In-hospital outcomes with extracorporeal membrane oxygenation alone versus combined with percutaneous left ventricular assist device.

BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (ECMO) is associated with increased afterload and hindered myocardial recovery. Adding a percutaneous left ventricular assist device (pLVAD) to ECMO is one strategy to unload the left ventricle. We evaluated in-hospital outcomes in cardiogenic shock patients treated with ECMO alone versus ECMO plus pLVAD. METHODS: We conducted a retrospective study using the National Inpatient Sample database from 2011 to 2019. Logistic regression analysis was performed to adjust for covariates. RESULTS: 20,171 patients were included. 16,064 (79.6 %) patients received ECMO alone and 4107 (20.4 %) patients received ECMO plus pLVAD. The ECMO plus pLVAD group had higher rates of mortality, stroke, acute kidney injury, pericardial complications, and vascular complications. After adjusting for covariates, combined therapy was associated with higher rates of mortality (OR 1.2; 95 % CI [1.1-1.3]) and stroke (OR 1.3; 95 % CI [1.2-1.5]), however lower bleeding (OR 0.7; 95 % CI [0.68-0.81]) (p < 0.001 for all). After adjusting for covariates, a subgroup analysis of 5019 patients with acute coronary syndrome cardiogenic shock (ACS-CS) demonstrated higher rates of mortality (OR 1.3; 95 % CI [1.2-1.5]) and stroke (OR 1.7; 95 % CI [1.4-2.1]; p < 0.001 for all) with combined therapy, however similar rates of bleeding compared to ECMO alone (OR 0.95; 95 % CI [0.8-1.1]; p = 0.54). CONCLUSIONS: In the overall group, ECMO plus pLVAD was associated with increased mortality and stroke, however decreased bleeding. In a sub-group of ACS-CS, ECMO plus pLVAD was associated with increased mortality and stroke, however similar rates of bleeding compared to ECMO alone.

Cephalometric Assessment of Differences in Soft Tissue and Dental Compensation in Skeletal Class II Div 1 Malocclusion.

Background: This study was conducted to evaluate the differences in soft tissue as well as dental compensation in skeletal Class II div 1 malocclusion. Methods and Materials: The study sample consists of pre-treatment lateral cephalograms of 100 subjects of both gender having skeletal Class II and dental Class II div 1 malocclusion visiting the Department of Orthodontics and Dentofacial Orthopaedics, Bharati Vidyapeeth Dental College, and Hospital Navi Mumbai. Cephalograms of the subjects fulfilling the inclusion criteria were included in this study. Results: This research was conducted to assess dental and soft tissue compensation in skeletal Class II div 1 malocclusion and comparative assessment of lip prominence measured from two soft tissue vertical reference lines. The 100 subjects selected randomly out of which 44 men and 56 women, age ranging from 18 to 35 years. Conclusion: ARNETT'S method and PROFFIT'S method showed statistically significant as P < 0.0001. PROFFIT'S method and LEGAN-BURSTONE'S method showed statistically significant as P < 0.0001.

Role of wearable devices in cardiac telerehabilitation: A scoping review.

BACKGROUND: Cardiac rehabilitation (CR) is an evidence-based comprehensive program that includes exercise training, health education, physical activity promotion, and extensive counseling for the management of cardiovascular risk factors. Wearable devices monitor certain physiological functions, providing biometric data such as heart rate, movement, sleep, ECG analysis, blood pressure, energy expenditure, and numerous other parameters. Recent evidence supports wearable devices as a likely relevant component in cardiovascular risk assessment and disease prevention. The purpose of this scoping review is to better understand the role of wearable devices in home-based CR (HBCR) and to characterize the evidence regarding the incorporation of wearable devices in HBCR programs and cardiovascular outcomes. METHODS & FINDINGS: We created a search strategy for multiple databases, including PubMed, Embase (Elsevier), CINAHL (Ebsco), Cochrane CENTRAL (Wiley), and Scopus (Elsevier). Studies were included if the patients were eligible for CR per Medicare guidelines and >18 years of age and if some type of wearable device was utilized during HBCR. Our search yielded 57 studies meeting all criteria. The studies were classified into 4 groups: patients with coronary heart disease (CHD) without heart failure (HF); patients with HF; patients with heart valve repair or replacement; and patients with exposure to center-based CR. In three groups, there was an upward trend toward improvement in quality of life (QOL) and peak VO2, less sedentary time, and an increase in daily step count in the intervention groups compared to control groups. CONCLUSIONS: HBCR using wearable devices can be a comparable alternative or adjunct to center-based CR for patients with CHD and HF. More studies are needed to draw conclusions about the comparability of HBCR to center-based CR in patients with heart valve repair or replacement.

Microcystic Meningioma - A Diagnostic Dilemma During Intraoperative Squash Smear Study.

Background: Meningiomas are generally slow-growing, benign, and non-infiltrating in nature. They are usually easy to diagnose cytologically if they are of the meningothelial type; however, they may cause diagnostic challenges when they manifest as unusual morphological variants, like the microcystic type. Because of the rarity of microcystic meningioma (MM), information on its cytological features is rarely available in the literature. Objectives: The goal of this study is to review the cytological features of MM in crush preparations prepared at the time of intra-op consultation and to identify the more common features which are helpful in rendering a correct diagnosis. Material and Methods: Cytological features of five cases of MM were reviewed and noted from the records. Results: There were five patients of MM with a male: female ratio of 1.5:1 and a mean age of 52 years. All tumors were supratentorial and dura-based. Magnetic resonance imaging (MRI) showed low signal intensity on T1 and high signal intensity on T2 weighted images in four cases. Cytosmears were moderate-to-highly cellular. There were variable-sized cystic spaces within the meningothelial cell clusters. In four cases, nuclear pleomorphism was frequently observed. Nuclear pseudoinclusions, atypical mitoses, vascular proliferation, and necrosis were absent in all cases. Whorling and psammoma bodies were seen in only one case. Conclusion: Cytological features identified would be helpful in the diagnosis of microcystic meningiomas, especially in unusual radiological findings. Their unusual cytological features might lead to problems in differential diagnosis from other intracranial tumors, including glioblastoma, metastatic tumor, etc.

The influence of conventional and novel blanching methods on potato granules, phytochemicals, and thermal properties of colored varieties.

Introduction: Colored potatoes comprise many bioactive compounds that potentially support human health. Polyphenols present in them have associated therapeutic benefits like antimutagenic and anticarcinogenic properties. Method: The current study aimed to explore the effects of different blanching methods (steam blanching, hot water blanching, and microwave-assisted blanching) on the phytochemical and structural aspects of PP-1901 and Lady Rosetta (LR) potato varieties. Changes in the antioxidant activity, color, total ascorbic acid, phenolic, and flavonoid content were based on the variations in parameters including temperature (blanching using hot water and steam) and capacity 100- 900 W (blanching using microwave). Results: For both PP-1901 and LR varieties, all the blanching methods led to a significant reduction in residual peroxidase activity, as well as affecting their color. The preservation of bioactive substances exhibited a microwave steam>hot water blanching trend. Blanching significantly increased the antioxidant activity of all the samples. Additionally, Fourier-transform infrared spectroscopy revealed that phytocompounds were retained to their maximum in microwave-blanched samples, especially at 300 W. The type of blanching method significantly affected the thermal properties of potatoes by disrupting the ordered structure of the matrix. Discussion: Microwaves at 300 W can be used as a novel and suitable alternative technique for blanching potatoes, which successfully retained the original quality of it in comparison to steam and hot water blanching.

Cerebral sparganosis masquerading brain neoplasm: A rare incidental case.

Sparganosis is a parasitic infection caused by plerocercoid larvae of the genera Spirometra. Cerebral sparganosis is one of its most serious complications wherein clinical and imaging findings may pose diagnostic challenge. Here we present a case of cerebral sparganosis which mimicked as brain tumour on clinicoradiological examination. The case is reported in view of its rarity in India and the need for awareness of the entity.

A Systematic Review on Metaheuristic Optimization Techniques for Feature Selections in Disease Diagnosis: Open Issues and Challenges.

There is a need for some techniques to solve various problems in today's computing world. Metaheuristic algorithms are one of the techniques which are capable of providing practical solutions to such issues. Due to their efficiency, metaheuristic algorithms are now used in healthcare data to diagnose diseases practically and with better results than traditional methods. In this study, an efficient search has been performed where 173 papers from different research databases such as Scopus, Web of Science, PubMed, PsycINFO, and others have been considered impactful in diagnosing the diseases using metaheuristic techniques. Ten metaheuristic techniques have been studied, which include spider monkey, shuffled frog leaping algorithm, cuckoo search algorithm, ant lion technique of optimization, lion optimization technique, moth flame technique, bat-inspired algorithm, grey wolf algorithm, whale optimization, and dragonfly technique of optimization for selecting and optimizing the features to predict heart disease, Alzheimer's disease, brain disorder, diabetes, chronic disease features, liver disease, covid-19, etc. Besides, the framework has also been shown to provide information on various phases behind the execution of metaheuristic techniques to predict diseases. The study's primary goal is to present the contribution of the researchers by demonstrating their methodology to predict diseases using the metaheuristic techniques mentioned above. Later, their work has also been compared and evaluated using accuracy, precision, F1 score, error rate, sensitivity, specificity, an area under a curve, etc., to help the researchers to choose the right field and methods for predicting the diseases in the future.

Machine Learning and Deep Learning Based Time Series Prediction and Forecasting of Ten Nations' COVID-19 Pandemic.

In the paper, the authors investigated and predicted the future environmental circumstances of a COVID-19 to minimize its effects using artificial intelligence techniques. The experimental investigation of COVID-19 instances has been performed in ten countries, including India, the United States, Russia, Argentina, Brazil, Colombia, Italy, Turkey, Germany, and France using machine learning, deep learning, and time series models. The confirmed, deceased, and recovered datasets from January 22, 2020, to May 29, 2021, of Novel COVID-19 cases were considered from the Kaggle COVID dataset repository. The country-wise Exploratory Data Analysis visually represents the active, recovered, closed, and death cases from March 2020 to May 2021. The data are pre-processed and scaled using a MinMax scaler to extract and normalize the features to obtain an accurate prediction rate. The proposed methodology employs Random Forest Regressor, Decision Tree Regressor, K Nearest Regressor, Lasso Regression, Linear Regression, Bayesian Regression, Theilsen Regression, Kernel Ridge Regressor, RANSAC Regressor, XG Boost, Elastic Net Regressor, Facebook Prophet Model, Holt Model, Stacked Long Short-Term Memory, and Stacked Gated Recurrent Units to predict active COVID-19 confirmed, death, and recovered cases. Out of different machine learning, deep learning, and time series models, Random Forest Regressor, Facebook Prophet, and Stacked LSTM outperformed to predict the best results for COVID-19 instances with the lowest root-mean-square and highest R 2 score values.

Enhanced functionality and shelf stability of burfi by incorporating kinnow (mandarin) fruit juice.

Burfi, an Indian traditional dairy dessert is highly popular, however, its low nutritive value and poor shelf life limits commercial viability. Kinnow juice was utilized to improve the phytonutritional profile and shelf stability of burfi. To further improve the quality, pectin was added at different concentrations (1-4%). Compared to control, inclusion of kinnow juice significantly (p < 0.05) improved minerals and phytochemical constituents as confirmed using FTIR analysis. Developed burfi presented a softer texture which was consistent with SEM results. Increasing the pectin levels, increased textural properties of kinnow burfi while decreased moisture content and water activity, without affecting color and nutritional properties. Based on desirable sensory and textural properties, kinnow burfi prepared with pectin (4% of added sugar) was selected for product development and evaluation of shelf life under room (25 ± 2 °C) and refrigerated (4 ± 2 °C) conditions. Irrespective of storage temperatures, moisture content and bioactive constituents decreased while titratable acidity, total and reducing sugars, free fatty acids, hardness of texture, and yeast and mould count increased significantly. Except moisture, the extent of quality changes was rapid at room temperature. The product showed high sensory acceptability as well as microbial safety up to 21 days at room temperature and 28 days under refrigeration.

Assessment of Impact of Fluoride on Mechanical Properties of NiTi and CuNiTi Orthodontic Archwires: An In Vitro Study.

AIM: The current study was carried out to assess the impact on the mechanical properties of orthodontic wires such as the nickel-titanium (NiTi) and copper-nickel-titanium (CuNiTi) wires by fluoride available in various prophylactic products. MATERIALS AND METHODS: Fifty-six wire specimens were randomly divided into two groups-control group in which deionized water was used as a medium and study group in which Phos-Flur gel was used. Both study group and control group were divided into two subgroups-NiTi wire group: 0.019 × 0.025 inch NiTi archwires (14 specimens) and CuNiTi wire group: 0.019 × 0.025 inch CuNiTi archwires (14 specimens). Testing of all the wires was done under a universal force testing machine. RESULTS: Mean loading force among NiTi wire group and CuNiTi wire group specimens with deionized water as a medium was 682.6 and 397.4 MPa, respectively, while the mean loading force among NiTi wire group and CuNiTi wire group specimens with Phos-Flur gel as a medium was 596.1 and 368.4 MPa, respectively. While comparing between study group and control group among NiTi wires, significant results were obtained. Also, while comparing between study group and control group among CuNiTi wires, significant results were obtained. CONCLUSION: Following exposure to fluoride agents, NiTi wires and CuNiTi wires are significantly associated with reduced mechanical properties. CLINICAL SIGNIFICANCE: Although fluoride acts as a vital adjunct in maintaining oral hygiene, particularly among patients undergoing fixed orthodontic treatment, its influence on the mechanical properties of the wires is an area to be explored further; thereby, its use is to be monitored.

Developmental Lead Exposure in Rats Causes Sex-Dependent Changes in Neurobiological and Anxiety-Like Behaviors that Are Improved by Taurine Co-treatment.

Lead (Pb2+) is a developmental neurotoxicant that causes alterations in the brain's excitation-to-inhibition (E/I) balance by disrupting the development of the GABAergic systems. These GABAergic disruptions have persistent neurobiological and neurobehavioral structure-function relationships that can be examined using animal models of Pb2+ exposure. Further, taurine, a GABA-AR agonist, has been shown to offer neuroprotection against neurodevelopmental Pb2+ exposure and senescence. The present study evaluated the effects of Pb2+ exposure (i.e., at 150 ppm and 1,000 ppm doses) on Long Evans hooded rats during the perinatal period of development on locomotor activity in the open field (OF) and anxiety-like behaviors in the elevated plus maze (EPM). This was followed by an examination of brain mass using an encephalization quotient (EQ) and isotropic fractionation (ITF) of total cells and the number of neurons and non-neuronal cells in the prefrontal cortex, hippocampus, and diencephalon. The results suggest that neurodevelopmental Pb2+ exposure caused persistent anxiety-like behaviors in both the OF and EPM with associated changes in EQ, but not ITF-determined cell density. Further, taurine treatment was observed to compensate for Pb2+ exposure in the behavioral assessments although precise neurobiological mechanisms remain unknown. Thus, more work is required to evaluate the role of taurine and other anxiolytic compounds in the alleviation of neurotoxicant-induced neurobehavioral syndromes and their associated neurobiological correlates.

Taurine-Derived Compounds Produce Anxiolytic Effects in Rats Following Developmental Lead Exposure.

Lead (Pb2+) is a developmental neurotoxicant that disrupts the GABA-shift and subsequently causes alterations in the brain's excitation-to-inhibition (E/I) balance. Taurine is a well-established neuroprotective and inhibitory compound for regulating brain excitability. Since mechanistically taurine can facilitate neuronal inhibition through the GABA-AR, the present study examined the anxiolytic potential of taurine derivatives. Treatment groups consisted of the following developmental Pb2+-exposures: Control (0 ppm) and Perinatal (150 ppm or 1,000 ppm lead acetate in the drinking water). Rats were scheduled for behavioral tests between postnatal days (PND) 36-45 with random drug assignments to either saline, taurine, or taurine-derived compound (TD-101, TD-102, or TD-103) to assess the rats' responsivity to each drug in mitigating the developmental Pb2+-exposure and anxiety-like behaviors through the GABAergic system. Long-Evans hooded rats were assessed using an open field (OF) test for preliminary locomotor assessment. Twenty-four hours later, the same rats were exposed to the elevated plus maze (EPM) and were given an i.p. injection of 43 mg/Kg of the saline, taurine, or TD drugs 15 min prior to testing. Each rat was tested using the triple-blind random assignment method for each drug condition. The OF data revealed that Control female rats had increased locomotor activity over Control male rats, and the Pb2+-exposed males and females had increased locomotor activity when compared to the Control male and female rats. However, in the EPM, the Control female rats exhibited more anxiety-like behaviors over Control male rats, and the Pb2+-exposed male and female rats showed selective responsivity to TD drugs when compared to taurine. For Pb2+-exposed males, TD-101 showed consistent recovery of anxiety-like behaviors similar to that of taurine regardless of Pb2+ dose, whereas in Pb2+-exposed females TD-101 and TD-103 showed greater anxiolytic responses in the EPM. The results from the present psychopharmacological study suggests that taurine and its derivatives are interesting drug candidates to explore sex-specific mechanisms and actions of taurine and the associated GABAergic receptor properties by which these compounds alleviate anxiety as a potential behavioral pharmacotherapy for neurodevelopmental Pb2+ exposure.

Malaria disrupts the rhesus macaque gut microbiome.

Previous studies have suggested that a relationship exists between severity and transmissibility of malaria and variations in the gut microbiome, yet only limited information exists on the temporal dynamics of the gut microbial community during a malarial infection. Here, using a rhesus macaque model of relapsing malaria, we investigate how malaria affects the gut microbiome. In this study, we performed 16S sequencing on DNA isolated from rectal swabs of rhesus macaques over the course of an experimental malarial infection with Plasmodium cynomolgi and analyzed gut bacterial taxa abundance across primary and relapsing infections. We also performed metabolomics on blood plasma from the animals at the same timepoints and investigated changes in metabolic pathways over time. Members of Proteobacteria (family Helicobacteraceae) increased dramatically in relative abundance in the animal's gut microbiome during peak infection while Firmicutes (family Lactobacillaceae and Ruminococcaceae), Bacteroidetes (family Prevotellaceae) and Spirochaetes amongst others decreased compared to baseline levels. Alpha diversity metrics indicated decreased microbiome diversity at the peak of parasitemia, followed by restoration of diversity post-treatment. Comparison with healthy subjects suggested that the rectal microbiome during acute malaria is enriched with commensal bacteria typically found in the healthy animal's mucosa. Significant changes in the tryptophan-kynurenine immunomodulatory pathway were detected at peak infection with P. cynomolgi, a finding that has been described previously in the context of P. vivax infections in humans. During relapses, which have been shown to be associated with less inflammation and clinical severity, we observed minimal disruption to the gut microbiome, despite parasites being present. Altogether, these data suggest that the metabolic shift occurring during acute infection is associated with a concomitant shift in the gut microbiome, which is reversed post-treatment.

The Rare Cases of Parotid Gland Arteriovenous Malformations.

Arteriovenous malformation (AVM) results from errors in vascular development during embryogenesis; absent capillary beds lead to shunting directly from the arterial to venous circulation. Although it is common in the head and neck region, AVMs located in the parotid gland are quite rare. Here, we report two cases of arteriovenous malformation of the parotid gland that presented to our out-patient setup with swelling in the parotid region and were diagnosed as arteriovenous malformation on histopathological study after surgical resection.

Assessment of Prevalence of Dental Caries among School-going Children: A Cross-sectional Study.

BACKGROUND: The background of the study was to assess the prevalence of dental caries among school-going children. MATERIALS AND METHODS: Six thousand eight hundred and ninety school-going children was enrolled. General clinical examination was carried out. Mouth mirror, probe, and explorer were used for carrying out the clinical examination. Over a time span of 6 months, the entire study was completed. All the examiners who performed clinical examination underwent a single-day training program for detecting dental caries. All the participants were seated on straight wooden chairs and were examined clinically. The prevalence of caries was recorded. RESULTS: The prevalence was 26.02%. Among these children with dental caries, 50.25% of the children belonged to the age group of 13-15 years, while the remaining 49.75% of the children belonged to the age group of 9-12 years. Prevalence of dental caries was significantly higher in females (71.11%) in comparison to males. Furthermore, dental caries was significantly more prevalent among participants with toothbrushing frequency of less than once a day (51.20%). CONCLUSION: There is an imperative need for intimating health check-up camps among school-going children.

Assessment of Prevalence of Recurrent Aphthous Stomatitis in the North Indian Population: A Cross-Sectional Study.

AIM AND OBJECTIVE: The present study was undertaken for assessing the prevalence of recurrent aphthous stomatitis (RAS) in the North Indian population. MATERIALS AND METHODS: Assessment of a total of 4255 patients was done over a period of 2 years, who came for a routine dental checkup. Recording of the complete demographic and clinical details of all the patients was done. The prevalence of RAS was assessed. Profile of patients with RAS was assessed separately. A pro forma was made and the type of treatment protocol followed by patients with RAS was also recorded. All the results were recorded in a Microsoft Excel sheet and were analyzed using SPSS software. RESULTS: Analysis of a total of 4255 patients was done. RAS was found to be present in 800 patients. The overall prevalence of RAS was found to be 18.93%. Significant results were obtained when analyzing age, gender, and occupation as risk factors for RAS. Labial/buccal mucosa involvement occurred in 51.875% of the cases. In 44% of the cases, the size of the RAS was between 1 cm and 3 cm. Home remedy was followed in 17.875% of the cases. CONCLUSION: A significant proportion of patients in the North Indian population is affected by RAS. In comparison to males, females are more commonly affected.

Assessment of Effect of Fixed Orthodontic Treatment on Gingival Health: An Observational Study.

BACKGROUND: Prime components of fixed orthodontic treatments decrease the self-cleansing ability of the tongue and the cheeks leading to an increase in production of bacterial plaque. Hence, the present study was undertaken for assessing the effect of fixed orthodontic treatment on gingival health. MATERIALS AND METHODS: A total of 120 patients who were scheduled orthodontic treatment were enrolled. Complete data records of all the patients were recorded. Intra- and extraoral radiographs were obtained and photographic records were noted in separate pro forma. Complete intraoral examination of all the patients was carried out for recording visible plaque, any inflammation (visible clinically), and gingival recession. Based on the assessment of gingival texture and capillary transparency, analysis of gingival biotype was done. Follow-up records were assessed. RESULTS: The mean visible plaque value before treatment and after treatment was found to be 3.11 and 5.81, respectively. The mean visible inflammation value before treatment and after treatment was found to be 2.89 and 15.43, respectively. The mean gingival recession score value before treatment and after treatment was found to be 0.19 and 0.383, respectively. A significant increase in the visible plaque value, visible inflammation value, and gingival recession score was observed posttreatment. While comparing the gingival biotype, it was seen that in both the maxillary and mandibular arches, there was an increase in the thick gingival biotype while there was a decrease in thin maxillary biotype. CONCLUSION: There is a significant increase in plaque accumulation, inflammation, and gingival recession following fixed orthodontic treatment. Hence, during the course of orthodontic treatment, regular oral prophylaxis should be done.

A Comparative Analysis of Clinical Characteristics and Histomorphologic and Immunohistochemical Spectrum of Gallbladder Carcinoma in Young Adults (< 45 Years) and Elderly Adults (> 60 Years).

Gallbladder carcinoma (GBC) is more frequent after 60 years of age; its behavior in young adults has not been much studied. A retrospective analysis was performed in patients who underwent a cholecystectomy procedure between the years 2001 to 2016. A group of young patients (< 45) were compared with elderly patients (> 60 years) with reference to various clinical, histomorphologic, and immunohistochemical parameters. Statistical analysis was performed using t test and Fisher's test. Survival curves were calculated by Kaplan-Meier actuarial survival curves and log-rank tests. One hundred and one patients with GBC were observed during the study period. Of these, 14 patients (13.9%) belonged to the study group (age range 20 to 45 years) and 43 patients (42.6%) constituted the comparison elderly control group (age range 60 to 80 years). Forty-four pts. were in the middle-aged group (46 to 59 years) and were thus excluded from the study. With reference to age (< 45 and > 60), no significant difference was found in sex (females 64.3% vs 69.8%, p = 0.7), presence of gall stones (64% vs 60%, p = 0.8), advanced disease at presentation (T4) (14.3% vs 7%, p = 0.40), incidental detection of gallbladder carcinoma (28.5% vs 28%, p = 0.9), tumor stage at presentation (stage I/II) (35.7% vs 49%, p = 0.39), and poor differentiation (tumor grades G3) (14% vs 12%, p = 0.79). Full-length involvement (28.5% vs 11.6%, p = 0.015) of the gallbladder and abundant tumor necrosis (43% vs 14%, p = 0.021) were more common in the younger patients group whereas adenosquamous and pure squamous cell carcinoma were predominantly observed in elderly patients. Immunohistochemical studies showed higher percentage of overexpression of p53 and Ki-67 proliferation indices in the younger population. Overall survival in younger patients was 48 months whereas in elderly patients it was 36 months. Histological markers denoting aggressive tumor behavior were observed in gallbladder carcinomas of younger individuals; further studies are needed to delineate the differences in molecular mechanisms involved in progression of the tumor in the two groups.

Canola produced under boreal climatic conditions in Newfoundland and Labrador have a unique lipid composition and expeller press extraction retained the composition for commercial use.

The average fatty acid (FA) composition of canola oil is made up of 62% oleic acid (C18:1n9), 19% linoleic acid (C18:2n6), 9% linolenic acid (C18:3n3) and 7% saturated FA (SFA). We investigated whether boreal climate (7.5-17.2 °C) favorably altered the FA composition of canola. Results indicate that canola cultivated in boreal climatic conditions had approximately twice the levels of omega-3 FA (17-20%) compared to canola from other growing areas (9%). The presence of monoacetyldiacylglycerol (MAcDG), a unique class of triglyceride, is reported for the first time in canola cultivated in a boreal climate, and has the potential to reduce the risk of obesity and other health related diseases. We further demonstrated that a non-solvent based extraction method retained the novel lipid composition without reducing the quality of oil being produced. Our results contribute significantly to the understanding of lipid accumulation in the world's second most important oil crop when cultivated in a boreal or northern climate.

Epilepsy knowledge, attitudes, and practices among primary healthcare providers in an Indian district.

INTRODUCTION: Scaling up the involvement of primary care providers in epilepsy management in low- and middle-income countries (LMICs) requires an understanding of their epilepsy knowledge, attitudes, and practices (KAP). AIM: The aim of the study was to document levels of knowledge about, attitudes towards, and practices regarding epilepsy among different ranks of primary healthcare providers in a North-Western Indian district. METHODS: The survey included government medical officers (MOs), auxiliary nurse midwives (ANMs), and accredited social health activists (ASHAs). They were administered a specially designed KAP questionnaire. Responses were analyzed according to rank. RESULTS: The survey showed that nearly 10% of ANMs and almost a fifth of ASHAs had never heard about epilepsy. A quarter of MOs and over two-thirds of ANMs and ASHAs had never provided care to someone with epilepsy. There were significant differences in the levels of knowledge between the three groups of workers. CONCLUSIONS: Closing the huge gaps in KAP by educating primary care and community health workers about epilepsy should be a priority before engaging them in the epilepsy care delivery.