Publications by authors named "Rai B"

Background: Singapore's large aging population poses significant challenges for the health care system in managing cognitive decline, underscoring the importance of identifying and implementing effective interventions. Cognitive training delivered remotely as a digital therapeutic (DTx) may serve as a scalable and accessible approach to overcoming these challenges. While previous studies indicate the potential of cognitive training as a promising solution for managing cognitive decline, understanding the attitudes and experiences of older adults toward using such DTx platforms remains relatively unexplored.

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Objectives: To survey kilovoltage (kV) radiotherapy in the UK, updating a 2016 study, focussing on radiotherapy physics, including equipment quality control (QC) and radiation dosimetry, with information on installed equipment and clinical activity.

Methods: All UK radiotherapy physics departments (n = 68) were invited to complete a comprehensive survey. An analysis of the installed equipment base, patient numbers, clinical activity, QC testing and radiation dosimetry processes were undertaken.

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The One Health concept is increasingly employed to combat zoonotic diseases. This study assessed the knowledge, attitudes, and practices regarding One Health and zoonotic diseases among key sector professionals to identify gaps and opportunities for enhancing One Health strategies in Bhutan. A cross-sectional, facility-based study was used to conduct a nationwide online questionnaire survey using a validated and pre-tested questionnaire among professionals from the Ministry of Health, the Ministry of Agriculture and Livestock, and universities.

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Background And Objective: Given the uncertainty regarding the role of radical nephroureterectomy (RNU) as part of a multimodal treatment strategy for upper tract urothelial carcinoma (UTUC) patients with cN+ disease, we aimed to perform a systematic review and meta-analysis of the corresponding literature.

Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, we identified 17 observational comparative and noncomparative studies, published between January 2000 and September 2024, evaluating UTUC patients with cTanyN+M0 disease (P) who received RNU as part of a multimodal treatment strategy (I), as compared with any treatment strategy if applicable (C), to assess oncological or postoperative outcomes (O). Meta-analyses were further performed, as appropriate.

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Realization of a sustainable hydrogen economy in the future requires the development of efficient and cost-effective catalysts for its production at scale. MXenes (MX) are a class of 2D materials with 'n' layers of carbon or nitrogen (X) interleaved by 'n+1' layers of transition metal (M) and have emerged as promising materials for various applications including catalysts for hydrogen evolution reaction (HER). Their properties are intimately related to both their composition and their atomic structure.

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Background: Almost half of all women will have at least one symptomatic urinary tract infection (UTI) in their lifetime. Although usually self-remitting, 74% of women contacting a health professional are prescribed an antibiotic, and in rare instances, they may progress to more severe infections. Therefore, the standard of care for the treatment of symptomatic uncomplicated UTIs is oral antibiotic therapy, which aims to achieve symptom resolution and prevent the development of complications such as pyelonephritis.

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Prolonged mechanical ventilation following cardiopulmonary and neurological events oftentimes necessitates a tracheostomy and tracheal granulation is one of its most common late complications. The literature recommends that large granulation be managed through surgical excision or endoluminal techniques. A 6-year-old boy presented with high-grade tracheal stenosis secondary to endotracheal cuff-related injury and prolonged tracheostomy.

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Background: The psychosocial consequences of tuberculosis (TB) are key barriers to ending TB globally. We evaluated and compared stigma, depression, and quality of life (QoL) among people with TB diagnosed through active (ACF) and passive (PCF) case-finding in Nepal.

Methods: We prospectively recruited adults with TB diagnosed through ACF and PCF in four districts of Nepal between August 2018 and April 2019.

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Background: In rural Nepal, poor road and transport networks and few testing laboratories impede tuberculosis diagnosis. A drone transport system was established to transport sputum samples to laboratories with advanced molecular diagnostic machines - GeneXpert MTB/RIF. This study explored the perceptions of using drones for tuberculosis diagnosis among community stakeholders, female community health volunteers, and healthcare providers from communities with drones implemented and without drone programs.

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Article Synopsis
  • * A qualitative study involving 35 patients with non-communicable diseases revealed that facilitators for using healthcare services included free medicines, accessibility, and positive interactions with providers, while barriers included insufficient services, high costs, and lack of information.
  • * The study concludes that improving the utilization of NCD services can be achieved by enhancing patient knowledge, motivation, and addressing misconceptions, along with strengthening healthcare accessibility and provider-patient communication.
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Multifocal functional tests are not routinely performed in diabetic retinopathy (DR) and diabetic macular edema (DME) management. We emphasise their importance and coin the term functional diabetic retinopathy (FDR). We reviewed current guidelines on management of DR/DME, and literature on diabetic retinal neurodegeneration (DRN) and functional deficits in DR/DME.

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Purpose: We conducted this study to determine the pattern and prevalence of retinal vein occlusion (RVO) in Bhutan to inform national health policy as no data has been compiled previously.

Methods: A retrospective cross-sectional survey was conducted over 3 years, including all new RVO cases. For patients with bilateral RVO, one eye was chosen randomly.

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Umami, a fundamental human taste modality, refers to the savory flavors in meats and broths, often associated with monosodium glutamate and protein richness. With limited knowledge of umami molecules, the food industry seeks efficient approaches for identifying novel tastants. In this study, we have devised a virtual screening pipeline for identifying highly potent umami tastants from large molecular databases.

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Article Synopsis
  • Clinical trials (CT) are essential for developing new medicines and require participant involvement, which is influenced by their attitudes and understanding of the trials.
  • A study at B.P. Koirala Institute of Health Sciences in Nepal assessed the knowledge and perceptions of 622 participants in a phase III CT, finding that a vast majority were literate, of indigenous backgrounds, and had not participated in a CT before.
  • Results showed that 91% of participants had adequate knowledge and 95.7% had a positive perception of CT, with most joining for disease protection and believing the trials benefit humanity, suggesting the need for future studies on knowledge before and after participation.
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Cortisol is established as a reliable biomarker for stress prompting intensified research in developing wearable sensors to detect it via eccrine sweat. Since cortisol is present in sweat in trace quantities, typically 8-140 ng/mL, developing such biosensors necessitates the design of bioreceptors with appropriate sensitivity and selectivity. In this work, we present a systematic biomimetic methodology and a semi-automated high-throughput screening tool which enables rapid selection of bioreceptors as compared to ab initio design of peptides via computational peptidology.

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Purpose: The purpose of this study was to provide risk estimations for vaginal morbidity with regard to vaginal dilation (summarizing the use of dilators and/or sexual activity) in patients with locally advanced cervical cancer treated with definitive radiochemotherapy and image guided adaptive brachytherapy within the prospective, multi-institutional EMBRACE-I study.

Methods And Materials: Physician-assessed vaginal morbidity (National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0), use of vaginal dilators, and patient-reported sexual activity (EORTC-CX24) were prospectively assessed at baseline and during regular follow-ups.

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  • The study aimed to compare the effectiveness and toxicity of two radiation techniques for treating locally advanced cervical cancer: traditional 3DCRT and advanced IG-IMRT, to lessen side effects while maintaining tumor control.
  • Conducted as a randomized trial, 173 patients were evaluated after being treated with external beam radiation and brachytherapy, with results showing IG-IMRT led to significantly reduced acute toxicities while maintaining similar tumor control rates to 3DCRT.
  • The findings suggest that using IG-IMRT with personalized margins might be a better option for minimizing treatment-related side effects in patients with locally advanced cervical carcinoma.
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  • *Researchers identified 34 differentially expressed microRNAs (miRNAs) in EVs from AA patients that target 235 HSPC genes related to important signaling pathways for blood cell formation.
  • *The findings suggest that specific miRNAs, particularly miR-139-5p targeting the hub gene IGF-1R, may play a significant role in HSPC function and could be explored as potential treatments for aplastic anemia.
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Leishmania is an intracellular protozoan transmitted by sand fly vectors; it causes cutaneous, mucocutaneous, or visceral disease. Its growth and survival are impeded by type 1 T helper cell responses, which entail interferon (IFN)-γ-mediated macrophage activation. Leishmania partially escapes this host defense by triggering immune cell and cytokine responses that favor parasite replication rather than killing.

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Background And Objective: This publication represents a summary of the updated 2024 European Association of Urology (EAU) guidelines for non-muscle-invasive bladder cancer (NMIBC), TaT1, and carcinoma in situ. The information presented herein is limited to urothelial carcinoma, unless specified otherwise. The aim is to provide practical recommendations on the clinical management of NMIBC with a focus on clinical presentation.

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Prostate cancer screening using prostate-specific antigen (PSA) testing is controversial but remains prevalent in many countries. There is little information in Sweden or elsewhere on the spatial variation in PSA testing. This study aims to describe the spatio-temporal variation in PSA testing prior to a prostate cancer diagnosis in the Stockholm region at the municipality and small area levels.

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Purpose: BIOEMBRACE was designed to study the impact of biomarkers in addition to clinicopathological factors on disease outcomes in patients treated with chemoradiation and magnetic resonance imaging (MRI)-guided brachytherapy (BT) for locally advanced cervical cancer in the EMBRACE study.

Methods And Materials: Between 2018 and 2021, 8 EMBRACE-I sites contributed tumor tissue for the immunohistochemistry of p16, PD-L1, and L1CAM. These biomarkers and clinicopathological factors (International Federation of Gynecology and Obstetrics 2009 stage, nodal status, histology, and necrosis on MRI) were analyzed to predict poor response at BT (high-risk clinical target volume [HR-CTV] ≥ 40 cc) at BT) and 5-year local control, pelvic control, and disease-free survival.

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The international authorities, such as the Food and Agriculture Organization of the United Nations, World Health Organization, World Organization for Animal Health, United Nations Environment Programme, and World Bank, have endorsed the One Health concept as an effective approach to optimize the health of people, animals, and the environment. The One Health concept is considered as an integrated and unifying approach with the objective of sustainably balancing and optimizing the health of people, animals, and ecosystems. Despite variations in its definitions, the underlying principle remains consistent - recognizing the interconnected and interdependent health of humans, animals, and the environment, necessitating interdisciplinary collaboration to optimize health outcomes.

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Background And Objective: Cytoreductive treatments for patients diagnosed with de novo synchronous metastatic hormone-sensitive prostate cancer (mHSPC) confer incremental survival benefits over systemic therapy, but these may lead to added toxicity and morbidity. Our objective was to determine patients' preferences for, and trade-offs between, additional cytoreductive prostate and metastasis-directed interventions.

Methods: A prospective multicentre discrete choice experiment trial was conducted at 30 hospitals in the UK between December 3, 2020 and January 25, 2023 (NCT04590976).

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