Interexaminer agreement among pediatric dental specialists in assessment of tonsil size, Friedman tongue position, and Friedman staging of obstructive sleep apnea in children: An observational study.

BACKGROUND: The evaluation of tonsil size, Friedman Tongue Position (FTP), and Friedman staging in pediatric obstructive sleep apnea (OSA) holds significant clinical importance, offering manifold advantages in diagnosis and surgical management. AIMS AND OBJECTIVES: This study aimed to assess the reliability of pediatric OSA evaluation by determining inter-examiner agreement among pediatric dental specialists. MATERIALS AND METHODS: Conducted at the Department of Pediatric Dentistry, PMS College of Dental Science and Research Hospital (2023-2024), this observational study utilized conventional consulting rooms, headlights, and examination chairs. Thirteen medical practitioners reviewed video recordings of the oropharyngeal regions of twelve pediatric patients exhibiting mouth breathing. Friedman staging was determined based on tonsil size and tongue position gradings.Inter-examiner agreement was evaluated using Fleiss kappa analysis. RESULTS: Observers, including residents and practitioners in pediatric dentistry, demonstrated poor agreement regarding FTP and tonsil grading. CONCLUSION: Understanding the nuances of tonsil size and FTP in pediatric OSA evaluation, along with identifying avenues for refinement, can enhance medical decision-making among healthcare providers, including pediatric dentists.

Highly sensitive and quantitative HiBiT-tagged Nipah virus-like particles: A platform for rapid antibody neutralization studies.

Biocontainment regulations restrict the research on NiV to BSL-4 laboratories, thus limiting the mechanistic studies related to viral entry and allied pathogenesis. Understanding the precise process of viral-particle production and host cell entry is critical for designing targeted therapies or particle-based vaccines. In this study, we have synthesized HiBiT-tagged-NiV-VLPs to ease in-vitro BSL-2 particle handling. We propose a simple yet effective approach of generating substantial amount of HiBiT-tagged NiV-VLPs in vitro by co-expressing viral structural proteins in HEK293T cells. Though homologous to parent virus, the incapacitated replication potential facilitates a BSL-2 handling of these particles. The inclusion of a highly sensitive HiBiT tag on these VLPs allows for a quick detection of viral binding and entry, as well as in assessing the efficiency of neutralizing antibodies in vitro using the NanoBiT technology. The HiBiT-tag binds in high affinity with LgBiT (Large BiT an 18 kDa fusion protein and complementary subunit of HiBiT peptide), and the resultant complex elicits high intensity luminescence in the presence of substrate. The VLPs produced were morphologically and functionally identical to the native virus, and the HiBiT-tag permitted their quick application in viral binding, entry, and antibody neutralization assays. "Thus, we report a simple setting for generating HiBiT-NiV VLPs which can be utilized in a BSL-2 laboratory, to concurrently quantify features of NiV assembly, binding and entry. This also offers an alternate-safe and effective platform for viral based antibody neutralization assays in vitro".

Diabetes and TB: Confluence of Two Epidemic and Its Effect on Clinical Presentation.

BACKGROUND: Tuberculosis (TB) has become a rising concern in low-income countries, particularly in those with Human Immuno Deficiency Virus (HIV) epidemics, and type 2 diabetes has emerged as a significant global chronic health problem, owing to increases in obesity, lifestyle changes, and ageing populations. Diabetes has been identified as a major risk factor for the development of TB. Despite the fact that diabetes imparts a substantially lower risk of TB (3-fold) as compared to HIV (>20-fold), in communities where the number of DM patients is high, the contribution of diabetes to TB might be bigger than HIV. METHODS: This review will focus on the link between TB and diabetes, which is now one of the most important topics for physicians since diabetes impacts the clinical presentation and outcome of TB and vice versa. RESULTS: Though TB is more common in type 1 diabetes, the extent of the problem in type 2 diabetes should be taken into account with equal care, as type 2 diabetes affects a substantially higher number of individuals. CONCLUSIONS: Diabetes patients are more vulnerable to infections because of their impaired immune systems. Increased glucose level leads to a rise in the infection status among TB patients and also leads to a rise in various complications. Extensive and increased screening for both TB and DM over years can help diagnose disease priorly and help in better management. TB, when diagnosed in its early stages, can be easily eradicated.

Epstein-Barr virus infection controls the concentration of the intracellular antioxidant glutathione by upregulation of the glutamate transporter EAAT3 in tumor cells.

Epstein-Barr virus or human herpesvirus 4 (EBV/HHV-4) is an omnipresent oncovirus etiologically associated with various B-cell lymphomas and epithelial cancers. The malignant transformation associated with the persistent expression of viral proteins often deregulates the host cellular machinery and EBV infection is coupled to elevated levels of reactive oxygen species. Here, we investigated the role that the glutamate transporter EAAT3 plays in regulating the antioxidant system as a protective mechanism of EBV-infected cells against the virus-induced oxidative stress. Our study demonstrated that the expression of EAAT3 was upregulated and localized to the plasma membrane in EBV latently infected and de novo EBV-infected cells. EAAT3 was regulated by the transcription factor NFAT5 in the infected cells. Membrane localized EAAT3 was found to be involved in the transportation of glutamate from the extracellular space into the cell, as EAAT3 and NFAT5 inhibitors markedly reduced the levels of intracellular glutamate levels in EBV latently infected cells. Additionally, our data demonstrated a notable decrease in the intracellular glutathione levels following treatment with an EAAT3 inhibitor. Collectively, our results suggest that upregulation of the glutamate transporter EAAT3 is an adaptation of EBV-infected cells to maintain cellular redox homeostasis against the virus-induced oxidative stress, and that this cellular balance could be therapeutically destroyed by targeting EAAT3 to impede EBV-associated cancers.

Identifying, Addressing, and Eliminating Microaggressions in Healthcare.

Description Microaggressions are pervasive throughout society, including in healthcare and academic institutions. They are often unconscious but accumulate over time, and they negatively impact the recipients' productivity and achievement by creating a sense of inadequacy as well as a lack of belonging. We outline several evidence-based strategies and teaching frameworks that institutions and training programs can adopt to reduce the prevalence and impact of microaggressions against trainees from historically marginalized groups, and that can promote psychological safety for everyone.

Thermoresponsive Pluronic based microgels for controlled release of curcumin against breast cancer cell line.

We developed here stimuli responsive curcumin loaded microgels based on Pluronic F-127. These microgels were prepared using coupling reaction between the amine modified Pluronic and EDTA. The microgel exhibited the affinity for hydrophobic drug, curcumin and showed pH as well as temperature-dependent release. Furthermore, the cytotoxicity study demonstrated dose-dependent inhibition of MDA-MB-231 cell growth with the most effective IC50 value (3.8 ±â€¯0.2 µg mL-1 after 24 h). Based on these findings, the fabricated curcumin loaded microgels offered additional advantages over conventional drug therapies for treatment of cancer.

Tissue Engineering of Cartilage Using Collagen Scaffold Enriched with Plant Polysaccharides.

Degenerative diseases associated with articular cartilage pose a huge burden on health care economics. The nature of the tissue involved and the changes therein do not allow self-healing; and most of these problems are progressive. Tissue engineering offers some solutions provided we focus on the right kind of cells and the appropriate surrounding niches created for a particular tissue. The present study deals with the formation of polysaccharide rich stable scaffold of collagen after cross-linking with oxidized gum arabic. The scaffold was tested for its biocompatibility and ability to support cells. The in vitro cytotoxicity of the scaffolds toward induced pluripotent stem cells and chondrocytes was evaluated. Evaluation of expression of lineage specific markers indicates differentiation of induced pluripotent stem cells to chondrogenic lineage and maintenance of chondrocytes per se when grown in the scaffold. Animal studies were carried out to study the efficacy of the scaffold to repair the knee injuries. Cells along with the scaffold appeared to be the best filling, in repair of injured cartilage. These studies show that these scaffolds are potential candidates in applications such as tissue engineering of cartilage.

Quantitative characterization of dielectric properties of polymer fibers and polymer composites using electrostatic force microscopy.

We use a new method based on electrostatic force microscopy (EFM) to perform quantitative measurements of the dielectric constants of individual electrospun nanofibers of poly(L-lactic acid) (PLLA), as well as composite fibers of PLLA with embedded multiwall carbon nanotubes (MWCNT-PLLA). The EFM data record the oscillation phase of an atomic force microscope (AFM) cantilever as a function of the AFM tip position. In our experiments the relative dielectric constants ϵ of the sample are measured from the EFM phase shifts vs. the tip-surface separation, according to a simple analytical model describing the tip-surface interactions. We perform a comprehensive study of how the dielectric constant depends on the fiber diameter for both electrospun PLLA and MWCNT/PLLA fiber composites. Our measurements show that EFM can distinguish between dielectric properties of PLLA fibers and fiber composites with different diameters. Dielectric constants of both PLLA and MWCNT-PLLA composite fibers decrease with increasing fiber diameter. In the limit of large fiber diameters (D > 100 nm), we measure dielectric constants in the range: ϵ = 3.4-3.8, similar to the values obtained for unoriented PLLA films: ϵfilm = 2.4-3.8. Moreover, the dielectric constants of the small diameter MWCNT-PLLA composites are significantly larger than the corresponding values obtained for PLLA fibers. For MWCNT-PLLA nanofiber composites of small diameters (D < 50 nm), ϵ approaches the values measured for neat MWCNT: ϵCN = 12 ± 2. These results are consistent with a simple fiber structural model that shows higher polarizability of thinner fibers, and composites that contain MWCNTs. The experimental method has a high-resolution for measuring the dielectric constant of soft materials, and is simple to implement on standard atomic force microscopes. This non-invasive technique can be applied to measure the electrical properties of polymers, interphases, and polymer nanocomposites.

Stress and Coping Styles in Mothers of Children with Autism Spectrum Disorder.

BACKGROUND: Children with autism spectrum disorder (ASD) require well-balanced care and a comprehensive therapeutic approach. Mental health problems often go unnoticed in mothers of children with ASD due to the focus on training for the children. The presence of stress and depressive symptoms in mothers can interfere with the quality of care and therapy given to the child. The present study aimed to assess the quality of life, coping styles, and symptoms of depression, anxiety, and stress in mothers of children with ASD. METHODS: This study recruited thirty mothers of children with ASD, to whom Depression, Anxiety and Stress Scale (DASS 21), WHO Quality of Life Scale (WHOQOL-BREF), and COPE Inventory were administered. RESULTS: Results indicated the presence of depressive and anxiety symptoms and impaired quality of life among the mothers. Despite this, they exhibited positive coping styles. CONCLUSION: As part of a comprehensive intervention for children with ASD, there is also a need to address the psychological distress and coping styles of mothers.

A dual metal organic framework based on copper-iron clusters integrated sulphur doped graphene as a porous material for supercapacitor with remarkable performance characteristics.

Herein, a novel bimetallic metal organic framework (MOF) using copper and iron as the metal centers with 1,3,5-tricarboxylic acid as a ligand (CuFeBTC) and its composite with sulphur doped graphene (S-GNS) have been investigated for supercapacitive performance. The synthesis of materials has been carried out using a facile wet chemical route. The physicochemical characterization of the materials employing various structural and surface techniques has been performed which confirms the successful formation of nanocomposite. The capacitive behavior of CuFeBTC, S-GNS and CuFeBTC/S-GNS has been systematically examined using 1 M Na2SO4 as an electrolyte in a three and two electrode assembly. The electrochemical studies reveal that CuFeBTC/S-GNS electrode demonstrates highest specific capacitance of 1164.3 F g-1 at 0.5 A g-1 with suffice rate capability as compared to CuFeBTC and S-GNS electrodes. Moreover, a symmetric supercapacitor is configured using the CuFeBTC/S-GNS nanocomposite electrodes which deliver remarkable energy and power output of 96.57 Wh kg-1 and 1595.12 W kg-1 at an operating voltage of 1.8 V. The as-fabricated symmetric supercapacitor displays competent energy storage retention of 50.2 Wh kg-1 even at current density of 20.0 A g-1 with high power density 26973.13 W kg-1. These deliverables epitomize the latest performance record of bimetallic MOFs based supercapacitors, suggesting that CuFeBTC/S-GNS is a promising active material for high performance electrochemical energy storage applications.

The Female Genital Self-image Scale in Adult Women With Vulvar Lichen Sclerosus.

OBJECTIVE: There is no agreed upon standard way to measure vulvar lichen sclerosus disease severity. The Female Genital Self-Image Scale (FGSIS) is a validated survey tool assessing female genital self-image and is positively correlated with women's sexual function. A lower score represents a negative genital self-image. We evaluated the FGSIS in women with vulvar lichen sclerosus. METHODS: Women with biopsy-proven lichen sclerosus and women presenting for routine gynecologic care without lichen sclerosus matched by age were surveyed with the 7-item FGSIS. National surveys of healthy women in the United States have shown the mean 7-item FGSIS score is 21. To detect one standard deviation (20% absolute difference) between groups with a power of 80% at p < .05, 15 women would are needed in each group. RESULTS: Sixteen women with lichen sclerosus and 16 matched controls were surveyed between February and July 2018. The mean ± SD age of women with lichen sclerosus was 56.8 ± 13.5 years, 94% were white, 69% married, 81% college educated, 69% postmenopausal, and 18% on hormone replacement therapy. None of these differences were statistically different from control women. Women with vulvar lichen sclerosus had a significantly lower median 7-item FGSIS when compared with control subjects, 18 (interquartile range = 16-21) versus 25 (interquartile range = 23-27), respectively, Mann-Whitney U test, p < .001. CONCLUSIONS: Women with vulvar lichen sclerosus have a lower score on the 7-item Female Genital Self-Image Scale compared with healthy controls.

Gnidia glauca- and Plumbago zeylanica-Mediated Synthesis of Novel Copper Nanoparticles as Promising Antidiabetic Agents.

Rapid, eco-friendly, and cost-effective one-pot synthesis of copper nanoparticles is reported here using medicinal plants like Gnidia glauca and Plumbago zeylanica. Aqueous extracts of flower, leaf, and stem of G. glauca and leaves of P. zeylanica were prepared which could effectively reduce Cu2+ ions to CuNPs within 5 h at 100°C which were further characterized using UV-visible spectroscopy, field emission scanning electron microscopy, high-resolution transmission electron microscopy, energy dispersive spectroscopy, dynamic light scattering, X-ray diffraction, and Fourier-transform infrared spectroscopy. Further, the CuNPs were checked for antidiabetic activity using porcine pancreatic α-amylase and α-glucosidase inhibition followed by evaluation of mechanism using circular dichroism spectroscopy. CuNPs were found to be predominantly spherical in nature with a diameter ranging from 1 to 5 nm. The phenolics and flavonoids in the extracts might play a critical role in the synthesis and stabilization process. Significant change in the peak at ∼1095 cm-1 corresponding to C-O-C bond in ether was observed. CuNPs could inhibit porcine pancreatic α-amylase up to 30% to 50%, while they exhibited a more significant inhibition of α-glucosidase from 70% to 88%. The mechanism of enzyme inhibition was attributed due to the conformational change owing to drastic alteration of secondary structure by CuNPs. This is the first study of its kind that provides a strong scientific rationale that phytogenic CuNPs synthesized using G. glauca and P. zeylanica can be considered to develop candidate antidiabetic nanomedicine.

Psychological status and coping styles of caregivers of individuals with intellectual disability and psychiatric illness.

BACKGROUND: The psychological status of caregivers of individuals with intellectual disability and psychiatric illness (PI) is important for effective management. The aim of this study was to examine the psychological status and its relationship with coping styles among these caregivers. MATERIALS & METHODS: Caregivers (N = 80) of individuals with intellectual disability (n = 40) and PI (n = 40) were administered a socio-demographic questionnaire, depression, anxiety and stress scale and COPE Inventory. RESULTS: Caregivers experienced depression, anxiety and stress symptoms. These symptoms were found to be significantly higher among caregivers of individuals with intellectual disability than those with PI. The most common coping style used was religious coping. Use of positive reinterpretation and growth was associated with lower levels of depression and stress symptoms. CONCLUSION: Caregivers' mental health plays an important role in the quality of care delivery and outcome. Use of appropriate coping styles can reduce the impact of these symptoms.

Resilience and Stress in Children and Adolescents with Specific Learning Disability.

OBJECTIVE: Presence of Specific Learning Disorder (SLD) can be extremely frustrating for a child. The present study aimed to assess the levels of resilience, depression, anxiety and stress among children and adolescents having SLD and to compare with those having Borderline Intellectual Functioning (BIF). It also aimed to evaluate the parental awareness about their child's learning disorder. METHODOLOGY: Eighty two children and adolescents, diagnosed as having SLD (N=41) and BIF (N=41) were selected for the present study. The participants completed Resilience Scale-14 and Depression, Anxiety and Stress Scales and parents completed the Parent Interview Profroma. RESULT: Low level of Resilience was found in 75% of the children and adolescents with SLD. Severe Stress (16.6%), severe Depression (14.2%) and severe Anxiety (23.8%) were seen in this sample. The level of Resilience was lower among participants with SLD as compared to those with BIF. Ninety percent of parents were aware that their child had SLD, however, only 39% gave individual attention for assisting them in their studies. CONCLUSION: The present study emphasizes the importance of individualized interventions dealing not only with remedial training, but also for incorporating components including parental awareness of the emotional consequences of SLD as well as individual interventions for children, focusing on strengthening their coping and Resilience.

OBJECTIF: La présence d'un trouble d'apprentissage spécifique (TAS) peut être extrêmement frustrante pour un enfant. La présente étude visait à évaluer les niveaux de résilience, de dépression, d'anxiété et de stress chez les enfants et les adolescents ayant un TAS, et à les comparer avec ceux ayant un fonctionnement intellectuel limite (FIL). Elle visait également à évaluer la connaissance parentale du trouble d'apprentissage de leur enfant. MÉTHODOLOGIE: Quatre-vingtdeux enfants et adolescents, ayant reçu un diagnostic de TAS (N = 41) et de FIL (N = 41) ont été sélectionnés pour la présente étude. Les participants ont rempli la Resilience Scale-14 et les Depression, Anxiety and Stress Scales, et les parents, la Parent Interview Profroma. RÉSULTAT: Un faible niveau de résilience a été constaté chez 75% des enfants et des adolescents ayant un TAS. Le stress sévère (16,6%), la dépression sévère (14,2%) et l'anxiété sévère (23,8%) ont été observés dans cet échantillon. Le niveau de résilience était plus faible chez les participants ayant un TAS comparativement à ceux ayant un FIL. Quatre-vingt-dix pour cent des parents étaient conscients que leur enfant avait un TAS, cependant, seulement 39% d'entre eux leur accordaient une attention individuelle pour les aider dans leurs études. CONCLUSION: La présente étude souligne l'importance d'interventions individualisées qui s'occupent non seulement de formation de rattrapage, mais aussi d'incorporer les composantes, y compris la connaissance parentale des conséquences émotionnelles du TAS ainsi que les interventions individuelles auprès des enfants, qui mettent l'accent sur le renforcement de leur adaptation et de leur résilience.

pH-responsive targeted and controlled doxorubicin delivery using hyaluronic acid nanocarriers.

Biocompatible nanogels were prepared using thiol modified hyaluronic acid and diacrylated pluronic F127 polymer. A simple Michael type addition reaction of activated thiol groups on acrylate moiety lead to the formation of these nanogels, which were further effectively fabricated with an anticancer drug for evaluating sustained drug release approach. Nanogels prepared were of 150nm in diameter with a narrow size distribution pattern. DOX released from these nanogels showed a slow and sustained release at acidic pH 5.0 as compared to minimal release at physiological pH 7.4. Cytotoxicity data revealed the higher efficiency of DOX loaded nanogels as compared to free DOX in Hela cell lines. Cellular uptake images supported the cytotoxicity data and displayed DOX intercalation at nuclear level of cells. The sustained drug delivery system showed DOX release after 24h and continued thereafter without affecting normal cells. Based on these findings, such nanogel system may be useful for delivering anticancer drug without hampering their toxicity value over longer durations and reducing the total dose amount in anticancer therapy.

Serous papillary cystadenofibroma of the fallopian tube: A case report and short review of literature.

Serous papillary cystadenofibromas (SPCAFs) of the fallopian tube are very rare benign tumors of the female genital tract. They are usually asymptomatic and are found incidentally. Until now, only 18 cases of this tumor have been reported in the world literature. We report a case of SPCAF of the left fallopian tube in a 30-year-old female who presented with a large abdominal mass and pain. On computed tomography, a diagnosis of ovarian neoplasm was given. However, during surgery the tumor was found to arise from the fallopian tube and was treated with tubal cystectomy with sparing of the ovary. We present this unique case on account of its rarity, unusual presentation, and huge size along with a short review of literature.