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The interaction between gut microbes and gastrointestinal (GI) tract carcinogenesis has always attracted researchers' attention to identify therapeutic targets or potential prognostic biomarkers. Various studies have suggested that the microbiota do show inflammation and immune dysregulation, which led to carcinogenesis in GI tract. In this review, we have focused on the role of microbes present in the gut, intestine, or faeces in GI tract cancers, including esophageal cancer, gastric cancer, and colorectal cancer. Herein, we have discussed the importance of the microbes and their metabolites, which could serve as diagnostic biomarkers for cancer detection, especially in the early stage, and prognostic markers. To maximize the effect of the treatment strategies, an accurate evaluation of the prognosis is imperative for clinicians. There is a vast difference in the microbiota profiles within a population and across the populations depending upon age, diet, lifestyle, genetic makeup, use of antibiotics, and environmental factors. Therefore, the diagnostic efficiency of the microbial markers needs to be further validated. A deeper understanding of the GI cancer and the host microbiota is needed to acquire pivotal information about disease status.

Development of ocular drug delivery system is one of the most technically challenging tasks, when compared with other routes of drug delivery. Eye (an intricate organ) is highly sophisticated and sensitive organ due to presence of various structurally differed anatomical layers, which many times limits the drug delivery approaches. Despite several limitations, many advancements have been made as evidence from various recent studies involving improvement of both residence time and permeation of the drug at the ocular region. In the last few decades, albumin(s) based ophthalmic products have been gained most attention to solve the major challenges associated with conventional ocular drug delivery systems. Interestingly, an albumin-based micro, nano, conjugates, and genetically fused target specific to ligand(s) formulation being exploited through many studies for successful ocular delivery of bioactives (mostly repurposed drugs). Past and current studies suggested that albumin(s) based ocular drug delivery system is multifunctional in nature and capable of extending both drug residence time and sustaining the release of drugs to deliver desired pharmacological outcomes. Despite wide applications, still complete progress made in albumin based ocular drug delivery is limited in literature and missing in market. So, herein we presented an overview to explore the key concepts of albumin-based nanocarrier(s) including strategies involved in the treatment of ocular disease, that have yet to be explored.

Neurodegenerative disorders occur when nerve cells in the brain or peripheral nervous system partial or complete fail in their functions and sometimes even die due to some injuries or aging. Neurodegenerative disorders such as Alzheimer's Disease (AD) and Parkinson's Disease (PD), have been majorly resulted due to degeneration of neurons and neuroinflammation progressively. There are many similarities that correlates both AD and PD on a cellular and sub-cellular level. Therefore, a hope for therapeutic advancement for simultaneous upgradation in both the diseases are directly depending on the discovery of common mechanism at molecular and cellular level. Recent and past evidences from scientific literature supporting the efficacy of plants flavonoids in treatment and protection of both AD and PD. Further, dietary flavones, specially Heptamethoxyflavone, Kaempferitrin, Vitexin and Amentoflavone gains recently much more attention for producing many health beneficiary effects including neuroprotection. Despite of these evidence a detailed updated overview of neuroprotective effects against both AD and PD by Heptamethoxyflavone, Kaempferitrin, Vitexin and Amentoflavone are still missing. In this context several published studies were assessed by using various online electronic search engines/databases to meet the objective from 1981 to 2021 (Approx. 224). Therefore, present review was designed to deliver the detailed description on these flavones including therapeutic benefits in AD, PD and other CNS complications with critical analysis on underlying mechanisms.

Background: Thalassemia is a hereditary autosomal recessive haemoglobinopathy that remains a major health problem throughout the world. Aims and Objectives: The aim of this study was to evaluate knowledge of the relatives of Thalassemia patients regarding different aspects of Thalassemia with special emphasis on the role of splenectomy. Material and Methods: This was a cross-sectional study conducted at a Government Tertiary Thalassemia day care centre. Initially, 131 relatives of Thalassemia patients were interviewed. Excluding 10 relatives, 87 (66.4 %) relatives having knowledge of splenectomy were further interviewed regarding various aspects of splenectomy. Result: In our survey, 67.2 % relatives had knowledge about the congenital origin of the disease. The knowledge about premarriage counselling, risk of consanguineous marriage, antenatal screening and medical termination of pregnancy was 55%, 29.8%, 70.2% and 64.1% respectively. Although all (100%) relatives knew about regular blood transfusion and iron chelation, only 74% and 63.4% of the relatives had the knowledge about splenectomy and bone marrow transplant as a treatment modality, respectively. In 87 relatives interviewed further, 37.9 % came to know about splenectomy from other relatives. The indications of splenectomy known were: splenomegaly (98.8%), increased blood transfusion (68.9%), low platelet count (20.6%) and low TLC (4.6%). Only 47.1% were aware about the optimal age of splenectomy. Awareness about serious complication of OPSI, its prevention by preoperative vaccinations and postoperative chemoprophylaxis was only 48.3%, 62% and 46% respectively. Around 59% knew about role of blood transfusion and 74.7% were aware about the need of regular follow up after splenectomy

Significance Although the overwhelming majority of COVID-19-related deaths are due to respiratory failure, little is known about the host response to SARS-CoV-2 in lung parenchyma. By profiling the lung and colon transcriptome and lung proteome of nine patients who died of COVID-19 during the first wave of the pandemic in Wuhan, China, we obtained molecular insights into the host response to severe SARS-CoV-2 infection. Interestingly, all samples had a low viral burden, a finding that suggests the patients’ deaths may be due to uncontrolled host inflammatory processes rather than an active viral infection. Taken together, our findings shed light on COVID-19 pathophysiology and offer potential therapeutic targets for severe COVID-19 disease., Coronavirus disease 2019 (COVID-19), the global pandemic caused by SARS-CoV-2, has resulted thus far in greater than 933,000 deaths worldwide; yet disease pathogenesis remains unclear. Clinical and immunological features of patients with COVID-19 have highlighted a potential role for changes in immune activity in regulating disease severity. However, little is known about the responses in human lung tissue, the primary site of infection. Here we show that pathways related to neutrophil activation and pulmonary fibrosis are among the major up-regulated transcriptional signatures in lung tissue obtained from patients who died of COVID-19 in Wuhan, China. Strikingly, the viral burden was low in all samples, which suggests that the patient deaths may be related to the host response rather than an active fulminant infection. Examination of the colonic transcriptome of these patients suggested that SARS-CoV-2 impacted host responses even at a site with no obvious pathogenesis. Further proteomics analysis validated our transcriptome findings and identified several key proteins, such as the SARS-CoV-2 entry-associated protease cathepsins B and L and the inflammatory response modulator S100A8/A9, that are highly expressed in fatal cases, revealing potential drug targets for COVID-19.

Idiopathic hypoparathyroidism leads to hypocalcemia and hyperphosphatasemia and usually has a genetic aetiology. The variable but often subtle signs and symptoms usually lead to a misdiagnosis of hypoparathyroidism. Case records of 32 patients of idiopathic hypoparathyroidism admitted over a period of five years were analysed. There was a lag period of 5.94 years from the onset of symptoms to the diagnosis. Carpopedal spasm was the most common indication for admission to the hospital. Trivial symptoms such as fatigue (84%) and paresthesia (62.5%) were the most common reported symptoms. A sum of 46.5% of the patients were on antiepileptic drugs before the correct diagnosis of hypoparathyroidism was made. This observation emphasized that Calcium profile should be obtained in patients with history of paresthesia and seizure to avoid the long delay in diagnosis of hypoparathyroidism.

Background: Insulin resistance (IR) is a pre-diabetic condition and has been reported in patients with acanthosis nigricans (AN) and acrochordon. AN and acrochordon are claimed to be cutaneous markers of IR. Aim: The purpose of this paper was to study the association of AN and acrochordon with IR. Methods: It was a cross-sectional hospital-based study. Both groups were assessed for IR by using homeostatic model assessment of insulin resistance (HOMA-IR) formula. Results: A total of 70 cases and an equal number of controls were studied. IR was observed more in cases (41.4%) compared to controls (17.1%) (P < 0.01). Mean HOMA-IR value was also significantly higher in cases (4.32 ± 4.44) compared to controls (2.27 ± 0.90) (P < 0.05). Limitations: Low number of cases and controls were taken in the study. Association with hyperlipidemia and metabolic syndrome was not elicited. Conclusions: AN and acrochordons were found to be associated with IR.

To match the current life-style, there is a huge demand and market for the processed food whose manufacturing requires multiple steps. The mounting demand increases the pressure on the producers and the regulatory bodies to provide sensitive, facile, and cost-effective methods to safeguard consumers’ health. In the multistep process of food processing, there are several chances that the food-spoiling microbes or contaminants could enter the supply chain. In this contest, there is a dire necessity to comprehend, implement, and monitor the levels of contaminants by utilizing various available methods, such as single-cell droplet microfluidic system, DNA biosensor, nanobiosensor, smartphone-based biosensor, aptasensor, and DNA microarray-based methods. The current review focuses on the advancements in these methods for the detection of food-borne contaminants and pathogens.

PURPOSE: The Consumer Assessment of Healthcare Providers and Systems (CAHPS) Cancer Care Survey is a systematic assessment of health care experiences of patients with cancer. It supports comparisons among all cancer treatment settings and modalities. METHODS: Formative research included 16 focus groups with patients receiving treatment and family members; advice from a panel of oncology and quality improvement experts; and interviews with stakeholders representing oncology associations, accredited cancer centers, and community oncology practices. We conducted cognitive tests of the instrument and field tests at six cancer centers and four community oncology practices, after which the survey was finalized and obtained the CAHPS trademark. RESULTS: The survey includes 56 questions that form six core composite measures (Getting Timely Care; Supporting Patient Self-Management; Available to Provide Care and Information; Provider Communication; Care Coordination; and Courteous Office Staff); two single-item measures of family participation in care and interpreter services; and two global ratings of cancer care and the treatment team. Sixteen additional items form three supplemental composite measures: Shared Decision-Making, Keeping Patients Informed, and Access to Care. CONCLUSION: Mail-only, mail-telephone mixed-mode, and Web-mail mixed-mode data collection methods are recommended. The questionnaires and instructions for use are free and available in English and Spanish on the CAHPS Website ( www.ahrq.gov/cahps ).

Ayurveda and contemporary science comprehends human body as model to understand disease state from very different perspective hence their methodology to describe disease manifestation also seems very different as they observe same problem from different viewpoints. For more precision in healthcare system it is essential that best of both systems need to be integrated, In Ayurvedic texts, the description of concept of basic constitution/Prakriti in health and disease states is well described. The scripts are not clearly understandable and hence its importance has not been properly understood by contemporary biological researchers and thus not utilized. According to Ayurveda individual’s basic constitution (Prakriti) influences and directs one’s disease status, its treatment & lifestyle regimen. In genomics, individual’s basic constitution is decided by its genetic makeup. The current trend in Ayurveda-related biomolecular studies is establishment of high correlation between Prakriti and Genomics. This approach of Ayurgenomics would facilitate the development of alternative methods for cost effective screening of predisposed individuals in the population. This would result in development of an integrated approach to systems biology for disease and health state. For the establishment and success of this concept the prerequisite is integration of Ayurveda into mainstream contemporary biology to achieve global acceptability for the concepts and science of Ayurveda, and for this Ayurvedic concept based phenotypic (Prakriti) assessment needs to be made so that difference among individuals from large population based on their physical, physiological and psychological status can be observed and they can be categorized by their specific predominant Prakriti i.e. Vata, Pitta, Kapha. Information about individual predominant Prakriti can be further analyzed on certain genomic parameters related to gene expression, genetic, epigenetic and biochemical factors, which can be further utilized for Integration of Ayurveda with Genomics for systems biology approach in predictive and personalized medicine.

Gastrointestinal (GI) syndrome is a serious side effect and dose-limiting toxicity observed in patients undergoing lower-abdominal radiotherapy. Previous mouse studies show that p53 gene dosage determines susceptibility to GI syndrome development. However, the translational relevance of p53 activity has not been addressed. Here, we used a knock-in mouse in which the p53–Mdm2 negative feedback loop is genetically disrupted. These mice retain biallelic p53 and thus, normal basal p53 levels and activity. However, due to the lack of p53-mediated Mdm2 transcription, irradiated Mdm2(P2/P2) mice exhibit enhanced acute p53 activity, which protects them from GI failure. Intestinal crypt cells residing in the +4 and higher positions exhibit decreased apoptosis, increased p21 expression, and hyperproliferation to reinstate intestinal integrity. Correspondingly, pharmacological augmentation of p53 activity in wild-type mice with an Mdm2 inhibitor protects against GI toxicity without affecting therapeutic outcome. Our results suggest that transient disruption of the p53–Mdm2 interaction to enhance p53 activity could be a viable prophylactic strategy for alleviating GI syndrome in patients undergoing radiotherapy.

BACKGROUND Major lumbar spine surgery causes severe postoperative pain. The primary objective of this randomized controlled study was to compare the effect of ultrasound (US)-guided erector spinae plane (ESP) block on 24-hour postoperative cumulative opioid requirements with standard (opioid-based) analgesia. Postoperative pain control and patient satisfaction were also assessed. MATERIALS AND METHODS Adults scheduled for elective lumbar spine surgery under general anesthesia were randomly assigned to the following (and they are): Control group-no preoperative ESP block, or ESP block group-preoperative bilateral US-guided ESP block. Both groups received standard general anesthesia during surgery. Postoperative pain score, number of patients requiring rescue analgesia, and total morphine consumption during the first 24 postoperative hours were recorded. Patient satisfaction was assessed 24 hours after surgery. RESULTS Postoperative morphine consumption was significantly lower in patients in the ESP group compared with those in the control group (1.4±1.5 vs. 7.2±2.0 mg, respectively; P

Background: Use of sunscreens on the face is becoming popular, and patients with melasma are prescribed sunscreen for use on the face. Results of a few Western studies on the effect of sunscreen use on serum vitamin D concentration are not applicable to Indian conditions. Aims: To examine the effect of use of a high sun protection factor (SPF 50+, PA++++) sunscreen on face in patients with melasma on serum concentration of 25-hydroxyvitamin D. Methods: Forty-five Indian patients (Fitzpatrick skin types III and IV) with melasma were advised to use a sunscreen with SPF 50 + for 3 months, 43 (33 female, 10 male; age 32.9 ± 8 years) completed the study. Patients staying outdoor for 4 hours reapplied sunscreen 4 hours after first application. Patients were provided a container to measure the amount of sunscreen for use, which was approximately equal to recommended thickness. Compliance was tested by weighing the used tubes and tubes in use during monthly visits. Serum concentration of 25-hydroxyvitamin D was tested before and after the study period. Results: Amount of sunscreen advised (100.5 ± 29.2 ml) and the actual amount used (96.6 ± 27.9 ml) were similar (P = 0.53, t-test). The difference between serum concentrations of 25-hydroxyvitamin D at the baseline (19.20 ± 9.06 ng/ml) and at 3 months (18.91 ± 8.39 ng/ml) was not significant (P = 0.87, paired t-test, 95% confidence interval of difference −3.33 to 3.92). No correlation was found between the amount of sunscreen used and the percentage change in serum 25-hydroxyvitamin D concentration at 3 months (rho = 0.099, P = 0.528, Spearman's rank correlation). Limitations: Longer duration of application and a larger sample size may detect minor differences in vitamin D concentration. Conclusion: Using a high SPF sunscreen on the face, along with physical photoprotection advice, in patients with melasma for 3 months does not influence serum 25-hydroxyvitamin D concentration in Indian conditions.

In this paper polyaniline-Graphene pellets are used for the implementation of a conducting polymer antenna which radiates at 6.8 GHz.The conducting polymer polyaniline is synthesized by oxidative polymerization and rapid mixing process. The conductivity enhancement is done by secondary doping and the incorporation of exfoliated graphene as filler in the polyaniline host matrix. As a result of the filler incorporation, conductivity is enhanced to 5000 S/m and it is pelletized and used as radiating elements of the antenna.FR4 with permittivity 4.4 and loss tangent of 0.001 is used as substrate. The antenna is designed to operate in 6.8GHz and it works with a bandwidth of 450 MHz.The proposed antenna shows a gain of -2.2 dBi for a thickness of 1.92mm.

Subcutaneous insulin therapy is associated with important injection site complications, which can influence insulin pharmacokinetics resulting in glycemic fluctuations above and below target levels for blood glucose.Our objective was to assess the prevalence and risk factors of cutaneous complications including insulin derived amyloidosis in insulin-injecting diabetes patients and to study the role of ultrasonography (in comparison to gel-assisted palpation) in early diagnosis of lipohypertrophy (LH).This was a cross-sectional study conducted at a tertiary care center in India, wherein 500 patients injecting insulin for ≥2 years were randomly enrolled and evaluated for the presence of cutaneous complications of insulin therapy through clinical examination, ultrasonography and punch biopsy of skin.Clinical examination detected LH in 44.6% of patients. Ultrasonography diagnosed additional 13.4% of patients with LH which were missed on clinical examination. Incorrect rotation of sites (P0.001) and insulin syringe reusage for more than five times (P0.001) significantly increased the risk of LH. Skin biopsy was performed in 100 cases, out of which two patients showed apple green birefringence and its association with insulin was confirmed by positive staining with anti insulin antibody in these two patients.Improper rotation of sites and reuse of needles were the leading causes of LH in Indian diabetic patients. Ultrasonography is more objective and reliable method of detecting LH. Insulin-derived amyloidosis may be a more common complication of insulin therapy than previously thought.

Interleukin-3 (IL-3) is produced during infections caused by parasites, bacteria and viruses, but its contribution to immunity in this context remains largely unknown. In mouse models of parasitic infections, in which the effects of IL-3 have been most extensively studied, IL-3 has been variously reported as protective, detrimental or inconsequential. Similarly, mixed results have been reported in viral and bacterial infection models. Here, we investigated the effects of IL-3 in mouse models of Mycobacterium tuberculosis and herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) infections by assessing the pathogen burden, disease manifestations and survival following infection. After infection with M. tuberculosis, IL-3 deficient mice showed higher bacillary burden, increased lung pathology and reduced survival compared to wild type mice. After infection with HSV-1 through cutaneous route and HSV-2 through vaginal route, IL-3 deficient mice showed higher viral burden, increased disease manifestations and reduced survival compared to wild type mice. Our results show that IL-3 makes a subtle but significant contribution to protective immunity in these mouse models of bacterial and viral infections.

Density functional theory-based first-principle calculations have been performed to study the structural and electronic properties of Cl functionalized armchair AlN nanoribbons (AAlNNRs). Functionalization was modeled in five different configurations. It is revealed that all structures prefer non-magnetic ground state. Moreover, functionalization of Al (N) by Cl (H), i.e., Cl -AlNNR-H results in energetically most favorable configuration over others. Further, the electronic bandgap depends strongly upon the Cl functionalization of the ribbon. Semiconductor to metallic transition is also noticed for selective structures which may find potential applications in upcoming nanoelectronic devices.

BACKGROUND: Rhino-orbito-cerebral mucormycosis(ROCM) is an uncommon yet potentially fatal fungal infection predominantly seen in immunocompromised individuals. However, there is very limited data available from India regarding outcome of patients with ROCM and diabetes mellitus. OBJECTIVE: To ascertain clinical parameters and factors in the final outcome of patients with diabetes mellitus and ROCM. MATERIALS AND METHODS: This series included retrospective analysis of medical records of 91 patients with diabetes mellitus who were diagnosed with ROCM from january 2007 to june 2019 at a tertiary care hospital in Punjab. RESULTS: The mean age of patients was 52.6 years (range 18–82 years), with men constituting the majority (71.4 %). Ophthalmoplegia was the most frequent presenting feature seen in 77 % of patients followed by proptosis (71 %). Intracranial involvement was seen in 20 % of the patients and cavernous sinus thrombosis was diagnosed in 9(10 %) patients. Out of 91 patients, 81 patients were subjected to appropriate surgical procedure depending upon site and extent of involvement by mucorales. A total of 53 (58.2 %) patients survived while 38(41.8 %) patients succumbed. Delay in presentation to hospital, intracranial extension and loss of vision at presentation adversely affected the outcome (p

A wideband non-resonant absorber is proposed, and its radar cross section (RCS) reduction is investigated. A discussion on the functional materials available is followed by the design of an absorber on a Plexiglas substrate with polyaniline-graphene nanocomposite as layered square inclusions with thicknesses and conductivities scaled to golden ratio. The measured dielectric properties of polyaniline-graphene nanocomposites are used in the fullwave simulation. The design parameters have been identified and optimized using CST Microwave Studio. As designed structure is fabricated and the reflection is measured. The objective of the work is to demonstrate the use of non-metallic conducting polymer composites devoid of metals for radar absorbing material (RAM) structural designs. The structure is an all-polymer and electrically thin design with a potential to be 3D printed to suit the target object.

The intentional yaw misalignment of leading, upwind turbines in a wind farm, termed wake steering, has demonstrated potential as a collective control approach for wind farm power maximization. The optimal control strategy and the resulting effect of wake steering on wind farm power production are in part dictated by the power degradation of the upwind yaw misaligned wind turbines. In the atmospheric boundary layer, the wind speed and direction may vary significantly over the wind turbine rotor area, depending on atmospheric conditions and stability, resulting in freestream turbine power production which is asymmetric as a function of the direction of yaw misalignment and which varies during the diurnal cycle. In this study, we propose a model for the power production of a wind turbine in yaw misalignment based on aerodynamic blade elements, which incorporates the effects of wind speed and direction changes over the turbine rotor area in yaw misalignment. The proposed model can be used for the modeling of the angular velocity, aerodynamic torque, and power production of an arbitrary yaw misaligned wind turbine based on the incident velocity profile, wind turbine aerodynamic properties, and turbine control system. A field experiment is performed using multiple utility-scale wind turbines to characterize the power production of yawed freestream operating turbines depending on the wind conditions, and the model is validated using the experimental data. The resulting power production of a yaw misaligned variable speed wind turbine depends on a nonlinear interaction between the yaw misalignment, the atmospheric conditions, and the wind turbine control system.

Dyslipidaemia has a prominent role in the onset of notorious atherosclerosis, a disease of medium to large arteries. Atherosclerosis is the prime root of cardiovascular events contributing to the most considerable number of morbidity and mortality worldwide. Factors like cellular senescence, genetics, clonal haematopoiesis, sedentary lifestyle-induced obesity, or diabetes mellitus upsurge the tendency of atherosclerosis and are foremost pioneers to definitive transience. Accumulation of oxidized low-density lipoproteins (Ox-LDLs) in the tunica intima triggers the onset of this disease. In the later period of progression, the build-up plaques rupture ensuing thrombosis (completely blocking the blood flow), causing myocardial infarction, stroke, and heart attack, all of which are common atherosclerotic cardiovascular events today. The underlying mechanism is very well elucidated in literature but the therapeutic measures remains to be unleashed. Researchers tussle to demonstrate a clear understanding of treating mechanisms. A century of research suggests that lowering LDL, statin-mediated treatment, HDL, and lipid-profile management should be of prime interest to retard atherosclerosis-induced deaths. We shall brief the Ox-LDL-induced atherogenic mechanism and the treating measures in line to impede the development and progression of atherosclerosis.

Introduction: Celiac Disease (CD) is a chronic autoimmune mediated disorder triggered by the ingestion of gluten. It is seen in genetically predisposed person and results in small intestine injury. Its aetiopathogenesis is not clear. Simple histopathology is not able to diagnose the disease many times. Aim: Aim of present study was to assess the prevalence of HLA DQ alleles and autoantibodies in diagnosis of the disease and association of DQ antigens with Type 1 Diabetes mellitus (T1DM) and autoimmune hypothyroidism in CD patients. Materials and Methods: Total 100 cases of CD and 31 healthy controls were studied, within a period of January 2015 to Febuary 2016. Autoantibodies like ANA, anti-tTg, anti-TPO and anti-scl 70 were done by ELISA kits. HLA DQ typing was done in 44 cases of CD, 20 cases of CD with T1DM, 22 cases of CD with autoimmune thyroid disease and 31 healthy controls. HLA DQ typing was done by SSO hybridisation method by Mr. SPOT machine. Results: About 70% patients were children between 6 months to 20 years of age and female formed the maximum number of cases (60%). Anti-tTg ab was positive in all cases (100%), anti-Scl 70 Ab was positive in 25%, anti-TPO ab was found in 22% and ANA was positive in only 10% cases. Most frequent DQβ1 haplotype in CD were DQβ1*02:01 (45.5%, p

Objective Little is known about factors affecting medical care experiences of cancer survivors. This study examined experience of care among cancer survivors and assessed associations of survivors' characteristics with their experience. Materials and Methods We used a newly-developed, unique data resource, SEER-CAHPS (NCI's Surveillance Epidemiology and End Results [SEER] data linked to Medicare Consumer Assessment of Healthcare Providers and Systems [CAHPS] survey responses), to examine experiences of care among breast, colorectal, lung, and prostate cancer survivors age > 66 years who completed CAHPS > 1 year after cancer diagnosis and survived ≥ 1 year after survey completion. Experience of care was assessed by survivor-provided scores for overall care, health plan, physicians, customer service, doctor communication, and aspects of care. Multivariable logistic regression models assessed associations of survivors' sociodemographic and clinical characteristics with care experience. Results Among 19,455 cancer survivors with SEER-CAHPS data, higher self-reported general-health status was significantly associated with better care experiences for breast, colorectal, and prostate cancer survivors. In contrast, better mental-health status was associated with better care experience for lung cancer survivors. College-educated and Asian survivors were less likely to indicate high scores for care experiences. Few differences in survivors' experiences were observed by sex or years since diagnosis. Conclusions The SEER-CAHPS data resources allows assessment of factors influencing experience of cancer among U.S. cancer survivors. Higher self-reported health status was associated with better experiences of care; other survivors' characteristics also predicted care experience. Interventions to improve cancer survivors' health status, such as increased access to supportive care services, may improve experience of care.

Objective: This case report will highlight the importance of histopathologic analysis of the gonads to differentiate ovotesticular disorder of sexual development (OT-DSD) from mixed gonadal dysgenesis. Both disorders may have the same clinical and cytogenetic presentation, but the latter presents high risk for gonadal malignancy, hence there is usually a need for early gonadectomy, while the former has a low risk for malignancy. Therefore OT-DSD patients may have the opportunity for spontaneous pubertal development and fertility with regular tumor surveillance.Methods: We report the case of a 22-year-old patient reared as a male with a 46,XY karyotype diagnosed as OT-DSD by gonadal biopsy. The patient presented with microphallus with chordee, penoscrotal hypospadias, poor virilization, and development of gynecomastia at puberty.Results: Histopathologic examination of the single tubule biopsy of the left gonad showed seminiferous tubules lined by Sertoli cells and Leydig cells in the interstitial space. Biopsy of the right gonad showed an ovary with Graafian follicles and fallopian tubes. There was also a uterus with the endometrium in the proliferative phase.Conclusion: OT-DSD is a rare disorder of sexual development characterized by the presence of both ovarian tissue with mature ovarian follicles as well as testicular tissue with distinct seminiferous tubules. These may present either in the same gonad or separately as opposite-side gonads in the same individual. It is associated with variable genotypes of which the most common karyotype is 46,XX with the 46,XY karyotype found in only 10% of cases.Abbreviations: DSD Disorder of sexual development OT-DSD ovotesticular disorder of sexual development

Background and Objectives: Type 2 diabetes is a multifactorial disorder that results from the interaction between genetic predisposition and environmental factors. Different Prakriti (body constitution) individuals have different susceptibility for the diseases, and this Prakriti is determined by both genetic and environmental factor. This study was undertaken to determine the association status of Methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C with type 2 diabetes and Prakriti. Materials and Methods: After informed consent, 54 patients with type 2 diabetes and 56 individuals as normal controls were analyzed. Their constitution and pathological data were collected and MTHFR C677T and A1298C genotypes were determined. Results: Kapha/Kapha-Pittaja Prakriti were associated and found to be strong risk factors (Chi-square test = 39.67, P < 0.00001, odds ratio [OR] = 16.133, 95% confidence interval [CI] = 6.32–41.20) for type 2 diabetes. MTHFR C677T was associated (Chi-square test = 7.743, P = 0.02) with type 2 diabetes where the major CC genotype was found to be a risk for type 2 diabetes (OR = 3.78, 95% CI = 1.14–12.45). A1298C was not associated with type 2 diabetes (Chi-square test = 2.264, P = 0.322). None of the Prakriti was associated with C677T and A1298C variants. Interpretation and Conclusion: In the present study, an extremely strong association between Prakriti (Kaphaja/Kapha-Pittaja) and type 2 diabetes (P < 0.00001) was detected. The present study gives a strong clue for the association of Prakriti (body constitutional) and clinical phenotype.

This work investigates the structural stability, electronic and transport properties of zigzag boron nitride nanoribbons (ZBNNRs) with hydrogenation/fluorination by using density functional theory (DFT) along with non-equilibrium Green’s function (NEGF) approach. The study reveals that ZBNNRs exhibit metallic to semiconducting transition via selected edge fluorination. Interestingly, edge fluorinated ZBNNRs demonstrate high structural stability due to the higher electronegativity of fluorine. It is also revealed that negative differential resistance (NDR) has also been observed for edge fluorinated two terminal devices with enormously high peak to valley current ratio (PVCR) of the order of 1 0 11 . We have also investigated the gate controllable current–voltage (I–V) characteristics of three terminal ZBNNRs field effect transistor (FET). The selective structures exhibit excellent gate controllability which can tune the observed PVCR. Our findings indicate the potential of fluorinated ZBNNRs towards upcoming ultra fast switches, rectifiers and oscillators etc.

Disruption of the p53 tumor suppressor pathway is a primary cause of tumorigenesis. In addition to mutation of the p53 gene itself, overexpression of major negative regulators of p53, MDM2 and MDM4, also act as drivers for tumor development. Recent studies suggest that expression of splice variants of Mdm2 and Mdm4 may be similarly involved in tumor development. In particular, multiple studies show that expression of a splice variant of MDM4, MDM4-S correlates with tumor aggressiveness and can be used as a prognostic marker in different tumor types. However, in the absence of prospective studies, it is not clear whether expression of MDM4-S in itself is oncogenic or is simply an outcome of tumorigenesis. Here we have examined the role of Mdm4-S in tumor development in a transgenic mouse model. Our results suggest that splicing of Mdm4 does not promote tumor development and does not cooperate with other oncogenic insults to alter tumor latency or aggressiveness. We conclude that Mdm4-S overexpression is a consequence of splicing defects in tumor cells rather than a cause of tumor evolution.

Sleeve gastrectomy has gained popularity over the years and is commonly performed laparoscopically through multiple small incisions. The arrival of single incision laparoscopic surgery has been a game changer, allowing for sleeve gastrectomy to be performed through a cosmetically more appeasing scar with improved patient satisfaction. In this article, we describe the history, technical challenges, proposed solutions to some of the hurdles faced during single-incision laparoscopic bariatric surgery and highlight our method of performing single incision laparoscopic sleeve gastrectomy purely through a single access device.

Palliative care is a growing specialty that addresses the needs of individuals diagnosed with advanced illness and their caregivers. Although palliative care has been shown to improve a variety of patient- and caregiver-centered outcomes, access to comprehensive palliative care services for patients is often limited. There is a need to identify the most effective approaches to delivering palliative care to patients in community settings. In fiscal year 2017, based on extensive input from a diverse set of stakeholders, the Patient-Centered Outcomes Research Institute (PCORI) funded nine multisite comparative clinical effectiveness research (CER) trials focused on community-based delivery of palliative care for a total investment of $80 million. These studies, focusing on advance care planning and models of palliative care delivery, represent some of the largest most complex palliative care trials funded to date. Each study evaluates both patient and caregiver outcomes, and together, these trials include a broad range of health conditions, interventions, and settings of care. PCORI has also fostered a learning network of the funded awardees to facilitate the successful conduct of these CER studies and to support awardee efforts to develop collaborative products relevant to advancing the field of palliative care research and practice. The protocols of each of the nine trials, detailed in this issue, demonstrate the expansive reach of the investment PCORI has made in an effort to further the research agenda and provide substantive research evidence in stakeholder-identified areas of need in the field of palliative care.

Cutaneous (keratotic) horn (CH) is a benign, elongated, keratinous projection usually few millimetres from the skin surface.[1–5][1] Few cases of giant CH (GCH) have been reported in English literature. We present a rare interesting case of GCH on the thumb in a woman. A 60-year-old female farmer

PURPOSE Pain, fatigue, and distress are common among patients with cancer but are often underassessed and undertreated. We examine the prevalence of pain, fatigue, and emotional distress among patients with cancer, as well as patient perceptions of the symptom care they received. PATIENTS AND METHODS Seventeen Commission on Cancer–accredited cancer centers across the United States sampled patients with local/regional breast (82%) or colon (18%) cancer. We received 2,487 completed surveys (61% response rate). RESULTS Of patients, 76%, 78%, and 59% reported talking to a clinician about pain, fatigue, and distress, respectively, and 70%, 61%, and 54% reported receiving advice. Sixty-one percent of patients experienced pain, 74% fatigue, and 46% distress. Among those patients experiencing each symptom, 58% reported getting the help they wanted for pain, 40% for fatigue, and 45% for distress. Multilevel logistic regression models revealed that patients experiencing symptoms were significantly more likely to have talked about and received advice on coping with these symptoms. In addition, patients who were receiving or recently completed curative treatment reported more symptoms and better symptom care than did those who were further in time from curative treatment. CONCLUSION In our sample, 30% to 50% of patients with cancer in community cancer centers did not report discussing, getting advice, or receiving desired help for pain, fatigue, or emotional distress. This finding suggests that there is room for improvement in the management of these three common cancer-related symptoms. Higher proportions of talk and advice among those experiencing symptoms imply that many discussions may be patient initiated. Lower rates of talk and advice among those who are further in time from treatment suggest the need for more assessment among longer-term survivors, many of whom continue to experience these symptoms. These findings seem to be especially important given the high prevalence of these symptoms in our sample.

The prognosis in breast cancer is worse in younger patients, invasive papillary, classic lobular and medullary cancers, tumors more than 1 cm in diameter, four or more positive axillary node and es...

In the present work, we employ first-principle calculations to investigate structural and electronic properties of zigzag GaN nanoribbons (ZGaNNR) functionalized with Cl. Five different configurations were explored to examine the effect of Cl functionalization on the ribbon edges. It is predicted that Cl functionalization is most preferred at Ga edge of the ribbon. Further, presence of Cl causes reduction in the magnitude of band gap (as compared to pristine ribbon) and an indirect to direct band gap conversion is also observed. For selective structures, even semiconductor to metallic transition has been noticed. The present findings may find important applications in upcoming nano-electronic devices.

We performed density functional theory (DFT) based first-principle calculations to study the CS2 scavenger characteristics of zigzag nitride nanoribbons (ZXNNR, X = Ga/Al/B). The sensing capabilities of Ga, Al and B based nitride nanoribbons have been systematically compared to reveal the optimum host and adsorption sites. The adsorption of CS2 on the edges is mediated via formation of stable chemical bonds while the same at the middle of ribbon is regarded to be physisorbed one. Various possible geometries have been investigated and the CS2 adsorption on considered materials is found to be energetically feasible. It is revealed that interaction with CS2 has a significant impact on the electronic and transport properties of the considered family of III-V nitride nanoribbons. A semiconductor to metallic transition is witnessed for adsorption on the edges. The observed metallic nature is also confirmed by the corresponding current–voltage (I-V) characteristics which further exhibit typical negative differential resistance (NDR) phenomenon in selective configurations. Our analysis shows that recovery time is significantly higher for adsorption at the ribbon edges. On the other hand, adsorption at the center of ribbon is favorable for re-usable sensors with significantly lower recovery time. Present findings are useful for selecting the active adsorption sites and designing the efficient CS2 scavengers.

Xanthones are important chemical class of bioactive products that confers therapeutic benefits. Of several xanthones, mangiferin is known to be distributed widely across several fruits, vegetables and medicinal plants. Mangiferin has been shown to exert neuroprotective effects in both in-vitro and in-vivo models. Mangiferin attenuates cerebral infarction, cerebral edema, lipid peroxidation (MDA), neuronal damage, etc. Mangiferin further potentiate levels of endogenous antioxidants to confer protection against the oxidative stress inside the neurons. Mangiferin is involved in the regulation of various signaling pathways that influences the production and levels of proinflammatory cytokines in brain. Mangiferin cosunteracted the neurotoxic effect of amyloid-beta, MPTP, rotenone, 6-OHDA etc and confer protection to neurons. These evidence suggested that the mangiferin may be a potential therapeutic strategy for the treatment of various neurological disorders. The present review demonstrated the pharmacodynamics-pharmacokinetics of mangiferin and neurotherapeutic potential in several neurological disorders with underlying mechanisms.