Effect of short-term exposure to Raag Bilawal of North Indian classical music on young Indian adults: a high-density electroencephalogram microstate study.

Introduction: the objective of the study was to find out the microstate map topographies and their parameters generated during the resting state and during listening to North Indian classical Music Raag 'the Raag Bilawal'. It was hypothesized that in the resting state and during listening to music conditions, there would be a difference in microstate parameters i.e. mean duration, global explained variance (GEV), and time coverage. Methods: a 128-channel electroencephalogram (EEG) was recorded for 12 Indian subjects (average age 26.1+1.4 years) while resting and listening to music using the EEG microstate investigation. Investigation and comparison of the microstate parameters were the mean duration, global explained variance (GEV), and time coverage between both conditions were performed. Results: seven microstate maps were found to represent the resting state and listening to music condition, four canonical and three novel maps. No statistically significant difference was found between the two conditions for time coverage and mean duration. The statistical significance levels of the map-1, map-2, map-3, map-4, map-5, map-6, and map-7 for the mean duration were 0.4, 0.6, 0.97, 0.34, 0.32, 0.69, and 0.29 respectively; and for time coverage were 0.92, 0.92, 0.96, 0.64, 0.78, 0.38, and 0.76 respectively. Map-1, map-4, and map-7 were the three novel maps we found in our study. Conclusion: similarities regarding stability and predominance of maps with small vulnerability exist in both conditions indicating that phonological, visual, and dorsal attention networks may be activated in both resting state and listening to music condition.

Global Effect on Cortical Activity in Young Indian Males in Response to "OM" Chanting: A High-Density Quantitative Electro-Encephalography Study.

Background: Meditation using the "OM" mantra is the most widely used practice in India. Though reports have been published about the relaxation effect during both verbal "OM" chanting and listening to "OM" chanting, there is a paucity of literature concerning the cortical areas activated/deactivated after verbal "OM" chanting and listening to "OM" chanting using quantitative electro-encephalography (qEEG). Purpose: The objective of this study was to compare the effects of verbal "OM" chanting and listening to "OM" chanting on cortical sources as compared to baseline, as assessed by qEEG. Method: Twenty adult male subjects with a mean age of 27.5 ± 7.5 years and no past or present history of psychiatric, neurological, or auditory disorders or previous exposure to yoga and meditation were recruited from the undergraduate and postgraduate student population of AIIMS, New Delhi. Subjects were given a paradigm designed using E-prime for both verbal and listening to "OM" chanting of 5 min each and a 5-min relaxation period in between the tasks. Electroencephalography recording was done using a 128-channel geodesic sensor net with band-pass filtered at 1-70 Hz, and 20-sec data of eyes-closed condition, post-verbal "OM", and post-listening to "OM" chanting were segmented and pre-processed. Further, source analysis was performed on the data using standardized low-resolution electromagnetic tomography. Result: The pre (baseline) versus post-verbal "OM" (p < .05) and post-listening to "OM" (p < .05) chanting showed significant differences in similar cortical areas in both verbal "OM" and listening to "OM" chanting except the three areas, that is, the orbital gyrus, the rectal gyrus, and the sub-callosal gyrus, which were additionally activated post-listening to "OM" chanting. Both verbal and listening to "OM" chanting induced activation of similar cortical areas, which were classified as the nodes/hubs of specific resting-state networks (RSNs) such as the attentional network, frontoparietal control network, and default mode network. Conclusion: The study results suggest that "OM" chanting could facilitate flexible switching between various RSNs to induce a relaxed state and could improve attention simultaneously.Both verbal and listening to "OM" chanting induced common activated areas that are classified into frontoparietal, dorsal attention, and default mode network areas. And it is hypothesized that flexible switching between these RSNs could induce a relaxed state and improve attention simultaneously with the possible role of the frontoparietal network.

Default mode network aberrance in subjects of alcohol and opioid use disorders during working memory task: An exploratory EEG microstates study.

Background: Aberrance in switching from default mode network (DMN) to fronto-parietal network (FPN) is proposed to underlie working memory deficits in subjects with substance use disorders, which can be studied using neuro-imaging techniques during cognitive tasks. The current study used EEG to investigate pre-stimulus microstates during the performance of Sternberg's working memory task in subjects with substance use disorders. Methods: 128-channel EEG was acquired and processed in ten age and gender-matched subjects, each with alcohol use disorder, opioid use disorder, and controls while they performed Sternberg's task. Behavioral parameters, pre-stimulus EEG microstate, and underlying sources were analyzed and compared between subjects with substance use disorders and controls. Results: Both alcohol and opioid use disorder subjects had significantly lower accuracy (P < 0.01), while reaction times were significantly higher only in subjects of alcohol use disorder compared to controls (P < 0.01) and opioid use disorder (P < 0.01), reflecting working memory deficits of varying degrees in subjects with substance use disorders. Pre-stimulus EEG microstate revealed four topographic Maps 1-4: subjects of alcohol and opioid use disorder showing significantly lower mean duration of Map 3 (visual processing) and Map 2 (saliency and DMN switching), respectively, compared to controls (P < 0.05). Conclusion: Reduced mean durations in Map 3 and 2 in subjects of alcohol and opioid use disorder can underlie their poorer performance in Sternberg's task. Furthermore, cortical sources revealed higher activity in both groups of substance use disorders in the parahippocampal gyrus- a hub of DMN; superior and middle temporal gyri associated with impulsivity; and insula that maintains balance between executive reflective system and impulsive system. EEG microstates can be used to envisage neural underpinnings implicated for working memory deficits in subjects of alcohol and opioid use disorders, reflected by aberrant switching between neural networks and information processing mechanisms.

Aberrance in default mode and executive network activity underlie working memory deficits in addictive disorders: A preliminary, exploratory case-control study.

BACKGROUND: Addiction can alter neural processes during rest and cognitive performance. Subjects with addictive disorders exhibit preoccupation and anticipation for the psychoactive substance when idle and cognitive deficits, during tasks. METHODS: 128 channel EEG was recorded in sixty subjects (30, with alcohol, opioid and internet addiction; 30 controls) during rest and while performing working memory task to ascertain underlying differences in cortical activity between the groups while at rest and during performance of the task. Artifactually clean data was then subjected to source analysis using sLORETA software in both the groups. RESULTS: EEG cortical source analysis in subjects with addictive disorders showed significant activation of areas of Default Mode Network (DMN) and reduced activation in dorsolateral prefrontal cortices (DLPFC), an area known to be involved in executive function, during performance of task. However, control subjects demonstrated significantly reduced activation in areas of DMN; and increased activation of DLPFC during task performance. CONCLUSION: Inability to suppress DMN inhibits reallocation of neural resources to areas of executive functioning leading to working memory deficits in subjects with addictive disorder.

A comprehensive study of temperature data during the filling and post-closure phases at a landfill in Québec, Canada: Application of a thermal-mechanical-biological model.

A 12-year field study on municipal solid waste (MSW) stabilization in Northern climates was conducted at Ste. Sophie landfill in Québec, Canada. Temperature and settlement data were collected from 12 instrument bundles placed at varying depths in two vertical columns within the waste during the filling and post-closure phases. The data demonstrated a 12-18 month delay in temperature rise during the filling stages due to frozen or partially frozen MSW and highlighted ambient temperature effects at shallow depths. A thermal-mechanical-biological (TMB) model was developed and calibrated to simulate the impact of temperatures on MSW stabilization, particularly emphasizing landfills without leachate recirculation in Northern climates. The biological model related anaerobic heat generation from MSW with temperature and expended energy from biodegradation. The resultant heat was integrated into the thermal model, allowing for the simulation of heat transfer through conduction. The thermal parameters were expressed as a function of density, which was updated in the mechanical model that combined a Generalized Kelvin-Voigt model with a biodegradation-induced strain term. This term was represented as the ratio of expended energy over time to total potential expended energy of the waste. The TMB model effectively predicted MSW behaviour, considering temperature rise delays in cold and sharp rises in warm conditions. This is essential for optimizing landfill operations by promoting waste stabilization before applying the final cover.

Dynamics of agricultural transformation in Punjab: Crop trends, instability and decomposition analysis.

Agricultural transformation in Punjab, spurred by the Green Revolution of the mid-1960s, has led to significant shifts in land use patterns, crop diversification, and cropping dynamics. This transformation has profound implications for sustainability and economic resilience. This study delves into the complex relationship among agricultural growth, instability, and environmental sustainability in Punjab. It examines the growth and instability in the state's key crops' area, production, and yield/productivity over 56 years, from 1966-1967 to 2021-2022. Using secondary data, this study employs an assortment of methodologies, including compound annual growth rate, simple linear regression, diversity indices such as the Herfindahl index and Simpson diversity index, instability analysis, and decomposition analysis. The results indicate an increase in cropping intensity, indicating agricultural intensification, with a shift towards wheat and rice monoculture from once diverse cropping patterns. The instability analysis reveals that wheat and rice emerge as the most stable crops in their area, production, and yield, while others exhibit instability, raising concerns about diminishing crop diversity and its implications for Punjab's natural resources. The study emphasizes the urgent necessity for sustainable agricultural practices and policies to counteract monoculture's adverse effects and ensure long-term agricultural resilience.

Synthesis of Triazolo[4',5':4,5]furo[2,3-c]pyridine via Post Modification of an Unusual Groebke-Blackburn-Bienaymé Multicomponent Reaction.

The Groebke-Blackburn-Bienaymé (GBB) reaction is a well-established three-component reaction for synthesizing imidazofused scaffolds from heterocyclic amidines, aldehydes, and isonitriles. However, the replacement of pyridoxal as an aldehyde component in this reaction results in the formation of the furo[2,3-c]pyridine skeleton as an "unusual GBB product". Despite the interesting nature of this unusual reaction, not much work was further reported. The present research investigates the optimization strategy for the synthesis of novel tricyclic triazolo[4',5':4,5]furo[2,3-c]pyridines via diazotization of 2,3-diamino-furo[2,3-c]pyridines specifically synthesized utilizing the chemistry of tert-alkyl isocyanide.

Autophagy and mitophagy as potential therapeutic targets in diabetic heart condition: Harnessing the power of nanotheranostics.

Autophagy and mitophagy pose unresolved challenges in understanding the pathology of diabetic heart condition (DHC), which encompasses a complex range of cardiovascular issues linked to diabetes and associated cardiomyopathies. Despite significant progress in reducing mortality rates from cardiovascular diseases (CVDs), heart failure remains a major cause of increased morbidity among diabetic patients. These cellular processes are essential for maintaining cellular balance and removing damaged or dysfunctional components, and their involvement in the development of diabetic heart disease makes them attractive targets for diagnosis and treatment. While a variety of conventional diagnostic and therapeutic strategies are available, DHC continues to present a significant challenge. Point-of-care diagnostics, supported by nanobiosensing techniques, offer a promising alternative for these complex scenarios. Although conventional medications have been widely used in DHC patients, they raise several concerns regarding various physiological aspects. Modern medicine places great emphasis on the application of nanotechnology to target autophagy and mitophagy in DHC, offering a promising approach to deliver drugs beyond the limitations of traditional therapies. This article aims to explore the potential connections between autophagy, mitophagy and DHC, while also discussing the promise of nanotechnology-based theranostic interventions that specifically target these molecular pathways.

Developing knowledge, attitude and practice questionnaire in desmoid tumours (KAPID study): applying e-Delphi to rare diseases.

Background: Rare diseases are associated with unique challenges encountered in diagnosis, treatment and conduct of clinical research. Desmoid tumour (DT) is one such ultra-rare malignancy about which awareness among medical professionals remains limited. We developed a questionnaire to assess knowledge, attitude and practice (KAP) among medical professionals on DT. Methods: E-Delphi method was used for the assessment of KAP for DT amongst clinical experts (experience of >/= 3 years in DT). 22 open-ended statements were developed by the core research group using current consensus guidelines. In round 1, experts provided subjective feedback which was incorporated into a 35-item questionnaire. Round 2 entailed experts giving feedback as a 5-point Likert scale classified into agreement (median score >/=4), neutral (median score 3) and disagreement (median score <3). Feedback from Round 2 was incorporated and questions with neutral consensus were modified. Questions in Round 3 achieved consensus if >/= 75% participants agreed. Results: 11 (64.7%) of 17 contacted experts responded in Round 1 including 6 (54.4%) who gave additional inputs and 5 (45.6%) who agreed to all statements. In round 2, 8 out of 11 experts responded to the 35-item questionnaire on knowledge (n = 16), attitude (n = 8) and practice (n = 11). 32 questions obtained agreement and 3 (8.5%) had neutral consensus. These were modified for round 3, in which consensus on 2 (66.6%) was attained. The final questionnaire comprises 34 items with 15, 8 and 11 questions on in the sections of knowledge, attitude and practice (KAP), respectively.

Amaranthus crop for food security and sustainable food systems.

MAIN CONCLUSION: This review ascertains amaranth grains as a potent crop for food security and sustainable food systems by highlighting its agricultural advantages, health benefits and applications in the food, packaging, and brewing industry. The global population surge and rapidly transitioning climatic conditions necessitate the maximization of nutritional crop yield to mitigate malnutrition resulting from food and nutrition insecurity. The modern agricultural practices adopted to maximize the yield of the conventional staple crops are heavily contingent on the depleting natural resources and are contributing extensively to the contamination of these natural resources. Furthermore, these agricultural practices are also causing detrimental effects on the environment like rising emission of greenhouse gasses and increased water footprints. To address these challenges while ensuring sustainable nutrient-rich crop production, it is imperative to utilize underutilized crops like Amaranthus. Amaranth grains are gluten-free pseudo-cereals that are gaining much prominence owing to their abundance in vital nutrients and bio-active components, potential health benefits, resilience to adverse climatic and soil conditions, minimum agricultural input requirements, potential of generating income for small holder farmers as well as various applications across the sustainable value chain. However, due to the limited awareness of these potential benefits of the amaranth grains among the consumers, researchers, and policymakers, they have remained untapped. This review paper enunciates the nutritional composition and potential health benefits of the grains while briefly discussing their various applications in food and beverage industries and accentuating the need to explore further possibilities of valorizing amaranth grains to maximize their utilization along the value chain.

Emerging Trends in Bilosomes as Therapeutic Drug Delivery Systems.

In recent years, there has been a notable surge in the utilization of stabilized bile acid liposomes, chemical conjugates, complexes, mixed micelles, and other drug delivery systems derived from bile acids, often referred to as bilosomes. The molecular structure and interactions of these amphiphilic compounds provide a distinctive and captivating subject for investigation. The enhanced stability of new generation bilosomes inside the gastrointestinal system results in the prevention of drug degradation and an improvement in mucosal penetration. These characteristics render bilosomes to be a prospective nanocarrier for pharmaceutical administration, prompting researchers to investigate their potential in other domains. This review paper discusses bilosomes that have emerged as a viable modality in the realm of drug delivery and have significant promise for use across several domains. Moreover, this underscores the need for additional investigation and advancement in order to comprehensively comprehend the prospective uses of bilosomes and their effectiveness in the field of pharmaceutical administration. This review study explores the current scholarly attention on bilosomes as prospective carriers for drug delivery. Therapeutic areas where bilosomes have shown outstanding performance in terms of drug delivery are outlined in the graphical abstract.

Unravelling the therapeutic potential of forkhead box proteins in breast cancer: An update (Review).

Breast cancer, a prominent cause of mortality among women, develops from abnormal growth of breast tissue, thereby rendering it one of the most commonly detected cancers in the female population. Although numerous treatment strategies are available for breast cancer, discordance in terms of effective treatment and response still exists. Recently, the potential of signaling pathways and transcription factors has gained substantial attention in the cancer community; therefore, understanding their role will assist researchers in comprehending the onset and advancement of breast cancer. Forkhead box (FOX) proteins, which are important transcription factors, are considered crucial regulators of various cellular activities, including cell division and proliferation. The present study explored several subclasses of FOX proteins and their possible role in breast carcinogenesis, followed by the interaction between microRNA (miRNA) and FOX proteins. This interaction is implicated in promoting cell infiltration into surrounding tissues, ultimately leading to metastasis. The various roles that FOX proteins play in breast cancer development, their intricate relationships with miRNA, and their involvement in therapeutic resistance highlight the complexity of breast cancer dynamics. Therefore, recognizing the progress and challenges in current treatments is crucial because, despite advancements, persistent disparities in treatment effectiveness underscore the need for ongoing research, with future studies emphasizing the necessity for targeted strategies that account for the multifaceted aspects of breast cancer.

Developmental events in the mandibular salivary gland of Indian sheep (Ovis aries): Morphological and histochemical studies.

At 22nd day of fetal development, the primordial anlage of mandibular gland was first noticed as a solid epithelial bud from oral epithelium. The terminal buds were arranged in the form of clusters with undifferentiated epithelial cells and terminated in a bulb like structure in 28-day-old fetus. The lumenization and branching of the main cord was noticed at 35th day. The primary septa, which divide the glandular mass into lobes was observed from 53rd day onwards which resulted in the formation of distinct lobulation at 58th day. At 61st day, the capsule formation was initiated by the aggregation of mesenchymal tissue. The terminal tubules differentiated to form the secretory end pieces and the tubular portion leads to the formation of intercalated and striated ducts at 98th day. Predominantly mucous types of acinar cells were seen from 108th day onwards. The number of lobules increased with steep increase in parenchyma from 128th day onwards. Micrometrical studies revealed that the mean diameter of acinar cells and all ducts was increased with the advancement of age and the significant differences were observed between groups. Localization of acidic and neutral mucopolysaccharides was observed in mucous cells and goblet cells. RESEARCH HIGHLIGHTS: The primordial anlage of mandibular salivary gland was seen at 22nd day. Lobulation of gland was appeared at 53rd day of development, however; it was completed at 58th day. At 98th day, the terminal tubules differentiated to form the secretory end pieces. The parenchyma of the gland showed predominantly mucous type of cells from 108th day onwards. Myoepithelial cells were first appeared as flattened basal cells initially around the developing acinar cells at 132nd day. Localization of acidic as well as neutral mucopolysaccharides was observed in mucous cells and goblet cells. Fine lipid droplets were observed in intralobular as well as interlobular connective tissue, however; phospholipids were observed in the cell membrane of secretory cells and ducts.

Unveiling novel metabolic alterations in postmenopausal osteoporosis and type 2 diabetes mellitus through NMR-based metabolomics: A pioneering approach for identifying early diagnostic markers.

BACKGROUND AND AIMS: Postmenopausal osteoporosis (PMO) and type 2 diabetes mellitus (T2DM) frequently coexist in postmenopausal women. The study aimed to explore metabolic variations linked to these circumstances and their simultaneous presence through proton nuclear magnetic resonance metabolomics (1H NMR). MATERIALS AND METHODS: Serum samples from 80 postmenopausal women, including 20 PMO individuals, 20 T2DM, 20 T2DM + PMO, and 20 healthy postmenopausal women, were analyzed using 1H NMR spectroscopy. RESULTS: Our study revealed significant metabolic profile differences among the four groups. Notably, the T2DM + PMO group showed elevated levels of alanine, pyruvate, glutamate, lactate, and aspartate, indicating their involvement in lipid metabolism, energy, and amino acids. Importantly, our multivariate statistical analysis identified a metabolite set that accurately distinguished the groups, suggesting its potential as an early diagnostic marker. CONCLUSION: The 1H NMR metabolomics approach uncovered metabolic biomarkers intricately linked to postmenopausal osteoporosis (PMO), type 2 diabetes mellitus (T2DM), and their concurrent presence. Among these biomarkers, alanine emerged as a pivotal player, showing its significant role in the metabolic landscape associated with PMO and T2DM. These findings shed light on the pathophysiological mechanisms underlying these conditions and underscore alanine's potential as a diagnostic biomarker.

Postoperative complications after surgery for lumbar spinal stenosis, assessment using two different data sources.

PURPOSE: Lumbar spinal stenosis (LSS) is a prevalent disorder, and surgery for LSS is a common procedure. Postoperative complications occur after any surgery and impose costs for society and costs and additional morbidity for patients. Since complications are relatively rare, medical registries of large populations may provide valuable knowledge. However, recording of complications in registries can be incomplete. To better estimate the true prevalence of complications after LSS surgery, we reviewed two different sources of data and recorded complications for a sample of Norwegian LSS patients. METHODS: 474 patients treated surgically for LSS during 2015 and 2016 at four hospitals reported to a national spine registry (NORspine). Postoperative complications were recorded by patients in NORspine, and we cross-referenced complications documented in NORspine with the patients´ electronic patient records (EPR) to re-test the complication rates. We performed descriptive statistics of complication rates using the two different data sources above, and analyzed the association between postoperative complications and clinical outcome with logistic regression. RESULTS: The mean (95%CI) patient age was 66.3 (65.3-67.2) years, and 254 (53.6%) were females. All patients were treated with decompression, and 51 (10.7%) received an additional fusion during the index surgery. Combining the two data sources, we found a total rate for postoperative complications of 22.4%, the NORspine registry reported a complication rate of 15.6%, and the EPR review resulted in a complication rate of 16.0%. However, the types of complications were inconsistent across the two data sources. According to NORspine, the frequency of reoperation within 90 days was 0.9% and according to EPR 3.4%. The rates of wound infection were for NORspine 3.1% and EPR review 2.1%. There was no association between postoperative complication and patient reported outcome. CONCLUSION: Postoperative complications occurred in 22% of LSS patients. The frequency of different postoperative complications differed between the two data sources.

Health-related quality of life, psychological issues and concerns among sarcoma survivors: a mixed method study.

Purpose: We aimed to explore the health-related quality of life (HRQoL), psychological issues and concerns among sarcoma survivors in India and assess their satisfaction with nursing care. Methods: This study employed a sequential mixed-methods design, enrolling 100 sarcoma survivors from July to December 2021, with data collected using standardised questionnaires for HRQoL, depression, anxiety, stress, cognitive impairment and self-structured satisfaction with nursing care. Qualitative data were gathered through focused group discussions. Results: The mean global health score among sarcoma survivors was 79.48 ± 16.26. A significant number of survivors had symptoms of mild-to-moderate depression (30%), severe anxiety (12%), stress (16%) and mild cognitive impairment (5%). Significant mean rank differences were observed between anxiety and financial difficulty (p < 0.05), emotional functioning (p < 0.001), cognitive functioning (p < 0.001), pain (<0.05), insomnia (p < 0.001), fatigue (p < 0.001), anorexia (p < 0.05) and nausea/vomiting (p < 0.001). Educational qualification had a significant association with depression and anxiety while family history of cancer emerged as a significant factor associated with anxiety and stress among survivors. Qualitative analysis revealed themes related to body image, societal discrimination, socio-economic impact, marriage concerns and fertility issues. Survivor satisfaction with nursing care was good. Conclusion: A substantial number of sarcoma survivors had an average HRQoL and experienced depression, anxiety and stress. Our study emphasizes the importance of holistic survivorship care, involving nurses in post-treatment support, and addressing societal discrimination and psychosocial concerns to enhance their quality of life. Implications for cancer survivors: Our study calls for a holistic approach to sarcoma survivor care and emphasizes the importance of personalised survivorship care plans led by nurses to address the diverse needs of sarcoma survivors in India. Such plans should encompass strategies for managing depression, anxiety and stress, along with addressing body image concerns and social support.

Simulation in contemporary medical education: Current practices and the way forward.

Integration of theoretical knowledge and practical skills is critical for effective medical education. Simulation is crucial in bridging the gap to prepare medical professionals for high-quality patient care in a safe environment. Simulation-based teaching has become the standard practice in medical education, especially in postgraduate courses like Anaesthesia. However, undergraduate medical education and other doctoral courses are still nascent. In line with the current National Medical Commission guidelines, it is imperative to complement the existing curriculum with a simulation-based approach as early as the first year of medical school. This review focuses on the current practices related to simulation-based medical education during undergraduate and postgraduate courses, particularly on anaesthesiology. We aim to discuss different types of simulation, the advantages of integration, students' perspectives, and the role of simulation in assessment and feedback. Finally, recommendations for future advancements of simulation in medical education and the way forward will be laid.

The role of private healthcare sector actors in health service delivery and financing policy processes in low-and middle-income countries: a scoping review.

The expansion of the private healthcare sector in some low-income and middle-income countries (LMICs) has raised key questions and debates regarding the governance of this sector, and the role of actors representing the sector in policy processes. Research on the role played by this sector, understood here as private hospitals, pharmacies and insurance companies, remains underdeveloped in the literature. In this paper, we present the results of a scoping review focused on synthesising scholarship on the role of private healthcare sector actors in health policy processes pertaining to health service delivery and financing in LMICs. We explore the role of organisations or groups-for example, individual companies, corporations or interest groups-representing healthcare sector actors, and use a conceptual framework of institutions, ideas, interests and networks to guide our analysis. The screening process resulted in 15 papers identified for data extraction. We found that the literature in this domain is highly interdisciplinary but nascent, with largely descriptive work and undertheorisation of policy process dynamics. Many studies described institutional mechanisms enabling private sector participation in decision-making in generic terms. Some studies reported competing institutional frameworks for particular policy areas (eg, commerce compared with health in the context of medical tourism). Private healthcare actors showed considerable heterogeneity in their organisation. Papers also referred to a range of strategies used by these actors. Finally, policy outcomes described in the cases were highly context specific and dependent on the interaction between institutions, interests, ideas and networks. Overall, our analysis suggests that the role of private healthcare actors in health policy processes in LMICs, particularly emerging industries such as hospitals, holds key insights that will be crucial to understanding and managing their role in expanding health service access.

Histomorphogenesis of sublingual salivary gland of Indian sheep.

The primordial anlage of sublingual gland was first noticed as a solid epithelial bud from oral epithelium at the 24th day of foetal development. The terminal buds were arranged in the form of clusters with undifferentiated epithelial cells and terminated in a bulb-like structure in the 30-day-old sheep foetus. On the 37th day, lumenization and branching of the main cord was noticed. The primary septa were observed from the 55th day onwards which resulted in the formation of lobulation on the 60th day. The capsule formation was initiated by aggregation of mesenchymal tissue on the 63rd day. On the 100th day, terminal tubules differentiated to form secretory end pieces. Tubular portions formed intercalated and striated ducts. Predominantly mucous type of acinar cells was seen from the 110th day onwards with myoepithelial cells. The number of lobules increased with increase in parenchyma from 130th day onwards. Micrometrical studies revealed that the mean diameter of acini, intercalated, striated and large ducts was increased with advancement of age and significant differences were observed between groups. Localization of acidic and neutral mucopolysaccharides were observed in mucous and goblet cells. Fine lipid droplets were observed in intralobular and interlobular connective tissue however, phospholipids were observed in cell membrane of acini and ducts. The current investigation provides microstructural standards for the organogenesis of the sublingual gland of miniature sheep and can lay the foundation for further studies in the morphological investigation of salivary gland development.

Patient-reported cognitive impairments and objective neuropsychological deficits in young sarcoma patients undergoing chemotherapy and its comparison to healthy controls: A tertiary health care study from India.

The study aims to investigate the patient-reported cognitive deficits and objective neuropsychological functions in younger adult (YA) sarcoma patients (16-40 years of age). Ninety patients and 30 age-matched healthy controls from a single tertiary healthcare hospital, were recruited into four groups: Pre-chemotherapy (Pre Cx), During chemotherapy (During Cx), Post-chemotherapy (Post Cx) and Controls. Neurocognitive functions were assessed subjectively using FACT-Cog v3 questionnaire; objectively using ACE-III and neuropsychological tests (NPT). FACT-Cog scores of During Cx (P = .041) and Post Cx (P = .008) groups were significantly lower than Pre Cx group. ACE-III scores of During Cx (P = .048) and Post Cx (P = .043) groups were lower as compared to Pre Cx group. In addition, reaction times and accuracies of the NPT (Flanker's, Sternberg's and Emotional Stroop tests) were worse (P < .05) in During Cx and Post Cx groups as compared to either Pre Cx or control groups. In the Post Cx group, the dose of chemotherapy showed significant negative correlation with the Sternberg reaction time (P = .040) as well as the scores of language (P = .047), and attention (P = .044) domains of ACE-III. Observations demonstrate that cancer/chemotherapy-related neurocognitive deficits fail to improve even after cessation of treatment, and high dosage of chemotherapy used, could be an underlying factor. This emphasizes the need for developing 'model of care' in these patients for monitoring the side effects, and possible titration in the therapeutic regimen for sarcoma in YA.