Leveraging Policy Solutions for Diabetes Disparities: Suggestions for Improving the National Clinical Care Commission Report's Recommendations for Hispanic/Latino Populations.

In the U.S., Hispanic/Latino populations face increased disparities in both the prevalence and management of type 2 diabetes mellitus (T2DM). This article critically examines the multifaceted nature of T2DM disparities among Hispanic/Latino populations in the U.S. and identifies key factors contributing to T2DM prevalence within these communities, including socioeconomic status, cultural influences, and healthcare access. Utilizing a modified expert consensus procedure, we evaluate the ways in which the National Clinical Care Commission (NCCC) recommendations apply to the Hispanic/Latino community as well as propose recommendations for improved efficacy. Through a comprehensive analysis of government-community health initiatives, food security, environmental exposures, and housing inequalities, we emphasize the need for targeted interventions and health policies to effectively address and dismantle these disparities. Overall, while the National Clinical Care Commission's recommendations provide a valuable framework for the implementation of policies pertaining to diabetes management and prevention in the general population, our analysis suggests that recommendations may be strengthened by considering the unique cultural, social, and economic needs of the Hispanic/Latino population moving forward.

Directed Differentiation of Human Pluripotent Stem Cells to Cytotrophoblast and Syncytiotrophoblast.

Human pluripotent stem cells (hPSCs) form an ideal system to study the formation of placental cells, from an undifferentiated human embryonic stem cell state. The conventional human in vitro model systems to study the human placenta cannot be employed for understanding placental dysfunctions or the development of specialized placental cell types. Hence, human PSCs make an ideal model system to study human placental development and disorders. Here, we describe an efficient and validated protocol to reproducibly study the formation of human cytotrophoblasts (CTBs) and syncytiotrophoblast (STBs) from undifferentiated hPSCs. CTBs are the trophoblast stem cells that can differentiate into specialized placental cell types such as STBs. The multinucleated STB plays vital role in the exchange of nutrients and gases across the placenta and secretes several hormones during pregnancy, such as human chorionic gonadotropin ß (hCGß). Here we describe two methods of seeding the hPSCs: chemical (clumps method) and enzymatic methods (single cells) to differentiate them to CTB and STB, activating BMP (B) signaling and inhibiting ACTIVIN/NODAL and FGF signaling pathways (2i), thus naming our protocol as "B2i" (Sudheer et al., Stem Cells Dev 21:2987-3000, 2012). This protocol forms the perfect model system for understanding in vitro placentation, modeling diseases arising from abnormal placentation that cause complications such as miscarriage, preeclampsia or intrauterine growth restriction (IUGR), and drug discovery for placental disorders.

Non-invasive detection of oral potentially malignant and malignant lesions using an optical multispectral screening device.

Oral carcinogenesis is a multistep process that usually arises in the superficial epithelial layer covering the lining of the body cavities. The early changes in the oral mucosa reflect as oral precancers or oral potentially malignant disorders (OPMD). The most common OPMD are erythroplakia and leukoplakia, with their chances of malignant transformation being approximately 90% and 10%, respectively. The development of epithelial precancers is initiated through changes in nuclear shape, size, and density of cells and overall thickening of the epithelial layer. Conventional oral examination (COE) with white light is the most common technique for detection of malignant changes in the oral cavity. This often poses a diagnostic challenge for the clinicians in differentiation of normal and early malignant changes. Thus, biopsy of the site is the accepted clinical procedure for diagnosis of the lesion. A major hurdle here is to identify visually, the most malignant location for a biopsy. As the selection of a site is subjective, the chosen site may not always be representative of the disease and this often leads to repeated biopsies and discomfort to the patients. A novel device known as OralScan was recently introduced by Sascan Meditech, Thiruvananthapuram, for screening and early detection of oral cancers. The clinical application of the device in different clinical scenarios are discussed in this case series report.

Human ES Cell Culture Conditions Fail to Preserve the Mouse Epiblast State.

Mouse embryonic stem cells (mESCs) and mouse epiblast stem cells (mEpiSCs) are the pluripotent stem cells (PSCs), derived from the inner cell mass (ICM) of preimplantation embryos at embryonic day 3.5 (E3.5) and postimplantation embryos at E5.5-E7.5, respectively. Depending on their environment, PSCs can exist in the so-called naïve (ESCs) or primed (EpiSCs) states. Exposure to EpiSC or human ESC (hESC) culture condition can convert mESCs towards an EpiSC-like state. Here, we show that the undifferentiated epiblast state is however not stabilized in a sustained manner when exposing mESCs to hESC or EpiSC culture condition. Rather, prolonged exposure to EpiSC condition promotes a transition to a primitive streak- (PS-) like state via an unbiased epiblast-like intermediate. We show that the Brachyury-positive PS-like state is likely promoted by endogenous WNT signaling, highlighting a possible species difference between mouse epiblast-like stem cells and human Embryonic Stem Cells.

The quest for pluripotency: a comparative analysis across mammalian species.

Pluripotency is the developmental potential of a cell to give rise to all the cells in the three embryonic germ layers, including germline cells. Pluripotent stem cells (PSCs) can be embryonic, germ cell or somatic cell in origin and can adopt alternative states of pluripotency: naïve or primed. Although several reports have described the differentiation of PSCs to extra-embryonic lineages, such as primitive endoderm and trophectoderm, this is still debated among scientists in the field. In this review, we integrate the recent findings on pluripotency among mammals, alternative states of pluripotency, signalling pathways associated with maintaining pluripotency and the nature of PSCs derived from various mammals. PSCs from humans and mouse have been the most extensively studied. In other mammalian species, more research is required for understanding the optimum in vitro conditions required for either achieving pluripotency or preservation of distinct pluripotent states. A comparative high-throughput analysis of PSCs of genes expressed in naïve or primed states of humans, nonhuman primates (NHP) and rodents, based on publicly available datasets revealed the probable prominence of seven signalling pathways common among these species, irrespective of the states of pluripotency. We conclude by highlighting some of the unresolved questions and future directions of research on pluripotency in mammals.