Search

Abstract In the current work, an innovative nondominated sorting colliding bodies optimization (NSCBO) technique is introduced to tackle multiobjective optimal power flow (MOOPF) challenges within electrical power networks. This method offers a means to generate a diverse array of nondominated solutions in a single iteration by including the nondominated (ND) sorting process and the concept of crowding distance. Additionally, it utilizes a spread indicator to archive the latest nondominated solutions. In the NSCBO method, the mass of each colliding body is determined by its nondominated rank rather than relying on objective function information. Moreover, a fuzzy decision-making strategy is employed to identify a suitable solution from the set of ND solutions. To showcase the scalability and viability of the NSCBO method, experiments are conducted on IEEE 30-bus, considering both bi- and tri-objective models. Comparative analysis with existing methods from recent literature demonstrates the efficacy of the NSCBO technique in handling constraints and deriving nondominated solutions for MOOPF problems.

Introduction: Reduction in visual acuity and glare are common indications for cataract surgery in patients with strabismus. The amblyopic eye is particularly sensitive to blur, despite reduced visual acuity and contrast sensitivity. However, the impact of cataracts on visual functions in strabismus patients is not well documented. Aim: To evaluate the Vision-related Quality of Life (VRQoL) after cataract surgery in strabismus patients. Materials and Methods: The present quasi-experimental study was conducted in the Department of Ophthalmology, RL Jalappa Hospital and Research Centre, Kolar, Karnataka, India, from August 2023 to September 2023. Study included 44 strabismus patients, which was assessed by Hirschberg and alternate cover tests. All patients underwent unilateral manual small incision cataract surgery on the worse eye. VRQoL was assessed using the Indian Vision-related Quality of Life Functioning Questionnaire-33 (IND-VFQ-33) questionnaire preoperatively and postoperatively. Statistical significance was determined using paired t-tests (p-value

Abstract The optimization of floating bifacial solar panels (FBS PV) in tropical freshwater systems is explored by employing response surface methodology (RSM) and central composite design (CCD). Previous studies have yet to explore the long-term durability, environmental impact, economic viability, and performance of FBS PV systems under various climatic conditions. This study addresses this gap by focusing on panel height, water depth, and tilt angle to improve performance. The quadratic model reveals significant non-linear relationships impacting FBS PV power generation with freshwater cooling. Our models demonstrate high explanatory power, with R-squared values of 0.9831 for output power and 0.9900 for Bi-Facial gain. Experimental validation using conventional white surface (CWS) and proposed freshwater surface (PFS) indicates notable improvements in power generation, achieving a 4.34 to 4.86% gain in bifacial efficiency across various irradiation levels. Under 950 W/m2 irradiation, freshwater cooling achieves a 3.19% higher bifacial gain compared to CWS cooling. Panel temperature analysis shows consistent reductions with freshwater cooling, ranging from 1.43 to 2.72 °C, enhancing overall efficiency and longevity. This research highlights the potential of freshwater cooling in optimizing bifacial solar systems, offering actionable insights for sustainable energy solutions in tropical regions.

Introduction: Supraclavicular approaches serve as a common method for administering regional anesthesia in upper limb procedures. In improving the impact with a length of pain relief, medical professionals frequently include additional substances such as dexmedetomidine, buprenorphine, dexamethasone, clonidine, sodium bicarbonate, and tramadol alongside local anesthetics. The intent of this study was to evaluate its impact of incorporating buprenorphine and dexmedetomidine into ropivacaine 0.5%. Materials and Methods: The trial of 90 patients between the ages of 18 and 60, who were identified as American Society of Anesthesiologists Grade 1 and 2, and scheduled upper limb surgery using the supraclavicular approach, were included. They were assigned into distinct groups, each of the groups consisting of thirty individuals. Group R was administered anesthesia consisting of 25 ml of ropivacaine 0.5% along with 1 ml of saline. Group B was administered anesthetics containing ropivacaine 0.5% and buprenorphine, which was diluted in saline. Group D was administered a solution containing ropivacaine 0.5% and dexmedetomidine, which was diluted in saline. Results: Group D had an earlier sensory blockade onset (8.25 min) compared to Group B (9.64 min) and Group R (12.89 min). Group D demonstrated a notably quicker motor blockade onset (9.21 min) in contrast to Group B (12.07 min) and Group R (15.03 min). In contrast with the other groups, Group D exhibited a more longer time frame of both sensory and motor blockades and also an extended period of anesthesia after the surgery. Conclusion: Dexmedetomidine was a more effective adjuvant over buprenorphine in the brachial plexus blocks. This resulted in significantly lower postoperative pain scores at 407.67 min and 612.32 min for the plain ropivacaine and buprenorphine groups, respectively.

Typhoid fever is a bacterial infection that can be fatal and a major concern globally. Due to the infection’s high morbidity and fatality rates, there is an urgent need for precise and quick diagnostic tests to help with disease management and prevention. The purpose of the current review is to evaluate the specificity and sensitivity of the currently commercially available typhoid fever rapid diagnostic kits (RDTs). Publicly available English databases, such as PubMed and Google Scholar, were used to screen the research papers. We mined a total of 371 research documents, of which 18 articles were selected based on the inclusion and exclusion criteria. Studies from 10 different developing countries evaluated the diagnostic performance of Typhidot, Typhidot-M, and Tubex. The average sensitivity and specificity were approximately 80%–90% and 65%–78% for Typhidot, 85%–94% and 77%–89% for Typhidot-M, and 94.7% and 80.4% for Tubex. The sensitivity and specificity of these diagnostics varied with the geographical location. In comparison to the widely used Widal test, the observed performance cannot support the exclusive use of a particular RDT. Hence, there is a need to develop affordable, antigen-based RDTs.

Abstract Musculoskeletal disorders encompass a wide range of conditions that impact the bones, joints, muscles, and connective tissues within the body. Despite the ongoing debate on toxicity and administration, ozone demonstrated promise in managing several musculoskeletal disorders, modulating pain and inflammation. A literature search was conducted. The research design, methods, findings, and conclusions of the studies were then examined to evaluate the physiological effects, clinical application, controversies, and safety of the application of ozone in musculoskeletal medicine. Ozone application demonstrates considerable therapeutic applications in the management of musculoskeletal disorders, including fractures, osteoarthritis, and chronic pain syndromes. Despite these advantages, studies have raised concerns regarding its potential toxicity and emphasized the importance of adhering to stringent administration protocols to ensure safety. Additionally, heterogeneities in patient reactions and hazards from oxidizing agents were observed. Given its anti-inflammatory and analgesic qualities, ozone therapy holds potential in the management of several musculoskeletal disorders. Additional high-quality research with long follow-up is required to refine indications, efficacy and safety profile. Finally, for wider clinical acceptability and utilization, the development of international recommendations is essential.

Abstract Solar eclipse has remarkable effect on behavior of animals. South India experienced a 97% magnitude annular eclipse on December 26, 2019 during 08:04–11:04 h with the totality phase appeared during 09:25–09:30 h. We investigated whether the foraging activity of the bees was limited by the eclipse, what bees are affected most, and which part of the eclipse was critical for bee activities to understand how a group of insects that rely the Sun, the sunlight, and the sun rays for their navigation and vision behaves to the eclipse. We opted to watch the bees in their foraging ground, and selected the natural flower populations of Cleome rutidosperma, Hygrophila schulli, Mimosa pudica, and Urena sinuata—some of the bee-friendly plants—to record the visitor richness and visitation rate on the flowers on eclipse and non-eclipse days and during the hour of totality phase and partial phase of the eclipse. Fewer flower-visiting species were recorded on the eclipse day than on the non-eclipse days, but in the period of totality, very few bee species were active, and limited their activity to only one population of C. rutidosperma. Visits of honey bees and stingless bees were affected most, but not that badly of solitary bees and carpenter bees. Bees, particularly the social bees use Sun for navigation and deciphering information on forage sources to fellow workers. The eclipse, like for many other animals, might hamper bees’ orientation, vision, and flight.

Background: Metabolic syndrome has increased globally due to sedentary lifestyles, unhealthy diets and obesity, which is posing a substantial burden on healthcare systems. Understanding the determinants of metabolic syndrome like lifestyle factors, socioeconomic status and the environment are vital for devising effective prevention and management. Research into these determinants helps to identify high-risk populations and develop interventions to reduce its occurrence. Objectives: i. To estimate the prevalence of metabolic syndrome among the adult population. ii. To determine the factors associated with metabolic syndrome among the adult population. Methodology: A cross-sectional study was carried out among 410 adults (≥18 years). A semi-structured questionnaire was used to collect data and National Cholesterol Education Program’s Adult Treatment Panel III criteria was used to diagnose metabolic syndrome. Continuous and categorical data were represented as mean and proportion, respectively. The strength of the association was determined using the prevalence ratio and adjusted prevalence ratio. Results: The mean age of the participants was 44.97 ± 14.7, about 58.3% of them were females. Metabolic syndrome prevalence was 39.8%. Multivariate regression analysis demonstrated that being over 40 years old, marital status, higher socioeconomic status, skilled workers, physical inactivity and obesity were independently linked to metabolic syndrome. Conclusions: The burden can be reduced by identifying the risk factors at the early stage through screening and by adopting a healthy lifestyle.

Background Colorectal cancer is a common condition with an uncommon burden of disease, heterogeneity in manifestation, and no definitive treatment in the advanced stages. Renewed efforts to unravel the genetic drivers of colorectal cancer progression are paramount. Early-stage detection contributes to the success of cancer therapy and increases the likelihood of a favorable prognosis. Here, we have executed a comprehensive computational workflow aimed at uncovering the discrete stagewise genomic drivers of colorectal cancer progression. Methods Using the TCGA COADREAD expression data and clinical metadata, we constructed stage-specific linear models as well as contrast models to identify stage-salient differentially expressed genes. Stage-salient differentially expressed genes with a significant monotone trend of expression across the stages were identified as progression-significant biomarkers. The stage-salient genes were benchmarked using normals-augmented dataset, and cross-referenced with existing knowledge. The candidate biomarkers were used to construct the feature space for learning an optimal model for the digital screening of early-stage colorectal cancers. The candidate biomarkers were also examined for constructing a prognostic model based on survival analysis. Results Among the biomarkers identified are: CRLF1, CALB2, STAC2, UCHL1, KCNG1 (stage-I salient), KLHL34, LPHN3, GREM2, ADCY5, PLAC2, DMRT3 (stage-II salient), PIGR, HABP2, SLC26A9 (stage-III salient), GABRD, DKK1, DLX3, CST6, HOTAIR (stage-IV salient), and CDH3, KRT80, AADACL2, OTOP2, FAM135B, HSP90AB1 (top linear model genes). In particular the study yielded 31 genes that are progression-significant such as ESM1, DKK1, SPDYC, IGFBP1, BIRC7, NKD1, CXCL13, VGLL1, PLAC1, SPERT, UPK2, and interestingly three members of the LY6G6 family. Significant monotonic linear model genes included HIGD1A, ACADS, PEX26, and SPIB. A feature space of just seven biomarkers, namely ESM1, DHRS7C, OTOP3, AADACL2, LPHN3, GABRD, and LPAR1, was sufficient to optimize a RandomForest model that achieved > 98% balanced accuracy (and performant recall) of cancer vs. normal on external validation. Design of an optimal multivariate model based on survival analysis yielded a prognostic panel of three stage-IV salient genes, namely HOTAIR, GABRD, and DKK1. Based on the above sparse signatures, we have developed COADREADx, a web-server for potentially assisting colorectal cancer screening and patient risk stratification. COADREADx provides uncertainty measures for its predictions and needs clinical validation. It has been deployed for experimental non-commercial use at: https://apalanialab.shinyapps.io/coadreadx/.

Introduction: Several psychological and social factors influence the incidence, treatment, and outcome of cancer patients. Depressive symptoms are more common in cancer patients, particularly in late stages. Women in Indian settings often exhibit delayed treatment-seeking behaviour. Aim: To assess the prevalence, type, and severity of psychiatric morbidity as well as the duration, type, and stage of illness in gynaecological oncology patients. Materials and Methods: This cross-sectional study was conducted among 100 gynaecological oncology patients aged 18 to 65 years, who were attending the gynaecologic Outpatient Department (OPD) and ward at a tertiary care hospital. The study took place at Government Rajaji Hospital, Madurai, between May 2013 and November 2013. Data was collected using a semistructured questionnaire from the patient and a reliable informant, after obtaining informed consent. The data was entered into Microsoft Excel and analysed using Statistical Package for Social Sciences (SPSS) software version 20.0. Central values, dispersion, and Chi-square tests were calculated. Results: The sample comprised 100 gynaecological oncology patients, with 30 (30%) diagnosed with malignancy, 43 (43%) with a benign condition, and 27 (27%) under investigation. Among the 100 patients assessed, 34 (34%) had psychiatric morbidity. There was a significantly higher prevalence among older patients, those with more than six months’ duration of gynaecological morbidity, and those exhibiting non fatal suicidal behaviour. Conclusion: Psychiatric morbidity is highly prevalent in gynaecological oncology patients. Depression was found to be more frequent and severe in patients with cancer. A previous history of suicidal attempts and a family history of psychiatric illness are important predictors of psychiatric morbidity in this population. Future studies on a larger population should explore the biological relationship between gynaecological oncology and psychiatric illness.

Abstract The study aimed to determine the accuracy of diagnosing periodontal conditions using the developed web-based PocketPerio application and evaluate the user’s perspective on the use of PocketPerio. First, 22 third-year dental students (DS3) diagnosed ten cases without PocketPerio (control) and with PocketPerio (test) during a mock examination. Then, 105 DS3, 13 fourth-year dental students (DS4), and 32 senior second-year International Standing Program students (ISP2) used PocketPerio chairside. Statistical analysis was performed using a non-parametric paired two-tailed test of significance with the Wilcoxon matched-pairs signed rank test. The null hypothesis that PocketPerio did not increase the accuracy of periodontal diagnoses was rejected at α

Introduction: Tuberculosis (TB), an infectious disease caused by the bacterium Mycobacterium Tuberculosis (MTB), continues to be a global health problem. Alpinia galanga (Linn.) of the Zingiberaceae family has antitubercular properties, and their mode of action in in-vitro as well as in-vivo conditions is well established. This knowledge of the active phytochemicals of Alpinia galanga has been utilised to identify new potent drugs for MTB. Aim: To perform molecular docking studies of various phytochemicals of Alpinia galanga and their derivatives with β-ketoacyl reductase (MabA) of MTB. Materials and Methods: The present study is an in-silico study conducted in the Bioinformatics facility of the Central Research Laboratory of Tagore Medical College and Hospital, Chennai, Tamil Nadu, India from November 2022 to April 2023. The receptor protein was downloaded from the Research Collaboratory for Structural Bioinformatics (RCSB) database. The phytochemicals in. sdf format were downloaded from the PubChem database. The derivatives were prepared by Chemsketch software. Docking was performed using AutoDock Vina with PyRx as the GUI (Graphical User Interface). Post-docking analysis was performed in LigPlot+. Results: Phytochemicals from Alpinia galanga were obtained from the PubChem database and docked with MabA of MTB. The derivatives were further subjected to docking analyses. From the docking study, two molecules, namely, (1E,6Z)-2,4-diamino-6-fluoro-1,7-bis(4-hydroxyphenyl)-1-sulfanylhepta-1,6-diene-3,5-dione and (2E,6Z,10E)-2,6,9,9-tetrakis(hydroxymethyl)cycloundeca-2,6,10-trien-1-one-ethane (1/1), were found to have good binding energy values. Conclusion: The present study helped us find drug-like molecules that can inhibit the MabA of MTB. Two compounds derived from the phytochemicals of A. galanga were found to have an effective binding capacity to the drug target in-silico. Hence, the outcome of present study has provided a therapeutic strategy for TB, especially for strains of MTB that are drug-resistant.

Abstract Skin Cancer is caused due to the mutational differences in epidermis hormones and patch appearances. Many studies are focused on the design and development of effective approaches in diagnosis and categorization of skin cancer. The decisions are made on independent training dataset under limited editions and scenarios. In this research, the kaggle based datasets are optimized and categorized into a labeled data array towards indexing using Federated learning (FL). The technique is developed on grey wolf optimization algorithm to assure the dataset attribute dependencies are extracted and dimensional mapping is processed. The threshold value validation of the dimensional mapping datasets is effectively optimized and trained under the neural networking framework further expanded via federated learning standards. The technique has demonstrated 95.82% accuracy under GWO technique and 94.9% on inter-combination of Trained Neural Networking (TNN) framework and Recessive Learning (RL) in accuracy.

Background & Aims: Anatomical variations in the branching pattern of arch of aorta are significant for diagnostic, surgical, and interventional procedures of the thorax and neck, and failure to recognize these patterns may have fatal outcome. Hence the present study aims to determine the percentage and type of aortic arch variations. Materials & Methods: This cross-sectional study was conducted on 30 formalin-fixed stillborn human fetuses of 35 weeks gestational age and above, in the Department of Anatomy, RIMS, Imphal, Manipur from 2018 to 2020. stillborn human fetuses were collected from the Obstetrics and Gynecology Department of RIMS, Imphal, Manipur, after taking due consent from parent. Fetus with gross abnormality and weighing less than 2.5 kg were excluded. whereas above 2.5 kg weight fetuses were included. The variations in the branching pattern of aortic arch were observed, noted and photographed. The variations were according to the classification by vicurevic et al., 2012. Results: The classical pattern of three branches of the arch of aorta were seen in 23 (76.66%) cases in the present study. In the remaining 7 (23.33%) cases, two different types of variations were observed with four and two branches arising in five and two cases respectively. Conclusion: Knowledge of normal anatomy and frequency in the variations in the branching pattern of the arch of aorta in the present study can be of significance for clinicians.

Introduction: The appendix, once considered a vestigial structure, is now recognised as a site of diverse pathologies beyond simple appendicitis through a systematic analysis of published literature and case studies. The diagnosis of appendiceal lesions is still a clinical phenomenon and a constant struggle. The gold standard for diagnosing appendiceal lesions, however, is meticulous histopathological examination. Aim: To determine the histopathological distribution of all the appendiceal lesions and to identify the rare and unusual histopathological findings in appendectomy specimens received at a tertiary care Centre. Materials and Methods: A cross-sectional study was conducted in the Department of Pathology at Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Chengalpattu, Tamil Nadu, India for a duration of 10 years, from August 2013 to August 2023. From the histopathological records of 832 appendectomies, 40 specimens with unusual histopathological findings were identified and analysed in this study. Relevant recorded data from all the appendiceal specimens reported during the study period, with special reference to age, sex, and histopathological findings, were retrieved and evaluated retrospectively. Corresponding slides and specimens were reviewed. The data were presented in the form of frequency tables and percentages. The analysis was done using Statistical Package for Social Sciences (SPSS) software version 20.0. Results: Out of 832 appendectomy specimens, there were 485 (58.29%) cases of acute appendicitis, 244 (29.33%) cases of chronic appendicitis, 59 (7.09%) cases of subacute appendicitis, and 4 (0.48%) cases of gangrenous appendicitis. Unusual histopathology findings were noted in 40 cases (4.81%). These include 17 cases of appendiceal neuroma, eight cases of Xanthogranulomatous appendicitis, seven cases of Enterobius vermicularis, three cases of Low-grade Appendiceal Mucinous Neoplasm (LAMN), one case of appendiceal Neuroendocrine Tumour (NET), one case of Goblet Cell Adenocarcinoma (GCA), one case of metastatic squamous cell carcinomatous deposit in the appendix, one case of urothelial rests in the appendix, and one case of appendiceal lipoma. Conclusion: In this study, 4.81% of patients had atypical appendiceal lesions. A complete histopathological examination of appendectomy specimens increases the chances of discovering unusual lesions of the appendix. Ultimately, this comprehensive analysis will contribute to future improvements in clinical management and prognostication, fostering better patient outcomes.

Introduction: The Modified Mallampati (MM) grading and Friedman’s Tongue Position (FTP) scores are two major scoring systems used to evaluate the oropharyngeal space. However, the current descriptions of performing these scores do not specify the route of breathing taken by the patient during the examination. The dynamic changes in the tongue and palate, in relation to the route of breathing, may contribute to the high interobserver variability in MM scoring. Aim: To explore the differences in MM scores and Friedman’s scores obtained during mouth breathing and nose breathing in order to standardise the scoring system. Materials and Methods: A community-based cross-sectional study was conducted at the Departments of Anaesthesiology and Community Medicine at Believers Church Medical College Hospital in Central Kerala, India between April 2022 and October 2022, on 702 adults. MM scores and FTP scores were recorded separately for each person during mouth breathing and nose breathing. Socio-demographic variables such as age, gender, and Body Mass Index (BMI) were also collected. The data was analysed using the Z-test for proportions. Results: The mean age of the study participants was 3.58±16.42 years. The majority of the participants were females (69.2%), and more than half (59%) were above 50 years of age. Out of the 135 participants with an MM Score-1 during mouth breathing, 99 (73.3%) had higher scores during nose breathing. For the 196 individuals with an MM Score-2 during mouth breathing, 87 (44.3%) had higher scores during nose breathing. Similarly, out of the 220 people with an MM score of -3 during mouth breathing, 106 (48.2%) had a Score-4 during nose breathing. A similar pattern was observed for the FTP scores. Conclusion: The present study demonstrates significant variability in MM and FTP scores obtained during oral and nasal breathing, highlighting the need to standardise the route of breathing during examination. The study suggests that advising patients to breathe through the mouth may relax the tongue and improve the predictive value of MM grading.

Background: Hematuria is rare in normal physiology. Proteinuria is almost always abnormal. It has been reported that hematuria and proteinuria are present even in apparently healthy children. Aims and Objectives: This study was carried out to find the prevalence of proteinuria and hematuria in asymptomatic pediatric age group in suburban Chennai. Materials and Methods: This cross-sectional study was carried out among 200 apparently healthy children of a suburban community in Chennai. Urine samples were collected from all children who satisfied the study criteria. The study period was from June 2020 to December 2021. The collected urine samples were analyzed in the laboratory for hematuria and proteinuria. The data were entered into Microsoft Excel and analyzed using SPSS version 23. Results: Of the 200 children, 105 (52.5%) were males and 95 (47.5%) were females. The mean±standard deviation of the age of the study participants was 6.275±4.0362. Twenty-nine (14.5%) had hematuria, 45 (22.5%) had proteinuria, and 10 (5%) children had both. Conclusion: Hematuria and proteinuria are present in asymptomatic children. Urinalysis is an effective, easy, and non-invasive screening method for early detection of an underlying renal disease.

Introduction: Diabetic Macular Oedema (ME) is the main cause of poor visual acuity due to the breakdown of the inner and/or outer Blood Retinal Barrier (BRB). This can occur at any stage of Diabetic Retinopathy (DR) due to increased vascular permeability from retinal capillaries, as well as from microaneurysms and Intraretinal Microvascular Abnormalities (IRMAs). A high level of Glycosylated Haemoglobin (HbA1c) is a well known risk factor for diabetic ME. Aim: To evaluate the relationship between glycosylated Haemoglobin (Hb) and macular thickness on Optical Coherence Tomography (OCT) in patients with Type 2 Diabetes Mellitus (T2DM). Materials and Methods: A cross-sectional study was in the Department of Ophthalmology at RL Jalappa Hospital, Kolar, Karnataka, India. The study duration was one year and eight months, conducted from January 2021 to September 2022. A total of 162 eyes of 81 patients with Diabetes Mellitus (DM) were included. Patients were assessed for age, gender, duration of diabetes, subfield macular thickness, total macular volume as measured by Optical Coherence Tomography (OCT), and HbA1c levels. Pearson’s correlation and paired t-test were used to identify the mean difference between paired data. A p-value 8% compared to those with HbA1c values 8% and a longer duration of diabetes exhibited increased macular thickness and total macular volume as measured by OCT, which was also observed in patients with severe non proliferative DR and proliferative DR.

Metabolomics involves the identification and quantitative analysis of all small metabolites present in cells, tissues, and bodily fluids that are formed as a result of biochemical reactions within the cell. These metabolites form a large pool of substrates and can be modified by serving as a substrate for enzymes involved in other metabolic pathways. Therefore, the metabolome in an organism is so dynamic that there is variation in their quantity and chemical composition over time. Nuclear Magnetic Resonance (NMR), Gas Chromatography Mass Spectrometry (GC-MS), and Liquid Chromatography Mass Spectrometry (LC-MS) are the most commonly used technologies in metabolomics. The metabolites are first isolated based on their polarity, chemical composition, and structural resemblances, after which they undergo specialised processes and are then analysed. Metabolomics, coupled with MS, has advanced rapidly and found widespread use in periodontal research. The presence of distinct metabolic and microbiological profiles in different types of periodontitis, as well as their link to clinical indicators of periodontal inflammation, has demonstrated the usefulness of metabolomics in screening, preventing, and monitoring prognosis. Conventional diagnostics fail to detect periodontitis in its early stages, cannot discriminate between past and present disease activity, and are incapable of analysing the entire repertoire of biomarkers in the biological system. Therefore, metabolomics, in conjunction with other omics technologies, can provide tailored periodontal disease therapy. The present review aimed to explore metabolomics, its applications in periodontics, and the potential for personalised treatment.

Abstract The formation of plasmon-exciton (plexciton) polariton is a direct consequence of strong light-matter interaction, and it happens in a semiconductor–metal hybrid system. Here the formation of plasmon-exciton polaritons was observed from an AgTe/CdTe Quantum Dot (QD) solid system in the strong coupling regime. The strong coupling was achieved by increasing the oscillator strength of the excitons by forming coupled QD solids. The anti-crossing-like behaviour indicates the strong coupling between plasmonic and excitons state in AgTe/CdTe QD solids, resulting in a maximum Rabi splitting value of 225 meV at room temperature. The formation of this hybrid state of matter and its dynamics were studied through absorption, photoluminescence, and femtosecond transient studies.

Abstract Background Cross-sectionally, older age and obesity are associated with increased coronavirus disease-2019 (COVID-19) risk. We assessed the longitudinal associations of baseline and changes in adiposity parameters with COVID-19 incidence in older adults at high cardiovascular risk. Methods This analysis included 6874 men and women (aged 55–75 years) with overweight/obesity and metabolic syndrome in the PREDIMED-Plus lifestyle intervention trial for cardiovascular risk reduction. Body weight, body-mass-index (BMI), waist circumference, waist-to-height ratio (WHtR), and a body shape index (ABSI) were measured at baseline and annual follow-up visits. COVID-19 was ascertained by an independent Event Committee until 31 December 2021. Cox regression models were fitted to evaluate the risk of COVID-19 incidence based on baseline adiposity parameters measured 5–6 years before the pandemic and their changes at the visit prior to censoring. Results At the time of censoring, 653 incident COVID-19 cases occurred. Higher baseline body weight, BMI, waist circumference, and WHtR were associated with increased COVID-19 risk. During the follow-up, every unit increase in body weight (HRadj (95%CI): 1.01 (1.00, 1.03)) and BMI (HRadj: 1.04 (1.003, 1.08)) was associated with increased COVID-19 risk. Conclusions In older adults with overweight/obesity, clinically significant weight loss may protect against COVID-19. Trial registration This study is registered at the International Standard Randomized Controlled Trial (ISRCT; http://www.isrctn.com/ISRCTN89898870 ).

Abstract Ectopic pregnancy (EP) is associated with high maternal morbidity and mortality. Ultrasonography is the only dependable diagnostic tool for confirming an ectopic pregnancy. In view of inadequate early detection methods, women suffer from a high-life risk due to the severity of EP. Early detection of EP using pathological/molecular markers will possibly improve clinical diagnosis and patient management. Salivary proteins contain potential biomarkers for diagnosing and detecting various physiological and/or pathological conditions. Therefore, the present investigation was designed to explore the salivary proteome with special reference to EP. Gel-based protein separation was performed on saliva, followed by identification of proteins using Liquid Chromatography-Tandem Mass Spectrometry (LC–MS/MS). Totally, 326 proteins were identified in the salivary samples, among which 101 were found to be specific for ruptured ectopic pregnancy (EPR). Reactome analysis revealed innate immune system, neutrophil degranulation, cell surface interactions at the vascular wall, and FCERI-mediated NF-kB activation as the major pathways to which the salivary proteins identified during EPR are associated. Glutathione-S-transferase omega-1 (GSTO1) is specific for EPR and has been reported as a candidate biomarker in the serum of EPR patients. Therefore, saliva would be a potential source of diagnostic non-invasive protein biomarker(s) for EP. Intensive investigation on the salivary proteins specific to EP can potentially lead to setting up of a panel of candidate biomarkers and developing a non-invasive protein-based diagnostic kit.

Retinitis pigmentosa (RP), a heterogenous group of inherited retinal disorder, causes slow progressive vision loss with no effective treatments available. Mutations in the rhodopsin gene (RHO) account for ~25% cases of autosomal dominant RP (adRP). In this study, we describe the disease characteristics of the first-ever reported mono-allelic copy number variation (CNV) in RHO as a novel cause of adRP. We (a) show advanced retinal degeneration in a male patient (68 years of age) harboring four transcriptionally active intact copies of rhodopsin, (b) recapitulated the clinical phenotypes using retinal organoids, and (c) assessed the utilization of a small molecule, Photoregulin3 (PR3), as a clinically viable strategy to target and modify disease progression in RP patients associated with RHO-CNV. Patient retinal organoids showed photoreceptors dysgenesis, with rod photoreceptors displaying stunted outer segments with occasional elongated cilia-like projections (microscopy); increased RHO mRNA expression (quantitative real-time PCR [qRT-PCR] and bulk RNA sequencing); and elevated levels and mislocalization of rhodopsin protein (RHO) within the cell body of rod photoreceptors (western blotting and immunohistochemistry) over the extended (300 days) culture time period when compared against control organoids. Lastly, we utilized PR3 to target NR2E3, an upstream regulator of RHO, to alter RHO expression and observed a partial rescue of RHO protein localization from the cell body to the inner/outer segments of rod photoreceptors in patient organoids. These results provide a proof-of-principle for personalized medicine and suggest that RHO expression requires precise control. Taken together, this study supports the clinical data indicating that RHO-CNV associated adRPdevelops as a result of protein overexpression, thereby overloading the photoreceptor post-translational modification machinery.

Oncocytic carcinomas are rare malignant salivary gland tumor most commonly involving major salivary glands. They are epithelial tumors defined by the presence of abundant eosinophilic granular cytoplasm due to high mitochondrial content. Although most commonly identified in the major salivary glands it can also arise in minor salivary gland tissue in the head and neck regions including paranasal sinuses, nasolacrimal system, and nasopharynx. Here we report a case of oncocytic carcinoma thought to be arising in a minor salivary gland of nasal cavity in a 65 year old gentleman managed by endoscopic resection and adjuvant radiotherapy.

Centric Relation (CR) and Centric Occlusion (CO) are commonly used references in clinical dentistry. CR represents bone-tobone contact independent of teeth contact, while CO refers to occlusal contact between the maxillary and mandibular teeth. The coincidence or discrepancy between CR and CO has been the subject of many challenging debates. These reference positions of the mandible typically do not align in natural dentition. When a discrepancy exists, the mandible slides from CR to CO to stabilise the occlusion. Such functional interferences can result in occlusal wear, excessive tooth mobility, poor periodontal health, temporomandibular joint dysfunction, and myofascial pain. Orthodontists who follow gnathologic occlusion recommend using study models mounted on articulators in the CR position to coincide with the treatment of CR-ICP (Maximal Intercuspal Position - ICP). Generally, a discrepancy of 1.5 mm in the vertical and horizontal planes and 0.5 mm in the transverse plane is considered acceptable as it does not cause significant pathology. In the present article authors, we discuss the discrepancy between CR and CO, the dentofacial characteristics of patients with CR-CO discrepancy, its relationship with TMJ dysfunction, and its impact on cephalometric analysis and deprogramming. A clear understanding of CO and CR allows clinicians to approach treatment planning in an organised manner.

Background: Neuroendocrine tumors (NET) are a rare group of epithelial neoplasms present in the gastrointestinal tract (GI) (67.5%) and bronchopulmonary tree (25.3–30%), and in 15% of cases, their primary sites cannot be identified. Although endoscopic screening, improvements in pathological techniques, and early detection have shown improvements in NET survival rates, the prognosis of advanced, metastatic, and poorly differentiated NET is very poor. In this study, we aimed to evaluate the effect of gastrointestinal and pancreatic (GEPs) NETs’ grade on overall survival. Method: We searched observational studies describing the overall survival or prognostic factors of primary GEP NETs from May 2011–May 2021 following the PRISMA guidelines. Studies describing the effect of primary grade 3 GEP NETs on overall survival were included. A meta-analysis was performed, and a pooled hazard ratio and their 95% confidence interval (95% CI) were obtained. Forest plots were created using random effects models and a sensitivity analysis was performed to account for the heterogeneity. Results: Seven studies with 7692 confirmed patients were included. In our meta-analysis, grade 3 GEP NETs were associated with higher odds of poor survival (pooled HR: 2.73; 95% CI: 1.36–5.47; p = 0.005), with a 92% heterogeneity between studies (p < 0.0001). To account for this heterogeneity, a sensitivity analysis was performed by removing two outlying studies (Fathi et al. and Foubert et al.) on funnel plots. The results after the sensitivity analysis did not change and still showed a significant association of grade 3 with a poor survival (pooled HR: 4.53; 95% CI: 3.54–5.78; p < 0.00001), with no heterogeneity between studies (p = 0.72; I2 = 0%). Conclusions: Our meta-analysis found that grade 3 GEP NETs are associated with poor survival and additional future studies are needed to identify other risk factors associated with poor survival in GEP NETs to improve their mortality.

OBJECTIVES/GOALS: Changes associated with placental vasculature contribute to the progression of gestational hypertensive disease preeclampsia. Caudal-type homeobox-2 (CDX2) regulates trophoblast stem cell differentiation. In this study, we investigate the role of placental CDX2 cells in healthy pregnancy and in conditions of preeclampsia. METHODS/STUDY POPULATION: To understand the role of CDX2 cells, here we collected human placenta samples from the prospectively enrolled cohort and also the de-identified cohort (n=84). We studied CDX2 distribution, and function using a lentivirus-based approach. We studied the CDX2 expression and functional differences using transcriptomics and examined the function in invasion and vasculogenesis in the presence and absence of the new target genes we have discovered in our study. RESULTS/ANTICIPATED RESULTS: Analysis of healthy human placenta samples showed that CDX2-expressing cells were present in fetal chorionic regions and are associated with HLA-G and cytokeratin-7 confirming their trophoblast identity. CDX2 cells demonstrated the potential to form a capillary network akin to endothelial cells. Placental samples from healthy (n=6) and preeclampsia (n=8) patients revealed higher levels of CDX2 expression in preeclampsia. Within preeclampsia CDX2 cells, Natriuretic peptide receptor 1 (NPR1), RET oncogene, and Homeobox D10 (HOXD10) were significantly differentially regulated, including a unique long-non-coding anti-sense RNA (KANSL1-AS1) that affected the function of CDX2 and trophoblast cells in invasion and normal vasculogenesis. DISCUSSION/SIGNIFICANCE: In sum, based on these observations, the present study postulates that CDX2 cells present in a healthy human placenta may serve as a prospective cellular reservoir for angiogenesis. Conversely, altered gene programs within CDX2 cells cause aberrant vascular function that could contribute to the progression of preeclampsia.

Background Many girls experience physical and emotional symptoms during and immediately before their menstrual period. This study surveyed adolescent schoolgirls in East Delhi, India to determine where they receive education regarding menstruation and the menstrual cycle. We recorded who they are most likely to turn to for advice on menstrual issues; documented the most common menstrual problems they face; and what formal education they receive, with the aim of identifying the most common menstrual problems and their associated factors.

BackgroundIn order for low and middle income countries (LMIC) to transition to Human Papilloma Virus (HPV) test based cervical cancer screening, a greater understanding of how to implement these evidence based interventions (EBI) among vulnerable populations is needed. This paper documents outcomes of an implementation research on HPV screening among women from tribal, rural, urban slum settings in India.MethodsA mixed-method, pragmatic, quasi-experimental trial design was used. HPV screening on self-collected cervical samples was offered to women aged 30-60 years. Implementation strategies were 1) Assessment of contextual factors using both qualitative and quantitative methods like key informant interviews (KII), focus group discussions (FGDs), pre-post population sample surveys, capacity assessment of participating departments 2) enhancing provider capacity through training workshops, access to HPV testing facility, colposcopy, thermal ablation/cryotherapy at the primary health care centers 3) community engagement, counselling for self-sampling and triage process by frontline health care workers (HCWs). Outcomes were assessed using the RE-AIM (Reach, Effectiveness, adoption, implementation, maintenance) framework.ResultsScreening rate in 8 months' of study was 31.0%, 26.7%, 32.9%, prevalence of oncogenic HPV was 12.1%, 3.1%, 5.5%, compliance to triage was 53.6%, 45.5%, 84.6% in tribal, urban slum, rural sites respectively. Pre-cancer among triage compliant HPV positive women was 13.6% in tribal, 4% in rural and 0% among urban slum women. Unique challenges faced in the tribal setting led to programme adaptations like increasing honoraria of community health workers for late-evening work and recalling HPV positive women for colposcopy by nurses, thermal ablation by gynaecologist at the outreach camp site.ConclusionsSelf-collection of samples combined with HCW led community engagement activities, flexible triage processes and strengthening of health system showed an acceptable screening rate and better compliance to triage, highlighting the importance of identifying the barriers and developing strategies suitable for the setting.Trial registrationCTRI/2021/09/036130.

In the urban scene segmentation, the "image-to-image translation issue" refers to the fundamental task of transforming input images into meaningful segmentation maps, which essentially involves translating the visual information present in the input image into semantic labels for different classes. When this translation process is inaccurate or incomplete, it can lead to failed segmentation results where the model struggles to correctly classify pixels into the appropriate semantic categories. The study proposed a conditional Generative Adversarial Network (cGAN), for creating high-resolution urban maps from satellite images. The method combines semantic and spatial data using cGAN framework to produce realistic urban scenes while maintaining crucial details. To assess the performance of the proposed method, extensive experiments are performed on benchmark datasets, the ISPRS Potsdam and Vaihingen datasets. Intersection over Union (IoU) and Pixel Accuracy are two quantitative metrics used to evaluate the segmentation accuracy of the produced maps. The proposed method outperforms traditional methods with an IoU of 87% and a Pixel Accuracy of 93%. The experimental findings show that the suggested cGAN-based method performs better than traditional techniques, attaining better segmentation accuracy and generating better urban maps with finely detailed information. The suggested approach provides a framework for resolving the image-to-image translation difficulties in urban scene segmentation, demonstrating the potential of cGANs for producing excellent urban maps from satellite data.

Diabetic renal injury is a microvascular complication associated with inflammation and oxidative stress, culminating in renal dysfunction. Conventionally, it is treated with hypoglycemic agents to address metabolic perturbations. However, the way to mitigate immunological, inflammation, and oxidative stress have seldom been studied. Hence, in the present study, the nephroprotective role of immunosuppressive and anti-inflammatory drugs, mycophenolate mofetil (MMF) in combination with the oral hypoglycemic agent glibenclamide, on streptozotocin (STZ)- induced diabetic renal damage was studied. Bodyweight, fasting blood glucose, and glycosylated hemoglobin levels were altered in the diabetic rats. Furthermore, renal injury was indicated by abnormal levels of urinary protein and creatinine and serum markers of renal function in diabetic rats. Hyperglycemia-induced oxidative stress and inflammation were also observed in the diabetic rats. The combination of MMF and glibenclamide treatment significantly attenuated the abnormal effects of hyperglycemia, oxidative stress, and inflammation-induced renal injury in diabetic rats. Histopathological studies confirmed the nephroprotective role of MMF and glibenclamide by reversing renal injury in diabetic rats. The present study suggests that MMF and glibenclamide have a protective role in STZ-induced diabetic renal damage.

Background and Aim: The suspicion of obstructive sleep apnea (OSA) has serious implications for an anesthesiologist perioperatively. This study examines the association between the modified Mallampati scoring (MMS) and the STOP-BANG score in a community setting. Materials and Methods: This was a community-based cross-sectional survey among 702 adults in a rural area in South India. Airway assessment using MMS and assessment for OSA using STOP-BANG scoring were made by junior doctors trained in the anesthesia department. The association between the Mallampati score and the STOP-BANG score was tested by the Chi-square test using the SPSS version 21. Results: Among the community-dwelling adults, 19.2% had a score of 1, 27.9% had a score of 2, 31.3% had a score of 3, and 21.5% had a score of 4 on the Mallampati scoring system. Using the STOP-BANG score for risk stratification of OSA, 29.2% had an intermediate risk and 5.8% had a high risk for OSA. Higher Mallampati Grades (3 and 4) were a significant risk factor for OSA (61.8% vs. 38.2%, P = 0.001). Conclusion: A higher Mallampati class (3 or 4) is significantly associated with an intermediate-to high risk for OSA as assessed using STOP-BANG score criteria. Therefore, we suggest using the MMS not only as an airway screening tool but also as a predictor of OSA, in view of the rising obesity rates in India.

Background: The end tuberculosis (TB) strategy emphasises early and correct diagnosis of TB. Chest X-ray (CXR) is an essential tool for triaging and screening TB and confirming the diagnosis in fewer situations. Greater Chennai Corporation (GCC) implemented Mobile Diagnostic Units (MDUs) retrofitted with X-rays with artificial intelligence (AI). Objectives: The study's objectives were to determine the X-ray triaging performance in MDU vans using AI tools in GCC, Tamil Nadu. Materials and Methods: AI is to increase access to quality TB screening diagnostics in high-risk locations. Genki AI-powered Public Health Screening Solution from Deeptek used for TB triaging after uploading CXR images from MDU. X-ray has been uploaded in AI software once taken, and the results were available immediately after uploading. The radiologist reports helped to take further courses of action. Results: A total of 79,462 CXR was taken from April 2019 to April 2022 from 7 MDU vans. Amongst 3.4% were identified as suggestive of TB, 1.4% old TB, 0.89% COVID (from 2020) and 7.2% other chest abnormalities. The sensitivity of CXR-AI was 0.98 (95% confidence interval [CI]: 0.97, 0.98), and the specificity was 0.96 (95% CI: 0.96, 0.97). Conclusion: AI helps in faster triage for further public health action and eliminates the challenges of the availability of functional X-rays, interpretation and reporting.

BackgroundPeople with disabilities experience numerous barriers to being physically active, such as transportation issues, a lack of trained exercise professionals who understand disabilities, and facility access. The use of a virtual exercise platform (VEP) may provide an alternative and limit certain barriers. ObjectiveThe aim of this mixed method study was to evaluate user interaction (effectiveness, efficiency, and satisfaction), the strengths and weaknesses of the user interface, and the user experience with a VEP. MethodsParticipants were recruited from a community fitness facility that offers programs for people with disabilities. Inclusion criteria were being older than 18 years, fluent in English, and availability of internet access. Features of the VEP included articles, prerecorded videos, live Zoom classes, web-based class registration, weekly progress tracking, incentives, and surveys. A one-on-one Zoom session was scheduled with each participant, during which they completed certain tasks: (1) create an account or login, (2) register for class, (3) join class, (4) add to calendar, and (5) complete surveys. As participants completed tasks, quantitative observations (time on task, task success, rate of task completion, and number of errors by users, which determined task difficulty), qualitative observations were made and interviews were conducted at the end of the session. The “concurrent think-aloud” method was encouraged by the moderator to gauge participants’ thoughts as they worked through testing. Participants also completed the System Usability Scale (SUS) and Questionnaire for User Interface Satisfaction (QUIS). ResultsA total of 5 people with disabilities (3 male, 2 female), aged 36-78 (mean 54) years, with education levels from high school to PhD, were recruited. Devices used for testing included a laptop (n=3), a Chromebook (n=1), and a desktop (n=1). All participants completed tasks #1 and #2 without errors but could not complete task #4. One participant completed task #5 with difficulty and another completed task #3 with difficulty. The average time to complete each task was: (1) 82 seconds (55-110), (2) 11 seconds (4-21), (3) 9 seconds (5-27), and (4) 921.5 seconds (840-958). The mean SUS score was 86.5/100, and the mean user QUIS score was 8.08 out of 10. Qualitative observations indicated that the system was simple, user-friendly, and accessible. ConclusionsPeople with disabilities reported high usability and user satisfaction with the web-based exercise platform, and the system appears to be an efficient and effective physical activity option.

Cervical squamous cell carcinoma, more commonly cervical cancer, is the fourth common cancer among women worldwide with substantial burden of disease, and less-invasive, reliable and effective methods for its prognosis are necessary today. Micro-RNAs are increasingly recognized as viable alternative biomarkers for direct diagnosis and prognosis of disease conditions, including various cancers. In this work, we addressed the problem of systematically developing an miRNA-based nomogram for the reliable prognosis of cervical cancer. Towards this, we preprocessed public-domain miRNA -omics data from cervical cancer patients, and applied a cascade of filters in the following sequence: (i) differential expression criteria with respect to controls; (ii) significance with univariate survival analysis; (iii) passage through dimensionality reduction algorithms; and (iv) stepwise backward selection with multivariate Cox modeling. This workflow yielded a compact prognostic DEmiR signature of three miRNAs, namely hsa-miR-625-5p, hs-miR-95-3p, and hsa-miR-330-3p, which were used to construct a risk-score model for the classification of cervical cancer patients into high-risk and low-risk groups. The risk-score model was subjected to evaluation on an unseen test dataset, yielding a one-year AUROC of 0.84 and five-year AUROC of 0.71. The model was validated on an out-of-domain, external dataset yielding significantly worse prognosis for high-risk patients. The risk-score was combined with significant features of the clinical profile to establish a predictive prognostic nomogram. Both the miRNA-based risk score model and the integrated nomogram are freely available for academic and not-for-profit use at CESCProg, a web-app (https://apalania.shinyapps.io/cescprog).

Background: Several biomarkers have been thrown into limelight to be an early predictor of Acute Kidney Injury (AKI). Aim and Objectives:To establish the relation between Urinary IL-18 (UIL-18) and AKI and the reliability for use as early markers in the detection of AKI compared to pre-existing surrogate markers for kidney injury such as creatinine and urea. Material and Methods: This is a cross-sectional study which was conducted at Gandhi Hospital, Hyderabad. Study was conducted for duration between 2018-2020 among the patients presenting with the history of snake bite. Total 80 patients with history of snake bite were included in present study after obtaining the informed consent from them all. The patients were followed up and the data were collected in proforma. Results: Mean age of the patients in present study was 39.32 ± 8.95 years of age, with male preponderance. Majority of the patients came with history of viper bite (45%) followed with unknown snake bite (30%), and (12.5%) each with cobra and krait bite. At 12 hr of admission, IL-18 showed a significant higher mean among AKI patients compared to urea and creatinine which were within the normal range. At 48 hr, all the three variables were significantly higher in AKI patients compared to patients without AKI. The cut-off of the 35.31 pg/ml of the UIL-18 was assessed to predict the AKI at 12 hr of follow-up with sensitivity of 48% and specificity of 93.3%. Conclusion:IL-18 helps to predict the occurrence of the AKI among the patients with snake bite when the urea and serum creatinine levels are well within the normal range at the 12 hr of the admission. There is a strong strength of association between the blood urea and serum creatinine with the UIL-18.

Background The association of the linear dimensions of the inferior turbinate hypertrophy with nasal septal deviation has been studied recently. However, the volumetric dimensions provide a more accurate status of the turbinate hypertrophy compared to linear measurements. The aim of this study was to analyze the association of inferior nasal turbinate volume with the degree of nasal septal deviation (NSD). Methods A retrospective evaluation of the cone beam computed tomography (CBCT) scans of 412 patients was carried out to obtain 150 scans which were included in the study. The scans were categorized into three groups. Group 1 comprised of 50 scans of patients with no inferior turbinate hypertrophy (ITH) and no nasal septal deviation. Group 2 comprised of 50 scans of patients with ITH and no NSD; whereas Group 3 included 50 scans of patients with ITH and NSD. The total turbinate volume of inferior turbinates (bilateral) were determined by using Vesalius 3D software (PS-Medtech, Amsterdam, Netherlands). Results The intraclass correlation coefficient (ICC) between the volumetric estimations performed by the two radiologists was 0.82. There were no significant age and gender related changes in the total turbinate volume. Patients in Group 3 had significantly higher (p = 0.001) total turbinate volume compared to Group 2 and Group 1. There was a positive and significant correlation (r = 0.52, p = 0.002) between the degree of septal deviation and total turbinate volume. When the total turbinate volume of the patients with different types of septal deviation was compared in Group 3, a statistically significant difference (p = 0.001) was observed. Regression analysis revealed that the septal deviation angle (SDA) (p = 0.001) had a relationship with total turbinate volume. From the results of the study we can conclude that the total turbinate volume is higher in patients with nasal septal deviation. It can also be concluded that the septal deviation angle has a positive correlation with total turbinate volume. The data obtained from the study can be useful in post-surgical follow up and evaluation of patients with nasal septal deviation and hypertrophied inferior nasal turbinate.

Cancer, which killed ten million people in 2020, is expected to become the world’s leading health problem and financial burden. Despite the development of effective therapeutic approaches, cancer-related deaths have increased by 25.4% in the last ten years. Current therapies promote apoptosis and oxidative stress DNA damage and inhibit inflammatory mediators and angiogenesis from providing temporary relief. Thioredoxin-binding protein (TXNIP) causes oxidative stress by inhibiting the function of the thioredoxin system. It is an important regulator of many redox-related signal transduction pathways in cells. In cancer cells, it functions as a tumor suppressor protein that inhibits cell proliferation. In addition, TXNIP levels in hemocytes increased after immune stimulation, suggesting that TXNIP plays an important role in immunity. Several studies have provided experimental evidence for the immune modulatory role of TXNIP in cancer impediments. TXNIP also has the potential to act against immune cells in cancer by mediating the JAK-STAT, MAPK, and PI3K/Akt pathways. To date, therapies targeting TXNIP in cancer are still under investigation. This review highlights the role of TXNIP in preventing cancer, as well as recent reports describing its functions in various immune cells, signaling pathways, and promoting action against cancer.

Candida albicans is a commensal fungus that asymptomatically colonizes the skin and mucosa of 60% of healthy individuals. Breaches in the cutaneous and mucosal barriers trigger candidiasis that ranges from asymptomatic candidemia and mucosal infections to fulminant sepsis with 70% mortality rates. Fungi influence at least several diseases, in part by mechanisms such as the production of pro-carcinogenic agents, molecular mimicking, and triggering of the inflammation cascade. These processes impact the interactions among human pathogenic and resident fungi, the bacteriome in various organs/tissues, and the host immune system, dictating the outcomes of invasive infections, metabolic diseases, and cancer. Although mechanistic investigations are at stages of infancy, recent studies have advanced our understanding of host–fungal interactions, their role in immune homeostasis, and their associated pathologies. This review summarizes the role of C. albicans and other opportunistic fungi, specifically their association with various diseases, providing a glimpse at the recent developments and our current knowledge in the context of inflammatory-bowel disease (IBD), cancers, and COVID-19. Two of the most common human diseases where fungal interactions have been previously well-studied are cancer and IBD. Here we also discuss the emerging role of fungi in the ongoing and evolving pandemic of COVID-19, as it is relevant to current health affairs.

Cancer stem cells (CSCs), which have the capacity to self-renew and differentiate into various types of cells, are notorious for their roles in tumor initiation, metastasis, and therapy resistance. Thus, underlying mechanisms for their survival provide key insights into developing effective therapeutic strategies. A more recent focus has been on exosomes that play a role in transmitting information between CSCs and non-CSCs, resulting in activating CSCs for cancer progression and modulating their surrounding microenvironment. The field of CSC-derived exosomes (CSCEXs) for different types of cancer is still under exploration. A deeper understanding and further investigation into CSCEXs’ roles in tumorigenicity and the identification of novel exosomal components are necessary for engineering exosomes for the treatment of cancer. Here, we review the features of CSCEXs, including surface markers, cargo, and biological or physiological functions. Further, reports on the immunomodulatory effects of CSCEXs are summarized, and exosome engineering for CSC-targeting is also discussed.

RNA granules and exosomes produced by tumour cells under various stresses in the microenvironment act as critical determinants of cell survival by promoting angiogenesis, cancer metastasis, chemoresistance, and immunosuppression. Meanwhile, developmental cancer/testis (CT) antigens that are normally sequestered in male germ cells of the testes, but which are overexpressed in malignant tumour cells, can function as tumour antigens triggering immune responses. As CT antigens are potential vaccine candidates for use in cancer immunotherapy, they could be targeted together with crosstalk between stress granules, exosomes, and immune cells for a synergistic effect. In this review, we describe the effects of exosomes and exosomal components presented to the recipient cells under different types of stresses on immune cells and cancer progression. Furthermore, we discuss their significance for cancer immunity, as well as the outlook for their future application.