Expression of p120 - catenin in oral squamous cell carcinoma and apparently normal mucosa adjacent to oral squamous cell carcinoma.

Background: An essential molecular occurrence in carcinogenesis that can lead to invasion and migration, predisposing cells to malignant transformation, involves alterations in cell adhesion molecules, such as p120 catenin. The destabilization of E-cadherin, caused by the loss or phosphorylation of p120 catenin (p120), regulates cadherin stability and turnover, impacting cell adhesiveness and migratory capacity. Consequently, p120 is associated with the invasiveness and progression of various human epithelial tumor types, including Oral Squamous Cell Carcinomas (OSCC). The present study aimed to assess and establish a correlation between the expression of p120 antibody in OSCC and Apparently Normal Mucosa Adjacent to OSCC (ANMAOSCC). Material and Methods: The immunoexpression of p120 in 300 selected cases was categorized into two groups: OSCC (n = 150) and ANMAOSCC (n = 150). Two 4µm-thick tissue sections from the selected blocks were prepared. One section was stained with Hematoxylin and Eosin, while the other underwent immunohistochemical (IHC) staining using anti-p120 catenin antibody (clone No. EP66; Catalog No. PR062; PathnSitu, Wayne, PA, USA). The analysis of p120 immunoexpression included parameters such as intensity, percentage, and the location of staining. Results: In OSCC, over 80% of cases expressed p120, with only 16% exhibiting loss of expression. In ANMAOSCC, all cells maintained p120 expression. In OSCC, p120 was predominantly localized to the membrane and cytoplasm in 76%, while in ANMAOSCC, over 90% showed membrane localization. Regarding positivity, only 19% of OSCC cases reported positivity in >50% of cells, compared to 64.7% in ANMAOSCC. The extent of staining in ANMAOSCC was observed up to the granular layer (45%) and corneal layer (19%). Conclusions: The atypical staining pattern of p120 may indicate a loss of adhesion and could serve as a marker for identifying the malignant potential of ANMAOSCC and the aggressiveness of OSCC. Key words:Oral Squamous Cell Carcinoma, P120 Catenin, Cell Adhesion Molecules, Gene Expression Regulation.

Core outcome sets for trials of interventions to prevent and to treat multimorbidity in low- and middle-income countries: the COSMOS study.

Introduction: The burden of multimorbidity is recognised increasingly in low- and middle-income countries (LMICs), creating a strong emphasis on the need for effective evidence-based interventions. A core outcome set (COS) appropriate for the study of multimorbidity in LMIC contexts does not presently exist. This is required to standardise reporting and contribute to a consistent and cohesive evidence-base to inform policy and practice. We describe the development of two COS for intervention trials aimed at the prevention and treatment of multimorbidity in LMICs. Methods: To generate a comprehensive list of relevant prevention and treatment outcomes, we conducted a systematic review and qualitative interviews with people with multimorbidity and their caregivers living in LMICs. We then used a modified two-round Delphi process to identify outcomes most important to four stakeholder groups with representation from 33 countries (people with multimorbidity/caregivers, multimorbidity researchers, healthcare professionals, and policy makers). Consensus meetings were used to reach agreement on the two final COS. Registration: https://www.comet-initiative.org/Studies/Details/1580. Results: The systematic review and qualitative interviews identified 24 outcomes for prevention and 49 for treatment of multimorbidity. An additional 12 prevention, and six treatment outcomes were added from Delphi round one. Delphi round two surveys were completed by 95 of 132 round one participants (72.0%) for prevention and 95 of 133 (71.4%) participants for treatment outcomes. Consensus meetings agreed four outcomes for the prevention COS: (1) Adverse events, (2) Development of new comorbidity, (3) Health risk behaviour, and (4) Quality of life; and four for the treatment COS: (1) Adherence to treatment, (2) Adverse events, (3) Out-of-pocket expenditure, and (4) Quality of life. Conclusion: Following established guidelines, we developed two COS for trials of interventions for multimorbidity prevention and treatment, specific to LMIC contexts. We recommend their inclusion in future trials to meaningfully advance the field of multimorbidity research in LMICs.

Is Tobacco Use Associated With Risk of Recurrence and Mortality Among People With TB?: A Systematic Review and Meta-Analysis.

BACKGROUND: Associations between tobacco use and poor TB treatment outcomes are well documented. However, for important outcomes such as TB recurrence or relapse and mortality during treatment, as well as for associations with smokeless tobacco (ST), the evidence is not summarized systematically. RESEARCH QUESTION: Is tobacco use associated with risk of poor treatment outcomes among people with TB? STUDY DESIGN AND METHODS: The MEDLINE, Embase, and Cumulative Index of Nursing and Allied Health Literature databases were searched on November 22, 2021. Epidemiologic studies reporting associations between tobacco use and at least one TB treatment outcome were eligible. Independent double-screening, extractions, and quality assessments were undertaken. Random effects meta-analyses were conducted for the two primary review outcomes (TB recurrence or relapse and mortality during treatment), and heterogeneity was explored using subgroups. Other outcomes were synthesized narratively. RESULTS: Our searches identified 1,249 records, of which 28 were included in the meta-analyses. Based on 15 studies, higher risk of TB recurrence or relapse was found with ever using tobacco vs never using tobacco (risk ratio [RR], 1.78; 95% CI, 1.31-2.43; I2 = 85%), current tobacco use vs no tobacco use (RR, 1.95; 95% CI, 1.59-2.40; I2 = 72%), and former tobacco use vs never using tobacco (RR, 1.84; 95% CI, 1.21-2.80; I2 = 4%); heterogeneity arose from differences in study quality, design, and participant characteristics. Thirty-eight studies were identified for mortality, of which 13 reported mortality during treatment. Ever tobacco use (RR, 1.55; 95% CI, 1.32-1.81; I2 = 0%) and current tobacco use (RR, 1.51; 95% CI, 1.09-2.10; I2 = 87%) significantly increased the likelihood of mortality during treatment among people with TB compared with never using tobacco and not currently using tobacco, respectively; heterogeneity was explained largely by differences in study design. Almost all studies in the meta-analyses scored high or moderate on quality assessments. Narrative synthesis showed that tobacco use was a risk factor for other unfavorable TB treatment outcomes, as previously documented. Evidence on ST was limited, but identified studies suggested an increased risk for poor outcomes with its use compared with not using it. INTERPRETATION: Tobacco use significantly increases the risk of TB recurrence or relapse and mortality during treatment among people with TB, highlighting the need to address tobacco use to improve TB outcomes. TRIAL REGISTRY: PROSPERO; No.: CRD42017060821; URL: https://www.crd.york.ac.uk/prospero/.

Correlation of dental pain and pain catastrophizing with oral health status among physically disabled.

Background: Physical disability results in impaired mobility, leading to increased dependency on others and may also have a negative impact on ones general and oral health. Moreover, such individuals could be at a greater risk of being prone to chronic pain conditions. A person's ability to cope with pain is a consistent and one of the most important predictors of clinical outcome. Catastrophization is known to be a maladaptive coping behaviour that could negatively influence such outcomes. Material and Methods: A cross-sectional study was conducted among 229 physically disabled individuals at Home for Disabled, Bansilalpet, Secunderabad. Extent of Physical disability was measured using Barthel index of Activities of Daily Living (ADL), type and severity of dental pain was assessed using the short form McGill Pain Questionnaire and catastrophizing using the Pain Catastrophizing Scale (PCS). Dentition status and periodontal status were assessed using the World Health Organization assessment form. Results: Caries prevalence of the population was 39.7% with a mean DMFT score of 2.8±4.09. Pain catastrophizing showed positive significant (p<0.05) correlation with sensory pain(r=0.182), visual analog scale(r=0.168), pain severity(r=0.161) and DMFT (r=0.4). It had significant negative correlation with ADL and bleeding gums. Conclusions: In this study it was apparent that irrespective of the dependency levels, dentition status had a significant effect on pain catastrophizing level of the individuals. Key words:Disability, Oral Health, Catastrophizing.

Efficacies of a locust bean gum polymer on the startup of a novel upflow anaerobic sludge blanket reactor treating municipal sewage.

The present study investigates the potential of locust bean gum (LBG), in accelerating the startup of a novel upflow anaerobic sludge blanket (UASB) reactor handling municipal sewage. Under identical conditions, two lab-scale UASB reactors were operated in parallel, to substantiate this idea. The novel reactor (RH) with an inner centric hybrid UASB module and an outer concentric downflow hanging sponge (DHS) unit started off with an LBG polymer as an additive. Its performance was compared with a conventional system (RC). RH outclassed with an accelerated startup in 40 days, with the highest COD removal of 89% by the UASB compartment and 95% by the entire system (UASB + DHS). RC took nearly 85 days to achieve the highest COD removal of 83%. The polymer also succeeded with a dense sludge bed fastening most of the anaerobes, read by the least sludge volume index (SVI) of 26 mL/g. Specific methanogenic activity (SMA) (RH - 0.715 ± 0.05 and RC - 0.670 ± 0.07 g CH4-COD/g VSS/ day) and extracellular polymer (ECP) concentration (0.30-0.32 g/g VSS) of biomass in both reactors were almost similar. This further confirmed that early granulation was induced solely by the polymer and it also had no deleterious impact on substrate transfer.

Implementation of the Community-based Health Planning and Services (CHPS) in rural and urban Ghana: a history and systematic review of what works, for whom and why.

Background: Despite renewed emphasis on strengthening primary health care globally, the sector remains under-resourced across sub-Saharan Africa. Community-based Health Planning and Services (CHPS) has been the foundation of Ghana's primary care system for over two decades using a combination of community-based health nurses, volunteers and community engagement to deliver universal access to basic curative care, health promotion and prevention. This review aimed to understand the impacts and implementation lessons of the CHPS programme. Methods: We conducted a mixed-methods review in line with PRISMA guidance using a results-based convergent design where quantitative and qualitative findings are synthesized separately, then brought together in a final synthesis. Embase, Medline, PsycINFO, Scopus, and Web of Science were searched using pre-defined search terms. We included all primary studies of any design and used the RE-AIM framework to organize and present the findings to understand the different impacts and implementation lessons of the CHPS programme. Results: N = 58 out of n = 117 full text studies retrieved met the inclusion criteria, of which n = 28 were quantitative, n = 27 were qualitative studies and n = 3 were mixed methods. The geographical spread of studies highlighted uneven distribution, with the majority conducted in the Upper East Region. The CHPS programme is built on a significant body of evidence and has been found effective in reducing under-5 mortality, particularly for the poorest and least educated, increasing use and acceptance of family planning and reduction in fertility. The presence of a CHPS zone in addition to a health facility resulted in increased odds of skilled birth attendant care by 56%. Factors influencing effective implementation included trust, community engagement and motivation of community nurses through salaries, career progression, training and respect. Particular challenges to implementation were found in remote rural and urban contexts. Conclusions: The clear specification of CHPS combined with a conducive national policy environment has aided scale-up. Strengthened health financing strategies, review of service provision to prepare and respond to pandemics, prevalence of non-communicable diseases and adaptation to changing community contexts, particularly urbanization, are required for successful delivery and future scale-up of CHPS. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214006, identifier: CRD42020214006.

A Study of Near-Death Experience in Patients With Chronic Kidney Disease.

BACKGROUND: The near-death experiences (NDE) in dialysis patients of our country have not been previously studied. The objective of this study is to investigate the characteristics of NDEs in patients on dialysis. MATERIALS AND METHODS: We performed a cross sectional study of the adult patients of chronic kidney disease stage 5 without dialysis and on dialysis who survived cardiac arrest by cardiopulmonary resuscitation (CPR) as per ACLS (Advanced Cardiac Life Support) guidelines and who sustained pulseless ventricular tachycardia/ventricular fibrillation and received CPR and/or direct cardioversion. We used two scales, Greyson's NDE scale and Ring's Weighted Core Experience Index (WCEI). RESULTS: We performed the study between 2016 and 2018. A total of 29 patients were included. The data based on Greyson's NDE scale and Ring's Weighted Core Experience Index (WCEI)were collected. CONCLUSIONS: Our study brings a perspective of NDE in CKD and dialysis patients. A similar study of NDE in dialysis patients should be considered by other nephrologists.

Performance evaluation of a novel upflow anaerobic sludge blanket reactor with built-in downflow hanging sponge module for the treatment of municipal sewage.

The present study investigates the potential of a novel upflow anaerobic sludge blanket (UASB) reactor with a built-in polishing facility for the treatment of municipal sewage. A laboratory-scale reactor, which combined an inner-centric hybrid UASB module and an outer concentric downflow hanging sponge (DHS) unit, was designed and fabricated as a part of this research work. The reactor had been continuously operated for 210 days under ambient conditions. With anaerobically digested sewage sludge (seed sludge blended with Locust bean gum polymer) as inoculum, the reactor attained a successful startup in 40 days. Ensuring startup, the reactor was employed under varying organic loading rates (OLR) from 0.87 to 5.09 kg COD/m3/d, with corresponding hydraulic retention times (HRT) of 24-4 h. The novel UASB reactor made its mark with a high COD and TSS removal of 93.2% and 93%, respectively, under the optimum conditions of 6-h HRT. In addition, biogas rich in methane content (68%), with a maximum specific yield of 0.42± 0.02 m3 biogas /kg COD destroyed, was generated. The VSS/TSS ratio observed a steady rise (0.51 to 0.75) with increasing sludge age, bearing witness to the active growth of biomass. Hence, in brief, the novel UASB reactor can be coined as an energy economic system with improved effluent quality.

Maturation of speech perception in noise abilities during adolescence.

BACKGROUND: Speech perception encompasses the perception of spectro-temporal cues. These cues include temporal envelope, temporal fine structure, and spectral shape of the signal. Extraction of these cues is essential for speech perception and, most importantly, for perceiving speech in the presence of noise (SPIN). Speech perception in noise scores improves with age in children and is crucial in their routine communications, including classroom learning. Though it is established that the speech perception in noise improves with age in children, the age at which SPIN scores become adult-like and the differences in the maturation pattern between the ears remains unclear. The present study aimed to assess and understand the maturation pattern of speech perception in noise abilities during adolescence. METHOD: The study included 146 participants who were divided into six crossectional age groups. Participants were in the age range of 10-15 years and adults of 18-19 years. SPIN was assessed for right and left ears for each of these sub-groups. The scores were compared across the different subgroups for both the ears. RESULTS: Results demonstrated that SPIN scores in the right ear were matured by the age of 10 years and were comparable with the right ear SPIN scores in adults. Pairwise comparison using Bonferroni's corrections for multiple comparisons of left ear SPIN scores revealed that SPIN scores in the left ear become adult-like between 13 and 14 years of age. DISCUSSION: Findings of the current study can be attributed to the morphological changes and differences in the developmental changes across the different regions of the cortex.

Career opportunities in periodontics: A road map to the future.

A solid career plan is crucial as it can provide a roadmap to the future. The motivating factors for selecting any career are complex, and periodontics is no exception. Periodontics is a dynamic profession that includes sophisticated treatment planning and a wide variety of treatment modalities ranging from conventional to advanced therapies. It is a unique branch of dentistry that enables both saving teeth and also replacing them in an effective way with implants. The purpose of this article is to provide an overview of various career opportunities for a periodontist. Career options in periodontics are manifold and diverse, enabling a periodontist a professionally gratifying and secure lifestyle. Future of the profession of periodontics appears exciting and rewarding but is not likely to happen without great effort and challenges. However, periodontics is not a static field and continues to evolve leaving a periodontist with no dearth in career opportunities.

A Policy Perspective on the Global Use of Smokeless Tobacco.

BACKGROUND: Globally, over 300 million people consume diverse smokeless tobacco (ST) products. They are addictive, cause cancer, increased cardiovascular mortality risks and poor pregnancy outcomes. PURPOSE OF REVIEW: To identify gaps in implementing key ST demand-reduction measures, focused literature reviews were conducted and findings synthesized according to relevant WHO Framework Convention on Tobacco Control (FCTC) Articles. RECENT FINDINGS: The literature supports implementation of ST demand-reduction measures. For taxation, labelling and packaging, most administrations have weaker policies for ST than cigarettes. Capacity to regulate ST contents and offer cessation support is lacking. There is poor compliance with bans on ST advertising, promotion and sponsorship. SUMMARY: The literature on implementation of WHO FCTC for ST is limited. Although strengths of ST demand-control activities are currently identifiable from available literature, full implementation of FCTC is lacking. A wider evidence-based response to WHO FCTC is proposed, particularly for countries facing the greatest disease burdens.

SAVINGS BY AND FOR THE POOR: A RESEARCH REVIEW AND AGENDA.

The poor can and do save, but often use formal or informal instruments that have high risk, high cost, and limited functionality. This could lead to undersaving compared to a world without market or behavioral frictions. Undersaving can have important welfare consequences: variable consumption, low resilience to shocks, and foregone profitable investments. We lay out five sets of constraints that may hinder the adoption and effective usage of savings products and services by the poor: transaction costs, lack of trust and regulatory barriers, information and knowledge gaps, social constraints, and behavioral biases. We discuss each in theory, and then summarize related empirical evidence, with a focus on recent field experiments. We then put forward key open areas for research and practice. JEL Codes: D12, D91, G21, O16.