Prevalence of gestational diabetes mellitus, its associated risk factors and pregnancy outcomes at a rural setup in Central India

Background: Gestational diabetes mellitus (GDM) is characterised by carbohydrate intolerance of varying severity with onset or first recognition during pregnancy. GDM is an important public health problem in India.Method: The present study was carried out in 300 antenatal women. Fasting blood glucose was measured after which they were given 75 g oral glucose and plasma glucose was estimated at 2 h. Patients with plasma glucose >140 mg/dl were labelled as GDM. Thus WHO criteria were used for diagnosing GDM. Data was collected from all subjects on demographic characteristics, socioeconomic status, education level, parity, family history of diabetes and/or hypertension, BMI, etc. and pregnancy outcome was studied.Results: Prevalence of GDM was found to be 8.33%. Gestational diabetes mellitus was found to be significantly associated with age, parity, BMI, socioeconomic status, education level and was also found to be associated with adverse pregnancy outcomes.Conclusion: GDM adversely affects maternal and fetal outcomes and its prevalence is steadily rising. Appropriate interventions are required for its control

Study of various gynaecological problems and reproductive health awareness amongst adolescents at a rural setup in central India

Background: Adolescent problems are increasing over the years and need special consideration. We, as health care providers, need to focus on young people as investing in their health today will reap rich rewards tomorrow.Methods: All the adolescents presenting with various gynaecological problems were evaluated by detailed history taking and thorough clinical examination after taking an informed consent and explaining them our objective. After examination, adolescent girls were given education by means of slide show about menstruation, care during menses, nutritional diet and prevention of anaemia.Results: Majority of adolescents had regular menstrual pattern. Oligomenorrhoea was the most prevalent abnormality of menstrual pattern in these adolescents. 15.58% adolescents had presented with breast problems like mastalgia, lump in breast, etc. Majority of adolescents studied were aware of the physical signs of puberty (77.25%) and HIV (74.14%). But very few adolescents were aware of the physiology involved in menstruation. Around half of all the adolescents were seen to follow proper menstrual hygiene.Conclusions: Healthy adolescence, the need of the hour

Telenoid android robot as an embodied perceptual social regulation medium engaging natural human–humanoid interaction

The present paper aims to validate our research on human–humanoid interaction (HHI) using the minimalist humanoid robot Telenoid. We conducted the human–robot interaction test with 142 young people who had no prior interaction experience with this robot. The main goal is the analysis of the two social dimensions (‘‘Perception’’ and ‘‘Believability’’) useful for increasing the natural behaviour between users and Telenoid.Weadministered our custom questionnaire to human subjects in association with a well defined experimental setting (‘‘ordinary and goal-guided task’’). A thorough analysis of the questionnaires has been carried out and reliability and internal consistency in correlation between the multiple items has been calculated. Our experimental results show that the perceptual behaviour and believability, as implicit social competences, could improve the meaningfulness and the natural-like sense of human–humanoid interaction in everyday life task-driven activities. Telenoid is perceived as an autonomous cooperative agent for a shared environment by human beings

Pre-treatment high-sensitivity troponin T for the short-term prediction of cardiac outcomes in patients on immune checkpoint inhibitors

Background: Immune checkpoint inhibitors (ICIs) are an emerging option for several advanced metastatic cancers, but may have cardiotoxic effects. The prognostic value of high-sensitivity troponin T (hs-TnT) before treatment start has never been investigated. Materials and methods: Thirty consecutive patients underwent measurement of hs-TnT before starting ICI therapy (pembrolizumab, 23%; nivolumab, 12%; atezolizumab, 6%; durvalumab, 5%). The primary endpoint of cardiovascular death, stroke or transient ischaemic attack, pulmonary embolism and new-onset heart failure, and the secondary endpoint of progression of cardiac involvement according to the CARDIOTOX classification were evaluated after 3 months from the first cycle. Results: Patients (median age 68 years, 77% men, 13% with coronary artery disease, 90% current or former smokers, 67% overweight or obese and 43% hypertensive) had a median hs-TnT of 12 ng/L (interquartile interval 8-23). The primary endpoint occurred only in patients with hs-TnT ≥ 14 ng/L at baseline. Therefore, only patients who had hs-TnT ≥ 14 ng/L before the first cycle died had a stroke/TIA or new-onset HF. Furthermore, nine out of 13 patients with the secondary endpoint (progression of cardiac disease) had hs-TnT ≥ 14 ng/L before the first cycle (P =.012). AUC values were 0.909 for the primary endpoint and 0.757 for the secondary endpoint. The best cut-off was 14 ng/L for both the primary (100% sensitivity, 73% specificity) and secondary endpoints (sensitivity 75%, specificity 77%). Conclusions: In patients on ICIs, baseline hs-TnT predicts a composite cardiovascular endpoint and the progression of cardiac involvement at 3 months, with 14 ng/L as the best cut-off

Moral Mediators in the Metaverse: Exploring Artificial Morality through a Talking Cricket Paradigm

As technological innovations continue to shape our social interactions, the Metaverse introduces immersive experiences that reflect real-life practices, accessible by users through their avatars. However, these interactions also bring forth potential negative aspects, including discrimination and cyberbullying. While current automatic detection systems exist, educating users on appropriate behaviour remains crucial. Leveraging recent advancements in Artificial Intelligence, the paper focuses on creating virtual AI-controlled moral agents within the Metaverse to guide users in dealing with moral dilemmas. The research aims to understand how such agents impact users' perceptions and behaviours in ethically challenging virtual environments

An android architecture for bio-inspired honest signalling in Human-Humanoid Interaction

This paper outlines an augmented robotic architecture to study the conditions of successful Human-Humanoid Interaction (HHI). The architecture is designed as a testable model generator for interaction centred on the ability to emit, display and detect honest signals. First we overview the biological theory in which the concept of honest signals has been put forward in order to assess its explanatory power. We reconstruct the application of the concept of honest signalling in accounting for interaction in strategic contexts and in laying bare the foundation for an automated social metrics. We describe the modules of the architecture, which is intended to implement the concept of honest signalling in connection with a refinement provided by delivering the sense of co-presence in a shared environment. Finally, an analysis of Honest Signals, in term of body postures, exhibited by participants during the preliminary experiment with the Geminoid Hi-1 is provided

Malignant pleural mesothelioma and mesothelial hyperplasia: A new molecular tool for the differential diagnosis

Malignant pleural mesothelioma (MPM) is a rare asbestos related cancer, aggressive and unresponsive to therapies. Histological examination of pleural lesions is the gold standard of MPM diagnosis, although it is sometimes hard to discriminate the epithelioid type of MPM from benign mesothelial hyperplasia (MH). This work aims to define a new molecular tool for the differential diagnosis of MPM, using the expression profile of 117 genes deregulated in this tumour. The gene expression analysis was performed by nanoString System on tumour tissues from 36 epithelioid MPM and 17 MH patients, and on 14 mesothelial pleural samples analysed in a blind way. Data analysis included raw nanoString data normalization, unsupervised cluster analysis by Pearson correlation, non-parametric Mann Whitney U-test and molecular classification by the Uncorrelated Shrunken Centroid (USC) Algorithm. The Mann-Whitney U-test found 35 genes upregulated and 31 downregulated in MPM. The unsupervised cluster analysis revealed two clusters, one composed only of MPM and one only of MH samples, thus revealing class-specific gene profiles. The Uncorrelated Shrunken Centroid algorithm identified two classifiers, one including 22 genes and the other 40 genes, able to properly classify all the samples as benign or malignant using gene expression data; both classifiers were also able to correctly determine, in a blind analysis, the diagnostic categories of all the 14 unknown samples. In conclusion we delineated a diagnostic tool combining molecular data (gene expression) and computational analysis (USC algorithm), which can be applied in the clinical practice for the differential diagnosis of MPM

Comparative distribution of azithromycin in lung tissue of patients given oral daily doses of 500 and 1000 mg

OBJECTIVES: The administration of antibacterial agents should be optimized on the basis of their distribution to enhance drug exposure and obtain bacterial eradication. This study examines the pharmacokinetics of azithromycin in plasma, lung tissue and bronchial washing in patients after oral administration of 500 mg versus 1000 mg once daily for 3 days. PATIENTS AND METHODS: Samples of plasma, lung tissue and bronchial washing were obtained from a cohort of 48 patients during open-chest surgery for lung resection up to 204 h after the last drug dose, and assayed for antibiotic concentrations. RESULTS: Azithromycin was widely distributed within the lower respiratory tract and sustained levels of the drug were detectable at the last sampling time in lung tissue. Doubling the dose of the antibiotic resulted in a proportional increase in lung area under the curve (AUC, 1245.4 versus 2514.2 h x mg/kg) and peak tissue concentration (Cmax, 8.93 +/- 2.05 versus 18.6 +/- 2.20 mg/kg). The pharmacodynamic parameter AUC/MIC for susceptible and intermediate strains of Streptococcus pneumoniae (MICs 0.5 and 2 mg/L, respectively) increased after administration of the 1000 mg schedule compared with 500 mg (AUC/MIC0.5 2414 versus 1144 and AUC/MIC2 2112 versus 814.1 h x mg/kg, respectively) in pulmonary tissue. CONCLUSIONS: Lung exposure to azithromycin is increased proportionally by doubling the dose, which results in a predictable pharmacokinetic behaviour of the drug in the lower respiratory tract

Estimating the cost of care giving on caregivers for people living with HIV and AIDS in Botswana: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Community home-based care is the Botswana Government's preferred means of providing care for people living with HIV (PLHIV). However, primary (family members) or volunteer (community members) caregivers experience poverty, are socially isolated, endure stigma and psychological distress, and lack basic care-giving education. Community home-based care also imposes considerable costs on patients, their caregivers and families in terms of time, effort and commitment. An analysis of the costs incurred by caregivers in providing care to PLHIV will assist health and social care decision makers in planning the most appropriate ways to meet future service needs of PLHIV and their caregivers.</p> <p>Methods</p> <p>This study estimated the cost incurred in providing care for PLHIV through a stratified sample of 169 primary and volunteer caregivers drawn from eight community home-based care groups in four health districts in Botswana.</p> <p>Results</p> <p>The results show that the mean of the total monthly cost (explicit and indirect costs) incurred by the caregivers was $(90.45 ± 9.08) while the mean explicit cost of care giving was$(65.22 ± 7.82). This mean of the total monthly cost is about one and a half times the caregivers' mean monthly income of $66.00 (± 5.98) and more than six times the Government of Botswana's financial support to the caregivers. In addition, the cost incurred per visit by the caregivers was$15.26, while the total expenditure incurred per client or family in a month was $184.17.</p> <p>Conclusions</p> <p>The study, therefore, concludes that as the cost of providing care services to PLHIV is very high, the Government of Botswana should substantially increase the allowances paid to caregivers and the support it provides for the families of the clients. The overall costs for such a programme would be quite low compared with the huge sum of money budgeted each year for health care and for HIV and AIDS.</p

ErbB in NSCLC as a molecular target: Current evidences and future directions

A number of treatments have been developed for HER1, 2 and 3-driven non-small cell lung cancer (NSCLC), of which the most successful have been the epidermal growth factor receptor-tyrosine kinase inhibitors in HER1-mutant tumours resulting in highly improved progression-free survival. Human epidermal growth factor (HER)2 and 3-driven tumours represent the minority of NSCLC, and effective therapies in these patients still represent an unmet medical need. The encouraging results seen with anti-HER2 and anti-HER3 monoclonal antibodies need to be validated in larger studies, even if the greatest obstacle is represented by the exiguous number of patients bearing deregulated HER2/3 system and abnormalities of signal transduction pathway. Considering NSCLC tumour heterogeneity, which affects response and resistance to treatment, combined multiparametric approaches, such as liquid biopsy together with radiomics, may provide a better understanding of the tumour dynamics and clonal selection during the treatments