Transitioning to GLP-1 RAs and SGLT2 Inhibitors as the First Choice for Managing Cardiometabolic Risk in Type 2 Diabetes.

PURPOSE OF REVIEW: This forward-looking review summarizes existing evidence from cardiovascular outcome trials on cardiometabolic risk-reduction in type 2 diabetes (T2DM) management, with attention to updating and personalizing recommendations from recent diabetes practice guidelines issued by cardiology societies. RECENT FINDINGS: T2DM management has shifted towards cardiometabolic outcome improvement rather than purely glycemic control. According to large clinical trials, sodium-glucose cotransporter-2 inhibitors showed robust results in reducing heart failure (HF) hospitalization and chronic kidney disease (CKD) progression, while glucagon-like peptide-1 receptor agonists demonstrated the largest effects on HbA1c reduction, weight loss, and atherosclerotic cardiovascular disease outcomes prevention, including stroke. Considering the distinct features of these new cardiometabolic agents, initial selection of therapy should be targeted to each individual patient, with consideration of combination therapy for the highest risk patients. Moreover, future studies should investigate the addition of obesity-predominant risk, in conjunction with coronary artery disease, stroke, CKD, and HF, as a new influential indicator for choosing the optimal cardiometabolic agent.

Multipolar Atom Types from Theory and Statistical Clustering (MATTS) Data Bank: Restructurization and Extension of UBDB.

A fast and accurate operational model of electron density is crucial in many scientific disciplines including crystallography, molecular biology, pharmaceutical, and structural chemistry. In quantum crystallography, the aspherical refinement of crystal structures is becoming increasingly popular because of its accurate description in terms of physically meaningful properties. The transferable aspherical atom model (TAAM) is quick and precise, though it requires a robust algorithm for atom typing and coverage of the most popular atom types present in small organic molecules. Thus, the University at Buffalo Databank (UBDB) has been renamed to the Multipolar Atom Types from Theory and Statistical clustering (MATTS) data bank, broadened, restructured, and implemented into the software DiSCaMB with 651 atom types obtained from 2316 small-molecule crystal structures containing C, H, N, O, P, S, F, Cl, and Br atoms. MATTS2021 data bank now covers most of the small molecules, peptides, RNA, DNA, and some frequently occurring cations and anions in biological, pharmaceutical, and organic materials, including the majority of known crystal structures composed of the above elements. The multipole model parameters (Pval, κ, κ', Plm) obtained for different atom types were greatly influenced by neighboring atom types, hybridization, geometrical strain in the ring system, and charges on the molecule. Contrary to previous findings, the atoms showing variable oxidation states and ions deviate from the linear dependence of monopole-derived charges on the expansion-contraction κ parameter.

Anti-proliferative and anti-malarial activities of spiroisoxazoline analogues of artemisinin.

A series of spiroisoxazoline analogues of artemisinin was synthesized by employing 1,3-dipolar cycloaddition between various in situ generated nitrile oxides and artemisitene. All the synthesized compounds were tested for their anti-proliferative and anti-malarial activities. Among the compounds tested, compound 11a was found to be potent against the HCT-15 cancer cell line with IC50 = 4.04 µM when compared to 5-fluorouracil (IC50 = 35.53 µM). DNA cell cycle analysis shows that 11a was inhibiting cell proliferation at the G2/M phase. Compound 11b was found to be most active against Plasmodium falciparum with IC50 = 0.1 µM and also blocked host hemoglobin hydrolysis by the falcipain-3 receptor. It was demonstrated to have better dynamics of parasite killing efficiency than artemisinin. Molecular docking studies revealed that these compounds interacted with falcipain-3 receptor sites.

Activation of the Hg-C Bond of Methylmercury by [S2]-Donor Ligands.

Here we report that [S2]-donor ligands BmmOH, BmmMe, and BmeMe bind rapidly and reversibly to the mercury centers of organomercurials, RHgX, and facilitate the cleavage of Hg-C bonds of RHgX to produce stable tetracoordinated Hg(II) complexes and R2Hg. Significantly, the rate of cleavage of Hg-C bonds depends critically on the X group of RHgX (X = BF4-, Cl-, I-) and the [S2]-donor ligands used to induce the Hg-C bonds. For instance, the initial rate of cleavage of the Hg-C bond of MeHgI induced by BmeMe is almost 2-fold higher than the initial rate obtained by BmmOH or BmmMe, indicating that the spacer between the two imidazole rings of [S2]-donor ligands plays a significant role here in the cleavage of Hg-C bonds. Surprisingly, we noticed that the initial rate of cleavage of the Hg-C bond of MeHgI induced by BmeMe (or BmmMe) is almost 10-fold and 100-fold faster than the cleavage of Hg-C bonds of MeHgCl and [MeHg]BF4 respectively, under identical reaction conditions, suggesting that the Hg-C bond of [MeHg]BF4 is highly inert at room temperature (21 °C). We also show here that the nature of the final stable cleaved products, i.e. Hg(II) complexes, depends on the X group of RHgX and the [S2]-donor ligands. For instance, the reaction of BmmMe with MeHgCl (1:1 molar ratio) afforded the formation of the 16-membered metallacyclic dinuclear mercury compound (BmmMe)2Hg2Cl4, in which the two Cl atoms are located inside the ring, whereas due to the large size of the I atom, a similar reaction with MeHgI yielded polymeric [(BmmMe)2HgI2]m·(MeHgI)n. However, the treatment of BmmMe with ionic [RHg]BF4 led to the formation of the tetrathione-coordinated mononuclear mercury compound [(BmmMe)2Hg](BF4)2, where BF4- serves as a counteranion.

Prevalence of Dental Anomalies in Odisha Population: A Panoramic Radiographic Study.

AIM: The aim of this study was to evaluate the prevalence of dental anomalies (DAs) in Odisha population using panoramic radiographs. MATERIALS AND METHODS: In this study, 1,080 panoramic radiographs were evaluated for DAs. Dental records were reviewed for diagnostic confirmation. Anomalies related to the shape, size, position of teeth, and number of roots (supernumerary roots) were evaluated. RESULTS: The study results showed the prevalence of DAs to be 35.27%. The most prevalent was dilaceration, which was seen in 46.71% cases followed by peg laterals in 20.99%. CONCLUSION: Dental anomalies were present in more than one-third of the study group, which was mostly related to shape of the teeth. Early diagnosis of these DAs helps in avoiding complications. CLINICAL SIGNIFICANCE: Identification of DAs requires proper examination and thereby subsequent correct diagnosis. These anomalies can pose complications in normal functioning of orofacial complex. The knowledge of the prevalence of such anomalies aids dental practitioners for a proper treatment plan.

Synthesis of novel 5-arylidenethiazolidinones with apoptotic properties via a three component reaction using piperidine as a bifunctional reagent.

The synthesis of a new library of 5-arylidenethiazolidinone compounds using an efficient three component reaction with thiazolidine-2,4-dione, piperidine and appropriate aldehydes is reported. This reaction is excellently high yielding, tolerant towards a variety of aldehydes and provides access to these compounds in a single step (in comparison to low yielding multistep syntheses reported in the literature). Once the reaction is complete, the desired product precipitates out of the reaction mixture and is isolated by filtration and purified by washing and recrystallization. These compounds revealed anti-proliferative activities against human breast cancer cells (MCF7 and MDA). Phenotypic profiling established the most active compound 17i (EC50 = 4.52 µM) as an apoptotic agent. A novel chemical proteomics approach identified ß-actin-like protein 2, γ-enolase and macrophage migration inhibitory factor (MMIF) as putative cellular binding partners of 17i.

A Comparative Assessment of Dental Caries Experience in Relation to Nutritional Status among 6-12-year-old School-going Children and Those with Congenital Heart Disease in Bhubaneswar City.

Aim: To assess the dental caries experience in relation to nutritional status among 6-12- year-old school-going children and those with congenital heart disease in Bhubaneswar city. Materials and methods: A cross-sectional study was conducted among 6-12-year-old healthy school-going children and those with congenital heart disease for a period of 6 months (October 2019-March 2020) in Bhubaneswar, India. Type III clinical examination was carried out as per American Dental Association (ADA) specifications using plane mouth mirrors and community periodontal index (CPI) probes. Clinical oral examination and measurement of the weight and height of the child were performed by a single examiner. Data was analyzed using Statistical Package for the Social Sciences (SPSS) version 21.0. Results: The overall mean decayed missing filled primary teeth surfaces (dmfs) in primary dentition was higher (5.93 ± 10.224) in subjects with congenital heart disease (CHD) (group I) than in healthy controls (3.41 ± 6.192). The overall mean decayed missing filled permanent teeth surfaces (DMFS) in permanent dentition was 0.33 ± 1.105 in subjects with CHD (group I) and 0.24 ± 0.714 in group II. In group I, the majority of them (58.9%) were underweight, followed by 41.1% who were a healthy weight. However, in group II, 47.9% of the study subjects were healthy weight, 26.1% were underweight, 14.4% were obese, and 11.7% were overweight. Conclusion: This study concluded that children with CHD have a higher dental caries experience and poor nutritional status as compared to healthy school-going children. How to cite this article: Hazarika SJ, Jnaneswar A, Jha K. A Comparative Assessment of Dental Caries Experience in Relation to Nutritional Status among 6-12-year-old School-going Children and Those with Congenital Heart Disease in Bhubaneswar City. Int J Clin Pediatr Dent 2024;17(1):1-6.

TAAM refinement on high-resolution experimental and simulated 3D ED/MicroED data for organic molecules.

3D electron diffraction (3D ED), or microcrystal electron diffraction (MicroED), has become an alternative technique for determining the high-resolution crystal structures of compounds from sub-micron-sized crystals. Here, we considered L-alanine, α-glycine and urea, which are known to form good-quality crystals, and collected high-resolution 3D ED data on our in-house TEM instrument. In this study, we present a comparison of independent atom model (IAM) and transferable aspherical atom model (TAAM) kinematical refinement against experimental and simulated data. TAAM refinement on both experimental and simulated data clearly improves the model fitting statistics (R factors and residual electrostatic potential) compared to IAM refinement. This shows that TAAM better represents the experimental electrostatic potential of organic crystals than IAM. Furthermore, we compared the geometrical parameters and atomic displacement parameters (ADPs) resulting from the experimental refinements with the simulated refinements, with the periodic density functional theory (DFT) calculations and with published X-ray and neutron crystal structures. The TAAM refinements on the 3D ED data did not improve the accuracy of the bond lengths between the non-H atoms. The experimental 3D ED data provided more accurate H-atom positions than the IAM refinements on the X-ray diffraction data. The IAM refinements against 3D ED data had a tendency to lead to slightly longer X-H bond lengths than TAAM, but the difference was statistically insignificant. Atomic displacement parameters were too large by tens of percent for L-alanine and α-glycine. Most probably, other unmodelled effects were causing this behaviour, such as radiation damage or dynamical scattering.

Hirshfeld atom refinement and dynamical refinement of hexagonal ice structure from electron diffraction data.

Reaching beyond the commonly used spherical atomic electron density model allows one to greatly improve the accuracy of hydrogen atom structural parameters derived from X-ray data. However, the effects of atomic asphericity are less explored for electron diffraction data. In this work, Hirshfeld atom refinement (HAR), a method that uses an accurate description of electron density by quantum mechanical calculation for a system of interest, was applied for the first time to the kinematical refinement of electron diffraction data. This approach was applied here to derive the structure of ordinary hexagonal ice (Ih). The effect of introducing HAR is much less noticeable than in the case of X-ray refinement and it is largely overshadowed by dynamical scattering effects. It led to only a slight change in the O-H bond lengths (shortening by 0.01 Å) compared with the independent atom model (IAM). The average absolute differences in O-H bond lengths between the kinematical refinements and the reference neutron structure were much larger: 0.044 for IAM and 0.046 Šfor HAR. The refinement results changed considerably when dynamical scattering effects were modelled - with extinction correction or with dynamical refinement. The latter led to an improvement of the O-H bond length accuracy to 0.021 Šon average (with IAM refinement). Though there is a potential for deriving more accurate structures using HAR for electron diffraction, modelling of dynamical scattering effects seems to be a necessary step to achieve this. However, at present there is no software to support both HAR and dynamical refinement.

Evaluation of Treatment Outcomes and Quality of Life in Patients with Obstructive Sleep Apnea Receiving Oral Appliance Therapy.

Background: A frequent sleep condition linked to considerable morbidity and death is obstructive sleep apnea (OSA). Continuous positive airway pressure (CPAP) therapy is not the only noninvasive treatment option for OSA. Another option is oral appliance therapy (OAT). The purpose of this study was to assess the quality of life and treatment results for OSA patients receiving OAT in a tertiary care environment. Methods: Over the course of 1 year, prospective observational research was carried out at a tertiary care facility. Patients with consecutive Obsructive Sleep apnea as per polysomnography report were enrolled in the sudy. Medical history, baseline demographics, and sleep characteristics were noted. Both before and after the start of OAT, objective sleep metrics and subjective results were evaluated. Adverse events and therapeutic compliance were tracked. To assess the effectiveness and tolerability of the medication, statistical analysis was done. Findings: The research had 150 patients in all, with a mean age of 52.4 years and a 66.7% male preponderance. Objective sleep metrics showed considerable improvements after starting OAT, with the apnea-hypopnea index decreasing from 28.7 to 9.3 episodes per hour (P < 0.001). Improvement was also evident in subjective outcomes as ESS ratings dropped from 12.6 to 6.2 (P < 0.05). Evaluations of quality of life indicated improvements in the categories of physical and mental health (P < 0.001). There were few reported adverse effects and a good level of adherence to OAT. In tertiary care settings, OAT is an effective and well-tolerated therapeutic option for individuals with OSA. The noteworthy enhancements in treatment results and overall well-being highlight the practicality of OAT as a substitute for CPAP therapy. To fully understand the long-term effectiveness and cardiovascular advantages of OAT in the treatment of OSA, more investigation is necessary.

Dental Services and their Awareness and Utilization among the Health Care Workers in a South Indian District - A Cross Sectional Study.

Aim: The present research was carried out to evaluate the amount of usage of dental care opportunities and also to assess the problems faced by health care workers (HCWs) of a south Indian district in using dental services. Methodology: This study had around 500 participants who belonged from various health care sectors who were selected with the help of multistage sampling. The data obtained from this cross-sectional research was analysed statistically using SPSS 22.0. Results: It was noticed that around 35% of participants went for a dentist's appointment in past 1 year where male members predominated (45%). One of the commonest reasons for utilizing dental care services was pain as an dental emergency factor (70%). Other reasons were dental caries (18%) restoration, breakage of tooth (10%) and a host of other factors (11%). Around 350 participants felt that going to the dentist was only necessary when there was an emergency (61%). Conclusion: The target population less frequently visited the dentist to maintain their teeth as they believed when you have pain, that is the time you go to a dental specialist.

The Association of Mitral Annular Calcification With Cardiovascular and Noncardiovascular Outcomes: The Multi-Ethnic Study of Atherosclerosis.

Mitral annular calcification (MAC) may be a potential marker of biologic aging. However, the association of MAC with noncardiovascular measures, including bone mineral density (BMD), incident renal failure, dementia, and noncardiovascular mortality, is not well-studied in a multiracial cohort. We used data from 6,814 participants (mean age: 62.2 ± 10.2 years, 52.9% women) without cardiovascular disease at baseline in the Multi-Ethnic Study of Atherosclerosis. MAC was assessed with noncontrast cardiac computed tomography at study baseline. Using multivariable-adjusted linear and logistic regression, we assessed the cross-sectional association of MAC with BMD and walking pace. Furthermore, using Cox proportional hazards, we evaluated the association of MAC with incident renal failure, dementia, and all-cause mortality. In addition, we assessed the association of MAC with cardiovascular and noncardiovascular mortality using competing risks regression. The prevalence of MAC was 9.5% and was higher in women (10.7%) than in men (8.0%). MAC was associated with low BMD (coefficient -0.04, 95% confidence interval [CI] -0.06 to -0.02), with significant interaction by gender (p-interaction = 0.035). MAC was, however, not associated with impaired walking pace (odds ratio 1.09, 95% CI 0.89 to 1.33). Compared with participants without MAC, those with MAC had an increased risk of incident renal failure, albeit nonsignificant (hazard ratio [HR] 1.18, 95% CI 0.95 to 1.45), and a significantly higher hazards of dementia (HR 1.36, 95% CI 1.10 to 1.70). In addition, participants with MAC had a substantially higher risk of all-cause (HR 1.47, 95% CI 1.29 to 1.69), cardiovascular (subdistribution HR 1.39, 95% CI 1.04 to 1.87), and noncardiovascular mortality (subdistribution HR 1.35, 95% CI 1.14 to 1.60) than those without MAC. MAC ≥100 versus <100 was significantly associated with reduced BMD, incident renal failure, dementia, all-cause, cardiovascular, and noncardiovascular mortality. In conclusion, MAC was associated with reduced BMD and dementia and all-cause, cardiovascular, and noncardiovascular mortality in this multiracial cohort. Thus, MAC may be a marker not only for atherosclerotic burden but also for other metabolic and inflammatory factors that increase the risk of noncardiovascular outcomes and death from other causes.

Prevalence of Aortic Valve Calcium and the Long-Term Risk of Incident Severe Aortic Stenosis.

BACKGROUND: Aortic valve calcification (AVC) is a principal mechanism underlying aortic stenosis (AS). OBJECTIVES: This study sought to determine the prevalence of AVC and its association with the long-term risk for severe AS. METHODS: Noncontrast cardiac computed tomography was performed among 6,814 participants free of known cardiovascular disease at MESA (Multi-Ethnic Study of Atherosclerosis) visit 1. AVC was quantified using the Agatston method, and normative age-, sex-, and race/ethnicity-specific AVC percentiles were derived. The adjudication of severe AS was performed via chart review of all hospital visits and supplemented with visit 6 echocardiographic data. The association between AVC and long-term incident severe AS was evaluated using multivariable Cox HRs. RESULTS: AVC was present in 913 participants (13.4%). The probability of AVC >0 and AVC scores increased with age and were generally highest among men and White participants. In general, the probability of AVC >0 among women was equivalent to men of the same race/ethnicity who were approximately 10 years younger. Incident adjudicated severe AS occurred in 84 participants over a median follow-up of 16.7 years. Higher AVC scores were exponentially associated with the absolute risk and relative risk of severe AS with adjusted HRs of 12.9 (95% CI: 5.6-29.7), 76.4 (95% CI: 34.3-170.2), and 380.9 (95% CI: 169.7-855.0) for AVC groups 1 to 99, 100 to 299, and ≥300 compared with AVC = 0. CONCLUSIONS: The probability of AVC >0 varied significantly by age, sex, and race/ethnicity. The risk of severe AS was exponentially higher with higher AVC scores, whereas AVC = 0 was associated with an extremely low long-term risk of severe AS. The measurement of AVC provides clinically relevant information to assess an individual's long-term risk for severe AS.

Association of aortic valve calcium with dementia and stroke: The Multi-Ethnic Study of Atherosclerosis.

BACKGROUND AND AIMS: Calcific aortic valve disease is associated with increased thrombin formation, platelet activation, decreased fibrinolysis, and subclinical brain infarcts. We examined the long-term association of aortic valve calcification (AVC) with newly diagnosed dementia and incident stroke in the Multi-Ethnic Study of Atherosclerosis (MESA). METHODS: AVC was measured using non-contrast cardiac CT at Visit 1. We examined AVC as a continuous (log-transformed) and categorical variable (0, 1-99, 100-299, ≥300). Newly diagnosed dementia was adjudicated using International Classification of Disease codes. Stroke was adjudicated from medical records. We calculated absolute event rates (per 1000 person-years) and multivariable adjusted Cox proportional hazards ratios (HR). RESULTS: Overall, 6812 participants had AVC quantified with a mean age of 62.1 years old, 52.9 % were women, and the median 10-year estimated atherosclerotic cardiovascular disease (ASCVD) risk was 13.5 %. Participants with AVC >0 were older and less likely to be women compared to those with AVC=0. Over a median 16-year follow-up, there were 535 cases of dementia and 376 cases of stroke. The absolute risk of newly diagnosed dementia increased in a stepwise pattern with higher AVC scores, and stroke increased in a logarithmic pattern. In multivariable analyses, AVC was significantly associated with newly diagnosed dementia as a log-transformed continuous variable (HR 1.09; 95 % CI 1.04-1.14) and persons with AVC ≥300 had nearly a two-fold higher risk (HR 1.77; 95 % CI 1.14-2.76) compared to those with AVC=0. AVC was associated with an increased risk of stroke after adjustment for age, sex, and race/ethnicity, but not after adjustment for ASCVD risk factors. CONCLUSIONS: After multivariable adjustment, AVC >0 was significantly associated with an increased risk of newly diagnosed dementia, but not incident stroke. This suggests that AVC may be an important risk factor for the long-term risk of dementia beyond traditional ASCVD risk factors.

Identifying People at High Risk for Severe Aortic Stenosis: Aortic Valve Calcium Versus Lipoprotein(a) and Low-Density Lipoprotein Cholesterol.

BACKGROUND: Aortic valve calcification (AVC), Lp(a) [lipoprotein(a)], and low-density lipoprotein cholesterol (LDL-C) are associated with severe aortic stenosis (AS). We aimed to determine which of these risk factors were most strongly associated with the risk of incident severe AS. METHODS: A total of 6792 participants from the MESA study (Multi-Ethnic Study of Atherosclerosis) had computed tomography-quantified AVC, Lp(a), and LDL-C values at MESA visit 1 (2000-2002). We calculated the absolute event rate of incident adjudicated severe AS per 1000 person-years and performed multivariable adjusted Cox proportional hazards regression. RESULTS: The mean age was 62 years old, and 47% were women. Over a median 16.7-year follow-up, the rate of incident severe AS increased exponentially with higher AVC, regardless of Lp(a) or LDL-C values. Participants with AVC=0 had a very low rate of severe AS even with elevated Lp(a) ≥50 mg/dL (<0.1/1000 person-years) or LDL-C ≥130 mg/dL (0.1/1000 person-years). AVC >0 was strongly associated with severe AS when Lp(a) <50 mg/dL hazard ratio (HR) of 33.8 (95% CI, 16.4-70.0) or ≥50 mg/dL HR of 61.5 (95% CI, 7.7-494.2) and when LDL-C <130 mg/dL HR of 31.1 (95% CI, 14.4-67.1) or ≥130 mg/dL HR of 50.2 (95% CI, 13.2-191.9). CONCLUSIONS: AVC better identifies people at high risk for severe AS compared with Lp(a) or LDL-C, and people with AVC=0 have a very low long-term rate of severe AS regardless of Lp(a) or LDL-C level. These results suggest AVC should be the preferred prognostic risk marker to identify patients at high risk for severe AS, which may help inform participant selection for future trials testing novel strategies to prevent severe AS.

Assessment of knowledge, attitude, and practice regarding intellectual property rights among medical, dental, and nursing professionals in a tertiary institution in Bhubaneswar City, Odisha: A cross-sectional survey.

BACKGROUND: To assess the knowledge, attitude, and practice (KAP) about intellectual property rights (IPRs) among medical, dental, and nursing students and faculties in a tertiary institute through cross-sectional survey in Bhubaneswar City, Odisha. MATERIALS AND METHODS: This study was a cross-sectional survey conducted from October to December, 2021 in a tertiary institution in Bhubaneswar city, Odisha. A self-structured, 29 close-ended questionnaires based on IPRs was used in the survey. The data obtained were tabulated and analyzed statistically using the Statistical Package for Social Sciences version 23.0. All the components of KAP were measured as absolute and relative frequencies. They were also assessed as mean and standard deviation. Descriptive analysis through frequency distribution was calculated and the Chi-square test was applied. The correlation between the domains was determined using Pearson's correlation coefficient. RESULT: A total of 489 participants participated in the survey, out of which 196 (40.1%) were males and 293 (59.9%) were females; 177 (36.2%) were interns, 147 (30.1%) were postgraduates, and 165 (33.7%) were faculties from all the three fields (medical, dental, and nursing). A total of 192 (39.3%) participants were from medical, 198 (40.5%) from dental, and 99 (20.2%) were from the nursing field. The mean KAP scores were significantly (P < 0.0001) higher among nursing interns respondents (2.963, 0.637, and 0.390), dental postgraduate respondents (2.213, 0.844, and 0.351), and dental faculties (1.953, 0.876, and 0.481). The mean knowledge score was significantly (P < 0.0001) greater among females than males and the mean attitude and practice scores were significantly (P < 0.0001) greater among males than females. Pearson's correlation coefficientwas found to be significant for knowledge-attitude, knowledge-practice domain. The values obtained were statistically significant. CONCLUSION: This study showed that more KAP was found in dental faculties, dental postgraduates, and nursing interns. However, the need to know IPR is still lacking among the healthcare professionals. Since IPR is the need of the hour and it has a potential ahead, it is necessary to include it in the curriculum so as to increase the knowledge about IPR among individuals, which will enable to creation of dynamic innovations in the near future.

Assessing knowledge, attitude, and readiness to use e-health among doctors in a tertiary health care unit in Bhubaneswar city, Odisha - A cross-sectional survey.

BACKGROUND: The term ""e-health"" refers to all technological applications in the delivery of a more affordable, high-speed, and widely accessible mode of health care. It is a definite solution to managing the public's health and well-being during the coronavirus disease (COVID-19) pandemic, and doctors from all fields of expertise are required to be at par with it in terms of knowledge, attitude, and readiness to use it to their advantage under the current circumstances. MATERIALS AND METHOD: A cross-sectional survey was conducted among the faculty, postgraduates, and interns of the medical and dental schools of a university, which used an expert-validated self-administered questionnaire assessing knowledge, attitude, and readiness to use e-health. RESULTS: Among the 400 participants, it was observed that the categories of age (P < 0.0001), gender (P = 0.018), designation (P = 0.031), and years of service (P < 0.0001) have significant differences across the groups. It was seen that the mean e-health knowledge (3.55 ± 0.52) and mean attitude (2.42 ± 0.59) to use e-health were more in dentists while participants from the medical field showed higher mean readiness (1.97 ± 0.58) to use e-health in daily practice. It was observed that male professionals had more mean knowledge (3.54 ± 0.60) than female professionals (3.43 ± 0.52) while female participants had more mean e-health readiness (1.96 ± 0.57). CONCLUSION: In a broad sense, the majority of participants responded positively to using e-health in their everyday practice. While medical doctors have a stronger outlook and preparedness, dentists showed more literacy and a supportive attitude to adopting e-health and telemedicine. Thus, it is necessary to step up comprehensive e-health workshops and training sessions for health care experts.

Aspherical atom refinements on X-ray data of diverse structures including disordered and covalent organic framework systems: a time-accuracy trade-off.

Aspherical atom refinement is the key to achieving accurate structure models, displacement parameters, hydrogen-bond lengths and analysis of weak interactions, amongst other examples. There are various quantum crystallographic methods to perform aspherical atom refinement, including Hirshfeld atom refinement (HAR) and transferable aspherical atom model (TAAM) refinement. Both HAR and TAAM have their limitations and advantages, the former being more accurate and the latter being faster. With the advent of non-spherical atoms in Olex2 (NoSpherA2), it is now possible to overcome some limitations, like treating disorder, twinning and network structures, in aspherical refinements using HAR, TAAM or both together. TAAM refinement in NoSpherA2 showed significant improvement in refinement statistics compared with independent atom model (IAM) refinements on a diverse set of X-ray diffraction data. The sensitivity of TAAM towards poor data quality and disorder was observed in terms of higher refinement statistics for such structures. A comparison of IAM with TAAM and HAR in NoSpherA2 indicated that the time taken by TAAM refinements was of the same order of magnitude as that taken by IAM, while in HAR the time taken using a minimal basis set was 50 times higher than for IAM and rapidly increased with increasing size of the basis sets used. The displacement parameters for hydrogen and non-hydrogen atoms were very similar in both HAR and TAAM refinements. The hydrogen-bond lengths were slightly closer to neutron reference values in the case of HAR with higher basis sets than in TAAM. To benefit from the advantages of each method, a new hybrid refinement approach has been introduced, allowing a combination of IAM, HAR and TAAM in one structure refinement. Refinement of coordination complexes involving metal-organic compounds and network structures such as covalent organic frameworks and metal-organic frameworks is now possible in a hybrid mode such as IAM-TAAM or HAR-TAAM, where the metal atoms are treated via either the IAM or HAR method and the organic part via TAAM, thus reducing the computational costs without compromising the accuracy. Formal charges on the metal and ligand can also be introduced in hybrid-mode refinement.

Recognition of Oral Pathology as a Subject among Dental Undergraduates: Addressing their Concerns.

Oral and Maxillofacial Pathology is a speciality department of dentistry which deals with identification of diseases affecting oral and maxillofacial regions and investigates the cause, processes and effect of these diseases. Books, internet, lectures have made great progress but there is still a gap between students' understanding and interest in the subject. The aim of this study was to evaluate and analyse the challenges faced by undergraduate students in understanding oral pathology theory & practical and modify the teaching process accordingly. A descriptive cross-sectional study of 300 BDS third year students was conducted in our college. The results stated that 83% of the participants attended classes, 90% found the topics covered to be useful, 97% reported that the classes were taken to provide an in depth view of the subject, 71% faced difficulties in understanding the topics in theory classes. 46% attended seminars, 68% viewed more than 4 slides on an average in one practical class, and 80% faced difficulties in identifying the slide. Our data concluded, that if certain measures will be taken so as to engage the students' interests, then this subject would prove to be a much better scope of learning for the budding dentists.

Investigating the association of traditional and non-traditional tobacco product use with subclinical and clinical cardiovascular disease: The Cross-Cohort Collaboration-Tobacco working group rationale, design, and methodology.

While the impact of combustible cigarette smoking on cardiovascular disease (CVD) is well-established, the longitudinal association of non-traditional tobacco products with subclinical and clinical CVD has not been fully explored due to: 1) limited data availability; and 2) the lack of well-phenotyped prospective cohorts. Therefore, there is the need for sufficiently powered well-phenotyped datasets to fully elucidate the CVD risks associated with non-cigarette tobacco products. The Cross-Cohort Collaboration (CCC)-Tobacco is a harmonized dataset of 23 prospective cohort studies predominantly in the US. A priori defined variables collected from each cohort included baseline characteristics, details of traditional and non-traditional tobacco product use, inflammatory markers, and outcomes including subclinical and clinical CVD. The definitions of the variables in each cohort were systematically evaluated by a team of two physician-scientists and a biostatistician. Herein, we describe the method of data acquisition and harmonization and the baseline sociodemographic and risk profile of participants in the combined CCC-Tobacco dataset. The total number of participants in the pooled cohort is 322782 (mean age: 59.7 ± 11.8 years) of which 76% are women. White individuals make up the majority (73.1%), although there is good representation of other race and ethnicity groups including African American (15.6%) and Hispanic/Latino individuals (6.4%). The prevalence of participants who never smoked, formerly smoked, and currently smoke combustible cigarettes is 50%, 36%, and 14%, respectively. The prevalence of current and former cigar, pipe, and smokeless tobacco is 7.3%, 6.4%, and 8.6%, respectively. E-cigarette use was measured only in follow-up visits of select studies, totaling 1704 former and current users. CCC-Tobacco is a large, pooled cohort dataset that is uniquely designed with increased power to expand knowledge regarding the association of traditional and non-traditional tobacco use with subclinical and clinical CVD, with extension to understudied groups including women and individuals from underrepresented racial-ethnic groups.