Systematic content analysis of self-help smokeless tobacco cessation smartphone applications available in India.

Background: The content of smartphone applications (apps) that offer smoking cessation interventions has been appraised in the past. Considering the high prevalence of smokeless tobacco (SLT) use in Southeast Asia, identifying high-quality and credible apps for SLT cessation would be more helpful. Objective: This study evaluated the technical quality of apps for SLT cessation and their content adherence with the standard tobacco cessation guidelines. Materials and methods: A systematic search of SLT cessation smartphone apps freely available in the Google PlayStore was conducted using nine relevant search terms, and the first fifty apps under each search term were identified. The technical quality of the apps was rated using the Mobile App Rating Scale (MARS). Adherence of the app content to the standard tobacco cessation guidelines was also determined. Results: Three apps were found to be relevant for SLT cessation. However, none of the apps was high-quality or incorporated existing evidence on SLT cessation. Conclusion: Adherence of these apps to the tobacco cessation guidelines by the National Tobacco Control Program (NTCP), India and the National Institute for Health and Care Excellence (NICE), U.K., was limited only to a few checklist parameters.

Comorbidity of Depression and Diabetes: A Literature Review on Systemic Flaws in Healthcare and the Benefits of Collaborative Diagnosis and Treatment in Primary Care Settings.

BACKGROUND: The increasing specialization and dispersion of healthcare systems have led to a shortage of resources to address comorbidities. Patients with coexisting mental and physical conditions are disadvantaged, as medical providers often only focus on the patient's mental illness while neglecting their physical needs, resulting in poorer health outcomes. OBJECTIVE: This study aimed to shed light on the systemic flaws in healthcare systems that contribute to suboptimal health outcomes in individuals with comorbid diseases, including depression and diabetes. This paper also discusses the clinical and economic benefits of collaborative methods for diagnosing and treating depressive disorders in primary care settings. METHODS: A comprehensive literature review of the relationship between depression and diabetes was conducted. The outcomes of the literature review were carefully analyzed. Several databases were searched using keywords such as "diabetes," "depression," "comorbidity," "prevalence," "epidemiology," and "risk factors" using Google Scholar and PubMed as search engines. The review and research papers written between 1961 and 2023 were our main focus. RESULTS: This study revealed improved depressive symptoms and better blood sugar and blood pressure control. Additionally, individuals with comorbid depression and diabetes have higher direct and secondary medical costs. Antidepressants and psychological interventions are equally effective in treating depressive symptoms in patients with diabetes, although they have conflicting effects on glycemic control. For individuals with comorbid diabetes and depression, clear care pathways, including a multidisciplinary team, are essential for achieving the best medical and mental health outcomes. CONCLUSION: Coordinated healthcare solutions are necessary to reduce the burden of illness and improve therapeutic outcomes. Numerous pathophysiological mechanisms interact with one another and may support the comorbidities of T2DM, and depressive disorders could exacerbate the course of both diseases.

Modeling the cost-effectiveness of school-based supervised toothbrushing program in reducing the dental caries burden in India.

BACKGROUND: Supervised toothbrushing (STB) significantly reduces the incidence and progression of dental caries. School years present a favorable age for introducing such healthy habits for a lifetime. AIM: To estimate the cost-effectiveness of implementing a STB program in India in preventing dental caries incidence. DESIGN: An operational framework of a national STB program was devised. A mathematical model was then developed to evaluate this program's clinical effectiveness and economic impact in the Indian scenario. This study considered a hypothetical cohort of the Indian population aged from 6 to 75 years. Two groups were compared: no intervention and STB in government schools. The health outcomes assessed were a number of tooth caries incidences averted and quality-adjusted life years gained. RESULTS: The STB program in the government schools of India would prevent at least one tooth from developing caries in an individual's lifetime. Considering the current treatment-seeking behavior, the STB program saves INR 153 (US$ 1.95) per carious tooth incidence averted and INR 22 202 (US$ 283) per QALY gained. CONCLUSION: In India, the school-based STB program is expected to be a cost-effective strategy for reducing the dental caries burden and its associated treatment costs.

Post-discharge Care Practices, Challenges, and Outcomes in Newborn Infants of Mothers With SARS-CoV-2 Infection: Insights From Public Hospitals.

Background The data regarding the care at home and outcomes in infants of mothers infected with SARS-CoV-2 continue to evolve. There is a paucity of studies beyond the immediate newborn period. Our research aims to improve the understanding in these areas by studying the newborn population discharged from public hospitals in several boroughs of New York City (NYC) through the first year of the COVID-19 pandemic. Objective The objective of this study is to assess parental perspective and describe post-discharge care practices, patterns of healthcare utilization, challenges in obtaining care, and outcomes in infants between six and 12 months of age born to mothers infected with SARS-CoV-2 at the time of delivery. Methods We conducted an institutional review board (IRB)-approved multi-center retrospective cohort study of infants born to SARS-CoV-2-positive mothers at five NYC public hospitals between March and December of 2020. Clinical and demographic data were collected from electronic medical records. A phone interview of the caregivers using a standard questionnaire was conducted to collect data about care at home, healthcare utilization patterns, and challenges with access to healthcare. Results Our study cohort included 216 infants born to SARS-CoV-2-positive mothers with 16 (7.4%) mothers being symptomatic at discharge. Ten infants tested positive, and two showed symptoms before discharge. Two hundred seven (95.8%) infants were discharged home to their parents, and eight (3.7%) were transferred to other facilities. One hundred thirty-eight (66%) infants had at least one visit to the emergency room (ER) for various complaints where two were found to have COVID-19 with one needing hospitalization. One hundred seventy-two (79.6%) families responded to the phone interview. Most mothers (78%) cohabitated with their infants at home, and 70.3% elected to breastfeed. However, only 56.3% of mothers reported using all the recommended infection prevention practices at home. More than half (57%) of the families reported financial hardship related to the pandemic. Although 46.2% of patients missed their in-person health maintenance visits, telemedicine was highly utilized for follow-up with most being phone visits (70.3%). The majority of the infants (95.5%) remained up-to-date with their routine immunizations. Conclusions Our results suggest that infants born to SARS-CoV-2-infected mothers showed increased utilization of medical care and telemedicine between six and 12 months of age. Mothers reported low adherence to infection prevention practices at home; however, infants rarely showed clinically significant SARS-CoV-2 infection while maintaining high breastfeeding rates after discharge.

Powered versus manual toothbrushes for plaque removal and gingival health amongst 55 and older individuals: A systematic review and meta-analysis.

OBJECTIVE: To compare manual and powered toothbrushes in older adults and to culminate available clinical evidence concerning efficiency with respect to plaque removal and reduced gingivitis. BACKGROUND: Manual dexterity decreases with age, negatively impacting daily activities, including oral hygiene practices. Effective plaque control in this age group is directly related to nutrition and overall health. Therefore, developing oral health interventions tailored to the ageing population is essential. MATERIAL AND METHODS: This systematic review was registered with PROSPERO (Registration No. CRD42023415876). Five electronic databases were searched to identify randomized controlled trials published from inception until March 2023. The risk of bias was assessed using the Cochrane Risk of Bias Tool. Meta-analyses were also performed for gingival, plaque, and bleeding indices. RESULTS: A total of 2118 records were identified, and six eligible publications were retrieved. Comparison of Plaque Indices between powered and manual toothbrushes showed a Standard mean difference (SMD) of -0.10; 95% CI [-0.37, 0.18] (p = .38). Comparison of the gingival index and bleeding index between powered and manual toothbrushes showed an SMD of -0.28; 95% CI [-0.72, 0.16] (p = .22) and SMD of -0.03 [-0.38, 0.32] (p = .84), respectively. CONCLUSION: According to the available literature, this study suggests the need for more streamlined research to support the superiority of either powered or manual toothbrushes in improving oral health (as measured by the indices) among the older population. The results will hence have significant reverberations for older adults looking to improve their oral hygiene practices.

Trend of risk factors for cardiovascular diseases among young and middle-aged indians: Insights from a nationally representative survey.

Background: India, as a nation is witnessing epidemiological transition, which is taking place across all the states at different level, over past couple of decades. Owing to the long natural history of non-communicable diseases (NCDs), early identification of these risk factors can aid in understanding the distribution and future development of cardiovascular diseases (CVDs). Also, studying the trend of these risk factors over time can help in prediction of burden of various CVDs in future. Thus, the present study aims at understanding the trend of various risk factors for CVDs across rural and urban India, and states. Methods: The present study was conducted using secondary data from the third, fourth and fifth round of the National Family Health Survey (NFHS) conducted in India. The surveys collected data for estimation of burden of the common modifiable risk factors of CVDs including tobacco and alcohol consumption overweight/obesity, raised blood pressure, and raised blood sugar. The analysis for the present study was done among interviewed males and females between 15 and 49 years. The weighted prevalence of these risk factors was computed and binary logistic regression was done to study the predictors for the same. Results: A declining trend of tobacco (29.2% in NFHS 3; 8.1%in NFHS 5) and alcohol consumption (14.2% in NFHS 3; 3.2%in NFHS 5) was observed from 2005 -06 to 2019-21. A rising trend of overall raised blood pressure (11.4% in NFHS 4; 12.2%in NFHS 5), raised blood sugar (6.2% in NFHS 4; 8.5%in NFHS 5), and overweight and obesity (11.4% in NFHS 3; 23.6%in NFHS 5) was observed from the three rounds of the survey. The odds of all the studied risk factors were significantly higher among older age across all the rounds of the survey. Except overweight/obesity, the odds of rest all studied risk factors was found to be higher among males compared to females. Also, higher odds of alcohol consumption, overweight/obesity, raised blood pressure, and raised blood sugar were found among the participants living in urban areas compared to rural areas, across all the rounds of the survey. Conclusion: The present highlights the rising burden of CVD risk factors, including overweight and obesity, raised blood pressure and raised blood sugar, and a declining trend of tobacco and alcohol consumption across the country. The study also highlights the need for in-depth assessment of predictors of these risk factors using longitudinal study designs.

An ankyrin repeat chaperone targets toxic oligomers during amyloidogenesis.

Numerous age-linked diseases are rooted in protein misfolding; this has motivated the development of small molecules and therapeutic antibodies that target the aggregation of disease-linked proteins. Here we explore another approach: molecular chaperones with engineerable protein scaffolds such as the ankyrin repeat domain (ARD). We tested the ability of cpSRP43, a small, robust, ATP- and cofactor-independent plant chaperone built from an ARD, to antagonize disease-linked protein aggregation. cpSRP43 delays the aggregation of multiple proteins including the amyloid beta peptide (Aß) associated with Alzheimer's disease and α-synuclein associated with Parkinson's disease. Kinetic modeling and biochemical analyses show that cpSRP43 targets early oligomers during Aß aggregation, preventing their transition to a self-propagating nucleus on the fibril surface. Accordingly, cpSRP43 rescued neuronal cells from the toxicity of extracellular Aß42 aggregates. The substrate-binding domain of cpSRP43, composed primarily of the ARD, is necessary and sufficient to prevent Aß42 aggregation and protect cells against Aß42 toxicity. This work provides an example in which an ARD chaperone non-native to mammalian cells harbors anti-amyloidal activity, which may be exploited for bioengineering.

Comparison of proposed National Institute of Child Health and Human Development panel recommendations with newborn sepsis risk calculator in term neonates exposed to maternal chorioamnionitis.

BACKGROUND: Maternal chorioamnionitis (MC) is one of the major risk factors for early-onset neonatal sepsis. Kaiser sepsis risk calculator (SRC) is a validated risk assessment tool for such newborns. The National Institute of Child Health and Human Development (NICHD) workshop on MC has proposed a risk assessment algorithm. The objective of the study was to compare the reduction in antibiotic use in newborns treated with SRC and NICHD algorithm and determine the antibiotic use correlation between them. METHODOLOGY: A retrospective chart review was performed on newborns born at ≥ 37 weeks to mothers with MC during the years 2018-2020. The same cohort of newborns was evaluated using SRC and NICHD algorithm to determine whether treatment with antibiotics could have been avoided in some patients. The data were analyzed using a t-test, Chi-square test, and ANOVA. RESULTS: During the study period, 101 newborns were born to mothers with chorioamnionitis and received antibiotics. When the newborns were assessed using the SRC, only 16/101 (15.84%) would have received treatment. When NICHD algorithm was applied to the same cohort 71/101 (70.30%) newborns would have received treatment. The two approaches agreed in their assessment for treatment or observation only in 44/101 (43.56%) of the cases. The NICHD treatment group had a higher incidence of chorioamnionitis as seen in placental pathology (94.37% vs. 75.00% for Kaiser, p-0.015). The SRC treatment group however had newborns with significantly lower Apgar score at 1 min (8.21 vs 6.63, p-0.006) and 5-minute (8.69 vs 8.00, p-0.019) and had significantly higher supplemental oxygen requirements at admission (62.50% vs. 21.13%, p < 0.001). CONCLUSION: Both SRC and NICHD algorithms expose fewer newborns to antibiotics; however, they differ in the number of newborns that would require antibiotics. Ventilation assistance and lower Apgar scores were associated with higher probability of antibiotic administration.

"Does the Exploration of the Temporomandibular Joint Using a Deep Subfascial Technique Result in a Superior Operative Outcome?"

PURPOSE: The literature is replete with various approaches for the temporomandibular joint (TMJ), each with its own distinct advantages and disadvantages. None of these approaches, however, have been associated with superior operative outcomes. The purpose of this study was to measure the efficacy of three operative approaches to TMJ, namely superficial, subfascial, and deep subfascial approaches. The aim was to contrast selected intraoperative and postoperative outcomes among these surgical approaches. METHODS: This was a prospective randomized clinical trial of subjects presenting to outpatient department. The primary predictor variables were three dissection planes of TMJ: Group-I (superficial), Group-II (subfascial), and Group-III (deep subfascial). The primary outcome variables were quality of surgical field employing fromme scale, dissection time in minutes, amount of blood loss in milliliters, and facial nerve function (FNF) using House-Brackmann scale. The secondary outcome variables were postoperative pain using visual-analog scale and swelling in millimeters measured on 1st, 3rd, and 7th postoperative days and quality of life using facial clinimetric evaluation questionnaire at 6-month follow-up. Age, gender, side, diagnosis, and type of surgery were the covariates. The data were analyzed using descriptive, comparative, and regression analysis. A P value of less than .05 was considered statistically significant. RESULT: The study included thirty subjects (8 males and 22 females) with various TMJ disorders ranging in age from 8 years to 65 years (mean 27.83 ± 10.52). On evaluation of intraoperative parameters, subfascial approach had statistically significant superior quality of surgical field (Group-I: 1.90 ± 0.57; Group-II: 1.10 ± 0.32; Group-III: 1.40 ± 0.52; P value = .006), statistically significant shortest dissection time (Group-I: 18.30 ± 3.74 min; Group-II: 13.240 ± 1.96 min; Group-III: 16.20 ± 1.99 min; with P value = .03), and statistically significant lower amount of blood loss compared with other groups (Group-I: 92.40 ± 4.74 ml: Group-II: 82.30 ± 3.77 ml; Group-III: 84.60 ± 3.06 ml; P value<.001). On assessment of postoperative parameters, only FNF of temporal branch showed statistically significant difference from 24 hours till 3 months with better outcome in deep subfascial approach. Mean scores of FNF at 24 hours and 1-week (Group-I: 4.20 ± 2.39; Group-II: 2.40 ± 2.27; Group-III: 1.50 ± 1.58 P = .02) and 1-month and 3-month (Group-I: 2.70 ± 1.82; Group-II: 1.20 ± 0.63; Group-III: 1.00 ± 0.00 P = .04). CONCLUSIONS: The subfascial approach significantly improved intraoperative outcomes and deep subfascial approach was comparatively safe with fewer incidence of facial nerve injury.

The Effects of Statins on Bone Formation Around Implants Placed in Animal Bones: A Systematic Review and Meta-Analysis.

Background: Implants are preferred for replacement of missing teeth by the clinicians as well as the patients. Lesser alveolar bone density doesn't preclude any individual for choosing this option but warrants for extra caution. Preclinical studies have explored the osteoinductive potential of statins, but results should be analyzed vigorously before implementing them in humans. There is no meta-analysis to document effect of statins on bone formation around implants in osteoporotic animals. Methods and material: PubMed, Embase and Cochrane were searched for studies investigating the effect of statins on bone implant contact (BIC %), bone mineral density (BMD %) and bone volume (BV %) around implants at 2, 4 and 12 weeks. Meta-analysis was performed on subgroups with osteoporotic animals which were administered statins through different routes. Results: Quantitative data from 12 studies showed favorable effect of statins on bone around implants. Positive difference was observed at 4 weeks in BIC (parenteral [SMD = 4.33 (2.89, 5.77); I 2 = 3%)], BMD (local [SMD = 1.33 (0.51, 2.15); I 2 = 0%] and BV (local [SMD = 1.58 (0.76, 2.40); I 2 = 0%]. BIC [SMD = 1.40 (0.89, 1.90); I 2 = 0%] and BV [SMD = 3.91 (2.33, 5.50); I 2 = 43%] were higher in experimental group after 12 weeks of oral administration. Conclusions: Statins can be investigated as potential bone graft materials to increase the predictability of osseointegration especially in osteoporotic individuals. Future research should focus to reproduce homogeneous data and conclusive recommendations which can be applied in clinical trials. Supplementary Information: The online version contains supplementary material available at 10.1007/s12663-023-01873-z.

Dodecamer assembly of a metazoan AAA+ chaperone couples substrate extraction to refolding.

Ring-forming AAA+ chaperones solubilize protein aggregates and protect organisms from proteostatic stress. In metazoans, the AAA+ chaperone Skd3 in the mitochondrial intermembrane space (IMS) is critical for human health and efficiently refolds aggregated proteins, but its underlying mechanism is poorly understood. Here, we show that Skd3 harbors both disaggregase and protein refolding activities enabled by distinct assembly states. High-resolution structures of Skd3 hexamers in distinct conformations capture ratchet-like motions that mediate substrate extraction. Unlike previously described disaggregases, Skd3 hexamers further assemble into dodecameric cages in which solubilized substrate proteins can attain near-native states. Skd3 mutants defective in dodecamer assembly retain disaggregase activity but are impaired in client refolding, linking the disaggregase and refolding activities to the hexameric and dodecameric states of Skd3, respectively. We suggest that Skd3 is a combined disaggregase and foldase, and this property is particularly suited to meet the complex proteostatic demands in the mitochondrial IMS.

Aortic stenosis: a review on acquired pathogenesis and ominous combination with diabetes mellitus.

BACKGROUND: Aortic stenosis (AS) is a progressive disease, with no pharmacological treatment. The prevalence of diabetes mellitus (DM) among AS patients is higher than in the general population. DM significantly increases the risk of AS development and progression from mild to severe. The interplay between AS and DM's mechanism is not entirely known yet. MAIN BODY: The increased accumulation of advanced glycation end products (AGEs) was linked to increased valvular oxidative stress, inflammation, expression of coagulation factors, and signs of calcification, according to an analysis of aortic stenotic valves. It is interesting to note that in diabetic AS patients, valvular inflammation did not correlate with serum glucose levels but rather only with long-term glycemic management markers like glycated haemoglobin and fructosamine. Transcatheter aortic valve replacement, which has been shown to be safer than surgical aortic valve replacement, is advantageous for AS patients who also have concurrent diabetes. Additionally, novel anti-diabetic medications have been proposed to lower the risk of AS development in DM patients, including sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonist that target reduction of AGEs-mediated oxidative stress. CONCLUSIONS: There are little data on the effects of hyperglycemia on valvular calcification, but understanding the interactions between them is essential to develop a successful treatment strategy to stop or at least slow the progression of AS in DM patients. There is a link among AS and DM and that DM negatively impacts the quality of life and longevity of AS patients. The sole successful treatment, despite ongoing efforts to find new therapeutic modalities, involves aortic valve replacement. More research is required to find methods that can slow the advancement of these conditions, enhancing the prognosis and course of people with AS and DM.

Influence of periodontitis and diabetes on structure and cytokine content of platelet-rich fibrin.

BACKGROUND: Platelet-rich fibrin (PRF) is a second-generation platelet concentrate with multiple applications in wound healing and regeneration in both periodontitis and diabetes. However, the three dimensional (3-D) structure and cytokine content of PRF might be altered in patients suffering from either/both of the chronic inflammatory conditions, ultimately influencing the efficacy of PRF as a biomaterial for regenerative medicine. AIM: The aim of the present study was hence to evaluate the effect of both these chronic inflammatory diseases on the 3-D structure of PRF membrane. An attempt was also made to compare the growth factor content between the plasma and RBC ends of the prepared PRF gel. MATERIALS & METHODS: L-PRF was prepared for twenty participants, healthy (5), periodontitis (5), T2DM (5) and T2DM with periodontitis (5). Porosity and fiber diameter of PRF membranes was visualized under FE-SEM and measured using ImageJ Software. PDGF-BB and TGF-ß1 levels in PRF gel were assessed by ELISA. RESULTS: The average diameter of fibrin fibers under FE-SEM was 0.15 to 0.30 micrometers. Porosity was higher at the plasma end (p = 0.042). Red blood cell (RBC) end of the membrane had thinner fibers arranged in a comparatively more dense and compact structure with smaller porosities. Healthy subjects had the least porous PRF compared to subjects with either/both of the chronic conditions. PDGF-BB levels were similar along all the four groups. TGF-ß1 levels were highest in healthy subjects. DISCUSSION: 3-D structure and growth factor content of PRF are influenced by a person's periodontal and/or diabetic status. The RBC end of the PRF membrane, as compared to the plasma end, has thinner fibers arranged in a comparatively more dense and compact structure with smaller porosities, and hence should be favored during periodontal regenerative procedures. CONCLUSION: Both periodontitis and diabetes have a significant influence on the 3-D structure and growth factor content of PRF produced.

Visual learning strategies for oral health promotion and treatment interventions in children and adolescents with hearing impairment - A systematic review.

AIM: People with hearing impairment (HI) prefer visual learning strategies in daily activities owing to their reliance on vision. The aim of this systematic review is to evaluate the effectiveness of visual learning as a communication strategy in improving oral hygiene and dental care of children and adolescents with HI. METHODS AND RESULTS: Four electronic databases were searched and complemented by hand searching for original intervention studies published till December 2021. Eligible studies were screened, data was extracted as per priori data collection form and analyzed by thematic content analysis. The quality of studies was assessed as per the validated tools appropriate for study designs including ROB2, ROBINS-I, and NIH quality assessment tool. Out of 4159 records identified and 1302 duplicates removed, 24 original studies were identified and the visual learning strategies were classified into sign language, visual aids with or without sign language, customized educational demonstrations and the interim role of training the teachers. These strategies helped in improving oral hygiene status, oral health-related knowledge and attitude as well as dental anxiety during treatment. Participants were found to be satisfied with these strategies, however, significant heterogeneity in the included studies precluded meaningful meta-analysis. ROB2 and ROBINS were rated as high and serious in all included trials, respectively, and NIH Quality Assessment Tool for Pre-Post Studies With No Control as fair in five studies and poor in three. CONCLUSION: Our findings emphasize the significance of visual learning, however, long-term rigorously designed trials are needed to better understand effective and patient-centered communication methods for people with HI.

JUE Insight: Urban flight seeded the COVID-19 pandemic across the United States.

We document large-scale urban flight in the United States during the COVID-19 pandemic. Regions that saw migrant influx experienced greater subsequent new COVID-19 cases, linking urban flight (as a disease vector) and coronavirus spread in destination areas. Urban residents fled to socially connected areas, consistent with the theory that individuals sheltered with friends and family, or in second homes. Populations that fled were disproportionately younger, whiter, and wealthier. The association between migration and subsequent new cases persists when instrumenting for migration with social networks.

Development and Pilot Testing of a Comprehensive Mobile Application to Assist Cell Count Determination During Peripheral Smear and Bone Marrow Examination.

BACKGROUND: In the modern era of complete blood count analysis, manual differential count is performed whenever 'flags' are generated by an automated hematology analyzer. Traditionally, tally counters with five or eight keys are used for manual differential count. A few mobile applications are available to perform this task; however, the application features and cell representation are limited. OBJECTIVES: The primary objective of our study was to develop an indigenous, comprehensive mobile application to assist with manual blood cell differential count. The secondary objective was to measure the usability of a newly developed application among undergraduate medical students. MATERIALS AND METHODS: A new mobile application was developed using a Java development kit, Version 11.0.13 (Oracle Corporation, Austin, USA) in Android Studio Dolphin (2021.3.1) (Google, California, USA). The application content was validated by three pathologists with more than five years of experience. The app's usability was tested among 60 participants using a validated mHealth App Usability Questionnaire (MAUQ). The questionnaire had 18 items covering three domains: ease of use, interface & satisfaction, and usefulness. RESULTS: The newly developed application supports peripheral smear WBC differential count, platelet count, reticulocyte count, malaria parasite quantification, and bone marrow differential count. During usability testing, the app was easy to use in 95% (57/60) of participants, time-efficient in 91.7% (55/60), and helpful for healthcare practice learning in 96.7% (58/60). The total mean score was 6.11, indicating high usability. CONCLUSION: A comprehensive mobile application to assist manual differential count with adequate cell representation was developed. The mobile application was easy to use, time-efficient, and valuable among the study participants.

Diabetes in pregnancy study group of India, the answer for gestational diabetes mellitus diagnosis dilemma: May be not!!!!

Introduction: For many years, there has been a lack of consensus over the appropriate diagnostic criteria for gestational diabetes mellitus (GDM) and the significance of the diagnosis. Multiple guidelines on diagnostic criteria across the world have complicated the diagnosis and further management of the disease, also complicating the healthcare delivery system. Aim: To compare the prevalence of GDM according to Modified Carpenter & Coustan, International association of Diabetes & Pregnancy Group (IADPSG) and DIPSI. Settings and Design: It was cross sectional observational study, conducted at KGMU, Lucknow, Uttar Pradesh between Aug 2016 and Sept 2017. 162 patients were enrolled after fulfilling the inclusion and exclusion criteria. Methods and Material: The study population was derived by screening pregnant females attending for their routine antenatal check up from 24 to 28 weeks of gestation. Plasma glucose levels was measured following 8hrs of overnight fasting. The pregnant females were given 82.5 glucose (equivalent to 75gm anhydrous glucose). Venous blood sample was collected for estimating plasma glucose at 0,1and 2hr. Results: In our study the prevalence of GDM among study population according to IADPSG criteria was 22.64%, as per Modified Carpenter & Coustan criteria was 17.61% while that as per DIPSI criteria was 13.21%. Conclusions: Considering IADPSG criteria as gold standard DIPSI is missing 66.6% of patients diagnosed as GDM by IADPSG. Considering Modified C&C criteria as gold standard over the years DIPSI is missing 64.2% of patients diagnosed as GDM by C&C.

A penetratin-derived peptide reduces the membrane permeabilization and cell toxicity of α-synuclein oligomers.

Parkinson's disease is a neurodegenerative movement disorder associated with the intracellular aggregation of α-synuclein (α-syn). Cytotoxicity is mainly associated with the oligomeric species (αSOs) formed at early stages in α-syn aggregation. Consequently, there is an intense focus on the discovery of novel inhibitors such as peptides to inhibit oligomer formation and toxicity. Here, using peptide arrays, we identified nine peptides with high specificity and affinity for αSOs. Of these, peptides p194, p235, and p249 diverted α-syn aggregation from fibrils to amorphous aggregates with reduced ß-structures and increased random coil content. However, they did not reduce αSO cytotoxicity and permeabilization of large anionic unilamellar vesicles. In parallel, we identified a non-self-aggregating peptide (p216), derived from the cell-penetrating peptide penetratin, which showed 12-fold higher binding affinity to αSOs than to α-syn monomers (Kdapp 2.7 and 31.2 µM, respectively). p216 reduced αSOs-induced large anionic unilamellar vesicle membrane permeability at 10-1 to 10-3 mg/ml by almost 100%, was not toxic to SH-SY5Y cells, and reduced αSOs cytotoxicity by about 20%. We conclude that p216 is a promising starting point from which to develop peptides targeting toxic αSOs in Parkinson's disease.