Nitrogen use efficiency in bread wheat: Genetic variation and prospects for improvement.

Nitrogen (N) is one of the primary macronutrients required for crop growth and yield. This nutrient is especially limiting wheat yields in the dry and low fertile agro-ecologies having low N in the root zone soil strata. Moreover, majority of farmers in India and South Asia are small to marginal with meagre capacity to invest in costly nitrogen fertilizers. Therefore, there is an immense need to identify lines that use nitrogen efficiently. A set of 50 diverse wheat genotypes consisting of indigenous germplasm lines (05), cultivars released for commercial cultivation (23) and selected elite lines from CIMMYT nurseries (22) were evaluated in an alpha-lattice design with two replications, a six-rowed plot of 2.5m length for 24 agro morphological, physiological and NUE related traits during two consecutive crop seasons in an N-depleted precision field under two different N levels of 50%-N50 (T1) and 100%-N100 (T2) of recommended N, i.e., 100 kg/ha. Analysis of variance revealed significant genetic variation among genotypes for all the traits studied. About 11.36% yield reduction was observed at reduced N levels. Significant correlations among NUE traits and yield component traits were observed which indicated pivotal role of N remobilization to the grain in enhancing yield levels. Among N-insensitive genotypes identified based on their yielding ability at low N levels, UASBW13356, UASBW13358, UASBW13354, UASBW13357 and KRL1-4 showed their inherent genotypic plasticity toward N application. The genotypes with more yield and high to moderate NUtE can be used as parents for the breeding of N efficient genotypes for marginal agro-ecologies. Low N tolerant genotypes identified from the current investigation may be further utilized in the identification of genomic regions responsible for NUE and its deployment in wheat breeding programs. The comprehensive data of 24 traits under different nitrogen levels for diverse genotypes from India and global sources (mainly CIMMYT) should be useful for supporting breeding for NUE and thus will be of great help for small and marginal farmers in India and South Asia.

A CROSS-SECTIONAL STUDY ON COVID-19 VACCINATION HESITATION AMONG UNIVERSITY STUDENTS.

Students serve as ambassadors, conveying effective messages to encourage the adoption of promotes healthy behaviors. Recognizing their consciousness about corona illness 2019 (COVID-19), desires to utilize the COVID-19 vaccines, and other associated variables will aid in developing viable vaccination promotion tactics for the present COVID-19 pandemic. A transverse-segment internet poll of university students in the healthcare and non-healthcare industries was conducted to analyze their motivations to be vaccinated against the coronavirus. To recruit research participants, a random snowball sampling approach was utilized using digital media sites and mails. The contestants were chosen from throughout India, including several main geographic areas, between Nov-2020 and Jan-2021, prior to the release of the COVID-19 vaccination. There were descriptive metrics utilized to illustrate the research participants' socio-demographics and vaccine-related behaviors. Using logistic regression modeling, key characteristics that are expected to influence vaccination uptake among students were modeled. p 0.06 was judged substantial in each study. 656 students participated in the study, with 48.4% coming from the healthcare sector & 51.5% from other fields. Of these 655 students, 43.6 and 22.4% came from India's northern and eastern areas. Graduate students accounted for 41.1% of the total population, and graduates for around 43.2%. The age range of 56.0% of the students was 18 to 25. Women made up 62% of the population, and 69.5% of them were unmarried. Seventy-eight percent of the students were from the medium socioeconomic level. Concerns about side effects and safety, distrust of government officials, and questions about the vaccine's efficacy were among the reasons given by students in this study for their reluctance to get vaccinated. It is essential to remember that these investigations were carried out at various times and in various nations; thus, the conclusions may not apply to all college students throughout the globe. According to the findings of this research, Indian university students showed rather a great deal of motivating desire to acquire COVID-19 immunizations. The people were either doubtful or reluctant to get the vaccination, which suggests possible vaccine aversion. There is a need for information campaigns and other actions to lessen vaccine hesitancy in order to promote the usage of COVID-19 vaccines.

Effectiveness of tobacco counseling training module (TCTM) in enhancing the knowledge, attitude, ability to identify oral manifestations, self-confidence, and skills (KAASS) in tobacco counseling among undergraduate dental students - An interventional study.

BACKGROUND: Tobacco use has emerged as a major public health issue with increasing tobacco-related morbidity and mortality. Despite evidence that even brief tobacco counseling by health care professionals is effective in motivating a tobacco user to quit, there was a lack of customized tobacco counseling training module (TCTM) for students of dentistry in their existing curriculum. This study was undertaken to evaluate the effectiveness of a customized TCTM in improving KAASS in tobacco counseling among undergraduate dental students. METHODS: TCTM that was previously pilot tested was implemented as a value addition in Public Health Dentistry for two academic years. Changes in knowledge, attitude, ability to identify oral manifestations, self-confidence, and skills (KAASS) in tobacco counseling were assessed before and after implementation of TCTM. Mean pre and post intervention scores were compared. RESULTS: Mean scores for knowledge, attitude, ability to identify oral manifestations, and self-confidence (KAAS) at baseline were 4.4 ± 0.9, 5.1 ± 0.7, 4.5 ± 1.1, and 1.3 ± 0.4, respectively. Mean KAAS scores post intervention were 13.5 ± 1.0, 8.7 ± 0.4, 9.4 ± 0.7, and 3.5 ± 0.5, respectively. There was a significant improvement in the mean KAAS score post intervention compared to baseline. Tobacco counseling skills also significantly improved among the participants following implementation of the training module (68.8%) did well compared to the baseline (0%). CONCLUSION: TCTM was effective in enhancing knowledge, attitude, ability to identify oral manifestations, and self-confidence in tobacco counseling among undergraduate dental students.

Insights on the structural characteristics and molecular dynamic studies of methyl vanillin Schiff base bio-compounds.

A new crystalline form of Schiff base, N-cyclohexyl-1-(3,4-dimethoxyphenyl)methanimine (CHADMB) was obtained from methanolic solution of cylohexylamine and (methylvanillin) 3,4dimethoxybenzaldehyde. Single crystal X-ray diffraction study reveals that the compound crystallized in monoclinic crystal system with P21/c space group having four molecules per unit cell (Z = 4). Hirshfeld surface (HS) analysis and 2D fingerprint plots reveals that weak non-covalent interactions are responsible for crystal packing. The UV-Vis spectroscopy study reveals that the optical band gap of the compound is 4.25 eV. The dielectric properties were studied as a function of frequency at room temperature and the results show that these properties can be exploited for optoelectronic applications. Thermal stability of the compound is revealed by thermogravimetric and differential thermogravimetric analysis. The in vitro antimicrobial activity against Gram negative (E. coli and P. aeruginosa and Gram positive (S. aureus ) bacterial strains and two fungal strains (C. albicans and A. niger) were studied by agar well diffusion method. It is found that the Schiff base is inhibiting the growth of the tested species to varying degrees. Molecular docking studies indicate that alkyl-pi and pi-pi weak interactions enhance the binding affinity of Schiff base-protein complexes. Molecular dynamics study reveals interaction of CHADMB complexed with bacterial protein, EC showed maximum stability which is in agreement with experimental result.Communicated by Ramaswamy H. Sarma.

New crystalline form of (N-cyclohexyl-1-(3,4-dimethoxyphenyl)methanimine Schiff base is synthesized.Synthesized compound is characterized by elemental analysis, SXRD, Raman, FT-IR, Mass, ¹H and ¹³C NMR spectroscopy.Band gap of the compound is calculated from absorption data.The dielectric properties of the compound are tested.Biological activity of the compound is tested against three bacterial and two fungal strains.Molecular docking and molecular dynamics studies were carried out to study the interaction of synthesized compound with various bacterial and fungal proteins.

First report of Fusarium poae Causing Fusarium head Blight of Wheat in India.

Wheat is one of major cereal crops with paramount importance that is cultivated across the globe. Fusarium head blight (FHB) is a catastrophic disease of wheat which has recently risen to prominence due to its direct impact on the quality and quantity of wheat on a global scale. During a field survey conducted in Rabi 2021-22, wheat spikes showing characteristic symptoms of head blight were observed in northern parts of the Karnataka, India, in the districts Bagalkote, Belagavi and Dharwad. The infected spikelets from the heads with symptoms of infection were washed well in distilled water and surface sterilized using 1% sodium hypochlorite solution. They were further washed using sterilized distilled water to remove the traces of sodium hypochlorite. These spikelets were then transferred to sterile potato dextrose agar (PDA) plates under aseptic conditions. The plates were incubated at a temperature of 27±1°C for ten days to obtain good fungal growth. The fungus produced white to orangish pink, dense mycelia and hyaline septate hyphae. Macroconidia were sickle-shaped measuring 35.7 to 52.6 x 3.2 to 5.1 µm, dorsoventrally curved with an elongated basal cell ending in a prominent long foot; the apical cell was also elongated, tapered, slightly curved. Spores had 3 to 4 cells and formed on monophialide. Microconidia and chlamydospores were present only in a few isolates. Fungal genomic DNA was extracted from all the established isolates using CTAB (Cetyl-trimethyl ammonium bromide) method (Murray and Thompson, 1980). The ITS region of r-DNA and translation elongation factor-1 alpha (TEF-1α) genes of the ten isolates were amplified using ITS1/ITS4 primer pair (White et al. 1990) and the species-specific EF1F/EF1R primer pair (O'Donnell et al., 1998) respectively, to detect and distinguish within Fusarium species. The results exhibited 95% similarity with Fusarium poae with GenBank Accession No. XMO44849482.1. which was previously reported as a causal agent of Fusarium head blight of wheat in Georgia, USA. The TEF1-α sequences were deposited in the GenBank and the accession numbers from OP716756 to OP716765 were obtained. For the pathogenicity test, spore suspension containing a load of 108 conidia ml-1 was prepared from ten days old Fusarium poae culture and sprayed on the healthy wheat heads of the susceptible variety UAS-304 during anthesis stage by using hand atomizer. Control plants were sprayed in a similar manner with sterile distilled water. In order to enhance disease development and increase the accuracy of the evaluation, humidity was maintained for 72 hours post-inoculation period by covering each spike with a plastic bag and misting at least once daily. The characteristic head blight symptoms were observed in the inoculated wheat spikes. No symptoms were noticed in the water-treated control. The plants initially showed bleaching in single spikelet after seven days of inoculation, which eventually spread to the entire spike. After fourteen days of inoculation, the spikes showed blighted appearance with pinkish or orangish mass of mycelia grown on the affected region. The pathogen was further reisolated from the infected plants and examined under the microscope. The similar morphological features as that of the originally inoculated pathogen was observed, hence fulfilling Koch's postulates. To our knowledge, this is the first report of Fusarium poae causing head blight of wheat in India. Keeping the current climate change scenario in view, the plausibility of this pathogen causing a major havoc in the near future must not be ignored, considering the fact that it has a wide host range and highly evolving nature. The ubiquity of the Fusarium head blight recently in northern parts of Karnataka urges the need to conduct further studies on the variability, distribution and management of the pathogen.

Experimental and theoretical analyses and investigation of intermolecular interactions and antibacterial activity of a novel proton transfer compound:8-hydroxyquinolinium oxalate monohydrate.

A novel proton transfer compound, 8-hydroxyquinolinium oxalate monohydrate was synthesised by solid state grinding of 8-hydroxyquinoline and oxalic acid. The resulting compound is characterised by single crystal X-ray diffraction (SXRD), FT-IR, UV-Visible, TG/DTG, DTA and DSC analyses. The compound crystallizes in monoclinic crystal system with space group P21/n. The carboxylate oxygen O2 which acts as a tetrafurcated acceptor of four hydrogen bonds is the main feature of the crystal structure. The molecules are linked together by O-H⋯O, N-H⋯O and C-H⋯O hydrogen bonds. Carbonyl-carbonyl interactions play a crucial role in stabilising the crystal packing. Hirshfeld surface analysis and the associated finger print plots facilitates the comparison of intermolecular interactions. The nature of charge density distribution and topological parameters of the proton transfer region N1-H1A⋯O2 hydrogen bond reveals that the bond has considerable covalent character. Natural Bond Orbital (NBO) has been extended to analyse the nature and strength of intermolecular interactions. Topology analysis using ELF and LOL reveals electron localisation and depletion regions. ADMET analysis reveals that the compound satisfies Lipinski's rule of five and drug likeness. Antibacterial activity was screened against 3 g positive - Bacillus subtilis, Enterococcus faecalis, Staphylococcus aureus and 2 g negative strains- Klebsiella pneumonia and Salmonella typhi by employing disc diffusion method.

Retrospective study on the distribution of hemoglobinopathies in Karnataka-A laboratory experience.

AIMS: The importance of screening for hemoglobinopathies is well-documented in India. However, information on the distribution of hemoglobinopathies in Karnataka is lacking. The present study focuses on determining the spectrum of hemoglobinopathies for various districts of Karnataka. MATERIALS AND METHODS AND RESULTS: A retrospective analysis of samples registered for hemoglobinopathies for a period of 5 years (2017-2021) was carried out. A total of 17066 records registered only from the Karnataka region, were anonymized and retrieved. The data included gender, age, district, and results of the tests. The results were based on complete blood count, peripheral smear, and capillary electrophoresis (CE) pattern. The data were revalidated by pathologists, and the unambiguous data were analyzed for the study. One-fourth of the records (25%) showed abnormal hematological parameters. The number of female records (66%) was twice that of males and both genders showed higher distribution of thalassemia, followed by variants and double heterozygotes (DH). Several cases of thalassemia major were identified below the age of 17 years. The majority of thalassemia cases were b thal and 93% of them were b thal trait. Among the variants, HbS was more prevalent than HbE. Among the districts, Hassan had a 35.2% thal, Mysuru had a 7.2% variant, and Chitradurga had a 5.5% DH. Thalassemia, variants, and DH were distributed across several districts of Karnataka to various levels. CONCLUSION: The comprehensive retrospective analysis of the spectrum of hemoglobinopathies in various districts of Karnataka serves as evidence to carry out a prospective study on population screening where the incidence of thalassemia and structural variants is high.

Real-world Data of Leukopenia Evaluation as Seen in a Community Academic Center.

Leukopenia on routine laboratory testing creates a concerning situation for primary care providers due to its association with hematological malignancies. Although not all leukopenia is due to underlying cancer, it can trigger an expensive and exhausting work-up in the process of ruling it out. There is neither real-world data on the prevalent causes of leukopenia as seen in the community nor definitive guidelines on the utilization of flow-cytometry in this setting. We conducted this retrospective study at our community academic center to demonstrate the distribution of various causes of leukopenia as well as the utility of flow-cytometry. Our study demonstrates that benign reversible causes of leukopenia are most prevalent and flow-cytometry is useful only in some very specific settings. These results provide a real-world estimate for clinicians to make informed decisions while evaluating leukopenia.

Surgical Delay-Induced Hemodynamic Alterations of the Superficial Inferior Epigastric Artery Flap for Autologous Breast Reconstruction.

BACKGROUND: The superficial inferior epigastric artery (SIEA) flap allows transfer of tissue without violating the rectus fascia. Traditionally it is best used in single stage reconstruction when vessel caliber is 1.5 mm; 56% to 70% of SIEAs are less than 1.5 mm and, therefore, not reliable. We aim to demonstrate the increased reliability of SIEA through surgical delay by quantifying reconstructive outcomes and delay-induced hemodynamic alterations. METHODS: Patients presenting for autologous breast reconstruction between May 2019 and October 2020 were evaluated with preoperative imaging and received either delayed SIEA or delayed deep inferior epigastric (DIEP) reconstruction based on clinical considerations, such as prior surgery and perforator size/location. Prospective data were collected on operative time, length of stay, and complications. Arterial diameter and peak flow were quantified with Doppler ultrasound predelay and postdelay. RESULTS: Seventeen delayed SIEA flaps were included. The mean age (± SD) was 46.2 ± 10.55 years, and body mass index was 26.7 ± 4.26 kg/m2. Average hospital stay after delay was 0.85 ± 0.90 days, and duration before reconstruction was 6 days to 14.5 months. Delay complications included 1 abdominal seroma (n = 1, 7.7%). Superficial inferior epigastric artery diameter predelay (mean ± 95% confidence interval) was 1.37 ± 0.20 mm and increased to 2.26 ± 0.24 mm postdelay. A significant increase in diameter was noted 0.9 ± 0.22 mm (P < 0.0001). Mean peak flow predelay was 14.43 ± 13.38 cm/s and 44.61 ± 60.35 cm/s (n = 4, P = 0.1822) postdelay. CONCLUSIONS: Surgical delay of the SIEA flap augments SIEA diameter, increasing the reliability of this flap for breast reconstruction. Superficial inferior epigastric artery delay results in low rates of complications and no failures in our series. Although more patients are needed to assess increase in arterial flow, use of surgical delay can expand the use of SIEA flap reconstruction and reduce abdominal morbidity associated with abdominal flap breast reconstruction.

Laryngeal Dysfunction in Acute Organophosphorus and Carbamate Poisoning.

Background: Organophosphorus (OP) and carbamate pesticides are widely used for crop protection. We describe the spectrum of laryngeal abnormalities in patients admitted to the intensive care unit (ICU) with acute OP and carbamate poisoning as there is limited information on it. Materials and methods: Consecutive patients admitted to the ICU with acute OP and carbamate poisoning over 20 months (December 2014-July 2016) were recruited. Patients were followed up post-discharge if they had undergone tracheostomy or developed hoarseness of voice or stridor following extubation. Asymptomatic individuals who consented underwent laryngoscopy after ICU discharge. The primary outcome was the development of laryngeal dysfunction. Other outcomes included length of stay, need for ventilation, mortality, tracheostomy, and time to decannulation of tracheostomy. Results: Of the 136 patients recruited, 71 (52%) underwent laryngoscopy. The overall mortality rate was 9.6%. Of the 71 patients who underwent laryngoscopy, 18 had abnormal findings, which included unilateral or bilateral vocal cord paresis or palsy (n = 14) and/or aspiration (n = 9), subglottic stenosis (n = 1), tracheal stenosis (n = 1), or arytenoid granuloma (n = 1). Laryngeal dysfunction was associated with the ingestion of a dimethyl OP compound (p = 0.04) and quantum consumed (p <0.001). Patients with laryngeal dysfunction had significantly (p = 0.004) longer hospital stay (19.1 ± 10.7 vs 11.8 ± 8.3 days). Conclusion: Laryngeal dysfunction is not uncommon in OP and carbamate poisoning and is associated with the ingestion of larger quantity of a dimethyl OP compound and longer hospital stay. Otorhinolaryngologists could be involved early to help identify these abnormalities and initiate an appropriate treatment to ensure a functional voice and good airway. How to cite this article: Mani GS, Mathews SS, Victor P, Peter JV, Yadav B, Albert RRA. Laryngeal Dysfunction in Acute Organophosphorus and Carbamate Poisoning. Indian J Crit Care Med 2022;26(2):167-173.

Autologous Breast Reconstruction with Bilateral Stacked Free Flaps in Massive Weight Loss Patients.

Patients with a history of massive weight loss who are undergoing autologous breast reconstruction after mastectomy represent a unique surgical challenge. Although these patients often have an abundance of excess skin, it may be difficult to acquire sufficient tissue volume for adequate reconstruction of bilateral breasts using single flap techniques due to the paucity of subcutaneous fat. Stacked flap techniques have emerged as an effective method in thinner patients with suboptimal fat distribution who desire autologous breast reconstruction. This can serve as an ideal strategy, specifically in this patient population, when it serves the dual function of providing adequate volume for bilateral breast reconstruction and the secondary benefit of removing the excess skin present after massive weight loss. In this article, we discuss surgical techniques used during two cases of bilateral stacked flap breast reconstruction in cancer patients subsequent to massive weight loss.

Dynamics of small molecules within the F127 PEO-PPO-PEO triblock copolymer gel and sol phases studied at the molecular scale.

Triplet excited states of guest molecules with different hydrophobicities were used to probe the association and dissociation dynamics of these guests with F127 micelles in the gel and sol phases. The dynamics probed was on a longer length scale than amenable with fluorescence techniques, but at a shorter length scale than probed in translational diffusion studies. The mobility of the guests at the molecular scale showed that subtle changes in the guest's structure affect the guest's release time from the micelles, where the structural features of the guest are more important than the phase, gel vs. sol, of the system.

Mechanism of a Disassembly-Driven Sensing System Studied by Stopped-Flow Kinetics.

We carried out steady-state and stopped-flow photophysical measurements to determine the kinetics of a discrete disassembly driven turn-on fluorescent system. On and off rates for both DimerDye1 assembly and nicotine binding were determined. Relative rates for these competing processes provide insight on how this system can be optimized for sensing applications. Kinetics studies in artificial saliva showed that moving to more complex media has minimal effects on the sensing ability of the system.

A Novel Technique for Radiographic Diagnosis of Sarcopenia that Accurately Predicts Postoperative Complications in Lower Extremity Free Flap Patients.

BACKGROUND: Sarcopenia is linked to poor outcomes throughout the surgical literature and can be assessed on preoperative imaging to potentially aid in risk stratification. This study examined the effects of sarcopenia on surgical morbidity following lower extremity (LE) reconstruction, and also compared two methods of assessment, one of which is novel ("ellipse method"). METHODS: A retrospective cohort study of 50 patients receiving free flap-based reconstruction of the LE was performed. Bilateral psoas density and area were quantified at L4 through tracing ("traditional method") and encircling ("ellipse method") to calculate Hounsfield unit average calculation (HUAC). Logistic regression and receiving operator curve analysis for the primary outcome of any postoperative complication was used to determine HUAC cutoffs (≤ 20.7 vs. ≤ 20.6) for sarcopenia. Risk of complications associated with sarcopenia was evaluated using Fisher's exact tests. RESULTS: Twelve patients (24%) met criteria for sarcopenia via the traditional method and 16 (32%) via the ellipse method. By both methods, sarcopenic patients were older and more often female and diabetic. These patients also had higher American Society of Anesthesiologists scores and lower serum prealbumin levels. The ellipse method was found to be more accurate, sensitive, and specific than the traditional method in predicting postoperative morbidity (p = 0.009). Via the ellipse method, sarcopenic patients were at higher risk for any complication (p = 0.002) and were at a higher risk for a deep vein thrombus or pulmonary embolism via the traditional method (p = 0.047). CONCLUSION: Sarcopenia is associated with greater pre- and postoperative morbidity in LE reconstruction. The novel ellipse method is a simplified and accurate method of assessing sarcopenia that can be easily performed in the clinical setting.

Dissecting miRNA facilitated physiology and function in human breast cancer for therapeutic intervention.

MicroRNAs (miRNAs) are key epigenomic regulators of biological processes in animals and plants. These small non coding RNAs form a complex networks that regulate cellular function and development. MiRNAs prevent translation by either inactivation or inducing degradation of mRNA, a major concern in post-transcriptional gene regulation. Aberrant regulation of gene expression by miRNAs is frequently observed in cancer. Overexpression of various 'oncomiRs' and silencing of tumor suppressor miRNAs are associated with various types of human cancers, although overall downregulation of miRNA expression is reported as a hallmark of cancer. Modulations of the total pool of cellular miRNA by alteration in genetic and epigenetic factors associated with the biogenesis of miRNA machinery. It also depends on the availability of cellular miRNAs from its store in the organelles which affect tumor development and cancer progression. Here, we have dissected the roles and pathways of various miRNAs during normal cellular and molecular functions as well as during breast cancer progression. Recent research works and prevailing views implicate that there are two major types of miRNAs; (i) intracellular miRNAs and (ii) extracellular miRNAs. Concept, that the functions of intracellular miRNAs are driven by cellular organelles in mammalian cells. Extracellular miRNAs function in cell-cell communication in extracellular spaces and distance cells through circulation. A detailed understanding of organelle driven miRNA function and the precise role of extracellular miRNAs, pre- and post-therapeutic implications of miRNAs in this scenario would open several avenues for further understanding of miRNA function and can be better exploited for the treatment of breast cancers.

Nonlinear Dependence on Na+ Ions for the Binding Dynamics of Cucurbit[6]uril with the trans-1-Methyl-4-(4-hydroxystyryl)pyridinium Cation.

The binding dynamics of the trans-1-methyl-4-(4-hydroxystyryl)pyridinium cation (HSP+) to cucurbit[6]uril (CB[6]) in the presence of Na+ cations were studied to establish the effect of the relative concentrations of the system's components (HSP+, CB[6], and Na+) on these dynamics. The formation of the HSP+@CB[6] complex was temporally uncoupled from the photoisomerization of trans-HSP+, while a nonlinear effect of the Na+ cation concentration on the HSP+@CB[6] dynamics was observed. This nonlinearity is a consequence of Na+ having the opposite effect on the association and dissociation rate constants for the HSP+@CB[6] complex, creating a conceptual framework for using such nonlinearities to control multistep reactions in cucurbit[n]uril chemistry.

Enhancing identification and counseling skills of dental undergraduate students using a customized Tobacco Counseling Training Module (TCTM) - A piloting of the process using ADDIE framework.

BACKGROUND: Tobacco use has emerged as a major public health problem. But, most graduates in medical and dental schools receive limited systematic training. The objective of this education innovation project was to enhance dental undergraduate student's ability to identify tobacco users through oral manifestations and improve their counseling skills using a customized Tobacco Counseling Training Module (TCTM). METHODS: A TCTM for students of dentistry was developed using ADDIE framework as a guide. Content and construct validation of the module was done by six subject experts using Delphi technique for obtaining consensus. Pilot testing was done on 20 students of third year BDS. Pre- and post-intervention assessment of knowledge, attitude, self-confidence was done using learning outcomes questionnaire. Ability to correctly identify oral manifestations was assessed using extended item MCQs and tobacco counseling skills using a modified KEECC. The difference in mean scores were computed and subjected to further statistical analysis using SPSS version 22. RESULTS: There was a significant improvement in post intervention scores for mean knowledge (5.5 ± 1.4 to 13.2 ± 1.1), attitude (5.6 ± 0.9 and 8.5 ± 0.5), self-confidence (1.5 ± 0.5 and 3.1 ± 0.2), ability to correctly identify oral manifestations (5.2 ± 1.4 and 9.4 ± 0.8) and tobacco counseling skills. CONCLUSION: It is possible to introduce the module in the existing curriculum and its effectiveness evaluation shows benefit in terms of Kirkpatrick's Level 1, 2, 3 (improvement in knowledge, attitude, self-confidence, ability to identify oral manifestations, and tobacco counseling skills) of training effectiveness.

Noninnocent Role of Na+ Ions in the Binding of the N-Phenyl-2-naphthylammonium Cation as a Ditopic Guest with Cucurbit[7]uril.

Na+ ions influence the mechanism for the binding of the ditopic guest N-phenyl-2-naphthylammonium cation (Ph-AH+-Np) to cucurbit[7]uril (CB[7]) by facilitating, at increased Na+ concentrations, the formation of a higher-order complex. Binding of the larger naphthyl moiety of Ph-AH+-Np forms the Ph-AH+-Np@CB[7] 1:1 complex (where "@" represents an inclusion complex) at low Na+ ion concentrations (≤5 mM), whereas the inclusion of the smaller phenyl moiety in CB[7] (CB[7]@Ph-AH+-Np) is transient. Ph-AH+-Np@CB[7] is formed by reactions with free CB[7] and CB[7]·Na+ (where "·" represents an exclusion complex) with displacement of the Na+ cation. Because of the latter reaction, the dissociation of Ph-AH+-Np@CB[7] is faster at higher Na+ concentrations. At high Na+ concentrations (≥25 mM), the Na+ ion stabilizes the inclusion of the phenyl moiety in CB[7] by capping the portal of CB[7]. The dynamics of the capped Na+·CB[7]@Ph-AH+-Np 1:1 complex is slower than in the absence of Na+ capping. This stabilization of the phenyl moiety inclusion in CB[7] by Na+ leads to the formation of the Na+·CB[7]@Ph-AH+-Np@CB[7] 2:1 host-guest complex, where each moiety of the ditopic guest is included in a different CB[7]. The opposing roles of Na+ cations in the formation of the two 1:1 complexes are essential for the switch in mechanism with changes in Na+ concentration and provide an example of systems chemistry, where new properties arise in the form of an increased diversity of complexes and altered complexation dynamics that depend on the system's composition.

Periodontitis Is Associated with Chronic Obstructive Pulmonary Disease.

Although they are known to share pathophysiological processes, the relationship between periodontitis and chronic obstructive pulmonary disease (COPD) is not fully understood. The aim of the present study was to test the hypothesis that periodontitis is associated with a greater risk of development of COPD, when smoking is taken into account. The analysis in a 5-y follow-up population-based cohort study was based on 900 community-dwelling Japanese adults (age: 68.8 ± 6.3 [mean ± SD], 46.0% male) without COPD aged 60 or older with at least 1 tooth. Participants were classified into 3 categories according to baseline periodontitis severity (no/mild, moderate, and severe). COPD was spirometrically determined by a fixed ratio of <0.7 for forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) and by FEV1/FVC below the lower limit of normal. Poisson regression was used to calculate the relative risk (RR) of developing COPD according to the severity of periodontitis. The population attributable fraction (PAF) was also calculated. During follow-up, 22 (2.4%) subjects developed COPD. Compared with no/mild periodontitis subjects, a significantly increased risk of COPD occurred among severe periodontitis subjects (RR = 3.55; 95% confidence interval [CI], 1.18 to 10.67), but no significant differences were observed between the no/mild and moderate categories (RR = 1.48; 95% CI, 0.56 to 3.90). After adjustment for potential confounders, including smoking intensity, the relationship between severe periodontitis and risk of COPD remained significant (RR = 3.51; 95% CI, 1.15 to 10.74). Likewise, there was a positive association of periodontitis severity with risk of COPD ( P for trend = 0.043). The PAF for COPD due to periodontitis was 22.6%. These data highlight the potential importance of periodontitis as a risk factor for COPD.

A Nondimensional Model Reveals Alterations in Nuclear Mechanics upon Hepatitis C Virus Replication.

Morphology of the nucleus is an important regulator of gene expression. Nuclear morphology is in turn a function of the forces acting on it and the mechanical properties of the nuclear envelope. Here, we present a two-parameter, nondimensional mechanical model of the nucleus that reveals a relationship among nuclear shape parameters, such as projected area, surface area, and volume. Our model fits the morphology of individual nuclei and predicts the ratio between forces and modulus in each nucleus. We analyzed the changes in nuclear morphology of liver cells due to hepatitis C virus (HCV) infection using this model. The model predicted a decrease in the elastic modulus of the nuclear envelope and an increase in the pre-tension in cortical actin as the causes for the change in nuclear morphology. These predictions were validated biomechanically by showing that liver cells expressing HCV proteins possessed enhanced cellular stiffness and reduced nuclear stiffness. Concomitantly, cells expressing HCV proteins showed downregulation of lamin-A,C and upregulation of ß-actin, corroborating the predictions of the model. Our modeling assumptions are broadly applicable to adherent, monolayer cell cultures, making the model amenable to investigate changes in nuclear mechanics due to other stimuli by merely measuring nuclear morphology. Toward this, we present two techniques, graphical and numerical, to use our model for predicting physical changes in the nucleus.