Explore the vast range of titles available.

Background : The existing training pathways to become a pediatric cardiac intensivist are very variable with physicians coming from varied training backgrounds of pediatric critical care, pediatric cardiology, neonatology, or pediatric anesthesia. Aim : To evaluate the impact of cardiac Intensive Care Unit (ICU) attending physician training background on outcomes in children undergoing heart operations. Setting and Design : Patients in the age group from 1 day to 18 years undergoing heart operation at a Pediatric Health Information System database participating hospital were included (2010-2015). Patients and Methods : Based on the training background of majority of attending physicians in an ICU, the participating ICUs were divided into three groups: critical care medicine (CCM), cardiology, and indeterminate. Statistical Analysis : Multivariable logistic regression models were fitted to evaluate the association of ICU physician training background with study outcomes. Results : A total of 54,935 patients from 42 ICUs were included. Of these, 31,815 patients (58%) were treated in the CCM group (26 ICUs), 19,340 patients (35%) were treated in the cardiology group (12 ICUs), and 3780 patients (7%) were treated in the indeterminate group (4 ICUs). In adjusted models, no specific group based on ICU attending physician training background was associated with lower mortality (CCM vs. cardiology, odds ratio: 0.75, 95% confidence interval: 0.48-1.18), or lower incidence of cardiac arrest, or prolonged hospital length of stay, or prolonged mechanical ventilation. Conclusions : This large observational study did not demonstrate any impact of ICU attending training background on outcomes in children undergoing heart operations.

Purpose The purpose of this study was to evaluate the association between early fluid accumulation and mortality in children with shock states. Methods We retrospectively reviewed children admitted in shock states to the pediatric intensive care unit (ICU) at a tertiary level children’s hospital over a 7-month period. The study was designed as a matched case–control study. Children with early fluid overload, defined as fluid accumulation of ≥10 % of admission body weight during the initial 3 days, were designated as the cases. They were compared with matched controls without early fluid accumulation. Cases and controls were matched for age, severity of illness at ICU admission and need for organ support. They were compared with respect to all-cause ICU mortality and other secondary outcomes. Results A total of 114 children (age range 0–17.4 years; N = 42 cases and 72 matched controls) met the study criteria. Mortality rate was 13 % (15/114) in this cohort. Multivariable logistic regression analysis identified the presence of early fluid overload [adjusted odds ratio (OR) 9.17, 95 % confidence interval (CI) 2.22–55.57], its severity (adjusted OR 1.11, 95 % CI 1.05–1.19) and its duration (adjusted OR 1.61, 95 % CI 1.21–2.28) as independent predictors of mortality. Cases had higher mortality than the controls (26 vs. 6 %; p 0.003), and this difference remained significant in the matched analysis (37 vs. 3 %; p 0.002). Conclusion The presence, severity and duration of early fluid are associated with increased ICU mortality in children admitted to the pediatric ICU in shock states.

In children with severe advanced heart failure where medical management has failed, mechanical circulatory support in the form of veno-arterial extracorporeal membrane oxygenation (VA ECMO) or ventricular assist device represents life-sustaining therapy. This review provides an overview of VA ECMO used for cardiovascular support including medical and surgical heart disease. Indications, contraindications, and outcomes of VA ECMO in the pediatric population are discussed.VA ECMO provides biventricular and respiratory support and can be deployed in rapid fashion to rescue patient with failing physiology. There have been advances in conduct and technologic aspects of VA ECMO, but survival outcomes have not improved. Stringent selection and optimal timing of deployment are critical to improve mortality and morbidity of the patients supported with VA ECMO.

Normally web services are classified originate in on the quality of service, wherever the term quality is not absolute and it is a relative term. The quality of web services is measured or derived using various parameters like reliability, scalability, flexibility, availability, etc. However, the limitation of these methods is that they are producing similar web services in recommendation lists some times. To address this research problem, the novel improved the Clustering-based web service recommendation method is proposed in this project. This approach is mainly dealing to produce diversity in the results of web service recommendation. In this method, functional interest, QoS preference, and diversity features are combined to produce the unique recommendation list of web services to end-users. To produce the unique recommendation results, we proposed a vary web service classify order that is clustering-based on web services' functional relevance such as non-useful pertinence, recorded client intrigue importance, potential client intrigue significance, etc.

A standardised multi-site approach to manage paediatric post-operative chylothorax does not exist and leads to unnecessary practice variation. The utilised the Pediatric Critical Care Consortium infrastructure to address this gap. Over 60 multi-disciplinary providers representing 22 centres convened virtually as a quality initiative to develop an algorithm to manage paediatric post-operative chylothorax. Agreement was objectively quantified for each recommendation in the algorithm by utilising an anonymous survey. \"Consensus\" was defined as ≥ 80% of responses as \"agree\" or \"strongly agree\" to a recommendation. In order to determine if the algorithm recommendations would be correctly interpreted in the clinical environment, we developed ex vivo simulations and surveyed patients who developed the algorithm and patients who did not. The algorithm is intended for all children (<18 years of age) within 30 days of cardiac surgery. It contains rationale for 11 central chylothorax management recommendations; diagnostic criteria and evaluation, trial of fat-modified diet, stratification by volume of daily output, timing of first-line medical therapy for \"low\" and \"high\" volume patients, and timing and duration of fat-modified diet. All recommendations achieved \"consensus\" (agreement >80%) by the workgroup (range 81-100%). Ex vivo simulations demonstrated good understanding by developers (range 94-100%) and non-developers (73%-100%). The quality improvement effort represents the first multi-site algorithm for the management of paediatric post-operative chylothorax. The algorithm includes transparent and objective measures of agreement and understanding. Agreement to the algorithm recommendations was >80%, and overall understanding was 94%.

Urinary tract infections caused by uropathogenic Escherichia coli ( E . coli) are a global health concern, with rising rates and antibiotic resistance demanding novel treatments. Therefore, in this study, we explored the potential of Oxacyclohexadecan-2-one obtained from Moringa oleifera (M . oleifera) seed, as antibacterial agent against three majorly prevalent carbapenemase-producing E . coli proteins, blaNDM-1 (New Delhi metallo-betalactamase-1), blaNDM-5 (New Delhi metallo-betalactamase-5) and blaOXA-48 (Oxacillinase-48) from the strains Ecw3, EC-114 and T20 respectively. The ethanolic extract of M . oleifera seed was subjected to GC-MS, identifying 135 compounds. PyRx virtual screening, identified the top 10 ligands for each protein following the Rule of 5 and ProTox classes V and VI, with Oxacyclohexadecan-2-one (PubChem ID: 235414) showing best binding affinity across all 3 proteins with an optimized dose (LD50) of 5000mg/kg. Hence, molecular docking was carried out for ligand 235414 along with Imipenem, belonging to the same class V toxicity class with an optimized dose (LD50) of 5000mg/kg. Imipenem is a commonly used FDA drug to treat UTIs, which served as the control in the study. Oxacyclohexadecan-2-one showed higher binding affinity for the beta-lactamase proteins with a docking score of -6.45 kcal/mol, -6.05 kcal/mol and -7.34 kcal/mol compared to -3.41 kcal/mol, -3.99 kcal/mol and -6.36 kcal/mol of Imipenem for NDM-1, NDM-5 and OXA-48 respectively. Dynamic Simulation was performed for 100 ns for Oxacyclohexadecan-2-one and Imipenem bound protein complexes to determine the stability, fluctuations, compactness, bond interaction, solvent accessibility area, free energy landscape and the binding free energy. The results of molecular docking and dynamics were promising for the Oxacyclohexadecan-2-one, suggesting its potent inhibitory effect against the beta-lactamase producing proteins.

The growth in the number of retracted publications in academic fields suggests that the problem is not but rather reflective of broader challenges in the research environment. This study seeks to address these concerns by focusing specifically on the trends and characteristics of retracted papers in Indian scientific publications. We examine the trend through 3162 retracted publications that appeared during 1990-2024 indexed in Web of Science database. It was observed that although a number of retracted publications were present in 1990 to 2016, the increase was more after 2016 and was highest in 2022, before declining in 2023. Most of these publications were published under collaborative authorship and 38.52 % publications came under international co-authorship with 66 countries including Ethiopia, Saudi Arabia, China, USA and received 13.60 citations per publication. There were 25.93 % publications published through institutional funds and 45.47 % publications appeared in non-OA journals. Subjects like computer science (fields like internet of things, machine learning, deep learning), medical science (apoptosis, oxidative state, covid-19), material science (nanotechnology, nano-tubes, polymer science) are the major three disciplines in where most of retractions were noticed. Highest number of retracted publications appeared in the journals having IF range 5.0 to 9.99 followed by 3.0 to 3.99. The rate of retracted articles did not necessarily decrease with increase of impact factor suggesting greater scrutiny of high-profile publications does not have an impact on retraction. Plagiarism was found as one of the major reasons for retraction followed by compromised peer review, emphasizing the need for stricter regulatory frameworks and better research practices.

Methicillin resistant Staphylococcus aureus (MRSA) is a predominant human pathogen with high morbidity that is listed in the WHO high priority pathogen list. Being a primary cause of persistent human infections, biofilm forming ability of S. aureus plays a pivotal role in the development of antibiotic resistance. Hence, targeting biofilm is an alternative strategy to fight bacterial infections. The present study for the first time demonstrates the non-antibacterial biofilm inhibitory efficacy of 5-Dodecanolide (DD) against ATCC strain and clinical isolates of S. aureus . In addition, DD is able to inhibit adherence of MRSA on human plasma coated Titanium surface. Further, treatment with DD significantly reduced the eDNA synthesis, autoaggregation, staphyloxanthin biosynthesis and ring biofilm formation. Reduction in staphyloxanthin in turn increased the susceptibility of MRSA to healthy human blood and H 2 O 2 exposure. Quantitative PCR analysis revealed the induced expression of agrA and agrC upon DD treatment. This resulted down regulation of genes involved in biofilm formation such as fnbA and fnbB and up regulation of RNAIII , hld , psmα and genes involved in biofilm matrix degradation such as aur and nuc . Inefficacy of DD on the biofilm formation of agr mutant further validated the agr mediated antibiofilm potential of DD. Notably, DD was efficient in reducing the in vivo colonization of MRSA in Caenorhabditis elegans . Results of gene expression studies and physiological assays unveiled the agr mediated antibiofilm efficacy of DD.

Japanese Encephalitis Virus (JEV) is a neurotropic virus that invades Central Nervous System (CNS) and causes severe neuroinflammation. Given the abundance and the position of astrocytes in the CNS, we speculate that they might play a critical role in the process of neuroinflammation. Unfortunately, the role of astrocytes in JEV-mediated neuroinflammation has long been understated. In this study, we have attempted to assess the role of astrocyte-mediated neuroinflammation upon JEV infection. Mouse model of JEV infection, generated by intraperitoneal injection, showed severe reactive astrogliosis. To further address our hypothesis, we employed immortalized astrocytic cell line (in vitro) and primary astrocyte-enriched culture (ex vivo) as experimental models. JEV infection in the astrocytes induces proinflammatory cytokines like MCP1/CCL2 and IL6 in both ex vivo and in vitro cultures as observed from the cytometric bead array analysis. A significantly altered cytokine profile was observed using PCR analysis in in vitro and ex vivo models upon infection, with respect to control, validating our previous results. We also show that there exists a major inconsistency in the viral replication kinetics, wherein the cell line showed a robust rate of replication whereas the primary astrocyte-enriched culture showed negligibly low number of plaques, underlining the importance of the selection of appropriate experimental model system. In conclusion, we claim that astrocytes significantly contribute to JEV-mediated neuroinflammation, despite not being a CNS immune cell.

Due to its potential geo-political and environmental implications, climate migration is an increasing concern to the international community. However, while there is considerable attention devoted to migration in response to sea-level rise, there is a limited understanding of human mobility due to freshwater and inland hydroclimatic changes. Hence, the aim of this paper is to examine the existing evidence on migration as an adaptation strategy due to freshwater and inland hydroclimatic changes. A meta-review of papers published between 2014 and 2019 yielded 67 publications, the majority of which focus on a handful of countries in the Global South. Droughts, floods, extreme heat, and changes in seasonal precipitation patterns were singled out as the most common hazards triggering migration. Importantly, most of the papers discuss mobility as part of a portfolio of responses. Motivations to migrate at the household level range from survival to searching for better economic opportunities. The outcomes of migration are mixed — spanning from higher incomes to difficulties in finding employment after moving and struggles with a higher cost of living. While remittances can be beneficial, migration does not always have a positive outcome for those who are left behind. Furthermore, this meta-review shows that migration, even when desired, is not an option for some of the most vulnerable households. These multifaceted results suggest that, while climate mobility is certainly happening due to freshwater and inland hydroclimatic changes, studies reviewing it are limited and substantial gaps remain in terms of geographical coverage, implementation assessments, and outcomes evaluation. We argue that these gaps need to be filled to inform climate and migration policies that increasingly need to be intertwined rather than shaped in isolation from each other.