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OBJECTIVES: The primary objective of this prospective cohort study was to assess the usefulness of a predefined multidisciplinary care pathway-based management on pregnancy outcome(s) in women with SLE who already had at least one adverse obstetric outcome(s). METHODS: Between March 2010 and March 2023, all consecutive, consenting women with SLE who already had at least one previous adverse obstetric outcome (preterm labour, pre-eclampsia, termination of pregnancy, miscarriage, intrauterine growth retardation (IUGR), preterm birth, low birth weight (LBW), intrauterine death (IUD) or stillbirth] were prospectively screened and counselled. The protocol comprised preconception and post-natal drug and disease status review, periodic ante-natal visits for the monitoring of pregnancy and drug and disease status review and post-natal drug and disease status review and contraception advice. Therapeutic changes were made as necessary at each visit. RESULTS: A total of 213 women were screened and 197 women (age, 28 ± 6.34 years) were enrolled who had 226 pregnancies. Previous poor obstetric outcomes were miscarriage(s), 186; termination of pregnancy, 4; preterm labour, 51; IUGR, 36; IUD or stillbirth, 16; low birth weight (LBW), 44 and pre-eclampsia, 4. Seventy-seven (39%) women had secondary APS and 37 (19%) had a history of lupus nephritis. There were 194/226 (86%) live births [40 LBW (18%); caesarean section in 101 (45%)]. Thirty pregnancies culminated in miscarriages and 2 in IUDs (14%). Sixty-eight patients (30%) experienced lupus flare during pregnancy (36 mild, 20 moderate and 8 severe). CONCLUSION: Our experience underscores the usefulness of a predefined multidisciplinary care pathway-based management for improving pregnancy outcomes in women with SLE who had previous adverse outcomes. Key Points • In women with SLE who had previous adverse obstetric outcome(s) a risk of poor outcome in subsequent pregnancy remains. • Good pregnancy outcomes in these women could be achieved by predefined  multidisciplinary care pathways focussed on addressing all relevant issues. • Improved access to rheumatology services and collaboration between rheumatologists and obstetricians is key to improving outcomes in SLE pregnancies.

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BACKGROUND: As Artificial Intelligence (AI) becomes pervasive in healthcare, including applications like robotic surgery and image analysis, the World Medical Association emphasises integrating AI education into medical curricula. This study evaluates medical students' perceptions of 'AI in medicine', their preferences for AI training in education, and their grasp of AI's ethical implications in healthcare. MATERIALS & METHODS: A cross-sectional study was conducted among 325 medical students in Kerala using a pre-validated, semi structured questionnaire. The survey collected demographic data, any past educational experience about AI, participants' self-evaluation of their knowledge and evaluated self-perceived understanding of applications of AI in medicine. Participants responded to twelve Likert-scale questions targeting perceptions and ethical aspects and their opinions on suggested topics on AI to be included in their curriculum. RESULTS & DISCUSSION: AI was viewed as an assistive technology for reducing medical errors by 57.2% students and 54.2% believed AI could enhance medical decision accuracy. About 49% agreed that AI could potentially improve accessibility to healthcare. Concerns about AI replacing physicians were reported by 37.6% and 69.2% feared a reduction in the humanistic aspect of medicine. Students were worried about challenges to trust (52.9%), patient-physician relationships (54.5%) and breach of professional confidentiality (53.5%). Only 3.7% felttotally competent in informing patients about features and risks associated with AI applications. Strong demand for structured AI training was expressed, particularly on reducing medical errors (76.9%) and ethical issues (79.4%). CONCLUSION: This study highlights medical students' demand for structured AI training in undergraduate curricula, emphasising its importance in addressing evolving healthcare needs and ethical considerations. Despite widespread ethical concerns, the majority perceive AI as an assistive technology in healthcare. These findings provide valuable insights for curriculum development and defining learning outcomes in AI education for medical students.

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Background: Teleconsultations have gained prominence as a viable method for delivering medical services remotely. In oral radiology, the ability to interpret radiographic images accurately is crucial for diagnosing and treating various dental conditions. The use of teleconsultations in this domain holds promise for extending specialized care to patients who are geographically distant from dental healthcare facilities. Materials and Methods: A total of 50 patients' oral radiographic images were collected for analysis in this study. These images were obtained from diverse geographical locations, showcasing the applicability of teleconsultations. Two groups of dental professionals, one conducting in-person evaluations and the other performing remote interpretations through teleconsultations, participated in the study. The radiographic findings were assessed for concurrence between the two groups. Statistical analysis included the calculation of P values to determine the level of agreement between the in-person and teleconsultation interpretations. Results: The results of this study revealed a substantial level of agreement between in-person and teleconsultation interpretations of oral radiographic images. The calculated P values indicated a statistically significant concordance between the two evaluation methods (P < .05). This suggests that teleconsultations can be a reliable approach for oral radiology interpretation, offering comparable results to traditional in-person evaluations. Conclusion: In conclusion, teleconsultations have demonstrated their potential as an effective means of interpreting oral radiographic images remotely.

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Periodontal disease is caused by specific pathogens which results in inflammation of the tooth-supporting structures and subsequently causes the continued breakdown of alveolar bone and periodontal ligament. Licorice (Glycyrrhiza glabra) is a perennial herb with substantial medicinal value. Licorice extract is derived from dried, unpeeled stolons and roots of Glycyrrhiza uralensis and G. glabra. The bioactive ingredients in licorice extract such as glycyrrhizin, licoricidin, glabridin, licochalcone A, and licorisoflavan A have anti-inflammatory, antimicrobial, and anti-adherence effects that are beneficial against periodontal disease. Since periodontal disease has a complex etiology that includes the host response and microorganisms, licorice phytochemicals offer a therapeutic advantage due to their dual functionality. The aim of this review was to enumerate the bioactive compounds present in herbal licorice extract and to elucidate the beneficial effects of licorice and its derivatives in periodontal therapy. Literature review and clinical trials evaluating the effect of licorice on periodontopathogens and periodontal disease are included in this article.

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ETHNOPHARMACOLOGICAL RELEVANCE: Sauropus androgynus is a medicinal shrub used for the treatment of fever in ethnomedical traditions in various Southeast Asian countries. AIM OF THE STUDY: This study was aimed to identify antiviral principles from S. androgynus against Chikungunya virus (CHIKV), a major mosquito-borne pathogen that re-emerged in the last decade, and to unravel their mechanism of action. MATERIALS AND METHODS: Hydroalcoholic extract of S. androgynus leaves was screened for anti-CHIKV activity using cytopathic effect (CPE) reduction assay. The extract was subjected to activity guided isolation and the resultant pure molecule was characterized by GC-MS, Co-GC and Co-HPTLC. The isolated molecule was further evaluated for its effect by plaque reduction assay, Western blot and immunofluorescence assays. In silico docking with CHIKV envelope proteins and molecular dynamics simulation (MD) analyses were used to elucidate its possible mechanism of action. RESULTS: S. androgynus hydroalcoholic extract showed promising anti-CHIKV activity and its active component, obtained by activity guided isolation, was identified as ethyl palmitate (EP), a fatty acid ester. At 1 µg/mL, EP led to 100% inhibition of CPE and a significant 3 log10 reduction in CHIKV replication in Vero cells at 48 h post-infection. EP was highly potent with an EC50 of 0.0019 µg/mL (0.0068 µM) and a very high selectivity index. EP treatment significantly reduced viral protein expression, and time of addition studies revealed that it acts at the stage of viral entry. A strong binding to the viral envelope protein E1 homotrimer during entry, thus preventing viral fusion, was identified as a possible mechanism by which EP imparts its antiviral effect. CONCLUSIONS: S. androgynus contains EP as a potent antiviral principle against CHIKV. This justifies the use of the plant against febrile infections, possibly caused by viruses, in various ethnomedical systems. Our results also prompt more studies on fatty acids and their derivatives against viral diseases.

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In plant development, flowering is the most widely studied process. Floral forms show large diversity in different species due to simple variations in basic architecture. To determine the floral gene expression during the past decade, MADS-box genes have identified as key regulators in both reproductive and vegetative plant development. Traditional genetics and functional genomics tools are now available to elucidate the expression and function of this complex gene family on a much larger scale. Moreover, comparative analysis of the MADS-box genes in diverse flowering and non-flowering plants, boosted by various molecular technologies such as ChIP and next-generation DNA sequencing, contributes to our understanding of how this important gene family has expanded during the evolution of land plants. Likewise, the big data analysis revealed combined activity of transcriptional regulators and floral organ identity factors regulate the flower developmental programs. Thus, with the help of cutting-edge technologies like RNA-Sequencing, sex determination is now better understood in few non-model plants Therefore, the recent advances in next-generation sequencing (NGS) should enable researchers to identify the full range of floral gene functions, which will significantly help to understand plant development and evolution. This review summarizes the floral homeotic genes in model and non-model species to understand the flower development genes and dioecy evolution.

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In the contemporary era of unprecedented innovations such as the Internet of Things (IoT), modern applications cannot be imagined without the presence of a wireless sensor network (WSN). Nodes in WSN use neighbor discovery (ND) protocols to have necessary communication among the nodes. The neighbor discovery process is crucial as it is to be done with energy efficiency and minimize discovery latency and maximum percentage of neighbors discovered. The current ND approaches that are indirect in nature are categorized into methods of removal of active slots from wake-up schedules and intelligent addition of new slots. This work develops a lightweight intrusion detection system (IDS) based on two machine learning approaches, namely, feature selection and feature classification, in order to improve the security of the Internet of Things (IoT) while transferring medical data through a cloud platform. In order to take advantage of the comparatively cheap processing cost of the filter-based technique, the feature selection was carried out. The two methods are found to have certain drawbacks. The first category disturbs the original integrity of wake-up schedules leading to reduced chances of discovering new nodes in WSN as neighbors. When the second category is followed, it may have inefficient slots in the wake-up schedules leading to performance degradation. Therefore, the motivation behind the work in this paper is that by combining the two categories, it is possible to reap the benefits of both and get rid of the limitations of both. Making a hybrid is achieved by introducing virtual nodes that help maximize performance by ensuring the original integrity of wake-up schedules and adding efficient active slots. Thus, a Hybrid Approach to Neighbor Discovery (HAND) protocol is realized in WSN. The simulation study revealed that HAND outperforms the existing indirect ND models.

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Cancer is one of the top causes of mortality, and it arises when cells in the body grow abnormally, like in the case of breast cancer. For people all around the world, it has now become a huge issue and a threat to their safety and wellbeing. Breast cancer is one of the major causes of death among females all over the globe, and it is particularly prevalent in the United States. It is possible to diagnose breast cancer using a variety of imaging modalities including mammography, computerized tomography (CT), magnetic resonance imaging (MRI), ultrasound, and biopsies, among others. To analyze the picture, a histopathology study (biopsy) is often performed, which assists in the diagnosis of breast cancer. The goal of this study is to develop improved strategies for various CAD phases that will play a critical role in minimizing the variability gap between and among observers. It created an automatic segmentation approach that is then followed by self-driven post-processing activities to successfully identify the Fourier Transform based Segmentation in the CAD system to improve its performance. When compared to existing techniques, the proposed segmentation technique has several advantages: spatial information is incorporated, there is no need to set any initial parameters beforehand, it is independent of magnification, it automatically determines the inputs for morphological operations to enhance segmented images so that pathologists can analyze the image with greater clarity, and it is fast. Extensive tests were conducted to determine the most effective feature extraction techniques and to investigate how textural, morphological, and graph characteristics impact the accuracy of categorization classification. In addition, a classification strategy for breast cancer detection has been developed that is based on weighted feature selection and uses an upgraded version of the Genetic Algorithm in conjunction with a Convolutional Neural Network Classifier. The practical application of the suggested improved segmentation and classification algorithms for the CAD framework may reduce the number of incorrect diagnoses and increase the accuracy of classification. So, it may serve as a second opinion tool for pathologists and aid in the early detection of diseases.

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BACKGROUND: The development of nano delivery systems is rapidly emerging area of nanotechnology applications where nanomaterials (NMs) are employed to deliver therapeutic agents to specific site in a controlled manner. To accomplish this, green synthesis of NMs is widely explored as an eco-friendly method for the development of smart drug delivery system. In the recent times, use of green synthesized NMs, especially metallic NMs have fascinated the scientific community as they are excellent carriers for drugs. This work demonstrates optimized green, biogenic synthesis of gold nanoparticles (AuNPs) for functionalization with quercetin (QT) and camptothecin (CPT) to enhance potential anti-inflammatory, anti-cancer and anti-angiogenic activities of these drugs. RESULTS: Gold nanoparticles were optimally synthesized in 8 min of reaction at 90 °C, pH 6, using 4 mM of HAuCl4 and 4:1 ratio of extract: HAuCl4. Among different capping agents tested, capping of AuNPs with polyethylene glycol 9000 (PG9) was found best suited prior to functionalization. PG9 capped AuNPs were optimally functionalized with QT in 1 h reaction at 70 °C, pH 7, using 1200 ppm of QT and 1:4 ratio of AuNPs-PG9:QT whereas, CPT was best functionalized at RT in 1 h, pH 12, AuNPs-PG9:CPT ratio of 1:1, and 0.5 mM of CPT. QT functionalized AuNPs showed good anti-cancer activity (IC50 687.44 µg/mL) against MCF-7 cell line whereas test of anti-inflammatory activity also showed excellent activity (IC50 287.177 mg/L). The CAM based assessment of anti-angiogenic activity of CPT functionalized AuNPs demonstrated the inhibition of blood vessel branching confirming the anti-angiogenic effect. CONCLUSIONS: Thus, present study demonstrates that optimally synthesized biogenic AuNPs are best suited for the functionalization with drugs such as QT and CPT. The functionalization of these drugs with biogenic AuNPs enhances the potential anti-inflammatory, anti-cancer and anti-angiogenic activities of these drugs, therefore can be used in biomedical application.

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Quantum dots (QDs) comprise an emerging group of materials with innumerable number of possibilities in biological research including cellular labelling. Among the leading members in this category, ZnSe/ZnS quantum dots (QDs) hold greater attractive possibilities in imaging primarily due to their higher biocompatibility and dispersibility. Nevertheless, the inherent toxicity of ZnSe/ZnS QDs is not yet completely explored which largely compromise most of their biomedical application potential. Strong blue emitting water soluble QDs effectively synthesized by aqueous phase route. Synthesized QDs further subjected to various optical and physicochemical characterization. Approximately 5-6 nm sized ZnSe/ZnS QDs illuminated bluish green fluorescence under UV lamp. Present study addresses possible adverse effects of ZnSe/ZnS QDs in hepatic system using HepG2 cells; which is the routinely employed in vitroliver cell model. A bundle of assays wasperformed out to reveal the cytotoxic nature of ZnSe/ZnS QDs and the mechanism behind it. Herein, absorption, distribution, metabolism, excretion and toxicity (ADME and T) of ZnSe/ZnS in mice were profiled in detail followed by intravenous (i.v.) and intraperitoneal (i.p.) administration at a dose of 10 mg/kg body weight. In a short review, it could be state that ZnSe/ZnS QDs did not exhibit any significant in vivo toxicity outcome in mice.

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Despite the versatility of quantum dots (QDs) in optoelectronics and biomedical field, their toxicity risks remain a considerable hindrance for clinical applications. Cytotoxicity of Cadmium containing QDs is well documented and reveals that they are toxic to cells. Reports suggest that the presence of toxic elements at the QD core (e.g., cadmium, selenium) is responsible for its toxicity in in vivo and in vitro levels. Hence, here the toxicity of heavy metal free ZnSe/ZnS QDs on two scenarios were assessed, (i) HEK cells as in vitro system and (ii) Swiss Albino mice as in vivo model. Before toxicity analysis, QDs subjected to various optical and physico-chemical characterization methods such as absorption and emission spectra analysis, observation under U.V light, TEM, DLS, Zeta potential, FTIR, Raman and XPS spectra, ICP-OES, TGA and DTG curve. It is very necessary to characterize the synthesized QDs because their toxicity greatly influenced by the physico-chemical properties. On checking the vulnerability of HEK cells on exposure to ZnSe/ZnS QDs, the obtained results disclose that ZnSe/ZnS QDs showed merest impact on cellular viability at a concentration less than 100 µg/ml. Acute toxicity of 10 mg/kg ZnSe/ZnS QDs was studied in mice and no clinical or behavioural changes were observed. It did not induce any changes in haematological parameters and any loss of body or organ weight. Moderate pathological changes were evident only in the liver, all others organs like kidney, spleen and brain did not show any manifestations of toxicity. Current work lays substantial bedrock for safe biomedical and environmental application of ZnSe/ZnS QDs in near future.

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The safety of drinking water is one of the most important public health issues as very high concentrations of metal like iron acts as a useful surrogate for other heavy metals. The present study demonstrates the use of almond skin extract (ASE) for simple and rapid synthesis of antibacterial silver nanoparticles (AgNPs) for the development of a highly selective and sensitive colorimetric method for the detection of Fe+2 in water samples. The optimization of various biogenic synthesis parameters showed ASE:AgNO3 ratio of 4:1,1 mM of AgNO3, pH 6 and incubation for 10 min at 70 °C were the optimum conditions. The test of antibacterial activity against widely used, representative Gram-negative and positive bacteria showed that AgNPs exhibit good activity against all five tested bacterial strains and comparatively were more effective against Gram-negative bacteria. Further, the test of AgNPs as a colorimetric probe for the detection of 20 different metal ions demonstrated that AgNPs were highly selective and sensitive towards the detection of Fe+2. The study of sensitivity of Fe+2 detection showed 245 ppm as the Limit of detection whereas, the intra-day recovery of Fe+2 in the range of 87.2-100.1 % with %RSD in the range of 4.2-6.5 % and inter-day recovery of Fe+2 in the range of 92.02-96.59 % with %RSD in the range of 2.9-3.8 % demonstrated the excellent precision and accuracy of the assay method. Thus, our AgNPs based selective and sensitive assay can be applied to the analysis of iron in drinking water samples.

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In this work, Pseudomonas stutzeri was used for the optimum biogenic synthesis of antibacterial silver nanoparticles (AgNPs) which were applied for colorimetric detection of platinum ions (Pt+2). The optimum synthesis conditions were 2 mM AgNO3, pH 9 and incubation at 60 °C for 24 h. The FTIR spectra indicated that biomolecules such as amino acids, proteins or enzymes from P. stutzeri were involved in the synthesis of AgNPs in the size range of 10-50 nm. Among the various metal ions tested and screened initially, the colloidal AgNPs probe-based colorimetric assay selectively detected Pt+2 with 50 ppm as the limit of detection (LOD). The assay demonstrated in the present study quantitatively recovered Pt+2 in the range of 70-150 % with good accuracy and precision. Further, the test of antibacterial activity of AgNPs alone, and in combination with ampicillin showed excellent activity against four of the six tested bacteria.

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Humboldtia unijuga Bedd., endemic to Agasthyamala in Western Ghats in India, is traditionally used by local Kani tribes for chicken pox, head ache and snake bite. This study reports the isolation of erythrodiol-3-acetate (HU-1) and 2,4-di-tert-butylphenol (HU-2) from H. unijuga roots and their anti-inflammatory and anticancer activities in macrophage, skin and breast cancer cell lines. Effects of HU-1 and HU-2 treatments (50, 100 µg/mL) on gene expression profiles of pro-inflammatory cytokines TNFα, IL-6 and IL-1ß, and apoptosis genes p53 and caspase 7 were studied. HU-2 exerted a significantly superior anti-inflammatory effect compared to HU-1 in all three pro-inflammatory genes. HU-2 showed a superior dose dependent anticancer effect through activation of p53 gene over HU-1 in MCF-7 cells. HU-1 exhibited a dose dependent effect on caspase 7 gene in both cell lines while HU-2 was more effective in A431. HU-2 has potential for development as a novel anti-inflammatory and anticancer agent.

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Fungiform papillae are raised lingual structures which contain taste buds and thus play an important role in taste perception. These structures vary in number due to their relative sensitivity to a range of systemic and local factors which affect the dorsum of the tongue. Taste sensation can be measured using both chemical and electrical methods; however, the number of fungiform papillae has a direct effect on chemogustometric and electrogustometric values during evaluation. This review provides a general overview of fungiform papillae, their quantification methods and the various factors which may affect these structures. In addition, numerous methods of recording taste sensation and their clinical applications are highlighted.

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To extend our understanding of molecular mechanism of sex determination in agro-economically important, polygamodioecious tree Garcinia indica (Kokum), high-throughput, next-generation flower transcriptome sequencing (NGS), and comparative analyses were performed to investigate differentially expressed gene in bisexual, female, and male flowers. A total of 49414 unigenes in BS, 45944 unigenes in FL, and 49028 unigenes in ML flowers were annotated. KO annotations revealed that 25 functional categories were large number of genes which were annotated to 'signal transduction'. We identified 33 genes for 'auxin response factor' and 50 for 'ethylene-responsive factor' whose expression changed significantly in all the three paired library combinations. Furthermore, key regulators of floral development such as FLC, SVP, AP1, AP2, AP3, AG, AGL2, AGL4, AGL9, and PI were identified. A total of 327 differentially expressed MADS-box genes were identified in G. indica transcriptome. Analysis of MADS-box genes identified five genes such as MADS AGL11, CRS2-associated factor chloroplastic, conserved hypothetical protein, uncharacterized protein LOC104422218, and MADS-box JOINTLESS-like isoform X3 significantly expressed in only FL flower. In addition, number of DEGs like dynamin 2A, auxin response factor, and spermidine synthase involved in sex expression and reproduction were discovered. The expression patterns of selected genes matched well with the expression levels of unigenes by transcriptome sequencing. Our large-scale comparative analyses may provide valuable hints for the next insights into the molecular mechanism of sex determination in G. indica.

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BACKGROUND: Many patients consider removal of caries to be a very unpleasant experience. Removal of caries with conventional drill is considered traumatic mainly due to fear and anxiety of children and their parents. Minimally invasive dentistry adopts a philosophy that integrates prevention, remineralization, and minimal intervention for the placement and replacement of restorations, thus reaching the treatment objective using the least invasive surgical approach, with the removal of the minimal amount of healthy tissues. Chemomechanical caries removal (CMCR) is a method for minimally invasive, gentle dentin caries removal based on biological principles which is an effective alternative to the traditional method. The present study was done to compare the microhardness of sound dentin before and after carious removal using a chemomechanical method and a conventional method. MATERIALS AND METHODS: The present in vitro study was done on 28 proximal surfaces of fourteen extracted primary molars (with active caries on one proximal surface and sound side as control). The study was done to assess the Knoop microhardness of remaining dentinal surface after caries removal using a slow speed conventional bur and a chemomechanical method (Carie-Care™). Results and. CONCLUSION: The rotary instrument group showed a consistent microhardness value with not much difference according to depth. The chemomechanical group showed a lesser microhardness value closer to the cavity floor than away from it. The microhardness values at all depths were significantly different for each treatment group with an increased value seen in the rotary group. The mean microhardness values of residual dentin in treated side were found to be insignificant when compared among each interval in each group. The microhardness of sound dentin had high significant difference from that of residual dentin in both the rotary group and the chemomechanical group.