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Fragmented QRS (fQRS) on electrocardiogram (ECG) may reflect myocardial fibrosis in both ischemic and nonischemic cardiomyopathy. Gray zone on cardiac magnetic resonance (CMR), which represents a heterogeneous interface between dense scar and viable myocardium, is a known predictor of appropriate implantable cardioverter-defibrillator (ICD) shocks or death. The relationship between fQRS and myocardial scar on CMR remains poorly studied and may improve risk stratification for ICD therapy. This study aimed to evaluate the relationship between fQRS and scar core/gray zone by CMR late gadolinium enhancement (LGE), and to determine whether fQRS predicts benefit from ICD therapy. We included 388 adults who underwent CMR followed by ICD implantation for primary or secondary prevention between 2005 and 2018 at 2 tertiary centers. ECGs were assessed for fQRS and CMR images were independently evaluated. The primary endpoint was a composite of all-cause mortality or appropriate ICD shock. Mean age was 61 ± 13 years and mean left ventricular ejection fraction (LVEF) was 32%. LGE was present in 69% and fQRS in 28%. fQRS was associated with greater scar burden on visual LGE assessment (p = 0.036), but not with quantitative LGE measures (2SD, 4SD, FWHM) or gray zone. Over a median follow-up of 61 months, 36% experienced the primary outcome. In multivariable analysis adjusting for LVEF and other prognosticators, fQRS was not independently associated with the primary outcome (HR 0.85; 95% CI: 0.67–1.08; p = 0.20). In conclusion, fQRS is associated with scar burden by visual assessment but does not provide incremental predictive value for ICD benefit.

Fragmented QRS (fQRS) on electrocardiogram (ECG) may reflect myocardial fibrosis in both ischemic and non-ischemic cardiomyopathy. Gray zone on cardiac magnetic resonance (CMR), which represents a heterogeneous interface between dense scar and viable myocardium, is a known predictor of appropriate implantable cardioverter-defibrillator (ICD) shocks or death. The relationship between fQRS and myocardial scar on CMR remains poorly studied and may improve risk stratification for ICD therapy. This study aimed to evaluate the relationship between fQRS and scar core/gray zone by CMR late gadolinium enhancement (LGE), and to determine whether fQRS predicts benefit from ICD therapy. We included 388 adults who underwent CMR followed by ICD implantation for primary or secondary prevention between 2005 and 2018 at two tertiary centers. ECGs were assessed for fQRS and CMR images were independently evaluated. The primary endpoint was a composite of all-cause mortality or appropriate ICD shock. Mean age was 61 ± 13 years and mean left ventricular ejection fraction (LVEF) was 32%. LGE was present in 69% and fQRS in 28%. fQRS was associated with greater scar burden on visual LGE assessment (p=0.036), but not with quantitative LGE measures (2SD, 4SD, FWHM) or gray zone. Over a median follow-up of 61 months, 36% experienced the primary outcome. In multivariable analysis adjusting for LVEF and other prognosticators, fQRS was not independently associated with the primary outcome (HR 0.85; 95% CI: 0.67-1.08; p = 0.20). In conclusion, fQRS is associated with scar burden by visual assessment but does not provide incremental predictive value for ICD benefit.Fragmented QRS (fQRS) on electrocardiogram (ECG) may reflect myocardial fibrosis in both ischemic and non-ischemic cardiomyopathy. Gray zone on cardiac magnetic resonance (CMR), which represents a heterogeneous interface between dense scar and viable myocardium, is a known predictor of appropriate implantable cardioverter-defibrillator (ICD) shocks or death. The relationship between fQRS and myocardial scar on CMR remains poorly studied and may improve risk stratification for ICD therapy. This study aimed to evaluate the relationship between fQRS and scar core/gray zone by CMR late gadolinium enhancement (LGE), and to determine whether fQRS predicts benefit from ICD therapy. We included 388 adults who underwent CMR followed by ICD implantation for primary or secondary prevention between 2005 and 2018 at two tertiary centers. ECGs were assessed for fQRS and CMR images were independently evaluated. The primary endpoint was a composite of all-cause mortality or appropriate ICD shock. Mean age was 61 ± 13 years and mean left ventricular ejection fraction (LVEF) was 32%. LGE was present in 69% and fQRS in 28%. fQRS was associated with greater scar burden on visual LGE assessment (p=0.036), but not with quantitative LGE measures (2SD, 4SD, FWHM) or gray zone. Over a median follow-up of 61 months, 36% experienced the primary outcome. In multivariable analysis adjusting for LVEF and other prognosticators, fQRS was not independently associated with the primary outcome (HR 0.85; 95% CI: 0.67-1.08; p = 0.20). In conclusion, fQRS is associated with scar burden by visual assessment but does not provide incremental predictive value for ICD benefit.

This randomised, crossover, sham-controlled study explored the neural basis of source-monitoring, a crucial cognitive process implicated in schizophrenia. Left superior temporal gyrus (STG) and dorsolateral prefrontal cortex (DLPFC) were the key focus areas. Thirty participants without neurological or psychological disorders underwent offline sham and active tDCS sessions with specific electrode montage targeting the left STG and DLPFC. Source-monitoring tasks, reality monitoring (Hear-Imagine), internal source-monitoring (Say-Imagine), and external source monitoring (Virtual–Real) were administered. Paired t-test and estimation statistics was performed with Graphpad version 10.1.0. The Benjamini–Hochberg procedure was employed to control the false discovery rate in multiple hypothesis testing. A significant improvement in internal source monitoring tasks (p = 0.001, Cohen's d = 0.97) was observed, but reality monitoring tasks demonstrated moderate improvement (p = 0.02, Cohen's d = 0.44). The study provides insights into the neural mechanisms of source monitoring in healthy individuals and proposes tDCS as a therapeutic intervention, laying the foundation for future studies to refine tDCS protocols and develop individualized approaches to address source monitoring deficits in schizophrenia.

A hybrid methodology for bearing fault and severity analysis using param, eter-optimized variational mode decomposition (VMD) and deep learning (DL) algorithms is presented in this study. Different localized defects are artificially seeded at the contacting surfaces of a self-aligning bearings, and vibration data is generated (Case study II) under various radial-load and speed conditions for DL algorithm development. This data is pre-processed using the parameter-optimized VMD, where the intrinsic mode function with the highest kurtosis is processed using a deep learning (DL) algorithm. Particle swarm optimization is used for optimizing two VMD parameters. Further, seven different DL algorithms are implemented to classify various fault severity of rolling-element bearings. These algorithms are validated against the standard repository dataset of Case Western Reserve University (Case study I). The reliability of these algorithms is also tested using the generated dataset (Case study II) and the results show that 1D-CNN, WaveNet and gated recurrent unit have outperformed all other algorithms by achieving accuracies of 99.65%, 97.05% and 97.33%, respectively.

Non-Communicable Diseases (NCDs) are now a leading cause of mortality and morbidity globally, and mental illness is a significant part of it. In India, the treatment gap for common mental disorders is over 80%. In order to bridge this gap, mental health treatment models recommend task-shifting to non-specialists and integration of mental health care into general healthcare services. Other NCDs are being managed effectively by non-specialist healthcare workers (HCWs) at primary care, and mental illness and substance misuse are highly comorbid with other NCDs; hence, integrating mental health care within the NCD services and care framework seems logically feasible and effective. However, country-specific characteristics pose a significant challenge to the implementation of integrated care for mental disorders and NCDs. The primary objective of this study includes the development and implementation of a service delivery model that would result in at least 70% coverage of screening, linkage to care, and management of common mental disorders and substance use disorders (MSUD) among persons seeking care for NCDs at public health facilities. Secondary objectives include assessment of the feasibility of adoption of the implementation model by the health care system and to evaluate the cost of the mental health service strengthening intervention package from the health system’s and the patient’s perspectives. It will be a multi-site implementation research study, employing a mixed-methods quasi-experimental, within-site, three-phase, single-arm, interrupted time series design. The implementation model comprises screening, treatment, and linkage of mental health services integrated into NCD care in at least three blocks in each of the seven selected districts of the seven selected states of India, which are geographically far apart. The expected outcome would be to increase the proportion of patients screened and managed for MSUDs among persons seeking care for NCDs at the public health facilities. The results of this implementation research will provide a roadmap for scaling up of integrated MSUDs services within general healthcare.

In this article, we present the synthesis of Piper longum leaves–derived ethanolic carbon dots (PLECDs) using the most simplistic environmentally friendly solvothermal carbonization method. The PLECDs fluoresced pink color with maximum emission at 670 nm at 397 nm excitation. Additionally, the dried PLECDs dissolved in water showed green fluorescence with higher emission at 452 nm at 370 nm excitation. The UV spectra showed peaks in the UV region (271.25 nm and 320.79 nm) and a noticeable tail in the visible region, signifying the efficient synthesis of nano-sized carbon particles and the Mie scattering effect. Various functional groups (–OH, –N–H, –C–H, –C = C, –C–N, and –C–O) were identified using Fourier transform infrared spectroscopy (FTIR). Its nanocrystalline property was revealed by the sharp peaks in the X-ray diffraction (XRD). High-resolution transmission electron microscopy (HRTEM) photomicrograph displayed a roughly spherical structure with a mean size of 2.835 nm. The energy dispersive X-ray (EDAX) and X-ray photoelectron spectroscopy (XPS) revealed the elemental abundance of C, O, and N. The high-performance thin-layer chromatography (HPTLC) fingerprint of PLECDs showed an altered pattern than its precursor ( Piper longum leaves ethanolic extract or PLLEE). The PLECDs sensed Cu 2+ selectively with a limit of detection (LOD) and limit of quantification (LOQ) of 0.063 μM and 0.193 μM, respectively. It showed excellent cytotoxicity toward MDA-MB-231 (human breast cancer), SiHa (human cervical carcinoma), and B16F10 (murine melanoma) cell lines with excellent in vitro bioimaging outcomes. It also has free radical scavenging activity. The PLECDs also showed outstanding bacterial biocompatibility, pH-dependent fluorescence stability, photostability, physicochemical stability, and thermal stability.

The development of carbon dots via a green synthesis approach from natural products is one of the most researched areas nowadays. Herein, we present the synthesis of Piper longum leaves-derived aqueous carbon dots (PLACDs) via the simplest ecofriendly hydrothermal carbonization method. The PLACDs exhibited excitation-dependent emission behavior with maximum emission at 450 nm at an excitation wavelength of 365 nm. The High-Resolution Transmission Electron Microscopy results showed a quasi-spherical shape with an average size of 4.121 nm. The sharp diffractions of X-ray diffraction revealed its nanocrystalline property. The Energy Dispersive X-ray spectra reflected the presence of carbon, nitrogen, and oxygen. The Fourier-Transform Infrared Spectroscopy disclosed the existence of –OH, –C=C, –C=O, and –C–O–C groups. The PLACDs presented excellent biocompatibility against B16F10 (melanoma) and SiHa (cervical carcinoma) cells lines with concentration-dependent in vitro bioimaging results. It also exhibited antiradical activity with the IC 50 value of 0.499 mg/mL and 0.051 mg/mL against DPPH and ABTS .+ , respectively. It showed Fe 3+ sensing with a lower limit of detection of 0.673 μM. Further, the PLACDs displayed excellent bacterial biocompatibility, pH-dependent fluorescence property, fluorescent ink property, photostability, physical, chemical, and thermal stability.

Background Pre-diagnosis attrition needs to be addressed urgently if we are to make progress in improving MDR-TB case detection and achieve universal access to MDR-TB care. We report the pre-diagnosis attrition, along with factors associated, and turnaround times related to the diagnostic pathway among patient with presumptive MDR-TB in Bhopal district, central India (2014). Methods Study was conducted under the Revised National Tuberculosis Control Programme setting. It was a retrospective cohort study involving record review of all registered TB cases in Bhopal district that met the presumptive MDR-TB criteria (eligible for DST) in 2014. In quarter 1, Line Probe Assay (LPA) was used if sample was smear/culture positive. Quarter 2 onwards, LPA and Cartridge-based Nucleic Acid Amplification Test (CbNAAT) was used for smear positive and smear negative samples respectively. Pre-diagnosis attrition was defined as failure to undergo DST among patients with presumptive MDR-TB (as defined by the programme). Results Of 770 patients eligible for DST, 311 underwent DST and 20 patients were diagnosed as having MDR-TB. Pre-diagnosis attrition was 60% (459/770). Among those with pre-diagnosis attrition, 91% (417/459) were not identified as ‘presumptive MDR-TB’ by the programme. TAT [median (IQR)] to undergo DST after eligibility was 4 (0, 10) days. Attrition was more than 40% across all subgroups. Age more than 64 years; those from a medical college; those eligible in quarter 1; patients with presumptive criteria ‘previously treated – recurrent TB’, ‘treatment after loss-to-follow-up’ and ‘previously treated-others’; and patients with extra-pulmonary TB were independent risk factors for not undergoing DST. Conclusion High pre-diagnosis attrition was contributed by failure to identify and refer patients. Attrition reduced modestly with time and one factor that might have contributed to this was introduction of CbNAAT in quarter 2 of 2014. General health system strengthening which includes improvement in identification/referral and patient tracking with focus on those with higher risk for not undergoing DST is urgently required.

Upon publication of the original article [1], it was noticed that the author’s name “Hemant Deepak Shewade” was incorrectly given as “Deepak Shewade”. This has now been acknowledged and corrected in this erratum.

This study was conducted to demonstrate the acaricide efficacy of novel indigenous veterinary medication shared by an outstanding knowledge holder against naturally infested cattle and efforts in mainstreaming such wisdom. An indigenous herbal medication in control of tick infestation was documented, and experimentation was held against naturally affected cattle. Eighteen clinically infested cattle population comprising 16 crossbred and 2 non-descript cattle were purposively selected. Majority of them were adult females, reported with a higher incidence of tick at Veterinary institution. The average pre-treatment tick count at 24 sites of observations among these animals was 18.91±2.04 (Mean [x̄]±standard error [SE]). The medication was topically applied once daily for 2 days and post-treatment observations were recorded for an experimental period of 14 days' duration. During 24-h post-treatment observation, the medication had shown 92.95% acaricidal property with clinically irrelevant rate of tick infestation of 1.33±0.39 (x̄ ±SE) was noticed before application of subsequent (second) dosage. This practice was found significantly effective at 5% level of significance (t =9.08) illustrating faster relief to livestock. Animals were treated with herbal medication as per dosage on the second day and no reinfestation was noticed up to 14 days of experimental observation. The study strengthens the belief that indigenous herbal acaricide can facilitate quality livestock service at geographically distant locations. These medications can provide quicker relief, minimize tick resistance and are favorable to the environment.