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Byline: Sandipan. Dhar, Divya. Gupta, Apurba. Ghosh Sir, A 10-month-old boy was referred because of greenish pigmentation on his deciduous teeth from the time of eruption. Intra-oral examination revealed yellowish-green [...]

PURPOSE Patients with well-differentiated, low-grade metastatic neuroendocrine neoplasms (NENs) usually have a longmedian survival and require complex, expensive care over many years atmultidisciplinary centers. The cost burden for patients and institutions serves as a barrier to care. Understanding the drivers of these costs and whether intense monitoring adds value will help to optimize value-based care. METHODS We adapted the cost of care per patient per day (CCPD) validated methodology to measure cost while accounting for varying follow-up duration. We queried the Stanford NEN Database, which aggregates data from the electronic health record and other electronic sources, to study patients with metastatic NENs receiving regular care at Stanford. Current Procedural Terminology codes for services incurred during the monitoring period for each patient were mapped to the corresponding cost conversion factor and date in the Medicare fee schedule. RESULTS Two hundred two patients between 2010 and 2017 were studied with a mean CCPD of $119.11 in US dollars (USD); NEN-specific systemic therapy made up 55% of this cost. Somatostatin analogs were the costliest systemic therapy. Systemic therapy was the driver of cost differences among patients with various primary tumor types, stage of disease, tumor differentiation and grade, and functional hormone status. Patients in the most expensive CCPD group did not have a significant survival benefit (P 5 .66). CONCLUSION The CCPD methodology was effective in studying cancer care value in NENs. Systemic therapy, specifically somatostatin analogs, was the primary driver of cost, and intense monitoring and higher-cost care did not improve survival outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Oral lesions are common occurrences in day-to-day clinical scenarios. The accurate diagnosis and appropriate therapeutic intervention are crucial aspects of delivering effective oral health care. It is well-established that the appearance of a lesion itself serves as key diagnostic data, particularly in cases of clinical dermatology. The primary objective of this study is to assess the concordance between clinical evaluations and histopathological diagnoses of pathologies in the oral cavity. Materials and Methods: The questionnaire comprised 10 questions based on clinical photographs, ensuring patient anonymity by avoiding the sharing of identifiable information. The questions aimed to elicit a comprehensive diagnosis for various categories such as odontogenic lesions, salivary gland origins, infectious lesions, and precancerous lesions. Additionally, questions regarding appropriate investigations for each type of lesion were included. The questionnaire was distributed to a diverse group of participants, including undergraduate students (third and final year), interns, postgraduate students, and faculty members from various departments. Results: The present cross-sectional study involved 160 participants, consisting of 71 (44%) undergraduates (UGs), 32 (20%) postgraduates (PGs), 30 (19%) interns, and 27 (17%) faculty members. A total of 10 clinical cases were evaluated. Conclusion: Clinicians should remain focused on the varied causative features and potential diagnostic possibilities, which may necessitate the collection of additional detailed information and a thorough clinical assessment of the patient. In instances where the clinical diagnosis does not align with the etiological factors or the results of laboratory or radiological investigations, the pathology (biopsy report) serves as the ultimate diagnostic tool. [ABSTRACT FROM AUTHOR]

Introduction: Cardiac allograft vasculopathy (CAV) limits long‐term survival in heart transplant (HTx) recipients. The use of biomarkers in CAV surveillance has been studied, but none are used in clinical practice. The predictive value of high‐sensitivity troponin I (hsTnI) has not been extensively investigated in HTx recipients. Methods: HTx patients undergoing surveillance coronary angiograms and enrolled in the Emory Cardiovascular Biobank had plasma hsTnI measured. CAV grade was assessed using ISHLT nomenclature. Multivariable cumulative link mixed modeling was performed to determine association between hsTnI level and CAV grade. Patients were followed for adverse outcomes over a median 10‐year period. Kaplan‐Meier survival analysis and Cox proportional hazard modeling were performed. Results: Three hundred and seventy‐two angiograms were analyzed in 156 patients at a median 8.9 years after transplant. hsTnI levels were positively correlated with concurrent CAV grade after adjustment for age, age at transplant, sex, BMI, hypertension, diabetes, hyperlipidemia, estimated glomerular filtration rate, and history of acute cellular rejection (p =.016). In an adjusted Cox proportional hazard model, initial hsTnI level above the median (4.9 pg/mL) remained a predictor of re‐transplantation or death (hazard ratio 1.82; 95% confidence interval 1.16–2.90; p =.01). Conclusion: An elevated hsTnI level reflects severity of CAV and is associated with poor long‐term outcomes in patients with HTx. [ABSTRACT FROM AUTHOR]

Climate action plans are essential for climate mitigation and adaptation as well as to achieve climate and development goals like the Paris Agreement and the Sustainable Development Goals (SDGs). However, the development and implementation of climate action plans at multiple levels involve decision-making processes. In this article, we examine the barriers and opportunities to decision-making in climate action plans for adaptation at three different governance levels in India: national, sub-national and local. Through a literature review and analysis of case studies, we find that lack of usable climate information, institutional weaknesses and capacity of actors are critical barriers to decision-making at all three levels in India. We recommend that providing usable and accessible climate information, creating evidence and knowledge on adaptation, strengthening the science-policy interface and institutional mechanisms, as well as building the capacities of actors can contribute to better decision-making and achieving targeted climate action plans and SDGs. [ABSTRACT FROM AUTHOR]

Plant glutathione S-transferases (GSTs) are integral to normal plant metabolism and biotic and abiotic stress tolerance. The GST gene family has been characterized in diverse plant species using molecular biology and bioinformatics approaches. In the current study, in silico analysis identified 44 GSTs in Vigna radiata. Of the total 44 GSTs identified, chromosomal locations of 31 GSTs were confirmed. The pI value of GST proteins ranged from 5.10 to 9.40. The predicted molecular weights ranged from 13.12 to 50 kDa. Subcellular localization analysis revealed that all GSTs were predominantly localized in the cytoplasm. The active site amino acids were confirmed to be serine in tau, phi, theta, zeta, and TCHQD; cysteine in lambda, DHAR, and omega; and tyrosine in EF1G. The gene architecture conformed to the two-exon/one-intron and three-exon/two-intron organization in the case of tau and phi classes, respectively. MEME analysis identified 10 significantly conserved motifs with the width of 8-50 amino acids. The motifs identified were either specific to a specific GST class or were shared by multiple GST classes. The results of the current study will be of potential importance in the characterization of the GST gene family in V. radiata, an economically important leguminous crop. Key words: bioinformatics, phi and tau glutathione S-transferases, LegumeInfo, plant stress metabolism, whole-genome sequencing. Chez les plantes, les glutathion S-transférases font partie intégrante du métabolisme normal de la plante, ainsi que de la résistance aux stress biotiques et abiotiques. La famille des gènes GST a été caractérisée chez diverses espèces végétales à l'aide d'outils de la biologie moléculaire et de la bioinformatique. Dans le présent travail, des analyses in silico ont permis d'identifier 44 GST chez le Vigna radiata. Des 44 GST identifiés, la position chromosomique pour 31 d'entre eux a été confirmée. Le pI de ces protéines GST variait entre 5,10 et 9,40. La masse moléculaire prédite variait entre 13,12 et 50 kDa. Une analyse de la localisation subcellulaire a révélé que toutes les GST étaient localisées principalement dans le cytoplasme. Les acides aminés du site actif ont été confirmés comme étant une sérine chez les classes tau, phi, thêta, zêta et TCHQD; une cystéine chez les classes lambda, DHAR et oméga; et une tyrosine chez les EF1G. L'architecture génique était soit de deux-exons/un-intron ou trois-exons/deux-introns chez les classes tau et phi, respectivement. Une analyse MEME a identifié 10 motifs affichant une conservation significative dont la longueur variait entre 8 et 50 acides aminés. Les motifs identifiés étaient soit spécifiques d'une classe ou partagés au sein de plusieurs classes de GST. Les résultats de la présente étude seront potentiellement importants pour la caractérisation de la famille des GST chez le V. radiata, une importante espèce de légumineuse cultivée. [Traduit par la Rédaction] Mots-clés : bioinformatique, GST de classes phi et tau, Legumelnfo, métabolisme du stress, séquençage génomique complet., Introduction Vigna radiata (L.) R. Wilczek, commonly known as mung bean, is a widely cultivated warm-season legume species, grown extensively in tropical and subtropical regions of the world. It belongs [...]