Lessons Learned From a Peer-Supported Differentiated Care and Nutritional Supplementation for People With TB in a Southern Indian State.

Two critical components of patient support systems for people with TB are regular counseling and locally managed nutritional support. As part of an ongoing differentiated TB care initiative called Tamil Nadu Kasanoi Erappila Thittam (meaning TB death-free initiative in Tamil, TN-KET) to reduce TB deaths, adults with TB with very severe undernutrition, respiratory insufficiency, or poor performance status are identified at diagnosis (triage-positive) and prioritized for referral, comprehensive clinical assessment, and inpatient care. Between January and June 2023, in 6 districts, a pilot exercise was conducted in which trained TB survivors, known as TB champions, provided baseline counseling and additional counseling (if required) to triage-positive people with TB at diagnosis. Additionally, people with TB with severe undernutrition were prioritized for nutritional supplementation for at least 3 months. Among 652 people with TB who were triage-positive at diagnosis, the program staff shared details of 145 (22%), and all were counseled by TB champions (baseline counseling). Program staff identified 74 (11%) triage-positive people with TB who required additional counseling (i.e., those refusing referral or admission or continued admission), and 71 (96%) were counseled by TB champions. Among these, 54 (76%) were admitted or readmitted and successfully discharged. In addition, among 1,042 people with TB with severe undernutrition, program staff shared details of 390 (38%), of which 60% received nutritional supplementation through the efforts of TB champions. We conclude that TB champions were able to provide quality and timely peer support through direct counseling and by mobilizing local resources for nutritional support. The engagement of TB champions can be further strengthened by establishing robust coordination mechanisms with the TB program. Lessons from this pilot will contribute to the Tamil Nadu State TB Cell's plans to expand the role of TB champions and enhance community participation to end TB in India.

Empowering sustainable manufacturing: Unleashing digital innovation in spool fabrication industries.

In industrial landscapes, spool fabrication industries play a crucial role in the successful completion of numerous industrial projects by providing prefabricated modules. However, the implementation of digitalized sustainable practices in spool fabrication industries is progressing slowly and is still in its embryonic stage due to several challenges. To implement digitalized sustainable manufacturing (SM), digital technologies such as Internet of Things, Cloud computing, Big data analytics, Cyber-physical systems, Augmented reality, Virtual reality, and Machine learning are required in the context of sustainability. The scope of the present study entails prioritization of the enablers that promote the implementation of digitalized sustainable practices in spool fabrication industries using the Improved Fuzzy Stepwise Weight Assessment Ratio Analysis (IMF-SWARA) method integrated with Triangular Fuzzy Bonferroni Mean (TFBM). The enablers are identified through a systematic literature review and are validated by a team of seven experts through a questionnaire survey. Then the finally identified enablers are analyzed by the IMF-SWARA and TFBM integrated approach. The results indicate that the most significant enablers are management support, leadership, governmental policies and regulations to implement digitalized SM. The study provides a comprehensive analysis of digital SM enablers in the spool fabrication industry and offers guidelines for the transformation of conventional systems into digitalized SM practices.

Evaluating the Role of AI in Predicting the Success of Dental Implants Based on Preoperative CBCT Images: A Randomized Controlled Trial.

Background: Dental implant surgery has become a widely accepted method for replacing missing teeth. However, the success of dental implant procedures can be influenced by various factors, including the quality of preoperative planning and assessment. Cone beam computed tomography (CBCT) imaging provides valuable insights into a patient's oral anatomy, but accurately predicting implant success remains a challenge. Materials and Methods: In this randomized controlled trial (RCT), a cohort of 150 patients requiring dental implants was randomly divided into two groups: an artificial intelligence (AI)-assisted group and a traditional assessment group. Preoperative CBCT images of all patients were acquired and processed. The AI-assisted group utilized a machine learning model trained on historical data to assess implant success probability based on CBCT images, while the traditional assessment group relied on conventional methods and clinician expertise. Key parameters such as bone density, bone quality, and anatomical features were considered in the AI model. Results: After the completion of the study, the AI-assisted group demonstrated a significantly higher implant success rate, with 92% of implants successfully integrating into the bone compared to 78% in the traditional assessment group. The AI model showed an accuracy of 87% in predicting implant success, whereas traditional assessment methods achieved an accuracy of 71%. Additionally, the AI-assisted group had a lower rate of complications and required fewer postoperative interventions compared to the traditional assessment group. Conclusion: The AI-assisted approach significantly improved implant success rates and reduced complications, underscoring the importance of incorporating AI into the dental implant planning process.

AI-Assisted Treatment Planning for Dental Implant Placement: Clinical vs AI-Generated Plans.

Background: Dental implant placement is a critical procedure in modern dentistry, requiring precise treatment planning to ensure successful outcomes. Traditionally, treatment planning has relied on the expertise of clinicians, but recent advancements in artificial intelligence (AI) have opened up the possibility of AI-assisted treatment planning. Materials and Methods: Twenty patients requiring dental implant placement were included in this comparative study. For each patient, a clinical treatment plan was created by an experienced dentist, while an AI algorithm, trained on a dataset of implant placement cases, generated an alternative plan. Various parameters, including implant position, angulation, and depth, were compared between the two plans. Surgical templates were fabricated based on both plans to guide implant placement accurately. Results: The results of this study indicate that AI-generated treatment plans closely align with clinical plans in terms of implant positioning, angulation, and depth. Mean discrepancies of less than 1 mm and 2 degrees were observed for implant position and angulation, respectively, between the two planning methods. The AI-generated plans also showed a reduction in planning time, averaging 10 min compared to the clinical planning, which averaged 30 min per case. Additionally, the surgical templates based on AI-generated plans exhibited similar accuracy in implant placement as those based on clinical plans. Conclusion: AI-assisted treatment planning for dental implant placement demonstrates promising results in terms of accuracy and efficiency.

Smart City IoT System Network Level Routing Analysis and Blockchain Security Based Implementation.

This paper demonstrates, network-level performance analysis and implementation of smart city Internet of Things (IoT) system with Infrastructure as a Service (IaaS) level cloud computing architecture. The smart city IoT network topology performance is analyzed at the simulation level using the NS3 simulator by extracting most of the performance-deciding parameters. The performance-enhanced smart city topology is practically implemented in IaaS level architecture. The intended smart city IoT system can monitor the principal parameters like video surveillance with a thermal camera (to identify the virus-like COVID-19 infected people), transport, water quality, solar radiation, sound pollution, air quality (O3, NO2, CO, Particles), parking zones, iconic places, E-suggestions, PRO information over low power wide area network in 61.88 km × 61.88 km range. Primarily we have addressed the IoT network-level routing and quality of service (QoS) challenges and implementation level security challenges. The simulation level network topology analysis is performed to improve the routing and QoS. Blockchain technology-based decentralization is adopted to enrich the IoT system performance in terms of security.

Crystal structure determination, molecular docking and dynamics of arylidene cyanoacetates as potential JNK-3 inhibitors for Ischemia reperfusion injury.

Ischemia reperfusion injury is a cardiovascular condition which causes hypoxia by means of obstruction of arterial blood flow eventually leads to reduced synthesis of adenosine tri-phosphate in the mitochondria. c-Jun N-terminal kinase-3 are related to several cascade of events like apoptosis, oxidative stress and mitochondrial dysfunction which can be further related to Ischemia-reperfusion injury. The present study was aimed at determining crystal structure of the ligand by x-ray methods and to perform molecular docking and molecular dynamics studies of the arylidene cyano-acetates with c-Jun N-terminal kinase-3. The binding energy of Ethyl (2E)-2-cyano-3-(4-methoxyphenyl)prop-2-enoate is -4.462 kcal/mol and ethyl (2E)-2-cyano-3-phenylprop-2-enoate is -6.135 kcal/mol. This has created a new rational approach to drug design, where the structure of drug is designed, based on its fit to structures of receptor site, rather than basing it on analogies to other active structures. The above compounds are binding strongly with c-Jun N-terminal kinase-3 protein.[Figure: see text]Communicated by Ramaswamy H. Sarma.

Arteriolymphatic Fistula: An Extremely Uncommon Adversary and its Management.

A 66-year-old female patient underwent transfemoral coronary angioplasty. Three weeks after the procedure, she presented with abdominal pain. An abdominal computed tomography scan revealed an unusual femoral arteriolymphatic fistula, which was managed with selective angiography-guided glue embolization. (Level of Difficulty: Advanced.).

Ceramide changes in abdominal subcutaneous and visceral adipose tissue among diabetic and nondiabetic patients.

BACKGROUND: This study profiles ceramides extracted from visceral and subcutaneous adipose tissue of human subjects by liquid chromatography-mass spectrometry to determine a correlation with status of diabetes and gender. METHODS: Samples of visceral and abdominal wall subcutaneous adipose tissue (n = 36 and n = 31, respectively) were taken during laparoscopic surgery from 36 patients (14 nondiabetic, 22 diabetic and prediabetic) undergoing bariatric surgery with a body mass index (BMI) >35 kg/m2 with ≥1 existing comorbidity or BMI ≥40 kg/m2 . Sphingolipids were extracted and analyzed using liquid chromatography-mass spectrometry. RESULTS: After logarithm 2 conversion, paired analysis of visceral to subcutaneous tissue showed differential accumulation of Cer(d18:1/16:0), Cer(d18:1/18:0), and Cer(d18:1/24:1) in visceral tissue of prediabetic/diabetic female subjects, but not in males. Within-tissue analysis showed higher mean levels of ceramide species linked to insulin resistance, such as Cer(d18:1/18:0) and Cer(d18:1/16:0), in visceral tissue of prediabetic/diabetic patients compared with nondiabetic subjects and higher content of Cer(d18:1/14:0) in subcutaneous tissue of insulin-resistant female patients compared with prediabetic/diabetic males. Statistically significant differences in mean levels of ceramide species between insulin-resistant African American and insulin-resistant Caucasian patients were not evident in visceral or subcutaneous tissue. CONCLUSIONS: Analysis of ceramides is important for developing a better understanding of biological processes underlying type 2 diabetes, metabolic syndrome, and obesity. Knowledge of the accumulated ceramides/dihydroceramides may reflect on the prelipolytic state that leads the lipotoxic phase of insulin resistance and may shed light on the predisposition to insulin resistance by gender.

Descemet Stripping Automated Endothelial Keratoplasty in Pediatric Age Group: A Decade of Our Experience.

PURPOSE: This study was to report the outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) in managing corneal endothelial disorders in children less than 14 years of age. METHODS: Medical records of 180 DSAEK performed, between 2008 and 2020, on 167 eyes of 111 children who had a visually significant endothelial dysfunction were retrospectively reviewed for the primary etiology of corneal decompensation, time of the onset and duration of cloudiness, preoperative visual acuity, the technique of endothelial keratoplasty, surgical modifications, and reintervention. RESULTS: Median age at surgical intervention was 7.9 years (interquartile range, 5.2-11.2 years). At a median postinterventional follow-up of 2.5 years (interquartile range, 0.9-3.4 years), 86.2% (144 of 167 eyes, 95% confidence interval 79.9%-90.1%) maintained a clear graft. Median best-corrected visual acuity (logarithm of the minimum angle of resolution) improved from 1.45 ± 0.70 preoperatively to 0.90 ± 0.06 at the last follow-up visit (P < 0.0001). The cumulative overall long-term graft survival was 92.7%, 86.5%, and 77.7% at 1, 3, and 7 years, respectively. Cox proportional hazards regression analysis showed that the indication for DSAEK (P = 0.007; hazards ratio: 2.17 ± 0.62), age at surgery (P = 0.02; hazards ratio: 0.87 ± 0.05), and any subsequent intervention after DSAEK (P = 0.003; hazards ratio: 0.11 ± 0.08) were significant risk factors for DSAEK failure. The endothelial cell loss was 40.1% at 6 months, 45.4% at 1 year, 55.2% at 5 years, and 61.9% at 7 years. CONCLUSIONS: DSAEK is a safe and effective surgical strategy in managing endothelial disorders among the pediatric age group.

Optimization and scale-up of α-amylase production by Aspergillus oryzae using solid-state fermentation of edible oil cakes.

BACKGROUND: Amylases produced by fungi during solid-state fermentation are the most widely used commercial enzymes to meet the ever-increasing demands of the global enzyme market. The use of low-cost substrates to curtail the production cost and reuse solid wastes are seen as viable options for the commercial production of many enzymes. Applications of α-amylases in food, feed, and industrial sectors have increased over the years. Additionally, the demand for processed and ready-to-eat food has increased because of the rapid growth of food-processing industries in developing economies. These factors significantly contribute to the global enzyme market. It is estimated that by the end of 2024, the global α-amylase market would reach USD 320.1 million (Grand View Research Inc., 2016). We produced α-amylase using Aspergillus oryzae and low-cost substrates obtained from edible oil cake, such as groundnut oil cake (GOC), coconut oil cake (COC), sesame oil cake (SOC) by solid-state fermentation. We cultivated the fungus using these nutrient-rich substrates to produce the enzyme. The enzyme was extracted, partially purified, and tested for pH and temperature stability. The effect of pH, incubation period and temperature on α-amylase production using A. oryzae was optimized. Box-Behnken design (BBD) of response surface methodology (RSM) was used to optimize and determine the effects of all process parameters on α-amylase production. The overall cost economics of α-amylase production using a pilot-scale fermenter was also studied. RESULTS: The substrate optimization for α-amylase production by the Box-Behnken design of RSM showed GOC as the most suitable substrate for A. oryzae, as evident from its maximum α-amylase production of 9868.12 U/gds. Further optimization of process parameters showed that the initial moisture content of 64%, pH of 4.5, incubation period of 108 h, and temperature of 32.5 °C are optimum conditions for α-amylase production. The production increased by 11.4% (10,994.74 U/gds) by up-scaling and using optimized conditions in a pilot-scale fermenter. The partially purified α-amylase exhibited maximum stability at a pH of 6.0 and a temperature of 55 °C. The overall cost economic studies showed that the partially purified α-amylase could be produced at the rate of Rs. 622/L. CONCLUSIONS: The process parameters for enhanced α-amylase secretion were analyzed using 3D contour plots by RSM, which showed that contour lines were more oriented toward incubation temperature and pH, having a significant effect (p < 0.05) on the α-amylase activity. The optimized parameters were subsequently employed in a 600 L-pilot-scale fermenter for the α-amylase production. The substrates were rich in nutrients, and supplementation of nutrients was not required. Thus, we have suggested an economically viable process of α-amylase production using a pilot-scale fermenter.

Biogenic Synthesis of NiO Nanoparticles Using Areca catechu Leaf Extract and Their Antidiabetic and Cytotoxic Effects.

Nanoworld is an attractive sphere with the potential to explore novel nanomaterials with valuable applications in medicinal science. Herein, we report an efficient and ecofriendly approach for the synthesis of Nickel oxide nanoparticles (NiO NPs) via a solution combustion method using Areca catechu leaf extract. As-prepared NiO NPs were characterized using various analytical tools such as powder X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), and UV-Visible spectroscopy (UV-Vis). XRD analysis illustrates that synthesized NiO NPs are hexagonal structured crystallites with an average size of 5.46 nm and a hexagonal-shaped morphology with slight agglomeration. The morphology, size, and shape of the obtained material was further confirmed using SEM and TEM analysis. In addition, as-prepared NiO NPs have shown potential antidiabetic and anticancer properties. Our results suggest that the inhibition of α-amylase enzyme with IC 50 value 268.13 µg/mL may be one of the feasible ways through which the NiO NPs exert their hypoglycemic effect. Furthermore, cytotoxic activity performed using NiO NPs exhibited against human lung cancer cell line (A549) proved that the prepared NiO NPs have significant anticancer activity with 93.349 µg/mL at 50% inhibition concentration. The biological assay results revealed that NiO NPs exhibited significant cytotoxicity against human lung cancer cell line (A549) in a dose-dependent manner from 0-100 µg/mL, showing considerable cell viability. Further, the systematic approach deliberates the NiO NPs as a function of phenolic extracts of A. catechu with vast potential for many biological and biomedical applications.

The suitability of surface waters from small west-flowing rivers for drinking, irrigation, and aquatic life from a global biodiversity hotspot (Western Ghats, India).

The present study provides surface water types and water quality indices (WQI) for 70 large coastal rivers of the Western Ghats (WG). Irrespective of seasons and lithology, concentration of cations (Ca2+ > Na+ > Mg2+ > K+) and anions (HCO3- > Cl- >SO42- > NO3- > PO43-) follow a typical trend all along the coast. The WG rivers can broadly be classified as calcium-bicarbonate-chloride (Ca2+-HCO3--Cl-) type. Pearson correlation analysis of major ions demonstrates natural sources influence on the riverine water composition across the WG region. Gibbs plot suggests water composition of these rivers is the result of the interaction of rock and precipitation. It means that ionic contributions from precipitation and chemical weathering of rock-forming minerals largely determine surface water quality. This biodiversity hotspot is facing high population pressure and anthropogenic activities. Despite it, quantitatively, all the physical parameters and chemical constituents are within the permissible limits of the World Health Organization (WHO) and Bureau of Indian Standards (BIS), thus making it suitable for drinking and domestic purposes. About 86% of the surface water samples are found to be suitable for irrigation (KR < 1) in non-monsoon seasons. Rivers near to Goa coast are only found unsuitable (KR > 1) for irrigation exclusively during non-monsoon seasons. From the majority of the calculated indices, it may be inferred that the river waters draining from the WG region are suitable for irrigation. Overall, the calculated WQI for studied rivers showed excellent to good water quality for drinking, agriculture, and aquatic life in monsoon seasons, which are then ranked from good to marginal in non-monsoon seasons.

Export of particulate organic carbon by the mountainous tropical rivers of Western Ghats, India: Variations and controls.

Transport of organic carbon by small mountainous rivers is essential, but the poorly constrained component of the global carbon cycle. In the current research, we sampled and analyzed particulate organic carbon (POC) contents from 70 sizeable tropical coastal rivers, draining the Western Ghats (WG) of India. This study aimed to investigate the spatiotemporal variability in POC contents, to estimate flux and to identify environmental controls on POC sources and transport characteristics across the region. The averaged value of organic carbon (OC) in the particulate samples is 3.24%, and the mean POC concentration is 2.86 mg l-1. We classified the samples based on total suspended matter (TSM) classes for source appropriation. Litter/riparian (42.5%) pools are the largest source of organic matter, followed by autochthonous (36%) and soil (21.5%) for the WG region. However, locally autochthonous sources contribute exceptionally to POC pools, indicating a favorable environmental condition for the growth of algae and phytoplankton. Land-use & land-cover, climate, topography, and sediment erosion seems to be determining the local variability in sources to POC pools and fluxes. The POC export rates suggest that within the region, the POC yields of the Deccan Trap (DT) and the Western Dharwar Craton (WDC) blocks are about two times higher than that of the Southern Granulite Terrain (SGT) region. With POC yield of 7.0 g m-2 yr-1, this region exports 0.79 Tg C (~ 0.5% of the global POC) to the Arabian Sea annually. The POC flux of the WG region (covering 0.25% of Asia's land area) is approximately 1.0% of Asia's riverine POC flux to the ocean.

Accurate identification of breast cancer margins in microenvironments of ex-vivo basal and luminal breast cancer tissues using Raman spectroscopy.

Better knowledge of the breast tumor microenvironment is required for surgical resection and understanding the processes of tumor development. Raman spectroscopy is a promising tool that can assist in uncovering the molecular basis of disease and provide quantifiable molecular information for diagnosis and treatment evaluation. In this work, eighty-eight frozen breast tissue sections, including forty-four normal and forty-four tumor sections, were mapped in their entirety using a 250-µm-square measurement grid. Two or more smaller regions of interest within each tissue were additionally mapped using a 25 µm-square step size. A deep learning algorithm, convolutional neural network (CNN), was developed to distinguish histopathologic features with-in individual and across multiple tissue sections. Cancerous breast tissue were discriminated from normal breast tissue with 90 % accuracy, 88.8 % sensitivity and 90.8 % specificity with an excellent Area Under the Receiver Operator Curve (AUROC) of 0.96. Features that contributed significantly to the model were identified and used to generate RGB images of the tissue sections. For each grid point (pixel) on a Raman map, color was assigned to intensities at frequencies of 1002 cm-1 (Phenylalanine), 869 cm-1 (Proline, CC stretching of hydroxyproline-collagen assignment, single bond stretching vibrations for the amino acids proline, valine and polysaccharides) and 1309 cm-1 (CH3/CH2 twisting or bending mode of lipids). The Raman images clearly associate with hematoxylin and eosin stained tissue sections and allow clear visualization of boundaries between normal adipose, connective tissue and tumor. We demonstrated that this simple imaging technique allows high-resolution, straightforward molecular interpretation of Raman images. Raman spectroscopy provides rapid, label-free imaging of microscopic features with high accuracy. This method has application as laboratory tool and can assist with intraoperative tissue assessment during Breast Conserving surgery.

Cytotoxicity of Formulated Graphene and Its Natural Rubber Nanocomposite Thin Film in Human Vaginal Epithelial Cells: An Influence of Noncovalent Interaction.

Graphene family materials (GFMs) are extensively explored for various biomedical applications due to their unique physical properties. The prime challenge is to establish a conclusive safety profile of these nanomaterials and their respective products or devices. Formulating GFMs with appropriate ingredients (e.g., surfactant/compatibilizer) will help to disperse them homogeneously (i.e., within the polymer matrix in the case of polymer-graphene nanocomposites) and aid in good interfacial interaction to achieve the desired properties. However, no cytotoxicity report is available on the effects of the additives on graphene and its incorporated materials. Here, we report in vitro cytotoxicity of formulated FLG (FLG-C), i.e., a mixture of FLG, melamine, and sodium poly(naphthalene sulfonate) (SPS), along with natural rubber (NR) latex and FLG-C-included NR latex nanocomposite (FLG-C-NR) thin films on human vaginal epithelial (HVE) cells. FLG-C shows reduced cellular proliferation (∼55%) only at a longer exposure time (72 h) even at a low concentration (50 µg/mL). It also displays significant down- and upregulation in mitochondrial membrane potential (MMP) and reactive oxygen species (ROS), respectively, whereas no changes are observed in lactate dehydrogenase (LDH), propidium iodide (PI), uptake, and cell cycle analysis at 48 h. In vitro experiments on NR latex and FLG-C-NR latex thin films demonstrate that the incorporation of FLG-C does not compromise the biocompatibility of the NR latex. Further substantiation from the in vivo experiments on the thin films recommends that FLG-C could be suitable to prepare a range of biocompatible rubber latex nanocomposites-based products, viz., next-generation condoms (male and female), surgical gloves, catheters, vaginal rings, bladder-rectum spacer balloon, etc.

Incidence, Risk Factors, and Outcome of Cardiac Arrhythmia Postcardiac Surgery in Children.

OBJECTIVE: To study the incidence of postoperative cardiac arrhythmias in children undergoing cardiac surgery and to evaluate the risk factors and outcome of these patients. MATERIALS AND METHODS: This retrospective observational study was conducted in the cardiac pediatric intensive care unit and included children <18 years of age. Children were monitored in the early postoperative period (72 h) for any sustained rhythm abnormality and were classified using standard definition. Details of treatment and their response were assessed. Risk factors for arrhythmias were evaluated using multivariate logistic regression analysis. RESULTS: Five hundred and thirty-six children were included and the prevalence of arrhythmia was 14.4% (n = 77). The most common arrhythmia was complete heart block (CHB) (n = 28; 5.2%), followed by junctional ectopic tachycardia (JET) (n = 25; 4.7%), junctional escape rhythm (n = 13; 2.4%), supraventricular tachycardia (SVT) (n = 8; 1.5%), and ventricular tachycardia (VT) (n = 3; 0.6%). Cardiac pacing was required in all CHB; 8 (28.6%) required a permanent pacemaker. Six (24%) patients with JET responded to conventional measures; 19 (76.0%) patients required amiodarone and 5 (20%) required cooling to 34°C or cardiac pacing. Temporary cardiac pacing was required in 9 (69.2%) cases of junctional escape rhythm. Seven (87.5%) events of SVT responded to adenosine and 1 (12.5%) required cardioversion. Two (66.7%) of VT responded to cardioversion while 1 (33.3%) was refractory. Five (6.5%) patients with arrhythmia died. In the multivariate logistic regression analysis, age <1 year, risk adjustment for congenital heart surgery category ≥3, and cross-clamp time >67 min were independent risk factors. CONCLUSION: Early postoperative period following cardiac surgery is extremely vulnerable to cardiac arrhythmias. Although majority are self-limiting, some can be life-threatening.

Applications of Raman spectroscopy in cancer diagnosis.

Novel approaches toward understanding the evolution of disease can lead to the discovery of biomarkers that will enable better management of disease progression and improve prognostic evaluation. Raman spectroscopy is a promising investigative and diagnostic tool that can assist in uncovering the molecular basis of disease and provide objective, quantifiable molecular information for diagnosis and treatment evaluation. This technique probes molecular vibrations/rotations associated with chemical bonds in a sample to obtain information on molecular structure, composition, and intermolecular interactions. Raman scattering occurs when light interacts with a molecular vibration/rotation and a change in polarizability takes place during molecular motion. This results in light being scattered at an optical frequency shifted (up or down) from the incident light. By monitoring the intensity profile of the inelastically scattered light as a function of frequency, the unique spectroscopic fingerprint of a tissue sample is obtained. Since each sample has a unique composition, the spectroscopic profile arising from Raman-active functional groups of nucleic acids, proteins, lipids, and carbohydrates allows for the evaluation, characterization, and discrimination of tissue type. This review provides an overview of the theory of Raman spectroscopy, instrumentation used for measurement, and variation of Raman spectroscopic techniques for clinical applications in cancer, including detection of brain, ovarian, breast, prostate, and pancreatic cancers and circulating tumor cells.

Overlap Syndrome between Primary Biliary Cholangitis and Primary Sclerosing Cholangitis.

Overlap syndrome indicates the coexistence of 2 or more autoimmune liver diseases in the same individual, occurring simultaneously or sequentially. Cases of overlap of autoimmune hepatitis (AIH) with primary biliary cholangitis (PBC) and of AIH with primary sclerosing cholangitis (PSC) are known and have defined criteria for diagnosis. Overlap between PBC and PSC has been reported in only a few case reports. The cause for the rarity of this entity compared to other overlap syndromes is unclear. We present a case of an overlap syndrome of PBC with PSC in a 35-year-old woman.

Poly(glycerol sebacate)-Based Polyester-Polyether Copolymers and Their Semi-Interpenetrated Networks with Thermoplastic Poly(ester-ether) Elastomers: Preparation and Properties.

Poly(glycerol sebacate) (PGS), produced from renewable monomers such as sebacic acid and glycerol, has been explored extensively for various biomedical applications. However, relatively less attention has been paid to explore PGS as sustainable materials in applications such as elastomers and rigid plastics, primarily because of serious deficiencies in physical properties of PGS. Here, we present two new approaches for enhancing the properties of PGS; (i) synthesizing block copolymers of PGS with poly(tetramethylene oxide)glycol (PTMO) and (ii) preparing a blend of PGS-b-PTMO with a poly(ester-ether) thermoplastic elastomer. The consequence of molar ratio (hard and soft segments) and M n of soft segment on tensile properties of the material was investigated. The PGS-b-PTMO with 25:75 mole ratios of hard and soft segments and having a medium M n soft segment (5350 g mol-1) exhibits an appreciable increase in percentage of elongation that is from 32% for PGS to 737%. Blends of PGS-b-PTMO and a thermoplastic polyester elastomer, Hytrel 3078, form a semi-interpenetrated polymer network, which exhibits increased tensile strength to 2.11 MPa and percentage of elongation to 2574. An elongation of such magnitude is unprecedented in the literature for predominantly aliphatic polyesters and demonstrates that the simple polyester can be tailored for superior performance.

Luciferase Activity of Insect Fatty Acyl-CoA Synthetases with Synthetic Luciferins.

Long-chain fatty acyl-CoA synthetases (ACSLs) are homologues of firefly luciferase but are incapable of emitting light with firefly luciferin. Recently, we found that an ACSL from the fruit fly Drosophila melanogaster is a latent luciferase that will emit light with the synthetic luciferin CycLuc2. Here, we have profiled a panel of three insect ACSLs with a palette of >20 luciferin analogues. An ACSL from the nonluminescent beetle Agrypnus binodulus (AbLL) was found to be a second latent luciferase with distinct substrate specificity. Several rigid luciferins emit light with both ACSLs, but styryl luciferin analogues are light-emitting substrates only for AbLL. On the other hand, an ACSL from the luminescent beetle Pyrophorus angustus lacks luciferase activity with all tested analogues, despite its higher homology to beetle luciferases. Further study of ACSLs is expected to shed light on the features necessary for bioluminescence and substrate selectivity.