Advancing psoriasis drug delivery through topical liposomes.

Psoriasis, recognized as a chronic inflammatory skin disorder, disrupts immune system functionality. Global estimates by the World Psoriasis Day consortium indicate its impact on approximately 130 million people, constituting 4 to 5 percent of the worldwide population. Conventional drug delivery systems, mainly designed to alleviate psoriasis symptoms, fall short in achieving targeted action and optimal bioavailability due to inherent challenges such as the drug's brief half-life, instability, and a deficiency in ensuring both safety and efficacy. Liposomes, employed in drug delivery systems, emerge as highly promising carriers for augmenting the therapeutic efficacy of topically applied drugs. These small unilamellar vesicles demonstrate enhanced penetration capabilities, facilitating drug delivery through the stratum corneum layer of skin. This comprehensive review article illuminates diverse facets of liposomes as a promising drug delivery system to treat psoriasis. Addressing various aspects such as formulation strategies, encapsulation techniques, and targeted delivery, the review underscores the potential of liposomes in enhancing the efficacy and specificity of psoriasis treatments.

Functional connectivity changes in meditators and novices during yoga nidra practice.

Yoga nidra (YN) practice aims to induce a deeply relaxed state akin to sleep while maintaining heightened awareness. Despite the growing interest in its clinical applications, a comprehensive understanding of the underlying neural correlates of the practice of YN remains largely unexplored. In this fMRI investigation, we aim to discover the differences between wakeful resting states and states attained during YN practice. The study included individuals experienced in meditation and/or yogic practices, referred to as 'meditators' (n = 30), and novice controls (n = 31). The GLM analysis, based on audio instructions, demonstrated activation related to auditory cues without concurrent default mode network (DMN) deactivation. DMN seed based functional connectivity (FC) analysis revealed significant reductions in connectivity among meditators during YN as compared to controls. We did not find differences between the two groups during the pre and post resting state scans. Moreover, when DMN-FC was compared between the YN state and resting state, meditators showed distinct decoupling, whereas controls showed increased DMN-FC. Finally, participants exhibit a remarkable correlation between reduced DMN connectivity during YN and self-reported hours of cumulative meditation and yoga practice. Together, these results suggest a unique neural modulation of the DMN in meditators during YN which results in being restful yet aware, aligned with their subjective experience of the practice. The study deepens our understanding of the neural mechanisms of YN, revealing distinct DMN connectivity decoupling in meditators and its relationship with meditation and yoga experience. These findings have interdisciplinary implications for neuroscience, psychology, and yogic disciplines.

Consistent movement of viewers' facial keypoints while watching emotionally evocative videos.

Neuropsychological research aims to unravel how diverse individuals' brains exhibit similar functionality when exposed to the same stimuli. The evocation of consistent responses when different subjects watch the same emotionally evocative stimulus has been observed through modalities like fMRI, EEG, physiological signals and facial expressions. We refer to the quantification of these shared consistent signals across subjects at each time instant across the temporal dimension as Consistent Response Measurement (CRM). CRM is widely explored through fMRI, occasionally with EEG, physiological signals and facial expressions using metrics like Inter-Subject Correlation (ISC). However, fMRI tools are expensive and constrained, while EEG and physiological signals are prone to facial artifacts and environmental conditions (such as temperature, humidity, and health condition of subjects). In this research, facial expression videos are used as a cost-effective and flexible alternative for CRM, minimally affected by external conditions. By employing computer vision-based automated facial keypoint tracking, a new metric similar to ISC, called the Average t-statistic, is introduced. Unlike existing facial expression-based methodologies that measure CRM of secondary indicators like inferred emotions, keypoint, and ICA-based features, the Average t-statistic is closely associated with the direct measurement of consistent facial muscle movement using the Facial Action Coding System (FACS). This is evidenced in DISFA dataset where the time-series of Average t-statistic has a high correlation (R2 = 0.78) with a metric called AU consistency, which directly measures facial muscle movement through FACS coding of video frames. The simplicity of recording facial expressions with the automated Average t-statistic expands the applications of CRM such as measuring engagement in online learning, customer interactions, etc., and diagnosing outliers in healthcare conditions like stroke, autism, depression, etc. To promote further research, we have made the code repository publicly available.

Pectin hydrogels for controlled drug release: Recent developments and future prospects.

Pectin hydrogels have emerged as a highly promising medium for the controlled release of pharmaceuticals in the dynamic field of drug delivery. The present review sheds light on the broad range of applications and potential of pectin-based hydrogels in pharmaceutical formulations. Pectin, as a biopolymer, is a versatile candidate for various drug delivery systems because of its wide range of properties and characteristics. The information provided on formulation strategies and crosslinking techniques provides researchers with tools to improve drug entrapment and controlled release. Furthermore, this review provides a more in-depth understanding of the complex factors influencing drug release from pectin hydrogels, such as the impact of environmental conditions and drug-specific characteristics. Pectin hydrogels demonstrate adaptability across diverse domains, ranging from applications in oral and transdermal drug delivery to contributions in wound healing, tissue engineering, and ongoing clinical trials. While standardization and regulatory compliance remain significant challenges, the future of pectin hydrogels appears to be bright, opening up new possibilities for advanced drug delivery systems.

Linking Generalized Ligamentous Laxity to Musculoskeletal Injury: A Study in the Indian Population.

Introduction Generalized ligamentous laxity (GLL) is defined as an increased range of motion across multiple joints in an individual beyond the mean range of motion in the general population, with a reported prevalence between 5% and 15%. It becomes less common with age and is more common in females and in the lower limbs. Musculoskeletal injury (MSI) is damage to musculoskeletal systems, usually due to strenuous activity. There is conflicting literature regarding whether the risk of MSI during strenuous activity is higher in individuals with GLL and a dearth of evidence from the Indian subcontinent regarding GLL. This study determines if GLL predisposes to musculoskeletal injuries among patients. Materials and methods One hundred eighty patients each were selected as cases and controls after obtaining informed consent, a Beighton score assessment, and a questionnaire regarding injury-filled in all participants with GLL. Result Thirty-three participants (18.33%) in the case group and 16 participants (8.89%) in the control group were found to have GLL. An odds ratio of 2.30 (using a 2x2 RC table) was calculated between participants with GLL among the cases and controls with a Beighton score of 4/9, and a significantly higher mean Beighton score (p=0.018) was found among participants presenting with MSI (cases) than participants without MSI (controls). Discussion The study found that there was a significant prevalence of GLL in the adult population, especially in females compared to males. The younger age group was also comparatively much more involved. It also proved that GLL was more common in patients with MSI and that hyper-mobile people had a twofold chance of injury compared to the general population. The joints of the lower limb were more frequently involved, probably the weight-bearing joints, the most common being the ankle and knee. People with GLL also had higher chances of repeating injuries. Conclusion This study has implications for the prevention of injuries in people with GLL. Screening such individuals to identify those with GLL using the Beighton score could be beneficial. Though orthopedic surgeons primarily manage people with MSI, they rarely identify individuals with GLL, and making a diagnosis regarding the same definitely helps these individuals live pain-free lives.

Prospective comparative evaluation of intraoperative joint stability and component placement between posterior approach to hip and its quadriceps coxae sparing modification for primary hip arthroplasty.

Background: Efforts at minimizing the propensity of posterior approach of hip for post-operative dislocation after total hip arthroplasty have been a subject of continual research. We comparatively evaluated the posterior approach to hip and its quadriceps coxae sparing (QCS) modification with regard to joint stability and component placement.Questions/Purposes: (1) Does sparing of Quadriceps Coxae tendons vis a vis their sectioning in posterior approach help in achieving better intraoperative stability? (2) Does sparing of Quadriceps Coxae tendons come in the way of adequate surgical exposure sufficient to place hip components accurately? (3) Does sparing of Quadriceps Coxae tendons result in better early functional outcome? Methods: Seventy-two patients requiring THA were enrolled prospectively and randomized into two groups: group A (posterior approach) and group B quadriceps coxae sparing (QCS) approach. They were compared for intraoperative joint stability, accuracy of component placement, duration of surgery, blood loss, any event of hip dislocation, and functional outcome. Results: QCS approach resulted in better intraoperative hip stability as the hips tolerated a higher value of 43.50±3.5° mean internal rotation (at 90° of flexion and 20° of adduction) in this group versus a mean value of 33.50±5.5° in posterior approach group (p < 0.01). No significant difference was observed for femoral version, acetabular inclination, and acetabular version in the two groups (p > 0.05). There was no difference between the two groups in terms of duration of surgery, intraoperative blood loss, and functional outcome at one year (p > 0.05). No event of hip dislocation was observed in QCS approach, whereas, one such event happened in the posterior-approach group. Conclusion: Preservation of the QC tendons improves the intraoperative stability of THA and they do not cause any hindrance in the exposure required for optimum component placement.

The impact of civil commitment laws for substance use disorder on opioid overdose deaths.

Objective: Our study analyzed the impact of civil commitment (CC) laws for substance use disorder (SUD) on opioid overdose death rates (OODR) in the U.S. from 2010-21. Methods: We used a retrospective study design using the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) dataset to analyze overdose death rates from any opioid during 2010-21 using ICD-10 codes. We used t-tests and two-way ANOVA to compare the OODR between the U.S. states with the law as compared to those without by using GraphPad Prism 10.0. Results: We found no significant difference in the annual mean age-adjusted OODR from 2010-21 between U.S. states with and without CC SUD laws. During the pre-COVID era (2010-19), the presence or absence of CC SUD law had no difference in age-adjusted OODR. However, in the post-COVID era (2020-21), there was a significant increase in OODR in states with a CC SUD law compared to states without the law (p = 0.032). We also found that OODR increased at a faster rate post-COVID among both the states with CC SUD laws (p < 0.001) and the states without the law (p = 0.019). Conclusion: We found higher age-adjusted OODR in states with a CC SUD law which could be due to the laws being enacted in response to the opioid crisis or physicians' opposition to or unawareness of the law's existence leading to underutilization. Recent enactment of CC SUD law(s), a lack of a central database for recording relapse rates, and disparities in opioid overdose rate reductions uncovers multiple variables potentially influencing OODR. Thus, further investigation is needed to analyze the factors influencing OODRs and long-term effects of the CC SUD laws.

Drivers' liability-based comparative severity analysis of motorized two-wheeler crashes.

OBJECTIVE: This study aims to investigate comparative severity analysis of motorized two-wheeler (MTW) crashes based on drivers' liability using police-reported a crash data base. METHODS: Using crash data from 2016 to 2020, this study examines and analyses the key factors affecting the severity of MTW injuries in Dehradun. For analysis, the ordinal logistic approach is used because severity levels are attributed with natural ordering. Differentiating from past studies, this research distinguished between collisions in which MTW crashes were considered as first party (crash in which MTW rider is accountable) and second person (crash in which MTW rider is a victim). RESULTS: Result suggests that age, pillion passenger, type of collision, road network, and impacting vehicle increase the seriousness of a crash in both cases. However, crash day, crash time, and light condition were found to be significant in the case of second-party crashes. Similarly, crash seriousness tends to decrease in first-party crashes, whereas it increases in the context of second-party crashes. CONCLUSION: The statistical results were correlated with past studies to provide proper justification in order to provide a better understanding of small-displacement MTW fatal accidents in developing countries. Additionally, this research aids in the development of mitigation strategies and future research directions to improve the safety of MTW users.

Sen-2 LULC: Land use land cover dataset for deep learning approaches.

Land Use Land Cover (LULC) classification is pivotal to sustainable environment and natural resource management. It is critical in planning, monitoring, and management programs at various local and national levels. Monitoring changes in LULC patterns over time is crucial for understanding evolving landscapes. Traditionally, LULC classification has been achieved through satellite data by remote sensing, geographic information system (GIS) techniques, machine learning classifiers, and deep learning models. Semantic segmentation, a technique for assigning land cover classes to individual pixels in an image, is commonly employed for LULC mapping. In recent years, the deep learning revolution, particularly Convolutional Neural Networks (CNNs), has reshaped the field of computer vision and LULC classification. Deep architectures have consistently outperformed traditional methods, offering greater accuracy and efficiency. However, the availability of high-quality datasets has been a limiting factor. Bridging the gap between modern computer vision and remote sensing data analysis can revolutionize our understanding of the environment and drive breakthroughs in urban planning and ecosystem change research. The "Sen-2 LULC Dataset" has been created to facilitate this convergence. This dataset comprises of 213,761 pre-processed 10 m resolution images representing seven LULC classes. These classes encompass water bodies, dense forests, sparse forests, barren land, built-up areas, agricultural land, and fallow land. Importantly, each image may contain multiple coexisting land use and land cover classes, mirroring the real-world complexity of landscapes. The dataset is derived from Sentinel-2 satellite imagery sourced from the Copernicus Open Access Hub (https://scihub.copernicus.eu/) platform. It includes spectral bands B4, B3, and B2, corresponding to red, green, and blue (RGB) channels, and offers a spectral resolution of 10 m. The dataset also provides an equal number of mask images. Structured into six folders, the dataset offers training, testing, and validation sets for images and masks. Researchers across various domains can leverage this resource to advance LULC classification in the context of the Indian region. Additionally, it catalyzes fostering collaboration between remote sensing and computer vision communities, enabling novel insights into environmental dynamics and urban planning challenges.

A Psittacine bite and subcutaneous basidiobolomycosis: A case with a therapeutic challenge.

Basidiobolus ranarum is a saprophyte that can be found in soil, rotting vegetables, and frogs' digestive tracts. Clinically, basidiobolomycosis presents as a persistent infection of subcutaneous tissue affecting the trunk and extremities in an immunocompetent host. We describe a case of subcutaneous basidiobolomycosis in a 56-year-old immunocompetent woman farmer by occupation residing at remote part of central India. This study highlights the traumatic implantation and zoonotic potential of fungal species. Clinical suspicion of fungal etiology and timely mycology laboratory diagnostic support is key to address such cases. This case is documented to emphasize the problems of compliance to treatment specially in remote and poor patients challenging the treatment with complete cure. 2012 Elsevier Ltd. All rights reserved.

Recent progress in the stabilization of low band-gap black-phase iodide perovskite solar cells.

All-inorganic and organic-inorganic hybrid perovskite solar cells (PSCs) have taken a quantum leap owing to their high performance and low-cost solution processability. Their efficiency has been dramatically increased up to ∼26%, matching the conventional inorganic photovoltaics like monocrystalline Si (26.1%), polycrystalline Si (21.6%), CdTe (22.1%), and CIGS (22.3%). Such outstanding performance has been achieved due to their excellent optoelectronic properties, such as a direct bandgap in the visible region, a very high absorption coefficient, a long charge-carrier diffusion length, and ambipolar carrier transport characteristics. FAPbI3 (FA = formamidinium) and CsPbI3 perovskites among the pool of perovskites are recommended for solar cell applications because they meet all the requirements for photovoltaic applications. However, the fundamental problem of these perovskites is that their photoactive black phase is highly unstable under ambient conditions due to small and large sizes of Cs+ and FA+ ions, respectively. The instability of the black phase of these perovskites hinders their applications in photovoltaic devices as a high-quality light absorber layer. Several approaches have been employed to prevent the formation of the photo-inactive yellow phase or to enhance the stability of the black phase of perovskites, such as dimensional and compositional engineering, the addition of external additives, and dimensional engineering. This perspective summarizes the various methods for stabilizing the black phase of CsPbI3 and FAPbI3 perovskites at room temperature as well as their application in photovoltaic devices.

Imaging Characteristics of Tongue Hematoma and Pseudoaneurysm Following Tooth Extraction Requiring Emergency Liquid Embolization.

Our case describes the imaging characteristics of a tongue hematoma and lingual artery pseudoaneurysm following oral surgery, treated with a liquid embolic agent prior to repeat instrumentation. Identifying particular imaging cues that suggest underlying vascular pathology is essential to prevent unnecessary, potentially fatal instrumentation. A liquid embolizing agent can be used to endovascularly treat an unstable pseudoaneurysm in the oral cavity.

Delineation of agricultural fields in arid regions from Worldview-2 datasets based on image textural properties.

Barren lands are being transformed into agricultural fields with the growing demand for agriculture-based products. Hence, monitoring these regions for better planning and management is crucial. Surveying with high-resolution RS (remote sensing) satellites like Worldview-2 provides a faster and cheaper solution than conventional surveys. In the study, the arid region comprising cropland and barrenlands are efficiently and autonomously delineated using its spectral and textural properties using state-of-the-art random forest (RF) ensemble classifiers. The textural information window size is optimized and at a GLCM (gray-level co-occurrence matrix) window size of 13, a stable trend in classification accuracy was observed. A further rise in window sizes did not improve the classification accuracy; beyond GLCM 19, a decline in accuracy was observed. Comparing GLCM-13 RF with the no-GLCM RF classifier, the GLCM-based classifiers performed better; thus, the textural information assisted in removing isolated crop-classified outputs that are falsely predicted pixel groups. Still, it also obscured information about barren lands present within croplands. Delineation accuracy was 93.8 % for the no-GLCM RF classifier, whereas, for the GLCM-13 RF classifier, an accuracy of 97.3 % was observed. Thus, overall, a 3.5 % improvement in accuracy was observed while using the GLCM RF classifier with window size 13. The textural information with proper calibration over high-spatial resolution datasets improves crop delineation in the present study. Henceforth, a more accurate cropland identification will provide a better estimate of the actual cropland area in such an arid region, which will assist in formulating a better resource management policy.

Potential of DESIS and PRISMA hyperspectral remote sensing data in rock classification and mineral identification:a case study for Banswara in Rajasthan, India.

Remote sensing datasets and methods are suitable for mapping and managing the natural resources like minerals, clean water, and energy and also govern their sustainability nowadays. Hyperspectral (HS) imaging has immense potential for rock type classification, mineral mapping, and identification. This work demonstrates the potential of feature extraction techniques and unsupervised machine learning methods for the space-borne hyperspectral remote sensing data in characterizing and identifying mineral and classifying rock type in Banswara, Rajasthan, India. Feature extraction techniques can reveal variations within the data, which can help identify geological areas, reduce noise, and check the dimensionality of the data. Singular value decomposition (SVD)-based principal component analysis (PCA), kernel PCA (KPCA), minimum noise fraction (MNF), and independent component analysis (ICA) were tested for lithological mapping using recently launched DLR Earth Sensing Imaging Spectrometer Hyperspectral (DESIS) and PRecursore IperSpettrale della Missione Applicativa (PRISMA) data in order to map geologically significant areas. Unsupervised machine learning methods, such as Iterative Self-Organizing Data Analysis Technique (ISODATA) and K-means, were also employed. Vertex component analysis (VCA) was utilized to check for similarity and identify various spectral features. Our work demonstrates the advantages of using feature extraction algorithms such as PCA and KPCA over MNF and ICA in geological mapping and interpretability. We recommend K-means as the preferred method for lithological classification of hyperspectral remote sensing data. Our work highlights the potential of advanced feature extraction algorithms for mineral mapping using hyperspectral data, providing different ways to identify minerals and ultimately leading to better mineral resource management.

Evaluation of vertebral shortening and interbody fusion with short segment pedicle screw fixation for unstable thoracolumbar fractures.

Background: Various operative procedures have been described for the treatment of traumatic paraplegia caused by unstable thoracolumbar fractures. We prospectively evaluated interbody fusion (IBF) with SS-PSF in these cases with regard to clinico-radiological outcome with the objectives: (1) Does IBF and short segment pedicle screw fixation (SS-PSF) prevent progression of kyphotic angle after surgery? (2) Can this procedure be safely performed in the setting of acute trauma?. Methods: Sixteen patients suffering from traumatic paraplegia caused by acute unstable thoracolumbar fractures were enrolled prospectively and underwent IBF with SS-PSF. They were evaluated for magnitude of shortening in spine, progression of kyphotic angle, and neurological improvement by American spinal injury association scale (ASIA). Results: Out of total sixteen, 14 patients were ASIA grade A and 2 were grade C, at the time of presentation. Thirteen out of these 14 remained grade A and one improved to B. Both the patients who had grade C involvement at the time of presentation improved to grade D at one-year follow-up. The mean blood loss was 750 ml (range; 650 ml-1150 ml). Mean kyphotic angle decreased from 20.6° (range; 13° to 37°) preoperatively to 6.2° (range; 3° to 10°) at postoperative day 2 (p = 0.002). Its mean value after 6 months was 6.5° (range; 3° to 11°). The procedure resulted in mean spinal column shortening of 18 mm (range; 16 mm-22 mm) in the spinal column. All the patients achieved bony union by a mean duration of 3.9 months (range; 3 months-6 months). Conclusions: IBF with SS-PSF has the shortest possible instrumented construct for thoracolumbar junction fusion done by posterior approach. The interbody fusion for unstable thoracolumbar junction fractures prevents the progression of kyphotic angle post-operatively. Level of evidence: Level 4.

Assessing variations in land cover-land use and surface temperature dynamics for Dehradun, India, using multi-time and multi-sensor landsat data.

Rapid urbanisation and industrialisation coupled with overpopulation have altered land cover/land use (LCLU) and surface temperature (ST) patterns in Dehradun. Monitoring these changes through satellite-based remote sensing is required to ensure the sustained development of this ecologically fragile region. Here, LU and ST dynamics of the Dehradun municipal area have been estimated using Landsat-5 datasets for 1991, 1998, and 2008 and Landsat-8 dataset for 2018. LU maps have been extracted using a Gaussian Maximum Likelihood classifier with an overall accuracy of over 88% and Kappa coefficients above 0.85. Results reveal that the urban region expanded by 80.6% in the 27 years while dense vegetation and dry river bed classes have declined sharply. Sparse vegetation has risen by 3 km2, whereas bare ground has decreased by about 4.3 km2. Mean ST has increased above 9 °C from 1991 to 2018 in every season. A seasonal influence is evident on the mean ST per LU class's trend, which rose between 8 °C and 12 °C for every LU class, indicating significant warming across each LU class. ST probably has non-linear relationships with its causal factors represented by spectral indices, elevation, and population density. Urban heat island (UHI) formation is thus evinced, promulgating the administration's urgent action to save the environment and redrawing policies for ambitious projects like smart cities.

Wedgeless V-Shaped Osteotomy of the Distal Medial Femur with Locking Plate Fixation for Correction of Genu Valgum in Adolescents and Young Adults.

Background: Genu valgum is a common disorder affecting adolescents and young adults. Treatment of this disorder requires restoration of normal mechanical axis alignment and joint orientation, for which it is important to assess whether the deformity arises from the distal femur, knee joint, or proximal tibia. Most commonly, the deformity originates from the distal femur, and various osteotomies of the distal femur have been described1-6. The presently described wedgeless V-shaped osteotomy7,8 is a good option among the various alternative procedures listed below. Description: The anesthetized patient is placed in the supine position on a radiolucent operating table. A bolster is placed beneath the knee to relax the posterior structures. A medial longitudinal skin incision is made that extends from the level of the medial joint line to 5 cm proximal to the adductor tubercle. The vastus medialis is identified and elevated anteriorly by detaching it from its distal and posterior aspects. The leash of vessels underneath the vastus medialis is identified, and the apex of the V-shaped osteotomy is kept just proximal to it. The anterior arm of the V is kept longer than the posterior one, both of them are kept perpendicular to each other, and the apex of the V is made to point distally. The osteotomy is performed on the medial cortex with use of an oscillating saw or multiple drill holes that are then connected using a thin osteotome. Care is taken not to utilize a saw or drill on the lateral cortex. A gentle valgus thrust is applied to break the lateral cortex without periosteal disruption. The apex of the V osteotomy on the proximal fragment is trimmed, and the deformity is corrected with varus force. The osteotomy site is stabilized with use of an anatomically contoured distal medial femoral locking plate or a medial proximal tibial L-shaped buttress plate (of the contralateral side). The implant position is verified under a C-arm image intensifier. The wound is closed in layers over a suction drain in a standard manner. Alternatives: Various types of corrective osteotomies of the distal femur have been described in the literature, including the lateral opening wedge, medial closing wedge, dome, and spike osteotomies1-6. All of these procedures have certain limitations and shortcomings. Rationale: The wedgeless V-shaped osteotomy is another described procedure that is inherently stable7,8. It is a safe procedure and yields good clinical outcomes8,9. The posterior arm of the V-shaped osteotomy is kept smaller than the anterior arm. The proximal cortical bone is allowed to dig into the cancellous bone of the wider distal metaphysis during deformity correction. Trimming the apex of proximal bone end after making the osteotomy facilitates the process. Expected Outcomes: In a study of 46 patients with a mean age of 16.9 years (range, 15 years to 23 years), Gupta et al.8 reported that the mean radiographic tibiofemoral angle improved from 22.2° (range, 16° to 29°) preoperatively to 5.1° (range, 0° to 10°) postoperatively (p < 0.001). Similarly, the mean lateral distal femoral angle improved from 79.2° preoperatively to 89.1° postoperatively (p < 0.001) and the mean mechanical axis deviation improved from 19.6 mm preoperatively to 3.7 mm postoperatively (p < 0.001). A total of 44 of 46 cases had an excellent functional outcome, with the other 2 having good outcomes. None of the patients in the study had an unsatisfactory outcome. Important Tips: It is important to keep the whole lower limb accessible to the image intensifier intraoperatively.Identification of the leash of vessels underneath the vastus medialis is important to decide the level of the osteotomy.It is important to preserve the periosteal sleeve on the lateral aspect of the femur. Acronyms and Abbreviations: CORA = center of rotation of angulationECG = electrocardiogramLDFA = lateral distal femoral angleMAD = mechanical axis deviationMPTA = medial proximal tibial angle.

Reservoir of Carbapenem-Resistant Acinetobacter baumannii in the Hospital Environment and Colonization Pressure: A Surveillance-Based Study in Indian Intensive Care Unit.

The endemicity of Acinetobacter baumannii in intensive care units (ICUs) is a serious concern. We studied the reservoirs of A. baumannii in the ICU and their effects on colonization pressure and transmission. A prospective surveillance (6 months) was conducted. Screening culture (rectal and axillary) swabs were collected within 48 hours admission and in 120 hours. Surveillance cultures from patients' surroundings, health care workers (HCWs), and hospital sewage were collected. A. baumannii was identified by phenotypic and genotypic methods. Carbapenem resistance and insertion sequence element were detected. Typing was done by repetitive extragenic palindromic-polymerase chain reaction and multilocus sequence typing. Colonization pressure was calculated and compared with environment colonizers. Of the 87 patients, 21.83% (19) were colonized with A. baumannii, 73.68% (14/19) were imported, and 26.31% (5/19) acquired carriers. Axilla was the commonest site. From the environment (15), bed rails 33.33% (5/15) and suction tubes 26.66% (4/15) were the common sites. HCWs showed 7.5% (3/40) carriage. Carbapenem resistance with blaOXA-51, blaOXA-23, and ISAba1 were 91.89% (34/37). Strong correlation between colonization pressures and environmental colonizers was seen (r2 = 0.719, p = 0.032). Carbapenem and polymyxin B were (p ≤ 0.05) significant exposures. Sequence type 623 was the predominant cluster with isolates from carriers, HCWs, and environment. Colonization pressure of carbapenem-resistant A. baumannii depends on their presence in the hospital. Hands of HCWs were an important vehicle for transmission. Infection control measure should consider reducing the environmental reservoir.

Using Traditional Typologies to Understand Posture Movement and Cognitive Performance - A cross sectional study.

Context: We employed two classification methods that characterize psycho-somatotype categorization to understand motor and cognitive performance. The Trunk Index produces three somatotypes/body type categories: ectomorphs, mesomorphs, and endomorphs, and Prakriti classifications categorizes people into three categories: Vata, Pitta, and Kapha. Comparing these two categorization methods offers insights into anthropometric measures that combine psychological and physical characteristics to account for motor and cognitive behavior. Aims: The present study examined variations in cognitive and motor performances using the two typologies - prakriti and somato body types using cross-sectional study design. Subjects and Methods: The study employed fifty-eight healthy young adults, classified into prakriti (vata, pitta, kapha) and ecto-, meso-, endo-morph body types, to examine their cognitive performance (reaction time [RT] and accuracy), and motor performance (posture stability and posture accuracy) in standing yoga postures. Statistical Analysis Used: Analysis of covariance was performed to compare the cognitive and postural performance across the three somato and prakriti types after adjusting for age and gender as covariates. Post-hoc analysis of Bonferroni was performed with the consideration of Levene's test. Partial correlations were employed to investigate the correlation between postural stability and cognitive performance measures for each of the prakriti- and somato-body types as well as between the prakriti typology (scores) and trunk index values (adjusting the effects of age and gender as control variables). A P < 0.05 was selected at the statistical significance level. SPSS 26.0 version was used for the analysis. Results: Cognitive performance was observed to vary in terms of RT across somato- and prakriti body types (P < 0.05). Postural stability and cognitive performance are positively connected only for ectomorph body types (P < 0.05). Variations in motor performance were not significant. Barring ectomorph type, no other somato- and prakriti body types showed significant relationships between postural stability and cognitive performance. Likewise, the association between the features used for prakriti classification, and the trunk index scores showed marginal significance, only for a small subset of physical features of prakriti assessment (P = 0.055) (P1). Conclusions: Comparing classifications that use psychophysical attributes might offer insights into understanding variations in measures of motor and cognitive performance in a sample of healthy individuals.