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Objective: This study aims to identify the proteins in hypomineralized second primary molars (HSPMs) and correlate their function in Amelogenesis. HSPM is a qualitative defect of the enamel of the second primary molars with no clear etiology., Material and Methods: Total protein quantification was performed using the Bradford Protein Assay, followed by the electrophoretic separation of samples using 2D-Gel electrophoresis to identify the proteins., Results: The results from the Bradford Protein Assay unveiled a five-fold increase in the protein content in HSPM. Proteins such as Dentin sialo-phosphoprotein (DSPP), Keratin, type I, Serum Albumin, Anti-thrombin III, Alpha-1-Antitrypsin, Histone H3.2, Actin, Heat shock Protein, Vimentin, Desmoglein-3, Glyceraldehyde-3-phosphate dehydrogenase, Inosine-5'-monophosphate dehydrogenase 2, Zinc Alpha 2 glycoprotein, Lysozyme C, Prothrombin, Vit-D binding Protein, Apolipoprotein A-1, Defensin 1, Immunoglobulin Gamma, Immunoglobulin Kappa, and Alpha-Amylase were all upregulated (p < 0.05) in HSPM., Conclusion: This investigation conclusively demonstrates that HSPM-affected teeth have higher protein content than healthy teeth. The study also supports the theory of proteolytic inhibition attributed to reduced protease activity and heightened protease inhibitor activity., (© 2025 The Author(s). Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Aim: To assess the prevalence of non-communicable disease risk factors among the nursing staff and educate them on prevention., Background: Nursing staff is integral to the Indian community healthcare systems. Recent studies report a high prevalence of non-communicable diseases in Indian nursing staff. Therefore, data on the prevalence of non-communicable disease risk factors among nursing staff are crucial for education on prevention., Design: A cross-sectional digital survey-based study., Method: We invited 4435 nursing staff to attend our online survey. We used a customized questionnaire for data collection, including a digitized version of the Community-Based Assessment Checklist form. A score of >4 was considered high risk and warranted screening., Result: Among 682 nursing staff who attended, 70% had never undergone screening for non-communicable diseases. The prevalence of non-communicable disease risk factors was significantly higher in male nursing staff. In addition, logistic regression analysis showed that age, tobacco and alcohol use, increased waist circumference, physical inactivity and family history of non-communicable diseases were significant risk factors among nursing staff., Conclusion: The study findings suggest that the nursing staff have suboptimal self-health concerns on non-communicable diseases. This situation warrants continued medical education, awareness campaigns on adopting a healthy lifestyle and health promotion., (© 2024 John Wiley & Sons Australia, Ltd.)

Objective: The Cancer Genome Atlas (TCGA) project identified favorable prognosis regarding the ultra-mutated endometrial cancer (EC) subtype linked to polymerase epsilon gene (POLE) mutations. This study investigated POLE mutations in EC of Indian patients., Methods: This retrospective analytical study was conducted between January 2016 and January 2023 at the Government Medical College, Kozhikode, and the MVR Cancer Center, Kozhikode, Kerala. Sanger sequencing of POLE gene exons 9 and 13 in 151 EC patients was carried out to analyze the relationship between mutations and epidemiological factors, clinicopathologic features, and treatment outcomes., Results: Among 151 cases enrolled, 39 were unique POLE-mutated cases. Significant associations were high-grade tumors, myometrial invasion >50%, and Lymph-vascular space invasion (LVSI). The median follow-up was 40 months (95% confidence interval [CI], 34-46). A lower mean disease-specific survival (DSS) of 51.7 months (95% CI, 43.7-59.6) was noted in the POLE-mutated group compared with 72.11 months (95% CI, 67.60-76.62) for the POLE wild-type. A statistically significant hazard ratio (HR) of 2.683 for DSS in the POLE-mutated group was noted. In advanced stages (FIGO stages II-IV), a nine-fold HR for DSS and overall survival (OS) compared with POLE wild-type was identified. After controlling for treatment effects using Cox proportional HR, advanced-stage POLE-mutated tumors had a significantly higher HR of 8.67 for DSS compared with POLE-wild-type tumors of the same stage., Conclusion: This study identified a unique set of POLE mutations in Indian EC patients associated with poor prognosis, which were particularly pronounced in advanced stages. Advanced stage of presentation, type of POLE mutations, and possibly ethnicity are predictors of adverse outcomes in POLE-mutated EC. The present study highlights ethnicity as a determinant of phenotypic expression of genetic change., (© 2024 International Federation of Gynecology and Obstetrics.)

Background: There is evidence that patients with spasticity are not receiving adequate care. Identifying the unmet needs of patients with spasticity is essential to develop services and treatment strategies to better support this population This is an effort to identify challenges related to treatment of spasticity and provide the springboard for the implementation of identified solutions., Objective: To identify the main barriers to spasticity care and identify potential solutions., Design: Delphi process., Setting: Expert panel., Participants: A total of 35 participants with diverse experience and knowledge related to spasticity care were invited and 29 attended an in-person 2022 Spasticity Summit hosted by the American Academy of Physical Medicine and Rehabilitation., Methods: The expert panel participated in a presummit survey to identify the main potential barriers to spasticity care. During the in-person meeting the panel initially worked in small groups and then as whole to reach consensus through the Delphi process. The panel also completed a postsummit survey., Results: Several barriers to spasticity care and potentials solutions were identified. Consensus was reached for the top three barriers and potential solutions (>50% and >75%, respectively). Top barriers included the need for a document listing all the challenges related to access of care for spasticity, increased caregiver and community awareness of spasticity, and education of clinicians regarding patient needs. Top solutions to barriers included increasing the number of providers who treat spasticity, enhancing patient and caregiver education, and developing and publishing a consensus guidance statement., Conclusions: Consensus was achieved on the top three barriers to spasticity care and potential solutions. The purpose of this analysis is to pave the way for further development of solutions to improve the care of patients with spasticity., (© 2023 American Academy of Physical Medicine and Rehabilitation.)

Objective: To investigate differences in angiotensin-converting-enzyme-2 (ACE2) and bitter taste receptor (TAS2R38) expression between patient age groups and comorbidities to characterize the pathophysiology of coronavirus 19(COVID-19) pandemic. ACE2 is the receptor implicated to facilitate SARS-CoV-2 infections and levels of expression may correlate to the severity of COVID-19 infection. TAS2R38 has many non-gustatory roles in disease, with some evidence of severe COVID-19 disease in certain receptor phenotypes., Methods: We conducted a prospective cohort study and collected nasal and lingual tissue from healthy pediatric ( n  = 22) and adult ( n  = 25) patients undergoing general anesthesia for elective procedures. RNA isolation and qPCR were performed with primers targeting ACE2 and TAS2R38., Results: A total of 25 adult (52% male; 44% obese) and 22 pediatric (50% male; 36% obese) patients were enrolled, pediatric tissue had 43% more nasal ACE2 RNA expression than adults with a median fold change of 0.69 (IQR 0.37, 0.98) in adults and 0.99 (IQR 0.74, 1.43) in children ( p  < .05). There were no differences between the age groups in ACE2 expression of lingual tissue ( p  = .14) or TAS2R38 expression collected from either nasal ( p  = 049) or lingual tissue ( p  = .49). Stratifying for obesity yielded similar differences between nasal ACE2 expression between adults and children with median fold change of 0.56 (IQR 0.32, 0.87) in adults and 1.0 (IQR 0.82, 1.52) in children ( p  < .05)., Conclusions: ACE2 receptor expression is higher in nasal tissue collected from children compared to adults, suggesting COVID-19 infectivity is more complicated than ACE2 and TAS2R38 mRNA expression., Level of Evidence: NA., Competing Interests: Jonathan M. Walsh reports educational consultant relationship with Smith & Nephew regarding Coblation technology. No direct conflict of interest for this project., (© 2024 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.)

Objective: To study and compare the maternal and neonatal outcomes of COVID-19 in pregnancy during the two waves of the pandemic in India., Methods: This observational, retrospective cohort study on pregnant women with SARS-CoV-2 infection was conducted in a 2700-bed tertiary referral center in South India from March 1, 2020 to June 30 2021. The clinical presentation, severity, and maternal and neonatal outcomes of COVID-19 were compared between the two waves., Results: A total of 623 pregnant women tested positive for SARS-CoV-2 infection in our institute; 379 (60.8%) were diagnosed during the first wave and 244 (39.2%) in the second wave. Most of the affected women (81.1%) were in their third trimester. Maternal mortality rate was 823 per 100 000 live births. Composite maternal outcome (increasing requirement for ventilation, pulmonary embolism, disease progression) were more pronounced during the second wave (2.1% vs 6.1%). Between the two waves, both maternal (1 vs 3; P = 0.162) and perinatal (3.2% vs 6.7%; P = 0.065) deaths were higher during the second wave. The cesarean section rate was high during the first wave (48% vs 32.4%; P < 0.001). Preterm births were comparable between the two waves (19.5% vs 22%; P < 0.500)., Conclusion: The women presented with more severe illness during the second wave of COVID-19. There was higher perinatal mortality, but the maternal mortality was similar between the two waves., (© 2023 International Federation of Gynecology and Obstetrics.)

The Centre of Regulatory Excellence (CoRE) launched an annual lecture series in 2021 in Singapore to honor the memory of the late Professor Sir Alasdair Breckenridge, CoRE's founding Chair, and foster dialogue on global biomedical and regulatory perspectives, challenges, and advances. The 2022 Sir Alasdair Breckenridge Lecture "Success and Opportunities in the Pandemic" was delivered by Dr Penny M Heaton, former CEO of the Bill & Melinda Gates Foundation Research Institute and current Global Therapeutics Lead for Vaccines at Johnson & Johnson. Dr Heaton highlighted key lessons on the importance of trust, collaboration, and transparency in the context of health care and vaccine production., (© 2023 The Authors. Clinical Pharmacology & Therapeutics published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics.)

Objectives: To evaluate the mode of birth in early-preterm, late-preterm, and near-term twins as well as to compare the maternal and neonatal outcomes of each group following vaginal birth (VB) and lower-segment cesarean section (LSCS)., Methods: A prospective cohort study was conducted of 100 twin pregnancies in a tertiary center between 2018 and 2019. Deliveries were allocated into the following three gestational age groups (weeks ± days) and compared: (1) early-preterm (28 to 31 ± 6), (2) late-preterm (32 to 35 ± 6), and (3) near-term (≥36 weeks)., Results: The proportion of VB and LSCS were similar when early-preterm twins (P = 0.766; relative risk [RR], 1.08) and late-preterm twins (P = 0.071; RR, 1.21) were compared separately with near-term twins. Perinatal outcomes did not differ between VB and LSCS within each gestational age group. When compared with the near-term group, the early-preterm group had more hypoglycemia (P < 0.001), hyperbilirubinemia (P < 0.001), respiratory distress (P < 0.001), low APGAR scores (P < 0.001), and death (P < 0.001) irrespective of the mode of birth. The late-preterm group had lower morbidity and mortality (P = 0.227). Postpartum hemorrhage and blood transfusion were similar between the groups., Conclusion: The proportion of VB and LSCS and associated maternal and neonatal outcomes did not differ in twins of different gestational ages. The data provide reassurance to practitioners to perform vaginal delivery in preterm twins., (© 2022 International Federation of Gynecology and Obstetrics.)

Background: Pediatric Epstein-Barr virus-negative monomorphic post solid organ transplant lymphoproliferative disorder [EBV(-)M-PTLD] comprises approximately 10% of M-PTLD. No large multi-institutional pediatric-specific reports on treatment and outcome are available., Methods: A multi-institutional retrospective review of solid organ recipients diagnosed with EBV(-)M-PTLD aged ≤21 years between 2001 and 2020 in 12 centers in the United States and United Kingdom was performed, including demographics, staging, treatment, and outcomes data., Results: Thirty-six patients were identified with EBV(-)M-PTLD. Twenty-three (63.9%) were male. Median age (range) at transplantation, diagnosis of EBV(-)M-PTLD, and interval from transplant to PTLD were 2.2 years (0.1-17), 14 years (3.0-20), and 8.5 years (0.6-18.3), respectively. Kidney (n = 17 [47.2%]) and heart (n = 13 [36.1%]) were the most commonly transplanted organs. Most were Murphy stage III (n = 25 [69.4%]). Lactate dehydrogenase was elevated in 22/34 (64.7%) and ≥2 times upper limit of normal in 11/34 (32.4%). Pathological diagnoses included diffuse large B-cell lymphoma (n = 31 [86.1%]) and B-non-Hodgkin lymphoma (B-NHL) not otherwise specified (NOS) (n = 5 [13.9%]). Of nine different regimens used, the most common were: pediatric mature B-NHL-specific regimen (n = 13 [36.1%]) and low-dose cyclophosphamide, prednisone, and rituximab (n = 9 [25%]). Median follow-up from diagnosis was 3.0 years (0.3-11.0 years). Three-year event-free survival (EFS) and overall survival (OS) were 64.8% and 79.9%, respectively. Of the seven deaths, six were from progressive disease., Conclusions: EFS and OS were comparable to pediatric EBV(+) PTLD, but inferior to mature B-NHL in immunocompetent pediatric patients. The wide range of therapeutic regimens used directs our work toward developing an active multi-institutional registry to design prospective studies., Plain Language Summary: Pediatric Epstein-Barr virus-negative monomorphic post solid organ transplant lymphoproliferative disorders (EBV(-)M-PTLD) have comparable outcomes to EBV(+) PTLD, but are inferior to diffuse large B-cell lymphoma in immunocompetent pediatric patients. The variety of treatment regimens used highlights the need to develop a pediatric PTLD registry to prospectively evaluate outcomes. The impact of treatment regimen on relapse risk could not be assessed because of small numbers. In the intensive pediatric B-non-Hodgkin lymphoma chemoimmunotherapy group, 11 of 13 patients remain alive in complete remission after 0.6 to 11 years., (© 2022 American Cancer Society.)

Numerous traditional medical imaging methods, including computed tomography with X-rays, positron emission tomography (PET), and magnetic resonance imaging (MRI), are utilized frequently in medical settings to screen for illnesses, diagnose patients, and track the effectiveness of treatments. When examining bone protrusions, CT is preferred over MRI for scanning connective tissue. Although the picture quality of PET is inferior to that of CT and MR, it is outstanding for detecting the molecular markers and metabolic functions of illnesses. To give high-resolution structural pictures and improved ailment sensitivity and specificity within another image, multimodal data and substantial therapeutic influence on advanced diagnostics and therapeutics have been used. The goal was to evaluate the clinical significance of multimodal photoacoustic/ultrasound (PA/US) articular imaging scoring, a cutting-edge image technique that may show the microvessels and oxygen levels of rheumatoid arthritis-related inflamed joints (RA). The PA/US imaging technology analyzed seven tiny joints. The PA and power Doppler (PD) impulses were semiquantified using a 0-3 grading scale, and the averages of the PA and PD scores for the seven joints are computed. Three PA+SO 2 types were found determined by the relative oxygen levels (SO 2 ) measurements of the affected joints. Researchers evaluated the relationships between the disease activity ratings and the PA/US imaging ratings. The PA scores and medical ratings that reflect the extent of the pain have strong relationships with each other, as do the PA+SO 2 combinations. PA may be clinically useful in assessing RA. Thus, the research evaluated the clinical symptoms of inflammatory arthritis using a multimodal photoacoustic image process., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this article., (Copyright © 2022 B. Rajasekar et al.)

The core objectives of the research were to prepare 5-fluorouracil nanoemulsion (FU-NE) and to evaluate the physiochemical properties and to study the i n vitro antiproliferation in HepG2 cell lines. The physiochemical parameters determined were compatibility, particle size (PS), polydispersity index (PDI), zeta potential (ZP), density, surface tension (ST), pH, viscosity, in vitro release of FU, cytotoxicity, and apoptosis study. The prepared FU-NE3 was stable, sterile, and homogeneous. On the HepG2 (120  μ g.mL -1 ) cells, in vitro cytotoxicity was obtained at IC 50 concentration. Apoptosis examination by AO/EBand Hoechst staining shows that the majority of cell demise was caused by apoptosis, with a tiny fraction of necrosis. Hence, this investigation concluded that the developed FU-NE has now desirable characteristics for drug delivery to the cancer cell and may be screened for the in vivo colorectal anticancer activity., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2022 Jamal Moideen Muthu Mohamed et al.)

Among cancers, leukemia is a multistep progression that involves genetic modifications of normal hematopoietic progenitor cells to cancerous cells. In recent times, leukemia cases and their mortality rate have increased rapidly. Therefore, the immense need for a therapeutic approach is crucial that can control this type of cancer. Phyllanthin is a lignan compound constituent from the Phyllanthus species and has numerous beneficial effects as a dietary component. The present study aims to determine the impact of phyllanthin on the MOLT-4 cytotoxic effect. MOLT-4 cells and MS-5 cells were cultured at different concentrations of phyllanthin (5, 10, 25, 50, 75, and 100 μM/ml), and the viability was assessed by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide method. The level of reactive oxygen species, the membrane potential of mitochondria, apoptosis by 2',7'-dichlorofluorescin-diacetate (DCF-DA), rhodamine, acridine orange (AO)/ethidium bromide (EB), 4',6-diamidino-2-phenylindole (DAPI)/propidium iodide (PI) staining, gene expression of signaling molecules, and protein levels were assessed by reverse-transcription polymerase chain reaction and western blot analysis. Phyllanthin did not show toxicity toward MS-5 cells and significantly decreased the cell viability of MOLT-4 cells with an IC 50 value of 25 µM/ml. Also, phyllanthin induced the production of reactive oxygen species and led to the loss of mitochondrial membrane potential. AO/EB and DAPI/PI staining fluorescent image confirmed the induction of apoptosis by phyllanthin treatment. The messenger RNA (mRNA) expression of cell cycle regulator cyclin D1, antiapoptotic gene Bcl-2, NF-κB, and TNF-α decreased, but the proapoptotic Bax mRNA expression was increased. The phosphorylated protein levels of p-PI3K1/2, p-ERK1/2, and p-AKT were decreased, whereas the levels of p-p38 and p-JNKT1/2 increased. Our results confirmed that phyllanthin inhibits the MOLT-4 cells, increases apoptosis, and inhibits MOLT-4 migration and cell invasion. Therefore, phyllanthin can be used as a potential target for leukemia treatment., (© 2021 Wiley Periodicals LLC.)

Detailed analysis of secondary envelopment of the herpesvirus human cytomegalovirus (HCMV) by transmission electron microscopy (TEM) is crucial for understanding the formation of infectious virions. Here, we present a convolutional neural network (CNN) that automatically recognises cytoplasmic capsids and distinguishes between three HCMV capsid envelopment stages in TEM images. 315 TEM images containing 2,610 expert-labelled capsids of the three classes were available for CNN training. To overcome the limitation of small training datasets and thus poor CNN performance, we used a deep learning method, the generative adversarial network (GAN), to automatically increase our labelled training dataset with 500 synthetic images and thus to 9,192 labelled capsids. The synthetic TEM images were added to the ground truth dataset to train the Faster R-CNN deep learning-based object detector. Training with 315 ground truth images yielded an average precision (AP) of 53.81% for detection, whereas the addition of 500 synthetic training images increased the AP to 76.48%. This shows that generation and additional use of synthetic labelled images for detector training is an inexpensive way to improve detector performance. This work combines the gold standard of secondary envelopment research with state-of-the-art deep learning technology to speed up automatic image analysis even when large labelled training datasets are not available., (© 2020 John Wiley & Sons Ltd.)

The marine invertebrates are one of the main leads to the derivation of anticancer compounds. The present investigation was to explore the anticancer effect of a potentially active polysaccharide fraction from marine clam Donax variabilis on human lung cancer cells (A549). A polysaccharide was purified from the whole tissue of D. variabilis by GFC and characterized by FT-IR and NMR spectroscopy. Subsequently, fraction 2.1 (F2.1) showed a significant inhibitory effect on A549 cells (p < .001) with cellular, nuclear, and apoptotic morphological changes along with DNA damage. Although, F2.1 treatment exhibit the cell cycle arrest in S-phase through the downregulation of cell cycle regulators such as Cyclin A and cdk2 and regulate ROS-induced mitochondrial-mediated apoptosis in A549 cells by an increased level of proapoptotic molecules such as Bax, Cyt-c, Cleaved caspase-3 and 9, and decreased the level of Bcl-2. All data were statistically evaluated by one-way ANOVA and a post hoc analysis with Dunnett testing. Together, purified polysaccharide fraction from marine clam could be a new source of the natural anticancer agent against lung cancer. PRACTICAL APPLICATIONS: Over the decades, a lot of anticancer drugs were designed from plant sources for therapies against various diseases. This was an attempt to isolate a novel anticancer agent from animal sources. Most of the marine mollusks are nutritionally rich and with some potent bioactive compounds. Donax variabilis is an edible marine clam, which was consumed as food among people where live in coastal regions. In the present investigation, the D. variabilis was chosen to isolate active polysaccharide fraction against lung cancer cells. Based on our findings, the purified polysaccharide fraction may be utilized as sources of natural bioactive agents in cancer prevention., (© 2020 Wiley Periodicals LLC.)

Background: We present the largest UK single institute robotic radical hysterectomy (RRH) case series for the management of cervical cancer (CC)., Methods: Data were collected on women who had a RRH as primary treatment for stage 1b1 CC between December 2009 and December 2018., Results: Ninty women had a robotic hysterectomy. Five-year follow-up data were available for 30%. The disease-free survival at 5 years was 89.6%. Overall survival at 3 and 5 years for death from any cause was 96.1% and 91.4%, respectively. The overall 5-year survival for death from disease only was 92.8%. Overall survival by tumour size alone showed that women with tumours less than 2 cm had a 98.3% 5-year survival compared to 83.4% for tumour size greater than 2 cm. Irrespective of tumour size, those that had no evidence of lymphovascular space invasion had a 100% 5-year survival., Conclusion: Our preliminary data supports the oncological safety of RRH in a selective cohort of patients with stage 1b1 CC., (© 2020 John Wiley & Sons, Ltd.)

Background: Assessment of possible infection with SARS-CoV-2, the novel coronavirus responsible for COVID-19 illness, has been a major activity of infection services since the first reports of cases in December 2019., Objectives: We report a series of 68 patients assessed at a Regional Infection Unit in the UK., Methods: Between 29 January 2020 and 24 February 2020, demographic, clinical, epidemiological and laboratory data were collected. We compared clinical features between patients not requiring admission for clinical reasons or antimicrobials with those assessed as needing either admission or antimicrobial treatment., Results: Patients assessed were aged from 0 to 76 years; 36/68 were female. Peaks of clinical assessments coincided with updates to the case definition for suspected COVID-19. Microbiological diagnoses included SARS-CoV-2, mycoplasma pneumonia, influenza A, non-SARS/MERS coronaviruses and rhinovirus/enterovirus. Nine of sixty-eight received antimicrobials, 15/68 were admitted, 5 due to inability to self-isolate. Patients requiring admission on clinical grounds or antimicrobials (14/68) were more likely to have fever or raised respiratory rate compared to those not requiring admission or antimicrobials., Conclusions: The majority of patients had mild illness, which did not require clinical intervention. This finding supports a community testing approach, supported by clinicians able to review more unwell patients. Extensions of the epidemiological criteria for the case definition of suspected COVID-19 lead to increased screening intensity; strategies must be in place to accommodate this in time for forthcoming changes as the epidemic develops., (© 2020 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.)

Objective: To examine the feasibility of implementing a high-risk HPV (hrHPV) DNA-based screening program for cervical cancer and the prevalence of hrHPV DNA-positive women in a community setting in rural India., Methods: A cross-sectional study was conducted at the community level in the Hunsur taluk of the Mysore district from January to August 2016. Cervical cancer screening was conducted with self-collected vaginal samples that were analyzed using the Hybrid Capture 2 (HC2) assay (Qiagen, USA)., Results: The majority of participants were aged 30-39 years, with no formal schooling, from a lower caste, and lived below an annual household income of US$1499. After group health education and one-on-one counseling, a total of 473 women underwent self-sampling. Of these, 36 (7.6%) were positive for hrHPV and only 24 (66.6%) underwent follow-up diagnostic triaging. Cancer was detected in two women, who were referred to appropriate healthcare facilities for further treatment., Conclusion: Implementation of hrHPV DNA-based screening tests using self-sampling can be feasible in rural settings in India. However, substantial resources are required for providing health education and one-on-one counseling to inform asymptomatic women about the benefits of testing and, more importantly, to improve compliance with follow-up., (© 2019 International Federation of Gynecology and Obstetrics.)

Circular RNAs (circRNAs) are newly discovered incipient non-coding RNAs with potential roles in disease progression in living organisms. Significant reports, since their inception, highlight the abundance and putative functional roles of circRNAs in every organism checked for, like O. sativa , Arabidopsis , human, and mouse. CircRNA expression is generally less than their linear mRNA counterparts which fairly explains the competitive edge of canonical splicing over non-canonical splicing. However, existing methods may not be sensitive enough for the discovery of low-level expressed circRNAs. By combining template-dependent multiple displacement amplification (tdMDA), Illumina sequencing, and bioinformatics tools, we have developed an experimental protocol that is able to detect 1,875 novel and known circRNAs from O. sativa . The same method also revealed 9,242 putative circRNAs in less than 40 million reads for the first time from the Nicotiana benthamiana whose genome has not been fully annotated. Supported by the PCR-based validation and Sanger sequencing of selective circRNAs, our method represents a valuable tool in profiling circRNAs from the organisms with or without genome annotation.

Aquaporins (AQPs) are integral membrane channels that facilitate the bidirectional transport of water and sometimes other small solutes across biological membranes. AQPs are important in mediating environmental adaptations in mosquitoes and are considered as a novel target for the development of effective insecticides against mosquitoes. Here, we expressed Aedes aegypti AQP6 ( AaAQP6) in human embryonic kidney (HEK) 293 cells and analyzed the water permeability by a conventional swelling assay, that is, a real-time change in cell size corresponding to the cell swelling induced by hyposmotic solution. The swelling assay revealed that AaAQP6 is a mercury-sensitive water channel. Gene expression studies showed that AaAQP6 is highly expressed in the pupae than other developmental stages. Heterologous expression of AaAQP6 in HEK cell was mainly observed intracellularly suggesting AaAQP6 possibly could be a subcellular water channel and may play an osmoregulatory function in the pupae of A. aegypti., (© 2018 Wiley Periodicals, Inc.)

Background: Hyaluronidase has been used over many decades as an adjunct to local anaesthetic solution to improve the speed of onset of eye blocks and to provide better akinesia and analgesia. With the evolution of modern eye surgery techniques, fast onset and akinesia are not essential requirements anymore. The assumption that the addition of hyaluronidase to local anaesthetic injections confers better analgesia for the patient needs to be examined. There has been no recent systematic review to provide evidence that hyaluronidase actually improves analgesia., Objectives: To ascertain if adding hyaluronidase to local anaesthetic solutions for use in ophthalmic anaesthesia in adults results in a reduction of perceived pain during the operation and to assess harms, participant and surgical satisfaction, and economic impact., Search Methods: We carried out systematic searches in Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and four other databases in June 2017. We searched the trial registers at www.ISRCTN.com, ClinicalTrials.gov and www.clinicaltrialsregister.eu for relevant trials. We imposed no language restrictions., Selection Criteria: We included randomized controlled trials (RCTs) that evaluated the effect of hyaluronidase on pain experienced by adults during intraocular surgery using a rating scale., Data Collection and Analysis: Two review authors (HR and KA) independently extracted data and assessed methodological quality using standard procedures as expected by Cochrane., Main Results: We included seven trials involving 500 participants that studied the effect of hyaluronidase on intraoperative pain. Four of the seven trials with 289 participants reported the primary outcome in a dichotomous manner, and we proceeded to meta-analyse the findings which showed a moderate heterogeneity that could not be explained (I 2 = 41% ). The pooled risk ratio (RR) for these four trials was 0.83 with the 95% confidence interval ranging from 0.48 to 1.42. The reduction in intraoperative pain scores in the hyaluronidase group were not statistically significant. Among the three trials that reported the primary outcome in a continuous manner, the presence of missing data made it difficult to conduct a meta-analysis. To further explore the data, we imputed standard deviations for the other studies from another included RCT (Sedghipour 2012). However, this resulted in substantial heterogeneity between study estimates (I² = 76% ). The lack of reported relevant data in two of the three remaining trials made it difficult to assess the direction of effect in a clinical setting.Overall, there was no statistical difference regarding the intraoperative reduction of pain scores between the hyaluronidase and control group. All seven included trials had a low risk of bias.According to GRADE, we found the quality of evidence was low and downgraded the trials for serious risk of inconsistency and imprecision. Therefore, the results should be analysed with caution.Participant satisfaction scores were significantly higher in the hyaluronidase group in two high quality trials with 122 participants. Surgical satisfaction was also superior in two of three high quality trials involving 141 participants. According to GRADE, the quality of evidence was moderate for participant and surgical satisfaction as the trials were downgraded for imprecision due to the small sample sizes. The risk of bias in these trials was low.There was no reported harm due to the addition of hyaluronidase in any of the studies. No study reported on the cost of hyaluronidase in the context of eye surgery., Authors' Conclusions: The effects of adding hyaluronidase to local anaesthetic fluid on pain outcomes in people undergoing eye surgery are uncertain due to the low quality of evidence available. A well designed RCT is required to address inconsistency and imprecision among the studies and to determine the benefit of hyaluronidase to improve analgesia during eye surgery. Participant and surgical satisfaction is higher with hyaluronidase compared to the control groups, as demonstrated in moderate quality studies. There was no harm attributed to the use of hyaluronidase in any of the studies. Considering that harm was only rarely defined as an outcome measure, and the overall small number of participants, conclusions cannot be drawn about the incidence of harmful effects of hyaluronidase. None of the studies undertook cost calculations with regards to use of hyaluronidase in local anaesthetic eye blocks.

Purpose: Provide an in-depth description of the health-related quality of life (HRQoL) in youth diagnosed with neurofibromatosis type 1 (NF1) and their families., Design and Methods: Data were drawn from qualitative interviews conducted for a larger study aimed at developing the Pediatric Quality of Life Inventory™ (PedsQL™) NF1 module., Results: Youth with NF1 and their families experience a wide range of concerns related to HRQoL due to the varied symptom expression and uncertain trajectory of the disorder., Practice Implications: Pediatric nurses should routinely assess for HRQoL in this population and develop strategies tailored to those concerns that require intervention., (© 2017 Wiley Periodicals, Inc.)

Ischemic strokes occur when there is a sudden obstruction of an artery supplying blood flow to an area of the brain, leading to a focal neurological deficit. Strokes can be thrombotic or embolic in etiology and are associated with underlying conditions such as hypertension and atherosclerosis. Possible etiologies of strokes include cardioembolic disease, hematologic disorders, connective tissue disorders, and substance abuse or can be cryptogenic. Most stroke cases are seen in patients over 65 years of age. However, about one-fourth of strokes occur in young adults. Iron deficiency anemia (IDA) has been described as a known cause for strokes in children, but very few case reports describe this association in adults. We describe a 20-year-old female who presented with sudden onset left side weakness. Magnetic Resonance Imaging (MRI) of the brain demonstrated ischemic infarctions. Patient was also found to be severely anemic. Patient had a thorough work-up including Magnetic Resonance Angiography (MRA) of the brain, echocardiogram, and an extensive screen for thrombophilia disorders. This, however, did not demonstrate a clear etiology. As it has been suggested that IDA is a potential cause for stroke, it is possible the stroke in this young patient was attributable to severe IDA., Competing Interests: The authors declare that they have no competing interests.

Thoracotomy pain is common after chest surgery and may result from injury to the lung pleura, intercostal muscles, costovertebral joint, or intercostal nerves. Inappropriately controlled postoperative pain can hinder recovery and increase the risk of complications such as infection, atelectasis, blood clots, and development of post-thoracotomy pain syndrome. A number of treatment options for acute pain are available, most of which require systemic medications or indwelling catheters that may be contraindicated in patients on anticoagulants. We present the case of a patient with post-thoracotomy pain that effectively was treated with an ultrasound-guided nerve block with liposomal bupivacaine. The patient experienced pain relief without adverse event. Liposomal bupivacaine may be considered a potential treatment option for patients with severe acute post-thoracotomy pain in whom other modalities have not worked or are contraindicated., Level of Evidence: N/A., (Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.)

Listeria monocytogenes is a food-borne pathogenic bacterium that invades intestinal epithelial cells through a phagocytic pathway that relies on the activation of host cell RAB5 GTPases. Listeria monocytogenes must subsequently inhibit RAB5, however, in order to escape lysosome-mediated destruction. Relatively little is known about upstream RAB5 regulators during L. monocytogenes entry and phagosome escape processes in epithelial cells. Here we identify RIN1, a RAS effector and RAB5-directed guanine nucleotide exchange factor (GEF), as a host cell factor in L. monocytogenes infection. RIN1 is rapidly engaged following L. monocytogenes infection and is required for efficient invasion of intestinal epithelial cells. RIN1-mediated RAB5 activation later facilitates the fusion of phagosomes with lysosomes, promoting clearance of bacteria from the host cell. These results suggest that RIN1 is a host cell regulator that performs counterbalancing functions during early and late stages of L. monocytogenes infection, ultimately favoring pathogen clearance., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

In this study, maize treated with nanosilica (20-40 nm) is screened for resistance against phytopathogens such as Fusarium oxysporum and Aspergillus niger and compared with that of bulk silica. The resistivity is measured for disease index and expression of plant responsive compounds such as total phenols, phenylalanine ammonia lyase, peroxidase and polyphenol oxidase. The results indicate that nanosilica-treated plant shows a higher expression of phenolic compounds (2056 and 743 mg/ml) and a lower expression of stress-responsive enzymes against both the fungi. Maize expresses more resistance to Aspergillus spp., than Fusarium spp. These results show significantly higher resistance in maize treated with nanosilica than with bulk, especially at 10 and 15 kg/ha. In addition, hydrophobic potential and silica accumulation percentage of nanosilica treated maize (86.18° and 19.14%) are higher than bulk silica treatment. Hence, silica nanoparticles can be used as an alternative potent antifungal agent against phytopathogens.

Despite currently available treatments, the prognoses of pulmonary arterial hypertension (PAH) and pulmonary capillary hemangiomatosis (PCH) remain poor. Platelet-derived growth factor and its receptor (PDGFR) have been implicated in the pathogenesis of pulmonary hypertension in PAH and PCH. Imatinib, a PDGFR antagonist, may be beneficial in the treatment of both conditions because of its potent antiproliferative effect. We report two cases that demonstrate the potential for safe and efficacious use of imatinib in PAH and PCH.

Silica and phosphate based bioactive glass nanoparticles (58SiO2-33CaO-9P2O5) with doping of neem (Azadirachta indica) leaf powder and silver nanoparticles were prepared and characterised. Bioactive glass nanoparticles were produced using sol-gel technique. In vitro bioactivity of the prepared samples was investigated using simulated body fluid. X-ray diffraction (XRD) pattern of prepared glass particles reveals amorphous phase and spherical morphology with a particle size of less than 50 nm. When compared to neem doped glass, better bioactivity was attained in silver doped glass through formation of hydroxyapatite layer on the surface, which was confirmed through XRD, Fourier transform infrared (FTIR), and scanning electron microscopy (SEM) analysis. However, neem leaf powder doped bioactive glass nanoparticles show good antimicrobial activity against Staphylococcus aureus and Escherichia coli and less bioactivity compared with silver doped glass particles. In addition, the biocompatibility of the prepared nanocomposites reveals better results for neem doped and silver doped glasses at lower concentration. Therefore, neem doped bioactive glass may act as a potent antimicrobial agent for preventing microbial infection in tissue engineering applications.