The silent epidemic of loneliness: identifying the antecedents of loneliness using a lagged exposure-wide approach.

BACKGROUND: A large and accumulating body of evidence shows that loneliness is detrimental for various health and well-being outcomes. However, less is known about potentially modifiable factors that lead to decreased loneliness. METHODS: We used data from the Health and Retirement Study to prospectively evaluate a wide array of candidate predictors of subsequent loneliness. Importantly, we examined if changes in 69 physical-, behavioral-, and psychosocial-health factors (from t0;2006/2008 to t1;2010/2012) were associated with subsequent loneliness 4 years later (t2;2014/2016). RESULTS: Adjusting for a large range of covariates, changes in certain health behaviors (e.g. increased physical activity), physical health factors (e.g. fewer functioning limitations), psychological factors (e.g. increased purpose in life, decreased depression), and social factors (e.g. greater number of close friends) were associated with less subsequent loneliness. CONCLUSIONS: Our findings suggest that subjective ratings of physical and psychological health and perceived social environment (e.g. chronic pain, self-rated health, purpose in life, anxiety, neighborhood cohesion) are more strongly associated with subsequent loneliness. Yet, objective ratings (e.g. specific chronic health conditions, living status) show less evidence of associations with subsequent loneliness. The current study identified potentially modifiable predictors of subsequent loneliness that may be important targets for interventions aimed at reducing loneliness.

Text-Mining and Video Analytics of COVID-19 Narratives Shared by Patients on YouTube.

This study explores how individuals who have experienced COVID-19 share their stories on YouTube, focusing on the nature of information disclosure, public engagement, and emotional impact pertaining to consumer health. Using a dataset of 186 YouTube videos, we used text mining and video analytics techniques to analyze textual transcripts and visual frames to identify themes, emotions, and their relationship with viewer engagement metrics. Findings reveal eight key themes: infection origins, symptoms, treatment, mental well-being, isolation, prevention, government directives, and vaccination. While viewers engaged most with videos about infection origins, treatment, and vaccination, fear and sadness in the text consistently drove views, likes, and comments. Visuals primarily conveyed happiness and sadness, but their influence on engagement varied. This research highlights the crucial role YouTube plays in disseminating COVID-19 patient narratives and suggests its potential for improving health communication strategies. By understanding how emotions and content influence viewer engagement, healthcare professionals and public health officials can tailor their messaging to better connect with the public and address pandemic-related anxieties.

Etiology, Clinical Manifestations, Diagnosis, and Treatment of Cobalamin (Vitamin B12) Deficiency.

Cobalamin, also known as vitamin B12, is a water-soluble vitamin. Cobalamin deficiency can be frequently seen in people all around the world. It can have non-specific symptoms, and in patients who are in a very critical state, it can lead to neurological or hematological abnormalities. While pernicious anemia used to be the main cause, it now accounts for a smaller number of cases, with food-bound cobalamin malabsorption being more common. Early diagnosis and appropriate management are crucial to avoid severe complications like spinal cord degeneration and pancytopenia. The primary method of treatment has been injections of vitamin B12 which are given through the intramuscular route but now the oral replacement therapy has also been very effective in treating the patients. There is increasing evidence linking increased levels of vitamin B12 to hematological and hepatic disorders, particularly cancers. This review has primarily highlighted the metabolism, clinical manifestations, diagnosis, and treatment of cobalamin deficiency in the past decade.

A Systematic Review on Polyester Scaffolds in Dental Three-dimensional Cell Printing: Transferring Art from the Laboratories to the Clinics.

Objective: The purpose of this systematic review is to describe developments in three-dimensional (3D) cell printing in the formation of dental pulp tissue using polyester as a scaffold to revitalize the damaged dental pulp tissue. Materials and methods: A literature search for all the data published in PubMed and Google Scholar from January 2000 to April 2022 was conducted. Articles with the keywords 3D cell printing, scaffolds, polyester, dental pulp, and dentistry were used. Inclusion criteria consisted of any publication in electronic or print media directly studying or commenting on the use of polyester scaffolds in 3D cell printing technology in the regeneration of dental pulp. A total of 528 articles were selected, of which 27 duplicates and 286 irrelevant articles were discarded. A total of 215 articles were finally included in the systematic review. Result and conclusion: For dental pulp regeneration, several scaffolds have been discovered to be appealing. Polylactic acid (PLA), polyglycolic acid (PGA), and their copolymers are nontoxic and biocompatible synthetic polyesters that degrade by hydrolysis and have received Food and Drug Administration (FDA) approval for a variety of applications. This review paper is intended to spark new ideas for using a certain scaffold in a specific regenerative approach to produce the desired pulp-dentin complex.

An overview of the implementation of SeDeM and SSCD in various formulation developments.

The Sediment Delivery Model explains experimental analysis and quantitative assessment of the powdered substance characterizing parameters, which offer pertinent data about the material's appropriateness for direct compression (DC) of tablet, which involves mathematical modeling and Semisolid Control Diagram using software like iTCM. The SeDeM diagram expert system (DES) determines the suitability of excipients and active ingredients for DC and the ratio of API to excipient is calculated. The DC is most suitable as it saves time and makes process easy, but these technique excipients compensate for their poor flow. Thus, a new system was required to help reduce number of experiments and time for making an optimized direct compression tablet. The SeDeM DES is based on quality by design (QbD) (ICH Q8) as it evaluates critical quality attributes that affect finished product's quality. This review mainly focuses on various dosage forms like Solid, Semisolid, Liquisolid, and Solidified liquid dosage forms. These techniques mainly characterize all substances using 12 parameters, resulting 12-sided regular polygon. However, parameters may increase or decrease according to the requirement of a particular dosage form like an Orodispersible tablet 15 and a Semisolid dosage form applying 5 parameters. The rationales behind limits for indexes are justified accordingly.

Dry Powder Inhaler with the technical and practical obstacles, and forthcoming platform strategies.

A Dry Powder Inhaler (DPI) is a technique as well as a device used to inhale formulation which is in the form of dry powder, and is inhaled through the nose or mouth. It was developed for the purpose of treating conditions like chronic obstructive pulmonary disease (COPD), Asthma, and even cystic fibrosis etc. The aim of the review is to discuss the different methods of preparation of dry powders along with the characterization of DPI. Here we present the outline of different methods like supercritical fluid extraction (SCF), spray drying, and milling. The review focussed on various devices including single and multi-dose devices used in the DPI. It also highlights on recent advances in the DPI including nano particulate system, siRNA-based medication, liposomes, and pro-liposomes based delivery. In COVID-19 silver nanoparticles-based DPIs provide very prominent results in the infected lungs. Moreover, this review states that the AI-based DPI development provides and improvement in the bioavailability and effectiveness of the drug along with the role of artificial neural networks (ANN). The study also showed that nasally administered drugs (nose to brain) can easily cross the blood-brain barrier (BBB) and enter the central nervous system (CNS) through the olfactory and trigeminal pathway which provides effective CNS concentrations at lower dosage. It is suggested that DPIs not only target respiratory complications but also treat CNS complications too. This review provides support and guides the researcher in the recent development and evaluation of DPI.

Modern Anchorage Systems in Orthodontics.

Anchorage has been a vital topic since the origin of orthodontics. In the orthodontic process, gentle, constant pressure is applied to the teeth that need to be moved against the other teeth, which serve as the anchoring unit. The anchoring teeth must be completely stable. The introduction of temporary anchorage devices to the orthodontic field has made it possible to overcome conventional anchorage and its limitations. Mini implants have widened the horizon of the orthodontic field. Skeletal anchorage has, to a large degree, replaced conventional anchorage in a situation where anchorage is considered either critical, insufficient, or likely to result in undesirable side effects such as vertical displacements generated by intermaxillary force systems. Over the last few years, anchorage control with mini-implants has acquired plenty of significance in the clinical management of orthodontic patients. The mode of anchorage facilitated by these implant systems has a unique characteristic owing to their temporary use, which results in a transient, albeit absolute anchorage. The foregoing properties, together with the recently achieved simple application of these screws, have increased their popularity, establishing them as a necessary treatment option in complex cases that would have otherwise been impossible to treat. This comprehensive review aims to present and discuss the historical view, clinical uses, benefits, and drawbacks of the mini-screw implants used to obtain a temporary anchorage for orthodontic applications. Topics to be discussed include classification, types and properties, types of screw, head, and thread, their clinical applications, sites, and placement method selection.

Whole plant response of Pongamia pinnata to drought stress tolerance revealed by morpho-physiological, biochemical and transcriptome analysis.

BACKGROUND: Pongamia is considered an important biofuel species worldwide. Drought stress in the early growth stages of Pongamia influences negatively on the germination and seedling development. Due to lack of cultivar stability under drought stress conditions, establishment of successful plantation in drought hit areas becomes a major problem. To address this issue, drought stress response of four Pongamia genotypes was studied at morphological, physio-chemical and transcriptome levels. METHODS AND RESULTS: Drought stress was levied by limiting water for 15 days on three months old seedlings of four genotypes. A significant effect of water stress was observed on the traits considered. The genotype NRCP25 exhibited superior morpho-physiological, biochemical drought responses. Also, the genotype had higher root length, photosynthetic pigments, higher antioxidant enzymes and solute accumulation compared to other genotypes. In addition, transcript profiling of selected drought responsive candidate genes such as trehalose phosphate synthase 1 (TPS1), abscisic acid responsive elements-binding protein 2 (ABF2-2), heat shock protein 17 (HSP 17 kDa), tonoplast intrinsic protein 1 (TIP 1-2), zinc finger homeodomain protein 2 (ZFP 2), and xyloglucan endotransglucolase 13 (XET 13) showed only up-regulation in NRCP25. Further, the transcriptome responses are in line with key physio-chemical responses exhibited by NRCP25 for drought tolerance. CONCLUSIONS: As of now, there are no systematic studies on Pongamia drought stress tolerance; therefore this study offers a comprehensive understanding of whole plant drought stress responsiveness of Pongamia. Moreover, the results support important putative trait indices with potential candidate genes for drought tolerance improvement of Pongamia.

Lupus Vulgaris in Darker Skin: Dermoscopic and Histopathologic Incongruity.

INTRODUCTION: Lupus Vulgaris (LV) is the chronic, progressive, tissue destructive form of cutaneous tuberculosis. LV should be diagnosed and treated to prevent scaring and deformities. Histopathology is the gold standard for the diagnosis. Dermoscopy is helpful tool in diagnosing different dermatological condition. Here, dermoscopic and histopathogical correlation in LV was attempted. MATERIALS AND METHODS: It was a cross sectional, observational study done from February 2019 to October 2019. Nineteen patients of LV were included. Dermlite 4 with attached smart phone (iphone) was employed. LV lesions were subjected to skin biopsy to confirm the diagnosis. RESULTS: Study enrolled 19 patients, with 8males, 5 female and 6 children. Dermoscopy showed yellowish-white globules, white structureless areas and white scales were noted in 19 (100%) patients. Telangiectasias were seen in 16 (84.21%) patients as long linear, branching and short linear vessels. Pinkish-red background was noted in all patients (100% n=19). Newer observations included white shiny streaks, white rosettes and bluish hue. Age, sex, duration of lesions had no influence in the dermoscopic patterns. Discrepancy in dermoscopic-histopathologic correlation was noted. Facial lesions showed increased frequency of follicular plugs, patulous follicles and white rosettes. CONCLUSION: Dermoscopy is widely gaining importance in the realm of dermatology. In this study, dermoscopy demonstrated characteristic patterns in LV. Thus, dermoscopy a non-invasive procedure can be used as diagnostic tool in many infective dermatoses.

Pregnancy Outcome in Patients with Solitary Kidney.

BACKGROUND: Solitary kidney may be congenital or as a result of nephrectomy. There is a lot of literature available on quality of life in these patients, but there is limited data on pregnancy outcome. OBJECTIVES: To study pregnancy outcome in patients with solitary kidney either congenital or due to nephrectomy. MATERIALS AND METHODS: Study Design This is a retrospective observational study conducted at tertiary health center in Ahmedabad, from 2011 to 2014. Sample Size There were 164 patients of solitary kidney, out of which two patients had congenital solitary kidney and the remaining had solitary kidney due to nephrectomy. Among 164 patients, 96 (58.53 %) patients had completed family, 37 (22.56 %) patients did not try for pregnancy, 15 (9.14 %) patients have conceived, 12 (7.3 %) were lost to follow up and 4 (2.43 %) patients were infertile. Method Patients in reproductive age group (20-40 years), with solitary kidney either congenital or due to nephrectomy, were included. Maternal and fetal outcome was studied, and patients were followed up till 2 years postpartum. Exclusion Criteria Patients with solitary kidney due to post-renal transplant were excluded. RESULTS: There were 15 (9.14 %) patients who had conceived, out of which 11 (73.33) patients delivered and 4 (26.67 %) patients had spontaneous abortion. Two patients developed gestational hypertension and one had preeclampsia. On follow-up, all babies were normal and none of them had delayed developmental milestones. CONCLUSION: Preconceptional counseling should be done in these patients regarding risk of developing preeclampsia during pregnancy and preterm delivery. These patients can have good pregnancy outcome with close monitoring during antenatal period.

An Overview on Fertility Outcome in Renal Transplant Recipients.

BACKGROUND: The number of patients undergoing renal transplant are increasing with time. Most of these patients fall in the reproductive age group, who are going to conceive sooner or later. But there are few recipients who either are infertile before transplant or became infertile due to underlying renal pathology responsible for transplantation. OBJECTIVE: To study fertility outcome in female renal transplant recipients. STUDY DESIGN: This is a retrospective study conducted at tertiary health center in Ahmedabad, from 2004 to 2014. INCLUSION CRITERIA: Renal transplant recipients in the reproductive age group (20-40 years of age) were followed up in gynecology outdoor patient department. SAMPLE SIZE: There were 211 female renal transplant recipients, out of which 113 (53.5 %) patients had complete family, 3 (1.41 %) patients were infertile, 16 (7.58 %) patients have conceived, 33 (15.63 %) patients were lost to follow-up and remaining 46 (21.8 %) did not try for pregnancy. EXCLUSION CRITERIA: Unmarried patients, divorced and widow patients were excluded. RESULTS: Out of 19 patients, 16 patients conceived and 3 were infertile. The main cause of infertility in these patients was ovarian factor in 2 patients and tubal factor in 1 patient. Among 16 patients, 8 patients had missed abortion, 2 patients had preterm deliveries and 6 patients had term deliveries. CONCLUSION: Peritransplant and preconceptional counseling plays an important role for renal transplant recipients to help them understand the effect of renal pathology and transplantation on their fertility. They can have good fertility and pregnancy outcome with optimum functioning graft.

Mesenchymal chondrosarcoma of the cervical spine: A case report.

Mesenchymal chondrosarcoma (MCS) is a rare tumour accounting for less than 1% of all chondrosarcomas. We report here, the case of a 30-year-old female who presented with neck pain, weakness and tingling and numbness starting on the right side and later involving all four limbs. MRI revealed an ill-defined neoplastic lesion showing specks of calcification and arising from the right half of C2 and C3 cervical vertebrae. Microscopy showed an admixture of well differentiated cartilage showing focal calcification and spindly cell areas having a hemangiopericytomatous pattern.