiography, as injury to this vessel can be catastrophic and lead to torrential haemorrhage or brain stem infarction. This anomaly can occur in association with other branching anomalies, like the left VA originating from the arch and the bovine arch. We are reporting an unusual case of aberrant RVA in a five-vessel aortic arch We aim to highlight the importance of CTA in detecting these anomalies of origin and course and their clinical implications.

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Radiofrequency ablation (RFA) targeting the iliohypogastric and ilioinguinal (IH/IL) nerves is a recognized treatment for lower abdominal neuropathic pain. Despite its effectiveness, RFA typically offers only a temporary reprieve, necessitating repeated procedures. RFA procedures of the IH/IL nerves have been well described but often result in patient non-compliance and commonly necessitate the use of increased sedation. This case report details an RFA technique as a novel therapeutic technique for managing neuropathic pain associated with IH and IL pain. The technique described was conducted on a patient with complex pain and profound hyperalgesia with remarkable patient compliance and, more importantly, with reduced sedation. This case report delves into the progressive interventions employed by this novel technique in a patient being treated for IH/IL neuralgia. This case report describes increased patient compliance and potentially increased safety profile associated with this innovative RFA technique in comparison to traditional RFA and steroid injection. The patient, whose pain was unresponsive to standard treatments, was thoroughly assessed and underwent multiple failed interventions requiring sedation before the novel RFA technique was considered. We describe the patient's progression through various treatments, illustrating the benefits of this novel RFA method over the established ones. The discussion highlights the advantages of the new technique in terms of its effectiveness and the duration of its pain relief, offering valuable insights into the pain management field. This case contributes to the growing array of therapeutic strategies in pain medicine, potentially enhancing patient outcomes for those with IH/IL neuropathic pain.

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Atrial switch surgery is performed in patients with transposition of the great arteries. One of the complications of this surgery is obstruction of the baffle created. We describe the computed tomography findings of one such case where there was delayed presentation of recurrent Mustard baffle obstruction in addition to pulmonary venous drainage obstruction in an adult previously operated on for intra-atrial repair of transposition of the great arteries.

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Over recent years, the scientific community has acknowledged the crucial role of certain microbial strains inhabiting the intestinal ecosystem in promoting human health, and participating in various beneficial functions for the host. These microorganisms are now referred to as next-generation probiotics and are currently considered as biotherapeutic products and food or nutraceutical supplements. However, the majority of next-generation probiotic candidates pose nutritional demands and exhibit high sensitivity towards aerobic conditions, leading to numerous technological hurdles in large-scale production. This underscores the need for the development of suitable delivery systems capable of enhancing the viability and functionality of these probiotic strains. Currently, potential candidates for next generation probiotics (NGP) are being sought among gut bacteria linked to health, which include strains from the genera Bacteroids, Faecalibacterium, Akkermansia and Clostridium. In contrast to Lactobacillus spp. and Bifidobacterium spp., NGP, particularly Bacteroids spp. and Clostridium spp., appear to exhibit greater ambiguity regarding their potential to induce infectious diseases. The present review provides a comprehensive overview of NGPs in terms of their health beneficial effects, regulation framework and risk assessment targeting relevant criteria for commercialization in food and pharmaceutical markets.

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The present work has developed a straightforward, gentle, and effective approach for synthesizing arylamines and 5-substituted-1H-tetrazole derivatives, and among the two tested catalysts, molybdenum trioxide (MoO3) proved to be highly effective. The selective hydrogenation of nitroarenes to arylamines presents a significant challenge due to the complex reaction mechanism and the competitive hydrogenation of other reducible functional groups. It facilitated the transfer hydrogenation of nitrobenzene using hydrazine hydrate-produced amino compounds and enabled the [3 + 2] cycloaddition of sodium azide with aromatic nitriles to yield 5-substituted-1H-tetrazoles. The structure of compound 5-(4-bromophenyl)-1H-tetrazole (5k) was verified through single-crystal X-ray analysis, and the calculation of Green Chemistry Metrics showed the optimal range. Notably, the MoO3 catalyst can be reutilized for up to seven cycles with minimal loss of effectiveness. These attributes make molybdenum trioxide particularly attractive for industrial applications. This methodology offers several advantages over traditional synthetic methods.

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Popliteal artery entrapment syndrome (PAES) is a frequently underdiagnosed condition that should be investigated in adults who experience exertional intermittent claudication in the lower limbs. If detected early, it is a surgically treatable cause of leg claudication in young individuals. PAES can be inherited or acquired through muscular hypertrophy, and the literature classifies it into six categories (I-VI) based on anatomical type. We intend to report the magnetic resonance imaging (MRI) findings of two cases with type II PAES and their management.

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The interplay of ESIPT+TICT mechanisms in 1,8-naphthalimide-hydroxyquinoline (NQ-OH) molecular rotor were reported for the near-IR 'turn-on' emission (λmax 600 nm) and ratiometric (A405nm/A345nm) absorbance-based detection of Al3+ ions in aqueous medium and live cells which were supported by NMR, IR and CV techniques. The limit of detection (LOD) for Al3+ ions is 100 nM and 14.57 nM. The self-assembled spherical aggregates of NQ-OH transformed into cuboidal aggregates upon coordination with Al3+ ions supported by microscopic and dynamic light scattering (DLS) techniques. The complex NQ-OH+Al3+ was further used for the secondary detection of F- ions in aqueous medium via displacement approach with LOD as low as 2.67 nM. A deeper study revealed that the NQ-OH is a solvatochromic dye. Probably, the NQ-OH either in the aggregated state or in the coordination state with Al3+ ions, showed an increase in the emission intensity at 600 nm due to inhibition of the ESIPT process and trigger of the TICT process. We have demonstrated the utility of NQ-OH for the detection of Al3+ ions and NQ-OH+Al3+ complex for the detection of F- ions in MCF7 live cells. We have also discussed the molecular docking studies of NQ-OH with acetylcholinesterase enzyme.

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Rationale: Invasive fungal infections (IFI) in the intensive care unit (ICU) are an emerging problem owing to the use of broad-spectrum antibiotics, immunosuppressive agents, and frequency of indwelling catheters. Timely diagnosis which is imperative to improve outcomes can be challenging. This position statement is aimed at understanding risk factors, providing a rational diagnostic approach, and guiding clinicians to optimize antifungal therapy. Objectives: To update evidence on epidemiology, risk factors, diagnostic approach, antifungal initiation strategy, therapeutic interventions including site-specific infections and role of therapeutic drug monitoring in IFI in ICU and focus on some practice points relevant to these domains. Methodology: A committee comprising critical care specialists across the country was formed and specific aspects of fungal infections and antifungal treatment were assigned to each member. They extensively reviewed the literature including the electronic databases and the international guidelines and cross-references. The information was shared and discussed over several meetings and position statements were framed to ensure their reliability and relevance in critical practice. The draft document was prepared after obtaining inputs and consensus from all the members and was reviewed by an expert in this field. Results: The existing evidence on the management of IFI was updated and practice points were prepared under each subheading to enable critical care practitioners to streamline diagnosis and treatment strategies for patients in the ICU with additional detail on site-specific infections therapeutic drug monitoring. Conclusion: This position statement attempts to address the management of IFI in immunocompetent and non-neutropenic ICU patients. The practice points should guide in optimization of the management of critically ill patients with suspected or proven fungal infections. How to cite this article: Bhattacharya PK, Chakrabarti A, Sinha S, Pande R, Gupta S, Kumar AAK, et al. ISCCM Position Statement on the Management of Invasive Fungal Infections in the Intensive Care Unit. Indian J Crit Care Med 2024;28(S2):S20-S41.

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This study addresses the critical need for efficient and sustainable methods to tackle organic pollutants and microbial contamination in water. The present work aim was to investigate the potential of multi-structured zinc oxide nanoparticles (ZnO NPs) for the combined photocatalytic degradation of organic pollutants and antimicrobial activity. A unique fusion of precipitation-cum-hydrothermal approaches was precisely employed to synthesize the ZnO NPs, resulting in remarkable outcomes. The synthesized CTAB/ZnO NPs demonstrated exceptional properties: they were multi-structured and crystalline with a size of 40 nm and possessed a narrow band gap energy of 2.82 eV, enhancing light absorption for photocatalysis. These nanoparticles achieved an impressive degradation efficiency of 91.75% for Reactive Blue-81 dye within 105 min under UV irradiation. Furthermore, their photocatalytic performance metrics were outstanding, including a quantum yield of 1.73 × 10-4 Φ, a kinetic reaction rate of 3.89 × 102 µmol g-1 h-1, a space-time yield of 8.64 × 10-6 molecules photon-1 mg-1, and a figure-of-merit of 1.03 × 10-9 mol L J-1 g-1 h-1. Notably, the energy consumption was low at 1.73 × 10-4 J mol-1, compared to other systems. Additionally, the ZnO NPs exhibited effective antimicrobial activity against S. aureus and P. aeruginosa. This research underscores the potential of tailored ZnO NPs as a versatile solution for addressing both organic pollution and microbial contamination in water treatment processes. The low energy consumption further enhances its attractiveness as a sustainable solution.

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Various design platforms are available to stabilize soluble HIV-1 envelope (Env) trimers, which can be used as antigenic baits and vaccine antigens. However, stabilizing HIV-1 clade C trimers can be challenging. Here, we stabilized an HIV-1 clade C trimer based on an Env isolated from a pediatric elite-neutralizer (AIIMS_329) using multiple platforms, including SOSIP.v8.2, ferritin nanoparticles (NP) and an I53-50 two-component NP, followed by characterization of their biophysical, antigenic, and immunogenic properties. The stabilized 329 Envs showed binding affinity to trimer-specific HIV-1 broadly neutralizing antibodies (bnAbs), with negligible binding to non-neutralizing antibodies (non-nAbs). Negative-stain electron microscopy (nsEM) confirmed the native-like conformation of the Envs. Multimerization of 329 SOSIP.v8.2 on ferritin and two-component I53-50 NPs improved the overall affinity to HIV-1 bnAbs and immunogenicity in rabbits. These stabilized HIV-1 clade C 329 Envs demonstrate the potential to be used as antigenic baits and as components of multivalent vaccine candidates in future.

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Re-discovery of known metabolites is a common challenge in natural product-based drug discovery, and to avoid re-discovery, dereplication has been proposed for identifying known metabolites at the early stage of isolation. A majority of methods use LCMS to profile the extract and ignore the known mass. LC-HRMS profiling may generate a long mass list of metabolites. The identification of a new metabolite is difficult within the mass list. To overcome this, it was hypothesized that identifying a 'new metabolite' in the whole metabolome is more difficult than identifying it within the class of metabolites. A prioritization strategy was proposed to focus on the elimination of unknown and uncommon metabolites first using the designed bias filters and to prioritize the known secondary metabolites. The study employed Murraya paniculata root for the identification of new metabolites. The LC-HRMS-generated mass list of 509 metabolites was subjected to various filters, which resulted in 93 metabolites. Subsequently, it was subjected to regular dereplication, resulting in 10 coumarins, among which 3 were identified as new. Further, chromatographic efforts led to the isolation of a new coumarin, named ghosalin (1). The structure of the new compound was established through 2D NMR and X-ray crystallography. Cytotoxicity studies revealed that ghosalin has significant cytotoxicity against cancer cell lines. The proposed prioritization strategy demonstrates an alternative way for the rapid annotation of a particular set of metabolites to isolate a new metabolite from the whole metabolome of a plant extract.

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