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Abstract Burkholderia cenocepacia is an opportunistic and infective bacterium containing an orphan DNA methyltransferase called M.BceJIV with roles in regulating gene expression and motility of the bacterium. M.BceJIV recognizes a GTWWAC motif (where W can be an adenine or a thymine) and methylates N6 of the adenine at the fifth base position. Here, we present crystal structures of M.BceJIV/DNA/sinefungin ternary complex and allied biochemical, computational, and thermodynamic analyses. Remarkably, the structures show not one, but two DNA substrates bound to the M.BceJIV dimer, with each monomer contributing to the recognition of two recognition sequences. We also show that methylation at the two recognition sequences occurs independently, and that the GTWWAC motifs are enriched in intergenic regions in the genomes of B. cenocepacia strains. We further computationally assess the interactions underlying the affinities of different ligands (SAM, SAH, and sinefungin) for M.BceJIV, as a step towards developing selective inhibitors for limiting B. cenocepacia infection.

Abstract Background When subject to stress conditions such as nutrient limitation microalgae accumulate triacylglycerol (TAG). Fatty acid, a substrate for TAG synthesis is derived from de novo synthesis or by membrane remodeling. The model industrial alga Chlorella sorokiniana accumulates TAG and other storage compounds under nitrogen (N)-limited growth. Molecular mechanisms underlying these processes are still to be elucidated. Result Previously we used transcriptomics to explore the regulation of TAG synthesis in C. sorokiniana. Surprisingly, our analysis showed that the expression of several key genes encoding enzymes involved in plastidic fatty acid synthesis are significantly repressed. Metabolic labeling with radiolabeled acetate showed that de novo fatty acid synthesis is indeed downregulated under N-limitation. Likewise, inhibition of the Target of Rapamycin kinase (TOR), a key regulator of metabolism and growth, decreased fatty acid synthesis. We compared the changes in proteins and phosphoprotein abundance using a proteomics and phosphoproteomics approach in C. sorokiniana cells under N-limitation or TOR inhibition and found extensive overlap between the N-limited and TOR-inhibited conditions. We also identified changes in the phosphorylation status of TOR complex proteins, TOR-kinase, and RAPTOR, under N-limitation. This indicates that TOR signaling is altered in a nitrogen-dependent manner. We find that TOR-mediated metabolic remodeling of fatty acid synthesis under N-limitation is conserved in the chlorophyte algae Chlorella sorokiniana and Chlamydomonas reinhardtii. Conclusion Our results indicate that under N-limitation there is significant metabolic remodeling, including fatty acid synthesis, mediated by TOR signaling. This process is conserved across chlorophyte algae. Using proteomic and phosphoproteomic analysis, we show that N-limitation affects TOR signaling and this in-turn affects the metabolic status of the cells. This study presents a link between N-limitation, TOR signaling and fatty acid synthesis in green-lineage.

Abstract A short prokaryotic Argonaute (pAgo) TIR-APAZ (SPARTA) defense system, activated by invading DNA to unleash its TIR domain for NAD(P)+ hydrolysis, was recently identified in bacteria. We report the crystal structure of SPARTA heterodimer in the absence of guide-RNA/target-ssDNA (2.66 Å) and a cryo-EM structure of the SPARTA oligomer (tetramer of heterodimers) bound to guide-RNA/target-ssDNA at nominal 3.15–3.35 Å resolution. The crystal structure provides a high-resolution view of SPARTA, revealing the APAZ domain as equivalent to the N, L1, and L2 regions of long pAgos and the MID domain containing a unique insertion (insert57). Cryo-EM structure reveals regions of the PIWI (loop10-9) and APAZ (helix αN) domains that reconfigure for nucleic-acid binding and decrypts regions/residues that reorganize to expose a positively charged pocket for higher-order assembly. The TIR domains amass in a parallel-strands arrangement for catalysis. We visualize SPARTA before and after RNA/ssDNA binding and uncover the basis of its active assembly leading to abortive infection.

Many microbes accumulate energy storage molecules such as triglycerides (TAG) and starch during nutrient limitation. In eukaryotic green algae grown under nitrogen-limiting conditions, triglyceride accumulation is coupled with chlorosis and growth arrest. In this study, we show that reactive oxygen species (ROS) actively accumulate during nitrogen limitation in the microalga Chlorella sorokiniana. Accumulation of ROS is mediated by the downregulation of genes encoding ROS-quenching enzymes, such as superoxide dismutases, catalase, peroxiredoxin, and glutathione peroxidase-like, and by the upregulation of enzymes involved in generating ROS, such as NADPH oxidase, xanthine oxidase, and amine oxidases. The expression of genes involved in ascorbate and glutathione metabolism is also affected under this condition. ROS accumulation contributes to the degradation of monogalactosyl diacylglycerol (MGDG) and thylakoid membrane remodeling, leading to chlorosis. Quenching ROS under nitrogen limitation reduces the degradation of MGDG and the accumulation of TAG. This work shows that ROS accumulation, membrane remodeling, and TAG accumulation under nitrogen limitation are intricately linked in the microalga C. sorokiniana.

Alpha and beta cobalt hydroxide nanostructures were synthesized by hydrothermal method and characterized using X-ray diffraction and electron microscopy. The turbostatic alpha-Co(OH)2 has large interlayer spacing compared to the beta-Co(OH)2 and is less explored in the literature. Both nanostructures were efficient in degrading methylene blue dye in the presence of visible light. Under identical conditions, the rate constant of photocatalytic dye degradation in the presence of alpha and beta cobalt hydroxide was calculated as 60.22 × 10−3 min−1 and 19.05 × 10−3 min−1, respectively, which is highest when compared to the previous reports. The superior activity of alpha-Co(OH)2 when compared to beta-Co(OH)2 is also demonstrated in this work. Additionally, a Csp value of 137 F/g and 2.4 F/g, respectively, at a current density of 1 A/g, was obtained from the GCD analysis of devices made using alpha-Co(OH)2 and beta-Co(OH)2. A higher cyclic stability and power density were observed for alpha-Co(OH)2 when compared to beta-Co(OH)2. The findings suggest that alpha and beta cobalt hydroxide nanostructures hold promise as effective catalysts for dye degradation and potential materials for high-performance supercapacitors. Further investigations into the unique properties of the relatively superior alpha-Co(OH)2 could lead to advancements in environmental remediation and energy storage technologies.

Introduction: The objectives of this study were to investigate the efficacy and safety of intravesical bupivacaine instillation in reducing catheter-related bladder discomfort (CRBD) and lower urinary tract symptoms (LUTS) after transurethral surgery. Methods: The study enrolled 100 American Society of Anesthesiologists (ASA) grade I–III patients aged ≥18 years undergoing transurethral resection of the prostate or transurethral resection of the bladder tumor, randomly assigned to Group B (intravesical bupivacaine) or Group S (saline). Double blinding was employed. Independent variables included demographics, surgery type, ASA grade, and intervention details. Dependent variables comprised CRBD severity, Patient Perception of Bladder Condition (PPBC), Pelvic Pain Urgency Frequency (PUF), Visual Analog Scale (VAS) for pain, need for additional analgesics, and International Prostate Symptom Score (IPSS). SPSS version 19 was used for analysis with a significance level of P < 0.05. Side effects such as hematuria were also recorded. Results: Group B reported significantly lower “moderate” CRBD immediately (2% vs. 40%, P < 0.001) and at 12 h (0% vs. 18%, P = 0.003) post-instillation compared to Group S and also required fewer additional analgesics (4% vs. 46%). The PPBC at catheter removal also favored Group B (P = 0.003) and day 1 (P < 0.001). The PUF scores were also significantly lower in Group B at catheter removal (P = 0.001) and at day 1 (P = 0.028). The IPSS was also significantly lower in the Group B on day 1 (P = 0.003) and 7 (P = 0.001). The VAS scores also favored the Group B consistently and although the side effects were higher in Group B but this was not statistically significant. Conclusion: Intravesical bupivacaine administration has the potential to alleviate CRBD and postoperative LUTS following lower urinary tract transurethral electrosurgery. The study’s findings underscore the importance of personalized pain management strategies in optimizing the patient comfort during the postoperative recovery.

Karima Chaabna,1 Anupama Jithesh,1 Jibrail Cheema,2 Jasmine Aboughanem,1 Ravinder Mamtani1 1Institute for Population Health, Weill Cornell Medicine – Qatar, Doha, Qatar; 2Weill Cornell Medicine – Qatar, Doha, QatarCorrespondence: Karima Chaabna, Institute for Population Health, Weill Cornell Medicine – Qatar, Education City, Qatar Foundation, P.O Box. 24144, Doha, Qatar, Tel +974 4492-8309, Fax +974 4492 8333, Email kac2047@qatar-med.cornell.eduPurpose: This systematic review aims to assess the use and perception of “Western” medical acupuncture—based on conventional biomedical mechanisms and evidence-based medicine for diagnosis and needle placement—for pain management among athletes and their healthcare providers.Methods: A systematic review is reported based on the PRISMA guidelines. PubMed, Web of Science, SPORTDiscus, Allied and Complementary Medicine databases, and Google Scholar were searched (search: from database inception to July 2023). Two authors independently conducted multi-stage screening, data extraction, and quality assessment. The outcomes of interest were prevalence of acupuncture prescriptions by healthcare professionals, prevalence of acupuncture use by athletes, and perceptions related to acupuncture effectiveness among healthcare professionals and athletes. Only studies wherein “Western” medical acupuncture was used for pain management were included.Results: Our review included 11 observational studies and clinical trials. The prevalence of “Western” medical acupuncture prescription varied from 15.4% (UK) to 58.4% (US) among sports medicine healthcare professionals. Prevalence of acupuncture use among athletes ranged from 2.2% among college athletes in Palestine to 61% among professional football players in the Netherlands. Acupuncture was used for managing delayed-onset of soreness and pain due to various types of musculoskeletal injuries. Both athletes and their healthcare providers reported positive perceptions of acupuncture.Conclusion: Our systematic review identifies a notable research gap in evaluating the practice and perception of “Western” medical acupuncture among healthcare professionals and athletes. Our findings suggest that “Western” medical acupuncture is not only prescribed by sport medicine professionals and used by athletes for diverse musculoskeletal pains but is also generally perceived positively for its effectiveness. Given the positive clinical experience of health professionals, athletes’ favorable perception, and acupuncture’s well-established safety profile, acupuncture should be given serious consideration—as a complementary approach—in the overall management of pain.Registration: Open Science Framework (https://osf.io/qb9gc).Keywords: western medical acupuncture, perception, pain, athletes

Background: Ojus in Ayurveda refers to the unique functioning state of bodily tissues favoring survival and homeostasis. Functional decline in ojus (ojakṣaya) is recognized in Ayurveda as a candidate causative factor for the incidence and progression of major psychiatric conditions (manasroga). Assessing the functional status of ojus shall predict the prognosis and its monitoring while intervention shall favor clinical decision-making across timelines. The characteristics of ojokshaya are reasonably detectable in current psychiatric clinical settings. However, the data collection strategies on ojus vary remarkably among physicians owing to its weightage for patient-reported subjective expressions. Subjective health status assessment-related data handling requires clinical expertise and validated tools. Aims: Thus, this study is committed to developing and validating a tool assessing the functional status of ojus in manasroga. The tool constructs are fairly developed based on patient-reported outcomes and need to be evaluated for their reliability and validity. Settings and Design: The work was conducted within the institute. The mixed methods study design was used. Subjects, Methods and Statistical Analysis: In phase one, the questionnaire was developed through literature review, expert evaluation, data from previous research works, focus group discussion for final consensus, and pretesting. The construct validity was established through principal component analysis/regression analysis. In phase two, the validity of the questionnaire after distinguished phases of the face (100 participants), content (six experts evaluation), and criterion (Pearson's correlation coefficient) sets; was obtained by conducting a cross-sectional survey on 82 participants. Cronbach's alpha value was used to assess the reliability of the questionnaire. Results: The 28-item questionnaire to assess ojus in manasaroga, named SOMA-Q, was developed. The results satisfied the tests for validity and reliability. Factor analysis was performed. The Cronbach's alpha value of the questionnaire was 0.897, suggesting a reasonable internal consistency. In split-half reliability testing, a significant decrease in reliability was noted for every item, and hence, no items were deleted from the questionnaire. Conclusions: The developed tool is valid for assessing the functional status of ojus (SOMA-Q) in psychiatric disorders.

Overexpression and aberrant activation of signal transducer and activator of transcription 3 (STAT3) contribute to tumorigenesis, drug resistance, and tumor-immune evasion, making it a potential cancer therapeutic target. BP1003 is a neutral liposome incorporated with a nuclease-resistant P-ethoxy antisense oligodeoxynucleotide (ASO) targeting the STAT3 mRNA. Its unique design enhances BP1003 stability, cellular uptake, and target affinity. BP1003 efficiently reduces STAT3 expression and enhances the sensitivity of breast cancer cells (HER2+, triple negative) and ovarian cancer cells (late stage, invasive ovarian cancer) to paclitaxel and 5-fluorouracil (5-FU) in both 2D and 3D cell cultures. Similarly, ex vivo and in vivo patient-derived models of pancreatic ductal adenocarcinoma (PDAC) show reduced tissue viability and tumor volume with BP1003 and gemcitabine combination treatments. In addition to directly affecting tumor cells, BP1003 can modulate the tumor microenvironment. Unlike M1 differentiation, monocyte differentiation into anti-inflammatory M2 macrophages is suppressed by BP1003, indicating its potential contribution to immunotherapy. The broad anti-tumor effect of BP1003 in numerous preclinical solid tumor models, such as breast, ovarian, and pancreatic cancer models shown in this work, makes it a promising cancer therapeutic.

Abstract. Background. Dietary supplementation with citrate-containing juices may serve as an effective alternative to potassium citrate therapy for preventing calcium oxalate stone recurrence. This study was performed to evaluate whether consumption of lemon–tomato juice can decrease the tendency for stone formation in the urine of calcium oxalate stone formers. Materials and methods. The study was conducted as a prospective interventional randomized crossover clinical trial with a repeated-measures design. Twenty-two patients with calcium oxalate stones and no metabolic abnormalities in the urine treated with lithotripsy at a tertiary care center from August 2017 to July 2018 were recruited. After a 14-hour overnight fasting, urine samples were collected after the patients consumed either milk only or milk and lemon–tomato juice. Their urine was tested for multiple parameters, including urine pH, specific gravity, calcium–creatinine ratio, and supersaturation with sodium oxalate, followed by optical density measurement via spectrophotometry. Results. There were no significant differences in the background characteristics between the 2 groups. The optical density of the urine samples obtained after consumption of milk only was significantly higher than that after consumption of milk and lemon–tomato juice (mean = 0.131 for milk only vs. 0.053 for milk and lemon–tomato juice, p < 0.001). The urine calcium–creatinine ratio was similar between the groups (mean = 0.141 for milk only vs. 0.076 for milk and lemon–tomato juice, p = 0.019). Conclusions. The addition of lemon–tomato juice as a source of citrate in the diet significantly decreases the established risk factors for calcium oxalate stone formation in patients. This study was prospectively registered at CTRI under number CTRI/2017/04/008312 on April 7, 2017.

Background: The visually impaired depend much on sound, speech, and touch, and therefore, promotion of oral hygiene maintenance through a health song can improve their oral hygiene practices. Aim and Objectives: To assess the effectiveness of oral health song on oral hygiene status among visually impaired children at baseline and after oral health education (OHE) at different time intervals. Materials and Methods: A study was carried out in Government Blind School, Salem, with prior permission. Out of 63 students, 57 students were taken to the study based on the inclusion and exclusion criteria. Seven students were lost to follow-up during the second visit and 9 students during the last visit. During the first visit, a health talk about brushing techniques was given without using any audiovisual aids, and oral health song which is of 2 min duration was taught to the students. Each of the students was given a tooth cast model and was taught how to brush. The oral hygiene status was assessed at baseline and 15th and 45th day using visible plaque index (VPI) and gingival bleeding index (GBI). Statistical analysis was done using IBM SPSS Statistics 25. The Bonferroni test was to compare the VPI and GBI scores between the baseline, 15 days, and 45 days, and P < 0.05 was considered statistically significant. Results: VPI and GBI scores were found to be statistically significant at different intervals (P < 0.001). The VPI anterior and posterior percentage (P < 0.001) and GBI anterior and posterior percentage (P < 0.001) at different intervals were found to be statistically highly significant. Conclusion: A song with music can increase interest and helps them retain information easily, which was found to be effective in the present study.

Hypomagnesemia is one of the electrolyte disturbances that can cause seizures. It is common in the hospitalized patients and can be induced by long-term usage of many medications. A 68-year-old male known to have hypertension and gastroesophageal reflux presented to the Emergency Department with an unprovoked first seizure at home followed by a temporary right-sided hemiparesis, dysphasia, and facial asymmetry. The hemiparesis, dysphasia, and facial asymmetry resolved within less than an hour after the seizure. His serum potassium was low with prolonged QT interval in the electrocardiogram (serum magnesium was not checked in the Emergency Department). He received intravenous IV potassium chloride infusion, and his serum potassium level was corrected, but he had a recurrent seizure after 10 h. At that time, his serum magnesium was found to be very low, he received IV magnesium sulfate infusion, and his indapamide, omeprazole, and metformin medications were stopped. He had no further seizures, the rest of his blood tests were normal, and his CT brain was unremarkable. He was treated for aspiration pneumonia, and his outpatient MRI brain and EEG came to be normal too.

Abstract Nuclear factor erythroid 2-related factor 2 (NRF2) is aberrantly activated in about 93% of pancreatic cancers. Activated NRF2 regulates multiple downstream molecules involved in cancer cell metabolic reprogramming, translational control, and treatment resistance; however, targeting NRF2 for pancreatic cancer therapy remains largely unexplored. In this study, we used the online computational tool CellMinerTM to explore the NCI-60 drug databases for compounds with anticancer activities correlating most closely with the mRNA expression of NQO1, a marker for NRF2 pathway activity. Among the >100,000 compounds analyzed, NSC84167, termed herein as NRF2 synthetic lethality compound-01 (NSLC01), was one of the top hits (r = 0.71, P

Abstract Despite advances in cancer therapeutics, pancreatic cancer remains difficult to treat and often develops resistance to chemotherapies. We have evaluated a bioavailable genistein analogue, AXP107‐11 which has completed phase Ib clinical trial, as an approach to sensitize tumor cells to chemotherapy. Using organotypic cultures of 14 patient‐derived xenografts (PDX) of pancreatic ductal adenocarcinoma, we found that addition of AXP107‐11 indeed sensitized 57% of cases to gemcitabine treatment. Results were validated using PDX models in vivo. Further, RNA‐Seq from responsive and unresponsive tumors proposed a 41‐gene treatment‐predictive signature. Functional and molecular assays were performed in cell lines and demonstrated that the effect was synergistic. Transcriptome analysis indicated activation of G‐protein‐coupled estrogen receptor (GPER1) as the main underlying mechanism of action, which was corroborated using GPER1‐selective agonists and antagonists. GPER1 expression in pancreatic tumors was indicative of survival, and our study proposes that activation of GPER1 may constitute a new avenue for pancreatic cancer therapeutics.

Background: Auranofin, a Food and Drug Administration–approved anti-rheumatic agent with anticancer properties for lung and ovarian cancer, has never been studied for pancreatic cancer. We hypothesize that auranofin may prevent pancreatic ductal adenocarcinoma progression by inhibition of Txnrd1 and HIF-1α. Methods: In vitro sensitivity of human pancreatic ductal adenocarcinoma cell lines was determined based on IC50. Western blot assays were used to interrogate mechanisms of apoptosis and resistance. Ex vivo live tissue slice assays of xenografts allowed for testing of a larger number of PDX samples with high efficiency. In vivo pancreatic ductal adenocarcinoma orthotopic mouse models using MiaPaCa-2 Luc + cells were designed to determine optimal dose and antitumor effect. Results: We found that 10 of 15 tested pancreatic ductal adenocarcinoma cell lines were sensitive to auranofin based on IC50s below 5 μmol/L. Ex vivo tissue growth inhibition greater than 44% was observed for 13 PDX tissue cases treated with 10 μmol/L auranofin. High Txnrd1 expression was observed for resistant cell lines. In vivo studies showed 15 mg/kg IP as the optimal dose with absence of gross solid organ metastasis up to 13 weeks post-treatment (median survival 8 and 12 weeks, respectively; P = .0953). Conclusions: We have demonstrated that auranofin prevents pancreatic ductal adenocarcinoma progression using multiple models. Our study suggests inhibition of Txnrd1 and HIF-1α as possible mechanisms of action, and Txnrd1 as a biomarker of resistance. Based on these data, an off-label Phase 0 clinical trial with this FDA-approved drug should be considered for patients with pancreatic cancer.

BaZr0.2[Ti(1-x)Mgx/3Ta2x/3]0.8O3 (x = 0.0, 0.05, 0.1, 0.2, 0.4, 0.6, 0.8, 1.0) (BZTMT) ceramics were prepared through conventional solid state ceramic route. The crystal structure and microstructure of the compounds were investigated respectively using XRD and SEM. The dielectric properties were measured in the frequency range of 100 Hz–1 MHz. The ferroelectric Curie temperature of BaZr0.2Ti0.8O3 (x = 0) shifted from 21°C to -10°C with the addition of minute amount of dopant (x = 0.025) and the paraelectric transition temperature is diffusive in nature. The relative permittivity and dielectric loss of BZTMT at 1 MHz varies from 5205 to 24 and 1.8 × 10–2 to 2.0 × 10–5 respectively, as the value of x increases from 0 to 1.

Aim: The aim of this study was to evaluate and compare the efficacy of three types of plaque control methods among 13- to 35-year-old subjects receiving fixed orthodontic treatment in Coorg Institute of Dental Sciences, Virajpet, Coorg district, Karnataka, India. Materials and Methods: A total of 111 subjects who fulfilled the inclusion and exclusion criteria were randomly included in the study. The subjects were recalled after 1 month of the commencement of fixed orthodontic treatment for the recording of baseline data including plaque index (PI), gingival index (GI), and modified papillary bleeding index (MPBI). After recording of the baseline data, the subjects were randomly allocated into each of the intervention groups, i.e., group A (manual tooth brush), group B (powered tooth brush), and group C (manual tooth brush combined with mouthwash) by lottery method. Further, all the subjects were recalled after 1 and 2 months for recording the data. Results: Regarding plaque levels, it was seen that there was a highly statistically significant difference between the three groups (P = 0.001), with the manual tooth brush combined with chlorhexidine mouthwash group recording the lowest mean PI score of 0.5±0.39. A comparison of the mean GI scores among the groups at the end of 2 months shows a highly statistically significant difference (P = 0.001). The mean MPBI scores at the end of 2 months were highly statistically significant among the three groups (P = 0.001), with the group C recording the lowest mean MPBI score of 0.3±0.3. Conclusion: The powered tooth brush group subjects exhibited significantly lesser PI, GI, and MPBI scores than the manual tooth brush group at the end of 2 months, whereas the manual tooth brush combined with chlorhexidine mouth wash group subjects showed maximum improvement, having significantly lesser PI and GI scores than the powered tooth brush group.

PKS 2247–131 is an active galaxy that has been emitting gamma-ray flares since October 2016. Here, the authors used data obtained with the Fermi Gamma-ray Space Telescope to find that PKS 2247–131 presents a relatively short, month-like flux oscillation at gamma-ray energies of 0.1–300 GeV.

Introduction: Dentistry has for some time been viewed as a profession with high-stress, and usually this begins from the days of dental school onward. Students are subjected to different kinds of stressors, some being the pressure from academics with an obligation to succeed, uncertainty regarding their future and difficulties of integrating into the system. Aim: The aim is to identify the perceived sources of stress among postgraduate students from a dental college in Coorg, Karnataka. Materials and Methods: A cross-sectional questionnaire study was carried out, and the study samples included all the postgraduates of all nine specialties, including all the seventy-seven postgraduate students as samples. Results: Stress was relatively general among all the groups of the study participants, certain factors or stressors such as the amount of assigned work, competition with peers, examination and grades, lack of confidence to be a successful student and fear of facing parents after failure hamper the academic life of these students and had more significance among groups when compared to others. Conclusion: The academic life of students seemed to be hampered due to various potential stressors such as the amount of assigned work, competition with peers, examination and grades, lack of confidence to be a successful student, and fear of facing parents after failure. Such issues that arise in the educational setting need to be addressed which will help improve the academic environment of the students.

Introduction: Nutrition has always been recognized as an integral part of oral health. However, most dentists do not incorporate diet counseling in routine dental practice. The current study was set to evaluate the knowledge, attitude, and practice (KAP) on diet counseling among dental house surgeons. Materials and Methods: Interns from four different colleges (under different universities) spread across the four states of South India were selected. Of them, 220 interns who completed the questionnaires were chosen for final analysis. Results: Of the subjects, 75% agreed that nutrition was a vital component of total health care. However, only 42% of the subjects reported that they had received adequate training in diet counseling. Most of the subjects agreed that diet counseling needed to be emphasized in dental education and only 37% of the subjects expressed their confidence in rendering diet counseling to their patients. Conclusions: Students possessed not only good knowledge but also a positive attitude toward diet counseling. Lack of confidence and apprehension about financial reimbursement were two main reasons cited as obstacles for the incorporation of diet counseling in routine clinical practice.

Introduction: Diabetic nephropathy is a serious chronic complication of Type 2 Diabetes Mellitus (T2DM) which impairs the quality of life, leading to increased morbidity and mortality. The high sensitivity C-reactive protein (hs-CRP) is an acute phase reactant which acts as a non-specific systemic marker of inflammation. Aim: To find out the relationship between serum hs-CRP and metabolic variables in Type 2 diabetic patients with and without nephropathy. Materials and Methods: The study group consists of 96 subjects that include non-diabetic healthy controls, Type 2 diabetic patients without any complications and patients with diabetic nephropathy. The study group was composed of both genders, aged 31-70 years, who reported after 10-12 hours overnight fasting; then, venous blood and fresh urine samples were collected, in the morning from all the study subjects. Data were analysed using Statistical Package for the Social Sciences (SPSS). Independent t-test was used to compare between the groups and Chi square test was used to find out the relationship between serum hs-CRP and metabolic variables. Results: The results showed a significantly (p0.05) between hs-CRP and HDL-Cholesterol in both diabetic and diabetic nephropathy subjects. Conclusion: Hs-CRP was strongly associated with the metabolic variables and predictors of cardiovascular risk in Type 2 diabetes mellitus with and without nephropathy. The hs-CRP might be considered as a predictor or illness indicator for the development of nephropathy and cardiovascular risk in Type 2 diabetic patients.

Unlocking the full potential of pathology data by gaining computational access to histological pixel data and metadata (digital pathology) is one of the key promises of computational pathology. Despite scientific progress and several regulatory approvals for primary diagnosis using whole-slide imaging, true clinical adoption at scale is slower than anticipated. In the U.S., advances in digital pathology are often siloed pursuits by individual stakeholders, and to our knowledge, there has not been a systematic approach to advance the field through a regulatory science initiative. The Alliance for Digital Pathology ( the Alliance) is a recently established, volunteer, collaborative, regulatory science initiative to standardize digital pathology processes to speed up innovation to patients. The purpose is: (1) to account for the patient perspective by including patient advocacy; (2) to investigate and develop methods and tools for the evaluation of effectiveness, safety, and quality to specify risks and benefits in the precompetitive phase; (3) to help strategize the sequence of clinically meaningful deliverables; (4) to encourage and streamline the development of ground-truth data sets for machine learning model development and validation; and (5) to clarify regulatory pathways by investigating relevant regulatory science questions. The Alliance accepts participation from all stakeholders, and we solicit clinically relevant proposals that will benefit the field at large. The initiative will dissolve once a clinical, interoperable, modularized, integrated solution (from tissue acquisition to diagnostic algorithm) has been implemented. In times of rapidly evolving discoveries, scientific input from subject-matter experts is one essential element to inform regulatory guidance and decision-making. The Alliance aims to establish and promote synergistic regulatory science efforts that will leverage diverse inputs to move digital pathology forward and ultimately improve patient care.

Introduction: Effective management of an emergency situation in the dental office is ultimately the dentist′s responsibility. The lack of training and inability to cope with medical emergencies can lead to tragic consequences and sometimes legal action. It is logical to provide training on emergency care during undergraduate years ensuring basic competence in all graduating healthcare students. Previous surveys of medical and dental schools have highlighted deficiencies in such training. This survey sought to assess awareness of emergency drug use among students and teaching faculty in a dental college in Coorg, Karnataka. Materials and Methods: The study was carried out among a convenience sample of 250 dental students (III rd BDS, IV th BDS, Interns, and post graduates) and teaching faculty at the Coorg Institute of Dental Sciences, Coorg, Karnataka. The Closed - ended questionnaire containing selected basic multiple choice questions was used to assess the awareness. Results: About 60% of the responders scored < 50% marks, 15.6% of the responders scored between 50% and 59% marks, 14% of the responders scored 60-69% marks, 4.8% scored marks between 70% and 79% marks, only 5.6% of the responders scored between 80% and 89% marks. Conclusion: Awareness of emergency drug use among dental students and teaching faculty needs to be improved and updated.

Introduction: Dental neglect (DN) has been defined as behavior and attitudes which are likely to have detrimental consequences for the individual′s oral health, or more specifically as failure to take precautions to maintain oral health, failure to obtain needed dental care, and physical neglect of the oral cavity. Aim: The aim was to assess the association of DN with dental caries and oral hygiene among adolescents in Virajpet, India. Materials and Methods: A total of six hundred adolescents aged 15-18 years were selected. DN was recorded using self-administered questionnaire. Oral health status was clinically assessed using simplified oral hygiene index (OHI-S) and dental caries through dentition status as per WHO criteria. Results: The mean DN score for this population was 10.18. Sociodemographic variables and Dental Attendance pattern were significantly associated with DN. Mean decayed missing filled value and OHI-S values were also significantly associated with DN. Conclusion: The present study revealed that variations in DN exist in relation to sociodemographic characteristics and pattern of dental attendance. In addition, oral health status was significantly associated with DN among adolescents.

Introduction: Stress Urinary Incontinence (SUI) is a highly prevalent condition in women. This condition is often associated with negative body image and reduced quality of life. Transobturator midurethral tape surgery is currently the most favored type of management. Several questionnaires are available to assess the impact of this surgery on quality of life. Materials and Methods: We studied 32 patients who underwent Transobturator Tape (TOT) procedure for SUI. All patients were administered the Norwegian female incontinence questionnaire for urinary incontinence pre and post-operatively. We studied only the quality of life aspects in this questionnaire. Results were analysed using Wilcoxon paired rank test. Results: Thirty two patients with a mean age of 45.97±8 years (33-65 years) were studied. The usage of incontinence pads per week following surgery markedly reduced from a mean of 3.16 to 0.41. Patients more often got involved in various social activities following surgery. The mean score improved from 2.88 to 0.25. In patients who avoided places and situations without easy availability of toilet, the mean score improved from 2.97 to 0.28 post operatively. The negative impact of urinary leakage on the patients vacation, family life, social life and sleep markedly reduced from a mean of 2.75 to 1.03 (p-value

Background: Human skin is a reservoir of numerous microorganisms. Even though hand washing with soap and water alone reduces the microbial load, the complementary uses of hand antiseptics enhance the antimicrobial effect. Aim: To compare the antimicrobial effectiveness of two commercially available hand antiseptics, routinely used in dental practice, after hand washing with antiseptic soap. Method: A clinical trial with cross over design was carried out on 12 health care workers (HCWs). The antibacterial effectiveness of two hand antiseptics (Alcohol based -Sterillium and Herbal Based-Himalaya′s ′Pure Hands′) compared using fingerprint contact sampling on blood agar. Bacterial samples were obtained before and after hand washing (with antiseptic soap) and after hand disinfection. The data was tabulated and analyzed using one way ANOVA and Tukey′s post hoc test for pair-wise comparison. Result: There was a slight decrease in the Colony forming units (CFUs) count following use of antiseptic soap when compared to the baseline values. A statistically significant reduction (p

Introduction: India has seen a large influx of refugee populations throughout history and the Tibetan immigration is one among them. Understanding the health status and needs of immigrants is imperative because of their growing numbers and their input to the health of the nation. The oral health professionals face many challenges while confronting refugees and immigrants from cultures different from their own. Earlier studies have shown that children, especially refugees and immigrants have had a higher prevalence of unmet oral health needs. Aim: The purpose of this study was to assess and compare the oral health status of 11-13 year old Tibetan and non-Tibetan school children in Bylakuppe, Karnataka, India. Materials and Methods: A stratified cluster sampling of 11- 13 year old Tibetan and non-Tibetan school children (431 and 434 respectively) formed the study participants for this study. Assessment of dental caries, periodontal disease and malocclusion was done in accordance with criteria laid down by WHO in oral health assessment survey basic methods, 1997. Data was collected by a single trained examiner. The results obtained were analyzed by SPSS version 18. The data was statistically analyzed by using chi-square test and independent t test. The level of significance was set at 5%. Results: The prevalence of caries was found to be higher among the Tibetan school children when compared to the nonTibetan school children (71% and 53.9% respectively). The mean number of sextants with healthy gingiva (2.49±2.40) and calculus (1.63±2.28) was higher among the non-Tibetan school children. The mean Dental Aesthetic Index score was found to be higher for Tibetan school children than the non-Tibetan school children (26.57±4.62 and 23.52±4.36 respectively). Conclusion: The prevalence of caries, periodontal disease and malocclusion were found to be higher among immigrant Tibetan school children as when compared to non-Tibetan school children. The high level of unmet needs in the study population highlights the need for a comprehensive dental care programme in Bylakuppe.

Inflammatory Myofibroblastic Tumour (IMT) or ‘pseudotumour’ of the kidney is a rare benign tumour of unknown aetiology affecting mostly young adults. A subset of IMT is neoplastic and harbours translocations of activin receptor-like kinase-1 (ALK-1) gene and can recur or rarely metastasize. Presentation varies from an incidentaloma to gross haematuria. Clinical examination and radiological investigations are usually inconclusive. Often, biopsy is inconclusive necessitating a management similar to that of Renal Cell Cancer (RCC). Diagnosis is based on immunohistochemistry. We are reporting a case of IMT in a 50-year-old male patient who presented with left flank mass which on evaluation was suggestive of left renal cell carcinoma. Excision of the tumour, histopathological examination and Immunohistochemistry proved the tumour to be IMT.

The recent advancements in medical research field mainly highlights the genetic and molecular aspects of various disease processes and related treatment options, in a specialized “custom-made” approach. The medical and dental field has made tremendous progress in providing even with the smallest insight into pathological entities, thus, making patient management more fruitful. But, short comings have occurred in dental treatments involving odontogenic lesions mainly due to poor understanding of the developmental cycle involved during early stages of developmental process. Multiple numbers of interactions take place during embryo formation and further proliferation of tissue. One such important step is the interaction between epithelium and mesenchyme which tantamount to functional requirements of an individual tooth. The role of extra cellular molecules and genes has to be studied in depth to assess the impact and significance attached to it as the synergistic function of various elements underlines the complex process of development.

We are starting a project to find γ -ray millisecond pulsars (MSPs) among the unidentified sources detected by the Large Area Telescope (LAT) onboard the Fermi Gamma-Ray Space Telescope (Fermi), by radio observations. The selection of good candidates from analysis of the LAT data is an important part of the project. Given that there is more than 10 years worth of LAT data and the advent of the newly released LAT 8-year point source list (FL8Y), we have conducted a selection analysis, on the basis of our previous analysis, and report the results here. Setting the requirements for the unidentified sources in FL8Y of Galactic latitudes | b | > 5 ∘ and curvature significances >3 σ , there are 202 sources with detection signficances >6 σ . We select 57 relatively bright ones (detection significances >15 σ ) and analyze their 10.2 years of LAT data. Their variability is checked to exclude variable sources (likely blazars), test statistic maps are constructed to avoid contaminated sources, and curvature significances are re-obtained and compared to their γ -ray spectra to exclude non-significant sources. In the end, 48 candidates are found. Based on the available information, mostly from multi-wavelength studies, we discuss the possible nature of several of the candidates. Most of these candidates are currently being observed with the 65-meter Shanghai Tian Ma Radio Telescope.