Optical projection tomography implemented for accessibility and low cost (OPTImAL).

Optical projection tomography (OPT) is a three-dimensional mesoscopic imaging modality that can use absorption or fluorescence contrast, and is widely applied to fixed and live samples in the mm-cm scale. For fluorescence OPT, we present OPT implemented for accessibility and low cost, an open-source research-grade implementation of modular OPT hardware and software that has been designed to be widely accessible by using low-cost components, including light-emitting diode (LED) excitation and cooled complementary metal-oxide-semiconductor (CMOS) cameras. Both the hardware and software are modular and flexible in their implementation, enabling rapid switching between sample size scales and supporting compressive sensing to reconstruct images from undersampled sparse OPT data, e.g. to facilitate rapid imaging with low photobleaching/phototoxicity. We also explore a simple implementation of focal scanning OPT to achieve higher resolution, which entails the use of a fan-beam geometry reconstruction method to account for variation in magnification. This article is part of the Theo Murphy meeting issue 'Open, reproducible hardware for microscopy'.

The effect of daily usage of Listerine Cool Mint mouthwash on the oropharyngeal microbiome: a substudy of the PReGo trial.

Introduction. ListerineÒ is a bactericidal mouthwash widely used to prevent oral health problems such as dental plaque and gingivitis. However, whether it promotes or undermines a healthy oral microbiome is unclear.Hypothesis/Gap Statement. We hypothesized that the daily use of Listerine Cool Mint would have a significant impact on the oropharyngeal microbiome.Aim. We aimed to assess if daily usage of Listerine Cool Mint influenced the composition of the pharyngeal microbiome.Methodology. The current microbiome substudy is part of the Preventing Resistance in Gonorrhoea trial. This was a double-blind single-centre, crossover, randomized controlled trial of antibacterial versus placebo mouthwash to reduce the incidence of gonorrhoea/chlamydia/syphilis in men who have sex with men (MSM) taking HIV pre-exposure prophylaxis (PrEP). Fifty-nine MSM taking HIV PrEP were enrolled. In this crossover trial, participants received 3 months of daily Listerine followed by 3 months of placebo mouthwash or vice versa. Oropharyngeal swabs were taken at baseline and after 3 months use of each mouthwash. DNA was extracted for shotgun metagenomic sequencing (Illumina Inc.). Non-host reads were taxonomically classified with MiniKraken and Bracken. The alpha and beta diversity indices were compared between baseline and after each mouthwash use. Differentially abundant bacterial taxa were identified using ANOVA-like differential expression analysis.Results. Streptococcus was the most abundant genus in most samples (n = 103, 61.7 %) with a median relative abundance of 31.5% (IQR 20.6-44.8), followed by Prevotella [13.5% (IQR 4.8-22.6)] and Veillonella [10.0% (IQR 4.0-16.8)]. Compared to baseline, the composition of the oral microbiome at the genus level (beta diversity) was significantly different after 3 months of Listerine (P = 0.006, pseudo-F = 2.29) or placebo (P = 0.003, pseudo-F = 2.49, permutational multivariate analysis of variance) use. Fusobacterium nucleatum and Streptococcus anginosus were significantly more abundant after Listerine use compared to baseline.Conclusion. Listerine use was associated with an increased abundance of common oral opportunistic bacteria previously reported to be enriched in periodontal diseases, oesophageal and colorectal cancer, and systemic diseases. These findings suggest that the regular use of Listerine mouthwash should be carefully considered.

Electrochemical Deposition for Cultivating Nano- and Microstructured Electroactive Materials for Supercapacitors: Recent Developments and Future Perspectives.

The globe is currently dealing with serious issues related to the world economy and population expansion, which has led to a significant increase in the need for energy. One of the most promising energy devices for the next generation of energy technology is the supercapacitor (SC). Among the numerous nanostructured materials examined for SC electrodes, inorganic nanosheets are considered to be the most favorable electrode materials because of their excellent electrochemical performance due to their large surface area, very low layer thickness, and tunable diverse composition. Various inorganic nanosheets (NS) such as metal oxides, metal chalcogenides, metal hydroxides, and MXenes show substantial electrochemical activity. Herein, a comprehensive survey of inorganic NS arrays synthesized through the electrodeposition method is reported with the discussion on detailed growth mechanism and their application in the fabrication of SC electrodes/devices for powering flexible and wearable electronics appliances. To begin with, the first section will feature the various types of electrodeposition working mechanism, SC types and their working mechanisms, importance of nanosheet structure for SCs. This review gives a profound interpretation of supercapacitor electrode materials and their performances in different domains. Finally, a perspective on NS array through electrodeposition method applications in diverse fields is extensively examined.

Improved tomato leaf disease classification through adaptive ensemble models with exponential moving average fusion and enhanced weighted gradient optimization.

Tomato is one of the most popular and most important food crops consumed globally. The quality and quantity of yield by tomato plants are affected by the impact made by various kinds of diseases. Therefore, it is essential to identify these diseases early so that it is possible to reduce the occurrences and effect of the diseases on tomato plants to improve the overall crop yield and to support the farmers. In the past, many research works have been carried out by applying the machine learning techniques to segment and classify the tomato leaf images. However, the existing machine learning-based classifiers are not able to detect the new types of diseases more accurately. On the other hand, deep learning-based classifiers with the support of swarm intelligence-based optimization techniques are able to enhance the classification accuracy, leading to the more effective and accurate detection of leaf diseases. This research paper proposes a new method for the accurate classification of tomato leaf diseases by harnessing the power of an ensemble model in a sample dataset of tomato plants, containing images pertaining to nine different types of leaf diseases. This research introduces an ensemble model with an exponential moving average function with temporal constraints and an enhanced weighted gradient optimizer that is integrated into fine-tuned Visual Geometry Group-16 (VGG-16) and Neural Architecture Search Network (NASNet) mobile training methods for providing improved learning and classification accuracy. The dataset used for the research consists of 10,000 tomato leaf images categorized into nine classes for training and validating the model and an additional 1,000 images reserved for testing the model. The results have been analyzed thoroughly and benchmarked with existing performance metrics, thus proving that the proposed approach gives better performance in terms of accuracy, loss, precision, recall, receiver operating characteristic curve, and F1-score with values of 98.7%, 4%, 97.9%, 98.6%, 99.97%, and 98.7%, respectively.

Visualization and Analysis of Vocal Fold Dynamics in Various Voice Disorders.

OBJECTIVES/HYPOTHESIS: This study aims to compare the glottal dynamics of vocal fold leukoplakia, laryngitis, and papilloma using various visualization techniques, including phonovibrograms (PVG) and glottovibrograms (GVG). It hypothesizes that these techniques can provide understanding of the vibratory dynamics of these voice disorders, which can aid in their objective diagnosis and deriving visual features for computer-assisted classifications. STUDY DESIGN: This work employs a comparative analysis of vocal fold disorders using visualization techniques. The study examines PVG, derivative of PVG (PVG-1), digital kymograms (DKG), and GVG to analyze the glottal dynamics of vocal fold leukoplakia, laryngitis, and papilloma. METHODS: The study utilizes high-speed video endoscopy to capture vocal fold behavior in different pathological conditions. PVG, GVG, and DKG techniques are applied to visualize and analyze the vibratory patterns of the vocal folds. PVG offers a comprehensive portrayal of vocal fold motion, while GVG presents the distance between vocal fold contours. The study also examines PVG-1 as a derivative of PVG. RESULTS: Distinct modifications in vocal fold vibrations across various stages (open, closed, closing, and opening) are documented using PVG, PVG-1, GVG, DKG, and PVG trajectory. Healthy vocal folds exhibit consistent periodic patterns, while disorders, such as leukoplakia, laryngitis, and papilloma, manifest unique features due to structural and functional variations. The methods employed identify both structural irregularities and functional deviations in vocal fold vibrations. CONCLUSIONS: Comparative analyses using PVG and other visualization techniques aid in understanding the glottal dynamics of voice disorders. While laryngoscopy and stroboscopy are valuable for real-time assessment, offline analysis techniques, such as PVG and GVG, are useful for tracking glottal dynamics during phonation and assessing treatment effectiveness over time. Studies like this will contribute to standardizing the PVG-based diagnostic criteria for its clinical utility, and development of classification tools for improved diagnosis and management of vocal fold pathologies.

Surgical pulmonary arterioplasty at bidirectional cavopulmonary anastomosis leads to favorable pulmonary hemodynamics at final stage palliation.

Objective: Pulmonary arterioplasty (PA plasty) at bidirectional cavopulmonary anastomosis (BDCA) is associated with increased morbidity, but outcomes to final stage palliation are unknown. We sought to determine the influence of PA plasty on pulmonary artery growth and hemodyamics at Fontan. Methods: We retrospectively reviewed clinical data and outcomes for BDCA patients from 2006 to 2018. PA plasty was categorized by extent (type 1-4), as previously described. Outcomes included pulmonary artery reintervention and mortality before final palliation. Results: Five hundred eighty-eight patients underwent BDCA. One hundred seventy-nine patients (30.0%) underwent concomitant PA plasty. Five hundred seventy (97%) patients (169 [94%] PA plasty) survived to BDCA discharge. One hundred forty out of 570 survivors (25%) required PA/Glenn reintervention before final stage palliation (59 out of 169 [35%]) PA plasty; 81 out of 401 (20%) non-PA plasty; P < .001). Twelve-, 24-, and 36-month freedom from reintervention after BDCA was 80% (95% CI, 74-86%), 75% (95% CI, 69-82%), and 64% (95% CI, 57-73%) for PA plasty, and 95% (95% CI, 93-97%), 91% (95% CI, 88-94%), and 81% (95% CI, 76-85%) for non-PA plasty (P < .001). Prefinal stage mortality was 37 (6.3%) (14 out of 169 PA plasty; 23 out of 401 non-PA plasty; P = .4). Five hundred four (144 PA plasty and 360 non-PA plasty) patients reached final stage palliation (471 Fontan, 26 1.5-ventricle, and 7 2-ventricular repair). Pre-Fontan PA pressure and pulmonary vascular resistance were 10 mm Hg (range, 9-12 mm Hg) and 1.6 mm Hg (range, 1.3-1.9 mm Hg) in PA plasty and 10 mm Hg (range, 8-12 mm Hg) and 1.5 mm Hg (range, 1.3-1.9 mm Hg) in non-PA plasty patients, respectively (P = .29, .6). Fontan hospital mortality, length of stay, and morbidity were similar. Conclusions: PA plasty at BDCA does not confer additional mortality risk leading to final palliation. Despite increased pulmonary artery reintervention, there was reliable pulmonary artery growth and favorable pulmonary hemodynamics at final stage palliation.

Unraveling the Ties: Type 2 Diabetes and Parkinson's Disease - A Nano-Based Targeted Drug Delivery Approach.

The link between Type 2 Diabetes (T2DM) and Parkinson's Disease (PD) dates back to the early 1960s, and ongoing research is exploring this association. PD is linked to dysregulation of dopaminergic pathways, neuroinflammation, decreased PPAR-γ coactivator 1-α, increased phosphoprotein enriched in diabetes, and accelerated α-Syn amyloid fibril production caused by T2DM. This study aims to comprehensively evaluate the T2DM-PD association and risk factors for PD in T2DM individuals. The study reviews existing literature using reputable sources like Scopus, ScienceDirect, and PubMed, revealing a significant association between T2DM and worsened PD symptoms. Genetic profiles of T2DM-PD individuals show similarities, and potential risk factors include insulin-resistance and dysbiosis of the gut-brain microbiome. Anti-diabetic drugs exhibit neuroprotective effects in PD, and nanoscale delivery systems like exosomes, micelles, and liposomes show promise in enhancing drug efficacy by crossing the Blood-Brain Barrier (BBB). Brain targeting for PD uses exosomes, micelles, liposomes, dendrimers, solid lipid nanoparticles, nano-sized polymers, and niosomes to improve medication and gene therapy efficacy. Surface modification of nanocarriers with bioactive compounds (such as angiopep, lactoferrin, and OX26) enhances α-Syn conjugation and BBB permeability. Natural exosomes, though limited, hold potential for investigating DM-PD pathways in clinical research. The study delves into the underlying mechanisms of T2DM and PD and explores current therapeutic approaches in the field of nano-based targeted drug delivery. Emphasis is placed on resolved and ongoing issues in understanding and managing both conditions.

Glutathione peroxidase (GPX1) - Selenocysteine metabolism preserves the follicular fluid's (FF) redox homeostasis via IGF-1- NMD cascade in follicular ovarian cysts (FOCs).

Follicular ovarian cysts (FOCs) are characterized by follicles in the ovaries that are >20 mm in diameter and persist for >10 days without the corpus luteum, leading to anovulation, dysregulation of folliculogenesis and subfertility in humans and livestock species. Despite their clinical significance, the precise impact of FOCs on oocyte reserve, maturation, and quality still needs to be explored. While FOCs are observed in both human and livestock populations, they are notably prevalent in livestock species. Consequently, livestock species serve as valuable models for investigating the molecular intricacies of FOCs. Thus, in this study, using goat FOCs, we performed integrated proteomic, metabolomic and functional analyses to demonstrate that oocyte maturation is hampered due to increased reactive oxygen species (ROS) in FOCs follicular fluid (FF) via downregulation of glutathione peroxidase (GPX1), a critical antioxidant seleno enzyme required to negate oxidative stress. Notably, GPX1 reduction was positively correlated with the FF's decline of free selenium and selenocysteine metabolic enzymes, O-phosphoryl-tRNA (Sec) selenium transferase (SEPSECS) and selenocysteine lyase (SCLY) levels. Adding GPX1, selenocysteine, or selenium to the culture media rescued the oocyte maturation abnormalities caused by FOCs FF by down-regulating the ROS. Additionally, we demonstrate that substituting GPX1 regulator, Insulin-like growth factor-I (IGF-1) in the in vitro maturation media improved the oocyte maturation in the cystic FF by down-regulating the ROS activity via suppressing Non-sense-mediated decay (NMD) of GPX1. In contrast, inhibition of IGF-1R and the target of rapamycin complex 1 (mTORC1) hampered the oocyte maturation via NMD up-regulation. These findings imply that the GPX1 regulation via selenocysteine metabolism and the IGF-1-mediated NMD may be critical for the redox homeostasis of FF. We propose that GPX1 enhancers hold promise as therapeutics for enhancing the competence of FOCs oocytes. However, further in vivo studies are necessary to validate these findings observed in vitro.

Dairy Farmers' Awareness of Vector-Borne Zoonotic Diseases: A Pilot Study.

Background: A quantitative cross-sectional pilot study was conducted to determine dairy farmers' general awareness of vector-borne zoonotic diseases, i.e., dengue fever and chikungunya fever caused by alphavirus and mosquito-borne flavivirus, as well as the relationship between these and other demographic variables such as gender and education level. Materials and Methods: A total of 42 farmers from the Wayanad district of Kerala were surveyed using a well-structured KAP (Knowledge, Attitude and Practice) questionnaire. Results: The study revealed that farmers have inadequate knowledge and attitudes regarding chikungunya, as well as inadequate practices regarding dengue fever. Similarly, there is a significant correlation between gender and chikungunya fever awareness. Conclusion: The study emphasizes the need to increase awareness of these diseases among dairy farmers and emphasizes the significance of conducting additional research on the area and population.

Prediction of internet addiction among high school students in a rural Southern Karnataka, India-A cross-sectional study.

BACKGROUND: According to the World Health Organization, there is an explosion in the use of electronic devices, the internet, and gaming platforms. In many countries, it is a significant public health concern, prompting calls to identify adequate public policy. We aimed to investigate the prevalence of internet addiction (IA) among high school students and to assess the relationship between the internet addiction level of high school students and their demographic features with internet use. MATERIALS AND METHODS: A cross-sectional study was conducted among 424 high school children studying in eighth standard-tenth standard. Among 121 public and private high schools listed by the BEO (Block Education Officer) Office in Kolar Taluk four high schools were selected by lottery method from July 2021 to August 2021. The Internet Addiction Test (IAT) by Young was used to assess the intensity of internet usage. RESULTS: The mean IAT score of study participants was 29.6. The mean age of the study population was 14.4 ± 0.84 years. The odds of internet addiction among female students were 4.5 times higher than among male students. The majority (91.5%) of the students had used the internet for educational purpose and the other common reasons for internet usage is social media (43%), entertainment (43%), and gaming purpose (21%). CONCLUSION: The prevalence of IA among high school students is 14.6% with the moderate-risk population was 12.5% and the high-risk population was 2.1%. Students using the internet for both academic and non-academic purposes were more internet addicted. The real challenge is to have control over the usage of social sites-the amount of time being spent and the type of activities adolescents are doing online.

Multi-omics delineate growth factor network underlying exercise effects in an Alzheimer's mouse model.

Physical exercise represents a primary defense against age-related cognitive decline and neurodegenerative disorders like Alzheimer's disease (AD). To impartially investigate the underlying mechanisms, we conducted single-nucleus transcriptomic and chromatin accessibility analyses (snRNA-seq and ATAC-seq) on the hippocampus of mice carrying AD-linked NL-G-F mutations in the amyloid precursor protein gene (APPNL-G-F) following prolonged voluntary wheel-running exercise. Our study reveals that exercise mitigates amyloid-induced changes in both transcriptomic expression and chromatin accessibility through cell type-specific transcriptional regulatory networks. These networks converge on the activation of growth factor signaling pathways, particularly the epidermal growth factor receptor (EGFR) and insulin signaling, correlating with an increased proportion of immature dentate granule cells and oligodendrocytes. Notably, the beneficial effects of exercise on neurocognitive functions can be blocked by pharmacological inhibition of EGFR and the downstream phosphoinositide 3-kinases (PI3K). Furthermore, exercise leads to elevated levels of heparin-binding EGF (HB-EGF) in the blood, and intranasal administration of HB-EGF enhances memory function in sedentary APPNL-G-F mice. These findings offer a panoramic delineation of cell type-specific hippocampal transcriptional networks activated by exercise and suggest EGF-related growth factor signaling as a druggable contributor to exercise-induced memory enhancement, thereby suggesting therapeutic avenues for combatting AD-related cognitive decline.

Noni (Morinda citrifolia) leaf extract incorporated methylcellulose active films: A sustainable strategy for browning inhibition in apple slice packaging.

Methylcellulose, a prominent polysaccharide prevalent in the food sector, was considered to fabricate the active films with glutaraldehyde as a crosslinker and Noni (Morinda citrifolia) Leaf Extract (NLE) as an active agent. FTIR analysis confirms the intermolecular -OH bonding, and SEM micrograms demonstrate methylcellulose active films' homogeneous, dense morphologic appearance. Due to the crosslinking effect of glutaraldehyde and noni leaf extract, tensile strength (41.83 ± 0.134 MPa) and crystallinity (62.91 %) of methylcellulose films were improved. Methylcellulose active films suppress water and moisture uptake at various relative humidities. The inhibition capability against foodborne pathogens and the excellent antioxidant activity [DPPH (93.191 ± 1.384 %) and ABTS (90.523 ± 1.412 %)] of NLE incorporation suggested that food packed in methylcellulose active films were effective against pathogenic and oxidative attacks. During preservation, to ensure the apple slices' nutritional values, they are covered with physiochemically enhanced methylcellulose active films for up to 120 h. The minimum reduction in vitamin C, reducing sugar content, percentage weight loss, pH, and total phenolic content of apple slices preserved in MGN active films at room temperature suggests it is an affordable and efficient replacement to traditional single-use plastic packaging in the cut fruit industry.

Artificial intelligence in age and sex determination using maxillofacial radiographs: A systematic review.

In the past few years, there has been an enormous increase in the application of artificial intelligence and its adoption in multiple fields, including healthcare. Forensic medicine and forensic odontology have tremendous scope for development using AI. In cases of severe burns, complete loss of tissue, complete or partial loss of bony structure, decayed bodies, mass disaster victim identification, etc., there is a need for prompt identification of the bony remains. The mandible, is the strongest bone of the facial region, is highly resistant to undue mechanical, chemical or physical impacts and has been widely used in many studies to determine age and sexual dimorphism. Radiographic estimation of the jaw bone for age and sex is more workable since it is simple and can be applied equally to both dead and living cases to aid in the identification process. Hence, this systematic review is focused on various AI tools for age and sex determination in maxillofacial radiographs. The data was obtained through searching for the articles across various search engines, published from January 2013 to March 2023. QUADAS 2 was used for qualitative synthesis, followed by a Cochrane diagnostic test accuracy review for the risk of bias analysis of the included studies. The results of the studies are highly optimistic. The accuracy and precision obtained are comparable to those of a human examiner. These models, when designed with the right kind of data, can be of tremendous use in medico legal scenarios and disaster victim identification.

Elevating pyrrole derivative synthesis: a three-component revolution.

Pyrrole is an essential chemical with considerable relevance as a pharmaceutical framework for many biologically necessary medications. The growing demand for biologically active compounds calls for a simple one-pot method for generating novel pyrrole derivatives. Nots surprisingly, several multicomponent reactions (MCRs) aim to synthesize pyrrole derivatives. However, this review presents the three-component synthesis of pyrrole derivatives, highlighting the significance of multicomponent reaction in synthesizing eclectic multi-functionalised pyrrole covering the selected literature on the three-component synthesis of substituted pyrrole from 2016 to late 2023. Furthermore, this article classifies the reactions based on the starting material with functional groups involved in the pyrrole ring formation.

Evaluating Health Expenditure Trends and Disease Burden in India: A Cost per DALY Approach.

Background: Efficient allocation of healthcare resources requires a comprehensive evaluation of healthcare spending and its impact on disease burden. This study aims to estimate the costs-per disability-adjusted life years (DALY) in India. Data from 2010 to 2019 on DALYs and health expenditure per capita (HEp) for individual states in India were utilised. Design and Methods: We followed the CHEERS statement 2022 to present our study's methodology and outcomes. Pearson's product-moment correlations were used to analyse associations between DALYs and HEp. A panel regression analysis was conducted using a log regression model to estimate changes in DALYs due to health expenditure changes. All costs are reported in Indian rupee (₹) along with its 95% CI, with a conversion factor of 1 US$ = ₹82.4 applied. Results: The costs-per-DALY were estimated for each state and India. DALY was negatively correlated with HEp. The estimated mean cost-per-DALY for India was ₹82,112 (₹55,810 to ₹1,08,413) [$997 ($667 to $1316)]. The mean cost per-DALY varied across states, with value of ₹27,058 (₹22,250 to ₹31,866) [$328 ($270 to $387)] for states in the first quartile based on Human Development Index (HDI) and ₹2,69,175 (₹1,05,946 to ₹4,32,404) [$3267 ($1286 to $5248)] for those in fourth HDI quartile. States such as Gujarat (0.16), Karnataka (0.17) and Maharashtra (0.22) have lower, and Arunachal Pradesh has the highest cost-per-DALY to Gross state domestic product per-capita ratio (2.41), followed by Nagaland (1.45). Conclusion: Higher healthcare investment has a lower disease burden; however, reduction in DALY varies across states. Study findings provide evidence to aid the setting up of differential willingness-to-pay thresholds across Indian states for efficient and equitable healthcare resource allocation.

Evaluation of Salivary Butylated Hydroxytoluene and Ascorbic Acid Levels in Type 2 Diabetes Mellitus Patients.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a global health concern associated with systemic as well as oral complications. The preventive antioxidants found in saliva naturally reduce the damaging effects of reactive oxygen molecules. Any disruption to the regular functioning of these antioxidants may lead to oxidative stress, which could boost an individual's vulnerability to oral diseases. Diabetes patients are vulnerable to various dental complications, such as oral mucosal disorders, dental caries, dry mouth, and periodontal disease. AIM: This study aimed to assess the salivary butylated hydroxytoluene (BHT) and ascorbic acid (AA) levels in patients with controlled and uncontrolled type 2 diabetes mellitus. MATERIALS AND METHODS: The present study included samples from patients aged 45-65. Group I consisted of 20 controlled diabetic patients, and Group II consisted of 20 uncontrolled diabetic patients. Unstimulated whole saliva samples were collected from both groups, and laboratory analysis was done. Salivary BHT and AA levels were quantified using enzyme-linked immunosorbent assay (ELISA) and spectrophotometric assay. RESULTS: Salivary butylated hydroxytoluene levels were found to be higher in the uncontrolled diabetic group than in the controlled diabetic group, and salivary AA levels were found to be higher in the controlled diabetic group than in the uncontrolled diabetic group. The mean ± standard deviation (SD) values of butylated hydroxytoluene among controlled and uncontrolled diabetic patients were 2.98 ± 0.12 and 2.99 ± 0.11 absorbance units, respectively. The mean ± SD value of AA in the controlled group was found to be 2.99 ± 0.15 absorbance units, and the mean ± SD value of AA in the uncontrolled group was 2.64 ± 0.96 absorbance units. However, it has been found that there is no statistically significant difference between salivary BHT and AA levels among controlled and uncontrolled diabetics, with p-values of 0.867 and 0.419, respectively. CONCLUSION: Values of salivary biochemical markers were distinctly different between controlled and uncontrolled diabetic groups. However, to establish a definite role of salivary BHT and AA levels as biomarkers in managing and monitoring type 2 diabetes, future studies are required, even though the trends exhibit possible alterations in biomarkers.

Strategies for primary HPV test-based cervical cancer screening programme in resource-limited settings in India: Results from a quasi-experimental pragmatic implementation trial.

BACKGROUND: In order for low and middle income countries (LMIC) to transition to Human Papilloma Virus (HPV) test based cervical cancer screening, a greater understanding of how to implement these evidence based interventions (EBI) among vulnerable populations is needed. This paper documents outcomes of an implementation research on HPV screening among women from tribal, rural, urban slum settings in India. METHODS: A mixed-method, pragmatic, quasi-experimental trial design was used. HPV screening on self-collected cervical samples was offered to women aged 30-60 years. Implementation strategies were 1) Assessment of contextual factors using both qualitative and quantitative methods like key informant interviews (KII), focus group discussions (FGDs), pre-post population sample surveys, capacity assessment of participating departments 2) enhancing provider capacity through training workshops, access to HPV testing facility, colposcopy, thermal ablation/cryotherapy at the primary health care centers 3) community engagement, counselling for self-sampling and triage process by frontline health care workers (HCWs). Outcomes were assessed using the RE-AIM (Reach, Effectiveness, adoption, implementation, maintenance) framework. RESULTS: Screening rate in 8 months' of study was 31.0%, 26.7%, 32.9%, prevalence of oncogenic HPV was 12.1%, 3.1%, 5.5%, compliance to triage was 53.6%, 45.5%, 84.6% in tribal, urban slum, rural sites respectively. Pre-cancer among triage compliant HPV positive women was 13.6% in tribal, 4% in rural and 0% among urban slum women. Unique challenges faced in the tribal setting led to programme adaptations like increasing honoraria of community health workers for late-evening work and recalling HPV positive women for colposcopy by nurses, thermal ablation by gynaecologist at the outreach camp site. CONCLUSIONS: Self-collection of samples combined with HCW led community engagement activities, flexible triage processes and strengthening of health system showed an acceptable screening rate and better compliance to triage, highlighting the importance of identifying the barriers and developing strategies suitable for the setting. TRIAL REGISTRATION: CTRI/2021/09/036130.