Precipitating change: Holocene climate change in the Asian monsoon based on sediment archives from tropical lakes

The Asian monsoon is a complex and dynamic system and a significant driver of hydrological change in the global climate system. A number of monsoon subsystems, distributed over various geographical areas, make up the larger Asian monsoon system. The dynamics of climate change in the Asian monsoon over the Holocene in these subsystems is of key interest, given that the instrumental record is short and geographically biased and there is a low density of palaeoclimate records of sufficient length and resolution to capture long-term broader scale change and variability. The response of the Asian monsoon over mainland Southeast Asia is an important yet little studied aspect of the monsoon system. This region is of interest due to its location on the cusp of the Indian monsoon and East Asian monsoon subsystems. Gaining a better understanding of broad scale events in the Holocene as experienced by this region can assist in clarifying whether climatic responses in the various geographical provinces of the Asian monsoon occur asynchronously or in concert. This deepens the understanding of the geographical behaviour of the monsoon in relation to teleconnections and forcing mechanisms. This study provides a high resolution independently dated record of climate variability from the early Holocene, from stable isotopes from authigenic carbonates held in lake sediment archives. It presents new insights into the timing of the onset of dryer conditions in this region following the Holocene Optimum, which will herald valuable insight into the climate dynamics and teleconnections in the tropics in the recent past

“Comparison Of Pelvic PNF And Lower Limb Strengthening Protocol For Prevention Of Fall In Post Menopausal Women”

Background: One of the most well-known physiological effects of menopause is hormonal changes. Women's hormone levels decrease year by year during menopause, following which they are more likely to experience many changes as a result of this hormonal imbalance. Estrogen reacts directly and indirectly over muscle and results in condition leading to muscle loss, that brings about which in turn results in restrictions in physical abilities, muscle strength, and balance accelerating their risk of falling. Therefore this studycompared fall prevention techniques in postmenopausal women by incorporating proprioceptive neuromuscular facilitation (PNF) andexercises utilizing elastic bands.OBJECTIVES - To find out effect of pelvic PNF and lower limb strengthening to improve balance and strength for fall prevention.METHOD- It is a control group experimental study with a pre-test and post-test design. total no. of 24 postmenopausal women of age 45 to 65 were included in the study, Pelvic PNF along with lower limb PNF was administered to Experimental Group whereas lower limb strengthening was given to Control group. Along with the above intervention, home based exercises was also provided. All the subjects in the study underwent a basic assessment and then they were randomly assigned into one of two groups, the 4-week treatment plan of 3 sessions per week for 30-35 minutes was given.RESULT: After the 4 week PNF and elastic band exercise, both the experimental group and control groups showed statistically significant differences within the groups, except for POMA in the control group that showed no significant results. FTSTS inexperimental group with p value (0.008*) and in control group with p-value (0.000*). POMA with p value (0.02*) within experimental group showedsignificant results and POMA with p value (0.152) within control group showed no significant results. EFST with p value (0.005*) and (0.005*) showed significant result with in experimental and control group respevtively. There was no significant difference between the two groups in the scores of EFST, POMA and FTSTS (p>0.05).CONCLUSION: Given the findings of the present study, Pelvic PNF and elastic band exercise should be recommended as a practical approach in order to improve strength, balance and reduce fall in postmenopausal women

Prospective Observational study to determine the causes of hypokalemia and in medical wards and its association with other comorbidities and death

OBJECTIVES : 1. Calculate proportion of patients with hypokalemia and its causes in adult medical wards. 2. Dose and duration of potassium required for correction. 3. Correlation of Hypokalemia and mortality. 4. Association of hypokalemia with other comorbidities. 5. Association of ECG changes with severity of hypokalemia. METHODS : Total of 201 patients were recruited after taking a written informed consent. Every tenth consecutive patient was a control (patients with serum potassium more than or equal to 3.5 meq/l). Cases were all patients who had serum potassium <3 meq/l on day 1 of hospital admission. Data was collected with the help of a data abstraction sheet. All patients were followed up till the point of death or discharge. Data collected at follow up were the dose, duration and route of potassium required for achieving eukalemia, final diagnosis and final outcome. Data entry was made using Epidata 3.1. Analysis was done using SPSS software. RESULTS : 1. Proportion of hypokalemic patients: 48%(CI 0.42-0.53); proportion of mild, moderate and severe hypokalemic patients: 37% (CI 0.32-0.42), 8% (CI 0.05-0.11) and 3% (0.01-0.05) respectively. 2. Underlying causes: undetermined (80.7%), vomiting (33.7%), loose stools (15.5%) 3. Mortality rate: cases (4.4%), control (0.4%). Statistically not significant Mortality rate based on severity of hypokalemia: Mild (3.9%), moderate (0%), severe (0.04%). Statistically not significant. 4. Univariate analysis of comorbidities and hypokalemia did not show a statistically significant relationship. 5. Univariate analysis of inciting agents and hypokalemia did not show a statistically significant relationship. 6. Most of the mild hypokalemics became eukalemic with minimal dose of potassium correction. Mainly intravenous correction was done at an average dose of 1.5 gram for an average duration of 4 hours. 7. Most of the moderate hypokalemics required potassium correction for becoming eukalemic, consisting of both oral and intravenous routes, at an average total dose of 6 grams. Through the intravenous route, an average dose of 4.5 gram was used. Oral route was mostly not used. If given orally, maximum number of patients received a dose of 0.13 gram. Duration for mild hypokalemics to become eukalemic was 12 hours at an average. 8. Severe hypokalemics needed an average of 15 gram for achieving eukalemia with an average intravenous dose of 9 gram of potassium. Oral correction was mostly not used. If oral route was used, then the maximum number of patients needed 9g correction through this route. It took an average of 28 hours for severe hypokalemics to achieve eukalemia 9. ECG changes occurred both in cases and control at equal frequency. Decreased T wave amplitude, QT prolongation and flattening of T waves were seen more among cases. U waves were observed only among cases

Comparative Evaluation of Voids Present in Conventional and Capsulated Glass Ionomer Cements Using Two Different Conditioners: An In Vitro

This in vitro study evaluated the presence of voids in powder-liquid and capsulated glass ionomer cement. 40 cavities were prepared on root surfaces of maxillary incisors and divided into four groups. Cavities were conditioned with glass ionomer cement liquid (GC Corporation, Tokyo, Japan) in Groups 1 and 3 and with dentin conditioner (GC Corporation, Tokyo, Japan) in Groups 2 and 4. Conventional powder-liquid glass ionomer cement (GC Fuji II, GC Corporation, Tokyo, Japan) was used as a restorative material in Groups 1 and 2. Capsulated glass ionomer cement (GC Fuji II, GC Corporation, Tokyo, Japan) was used in Groups 3 and 4. Samples were sectioned and viewed under stereomicroscope to check for the presence of voids within the cement and at the cement-tooth junction. Data was analyzed using one-way ANOVA and Tukey’s post hoc tests. Group 4 showed statistically significant results (P<0.05) when compared to Groups 1 and 2 for voids within the cement. However, for voids at the margins, the results were statistically insignificant

High-level and Low-level Feature Set for Image Caption Generation with Optimized Convolutional Neural Network, Journal of Telecommunications and Information Technology, 2022, nr 4

Automatic creation of image descriptions, i.e. captioning of images, is an important topic in artificial intelligence (AI) that bridges the gap between computer vision (CV) and natural language processing (NLP). Currently, neural networks are becoming increasingly popular in captioning images and researchers are looking for more efficient models for CV and sequence-sequence systems. This study focuses on a new image caption generation model that is divided into two stages. Initially, low-level features, such as contrast, sharpness, color and their high-level counterparts, such as motion and facial impact score, are extracted. Then, an optimized convolutional neural network (CNN) is harnessed to generate the captions from images. To enhance the accuracy of the process, the weights of CNN are optimally tuned via spider monkey optimization with sine chaotic map evaluation (SMO-SCME). The development of the proposed method is evaluated with a diversity of metrics

ANALGESIC ACTIVITY OF BARK AND LEAVES OF FICUS RELIGIOSA L. FROM NEPAL

Objective: Because of adverse side effects, caused by NSAIDs, tolerance, and dependence induced by opiates, the use of these analgesic agents has not been successful in all cases. Therefore, alternative analgesic drugs from plant sources are the new target now days. The objective of this study was to evaluate the analgesic activity of ethanolic extracts of stem barks and leaves of Ficus religiosa. Methods: The analgesic activity of ethanolic extract of stem barks and leaves was evaluated in the Swiss albino mice model using acetic acid-induced writing response and Eddy’s hot plate method. Analgesic activity was demonstrated with the percentage inhibition of acetic acid induced writings and the percentage increased in latency time of paw licking. The potency of test extracts was compared with standard drug, Diclofenac. Results: Ethanolic extract of leaves and bark of F. religiosa showed potential analgesic activity from both methods. From Eddy’s hot plate model, it was observed that the percentage of increased latency time at 90 min by ethanolic extract of leaves and stem bark was found to be 70.81 % (8.54 min) and 70.78 % (8.53 min) respectively at a dose of 400 mg/kg. Both of these results are statistically significant (p&lt;0.05) as compared to the test group. Furthermore, both of these extracts showed the dose-dependent and time-dependent increased in latency time and these results are compared to that of standard drug Diclofenac. Similarly, ethanolic extract of leaves and stem at 400 mg/kg significantly inhibited the number of writhings induced by acetic acid. The percentage inhibition of writhings by ethanolic extract of leaves at a dose of 400 mg/kg was 68.47 % which was similar to that of standard drug Diclofenac (68.47 %). However, ethanolic extract of bark showed relatively lower percentage inhibition (60.79 %) as compared to leaf extract and standard, but the result was significant as compared to that of the test group (p&lt;0.05). Conclusion: Ethanolic extracts of F. religiosa stem bark and leaf possess both central and peripheral analgesic properties and these effects may be beneficial for the management of pain

Leveraging Genomic Associations in Precision Digital Care for Weight Loss: Cohort Study

Background: The COVID-19 pandemic has highlighted the urgency of addressing an epidemic of obesity and associated inflammatory illnesses. Previous studies have demonstrated that interactions between single-nucleotide polymorphisms (SNPs) and lifestyle interventions such as food and exercise may vary metabolic outcomes, contributing to obesity. However, there is a paucity of research relating outcomes from digital therapeutics to the inclusion of genetic data in care interventions. Objective: This study aims to describe and model the weight loss of participants enrolled in a precision digital weight loss program informed by the machine learning analysis of their data, including genomic data. It was hypothesized that weight loss models would exhibit a better fit when incorporating genomic data versus demographic and engagement variables alone. Methods: A cohort of 393 participants enrolled in Digbi Health’s personalized digital care program for 120 days was analyzed retrospectively. The care protocol used participant data to inform precision coaching by mobile app and personal coach. Linear regression models were fit of weight loss (pounds lost and percentage lost) as a function of demographic and behavioral engagement variables. Genomic-enhanced models were built by adding 197 SNPs from participant genomic data as predictors and refitted using Lasso regression on SNPs for variable selection. Success or failure logistic regression models were also fit with and without genomic data. Results: Overall, 72.0% (n=283) of the 393 participants in this cohort lost weight, whereas 17.3% (n=68) maintained stable weight. A total of 142 participants lost 5% bodyweight within 120 days. Models described the impact of demographic and clinical factors, behavioral engagement, and genomic risk on weight loss. Incorporating genomic predictors improved the mean squared error of weight loss models (pounds lost and percent) from 70 to 60 and 16 to 13, respectively. The logistic model improved the pseudo R 2 value from 0.193 to 0.285. Gender, engagement, and specific SNPs were significantly associated with weight loss. SNPs within genes involved in metabolic pathways processing food and regulating fat storage were associated with weight loss in this cohort: rs17300539_G (insulin resistance and monounsaturated fat metabolism), rs2016520_C (BMI, waist circumference, and cholesterol metabolism), and rs4074995_A (calcium-potassium transport and serum calcium levels). The models described greater average weight loss for participants with more risk alleles. Notably, coaching for dietary modification was personalized to these genetic risks. Conclusions: Including genomic information when modeling outcomes of a digital precision weight loss program greatly enhanced the model accuracy. Interpretable weight loss models indicated the efficacy of coaching informed by participants’ genomic risk, accompanied by active engagement of participants in their own success. Although large-scale validation is needed, our study preliminarily supports precision dietary interventions for weight loss using genetic risk, with digitally delivered recommendations alongside health coaching to improve intervention efficac

In Vitro

Root canal sealers that possess good antimicrobial property can prevent residual and recurrent infection and contribute to successful endodontic therapy. This study evaluated the antimicrobial activity of four endodontic sealers, AH Plus, Tubliseal EWT, EndoRez, and iRoot SP, against three different microorganisms, E. faecalis, C. albicans, and S. aureus, by direct contact test. 10 μL microbial suspensions were allowed to directly contact the four endodontic sealers for 1 hr at 37°C. Subsequently microbial growth was measured spectrophotometrically every 30 min for 18 hours. The microbial suspensions were simultaneously tested to determine the antimicrobial effect of components which are capable of diffusing into the medium. The results revealed that AH Plus and iRootSP had significantly higher antimicrobial activity against E. faecalis. AH Plus and Tubliseal EWT showed significantly higher antimicrobial activity against C. albicans and S. aureus compared to iRoot SP and EndoRez. EndoRez showed the least antimicrobial activity against all the three microorganisms. Inhibition of microbial growth is related to the direct contact of microorganisms with the sealers. In conclusion AH Plus had significantly higher antimicrobial activity against E. faecalis, C. albicans, and S. aureus

LEARN: A multi-centre, cross-sectional evaluation of Urology teaching in UK medical schools

OBJECTIVE: To evaluate the status of UK undergraduate urology teaching against the British Association of Urological Surgeons (BAUS) Undergraduate Syllabus for Urology. Secondary objectives included evaluating the type and quantity of teaching provided, the reported performance rate of General Medical Council (GMC)-mandated urological procedures, and the proportion of undergraduates considering urology as a career. MATERIALS AND METHODS: LEARN was a national multicentre cross-sectional study. Year 2 to Year 5 medical students and FY1 doctors were invited to complete a survey between 3rd October and 20th December 2020, retrospectively assessing the urology teaching received to date. Results are reported according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). RESULTS: 7,063/8,346 (84.6%) responses from all 39 UK medical schools were included; 1,127/7,063 (16.0%) were from Foundation Year (FY) 1 doctors, who reported that the most frequently taught topics in undergraduate training were on urinary tract infection (96.5%), acute kidney injury (95.9%) and haematuria (94.4%). The most infrequently taught topics were male urinary incontinence (59.4%), male infertility (52.4%) and erectile dysfunction (43.8%). Male and female catheterisation on patients as undergraduates was performed by 92.1% and 73.0% of FY1 doctors respectively, and 16.9% had considered a career in urology. Theory based teaching was mainly prevalent in the early years of medical school, with clinical skills teaching, and clinical placements in the later years of medical school. 20.1% of FY1 doctors reported no undergraduate clinical attachment in urology. CONCLUSION: LEARN is the largest ever evaluation of undergraduate urology teaching. In the UK, teaching seemed satisfactory as evaluated by the BAUS undergraduate syllabus. However, many students report having no clinical attachments in Urology and some newly qualified doctors report never having inserted a catheter, which is a GMC mandated requirement. We recommend a greater emphasis on undergraduate clinical exposure to urology and stricter adherence to GMC mandated procedures

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely