Addition of nisin to high-viscosity glass-ionomer cement: a comparative in vitro study on antibacterial and physical properties

PURPOSE

Nisin is a lantibiotic effective against Gram-positive microorganisms such as Streptococcus mutans. The study aimed to determine the effect of the addition of nisin to high-viscosity glass-ionomer cement (HVGIC) on its antibacterial activity, setting time, surface microhardness, and compressive strength.

METHODS

1 and 3% w/w nisin were added to HVGIC before mixing. Unmodified HVGIC was the control. Agar disc diffusion, direct contact test, and scanning electron microscopy (SEM) analysis were used to evaluate antibacterial activity against S. mutans. Setting time, surface microhardness, and compressive strength were measured using Gilmore needle apparatus, digital microhardness tester, and universal testing machine, respectively. Statistical analysis included Student's t test, one-way ANOVA with Tamhane's post hoc test, and repeated-measures ANOVA.

RESULTS

As evidenced by the agar disc diffusion (p < 0.001), direct contact tests (p = 0.025), and SEM analysis of the S. mutans cell count and cell surface area (p = 0.049 and 0.003), 3% nisin had the strongest antibacterial activity. There was a dose-dependent increase in setting time (p = 0.005) and surface microhardness (p = 0.006), with no significant difference in compressive strength compared to control.

CONCLUSION

The addition of 3% nisin to HVGIC enhances the antibacterial action against S. mutans and surface microhardness without adversely affecting setting time and compressive strength.

Comparison of cognitive workload and surgical outcomes between a three-dimensional and conventional microscope macular hole surgery

BACKGROUND

Performing a surgical task subjects the surgeon to multitudinal stressors, especially with the newer 3D technology. The quantum of cognitive workload using this modern surgical system in comparison to the Conventional microscope system remains unexplored. We evaluate the surgeon's cognitive workload and the surgical outcomes of macular hole(MH) surgery performed on a 3D versus a Conventional microscope operating system.

METHODS

50 eyes of 50 patients with MH undergoing surgery using the 3D or Conventional microscope visualization system. Cognitive workload assessment was done by real-time tools(Surgeons' heart rate [HR] and oxygen saturation[SPO2]) and self-report tool(Surgery Task Load Index[SURG-TLX] questionnaire) of three Vitreoretinal surgeons. Based on the SURG-TLX questionnaire, an assessment of the workload was performed.

RESULTS

Of the 50 eyes, 30 eyes and 20 eyes underwent surgery with the Conventional microscope and the 3D system, respectively. No difference was noted in the MH basal-diameter(p = 0.128), total surgical-duration(p = 0.299), internal-limiting membrane(ILM) peel time(p = 0.682), and the final visual acuity (VA; p = 0.515) between the two groups. Both groups showed significant improvement in VA(p < 0.001) with a 90% closure rate at one-month post-surgery. Cognitive workload comparison, the intraoperative HR(p = 0.024), total workload score(P = 0.005), and temporal-demand dimension(p = 0.004) were significantly more in Conventional microscope group as compared to 3D group. In both the groups, the HR increased significantly from the baseline while performing ILM peeling and at the end.

CONCLUSION

The surgeon's cognitive workload is markedly reduced while performing macular hole surgery with a 3D viewing system. Moreover, duration of surgery including ILM peel time, MH closure rates, and visual outcomes remains unaffected irrespective of the operating microscope system.

Optimising peak energy reduction in networks of buildings

Buildings are amongst the world's largest energy consumers and simultaneous peaks in demand from networks of buildings can decrease electricity system stability. Current mitigation measures either entail wasteful supply-side over-specification or complex centralised demand-side control. Hence, a simple schema is developed for decentralised, self-organising building-to-building load coordination that requires very little information exchange and no top-down management-analogous to other complex systems with short range interactions, such as coordination between flocks of birds or synchronisation in fireflies. Numerical and experimental results reveal that a high degree of peak flattening can be achieved using surprisingly small load-coordination networks. The optimum reductions achieved by the simple schema can outperform existing techniques, giving substantial peak-reductions as well as being remarkably robust to changes in other system parameters such as the interaction network topology. This not only demonstrates that significant reductions in network peaks are achievable using remarkably simple control systems but also reveals interesting theoretical results and new insights which will be of great interest to the complexity and network science communities.

Synthesis, Optical, Dielectric, SHG, Magnetic and Visible Light Driven Catalytic Studies on Compounds Belonging to the Swedenborgite Structure

A new compound, InBaZn3 GaO7 , with swedenborgite structure along with transition metal (TM) substituted variants have also been prepared. The structure contains layers of tetrahedral ions (Zn2+ /Ga3+ ) connected by octahedrally coordinated In3+ ion forming the three-dimensional structure with voids where the Ba2+ ions occupy. The TM substituted compounds form with new colors. The origin of the color was understood based on the ligand-field transitions. The near IR reflectivity studies indicate that the Ni - substituted compounds exhibit good near - IR reflectivity behavior, making them possible candidates for 'cool pigments'. The temperature dependent dielectric studies indicate that the InBaZn3 GaO7 compound undergoes a phase transition at ~360 °C. The compounds are active towards second harmonic generation (SHG). Magnetic studies show the compounds, InBaZn2 CoFeO7 and InBaZn2 CuFeO7 to be anti-ferromagnetic in nature. The copper containing compounds were found to be good catalysts, under visible light, for the oxidation of aromatic alkenes. The many properties observed in the swedenborgite structure-based compounds suggests that the mineral structure offers a fertile ground to investigate newer compounds and properties.

Turn-off luminescence sensing, white light emission and magnetic studies of two-dimensional lanthanide MOFs

The lanthanide metal organic framework compounds [Ln(BPTA)1.5(Bpy)]·0.5DMF (Ln = Y, Eu, Gd, Tb, Dy; 1a-5a) and [Ln(BPTA)1.5(Phen)]·0.5DMF (Ln = Y, Eu, Gd, Tb, Dy; 1b-5b) were prepared by employing 2,5-bis(prop-2-yn-1-yloxy)terephthalic acid (2,5-BPTA) as the primary ligand and 2,2'-bipyridine (1a-5a) and 1,10-phenanthroline (1b-5b) as the secondary ligands. Single-crystal structural studies on [Gd(BPTA)1.5(Bpy)]·0.5DMF (3a) and [Dy(BPTA)1.5(Phen)]·0.5DMF (5b) indicated that the compounds have a two-dimensional structure. The Y compound exhibits blue emission, and the other compounds exhibit emission in the expected regions (λex = 350 nm). White light emission was achieved by careful mixing of the red (Eu3+) and green (Tb3+) components in the blue emitting Y compound. Thus, Y0.96Tb0.02Eu0.02 (bpy) and Y0.939Tb0.06Eu0.001 (phen) were found to show white emission when excited using a wavelength of 350 nm. The introduction of N-N-containing ancillary ligands (i.e., bpy and phen) increased the overall quantum yield (QY) of white light emission to 31% and 43%, respectively. The high QY observed for the Tb and Eu compounds was found to be sensitive and selective for the fluorometric detection of azinphos-methyl pesticide and trinitrophenol (TNP) in an aqueous medium at the ppb level. The same behaviour was observed when utilising the compounds as onsite paper strip sensors. Their magnetic properties were also studied, revealing for the Tb and Dy derivatives slow relaxation of the magnetisation at low temperature. The present study highlights the usefulness of rigid π-conjugated molecules such as 2,2'-bipyridine and 1,10-phenanthroline in enhancing the many utilities of rare-earth-containing MOFs towards white light emission, the sensing of harmful and dangerous substances and magnetic properties.

Influence of indoor volatile organic compounds and its relative respiratory effects among children living in rural biomass cooking households of Tamil Nadu and Andhra Pradesh

PURPOSE

Exposures to volatile organic compounds (VOCs) cause respiratory symptoms among children, a known vulnerable group. Reports on exposures to VOCs and respiratory symptoms among South Indian children living in biomass-using households are not available thus far.

METHODS

A cross-sectional study was conducted among 313 rural children to assess the influence of emitted VOCs on their respiratory health. Standard analytical procedures for VOCs and Pulmonary Function Test (PFT), allied questionnaires, and all ethical considerations were fulfilled in the study.

RESULTS

The increase in VOC concentrations was observed proportional to the amount of burnt biomass fuel in two selected sites in Tamil Nadu (TN) and Andhra Pradesh (AP). Houses cooked for more than 60 min showed a remarkable increase in VOC concentrations and was observed as statistically significant (p < 0.01) in AP households. Among the younger children, the peak expiratory flow rate (PEFR) values were found significantly higher than comparatively older children in both the sites, TN and AP. However, the trend with respect to FEV1 is statistically significant (p < 0.01) among AP children.

CONCLUSIONS

This study reports reduced lung function for a considerable proportion of the VOC-exposed selected children. Based on PFT, the children who were interpreted to be normal were found to be exposed to lesser indoor TVOC concentrations in comparison with the children of the households having restrictive or obstructive impairments. Diagnostic ratios with Benzene/Toluene (B/T) and Xylene/Ethyl benzene (X/E) confirmed the presence of VOCs-emissions from adjacent cooking fuels only. The observed results of this study recommends cleaner cooking fuel-use for better respiratory health among the citizens across the country, which in turn, in line with the Pradhan Mantri Ujjwala Yojana (PMUY), Government of India.

Fixing CO2 under Atmospheric Conditions and Dual Functional Heterogeneous Catalysis Employing Cu MOFs: Polymorphism, Single-Crystal-to-Single-Crystal (SCSC) Transformation and Magnetic Studies

New copper compounds, [Cu(C14H8O6)(C10H8N2)(H2O)] (1), [Cu(C14H8O6)(C10H8N2)(H2O)]·(C3H7ON)2 (2), [Cu(C14H8O6)(C10H8N2)(H2O)2]·(C3H7ON) (3), [Cu(C14H8O6)(C10H8N4)] (4), and [Cu(C14H8O6)(C10H8N4)]·(H2O) (5), were prepared employing 2,5-bis(prop-2-yn-1-yloxy)terephthalic acid (2,5-BPTA) as the primary ligand and 4,4'-bipyridine (1-3) and 4,4'-azopyridine (4-5) as the secondary ligands. Single-crystal studies indicated that compounds 1-4 have two-dimensional layer structures and compound 5 has a three-dimensional structure. Compounds 1-3 were isolated from the same reaction mixture but by varying the time of reaction. The framework structures of compounds 1-3 are similar and may be considered as polymorphic structures. Compounds 4 and 5 can also be considered polymorphic with a change in dimensionality of the structure. Compounds 1-3 can be formed through a single-crystal-to-single-crystal transformation under a suitable solvent mixture. The Cu center was explored for the Lewis acid-catalyzed cycloaddition reaction of epoxide and CO2 under ambient conditions in a solventless condition and also for the synthesis of propargylamine derivatives by three-component coupling reactions (A3 coupling) in a DCM medium. The Lewis basic functionality of the MOF (-N═N- group) has been explored for the Henry reaction (aldol condensation) in a solventless condition. In all of the catalytic reactions, good yields and recyclability were observed. The magnetic studies indicated that compounds 1 and 4 have antiferromagnetic interactions and compound 5 has ferromagnetic interactions. The present studies illustrated the rich diversity that the copper-containing compounds exhibit in extended framework structures.

A data-driven reduced-order surrogate model for entire elastoplastic simulations applied to representative volume elements

This contribution discusses surrogate models that emulate the solution field(s) in the entire simulation domain. The surrogate uses the most characteristic modes of the solution field(s), in combination with neural networks to emulate the coefficients of each mode. This type of surrogate is well known to rapidly emulate flow simulations, but rather new for simulations of elastoplastic solids. The surrogate avoids the iterative process of constructing and solving the linearized governing equations of rate-independent elastoplasticity, as necessary for direct numerical simulations or (hyper-)reduced-order-models. Instead, the new plastic variables are computed only once per increment, resulting in substantial time savings. The surrogate uses a recurrent neural network to treat the path dependency of rate-independent elastoplasticity within the neural network itself. Because only a few of these surrogates have been developed for elastoplastic simulations, their potential and limitations are not yet well studied. The aim of this contribution is to shed more light on their numerical capabilities in the context of elastoplasticity. Although more widely applicable, the investigation focuses on a representative volume element, because these surrogates have the ability to both emulate the macroscale stress-deformation relation (which drives the multiscale simulation), as well as to recover all microstructural quantities within each representative volume element.

Multistep Cascade Catalytic Reactions Employing Bifunctional Framework Compounds

Multistep cascade reactions are important to achieve atom as well as step economy over conventional synthesis. This approach, however, is limited due to the incompatibility of the available reactive centers in a catalyst. In the present study, new MOF compounds, [Zn₂(SDBA)(3-ATZ)₂]·solvent, I and II, with tetrahedral Zn centers as good Lewis acidic sites and the free amino group of the 3-amino triazole ligand as a strong Lewis base center were shown to perform 4-step cascade/tandem reaction in a facile manner. Effective conversion of benzaldehyde dimethyl acetal in the presence of excess nitromethane at 100 °C in water to 1-(1,3-dinitropropan-2-yl) benzene was achieved in 10 h with yields of ∼95% (I) and ∼94% (II). This 4-step cascade reaction proceeds via deacetalization (Lewis acid), Henry (Lewis base), and Michael (Lewis base) reactions. The present work highlights the importance of spatially separated functional groups in multistep tandem catalysis─the examples of which are not common.

Type III Monteggia Fracture-dislocation with Radial Nerve Injury in Adults - A Case Report of two Cases

Introduction

Uncommon complication of Monteggia fracture is associated PIN palsy. The PIN palsy following Monteggia fracture-dislocation is neuropraxias and will recover spontaneously.

Case Report

Two cases who were diagnosed as Monteggia fracture-dislocation with PIN palsy and associated superficial branch of radial nerve injury - Power 0/5 and sensations 0/2 were taken up for surgery (open reduction internal fixation of fracture of ulna + closed reduction of radial head). By the end of 7 weeks, both sensory and motor power were fully recovered spontaneously in both the cases.

Discussion

Most of the PIN injuries following Monteggia fracture-dislocation are neuropraxias and will recover spontaneously after closed reduction of radial head without any intervention to the nerve. The nerve needs to be intervened if there are no signs of recovery by 3 months. The time frame for the nerve to be intervened remains controversial.

Conclusion

In both of our cases, the injury is probably proximal to the terminal division of radial nerve and the injuries were neuropraxias and have recovered spontaneously. Hence, we suggest not exploring the nerve in all cases with Monteggia fracture-dislocation immediately even when there is associated sensory deficit.

Monitoring of polycyclic aromatic hydrocarbons emitted from kerosene fuel burning and assessment of health risks among women in selected rural and urban households of South India

Polycyclic aromatic hydrocarbons (PAHs) are well-known hazardous substances; nevertheless, research on their exposure and health concerns associated with kerosene fuel emissions is limited. In this study, PAH (combined gaseous and particle phase) monitoring was carried out in the kitchen and living room in selected households. Personal exposure and cooking time monitoring were also carried out, simultaneously. The study's findings revealed that BaP, BA, BbF, and Nap were the most prevalent PAHs in both the summer and winter seasons, regardless of urban or rural households. The estimated values of average incremental lifetime cancer risks were found to be greater than the USEPA level, i.e., 1 × 10^-6, in both urban and rural households, regardless of seasonal fluctuation. In both seasons, the non-carcinogenic risk for developmental and reproductive effects was higher in rural women than in urban women, and in case of developmental risk it showed greater than unity (rural: 1.11 and urban 1.03) in the winter season. On the other hand, Monte Carlo simulation model revealed that concentrations of PAHs (97.1% and 97.5%) and exposure duration (51.7% and 56.7%) were the most sensitive factors contributed for health risk estimations for urban and rural area in both seasons, respectively. Furthermore, the results clearly showed that women who were using kerosene for cooking were at a greater risk of acquiring both carcinogenic and non-carcinogenic health consequences from PAH exposure from kerosene cookstoves. It was recommended that they should utilize clean fuel, either by using LPG under the PMUY scheme or by using electricity/solar power to reduce health risks for better health.

Sequential Assembly and Stabilization of Cu6S6 Octahedral Clusters in NaCl-, NiAs-, and CdI2-Related Structures and Their Utility toward Thermochromism and Multicomponent Hantzsch Reaction

Seven new inorganic-organic coordination polymer compounds have been synthesized and their structures are determined by single-crystal structure determination. The compounds were prepared by the sequential assembly of a [Cu₆(mna)₆]^6- moiety in the presence of a Mn salt and a secondary amine ligand. Of the seven compounds, [{Cu₆(mna)₆}Mn₃(H₂O)(H₂O)_1.5]·5.5H₂O (I), [{Cu₆(mna)₆}Mn₃(H₂O)(Im)_1.5]·3.5H₂O (Ia), [{Cu₆(mna)₆}{Mn(BPY)(H₂O)}₂{Mn(H₂O)₄}]·2H₂O (III), and [{Cu₆(mna)₆}{Mn(BPE)_0.5(H₂O)₂}₂{Mn(BPE)(H₂O)₂}] (IV) have a three-dimensional structure, whereas [{Cu₆(mna)_4.5(Hmna)_1.5}{Mn(BPA)(H₂O)₂}{Mn(H₂O)}]{Mn_0.25(H₂O)₃}·7H₂O (II), [{Cu₆(mna)₆}{Mn(4-BPDB)_0.5H₂O}{Mn(H₂O)₂}].{Mn(H₂O)₆}·6H₂O (V), and [{Cu₆(mna)₄(Hmna)₂}·{Mn(H₂O)₃}₂]·(4-APY)₂·6H₂O (VI) have a two-dimensional structure. Some of the prepared compounds exhibit structures that closely resemble the classical inorganic structures, such as NaCl (Ia, III), NiAs (I), and CdI₂ (IV and VI). The stabilization of such simple structures from the assembly of octahedral Cu₆S₆ clusters and different Mn species and aromatic nitrogen-containing ligands suggests the subtle interplay between the constituent reactants. The compounds were examined for the multicomponent Hantzsch reaction, which gave the product in good yields. The compounds, II and VI, on heating to 70 °C change color reversibly from pale yellow to deep red, which suggests the possible use of these compounds as thermochromic materials. The present study suggests that the Cu₆S₆ octahedral clusters can be assembled into structures that resemble classical inorganic structures.

Highly Selective MOF-Based Turn-Off Luminescence Detection of Hg2+ Ions in an Aqueous Medium and Its Dual Functional Catalytic Activity toward Aldol Condensation and β-Enamination Reactions

A new organic ligand, 5-(carboxyformamido)isophthalic acid (5-CFIA), was prepared and employed for the synthesis of two compounds [M₃(C₁₀H₄O₇N₁)₂(8H₂O)]·H₂O (M = Cd, Mn). The compounds have three-dimensionally extended structures. Both the compounds were found to be luminescent at room temperature. The luminescence nature was exploited for the detection of Hg²⁺ ions in an aqueous medium with good selectivity. The interactions between Hg²⁺ ions and the compounds quench the luminescence intensity and act as a turn-off sensor. Both the compounds exhibited low limits for the detection of Hg²⁺ ions and in the range mandated by the WHO. The interactions between Hg²⁺ ions and the compound involve the -NH group, which was probed using Raman and IR spectroscopic techniques. These studies provide important pointers toward the mechanism of this turn-off luminescence behavior. The compounds were explored for base-catalyzed aldol condensation and Lewis acid-promoted β-enaminoester formation reactions. The aldol condensation reaction uses the -NH functionality as a base. The studies indicate that the electron-withdrawing group produces products with higher yields. The β-enaminoester reaction uses the Lewis acid centers, and the studies reveal that the electron-withdrawing groups produce lesser yields of the products. The catalytic nature of the reaction and recyclability of the catalysts were also established. The catalytic reactions employ ethanol (aldol condensation) and no solvent (β-enaminoester), which suggests that the reactions are green and environmentally friendly. The Mn compound was observed to be anti-ferromagnetic.

Post market surveillance registry (PIONEER) of the Yukon Choice PC-Elite Coronary Stent System for percutaneous coronary intervention in Indian acute coronary syndrome population

AIM

The aim of this study was to assess the safety and efficacy profile of a newer generation biodegradable DES, the Yukon Choice PC Elite with a temperature controlling mechanism, in patients with acute coronary syndrome (ACS).

METHODS

This prospective multi-center study (PIONEER Registry) was conducted in an Indian ACS population, therefore providing data in real world clinical practice. Patients with ACS underwent DES implantation in de novo native-vessel coronary lesions with the Yukon Choice PC Elite biodegradable polymer DES and were followed up for a year.

RESULTS

A total 999 patients were evaluated. The majority of patients were male (79.2%). A total of 6.7% of the patients had a history of prior myocardial infarction (MI) and 2.7% of patients had a history of previous coronary artery bypass graft. The clinical presentations of the patients included: unstable angina pectoris (UA) (46.4%), ST-segment elevation MI (STEMI) (38.1%), and Non-ST-segment elevation MI (NSTEMI) (15.4%). Implantation of the device was successful in 99.9% of cases. The median stent length and stent size were 21.0 mm (Range: 8.0-40.0 mm) and 2.8 mm (Range 2.0-4.0 mm), respectively. Through to one-year clinical follow-up after percutaneous coronary intervention, all-cause death occurred in 4 of 999 patients (Crude Percentage: 0.4%). Cardiac death, MI, TLR, and stent thrombosis were occurred in 1 (0.1%), 8 (0.8%), 12 (1.2%) and 1 (0.1%) patients, respectively.

CONCLUSION

The results of this post marketing surveillance registry suggest favorable safety and efficacy outcomes associated with the Yukon Choice PC Elite biodegradable DES in a real world Indian ACS population.

Awareness and perception of an Indian dental professional in context to the process and their role in disaster victim identification as a taskmaster

Forensic odontology is a young area in India. However, it has been used as an integral component in a various medicolegal cases in India. However, the involvement of a dentist in mass disasters still needs to be well recognized. The role of the dentists in any unforeseen circumstances is to contribute as an adjunct hand in Disaster Victim Identification (DVI) which is in an emergent stage in India. This study aimed to assess an Indian dental professional's knowledge and awareness of their role in DVI. A pre-tested, self-administered anonymous questionnaire consisting of 6 open-ended and 14 close-ended questions was mailed to the participants. A total of 441 responses were recorded. The study indicated adequate knowledge and awareness among dental practitioners. Conversely, only a handful of people had first-hand autopsy experience. Thus, to supplement the skills needed to work at ground zero, it is recommended to develop hands-on training programs for dentists in each state of India. Also, creating a pool of experts in each state of India can strengthen the task force.

A novel application of a bioactive material as a pit and fissure sealant: in vitro pilot study evaluating the sealing ability and penetration

PURPOSE

To compare the sealing ability and penetration of a bioactive material used as pit and fissure sealant to those of glass ionomer sealant.

METHODS

This was an in vitro experimental study conducted on 20 permanent teeth. For Group I of ten teeth, ACTIVA BioACTIVE-Base/Liner was applied as a sealant on pits and fissures, and the remaining ten teeth of Group II were sealed using glass ionomer cement. After thermocycling, the apex of the teeth was sealed using composite resin and they were immersed in 1% methylene blue solution, buffered at pH 7 for 24 h. Longitudinal sections were obtained from each tooth for evaluating the sealing ability and penetration, using a binocular light microscope at 4 × magnification. The obtained data were subjected to analysis using the Chi-square test and independent t test.

RESULTS

The comparison of the sealing ability and sealant penetration, between the two groups, showed statistically no significant difference (p = 0.104 and p = 1.0, respectively).

CONCLUSION

Bioactive material as a pit and fissure sealant, performed on par with glass ionomer sealant in terms of tested properties like sealing ability and penetration.

Blue-Emitting Ligand-Mediated Assembly of Rare-Earth MOFs toward White-Light Emission, Sensing, Magnetic, and Catalytic Studies

New lanthanide carboxylate compounds with two- (2D) and three-dimensional (3D) structures have been prepared by employing 2,5-bis(prop-2-yn-1-yloxy)terephthalic acid (2,5-BPTA) as an organic linker. The compounds, [Ln(C₁₄H₈O₆)(C₇O₃H₄)·2H₂O]·4(H₂O), Ln = Y, Pr, Nd, Sm, Eu, Gd, Tb, Dy and [Ln(C₇O₃H₄)₃·(C₃H₇ON)·(H₂O)]·2(H₂O)(C₃H₇NO), Ln = La, Ce, Pr, have two- and three-dimensional structures, respectively. In all compounds, lanthanide ions are connected together, forming a dimer, which is connected by the 2,5-BPTA ligand. In the two-dimensional structure, there are two 2,5-BPTA moieties present, and in the three-dimensional structure, there are three 2,5-BPTA moieties present. The lanthanide centers are nine-coordinated, the 2D structure has a tricapped trigonal prismatic arrangement, and the 3D structure has a monocapped distorted square antiprismatic arrangement. The Pr compound forms in both 2D and 3D structures, whose formation depends on the time of the reaction (2 days─2D and 5-6 days─3D). The ligand emits in the blue region, and using the characteristic emission of Eu³⁺ (red) and Tb³⁺ (green) ions, we achieve white light emission in the (Y_0.96Tb_0.02Eu_0.02) compound. The overall quantum yield for the white light emission is 28%. The strong green luminescence of the Tb³⁺-containing compound was employed to selectively sense the Cr³⁺ and Fe³⁺ ions in aqueous solution with limits of detection (LODs) at 0.41 and 8.6 ppm, respectively. The Tb compound was found to be a good heterogeneous catalyst for the Ullman-type O-arylation reaction between phenol and bromoarene with yields of 95%. Magnetic studies on the Gd-, Tb-, and Dy-containing compounds showed weak exchange interactions within the dimeric Ln₂ units. The present work demonstrates the many utilities of the rare-earth-containing MOFs, especially toward white-light emission, metal-ion sensing, and heterogeneous catalysis.

216 Improving Patient Education About Pre-Diabetes in the Community

Aim

Pre-diabetes is a common condition and although its development is linked to lifestyle factors, many patients are unaware of interventions that can improve their condition. One-to-one consultations between patients and GPs focused on reducing carbohydrate consumption are known to be effective at improving pre-diabetes. This QIP aimed to improve patients' understanding of pre-diabetes and reduce carbohydrate intake.

Method

Patients were included if they had 2 HbA1c measurements between 42 – 48mmol/mol and the ability to make dietary changes independently. A questionnaire based on the UK Diabetes and Diet Questionnaire was constructed and used to ask patients about their concern about pre-diabetes, knowledge of foods that contribute to the condition and the frequency at which they consumed various carbohydrates. Advice about reducing carbohydrate intake was given verbally and patients were provided with a diet sheet produced by Unwin et al. Patients were called again after 7 – 14 days to assess dietary changes and the impact of the advice.

Results and Conclusions

31 patients responded to the initial telephone call of which 58.1% were concerned about pre-diabetes and 38.7% mentioned foods high in carbohydrate as a cause of pre-diabetes. 90.3% of patients consumed food high in carbohydrate on 4 or more days per week. 22 patients responded to the follow up telephone call of which 63.6% reported a reduction in carbohydrate intake, 95.5% knew more about pre-diabetes and 90.9% found the dietary advice helpful. These results suggest that pre-diabetic patients should be given verbal and written information about lowering carbohydrate intake at GP consultations.

Intercalation of Nanoscale Multiferroic Spacers between the Two-Dimensional Interlayers of MXene

We report a facile synthesis of MXene/bismuth ferrite (Ti₃C₂T _x @ BiFeO₃) nanocomposites using hydrazine hydrate induced with the hydrothermal method. Preparation of the composite with hydrazine hydrate prevents the formation of Bi₂₅FeO₃₉ inside the matrix. The 25 wt % loading of BiFeO₃ acts as spacers for the multilayer restacking of MXene flakes by retaining the (002) plane. This promotes large dc conductivity with interfacial and defect dipole polarization mechanisms inside the composite material. The thinner M-H loop also indicates the minimal magnetic loss inside the composites. The facile synthesis strategy provides outstanding properties in Ti₃C₂T _x @ BiFeO₃ composites as two-dimensional multiferroic materials.

The Impact of the First Wave of Covid 19 on Orthopaedic Surgeries in a Tertiary Care Teaching Hospital

Background: The Covid 19 was declared a global pandemic that had a sizeable impact on the health care services in the surgical field including the orthopaedic department. There was additionally a decreased accessibility to healthcare personnel and facilities reallocated to manage the Covid patients. The study was mainly conducted to find out the impact of the first wave of COVID-19 on the orthopaedic surgeries. Aim: The main aim of the study is to find out the alteration in the number, type of surgeries, financial implications, duration of hospital stay, delay in surgery during the first wave of the COVID-19 pandemic. Study Design: Retrospective crossectional study. Methods: All the surgeries conducted in the orthopaedic department in the year 2019 and 2020 following first peak in March including pre-op and post-op COVID cases are included in the study. The procedure conducted, date of admission, date of surgery, date of discharge, investigations done and the cost expenses are the various parameters that are taken into consideration. The results are analysed for each year and comparisons are made using statistical methods. Results: The comparative analysis of the data collected from the years 2019 and 2020 showed an increase in the duration of hospital stay, delay in surgery, additional expenditure, back log in the number of elective surgeries done during the Pandemic.

Kabasura Kudineer (KSK), a poly-herbal Siddha medicine, reduced SARS-CoV-2 viral load in asymptomatic COVID-19 individuals as compared to vitamin C and zinc supplementation: findings from a prospective, exploratory, open-labeled, comparative, randomized controlled trial, Tamil Nadu, India

INTRODUCTION

Despite several ongoing efforts in biomedicine and traditional medicine, there are no drugs or vaccines for coronavirus disease 2019 (COVID-19) as of May 2020; Kabasura Kudineer (KSK), a polyherbal formulation from India's Siddha system of medicine, has been traditionally used for clinical presentations similar to that of COVID-19. We explored the efficacy of KSK in reducing viral load and preventing the disease progression in asymptomatic, COVID-19 cases.

METHODS

A prospective, single-center, open-labeled, randomized, controlled trial was conducted in a COVID Care Centre in Chennai, India. We recruited reverse-transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19 of 18 to 55 years of age, without clinical symptoms and co-morbidities. They were randomized (1:1 ratio) to KSK (60 mL twice daily for 7 days) or standard of care (7 days supplementation of vitamin C 60,000 IU morning daily and zinc 100 mg evening daily) groups. The primary outcomes were reduction in the SARS-CoV-2 load [as measured by cyclic threshold (CT) value of RT-PCR], prevention of progression of asymptomatic to symptomatic state, and changes in the immunity markers including interleukins (IL-6, IL-10, IL-2), interferon gamma (IFNγ), and tumor necrosis factor (TNF α). Siddha clinical assessment and the occurrence of adverse effects were documented as secondary outcomes. Paired t-test was used in statistical analysis.

RESULTS

Viral load in terms of the CT value (RdRp: 95% CI = 1.89 to 5.74) declined significantly on the seventh day in the KSK group and that of the control group, more pronounced in the study group. None progressed to the symptomatic state. There was no significant difference in the biochemical parameters. We did not observe any changes in the Siddha-based clinical examination and adverse events in both groups.

CONCLUSION

KSK significantly reduced SARS-CoV-2 viral load among asymptomatic COVID-19 cases and did not record any adverse effect, indicating the use of KSK in the strategy against COVID-19. Larger, multi-centric trials can strengthen the current findings.

TRIAL REGISTRATION

Clinical Trial Registry of India CTRI2020/05/025215 . Registered on 16 May 2020.

Biomechanical design framework for prosthetic feet: Experimentally validated non-linear finite element procedure

Performance evaluation of prosthetic feet during their design is typically performed experimentally, which may be time and cost intensive. This work presents a first-of-its-kind application of a numerical procedure for the a priori determination of various stance phase biomechanical parameters of a prosthetic foot, such as its roll-over characteristics, centre of pressure trajectory, ankle flexion moment arm and ankle range of motion, to aid in its design. The numerical procedure is based on finite element analysis, which includes geometric, material and contact non-linearity. Boundary conditions emulating the rocker-based inverted pendulum model were employed to evaluate the biomechanical parameters. The finite element model was validated by employing an inverted pendulum-based apparatus using the structurally complex Ottobock Solid Ankle Cushioned Heel (SACH) prosthetic foot as the test device. A comparison of the numerical and experimental results showed low magnitude of errors. For example, the percentage error of the radius of curvature of the roll-over shape was ~0.1%. The differences found appear to be clinically insignificant, which substantiates the reliability of the model. The proposed numerical model can be employed to obtain detailed a priori insights into the biomechanical parameters influencing a prosthetic foot's characteristics during gait, which can better inform the design, analysis and prescription of prosthetic feet.

Siddha Varmam and Thokkanam therapy in the treatment of adhesive capsulitis-A case report

A 60 year married female from Chennai presented with pain and restricted abduction, adduction, external rotation and flexion of right shoulder both in active and passive movements for 2 months. She was diagnosed to be affected by adhesive capsulitis which is equated to Kumbavatham, one of the vatha diseases mentioned in Siddha system of medicine. She was treated with Siddha Varmam therapy and thokkanam with Vathakesari thylam. After 15 days of hospital stay the patient was discharged and was followed for 6 months. There were no adverse reactions/events observed during the course of treatment. The combination therapy has provided the reduction in pain and restricted movements which was measured using goniometer and SPADI index.

Diabetic retinopathy screening guidelines in India: All India Ophthalmological Society diabetic retinopathy task force and Vitreoretinal Society of India Consensus Statement

Diabetic retinopathy (DR) is an emerging preventable cause of blindness in India. All India Ophthalmology Society (AIOS) and Vitreo-Retinal Society of India (VRSI) have initiated several measures to improve of DR screening in India. This article is a consensus statement of the AIOS DR task force and VRSI on practical guidelines of DR screening in India. Although there are regional variations in the prevalence of diabetes in India at present, all the States in India should screen their population for diabetes and its complications. The purpose of DR screening is to identify people with sight-threatening DR (STDR) so that they are treated promptly to prevent blindness. This statement provides strategies for the identification of people with diabetes for DR screening, recommends screening intervals in people with diabetes with and without DR, and describes screening models that are feasible in India. The logistics of DR screening emphasizes the need for dynamic referral pathways with feedback mechanisms. It provides the clinical standards required for DR screening and treatment of STDR and addresses the governance and quality assurance (QA) standards for DR screening in Indian settings. Other aspects incorporate education and training, recommendations on Information technology (IT) infrastructure, potential use of artificial intelligence for grading, data capture, and requirements for maintenance of a DR registry. Finally, the recommendations include public awareness and the need to work with diabetologists to control the risk factors so as to have a long-term impact on prevention of diabetes blindness in India.

Aliphatic amine mediated assembly of [M6(mna)6] (M = Cu/Ag) into extended two-dimensional structures: synthesis, structure and Lewis acid catalytic studies

New aliphatic amine directed two-dimensional cadmium coordination polymers were shown to exhibit Lewis-acid catalytic activity for the cyanation of imines.

Tuning the Langasite, La3SbZn3Si2O14, towards white light emission: synthesis, structure, SHG and photoluminescence studies

A series of single-phase color-tunable Langasite, La3SbZn3Si2O14:RE3+ (RE = Eu, Tb, and Tm) phosphors have been prepared and characterized employing X-ray diffraction (XRD), Raman, and photoluminescence (PL) studies. The substituted compounds, La3SbZn3Si2O14:Eu3+, La3SbZn3Si2O14:Tb3+ and La3SbZn3Si2O14:Tm3+ exhibit the characteristic emissions of Eu3+ (red), Tb3+ (green) and Tm3+ (blue), respectively. By carefully adjusting the concentration of Eu3+ ions in the La3SbZn3Si2O14:1% Tm3+, 2% Tb3+, x% Eu3+ system, we achieved a white emission with a reasonable quantum yield. The compounds are found to be SHG (second-harmonic generation) active with the highest values of 3.6 × KDP (potassium dihydrogen phosphate). In addition, the compounds exhibit reasonable dielectric constants with low loss. The present study demonstrates the color tunability of the Langasite family of compounds and establishes it as an adaptable structure.

The efficacy of Siddha Medicine, Kabasura Kudineer (KSK) compared to Vitamin C & Zinc (CZ) supplementation in the management of asymptomatic COVID-19 cases: A structured summary of a study protocol for a randomised controlled trial

OBJECTIVES

The primary objectives of this study are to determine efficacy of Siddha medicine, Kabasura kudineer in reduction of SARS-CoV-2 viral load and reducing the onset of symptoms in asymptomatic COVID-19 when compared to Vitamin C and Zinc (CZ) supplementation. In addition, the trial will examine the changes in the immunological markers of the Siddha medicine against control. The secondary objectives of the trial are to evaluate the safety of the Siddha medicine and to document clinical profile of asymptomatic COVID-19 as per principles of Siddha system of Medicine.

TRIAL DESIGN

A single centre, open-label, parallel group (1:1 allocation ratio), exploratory randomized controlled trial.

PARTICIPANTS

Cases admitted at non-hospital settings designated as COVID Care Centre and managed by the State Government Stanley Medical College, Chennai, Tamil Nadu, India will be recruited. Eligible participants will be those tested positive for COVID-19 by Reverse Transcriptase Polymerase Chain reaction (RT-PCR) aged 18 to 55 years without any symptoms and co-morbidities like diabetes mellitus, hypertension and bronchial asthma. Those pregnant or lactating, with severe respiratory disease, already participating in COVID trials and with severe illness like malignancy will be excluded.

INTERVENTION AND COMPARATOR

Adopting traditional methods, decoction of Kabasura kudineer will be prepared by boiling 5g of KSK powder in 240 ml water and reduced to one-fourth (60ml) and filtered. The KSK group will receive a dose of 60ml decoction, orally in the morning and evening after food for 14 days. The control group will receive Vitamin C (60000 IU) and Zinc tablets (100mg) orally in the morning and evening respectively for 14 days.

MAIN OUTCOMES

The primary outcomes are the reduction in the SARS-CoV-2 load [as measured by cyclic threshold (CT) value of RT-PCR] from the baseline to that of seventh day of the treatment, prevention of progression of asymptomatic to symptomatic state (clinical symptoms like fever, cough and breathlessness) and changes in the immunity markers [Interleukins (IL) 6, IL10, IL2, Interferon gamma (IFNγ) and Tumor Necrosis Factor (TNF) alpha]. Clinical assessment of COVID-19 as per standard Siddha system of medicine principles and the occurrence of adverse effects will be documented as secondary outcomes.

RANDOMISATION

The assignment to the study or control group will be allocated in equal numbers through randomization using random number generation in Microsoft Excel by a statistician who is not involved in the trial. The allocation scheme will be made by an independent statistician using a sealed envelope. The participants will be allocated immediately after the eligibility assessment and informed consent procedures.

BLINDING (MASKING)

This study is unblinded. The investigators will be blinded to data analysis, which will be carried out by a statistician who is not involved in the trial.

NUMBERS TO BE RANDOMISED (SAMPLE SIZE)

Sample size could not be calculated, as there is no prior trial on KSK. This trial will be a pilot trial. Hence, we intend to recruit 60 participants in total using a 1:1 allocation ratio, with 30 participants randomised into each arm.

TRIAL STATUS

Protocol version 2.0 dated 16^th May 2020. Recruitment is completed. The trial started recruitment on the 25^th May 2020. We anticipate study including data analysis will finish on November 2020. We also stated that protocol was submitted before the end of data collection TRIAL REGISTRATION: The study protocol was registered with clinical trial registry of India (CTRI) with CTRI/2020/05/025215 on 16 May 2020.

FULL PROTOCOL

The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).

Visible-Light-Activated C-C Bond Cleavage and Aerobic Oxidation of Benzyl Alcohols Employing BiMXO5 (M=Mg, Cd, Ni, Co, Pb, Ca and X=V, P)

The synthesis, structure, optical and photocatalytic studies of a family of compounds with the general formula, BiMXO₅ ; M=Mg, Cd, Ni, Co, Pb, Ca and X=V, P is presented. The compounds were prepared by regular solid-state reaction of constituents in the temperature range of 720-810 °C for 24 h. The compounds were characterized by powder X-ray diffraction (PXRD) methods. The Rietveld refinement of the PXRD patterns have been carried out to establish the structure. The optical absorption spectra along with the colors in daylight have been explained employing the allowed d-d transition. In addition, the observed colors of some of the V⁵⁺ containing compounds were explained using metal-to-metal charge transfer (MMCT) from the partially filled transition-metal 3d orbitals to the empty 3d orbitals of V⁵⁺ ions. The near IR (NIR) reflectivity studies indicate that many compounds exhibit good NIR reflectivity, suggesting that these compounds can be employed as 'cool pigments'. The experimentally determined band gaps of the prepared compounds were found to be suitable to exploit them for visible light activated photocatalysis. Photocatalytic C-C bond cleavage of alkenes and aerobic oxidation of alcohols were investigated employing visible light, which gave good yields and selectivity. The present study clearly demonstrated the versatility of the Paganoite family of compounds (BiMXO₅ ) towards new colored inorganic materials, visible-light photocatalysts and 'cool pigments'.

Evolving consensus on managing vitreo-retina and uvea practice in post-COVID-19 pandemic era

The COVID-19 pandemic has brought new challenges to the health care community. Many of the super-speciality practices are planning to re-open after the lockdown is lifted. However there is lot of apprehension in everyone's mind about conforming practices that would safeguard the patients, ophthalmologists, healthcare workers as well as taking adequate care of the equipment to minimize the damage. The aim of this article is to develop preferred practice patterns, by developing a consensus amongst the lead experts, that would help the institutes as well as individual vitreo-retina and uveitis experts to restart their practices with confidence. As the situation remains volatile, we would like to mention that these suggestions are evolving and likely to change as our understanding and experience gets better. Further, the suggestions are for routine patients as COVID-19 positive patients may be managed in designated hospitals as per local protocols. Also these suggestions have to be implemented keeping in compliance with local rules and regulations.

Tetanus of suspected dental causality

Tetanus infection by Clostridium tetani is a major health problem in many developing countries, including India. Significant morbidity and mortality is attributed to lack of awareness, hygiene and incomplete vaccination. The most common cause of tetanus infection follows cutaneous injury or infection. However, a localized point of entry cannot always be determined. Tetanus has been associated with tooth extraction, root canal therapy, gross caries, periodontal abscess and intraoral soft tissue trauma. The classic symptoms of trismus and risus sardonicus may result in an initial presentation to an oral and maxillofacial surgeon. Due to the rarity of this infection, the dentist or the health care provider may fail to corroborate the findings and be unsuspecting of the diagnosis. Prompt recognition is the key in such a scenario due to the inherent risk of rapid progress of symptoms, progressive deterioration of the health condition and catastrophic complications. A sound knowledge of the effects of tetanospasmin, the disease process, prevention and vaccination against tetanus with its management is essential for health care workers. The authors hereby present a case of tetanus with a suspected dental etiology to make the dental fraternity aware of this lurking malady.

All India Ophthalmological Society - Indian Journal of Ophthalmology consensus statement on preferred practices during the COVID-19 pandemic

The COVID-19 pandemic has taken tragic proportions and has disrupted lives globally. In the wake of governmental lockdowns, ophthalmologists need practical and actionable guidelines based on advisories from national health departments on how to conduct their duties during nationwide lockdowns and after these are lifted. In this paper, we present a preferred practice pattern (PPP) based on consensus discussions between leading ophthalmologists and health care professionals in India including representatives from major governmental and private institutions as well as the All India Ophthalmological Society leadership. In this document, the expert panel clearly defines the range of activities for Indian ophthalmologists during the ongoing lockdown phase and precautions to be taken once the lockdown is lifted. Guidelines for triage, governmental guidelines for use of personal protective equipment from ophthalmologists' point of view, precautions to be taken in the OPD and operating room as well as care of various ophthalmic equipment have been described in detail. These guidelines will be applicable to all practice settings including tertiary institutions, corporate and group practices and individual eye clinics and should help Indian ophthalmologists in performing their professional responsibilities without being foci of disease transmission.

A tissue-mimicking prostate phantom for 980 nm laser interstitial thermal therapy

Purpose: To develop a phantom with optical and thermal properties matched to human prostate. This phantom will provide a platform for the development and characterization of 980 nm laser interstitial thermal therapy (LITT) systems. Methods: A polyacrylamide gel was doped with Naphthol Green B, Intralipid, and Bovine Serum Albumin (BSA). The necessary concentration of each ingredient was determined by measuring the optical properties via fluence measurements and light diffusion theory. LITT was then performed under the same conditions as a previous clinical trial in which temperature was monitored via a thermal probe. The thermal data and induced coagulation zone were compared to clinical data to illustrate the similarity between the phantom and patient. LITT was also performed under magnetic resonance thermometry (MRT). Results: The requisite concentrations of Naphthol Green B, Intralipid and BSA were found to be 0.144% (w/v), 8.06% (v/v) and 31.4% (v/v) respectively. In the native state, the absorption coefficient and reduced scattering coefficient ( μs' ) were found to be 0.66 ± 0.06 cm^-1 and 8.27 ± 0.50 cm^-1 respectively, with μs' increasing to 17.63 ± 1.41 cm^-1 after coagulation. The thermal response of the phantom was similar to that observed clinically with maximum thermal probe measurements of 64.2 °C and 66.9 °C respectively. The shape of the induced coagulation zone was qualitatively and quantitatively similar to the MRT zone of elevated temperature and the coagulation zone observed clinically. Conclusions: A phantom which simulates optical and thermal response to 980 nm LITT was constructed and demonstrated to be similar to human prostate.

Syntheses and Characterisation of Amide Adducts of Uranyl Bis (β-Diketonates) the Molecular Structure of [UO2(DBM)2.C4H9CON(3-C5H11) (sec-C4H9)]

The first structurally characterised uranyl bis (β-diketonate)-amide adduct compound [UO2(DBM)2. C4H9CON ( 3-C5H11) ( sec-C4H9)] (DBM = dibenzoylmethanate) shows that the amide ligand bonded through its amido oxygen atom to the uranyl group. The average bond distances for U–O(uranyl), U–O(DBM) and U–O(amide) are 1.778(5), 2.346(5) and 2.411(5)Å respectively.

Treatment of acute avulsion of posterior cruciate ligament of left knee with bony fragment by Siddha Varmam therapy and traditional bone setting method

A 42-year-old man with the complaints of left knee swelling, severe pain, difficult to stand was reported to Siddha Varmam division after a road accident. He was diagnosed as acute avulsion of Posterior cruciate ligament (PCL). It was diagnosed based on the history of trauma, knee pain and swelling after trauma, positive posterior drawer test and avulsion fracture shown by radiograph. He was treated with Siddha Varmam therapy and traditional bone setting. After a month of treatment, the PCL avulsion fracture got healed without any surgical interventions and patient able to walk normally. This case report summarises the novel Siddha Varmam therapy and traditional bone setting treatments for acute avulsion of PCL with bony fragment.