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Abstract Background Skin cancer continues to be an imperative global health issue, urging continuous exploration of treatment methodologies. Conventional treatments for skin cancer include surgical interventions, immunotherapy, targeted therapy, chemotherapy, and radiation therapy. However, these methods often present obstacles like treatment resistance, systemic toxicity, limited effectiveness in advanced stages, infection risk, pain, long recovery, and impact on healthy tissue. Main body of the abstract Nanomedicine holds promise by facilitating precise drug administration, early detection, and heightened therapeutic efficiency via targeted and localized delivery systems. The integration of nanomedicine into skin cancer alleviation therapies demonstrates optimistic outcomes, including refined drug delivery, augmented bioavailability, minimized adverse effects, and potential theranostic applications. Recent breakthroughs in nanomedicine have propelled advancements in skin cancer treatment, showing significant potential in transforming the treatment paradigm. The presents review provides comprehensive aspects of existing skin cancer treatments and their challenges, spotlighting recent breakthroughs propelled by nanomedicine. Short conclusion This abstract delineates the present landscape of skin cancer treatments, underscores their constraints, and highlights recent strides in nanomedicine that have the potential to transform the paradigm of skin cancer treatment, ultimately elevating patient prognosis. Importantly, the present review emphasizes substantial challenges that hinder the clinical translation of nanomedicines and suggests possible remedies to surpass them. Graphic abstract

Introduction: Because of wide heterogeneity in the epidemiology of heart failure among different populations, it is imperative to establish population-specific databases. Aims and Objectives: To describe the clinical profile, treatment patterns, and outcomes of heart failure patients admitted to our tertiary care hospital. Material and Methods: The study was a prospective observational study conducted over two years at our tertiary care hospital. It included patients admitted with acute and acute-on-chronic heart failure. Results: We recruited 264 patients. Mean age of the study population was 57.8 ± 15.14 years. Males were 157 (59.5%). Dilated cardiomyopathy was the most common cause followed by ischemic heart disease. Most common risk factors were hypertension, tobacco use, anemia, and diabetes. Heart failure with reduced ejection fraction was present in 154 (62%) patients. Acute de novo heart failure was present in 91 (34.5%) patients. The most common precipitant for heart failure exacerbation was infection, followed by ischemic causes and non-adherence to drugs. The mean duration of hospital stay was 7.5 ± 3.1 days. The in-hospital mortality was 8.7%, and cumulative six-month and one-year mortality was 23% and 28%, respectively. In multivariate analysis, renal failure, readmission, and not being on guideline-directed medical treatment were significant predictors of mortality. Conclusion: Our patients were younger, predominantly males, with dilated and ischemic cardiomyopathy as commonest etiology. Hypertension and tobacco smoking were most common risk factors, with infections as most common precipitants. Only one-third of patients were on guideline-directed medical therapy. The one-year mortality was 28% and was higher in those without guideline-directed medical therapy.

This study analyses the impact of information and communications technology (ICT) diffusion and e-governance on sustainability in 148 Belt and Road Initiative (BRI) partner countries. It considers control variables such as institutional quality, urbanization, research and development (R&D), and the COVID-19 effect as dummy variables. Two step-generalised method of moments analysis of a panel dataset of 148 BRI partner countries from 2013 to 2021 reveals that ICT diffusion and e-governance benefit sustainability, with R&D and institutional quality also making positive contributions, while urbanization and the pandemic negatively impact sustainability. The findings were validated through D-K regression checks and support the technology spill-over effect, innovation, triple bottom line, endogenous growth, and stakeholder theories. They highlight the significance of investing in ICT infrastructure and digital literacy programs, improving institutional reforms and governance practices, putting sustainable urban planning into practice, and supporting R&D projects to advance sustainability in BRI partner nations. This study clarifies the potential problems brought forth by the pandemic and makes suggestions for reducing its negative effects on sustainability. It contributes to evidence-based decision-making, guiding sustainable practices in BRI partner nations.

Introduction: The most prevalent oral mucosal conditions in humans are leukoplakia, oral lichen planus (OLP), and oral submucous fibrosis (OSMF). These conditions should be studied as psychosomatic conditions, but little research has been done on how these conditions relate to stress. Materials and Methods: A total of 280 patients of both genders with ages 35–60 years were divided into four groups: leukoplakia, OSMF, OLP, and control. Whole blood samples were collected from all the participants and analyzed for serum cortisol by using ELISA with a commercial kit. Detailed case history and DASS-21 questionnaire were recorded for psychological assessment. To assess the variables, the student t test and Chi-square test were used. P values of

This study investigates the impact of income distribution as poverty reduction on sustainable development (SD), by taking the moderating role multidimensional regional integration (MRII) in fostering the integrated sustainability across 64 Belt and Road Initiative (BRI) countries from 2005 to 2020. Utilising Sys-GMM methodology, the findings support the notion that countries within the BRI are theoretically aligned with a sustainable development path as suggested by economic theory. Moreover, MRII significantly contributes to the integrated sustainability path. The direct channel analysis reveals a negative yet significant effect of income distribution on sustainable development, indicating an increase in disparity and capital management system. Conversely, the indirect channel suggests a reduction in disparity and regionally integrated BRI boost the sustainable poverty reduction. This study identifies positive contributions from macroeconomic conditions, institutional quality, and population size to BRI countries' sustainable development. Additionally, it suggests the inefficient utilisation of resources by BRI countries, particularly in government consumption. The study underscores the need for enhanced regional policies aimed at increasing income and reducing poverty to foster sustainable development. Upcoming research should investigate the unexplored effects of household consumption, financial inclusion, financial aid, and energy poverty influence on integrated sustainability, regarding global financial integration.

Oxidative stress contributes to the pathogenesis of hypertension and studies have shown that hypertension is associated with an increase in oxidative stress. Reactive oxygen species (ROS) lead to hypertension and antioxidants may be beneficial for its prevention. The main cause of oxidative stress in hypertension is endothelial dysfunction due to the malfunctions in the vasodilator systems, specifically the molecular mechanism of ROS and nitric oxide (NO). The level of malondialdehyde (MDA), a biomarker of lipid peroxidation and oxidative stress, is found to be higher in hypertension patients. Total antioxidant capacity (TAC), which has a strong relationship with blood pressure, is determined through the ferric reducing antioxidant power (FRAP). The aim of the review article is to elucidate the role of MDA and FRAP in hypertension. Keywords: oxidative stress, hypertension, blood pressure, oxidative damage, malondialdehyde, FRAP

Objectives: Community Health Workers (CHWs) are important healthcare professionals and key members of team. The purpose of this research is to identify the roles and responsibilities of CHWs in developed and developing countries who provide healthcare assistance to pregnant and lactating women.Methods: For this particular study, a comparison was conducted between CHWs role in seven developed countries, seven South Asian developing countries, and India, with special emphasis on improving maternal health status.Results: CHW programs are essential in communities, institutional health programs, and outreach delivery systems. Without active community involvement, CHWs cannot reach their full potential. Developed countries have frameworks for CHWs, such as the Swasthya Shebika Program, Village Health Worker Cadret, Lady Health Worker Programme, and Accredited Social Health Activist program. CHWs are well-paid in developed nations and work with marginalized groups to spread health messages. However, up to 60% of community health workers in low- and lower-middle-income countries do not receive remuneration.Conclusion: Health systems must support CHWs in choosing technical interventions and providing necessary training, supervision, and logistical support.

Background: Central obesity is a leading cause of insulin resistance, type 2 diabetes mellitus, dyslipidemia, and Cardiovascular Disease (CVD). Central obesity may act as an independent predictor for CVD. Aim and Objectives: To study the correlation of central obesity among obese patients with the risk factors for CVD. Material and Methods: In this case-control study, 50 non-obese and 50 obese subjects aged between 30-70 years were enrolled. Biochemical parameters: Fasting Blood Sugar (FBS), Glycated Hemoglobin (HbA1c), Total Cholesterol (TC), Triglyceride (TG), High-Density Lipoprotein-Cholesterol (HDL-C) and Low-Density Lipoprotein-Cholesterol (LDL-C) were estimated along with Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Body Mass Index (BMI) and Waist Circumference (WC). Value of p less than 0.05 was considered statistically significant. Results: Mean of FBS, HbA1c, TC, TG, LDL-C, SBP, DBP, BMI, and WC were significantly raised in obese compared to non-obese (p

A library of 121 potent, synthesized, and characterized compounds from different heterocyclic derivatives such as pyrimidine, phthalazine, benzothiazole, benzpyrazoline, indoline, benzimidazole, phthalazine, indole, quinoline, quinazoline were selected based on their anti-renal cancer activity. The Drug likeness, Bioactivity, Absorption, Distribution, Metabolism, Excretion, and Toxicity of all the screened compounds were predicted through Molinspiration, PreADMET, and Osiris software. After screening 121 compounds, 19 compounds showed drug-like properties and an absorption percentage better than the standard drug Sorafenib. These compounds were further assessed based on their distribution parameter and the compounds that showed plasma protein binding equal to or below 90% and blood-brain barrier penetration below 1.000 were selected, i.e., compounds 3, 23, 64, 65 were then further assessed for the toxicity. Osiris property explorer was used to predict drug relevance and toxicity of the synthesized compounds. Compounds 3 and 23 were non-toxic similar to the standard drug Sorafenib. Compounds 3 and 23 were found to be active as Kinase Inhibitors, with a bioactivity score of 0.2 and 0.6 compared to standard drug sorafenib, which scored 0.44. Therefore Compound 3 N-(4-fluoro-2-methoxyphenyl)-7-methyl-5,6,7,8-tetrahydropyrido [4',3':4,5] thieno[2,3-d] pyrimidin-4-amine and compound 23 1-(4-fluorophenyl)-3-methyl-N-phenyl-3a,7a-dihydro-1H-pyrazolo[3,4-d] pyrimidin-4-amine belonging to pyrimidine derivatives were considered as best and suggested to be taken further for preclinical and clinical trials. The pyrimidine derivatives with anti-renal cancer activity can serve as a scaffold for the design of renal cancer targeting agents and motivates the further development of effective and safer compounds.

Development and sharing of model approaches to national science policies can enable States Parties to effectively raise awareness about the security dimensions of life science research and to promote research integrity and the responsible use of science, as well as enhancing accountability practices among practitioners and fostering access to emerging capabilities in science and technology. It is also important to incorporate convergent domains of scientific endeavors in biological and particularly computer and information sciences, upon which the life sciences increasingly depend. Indeed, the rapid development of science and technology may be outpacing necessary ethical and regulatory practices. Thus, governments and civil society often struggle to anticipate emerging capabilities and to identify and implement appropriate oversight mechanisms, particularly for activities that occur outside the direct oversight of government programs. However, these efforts are critical for public health and serve as an extremely powerful action to counter the use of biological weapons.

Background: Chronic kidney disease (CKD) refers to a long-term loss of kidney function. The progression of CKD leads to the damage of other organs including cardiovascular disease which increased the risk of mortality. Early detection of kidney failure can slow down the end-stage renal disease. Aims and Objectives: To estimate the inflammatory marker Adenosine deaminase (ADA) activity in different stages of CKD. To correlate the level of ADA activity with Serum Creatinine with different stages of CKD on the basis of estimated glomerular filtration rate (eGFR). Materials and Methods: The participants having age more than 18 and

Introduction: Adiponectin (APN) is an adipose-derived protein. It has shown a variety of functions such as anti-inflammatory, anti-atherogenic, antidiabetic, and insulin-sensitizing and lipid-oxidation-enhancing activities. The APN levels have shown a significant relationship with the risk factors for type 2 diabetes mellitus (T2DM). As per the Madras Diabetes Research Foundation-Indian Diabetes Risk Score (MDRF-IDRS), Asian Indians have high risk factors for T2DM and its complications. APN levels influence the risk factors for T2DM and its complications. Its circulatory level also varied with the age, family history of T2DM, waist circumference, and level of physical activity. Aim: The purpose of this narrative review is to find the association of circulatory APN with the parameters of MDRS-IDRS. Materials and Methods: Articles were searched by various databases such as PubMed, MEDLINE, Scopus, Web of Science, and Google Scholar. Abstract, free full-text, and full-text articles were searched from the year 2003 to 2022. For this review, observational study, original articles, narrative review, systematic review, and meta-analysis articles published in the English language were included. It is needed to establish the association between the APN levels and the parameters of MDRF-IDRS. The modifiable risk factors of MDRF-IDRS may play a significant role to regulate the level of APN. The non-modifiable risk factors of MDRF-IDRS may help in the better management of APN levels and reduce the prevalence of T2DM. It is needed to clear that the APN levels influence the disease severities or not. It is also needed to improve the physical activity to regulate the APN level and to reduce the systemic inflammation and insulin resistance in Asian Indian population. Conclusion: Improvement in modifiable risk factors of MDRF-IDRS and level of APN may play a significant role in the therapeutic approach to prevent and/or delay the development of T2DM and its complications.

Polycystic ovary syndrome (PCOS) is a metabolic and endocrine disorder affecting the global population, originally named as “schlerocystic ovaries”, “multicystic ovaries”, “Stein Leventhal Syndrome”. Obesity is believed to play a central role in the development of PCOS, as women with this condition are reported to be overweight or obese and the effect of excess weight is inconsistent. Numerous hormonal imbalances, including hyperandrogenism, insulin resistance (IR), and hyperinsulinemia, are reported to be present. The hypothalamus-hypophysis-ovary axis appears to be disrupted by insulin, and insulin resistance in ovarian tissue leads to impaired metabolic signalling but intact mitogenic and steroidogenic activity, favouring hyperandrogenemia, is thought to be the primary cause of PCOS. The metabolic issues of PCOS seem to have IR as a common pathophysiologic mechanism, which is described as a metabolic state marked by a reduction in cellular responsiveness to insulin signalling. Despite the fact that IR plays a role in the development of PCOS, patients exhibit unique ovarian dysfunction-causing processes that are unrelated to IR. PCOS is a polygenic and multifactorial syndrome/disorder and many genes have been associated with PCOS such as fat mass and obesity-associated (FTO) gene. The review article presents the current understanding of the disease and the clinical spectrum and genetic variants associated with PCOS. The mechanisms by which variants in the genes confer risk of PCOS and the genetic elements underlying PCOS remain to be determined. Elucidation of genetic markers and cellular pathways underlying PCOS will be useful in understanding the pathophysiology of this syndrome.

Periodontitis, a chronic inflammatory disease of oral cavity, caused by the complex interactions between host immune system and sub-gingival microbiota leading to chronic gingival inflammation, loss of periodontal ligament attachment, dental impairment, and finally tooth loss. Prevalence of periodontal disease varies and reported a higher prevalence in Asian countries. The conventional diagnostic techniques used for periodontitis are inherently limited. Periodontitis immunopathogenesis studies and mediator analyzes in saliva allowed the identification of a number of disease-specific molecular biomarkers. In this review article, diagnostic role of various salivary biomarkers in periodontitis has been discussed. Original articles, systematic and narrative reviews related to relevant study, published since 2009-2019 were included in the literature search through PubMed, Google Scholar, Web of Science and Scopus. Convenient assessments of these salivary biomarkers with analytical chair facilities will yield more accurate diagnostic results which will further aid in early detection and better clinical management of periodontitis patients.

Among various metal-based nanoparticles, silver nanoparticles (AgNPs) manifest superior inhibitory effects against several microorganisms. In fact, the AgNP-based treatment has been reported to inhibit both sensitive and resistant isolates of bacteria and other disease-causing microbes with equal propensity. Keeping this fact into consideration, we executed bio-mediated synthesis of AgNPs employing extract of flower and various other parts (such as bud and leaf) of the Hibiscus rosa-sinensis plant. The physicochemical characterization of as-synthesized AgNPs was executed employing transmission electron microscopy (TEM), dynamic light scattering (DLS), zeta potential, Fourier transform infrared (FTIR) spectroscopy, and UV-Vis spectroscopy, etc. The as-synthesized AgNPs demonstrated strong antimicrobial activity against both Gram-positive and Gram-negative bacteria with equal propensity. The as-synthesized AgNPs successfully inhibited Streptococcus mutans (S. mutans), one of the main causative bacteria responsible for dental caries. Considering the fact that orthodontic appliances facilitate infliction of the oral cavity with a range of microbes including S. mutans, we determined the growth inhibitory and anti-adherence activities of AgNPs on orthodontic appliances. We performed microbiological assays employing AgNPs adsorbed onto the surface of nickel–titanium (Ni-Ti) orthodontic wires. A topographic analysis of the decontaminated Ni-Ti orthodontic wires was performed by scanning electron microscopy. In addition to antimicrobial and anti-biofilm activities against oral S. mutans, the as-fabricated AgNPs demonstrated significant inhibitory and anti-biofilm properties against other biofilm-forming bacteria such as Escherichia coli and Listeria monocytogenes.

Objectives: To assess knowledge, attitude and practice of medical and paramedical staff about cervical cancer as well as its screening and prevention. Methods: The descriptive cross-sectional study was conducted at the Jinnah Post-graduate Medical Centre, Karachi, from March 1 to August 30, 2019, and comprised women medical and paramedical staff randomly selected from different specialties. Data was collected using a structured questionnaire. Data was analysed using SPSS 20. Results: Of the 347 participants 144(41.5%) were nurses and 203(58.5%) were doctors. The overall mean age was 26.22±6.38 years. Of the total, 108(30%) respondents were married and 239(68%) were single. Overall, 239(68.8%) were well aware of Pap smear being the screening test; 85(24.5%) were aware of the true guidelines to repeat the test; 152(43.8%) had an idea of the exact use of visual Inspection with acetic acid; 61(17.6%) had got a Pap smear done; and 156(45%) thought they were at risk of developing carcinoma cervix. The common risk factors identified were multiple sexual partners 254(73.2%), age at first sexual intercourse 160(46%), smoking 131(37.8%), foul-smelling discharge 221(63.7%), and post-coital bleeding 231(66.6%). Conclusion: Cervical cancer prevalence is rising due to inadequate knowledge and awareness among healthcare personals. Improvement can be brought by regular use of Pap smear. Key Words: Cervical cancer, Pap smear, Healthcare professionals, Visual inspection with acetic acid.

Ossifying fibroma is a rareentity among the other type of fibro-osseous lesions. It is a non-odontogenic, benign tumor of the jaw, which arises from the multipotential cells of the periodontal ligament. Previously in 1992, WHO classified this type of lesion into ossifying fibroma and cemento-ossifying fibroma. Now the term- “cemento-ossifying fibroma” is replaced with “ossifying fibroma” in recent WHO classification (2005). These tumors are slow growing, painless and occur more commonly in the mandible and in the third and fourth decades of life with slight female predilection. Hereby, in this article, an unusual case of central ossifying fibroma in an 80-year-old female patient with expansile swelling of the right side of mandible since 2 months is repotred. The diagnosis was further confirmed by Cone beam computed tomography (CBCT) and histopathological evaluation. The main objective of this article is to enlighten about the diagnostic dilemma of mandibular swellings and atypical clinical behavior of central ossifying fibroma.

In developing countries, one of the usual practices is the uncontrolled, open burning of corn stalk (CS) or its utilization as a fuel. It is known that the ash obtained under uncontrolled burning conditions constitutes blackish and unburnt carbon particles as well as whitish and grayish particles (representing crystallization of silica) due to over burning. However, controlling the burning process can improve the quality of ash produced to effectively use it in cement-based materials. Hence, this research was aimed at exploring the pozzolanic properties of corn stalk ash upon calcination and grinding, for it to be used in the manufacturing of sustainable cement-based materials. In order to obtain a suitable corn stalk ash (CSA), which can be used in cement/concrete, a research investigation consisted of two phases. In the first phase, calcination was carried out at 400°C, 500°C, 600°C, 700°C, and 800°C for 2 hours. The tests applied on the resulting ashes were weight loss, XRD, pozzolanic activity index (PAI), Chapelle, Fratini, and consistency. From XRD spectra, it was found that, at lower temperatures, silica remained amorphous, while it crystallized at higher temperature. Ash combusted at a temperature of 500°C possessed largest pozzolanic activity of 96.8%, had a Fratini CaO reduction of 93.2%, and Chapelle activity of 856.3 mg/g. Thus, 500°C was chosen as an optimum calcination temperature. In the second phase, the ash produced at 500°C was grinded for durations of 30, 60, 120, and 240 minutes to ascertain the optimum grinding times. Resulting ashes were examined for hydrometer analysis, Blaine fineness, Chapelle activity, and pozzolanic activity. Experiment outcomes revealed a direct relationship between values of Blaine fineness, surface area, Chapelle activity, PAI, and grinding duration. It was concluded that CSA can be used as a pozzolan, and thus, its utilization in cement/concrete would solve ash disposal problems and aid in production of eco-friendly cement/concrete.

The mechanistic link between metabolic stress and associated cardiomyopathy is unknown. Here the authors show that high fat diet causes calpain-1-dependent degradation of ERK5 leading to mitochondrial dysfunction, suggesting the maintenance of cardiac ERK5 as a therapeutic approach for cardiomyopathy prevention and/or treatment.

Hypertension, a worldwide epidemic at present, is not a disease in itself rather it is an important risk factor for serious cardiovascular disorders including myocardial infarction, stroke, heart failure, and peripheral artery disease. Though numerous drugs acting via different mechanism of action are available in the market as conventional formulations for the treatment of hypertension but they face substantial challenges regarding their bioavailability, dosing and associated adverse effects which greatly limit their therapeutic efficacies. Various studies have demonstrated that nanocarriers can significantly increase the drug bioavailability thereby reducing the frequency of dosing in addition to minimizing toxicity associated with high dose of the drug. The present review provides an insight into the challenges associated with the conventional antihypertensive formulations and need for oral nanoparticulate systems in order to overcome problems associated with conventional formulations. Hypertension has circadian pattern of blood pressure, therefore chronotherapeutics can play a decisive role for the treatment, and however, nanoparticulate system can play major role in hypertension management. Future prospective for particulate nanocarriers in drug delivery for hypertension includes chronotherapeutics and emerging technique like gene therapy which is also covered in the review.

The main aim of the present study was to develop and evaluate Terbinafine HCl (TH)-loaded nanostructured lipid carrier (NLC) for the treatment of fungal infection via topical administration. Fungal infections are tremendously widespread and the treatments are effective but associated toxicities restrict their use. TH-NLC was prepared using high pressure homogenization technique using Glyceryl Monostearate (GMS) as solid lipid, Labrasol as liquid lipid and Pluronic F-127 as surfactant, binary lipid phase was selected in the ratio 6:4 w/w (solid:liquid lipid ratio). The mean diameter of optimized TH-NLCs was found to be 128 ± 4.5 nm. Spherical shape and size were confirmed using scanning electron microscopy (SEM) and transmission electron microscopy (TEM) analyses. The in vitro release studies showed 92.60 ± 0.87% drug release over 24 h as compared to the marketed formulation which showed only 82.826 ± 0.29%. Ex vivo skin permeation study showed about 86.35% permeation however from the marketed formulation it showed 69.41%. The pharmacodynamic studies indicated that TH-NLC (771 ± 41.797 CFUs) gel efficiently reduced the fungal burden in shorter duration of time as compared to marketed formulation (1558 ± 140.524 CFUs) and dispersion (95,582 ± 2316.619 CFUs) (p value > 0.001). Therefore, it can be concluded that the developed NLCs showed a sustained release pattern and reduction of fungal burden in the infected area. Hence, TH-NLC could be a potential alternative for treatment of topical fungal infection after clinical evaluation in near future.

In the present study, midazolam (MDZ)-loaded chitosan nanoparticle formulation was investigated for enhanced transport to the brain through the intranasal (IN) route. These days, IN MDZ is very much in demand for treating life-threatening seizure emergencies; therefore, its nanoparticle formulation was formulated in the present work because it could substantially improve its brain targeting via the IN route. MDZ-loaded chitosan nanoparticles (MDZ-CSNPs) were formulated and optimized by the ionic gelation method and then evaluated for particle size, particle size distribution (PDI), drug loading (DL), encapsulation efficiency (EE), and in vitro release as well as in vitro permeation. The concentration of MDZ in the brain after the intranasal administration of MDZ-CSNPs (Cmax 423.41 ± 10.23 ng/mL, tmax 2 h, and area under the curve from 0 to 480 min (AUC0-480) of 1920.87 ng.min/mL) was found to be comparatively higher to that achieved following intravenous (IV) administration of MDZ solution (Cmax 245.44 ± 12.83 ng/mL, tmax 1 h, and AUC0-480 1208.94 ng.min/mL) and IN administration of MDZ solution (Cmax 211.67 ± 12.82, tmax 2 h, and AUC0-480 1036.78 ng.min/mL). The brain–blood ratio of MDZ-CSNPs (IN) were significantly greater at all sampling time points when compared to that of MDZ solution (IV) and MDZ (IN), which indicate that direct nose-to-brain delivery by bypassing the blood–brain barrier demonstrates superiority in brain delivery. The drug-targeting efficiency (DTE%) as well as nose-to-brain direct transport percentage (DTP%) of MDZ-CSNPs (IN) was found to be comparatively higher than that for other formulations, suggesting better brain targeting potential. Thus, the obtained results demonstrated that IN MDZ-CSNP has come up as a promising approach, which exhibits tremendous potential to mark a new landscape for the treatment of status epilepticus.

Introduction The importance of Indigenous data sovereignty and Indigenous-led research processes is increasingly being recognized in Canada and internationally. For First Nations in Ontario, Canada, access to routinely-collected demographic and health systems data is critical to planning and measuring health status and outcomes in their populations. Linkage of this data with the Indian Register (IR), under First Nations data governance, has unlocked data for use by First Nations organizations and communities. Objectives To describe the linkage of the IR database to the Ontario Registered Persons Database (RPDB) within the context of Indigenous data sovereignty principles. Methods Deterministic and probabilistic record linkage methods were used to link the IR to the RPDB. There is no established population of First Nations people living in Ontario with which we could establish a linkage rate. Accordingly, several approaches were taken to determine a denominator that would represent the total population of First Nations we would hope to link to the RPDB. Results Overall, 201,678 individuals in the national IR database matched to Ontario health records by way of the RPDB, of which 98,562 were female and 103,116 were male. Of those First Nations individuals linked to the RPDB, 90.2% (n=181,915) lived in Ontario when they first registered with IR, or were affiliated with an Ontario First Nation Community. The proportion of registered First Nations people linking to the RPDB improved across time, from 62.8% in the 1960s to 94.5% in 2012. Conclusions This linkage of the IR and RPDB has resulted in the creation of the largest First Nations health research study cohort in Canada. The linked data are being used by First Nations communities to answer questions that ultimately promote wellbeing, effective policy, and healing.

Background: Indigenous peoples in Canada have higher rates of kidney disease than non-Indigenous Canadians. However, little is known about the risk of kidney disease specifically in the Métis population in Canada. Objective: To compare the prevalence of chronic kidney disease and incidence of acute kidney injury and end-stage kidney disease among registered Métis citizens in Ontario and a matched sample from the general Ontario population. Design: Population-based, retrospective cohort study using data from the Métis Nation of Ontario’s Citizenship Registry and administrative databases. Setting: Ontario, Canada; 2003-2013. Patients: Ontario residents ≥18 years. Measurements: Prevalence of chronic kidney disease and incidence of acute kidney injury and end-stage kidney disease. Secondary outcomes among patients hospitalized with acute kidney injury included non-recovery of kidney function and mortality within 1 year of discharge. Methods: Database codes and laboratory values were used to determine study outcomes. Métis citizens were matched (1:4) to Ontario residents on age, sex, and area of residence. The analysis included 12 229 registered Métis citizens and 48 916 adults from the general population. Results: We found the prevalence of chronic kidney disease was slightly higher among Métis citizens compared with the general population (3.1% vs 2.6%, P = 0.002). The incidence of acute kidney injury was 1.2 per 1000 person-years in both Métis citizens and the general population ( P = 0.54). Of those hospitalized with acute kidney injury, outcomes were similar among Métis citizens and the general population except 1-year mortality, which was higher for Métis citizens (24.5% vs 15.3%, P = 0.03). The incidence of end-stage kidney disease did not differ between groups (

Mechanistic investigations coupled with epidemiology, case-control, cohort and observational studies have increasingly linked isocyanate exposure (both chronic and acute) with pulmonary morbidity and mortality. Though ascribed for impairment in endothelial cell function, molecular mechanisms of these significant adverse pulmonary outcomes remains poorly understood. As preliminary studies conducted in past have failed to demonstrate a cause-effect relationship between isocyanate toxicity and compromised pulmonary endothelial cell function, we hypothesized that direct exposure to isocyanate may disrupt endothelial structural lining, resulting in cellular damage. Based on this premise, we comprehensively evaluated the molecular repercussions of methyl isocyanate (MIC) exposure on human pulmonary arterial endothelial cells (HPAE-26). We examined MIC-induced mitochondrial oxidative stress, pro-inflammatory cytokine response, oxidative DNA damage response and apoptotic index. Our results demonstrate that exposure to MIC, augment mitochondrial reactive oxygen species production, depletion in antioxidant defense enzymes, elevated pro-inflammatory cytokine response and induced endothelial cell apoptosis via affecting the balance of mitochondrial-nuclear cross talk. We herein delineate the first and direct molecular cascade of isocyanate-induced pulmonary endothelial cell dysfunction. The results of our study might portray a connective link between associated respiratory morbidities with isocyanate exposure, and indeed facilitate to discern the exposure-phenotype relationship in observed deficits of pulmonary endothelial cell function. Further, understanding of inter- and intra-cellular signaling pathways involved in isocyanate-induced endothelial damage would not only aid in biomarker identification but also provide potential new avenues to target specific therapeutic interventions.

Aim: Betel chewer′s mucosa, although not considered as a potentially malignant lesion, has been suggested to be a precursor of oral submucous fibrosis (OSMF). Thus a study was undertaken to asses various quid chewing patterns in patients with chewer′s mucosa and to evaluate possible association between chewer′s mucosa and a particular quid usage patter. Materials and methods: The study was done on 150 subjects clinically diagnosed of having chewers mucosa lesion. After complete oral examination, a detailed habit history was taken through preformed questionnaire. The data obtained was analyzed using Chi-square test. Results: Among the 150 subjects males to female ratio was 8:2- Majority of the subjects were within the age group of 20 to 30 years and chewed a combination of betel leaf, arecanut, tobacco, lime- Majority of the subjects of chewer′s mucosa used the quid for a duration of 1 to 5 years, a frequency of three to five quid per day. Conclusion: In the present study, chewers mucosa was seen in majority of the subjects who used the quid for a duration of 1 to 5 years, a frequency of three to five quid per day and chewed the quid containing betel leaf, arecanut, tobacco, lime as its constituents.

The burden of cardiovascular disease in the Métis, Canada's fastest growing Aboriginal group, is not well studied. We determined rates of five cardiovascular diseases and associated outcomes in Ontario Métis, compared to the general Ontario population.Métis persons were identified using the Métis Nation of Ontario Citizenship Registry. Métis citizens aged 20-105 were linked to Ontario health databases for the period of April 2006 to March 2011. Age- and sex-standardized prevalence and incidence of acute coronary syndromes (ACS), congestive heart failure (CHF), cerebrovascular disease (stroke), atrial fibrillation, and hypertension were compared between the Métis and the general population. Secondary outcome measures included one-year hospitalizations and mortality following the incident cardiovascular diagnosis, as well as quality-of-care measures.There were 12,550 eligible Métis persons and 10,144,002 in the general population. The adjusted prevalence of each disease was higher (p

Osteomas are relatively rare benign osteogenic neoplasm′s characterized by the proliferation of compact or cancellous bone. Osteomas can develop as peripheral (periosteal) masses attached to the cortical plates or as central lesions arising from endosteal bone surfaces. Although multiple osteomas of the jaws are a hallmark of Gardner′s syndrome (familial adenomatous polyposis), non-syndromic cases are typically solitary. The purpose of this paper is to present a large peripheral osteoma originating from the buccal surface of the mandible and causing asymmetry in a 35-year-old woman.

INTRODUCTION: Chronic respiratory diseases cause a significant health and economic burden around the world. In Canada, Aboriginal populations are at increased risk of asthma and chronic obstructive pulmonary disease (COPD). There is little known, however, about these diseases in the Canadian Métis population, who have mixed Aboriginal and European ancestry. A population-based study was conducted to quantify asthma and COPD prevalence and health services use in the Métis population of Ontario, Canada's largest province. METHODS: The Métis Nation of Ontario Citizenship Registry was linked to provincial health administrative databases to measure and compare burden of asthma and COPD between the Métis and non-Métis populations of Ontario between 2009 and 2012. Asthma and COPD prevalence, health services use (general physician and specialist visits, emergency department visits, hospitalizations), and mortality were measured. RESULTS: Prevalences of asthma and COPD were 30% and 70% higher, respectively, in the Métis compared to the general Ontario population (p

Many award-winning books for young people take the form of a hero's journey, as conceptualized by Joseph Campbell. The young protagonists of these books (which include Lewis's The Lion, the [...]

Abstract This submission is part of AAMC/ADEA project, Building Oral Health Capacity in Medical Curriculum. This resource is designed to provide the learner about oral specifically periodontal health and how it relates to systemic health. Through clinical pictures and radiographs, this resource will enable the learners to recognize signs of inflammation and periodontal disease and be able to compare and contrast between health state and disease state. It will also familiarize the learners of the adverse effect of commonly prescribed medications. Risk Assessment form will help learners to identify patients at risk of periodontal disease. This resource will also will present some of the studies that found potential correlation between periodontal disease and systemic health. Prevention of periodontal disease is presented through three videos, showing a dentist performing a periodontal exam and oral hygiene instructions. Resources provided in this publication facilitate referral process to dental professionals. Interactive Quizzes are included to help the learners to test the knowledge obtained through this presentation. Periodontal disease is a common preventable inflammatory disease triggered by microorganisms. Oral health exam is an integral part of systemic health yet it is often overlooked by physicians. Periodontal disease can affect and be affected by systemic diseases. Emerging evidence has found correlation between periodontal disease, being a source of infection and inflammation, and systemic diseases such as diabetes, preterm labor, smoking and cardiovascular diseases. Although some of these studies have shown strong correlations, other studies did not find any association at all. This presentation will present studies representing both kinds of studies. This resource hopefully will be an initiative for including oral health in medical education curriculum as an inseparable part of the human body. This resource will raise awareness amongst health care professionals to hopefully include a simple oral exam in their physical exam. This will help identify potential dental and health problems. Resources in this submission will help them assess the risk and provide referral information for their patients. Videos included will familiarize the learner with periodontal exams and proper Oral hygiene practices, considered a preventive public health measure. This submission will enhance collaboration between health care providers and so treat the patient as a whole, enhancing overall individual and public health.

This article focuses on 13 picturebooks by South Asian authors which the author categorizes as culturally conscious picturebooks. These books show the beauty of the lived experiences of South Asian American families. The author argues that in response to the sociopolitical realities, social studies educators can expand their curricula to weave in voices from South Asian communities.

Purpose: Early career teachers (ECTs) of Color are key in making change, resisting racism and pushing back against white supremacy in K-12 education, specifically in English Language Arts (ELA) classrooms. Through a narrative telling inquiry (Clandinin and Connelly, 2000) of Nora, an Asian American ELA ECT in the Midwest, and by drawing on Fisher's (2011) Critical Integral Pedagogy of Fearlessness, this study aims to recognize the narrative power within teaching praxis as Nora stories herself toward becoming a critical pedagogue. Design/methodology/approach: Using narrative inquiry methodology and methods (Clandinin and Connelly, 2000), the authors simultaneously considered the commonplace tenets of narrative inquiry -- temporality, sociality and place -- of the intertwined relationships of the participants and observers. The field texts included in the corpus of data include myriad tellings of Nora's experiences in her initial years of teaching ELA. Data were analyzed in stages of parsing out narrative blocks and structures. Findings: The findings indicate that Nora, as an ECT, went through recursive cycles of fear as conceptualized by Fisher (2011) -- bravery, courageousness and being fear-less -- of working toward radical love (Hooks, 2000) within her ELA instruction. The authors argue that Nora confronted her personal and professional fears as she strove to become a critical pedagogue in her ELA classroom. Originality/value: Current scholarship portrays ECTs as lacking agency in their development and/or effectiveness in the classroom and little is said about Asian American ELA ECTs and critical instruction. The authors present Nora's counter-narrative to make visible what is right with ELA ECTs, specifically teachers of Color, as they transform their fear into courage to fight for educational equity.

Transformative, anti-oppressive curricula, as theorized by Banks (1989, 2014) and Kumashiro (2001, 2009), directly address present-day realities of racism, discrimination, and oppression. According to Banks (1989), a transformative curriculum includes "the infusion of various perspectives, frames of reference, and content from various groups, that will extend students' understandings of the nature, development, and complexity of U.S. society" (p. 18). Transformative curricula challenge the dominant narrative of the United States as a nation that was built upon the principle of equality for all. For teachers, integrating children's literature means making decisions that require a deep understanding of curriculum, learning processes, social context, and literature. These decisions require risk-taking on the part of the teacher who is stepping away from a prescribed curriculum and into topics and content that may disrupt the values represented in the traditional curriculum. (Flores et al., 2019) The standard U.S. literacy curricula are not built on a foundation of cultural relevance, criticality, or social justice (Ladson-Billings, 2014; Muhammad, 2020); therefore, the resources prescribed for teaching literacy, including children's literature, are perceived as culturally neutral and racially color-blind. However, critical teachers and scholars begin with the premise that all stories are political in nature. This study investigated the curriculum development practices of two critical elementary educators who used their daily read-aloud time to challenge the dominant narrative that the United States is equitable and just.

This review of literacy education scholarship examines the ways that children's literature is used as a resource within literacy methods courses in the preparation of preservice teachers (PTs) as transformative intellectuals. The research indicates that the use of children's literature in literacy methods courses has served two distinct purposes: (a) to engage PTs in learning literacy instructional practices and (b) to engage PTs in building sociocultural knowledge and learning transformative (e.g., culturally relevant) pedagogies. This review is framed by Giroux's call for educators to disrupt technocratic approaches to instruction. The findings emphasize the importance of using children's literature with PTs to broaden PTs' understandings of their future student's lives, so they might engage in transformative pedagogies as future K-12 literacy educators.

Although the call for teachers to address the demographic imperative has existed for decades, recently, there has been an uptake of frameworks of multicultural education, culturally responsive pedagogies, critical literacy, and others into literacy teacher preparation. In this study, we examine connections that pre-service teachers make as a result of experiences focused on sociocultural knowledge and literacy and barriers they face in building these connections. Areas of connection include examining one's past; recognizing students' lives and resources in literacy teaching; considering race, racism, and students' racial identity; drawing on multilingualism as a strength of students for literacy learning; and engaging actively and inquiring into literacy.

Many teacher education programs provide teachers with opportunities to read, write, and discuss critical pedagogy, with the hope that such work will allow them to develop more equitable and just teaching practices. Yet, there often remains a gap between the theoretical discussions of teaching and learning in teacher education classrooms and the pedagogical practice in those teachers' K-12 classrooms. In this study, we examine how one teacher, Gabriela, used narratives to make connections between her third-grade classroom and the critical concepts she was exploring in a teacher education course. Embedded within an ethnographic case study of an inservice teacher education program, we used a discourse analytic approach to examine both the sociocultural knowledge and the identities Gabriela constructed through narrative as she engaged with issues of language, race, and power within the course. We consider some of the affordances of narrative in this space, including how it allowed Gabriela to integrate her understandings of multiple course topics, to position herself in multiple ways as a teacher, and to disrupt her existing understandings of race and racism in the classroom. This analysis suggests that critically oriented teacher education programs might more intentionally make space for narrative to connect critical theory and pedagogical practice.

Background and objectives: As microbes are developing resistance to antibiotics, natural, botanical drugs or traditional herbal medicine are presently being studied with an eye of great curiosity and hope. Hence, complementary and alternative treatments for uncomplicated pelvic inflammatory disease (uPID) are explored for their efficacy. Therefore, this study determined the therapeutic efficacy and safety of Sesamum indicum Linn seeds with Rosa damascena Mill Oil in uPID with standard control. Additionally, we analyzed the data with machine learning. Materials and methods: We included 60 participants in a double-blind, doubledummy, randomized standard-controlled study. Participants in the Sesame and Rose oil group (SR group) (n = 30) received 14 days course of black sesame powder (5 gm) mixed with rose oil (10 mL) per vaginum at bedtime once daily plus placebo capsules orally. The standard group (SC), received doxycycline 100 mg twice and metronidazole 400 mg thrice orally plus placebo per vaginum for the same duration. The primary outcome was a clinical cure at post-intervention for visual analogue scale (VAS) for lower abdominal pain (LAP), and McCormack pain scale (McPS) for abdominal-pelvic tenderness. The secondary outcome included white blood cells (WBC) cells in the vaginal wet mount test, safety profile, and health-related quality of life assessed by SF-12. In addition, we used AdaBoost (AB), Naïve Bayes (NB), and Decision Tree (DT) classifiers in this study to analyze the experimental data. Results: The clinical cure for LAP and McPS in the SR vs SC group was 82.85% vs 81.48% and 83.85% vs 81.60% on Day 15 respectively. On Day 15, pus cells less than 10 in the SR vs SC group were 86.6% vs 76.6% respectively. No adverse effects were reported in both groups. The improvement in total SF-12 score on Day 30 for the SR vs SC group was 82.79% vs 80.04% respectively. In addition, our Naive Bayes classifier based on the leave-one-out model achieved the maximum accuracy (68.30%) for the classification of both groups of uPID. Conclusion: We concluded that the SR group is cost-effective, safer, and efficacious for curing uPID. Proposed alternative treatment (test drug) could be a substitute of standard drug used for Female genital tract infections. [ABSTRACT FROM AUTHOR]