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Three metal‐free organic D−π−A dyes with benzothieno[3,2‐b]indole as electron donor, cyanoacrylic acid as both electron acceptor and anchoring group with benzene (BID‐1), thiophene (BID‐2) and furan (BID‐3) as π‐spacers were designed and synthesized for application in dye‐sensitized solar cells (DSSCs). A planar and electron‐rich heterocycle such as benzothieno[3,2‐b]indole offers better backbone rigidity and improves charge transport properties in comparison to indolo[3,2‐b]indole donor, previously reported from our group. Additionally, we synthesized a benzothieno[3,2‐b]indole donor grafted with longer alkyl chains which efficiently prevented the approach of oxidized species in the electrolyte coming closer to semiconductor thereby arresting recombination. A power conversion efficiency of 4.11 % was achieved for dye‐sensitized solar cells based on the furan π‐spacer benzothieno[3,2‐b]indole dye BID‐3 in comparison to the corresponding indolo[3,2‐b]indole dye (IID‐3) having an efficiency of 1.71 %. Detailed interfacial electrical measurements along with theoretical calculations disclosed the mechanism of back electron transfer and improvement in photovoltaic performance with respect to variation in both donor and π‐spacer. [ABSTRACT FROM AUTHOR]

Stroke causes brain damage and is one of the main reasons for death. Most survivors of stroke face long-term physical disabilities and cognitive dysfunctions. In addition, they also have persistent emotional and behavioral changes. The two main treatments that are effective are reperfusion with recombinant tissue plasminogen activator and recanalization of penumbra using mechanical thrombectomy. However, these treatments are suitable only for a few patients due to limitations such as susceptibility to hemorrhage and the requirement for administering tissue plasminogen activators within the short therapeutic window during the early hours following a stroke. The paucity of interventions and treatments could be because of the multiple pathological mechanisms induced in the brain by stroke. The ongoing immune response following stroke has been attributed to the worsening brain injury. Hence, novel compounds with immunomodulatory properties that could improve the outcome of stroke patients are required. Natural compounds and medicinal herbs with anti-inflammatory activities and having minimal or no adverse systemic effect could be beneficial in treating stroke. Ocimum sanctum is a medicinal herb that can be considered an effective therapeutic option for ischemic brain injury. Ocimum sanctum , commonly known as holy basil or "Tulsi," is mentioned as the "Elixir of Life" for its healing powers. Since antiquity, Tulsi has been used in the Ayurvedic and Siddha medical systems to treat several diseases. It possesses immuno-modulatory activity, which can alter cellular and humoral immune responses. Tulsi can be considered a potential option as an immuno-modulator for treating various diseases, including brain stroke. In this review, we will focus on the immunomodulatory properties of Tulsi, specifically its effect on both innate and adaptive immunity, as well as its antioxidant and antiinflammatory properties, which could potentially be effective in treating ongoing immune reactions following ischemic brain injury., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background Clopidogrel has become essential in managing coronary artery disease and other atherothrombotic diseases. It is an inactive prodrug that needs biotransformation in the liver by various cytochrome P (CYP) 450 isoenzymes for its active metabolite formation. However, 4-30% of patients on clopidogrel have shown no or decreased antiplatelet response. This condition is called 'clopidogrel non-responsiveness' or 'clopidogrel resistance.' This is attributed to genetic heterogeneity causing interindividual variation and increased risk of major adverse cardiac events (MACEs). This study aimed to assess MACEs and their association with CYP450 2C19 polymorphisms in post-coronary intervention patients on clopidogrel. Methods This prospective observational study was conducted on acute coronary syndrome patients, started on clopidogrel following coronary intervention. After considering inclusion and exclusion criteria, 72 patients were enrolled, and a genetic analysis was done. Based on genetic analysis, patients were divided into two groups, normal (CYP2C19*1) and abnormal phenotypes (CYP2C19*2 & *3). These patients were followed for two years, and the MACE during the first year and second year was compared between these two groups. Results Of 72 patients, 39 (54.1%) were normal, and 33 (45.8%) were abnormal genotypes. The mean age of patients is 67.71 ± 9.968. A total of 19 and 27 MACEs were seen during first- and second-year follow-ups. During the first-year follow-up, three (9.1%) patients with abnormal phenotypes developed ST-elevation myocardial infarction (STEMI), and none of the phenotypically normal patients developed STEMI (p-value = 0.183). Non-ST elevation myocardial infarction (NSTEMI) was seen in three (7.7%) normal and seven (21.2%) abnormal phenotype patients (p-value=0.19). Other events, such as thrombotic stroke, stent thrombosis, and cardiac death, were seen in two (6.1%) abnormal phenotypic patients (p-value=0.401). During the second-year follow-up, STEMI was seen in one (2.6%) normal and three (9.7%) abnormal phenotypic patients (p-value=0.183). NSTEMI was seen in four (10.3%) normal and nine (29%) abnormal phenotype patients (p=0.045). Comparison of total MACEs between normal and abnormal phenotypic groups at the end of the first year   (p-value=0.011) and second year (p-value=<0.01) has statistical significance. Conclusion We can infer that the risk of developing a recurrent MACE in post-coronary intervention patients on clopidogrel is significantly high in the abnormal phenotypic group (CYP2C19*2 & *3) than in normal phenotypic patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Kambhampati et al.)

Oral rehabilitation is essential in patients having multiple missing teeth, to restore esthetics and function. However replacement of complete dentition may not be possible in high risk patients or patients of low income group. The concept of SDA can be utilized in such patients to increase affordability and avoid over restoring. The aim of this study was to understand the prevalence of the requirement of oral rehabilitation according to age and gender of the individual as well as to compare the quality of life of patients rehabilitated with complete and short dental arches. Case sheets of around 28,000 patients were reviewed from March 2019 to June 2020 out of which 113 patients were undergoing oral rehabilitation. To eliminate bias all patients affected by the disease were included in the study. Epidemiological data of the patient along with their ongoing treatment was collected and tabulated in MS Excel sheet. Amongst the patients 36 patients were selected using simple stratified sampling and patients were asked to report their quality of life on a VAS scale using a quality of life questionnaire. The data was then analyzed using IBM SPSS software version 23. The prevalence of oral rehabilitation in males was 53.98% while in females it was 48.02%. Age group of 41-60 years was found to be most commonly undergoing oral rehabilitation. The most common extent of rehabilitation was 2nd molar - 2nd molar, around 23% patients underwent rehabilitation from 1st molar-1st molar and around 10% patients underwent rehabilitation from 2nd premolar-2nd premolar. Patient satisfaction was greatest in patients with complete arch restoration when compared to short dental arch restoration. Amongst SDA restoration patients rehabilitated till the first molar had greater satisfaction than patients rehabilitated till second premolar. With increase in lifespan the need for oral rehabilitation has increased, however it is not always possible or advised to restore the complete dentition of an individual. The present study helps us understand the prevalence of oral rehabilitation according to the gender and age of the patients as well as use of newer concepts such as SDA in the management of high risk patients. Within the limitations of the present study patient satisfaction was greater in complete arch restoration compared to SDA. Thus it is important to understand the requirements of the patient and rehabilitate accordingly, so as to provide the patient with the best esthetics and function possible., Competing Interests: There were no conflicts of interest present, (© 2022 Biomedical Informatics.)

Background: To analyse the clinical characteristics of COVID-19 with acute ischaemic stroke (AIS) and identify factors predicting functional outcome., Methods: Multicentre retrospective cohort study of COVID-19 patients with AIS who presented to 30 stroke centres in the USA and Canada between 14 March and 30 August 2020. The primary endpoint was poor functional outcome, defined as a modified Rankin Scale (mRS) of 5 or 6 at discharge. Secondary endpoints include favourable outcome (mRS ≤2) and mortality at discharge, ordinal mRS (shift analysis), symptomatic intracranial haemorrhage (sICH) and occurrence of in-hospital complications., Results: A total of 216 COVID-19 patients with AIS were included. 68.1% (147/216) were older than 60 years, while 31.9% (69/216) were younger. Median [IQR] National Institutes of Health Stroke Scale (NIHSS) at presentation was 12.5 (15.8), and 44.2% (87/197) presented with large vessel occlusion (LVO). Approximately 51.3% (98/191) of the patients had poor outcomes with an observed mortality rate of 39.1% (81/207). Age >60 years (aOR: 5.11, 95% CI 2.08 to 12.56, p<0.001), diabetes mellitus (aOR: 2.66, 95% CI 1.16 to 6.09, p=0.021), higher NIHSS at admission (aOR: 1.08, 95% CI 1.02 to 1.14, p=0.006), LVO (aOR: 2.45, 95% CI 1.04 to 5.78, p=0.042), and higher NLR level (aOR: 1.06, 95% CI 1.01 to 1.11, p=0.028) were significantly associated with poor functional outcome., Conclusion: There is relationship between COVID-19-associated AIS and severe disability or death. We identified several factors which predict worse outcomes, and these outcomes were more frequent compared to global averages. We found that elevated neutrophil-to-lymphocyte ratio, rather than D-Dimer, predicted both morbidity and mortality., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Aim and Objective: The aim of the research was to evaluate the histocompatibility of thermopolymerized (TP) novel denture copolymer containing 3,9-dimethylene-1,5,7,11-tetraoxaspiro[5,5]undecane (DMTOSU) comonomer in rats' palatine tissue., Materials and Methods: The rats were randomly categorized into four groups ( n = 6 per group). G CW : Denture base appliance (DBA) fabricated by short polymerization cycle in a water bath without DMTOSU; G TW : DBA with 20 wt.% DMTOSU polymerized at 70°C for 2 hours followed by short polymerization cycle in a water bath; G TA : DBA with 20 wt.% DMTOSU polymerized at 60°C for 45 minutes followed by 130°C for 20 minutes in an autoclave; and Group NC (negative control): rats with no DBA. The rats were euthanized after 2 weeks and the palatal tissues were subjected to histological examination. Epithelial thickness (ET), connective tissue thickness (CT), and keratin layer thickness (KT) were measured., Results: G CW exhibited greater ET, CT, and KT than the other groups. The ET and KT of G TA were significantly lesser than G TW . Multiple comparisons exhibited significant differences between the groups, except for G TW and G TA concerning the CT., Conclusion: The novel denture copolymer containing 20 wt.% of DMTOSU comonomer is histocompatible with rats' palatine tissue., Clinical Significance: As DMTOSU is a double-ring-opening antishrinking oxaspiro monomer, its incorporation in TP-DBR would result in dimensionally accurate and stable dentures without endangering the biocompatibility in the prospective years.

Introduction: Medical schools have reported on the integration of humanities, through literature, which offer diverse content and approaches that can be used to enhance patient care. The integration of humanities in dental education is a recent development. At the International Medical University (IMU) Malaysia, a literature module which focused on perspective taking activities was offered to the Bachelor of Dentistry program. We aimed to study if the module impacted dental students' understanding of patient care., Methods: Third-year undergraduate dental students were facilitated to discuss stories, engage in perspective taking activities and keep a portfolio for assessment in the Stories and Perspectives selective. Thematic analysis was used to analyze the data in their portfolios., Results: The dental students identified key learning points that would better prepare them for patient-centered care. Three themes emerged: (1) facilitate empathy in students, (2) stimulate self-awareness in students, and (3) motivate students to be perceptive communicators. Students were able to appreciate the complexities of care giving as it involved taking into account the thoughts and feelings of the other while recognizing their own mental state. They further valued the choice of appropriate words and actions in mediating this process., Conclusion: The potential for incorporating humanities based approaches to teach patient care to dental students is favorable. Reading stories and extending this to perspective taking activities to induce creative ways to shift between experiences of self and other is a positive approach in preparing health professionals for care giving encounters.

Oxidative stress and excitotoxicity are some of the pathophysiological abnormalities in hypoxia-induced brain injury. This study evaluated the intrinsic antioxidant property of methanol fruit extract of Tetrapleura tetraptera (TT), traditionally used for managing brain diseases such as cerebral infarction in West Africa, and its ability to protect primary astrocytes from anoxia-induced cell death. The effect of the phytochemicals present in TT on excitotoxicity was assessed in silico , through docking with human glutamate synthetase (hGS). Chromatographic and spectrophotometric analyses of TT were performed. Primary astrocytes derived from neural stem cells were treated with TT and its effect on astrocyte viability was assessed. TT-treated astrocytes were then subjected to anoxic insult and, cell viability and mitochondrial membrane potential were evaluated. Molecular docking of hGS with detected phytochemicals in TT (aridanin, naringenin, ferulic acid, and scopoletin) was performed and the number of interactions with the lead compounds, aridanin, analyzed. HPLC-DAD analysis of TT revealed the presence of various bioactive phytochemicals. TT demonstrated notable antioxidant and radical scavenging activities. TT also protected astrocytes from anoxic insult by restoring cell viability and preventing alteration to mitochondrial membrane integrity. Aridanin, naringenin, ferulic acid, and scopoletin demonstrated good binding affinities with hGS indicating that Tetrapleura tetraptera is a potential source of new plant-based bioactives relevant in the therapy of neurodegenerative diseases., Competing Interests: The authors report no declarations of interest., (© 2021 The Authors.)

Ethnopharmacological Relevance: Tetrapleura tetraptera Taub. (family Fabaceae), is generally found in the lowland forest of tropical Africa. Its leaves and fruits are traditionally used in West Africa for the management of brain disorders., Aim of the Study: This study evaluated the effect of Tetrapleura tetraptera methanol fruit extract (TT) on bilateral common carotid artery occlusion-induced cerebral ischemia/reperfusion (I/R) injury in male Wistar rats., Materials and Methods: Rats pretreated with TT for 7 days before a 30 min bilateral common carotid artery occlusion and reperfusion for 24 h were assessed for neurobehavioural deficits. Cortical, striatal and hippocampal oxidative stress, pro-inflammatory events, electrolyte imbalance and neurochemical dysfunctions, as well as hippocampal histopathological alterations, were also evaluated. HPLC-DAD analysis was performed to identify likely compounds contributing to the bioactivity of the extract., Results: TT reduced I/R-induced behavioral deficits and ameliorated I/R-induced oxidative stress by restoring reduced glutathione level, increasing catalase and superoxide dismutase activities, and also reducing both lipid peroxidation and xanthine oxidase activity in the brain. TT attenuated I/R-increased myeloperoxidase and lactate dehydrogenase activities as well as disturbances in Na + and K + levels. Alterations elicited by I/R in the activities of Na + /K + ATPase, complex I, glutamine synthetase, acetylcholinesterase, and dopamine metabolism were abated by TT pretreatment. TT prevented I/R-induced histological changes in the hippocampus. HPLC-DAD analysis revealed the presence of aridanin, a marker compound for Tetrapleura tetraptera, and other phytochemicals., Conclusions: These findings indicate that Tetrapleura tetraptera fruit has a protective potential against stroke through modulation of redox and electrolyte imbalances, and attenuation of neurotransmitter dysregulation and other neurochemical dysfunctions. Tetrapleura tetraptera fruit could be a promising source for the discovery of bioactives for stroke therapy., (Copyright © 2020 Elsevier B.V. All rights reserved.)

The absence of upper anterior teeth is a serious problem and often needs a challenging treatment. The treatment alternatives include resin-bonded bridge work, osseointegrated implants, removable dentures, and autotransplantation of developing premolars. The aim of the study was to evaluate implant prosthesis as a treatment option for missing maxillary anterior teeth among young adults. A study comparing different treatment modalities advised for replacement of missing anterior teeth with implants placed in those patients was conducted. Date of age, gender, type of replacement advised and chosen by the patients were obtained from the records at the dental hospital. About 64.07% of patients were advised for fixed partial dentures and 35.93% of patients were advised for implants in replacement of missing anterior teeth among young adults. The 21-30 years age group was found to be the most common age group with replacement of implant in the missing anterior tooth among young adults with higher incidence among males (84.81%). Anterior implant supported prosthesis in patients with missing maxillary teeth improves patients' psychological outlook in terms of dental aesthetics and instills a positive attitude and behaviors among patients.

The ultimate goal of modern dentistry is to restore the normal comfort, contour, function, aesthetics, health, and speech of a patient's dentition while restoring or replacing teeth. When it comes to the anterior region, particularly the maxillary anteriors, aesthetics is of prime importance as it shapes the smile of the patient and builds confidence. The most ideal treatment option for replacement of a single missing tooth in the anterior region is the placement of implants. This study aims to analyze the age and gender prevalence of patients undergoing implant placement in the anterior region of the maxilla among middle aged adults. A retrospective study was performed among patients visiting the Department of Implantology opting for implant prosthesis placement in the maxillary anterior region within the age group 30 to 60 years. Data was collected from case sheets of patients visiting a private dental hospital in Chennai, India; tabulated and descriptive statistics was performed. A total of 2563 patients were identified with missing maxillary anterior teeth and were advised implant prosthesis out of which only 55 patients opted for implant prosthesis. Prevalence of males (51%) willing for implant prosthesis in the maxillary anteriors was greater than females (49%), p > 0.05. Patients within the age group of 41-50 years were more willing for implant placement in the maxillary anterior region (49.1%). Overall, tooth number 22 was the most replaced tooth by implant prosthesis (21.8%) followed by tooth number 23 (20.0%). In females, canines were the most replaced and incisors in males.

Background: It has become increasingly accepted that establishing and maintaining a complex and diverse gut microbiota is fundamental to human health. There are growing efforts to identify means of modulating and influencing the microbiota, especially in individuals who have experienced a disruption in their native microbiota. Faecal microbiota transplantation (FMT) is one method that restores diversity to the microbiota of an individual by introducing microbes from a healthy donor. FMT introduces the total microbial load into the recipient, including the bacteria, archaea, yeasts, protists and viruses. In this study, we investigated whether an autochthonous faecal viral transfer (FVT), in the form of a sterile faecal filtrate, could impact the recovery of a bacteriome disrupted by antibiotic treatment., Results: Following antibiotic disruption of the bacteriome, test mice received an FVT harvested prior to antibiotic treatment, while control mice received a heat- and nuclease-treated FVT. In both groups of mice, the perturbed microbiome reverted over time to one more similar to the pre-treatment one. However, the bacteriomes of mice that received an FVT, in which bacteriophages predominate, separated from those of the control mice as determined by principal co-ordinate analysis (PCoA). Moreover, analysis of the differentially abundant taxa indicated a closer resemblance to the pre-treatment bacteriome in the test mice that had received an FVT. Similarly, metagenomic sequencing of the virome confirmed that faecal bacteriophages of FVT and control mice differed over time in both abundance and diversity, with the phages constituting the FVT persisting in mice that received them., Conclusions: An autochthonous virome transfer reshaped the bacteriomes of mice post-antibiotic treatment such that they more closely resembled the pre-antibiotic microbiota profile compared to mice that received non-viable phages. Thus, FVT may have a role in addressing antibiotic-associated microbiota alterations and potentially prevent the establishment of post-antibiotic infection. Given that bacteriophages are biologically inert in the absence of their host bacteria, they could form a safe and effective alternative to whole microbiota transplants that could be delivered during/following perturbation of the gut flora.

Gliomatosis Cerebri (GC) is a rareand rapidly progressive pattern of growth of diffusely infiltrating gliomas with limited treatment options. Imaging findings are usually nonspecific and can mimic other neurologic disorders, including demyelination, encephalitis, and multicentric/multifocal glioma. In this report, we describe a case of a 53-year-old female who presented with left hemiparesis, global headache, and gait ataxia with imaging features initially thought to represent demyelinating disease. A combination of conventional and advanced imaging findings with brain biopsy was utilized to make the diagnosis of GC. In patients with widespread abnormalities on brain imaging, GC should strongly be considered when cortical expansion, involvement of the septum pellucidum and elevated myoinositol levels are observed and the clinical and laboratory findings are atypical for demyelination or infection. Considering GC in such cases can facilitate early biopsy with prompt diagnosis and avoid delay in appropriate treatment., (© 2020 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Pineal glioblastoma is an exceedingly rare potential etiology for a pineal region mass. The presentation, imaging appearance, and changes in treatment have been documented in a select number of cases since its first description in 1954. Through these cases, changes in treatment have shown to improve outcomes in select patients, some of which have had survival times over two or three years. We present a case of a 39 year old female with biopsy proven pineal glioblastoma who demonstrates improvement on imaging and survival >12 months after treatment with radiation therapy and chemotherapy. Our case and the prior reported cases enable future research into improving treatment, classification, and imaging recognition for this unlikely disease., (Published by Elsevier Inc.)

Fluoroscopic-guided lumbar puncture (LP) is a procedure commonly performed by radiologists, which in some circumstances may be difficult or impossible using a traditional posterior interspinous or interlaminar approach. Alternatives to LP include cervical and cisternal punctures, placement of an Ommaya reservoir, and lumbar laminectomy. More recently, however, there has been a move toward access of the thecal sac through a transforaminal approach in patients with challenging anatomy. This report outlines our approach and experience using transforaminal LP (TFLP) in patients with spinal muscular atrophy (SMA) with a 100% success rate. We discuss its utility in other patients with difficult access and compare TFLP with other techniques to access the intrathecal space., (Published by Elsevier Ltd.)