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Abstract Purpose This study aims to investigate the relationship between institutional support, green export strategies, and export performance among small and medium-sized enterprises (SMEs) operating in various sustainability-focused sectors. Design/methodology/approach Utilising a quantitative approach, structural equation modelling (SEM) is employed to analyse data collected from 227 SMEs in sectors including sustainable agriculture, eco-friendly consumer goods, special woven fabrics, organic food and beverages, green fashion and textiles, and health and wellness. Findings The study reveals a significant association between institutional support and key aspects of green export readiness, green export activities, and green innovation. Moreover, mediating roles of green innovation, green export readiness, and green export activities are identified, elucidating their influence on the relationship between institutional support and green export strategy. Importantly, effective green export strategies positively impact export performance, enhancing SMEs’ competitive positioning in global markets. Originality This research contributes novel insights into SMEs’ engagement in green export, shedding light on the critical role of institutional support and the mediating mechanisms that facilitate the adoption of successful green export strategies. Research limitations One limitation of this study is the cross-sectional nature of the data, which restricts the ability to establish causal relationships. Future research could explore longitudinal data to further investigate the dynamics between institutional support, green export strategies, and export performance. Practical implications The findings provide valuable insights for SMEs seeking to enhance their sustainability-driven international business practices. Managers can leverage institutional support and focus on developing green export strategies to improve their export performance and competitiveness in global markets. Social implications By embracing green export strategies, SMEs can contribute to sustainable development goals and promote environmentally responsible practices in the global marketplace, thereby fostering positive social and environmental impacts.

Background: Endodontic treatment aims to preserve compromised teeth by eliminating microorganisms from the root canal system. Persistent root canal infections, especially those involving Enterococcus faecalis (E. faecalis), can lead to treatment failure. This study evaluates the antimicrobial efficacy of both traditional and novel intracanal medicaments against E. faecalis. Materials and Methods: The study employed an in-vitro design to assess the antimicrobial efficacy of various intracanal medicament combinations against E. faecalis (ATCC 29212). The medicaments tested included 2% Chlorhexidine (CHX) combined with Alexidine, Calcium Hydroxide (Ca(OH)2), Metronidazole, and Silver Nanoparticles (AgNPs). Antimicrobial activity was determined using the disc diffusion method, and the zone of inhibition (ZOI) was measured at 24, 48, and 72 hours. Results: Group 1 (2% CHX + Alexidine) and Group 5 (2% CHX + Ca(OH)2) showed the highest initial antimicrobial efficacy at 24 hours, with mean ZOIs of 18.16 mm and 18.09 mm, respectively. At 48 and 72 hours, Group 4 (2% CHX + AgNPs) exhibited the highest efficacy with a mean ZOI of 16.17 mm. Statistical analysis showed significant differences between groups at all time intervals (P < 0.05). Conclusion: The combination of traditional and novel intracanal medicaments, specifically CHX with Alexidine and CHX with AgNPs, significantly enhanced antimicrobial efficacy against E. faecalis. The combination of CHX and Alexidine demonstrated the highest initial activity, while CHX and AgNPs provided sustained antimicrobial effects.

Abstract The present study aimed at exploring to explore the penoxsulam toxicity and protective effects of blueberry extract in roots of Allium cepa L. The effective concentration (EC50) of penoxsulam was determined at 20 µg/L by the root growth inhibition test as the concentration reducing the root length by 50%. The bulbs of A. cepa L. were treated with tap water, blueberry extracts (25 and 50 mg/L), penoxsulam (20 µg/L) and combination of blueberry extracts (25 and 50 mg/L) with penoxsulam (20 µg/L) for 96 h. The results revealed that penoxsulam exposure inhibited cell division, rooting percentage, growth rate, root length and weight gain in the roots of A. cepa L. In addition, it induced chromosomal anomalies such as sticky chromosome, fragment, unequal distribution of chromatin, bridge, vagrant chromosome and c-mitosis and DNA strand breaks. Further, penoxsulam treatment enhanced malondialdehyde content and SOD, CAT and GR antioxidant enzyme activities. Molecular docking results supported the up-regulation of antioxidant enzyme SOD, CAT and GR. Against all these toxicity, blueberry extracts reduced penoxsulam toxicity in a concentration-dependent manner. The highest amount of recovery for cytological, morphological and oxidative stress parameters was observed when using blueberry extract at a concentration of 50 mg/L. In addition, blueberry extracts application showed a positive correlation with weight gain, root length, mitotic index and rooting percentage whereas a negative correlation with micronucleus formation, DNA damage, chromosomal aberrations, antioxidant enzymes activities and lipid peroxidation indicating its protecting effects. As a result, it has been seen that the blueberry extract can tolerate all these toxic effects of penoxsulam depending on the concentration, and it has been understood that it is a good protective natural product against such chemical exposures.

Salinity stress negatively affects the growth and development of wheat leading to diminished grain yield and quality. Salt stress during reproductive stage is one of the significant factors leading to the drastic reduction in grain yield. The objective of this study was to investigate the biochemical responses of pre-anthesis stage salt stress and yield related traits in KRL1-4 salt tolerant and UP2338 salt sensitive cultivar of Wheat. Three different levels of salinity stress (100, 200 and 300 mM NaCl) was induced. Untreated plants were kept as control. Samples were analyzed at pre- anthesis stage (50 DAS and 60 DAS) for various biochemical parameters viz., proline content, total reducing sugar content, total nitrogen content and total protein content. Yield related traits harvest index, tiller numbers per plant, spike height and spike weight were recorded at maturity stage. The amount of proline and reducing sugar increased with increasing salinity, the increase being more in tolerant than in sensitive cultivar. Total nitrogen and total protein content, however, decreased with increasing salt concentration and reduction being more in sensitive than in tolerant cultivar. Yield attributes were affected negatively. The effect was more pronounced in sensitive cultivar compared to tolerant.

Zika is a flavivirus that is transmitted primarily by the bite of an infected Aedes mosquito. It can also be transmitted by blood transfusion, sexual contact, and from an infected mother to the unborn baby. Zika virus infection is of particular concern in pregnancy as transplacental transmission of the virus has the potential to cause significant fetal morbidity. Ultrasonography plays a pivotal role in the fetal surveillance of a pregnant woman infected with Zika. There have been outbreaks of Zika virus infection in various parts of India, the most recent occurring in Kanpur in November 2021. We report a case of a primigravida who had Zika virus infection during the first trimester of pregnancy but the fetus presented with the sequelae of infection in the third trimester. This report highlights the sonographic red flags for fetal Zika infection and the importance of serial monitoring in pregnant women exposed to Zika virus.

Thalassemia syndromes represent a group of inherited disorders characterized by decreased synthesis of one or more of the four globin chains in hemoglobin. The clinical spectrum ranges from asymptomatic carrier state to transfusion-dependent severe disease. The availability of better treatment options has increased the life expectancy in these patients and consequently paved the way to develop malignancies. Although many studies are published on the association of solid organ and lymphoid malignancies, only one case has been reported so far for acute myeloid leukemia (AML) coexisting with thalassemia syndromes. Herein, we report the first case of AML associated with beta-thalassemia in an adult Indian expatriate woman in Qatar. She presented with prolonged bleeding after a dental procedure. She was diagnosed as concurrent AML and beta-thalassemia trait on the laboratory evaluation. This case signifies the use of peripheral blood film evaluation for any abnormal hemograms in the modern era of automation. It also warrants caution for clinicians in suspecting malignancies in thalassemia although direct genetic linkage or associated risk is a matter of research.

Therapeutic Area: ASCVD /CVD Risk Reduction Background: Homozygous familial hypercholesterolemia (HoFH) is a rare genetic disorder characterized by severely elevated low-density lipoprotein cholesterol (LDL-C) levels. Currently, few treatments effectively lower LDL-C levels in pediatric patients with HoFH. Here, we report the efficacy and safety of evinacumab, a monoclonal antibody inhibitor of angiopoietin-like 3, in pediatric patients with HoFH. Methods: This is a three-part, open-label study (NCT04233918); Part B results are reported here. Part B enrolled 14 patients with HoFH 5–11 years old with LDL-C >130 mg/dL on optimized lipid-lowering therapy, including apheresis and lomitapide. All patients received intravenous evinacumab 15 mg/kg every 4 weeks. Results: All 14 patients completed Part B. Evinacumab treatment reduced mean (standard deviation) LDL-C from 263.7 (91.0) mg/dL at baseline to 131.8 (109.8) mg/dL at Week 24, with a mean (standard error [SE]) percent reduction of −48.3% (10.4%). Mean (SE) reductions in apolipoprotein B (−41.3% [9.0%]), non-high-density lipoprotein cholesterol (−48.9% [9.8%]), and total cholesterol (−49.1% [8.1%]) were also observed. Furthermore, percent LDL-C reduction observed at Week 24 from baseline based on the baseline LDL-C values or the presence of lomitapide treatment are presented in a Table. Additionally, the percent change from baseline in Lp(a) at Week 24 according to baseline apheresis status (Yes vs No) was similar: −43.7% (1.6%) versus −32.7% (1.4%), respectively. Treatment-emergent adverse events (TEAEs) occurred in 10 (71.4%) patients; no deaths or treatment discontinuations due to TEAEs were reported. Conclusions: Evinacumab substantially reduced LDL-C levels and other key atherogenic lipid parameters in pediatric patients with HoFH additive to any pre-existing treatment (including apheresis and lomitapide). Evinacumab was generally well-tolerated.

This work presents a new active block called the differential current conveyor cascaded transconductance amplifier (DCCCTA) and implemented multi-mode biquadratic universal shadow filter. The frequency-hopping filter is implemented using a multi-mode universal shadow filter. The proposed circuit has two modes of operation: current mode (CM) and transadmittance mode (TAM). All-pass (AP), band-pass (BP), band-reject (BR), high-pass (HP), and low-pass (LP) responses are simultaneously accomplished. As intended, low input impedance for CM and high input impedance for TAM are acquired, while high output impedance is attained for both modes of operation. Inter-modulation distortion (IMD), percentage total harmonic distortion (%THD), and Monte Carlo analysis are also obtained. The theoretical results are verified using Cadence Virtuoso in 180 nm TSMC technology.

Background: The Sangrur population-based cancer registry, Punjab state, India experienced several challenges in confirming residence as well as updating the follow-up status of cancer cases, which is critical for accurately labelling incidence and providing cancer survival. This study presents innovative field strategies adopted by the Sangrur population-based cancer registry for residence confirmation and updating follow-up status of cancer cases. Methods: A network was developed with the involvement of local community members to validate the address and follow-up status of cancer cases. In addition, social media was used to trace patients who were loss to follow-up. Results: The Sangrur population-based cancer registry was unable to trace a total of 31 cancer cases. After implementing innovative field methods, 26 (83.9%) cases were successfully traced back; while 5 (16.1%) cases were untraced despite several efforts. A majority of these 31 cases were from urban areas (93.5%) compared to rural (6.5%). True Caller with the help of WhatsApp contributed significantly by tracing 9 cases (34.6%); followed by 4 cases (15.4%) traced with the help of a postman, 3 cases each (11.5%) with the electoral list and gas agency personnel, and 2 cases (7.7%) through medical shops. Also, 2 cases (7.7%) were traced with the help of treating hospital while Facebook and property tax office traced 1 case (3.8%) each. Conclusion: By engaging with the local community, and with the use of social media, the patient's residence and follow-up status can be updated. Due to this method, accurate labelling of the incidence can be achieved.

With large-scale Cyber-Physical Systems (Internet of Things) deployments, the low-cost networked devices are becoming ubiquitous. Time stamping of events is a basic requirement and it is crucial for distributed/isolated systems/devices to work in unison. The system clocks of these devices are not very stable and their behaviour is affected by ageing and environmental conditions. A clock's timing behaviour is generally analysed independently by comparison to a highly stable standard reference clock using specialized instruments. Network Time Protocol (NTP) is widely used for time synchronization over computer networks. As the NTP server clock is more stable in comparison to a client's system clock, the variation in the end device's clock offset values with respect to the NTP server clock over a long time can be considered for analysing the behaviour of the end device's clock. This paper presents a method for analysing clock behaviour based on NTP messages. A computer programme is developed, which utilizes an open-source NTP client library to exchange NTP messages and records end device's system clock's offset variations over time for a given periodicity to analyse the behaviour. This black box analysis approach does not require any direct access to the end device's clock circuit. The solution may be useful for analysing clock behaviour for long-term stability under actual environmental conditions, for deciding time synchronization periodicity to optimize the number of synchronization packet exchanges, and for pre-deployment timing stability assessment of devices for deployment scenarios having intermittent/non-availability of periodic time synchronization. [ABSTRACT FROM AUTHOR]

Abstract The present study aimed to assess the toxic effects of pendimethalin herbicide and protective role of curcumin using the Allium test on cytological, biochemical and physiological parameters. The effective concentration (EC50) of pendimethalin was determined at 12 mg/L by the root growth inhibition test as the concentration reducing the root length by 50%. The roots of Allium cepa L. was treated with tap water (group I), 5 mg/L curcumin (group II), 10 mg/L curcumin (group III), 12 mg/L pendimethalin (group IV), 12 mg/L pendimethalin + 5 mg/L curcumin (group V) and 12 mg/L pendimethalin + 10 mg/L curcumin (group VI). The cytological (mitotic index, chromosomal abnormalities and DNA damage), physiological (rooting percentage, root length, growth rate and weight gain) and oxidative stress (malondialdehyde level, superoxide dismutase level, catalase level and glutathione reductase level) indicators were determined after 96 h of treatment. The results revealed that pendimethalin treatment reduced rooting percentage, root length, growth rate and weight gain whereas induced chromosomal abnormalities and DNA damage in roots of A. cepa L. Further, pendimethalin exposure elevated malondialdehyde level followed by antioxidant enzymes. The activities of superoxide dismutase and catalase were up-regulated and glutathione reductase was down-regulated. The molecular docking supported the antioxidant enzymes activities result. However, a dose-dependent reduction of pendimethalin toxicity was observed when curcumin was supplied with pendimethalin. The maximum recovery of cytological, physiological and oxidative stress parameters was recorded at 10 mg/L concentration of curcumin. The correlation studies also revealed positive relation of curcumin with rooting percentage, root length, weight gain, mitotic activity and glutathione reductase enzyme level while an inverse correlation was observed with chromosomal abnormalities, DNA damage, superoxide dismutase and catalase enzyme activities, and lipid peroxidation indicating its protective effect.

IntroductionFoxtail millet (Setaria italica L. beauv) is an important crop in underdeveloped countries; however, yield levels are low. The use of varied germplasm in a breeding approach is critical for increasing productivity. Foxtail millet can be cultivated effectively in a wide range of environmental circumstances but it is best suited to hot and dry climates.MethodsIn the current study, multivariant traits were used to define 50 genotypes in the first year and 10 genotypes in the second year. The phenotypic correlations among all traits in the entire germplasm were assessed, and the data acquired for all quantitative characters were subjected to analysis of variance for augmented block design. Furthermore, WINDOWS STAT statistical software was used to carry out a principal component analysis (PCA). The presence of substantial variations in most symptoms was shown by analysis of variance.ResultsGenotypic coefficient of variation (GCV) projections for grain yields were the highest, followed by panicle lengths and biological yields. Plant height and leaf length had the highest PCV estimates, followed by leaf width. Low GCV and phenotypic coefficient of variation (PCV) were measured as leaf length and 50% flowering in days. According to the PCV study, direct selection based on characters, panicle weight, test weight, and straw weight had a high and positive effect on grain yield per plant in both the rainy and summer seasons, indicating the true relationship between these characters and grain yield per plant, which aids indirect selection for these traits and thus improves grain yield per plant. Variability in foxtail millet germplasm enables plant breeders to effectively select appropriate donor lines for foxtail millet genetic improvement.DiscussionBased on the average performance of genotypes considered superior in terms of grain yield components under Prayagraj agroclimatic conditions, the best five genotypes were: Kangni-7 (GS62), Kangni-1 (G5-14), Kangni-6 (GS-55), Kangni-5 (GS-389), and Kangni-4 (GS-368).

Clean sources of energy are a priority area for many organizations. The regulators and government are incentivizing these initiatives, which would also aid in achieving sustainable development goals (SDGs). Electric vehicle adoption (EVA) is an important pillar of clean energy which would help establish a sustainable transportation ecosystem in a nation. This study aims to comprehend the global trends in research on EVA since the 1980s. The bibliometric insights highlight that there has been a growing interest in EVA since early 2010, which is reflected in the number of publications and scholars conducting research in this domain. A corpus of 1077 research papers on EVA was analyzed using Vosviewer, Gephi, and Bibliometrix tools. The study maps the entire intellectual structure that covers EV adoption by individuals, organizations, and society. The study also proposes research agenda for future researchers working in the field of promotion of cleaner and sustainable transportation.

Patients with neurovascular disorders sometimes approach the ophthalmologists with mild ophthalmic clinical features such as conjunctival congestion, slowly progressive proptosis, lateral rectus palsies and at other times with ophthalmic emergencies like sudden increase in proptosis, ophthalmoplegia, diplopia, and ptosis before the onset of neurological manifestations which may be life-threatening if not detected in time. The aim of this article is to focus on ophthalmic manifestations of neurovascular emergencies and role of ophthalmologists in its management. In this communication, to make the ophthalmologist aware of clinical presentations, the imaging modality of choice, diagnostic features, medical and interventional treatments. We have searched PubMed, Web of Science, Google Scholar and reviewed some of the commonly encountered neurovascular emergencies with ocular manifestations such as carotid-cavernous fistula, cerebral venous sinus thrombosis, cerebral artery aneurysms, arterio-venous malformations.

In her article, around the vision of Obiora Ike, the author presents how multicultural education is made possible, in a world where, as university education functions as a fantastic bridge builder, it is a good catalyst for social reforms and equality. University is a place for dynamical leadership at all levels and for a peaceful engagement along the advancement of the digital revolution and reliance on information technology.

X-linked hypophosphatemia (XLH), an inheritable form of rickets is caused due to mutation in Phex gene. Several factors are linked to the disease’s aetiology, including non-coding RNA molecules (miRNAs), which are key post-transcriptional regulators of gene expression and play a significant role in osteoblast functions. MicroRNAs sequence analysis showed differentially regulated miRNAs in phex silenced osteoblast cells. In this article, we report miR-539-3p, an unidentified novel miRNA, in the functional regulation of osteoblast. MiR-539-3p overexpression impaired osteoblast differentiation. Target prediction algorithm and experimental confirmation by luciferase 3’ UTR reporter assay identified LRP-6 as a direct target of miR-539-3p. Over expression of miR-539-3p in osteoblasts down regulated Wnt/beta catenin signaling components and deteriorated trabecular microarchitecture leading to decreased bone formation in ovariectomized (Ovx) mice. Additionally, biochemical bone resorption markers like CTx and Trap-5b were elevated in serum samples of mimic treated group, while, reverse effect was observed in anti-miR treated animals along with increased bone formation marker P1NP. Moreover, transcriptome analysis with miR-539-3p identified a novel uncharacterized Akap-3 gene in osteoblast cells, knock down of which resulted in downregulation of osteoblast differentiation markers at both transcriptional and translational level. Overall, our study for the first time reported the role of miR-539-3p in osteoblast functions and its downstream Akap-3 signalling in regulation of osteoblastogenesis.

Even under optimal conditions many metabolic processes produce ROS like superoxide anion (O2.-), hydrogen peroxide (H2O2) and hydroxyl radicals (OH⋅), particularly in chloroplast and mitochondria. The overproduction of ROS (O2.-, H2O2, OH., RCO etc.) results from the exposure to various environmental conditions like dehydration, heat, salinity and biotic stresses. All biomolecules like lipids, proteins and DNA are extensively damaged by the reactive oxygen species which disrupts the cell integrity further leading to its death. Plants possess both enzymic and non-enzymatic mechanism for scavenging ROS. The enzymic mechanisms are designed to minimize the concentration of O2 and H2O2. The overproduced enzymes are superoxide dismutase (SOD), peroxidase (POX), catalase (CAT), glutathione reductase (GR) and glutathione-synthesizing enzymes. Several evidences have shown that although oxidative stress is a lethal situation for cell by ROS (especially H2O2 and O2⋅-, it may be involved in cellular signaling procedure as second messenger to induce a large number of genes and produce proteins and osmoprotectant involved in salt stress defenses. This review gives an insight into the recent advancements on how antioxidant defense machinery, the antioxidant enzymes and the non-antioxidant metabolites work together to alleviate the negative effects of ROS and cross-talk with reactive sulfur nitrogen and carbomyl species which also act as an important signal molecule. This comprehensive knowledge about ROS action, their regulation through antioxidant machinery, interactions with RNS, RSS and RCS and in signal transduction will empower us in the development of salinity tolerant plants.

A 46-year-old male with mild coronavirus disease 2019 (COVID-19) symptoms presented to the emergency department complaining of decreased vision in the right eye (RE). Funduscopic examination revealed serous macular detachment at the posterior pole with loss of foveal reflex in the RE. Fundus fluorescein angiography revealed pinpoint leakage in the early phase, which was enlarged in the late phase to appear like inkblot suggestive of central serous chorioretinopathy (CSCR), which was confirmed on optical coherence tomography as hyporeflective space due to the collection of serous fluid between the neurosensory retina and retinal pigment epithelium. He received COVID-19 directed therapy. The patient became systemically alright and his vision in the RE improved. Severe acute respiratory syndrome coronavirus 2 is associated with thromboembolic events and retinal ischemia may create hyperpermeability of choroid leading to the formation of CSCR.

Abstract Octanoic acid is a medium-chained saturated fatty acid found abundantly in the ketogenic dietary supplements containing medium chained triglycerides (MCT) along with decanoic acid. The MCT ketogenic diet is commonly consumed for weight loss but has also showcased neuroprotective potential against neurodegenerative disorders. However, recent clinical findings have reported a critical disadvantage with the long-term consumption of ketogenic diet i.e. bone loss. The following study was employed to investigate whether the two major components of MCT diet also possess bone loss potential as observed with classical ketogenic diet. Swiss albino mice aged between 10 and 12 weeks, were divided into 3 treatment groups that were administered with oral suspensions of octanoic acid, decanoic acid and a combination of both for 4 weeks. Bone specific markers, microarchitectural parameters, using micro computed tomography, and biomechanical strength were analyzed. Remarkably deleterious alterations in the trabecular bone microarchitecture, and on bone markers were observed in the octanoic acid treated groups. Our results suggest significant negative effects on bone health by octanoic acid. These findings require further investigation and validation in order to provide significant clinically relevant data to possibly modify dietary composition of the MCT ketogenic diet.

Plant biodiversity of some of the high-altitude national parks of Indian Himalaya is increasingly experiencing anthropogenic pressure. Consequently, plant species composition, vegetation structure, and diversity patterns of these protected areas are assumed to be substantially altered. However, limited efforts are made to quantify the impact of anthropogenic disturbances on the species richness of such high-altitude national parks of Indian Himalaya. To overcome this data gap, this study is aimed at quantifying the impact of anthropogenic disturbances on the vegetation community patterns of two Indian Himalayan National Parks along elevation transects, i.e., the Valley of Flowers National Park (VoFNP, altitude ranging from 3,200 to 6,700 m a.s.l.) and the Great Himalayan National Park (GHNP, altitude ranging from 1,500 to 6,000 m a.s.l.), India. The impact of anthropogenic disturbances along the elevation zone (3,200–4,500 m) on the vegetation community patterns was assessed by comparing plant species richness and diversity between selected disturbed and undisturbed sites along the altitudinal gradient. The disturbed sites, near to pathways within each national park, experienced the frequent human interventions than the undisturbed sites which were beyond 25–50 m from the pathway within each national park. Diversity profiles calculated as hill numbers (q = 0, 1, 2) showed significant variation between disturbed and undisturbed sites exhibiting high level of disturbance, especially in VoFNP. The non-metric multidimensional scaling of species composition data along the elevation of both national parks indicated that heterogeneously grouped plant species were much higher for disturbed sites than undisturbed ones. The quantum of anthropogenic pressure on disturbed sites of both VoFNP and GHNP was discernible through statistically significant lower values of soil moisture, bulk density, porosity, potassium, and phosphorous content than the undisturbed sites. As a consequence, disturbed sites were clearly noted to have lower numbers of threatened and endemic species (20 and 17, respectively) in comparison with undisturbed sites (32 and 31, respectively). The canonical correlation analyses of species compositions and soil properties of VoFNP and GHNP indicated that soil moisture and pH were the two major factors that control species composition for both disturbed and undisturbed sites, whereas soil porosity played a major role in species composition of undisturbed sites. The disturbed sites of lower elevation zones (3,200–3,500 m) of both parks were found with a higher density of invasive species (i.e., Polygonum polystachyum, Impatiens sulcata, Cuscuta europaea, etc.). Our study indicated that anthropogenic pressures on the high-altitude national parks of India not only altered the soil properties, but potentially threatened the species composition, thus accelerating urgent need to implement mitigation measures for restoration of degrading habitat of the native, endemic, and threatened plants in both the parks.

Leprosy (Hansen's disease), a chronic granulomatous infection caused by Mycobacterium leprae, frequently affects the areas of skin, which have a relatively low temperature and/or are prone to trauma. Several zones of skin, for example, scalp, palms and soles, groins, genitalia, axillae, eyelids, and perineum, have usually been described as “immune” to lesions of leprosy. However, clinical, bacteriological, and pathologic evidence of involvement of these so-called “immune zones” has rarely been documented. Therefore, now many workers have proposed that these “immune zones” should be called “relatively immune,” rather than “absolute immune.” Hereby, we report a rare case of leprosy with palmar involvement.

Background Cancer is characterized by an accumulation of somatic mutations, of which a significant subset can generate cancer-specific neoepitopes that are recognized by autologous T cells. Such neoepitopes are emerging as important targets for cancer immunotherapy, including personalized cancer vaccination strategies.Methods We used whole-exome and RNA sequencing analysis to identify potential neoantigens for a patient with non-small cell lung cancer. Thereafter, we assessed the autologous T-cell reactivity to the candidate neoantigens using a long peptide approach in a cultured interferon gamma ELISpot and tracked the neoantigen-specific T-cells in the tumor by T-cell receptor (TCR) sequencing. In parallel, identified gene variants were incorporated into a Modified Vaccinia Ankara-based vaccine, which was evaluated in the human leucocyte antigen A*0201 transgenic mouse model (HHD).Results Sequencing revealed a tumor with a low mutational burden: 2219 sequence variants were identified from the primary tumor, of which 23 were expressed in the transcriptome, involving 18 gene products. We could demonstrate spontaneous T-cell responses to 5/18 (28%) mutated gene variants, and further analysis of the TCR repertoire of neoantigen-specific CD4+ and CD8+ T cells revealed TCR clonotypes that were expanded in both blood and tumor tissue. Following vaccination of HHD mice, de novo T-cell responses were generated to 4/18 (22%) mutated gene variants; T cells reactive against two variants were also evident in the autologous setting. Subsequently, we determined the major histocompatibility complex restriction of the T-cell responses and used in silico prediction tools to determine the likely neoepitopes.Conclusions Our study demonstrates the feasibility of efficiently identifying tumor-specific neoantigens that can be targeted by vaccination in tumors with a low mutational burden, promising successful clinical exploitation, with trials currently underway.