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Rebecca J Lendzion,1,2 Ankur Sidhu,1 Basil D’Souza1,3 1Department of Colorectal Surgery, St. Vincent’s Hospital, Fitzroy, Melbourne, VIC, 3065, Australia; 2Department of Colorectal Surgery, Macquarie University Hospital, Macquarie University, Sydney, NSW, Australia; 3Department of Colorectal Surgery, The Northern Hospital, Epping, Melbourne, VIC, 3076, AustraliaCorrespondence: Rebecca J Lendzion, Department of Colorectal Surgery, Macquarie University Hospital, 3 Technology Place, Macquarie Park, Sydney, NSW, 2109, Australia, Tel +61 2 9812 3880, Fax +61 2 9812 3886, Email dr.rebeccalendzion@gmail.comPurpose: Enhanced recovery after surgery (ERAS) programs are evidence-based protocols designed to standardize medical care, improve outcomes, and lower costs. Research shows that ERAS in colorectal surgery is associated with reduced length of stay (LOS) and morbidity, faster recovery and comparable or reduced readmission rates versus traditional models. Very little evidence exists assessing ERAS outcomes in inflammatory bowel disease (IBD) surgery. We hypothesized that ERAS protocols following IBD surgery is associated with a reasonable LOS and morbidity. Secondary aims were to identify factors affecting patient selection for ERAS programs in IBD surgery.Patients and methods: A retrospective review of 119 patients undergoing abdominal surgery in a high volume IBD tertiary referral centre with a well-established ERAS protocol.Results: During the study period, 119 patients with IBD underwent surgery. Of these, 78 patients were allocated to an ERAS protocol; compliance was 72%. The ERAS cohort were more likely to have laparoscopic surgery (53.8%), compared to the non-ERAS cohort (N-ERAS) (46.3%). Median hospital stay was significantly shorter in the ERAS cohort compared to the N-ERAS cohort (7 vs 9 days; p < 0.05). Operative time was significantly longer in the N-ERAS cohort (233 ± 73.0 vs 266 ± 96; p = 0.040). Complication rates were higher in the N-ERAS cohort (48.8% vs 37.1%; p = 0.33).Conclusion: Patients undergoing surgery with an ERAS protocol have improved outcomes compared with patients deemed not suitable for ERAS. Factors affecting suitability are longer operations, a requirement for stoma, malnourished patients, patients with a higher ASA and the commencement of a new fellow to the unit.Keywords: Crohn’s disease, ulcerative colitis, enhanced recovery after surgery, perioperative care

Abstract Early and accurate diagnosis of human immunodeficiency virus (HIV) infection is essential for timely initiation of antiretroviral therapy (ART) and prevention of new infections. However, conventional nucleic-acid-based tests for HIV detection require sophisticated laboratory equipment and trained personnel, which are often unavailable at the point-of-care (POC) or unaffordable in resource-limited settings. We report our development of a low-cost, integrated platform for POC testing of HIV. The platform integrates viral nucleic acid extraction on a paper substrate and reverse transcription loop-mediated isothermal amplification (RT-LAMP) in a portable, battery-powered heating device with real-time detection. The platform does not require laboratory infrastructure such as power outlets. The assay showed a detection limit of 30 copies/mL of HIV RNA in 140 μL human serum or 4 copies/reaction using 50 μL human serum, with no cross-reactivity with hepatitis C virus (HCV). We validated the platform using both plasma samples spiked with HIV and clinical samples from HIV-positive individuals, and compared it with standard laboratory assays based on polymerase chain reaction (PCR). These results demonstrate the feasibility of our platform for HIV testing at the POC.

Abstract Soil salinity is a major threat to global agriculture, limiting plant growth and lowering crop yields. Recent advances in CRISPR/Cas9 genome editing technology provide unprecedented precision and efficiency for addressing these challenges by directly modifying the central dogma (CD) of molecular biology in plants. The CD naturally lends itself to tighter multi-level regulation, where transcription and translation are both under control at the same time. A multilayer component of CD such as epigenetic modification, transcription, post-transcriptional modification, translation, and post-translational modification contributes significantly to stress tolerance. Strict control of CD components by Clustered Regularly Interspaced Short Palindromic Repeats, CRISPR-associated protein 9 (CRISPR/Cas9) might lead to the generation of climate smart crops. This review delves into the latest developments in the CRISPR toolbox that improve plant salt tolerance. By targeting key genes involved in transcription and translation, CRISPR/Cas9 makes it easier to modify critical components of the central dogma, allowing plants to better manage salt stress. We explore various CRISPR-based strategies, including base editing, prime editing, transcription regulation, multiplexing, RNA and many more, that reprogram gene expression and protein function to improve salt tolerance. In addition, we discuss how CRISPR can be combined with transcriptional regulation and epigenetic modifications to provide a comprehensive approach to salinity resistance for plants. The review also addresses the issues of off-target effects and efficient delivery systems, recommending novel solutions to improve the precision and applicability of CRISPR technology. This review emphasizes the transformative potential of CRISPR in modifying the central dogma to develop salt-tolerant crops, thereby contributing to sustainable agriculture and global food security.

Abstract TQS‐168, a first‐in‐class small‐molecule inducer of peroxisome proliferator‐activated receptor gamma coactivator 1‐alpha gene expression, is in development for the treatment of amyotrophic lateral sclerosis. A single‐ascending‐dose (SAD) and multiple‐ascending‐dose (MAD) study of TQS‐168 was carried out in healthy male subjects to investigate safety, tolerability, pharmacokinetics (PK), food effect, and preliminary pharmacodynamic effects (PD). Since solubility enhancement could be beneficial, assessment of three formulations was incorporated into the study using an integrated rapid manufacturing and clinical testing approach. Dosing in the SAD part was initiated with a crystalline methylcellulose (MC) suspension, and then spray‐dried dispersion (SDD) and hot‐melt extrusion (HME) suspensions were evaluated. The HME and SDD formulations showed two and fourfold higher exposure than the MC suspension, respectively, and the SDD formulation was selected for progression to subsequent SAD and MAD cohorts, in which there was further investigation of the food effect on exposure in addition to assessments of safety, tolerability, PK, and PD. Cmax and AUC plasma exposures of TQS‐168 were supra‐proportional at higher doses, irrespective of formulation. Median Tmax for TQS‐168 occurred between 0.5 and 4.0 h post‐dose and occurred later with higher doses. Geometric mean half‐lives (T1/2) for TQS‐168 were independent of formulation and food, ranging from 3.2 to 10.5 h following single doses and 4.1 to 7.3 h following multiple doses. Food blunted TQS‐168 Cmax but had minimal impact on AUC. TQS‐168 was considered to be safe and generally well tolerated following single and multiple oral doses. The SDD formulation was selected for future patient studies.

Background: The faecal immunochemical test (FIT) is an immunoassay used to detect human blood in the stool. The role of FIT as a screening tool for small bowel pathology remains unclear. Objectives: This study aimed to investigate the role of FIT in predicting small bowel pathology in patients with iron deficiency anaemia (IDA). Design: This was a single tertiary centre prospective study. The inclusion criterion was adults (⩾18 years and 10) had a sensitivity, specificity, positive predictive value and negative predictive value of 34.29%, 54.55%, 37.5% and 51.08%, respectively. In the control group ( n = 100), 37% of the patients had significant pathology on SBCE. On logistic regression, age (OR 1.06; 95% CI: 1.03–1.11) was the only factor related to the probability of having a positive finding on SBCE. Conclusion: Over a third of the patients with IDA have significant findings on SBCE. However, in this study, we did not find that FIT conferred any additional benefit in the detection of small bowel pathology.

Objective The preoperative (clinical and radiological) depth of invasion (DOI) in early tumours can guide the surgeons in deciding elective neck dissection, the extent of invasive surgery, the need for reconstruction, potential adjuvant treatment and the patient's prognosis. This study aimed to validate the 8th AJCC clinical T stage using DOI, assess interobserver bias, and correlate the clinical, radiological and pathological T stages. Materials and methods: This was a prospective clinical study carried out from December 2019 to June 2023 at an academic tertiary care centre. Patients with squamous cell carcinoma of oral cavity and lip without involvement of skin or bone undergoing upfront surgery were included. The clinical assessment of T stage using DOI was done by three examiners, blinded to each other. The radiological T stage was assessed by an MRI and pathological T stage on fixed formalin surgical specimen. Results: A total of 173 patients were assessed during the study period, out of which 44 met the inclusion criteria. There was a fair agreement regarding the combined clinical T stage between all three examines. A statistically significant correlation was found between the clinical and pathological T stage (p-value 0.010), the radiological and pathological T stage (p-value 0.001) and clinical and radiological T stage (p-value 0.004). Conclusion: The clinical and radiological T stage using DOI correlated well with the pathological T stage. The 8th AJCC clinical T stage of oral squamous cell carcinoma was accurate in our study population.

Phosphorus (P) is an indispensable nutrient for agricultural crops, existing in both organic and inorganic forms within the soil matrix. However, its runoff and leaching could potentially pollute the natural water bodies worldwide through eutrophication. Despite the elevated soil P levels indicated by soil tests, the potato crop necessitates substantial P fertilization due to its relatively superficial root structure and short growth period, particularly when compared to longer-cycle agronomic crops such as corn or cotton. This investigation was designed to assess the response of potato tuber yield and quality to incremental P fertilizer applications during the 2021 and 2022 growing seasons. The research was performed in the 2021 growing season across two different agricultural sites at the Hastings Agricultural Extension Center (HAEC), incorporating eight varying rates of Triple Super Phosphate (TSP) (formulation 0-46-0% N–P2O5–K), specifically 0, 28, 56, 84, 112, 140, 168, and 224 ​kg P2O5 ha−1. In the subsequent 2022 season, the study expanded to include three additional sites at HAEC, testing six different TSP levels at 0, 22, 45, 67, 90, and 112 ​kg P2O5 ha−1. A randomized complete block design (RCBD) with four replications was employed throughout the 2021 and 2022 seasons. The cumulative data from 2021 to 2022 indicated that total and marketable yields across all sites increased in response to increasing P rates (p ​

Abstract Background α-synuclein [α-Syn]-mediated activation of GSK-3β leading to increases in hyperphosphorylated Tau has been shown by us to occur in striata of Parkinson's diseased [PD] patients and in animal models of PD. In Alzheimer's disease, tauopathy exists in several brain regions; however, the pattern of distribution of tauopathy in other brain regions of PD or in animal models of PD is not known. The current studies were undertaken to analyze the distribution of tauopathy in different brain regions in a widely used mouse model of PD, the α-Syn overexpressing mouse. Results High levels of α-Syn levels were seen in the brain stem, with a much smaller increase in the frontal cortex; neither cerebellum nor hippocampus showed any overexpression of α-Syn. Elevated levels of p-Tau, hyperphosphorylated at Ser202, Ser262 and Ser396/404, were seen in brain stem, with lower levels seen in hippocampus. In both frontal cortex and cerebellum, increases were seen only in p-Ser396/404 Tau, but not in p-Ser202 and p-Ser262. p-GSK-3β levels were not elevated in any of the brain regions, although total GSK-3β was elevated in brain stem. p-p38MAPK levels were unchanged in all brain regions examined, while p-ERK levels were elevated in brain stem, hippocampus and cerebellum, but not the frontal cortex. p-JNK levels were increased in brain stem and cerebellum but not in the frontal cortex or hippocampus. Elevated levels of free tubulin, indicating microtubule destabilization, were seen only in the brain stem. Conclusion Our combined data suggest that in this animal model of PD, tauopathy, along with microtubule destabilization, exists primarily in the brain stem and striatum, which are also the two major brain regions known to express high levels of α-Syn and undergo the highest levels of degeneration in human PD. Thus, tauopathy in PD may have a very restricted pattern of distribution.

The purpose of this article is to provide information to cotton farmers, Extension agents, and crop consultants about the symptoms of sulfur deficiency, the various sources of sulfur, and its interaction with changing rates of other major nutrients such as nitrogen. Written by Hardeep Singh, Ethan Carter, Lakesh Sharma, Sudeep Sidhu, and Peter Omara, and published by the UF/IFAS Agronomy Department, November 2023.

Abstract Background Biologic and targeted synthetic disease modifying agents (b/tsDMARDs) have broadened the treatment landscape for autoimmune diseases particularly in patients refractory to conventional DMARDs. More recently, the introduction of biosimilars has reduced the price of bDMARDs, potentially improving accessibility. Though efficacy and safety have been described, patient attitudes to b/tsDMARDs are not well-understood. We aim to investigate patients’ beliefs about biologic and biosimilar therapy, and the factors influencing their perceptions. Methods Patient consumer groups (Arthritis Australia, Crohn’s and Colitis Australia) assisted in advertising an online questionnaire for people with a self-reported diagnosis of inflammatory arthritis (IA) or inflammatory bowel disease (IBD). The questionnaire incorporated the Belief about Medicines Questionnaire (BMQ) and the single-item literacy screener (SILS). Sources and favourability of biologic/biosimilar information were analysed, using the chi-square and a non-parametric trend test for unordered and ordered categorical variables respectively, comparing respondents with IA and IBD. Results Eight hundred and thirty eight people (686–IA, 144–IBD, 8 both) responded. 658 (79%) used b/tsDMARDs. The BMQ demonstrated high necessity belief (median 4.2) with moderate concerns (median 2.8) about biologics. 95% of respondents obtained medication information from specialists though most used multiple sources (median 4). The most positive resources were specialists and specialist nurses. 73/141 (52%) respondents with IBD obtained information from specialist nurses compared with 202/685 (29%) with IA (p = 0.012). Respondents with limited reading ability on SILS were more likely to discuss information with a general practitioner or pharmacist. Younger respondents and those with higher BMQ concern scores more frequently consulted less reliable sources (e.g. social media). 502 respondents (60%) answered the biosimilar questions. Only 23 (4.6%) reported currently using a biosimilar and 336 (66.9%) were unsure if biosimilars were available in Australia. Specialist recommendation was the most frequent factor that would influence a patient to change from originator to biosimilar (352/495, 71.1%). Conclusions There is a high level of trust in specialists’ recommendations about b/tsDMARDs, although most people also utilise additional information sources. Contextual factors influencing resource selection include age, reading ability and degree of concern about medicines. People with IA and IBD have similar attitudes though those with IBD more frequently access specialist nurse advice.

Engineered chromodomains are promising probes to analyze histone methylation. Here the authors designed high-affinity chromodomains for enhanced genome-wide binding analysis, live-cell imaging and ultra-potent CRISPR-based gene repression.

Major dams are found to disrupt platypus gene flow and dispersal, with higher genetic differentiation found across dams than along similar stretches of undammed rivers, indicating that they act as significant barriers to platypus movement.

The antigenic landscape of α-HCoVs S proteins is revealed, highlighting the challenges faced by pan-HCoV vaccine design but also revealing opportunities for development of broadly effective vaccines against a subset of HCoVs.

Abstract Background This single-center, randomized controlled trial aimed to determine the effectiveness of a novel, biofilm-disrupting, mouth rinse that combines Cetylpyridinium chloride (CPC) and essential oils in preventing re-accumulation of supragingival plaque and supragingival microbiome in patients with gingivitis after dental prophylaxis. Methods One hundred eighteen participants were randomly assigned in a 1:1 ratio to receive twice-daily test mouth rinse (59) or carrier rinse control (59) for 12 weeks after dental prophylaxis. Results In a per-protocol analysis that included patients who completed the intervention, the treatment group (39) had significantly lower supragingival plaque scores at 6 and 12 weeks compared to the control group (41; p = 0.022). Both groups showed similar improvement in gingivitis score, but neither group had improvement in bleeding score or probing depth. Thirty-eight (29%) patients did not complete the study due to loss of follow-up (17) or early discontinuation of the assigned intervention (21). Microbiome sequencing showed that the treatment rinse significantly depleted abundant and prevalent members of the supragingival plaque microbiome consortium. Conclusions Among patients with gingivitis, the novel mouth rinse significantly reduced re-accumulation of supragingival plaque following dental prophylaxis by depleting supragingival plaque microbiome. However, long-term adherence to the rinse may be limited by adverse effects ( ClinicalTrials.gov number, NCT03154021).

Abstract Introduction Remote home monitoring models were implemented during the COVID‐19 pandemic to shorten hospital length of stay, reduce unnecessary hospital admission, readmission and infection and appropriately escalate care. Within these models, patients are asked to take and record readings and escalate care if advised. There is limited evidence on how patients and carers experience these services. This study aimed to evaluate patient experiences of, and engagement with, remote home monitoring models for COVID‐19. Methods A rapid mixed‐methods study was carried out in England (conducted from March to June 2021). We remotely conducted a cross‐sectional survey and semi‐structured interviews with patients and carers. Interview findings were summarized using rapid assessment procedures sheets and data were grouped into themes (using thematic analysis). Survey data were analysed using descriptive statistics. Results We received 1069 surveys (18% response rate) and conducted interviews with patients (n = 59) or their carers (n = 3). ‘Care’ relied on support from staff members and family/friends. Patients and carers reported positive experiences and felt that the service and human contact reassured them and was easy to engage with. Yet, some patients and carers identified problems with engagement (e.g., hesitancy to self‐escalate care). Engagement was influenced by patient factors such as health and knowledge, support from family/friends and staff, availability and ease of use of informational and material resources (e.g., equipment) and service factors. Conclusion Remote home monitoring models place responsibility on patients to self‐manage symptoms in partnership with staff; yet, many patients required support and preferred human contact (especially for identifying problems). Caring burden and experiences of those living alone and barriers to engagement should be considered when designing and implementing remote home monitoring services. Patient or Public Contribution The study team met with service users and public members of the evaluation teams throughout the project in a series of workshops. Workshops informed study design, data collection tools and data interpretation and were conducted to also discuss study dissemination. Public patient involvement (PPI) members helped to pilot patient surveys and interview guides with the research team. Some members of the public also piloted the patient survey. Members of the PPI group were given the opportunity to comment on the manuscript, and the manuscript was amended accordingly.

Abstract Background Previous research in high-income countries (HICs) has shown that smokers reduce their cognitive dissonance through two types of justifications over time: risk minimizing and functional beliefs. To date, however, the relationship between these justifications and smoking behaviors over time has limited evidence from low- and middle-income countries. This study examines these of justifications and their relation to quitting behavior and intentions among smoking tobacco users in India. Methods The data are from the Tobacco Control Policy (TCP) India Survey, a prospective cohort of nationally representative sample of tobacco users. The respondents include smoked tobacco (cigarettes and bidi) users (n = 1112) who participated in both Wave 1 (W1; 2010–2011) and Wave 2 (W2; 2012–2013) surveys. Key measures include questions about psychosocial beliefs such as functional beliefs (e.g., smoking calms you down when you are stressed or upset) and risk-minimizing beliefs (e.g., the medical evidence that smoking is harmful is exaggerated) and quitting behavior and intentions at Wave 2. Findings Of the 1112 smokers at W1, 78 (7.0%) had quit and 86 (7.8%) had intentions to quit at W2. Compared to W1, there was a significant increase in functional beliefs at W2 among smokers who transitioned to mixed use (using both smoking and smokeless tobacco) and a significant decrease among those who quit. At W2, smokers who quit held significantly lower levels of functional beliefs, than continuing smokers, and mixed users ((M = 2.96, 3.30, and 3.93, respectively, p

Abstract Background Acute pancreatitis is one of the most common causes of acute abdomen. It is associated with multiple complications. Gastric perforation and isolated renal vein thrombosis are two infrequent complications. We present a case of acute pancreatitis with gastric perforation and isolated renal vein thrombosis in the same patient. Case presentation A 28-year-old gentleman with chronic alcohol intake presented with complaints of abdominal pain and not responding to analgesics. Biochemical investigations revealed elevated amylase and lipase level. Contrast-enhanced computed tomography (CECT) showed necrotizing pancreatitis with necrotic collection in the lesser sac. On oral contrast, active contrast extravasation from gastric perforation was picked up. Renal vein and splenic vein thrombosis was observed. Conclusions Gastric perforation and renal vein thrombosis are two infrequent complications of acute pancreatitis. High-end radiological suspicion is needed to reduce the associated morbidity and mortality.

The majority of the children experience milder coronavirus disease 2019 (COVID-19) symptoms. Children represent a significant source of community transmission. Children under 18 years of age account for an estimated 4.8% of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections globally. However, no conclusive statements pertaining to the multi-fold aspects of the virus in children could be drawn due to the lower prevalence of pediatric cases. The present study was conducted to identify the indirect impact of SARS-CoV-2 infections on developing herd immunity among children in the age group 3 to 18 years by investigating their antibody levels. In the study, 240 children aged 3~18 years were recruited by the Department of Pediatrics, Government Medical College and Hospital, Amritsar, India, and quantification of the antibodies was performed at the Viral Research and Diagnostic Laboratory (VRDL), Government Medical College (GMC), Amritsar, India. Out of the 240 serum samples, 197 (82.08%) showed seropositivity, while 43 (17.92%) were seronegative. When stratified, it was observed that in the age group 3~6 years, 22.33% of children were found to have anti-SARS-CoV-2 antibodies while in the age groups 7~10 years, 11~14 years, and 15~18 years, respectively, 37.06%, 30.46%, and 10.15% were seropositive. Although there was seroconversion among children which was useful for predicting the next wave, no differences in seropositivity were observed between adults and children.

Introduction: COVID-19 pandemic imposed challenges towards management of transfusion-dependent thalassemia patients (TDT). The need for regular blood transfusions and iron chelation therapy in these patients added further uncertainty about managing COVID-19 in this subset of patients. Aims: To describe the clinical manifestations of SARS-CoV2 infection in patients with TDT and to evaluate feasibility of home management for patients with mild disease. Methodology: The study involved TDT patients registered with thalassemia day care center, DMCH, who tested positive for COVID-19 by RTPCR. The demographics, clinical characteristics and baseline investigations were recorded. Patients with mild disease were managed at home and others were hospitalized. The daily home monitoring and the hospital course were noted and analyzed. Results: The study involved 14 TDT patients who were infected with SARS-CoV2 with a mean age of 18.9 ± 6.7 years and a male to female ratio of 6:1. Five patients each were in low and high-risk groups and 4 patients were in highest risk group. The symptoms reported by these patients were fever, fatigue, sore throat etc. Two patients were hospitalized with one patient requiring oxygen therapy. He was discharged after 48 hours. The other patient had severe cardiac iron overload and diabetes mellitus. His iron chelation therapy was witheld during hospitalization. He presented with a cardiac arrhythmia later and was cardioverted. Thus, all other patients were continued on iron chelation with deferasirox. Twelve patients were successfully managed at home with regular telephonic monitoring. Conclusion: Patients with thalassemia do not necessarily need hospitalization for management of COVID-19. Home management can be offered to patients with mild disease in a resourse limited setting. Iron chelation with deferasirox can be continued safely.

Geopolitical tensions in Southern Asia are characterized by shared borders, major territorial disputes, history of wars, political volatility and instability. This fraught dynamic is compounded by China–India–Pakistan nuclear relations or the nuclear “trilemma” which is shaped by military developments, threat perceptions, as well as alliance, adversary and deterrence relations between the three nuclear-armed states. To mitigate the growing risks in Southern Asia and the impact across the Asia-Pacific, the Asia-Pacific Leadership Network for Nuclear Non-Proliferation and Disarmament and the Toda Peace Institute have collaborated on a research project to map the contours of the China–India–Pakistan nuclear trilemma. The series of articles published in this special issue of the Journal for Peace and Nuclear Disarmament is a selection of nine papers commissioned for the project that address different aspects of the trilemma, examining bilateral, trilateral and plurilateral drivers; exploring practical nuclear risk reduction, crisis stability and confidence building measures and a potential nuclear restraint regime; and identify mechanisms and opportunities for tension reduction and conflict resolution in order to normalize interstate relations and promote people-people ties.

The narrow exit tunnel of the ribosome is important for cotranslational protein folding. Here, authors show that their rationally designed and engineered exit tunnel protein loops modulate the free energy of nascent chain dynamics and folding.

In scaling to global distances, future quantum networks are expected to make use of satellite-based orbiting quantum memories. In this manuscript, the authors simulate the performance of memory-assisted quantum key distribution (MA-QKD) schemes under a range of operating conditions and network configurations, with encouraging conclusions as to the feasibility of implementing such networks with near-term devices.

Abstract Introduction Malignant pleural effusions (MPEs) are common. MPE causes significant breathlessness and impairs quality of life. Indwelling pleural catheters (IPC) allow ambulatory drainage and reduce hospital days and re-intervention rates when compared to standard talc slurry pleurodesis. Daily drainage accelerates pleurodesis, and talc instillation via the IPC has been proven feasible and safe. Surgical pleurodesis via video-assisted thoracoscopic surgery (VATS) is considered a one-off intervention for MPE and is often recommended to patients who are fit for surgery. The AMPLE-3 trial is the first randomised trial to compare IPC (±talc pleurodesis) and VATS pleurodesis in those who are fit for surgery. Methods and analysis A multi-centre, open-labelled randomised trial of patients with symptomatic MPE, expected survival of ≥ 6 months and good performance status randomised 1:1 to either IPC or VATS pleurodesis. Participant randomisation will be minimised for (i) cancer type (mesothelioma vs non-mesothelioma); (ii) previous pleurodesis (vs not); and (iii) trapped lung, if known (vs not). Primary outcome is the need for further ipsilateral pleural interventions over 12 months or until death, if sooner. Secondary outcomes include days in hospital, quality of life (QoL) measures, physical activity levels, safety profile, health economics, adverse events, and survival. The trial will recruit 158 participants who will be followed up for 12 months. Ethics and dissemination Sir Charles Gairdner and Osborne Park Health Care Group (HREC) has approved the study (reference: RGS356). Results will be published in peer-reviewed journals and presented at scientific meetings. Discussion Both IPC and VATS are commonly used procedures for MPE. The AMPLE-3 trial will provide data to help define the merits and shortcomings of these procedures and inform future clinical care algorithms. Trial registration Australia New Zealand Clinical Trial Registry ACTRN12618001013257 . Registered on 18 June 2018. Protocol version: Version 3.00/4.02.19

Keypoints Cyanobacterial Synechocystis pevalekii cells induced calcification on cement mortar. Both live and UV-treated cells increased the compressive strength and reduced the water absorption. Biomineralization by S. pevalekii serves as a low-cost and eco-friendly MICCP technology.

Abstract We demonstrate a dispersion-free wavefront splitting attosecond resolved interferometric delay line for easy ultrafast metrology of broadband femtosecond pulses. Using a pair of knife-edge prisms, we symmetrically split and later recombine the two wavefronts with a few tens of attosecond resolution and stability and employ a single-pixel analysis of interference fringes with good contrast using a phone camera without any iris or nonlinear detector. Our all-reflective delay line is theoretically analyzed and experimentally validated by measuring 1st and 2nd order autocorrelations and the SHG-FROG trace of a NIR femtosecond pulse. Our setup is compact, offers attosecond stability with flexibility for independent beam-shaping of the two arms. Furthermore, we suggest that our compact and in-line setup can be employed for attosecond resolved pump-probe experiments of matter with few-cycle pulses.

Abstract Background Primary signet-ring cell carcinoma (SRCC) of the prostate is a rare and aggressive subtype of prostate adenocarcinoma with a poor prognosis, with only approximately 60 cases reported worldwide. Case presentation A 62-year-old man presented with acute urinary retention and hematuria, after a year’s history of lower urinary tract symptoms. Digital rectal examination revealed an irregular and hard prostate. Flexible cystoscopy showed bladder base infiltration by the enlarged prostate obscuring both ureteric orifices, necessitating nephrostomy and subsequent bilateral antegrade stenting to relieve the obstruction and improve his renal function. Transrectal ultrasonography biopsy of the prostate was performed revealing histological features of SRCC. Due to its rarity, there is currently no standardized treatment approach and it is often similarly treated according to the traditional management of prostate adenocarcinoma. Conclusions SRCC of the prostate is a rare and aggressive subtype of acinar adenocarcinoma with no established guidelines. Histological criteria for SRCC of the prostate are highly variable in the available literature. It is important to differentiate between the primary and metastatic SRCC of the prostate as both are managed differently. However, the overall prognosis remains poor in general.

The function of voltage-gated calcium channels in T cells is not well understood and controversial. Here the authors report that a regulatory beta subunit of voltage-gated calcium channels regulates T cell function despite no evidence that these channels were functional within T cells during activation.

Abstract Background Physical inactivity is a leading risk factor for chronic disease. Brief physical activity counselling delivered within healthcare systems has been shown to increase physical activity levels; however, implementation efforts have mostly targeted primary healthcare and uptake has been sub-optimal. The Brief Physical Activity Counselling by Physiotherapists (BEHAVIOUR) trial aims to address this evidence-practice gap by evaluating (i) the effectiveness of a multi-faceted implementation strategy, relative to usual practice for improving the proportion of patients receiving brief physical activity counselling as part of their routine hospital-based physiotherapy care and (ii) effectiveness of brief physical activity counselling embedded in routine physiotherapy care, relative to routine physiotherapy care, at improving physical activity levels among patients receiving physiotherapy care. Methods Effectiveness-implementation hybrid type II cluster randomised controlled trial with embedded economic evaluation, qualitative study and culturally adapted patient-level outcome measures. The trial will be conducted across five hospitals in a local health district in Sydney, Australia, with a lower socioeconomic and culturally diverse population. The evidence-based intervention is brief physical activity counselling informed by the 5As counselling model and behavioural theory, embedded into routine physiotherapy care. The multi-faceted strategy to support the implementation of the counselling intervention was developed with key stakeholders guided by the Consolidated Framework for Implementation Research and the Capabilities, Opportunities, Motivation-Behaviour (COM-B) theoretical model, and consists of clinician education and training, creating a learning collaborative, tailored strategies to address community referral barriers, team facilitation, and audit and feedback. Thirty teams of physiotherapists will be randomised to receive the multi-faceted implementation strategy immediately or after a 9-month delay. Each physiotherapy team will recruit an average of 10 patients (n=300) to collect effectiveness outcomes at baseline and 6 months. The primary effectiveness outcome is self-reported planned physical activity using the Incidental and Planned Exercise Questionnaire, and the primary implementation outcome is reach (proportion of eligible new physiotherapy patients who receive brief physical activity counselling). Secondary effectiveness and implementation outcomes will also be collected. Discussion This project focuses on physiotherapists as health professionals with the requisite skills and patterns of practice to tackle the increasing burden of chronic disease in a high-risk population. Trial registration ANZCTR, ACTRN12621000194864 . Registered on 23 February 2021.

INTRODUCTION: Post-operative pain following anterior cruciate ligament reconstruction remains an important challenge. Steroids are used in various surgical procedures to decrease post-operative nausea, vomiting and pain. However, only a few studies have reported the effect of systemic administration of steroids in controlling post- operative pain after anterior cruciate ligament surgery. MATERIALS AND METHODS: We have conducted a prospective randomised trial with 109 patients divided into two groups to determine if administration of dexamethasone in the perioperative period improves pain in the post-operative period. The patients were divided into two groups: D, treatment (dexamethasone) and P, control placebo (saline). Patients in the D treatment group were given the first dose of 10mg of intravenous dexamethasone intravenously intra- operatively and the second dose on transferring of the patient to the inpatient department. The patients in the placebo P group, were administered normal saline in the perioperative period in a similar manner. RESULTS: Post-operative pain was significantly less in the dexamethasone group at rest and on walking (p

In the present study, radiation shielding and protection ability of prepared Flyash-lime-Gypsum (FaLG) bricks has been studied in terms of energy exposure build up factors and dose parameters. The energy exposure build up factors of Flyash-lime-Gypsum (FaLG) bricks have been calculated for the energy range of 0.015 MeV–15 MeV and for penetration depth upto 40 mfp directly using a new and simplified Piecewise Linear Spline Interpolation Method (PLSIM). In this new method, the calculations of G.P fitting parameters are not required. The verification and accuracy of this new method has been checked by comparing the results of exposure build up factor for NBS concrete calculated using present method with the results obtained by using G.P fitting method. Further, the relative dose distribution and reduced exposure dose rate for various radioactive isotopes without any shielding material and with Flyash-lime-Gypsum (FaLG) bricks have been calculated in the energy range of 59.59–1332 keV. On the basis of the obtained results, it has been reported that the prepared Flyash-lime-Gypsum (FaLG) bricks possess satisfactory radiation shielding properties and can be used as environmentally safe storage facilities for low level nuclear waste.

Abstract Global quantum communications will enable long-distance secure data transfer, networked distributed quantum information processing, and other entanglement-enabled technologies. Satellite quantum communication overcomes optical fibre range limitations, with the first realisations of satellite quantum key distribution (SatQKD) being rapidly developed. However, limited transmission times between satellite and ground station severely constrains the amount of secret key due to finite-block size effects. Here, we analyse these effects and the implications for system design and operation, utilising published results from the Micius satellite to construct an empirically-derived channel and system model for a trusted-node downlink employing efficient Bennett-Brassard 1984 (BB84) weak coherent pulse decoy states with optimised parameters. We quantify practical SatQKD performance limits and examine the effects of link efficiency, background light, source quality, and overpass geometries to estimate long-term key generation capacity. Our results may guide design and analysis of future missions, and establish performance benchmarks for both sources and detectors.

Abstract The infrastructure plays a vital role in stimulating economic growth. Any infra project requires proper planning, design, construction, quality control (QC), and quality assessment (QA). It is important to comply with QC and QA to avoid failure and enhance the long-term pavement performance in order to provide a safe and solid system of transportation. Researchers were replacing laborious and time-consuming density-based methods (sand cone and/or core cutter) with advanced stiffness or modulus-based NDT devices for the QC of compacted geomaterials. The lightweight deflectometer (LWD) is such a highly advanced and sophisticated device that was developed to evaluate the deformation modulus (ELWD) of compacted geomaterials as an alternative of density test. This device is portable, light-weight, user-friendly, and it is ideally suitable for all constructional geomaterials. This study is intended to provide a state-of-the-art on the LWD device as well as presented the ranges of deformation modulus for various geomaterials from several studies. For instance, in the case of soils, aggregates, and asphalt materials deformation modulus values were found to be in the range of 35–60 MPa, 80–120 MPa, and 120–170 MPa respectively. In addition, several studies have been compiled to completely comprehend the relationship between LWD and various devices.

Background: The gold standard treatment for infected total knee arthroplasty (TKA) is two-stage revision. The first stage involves a temporary antibiotic spacer, which can be static or articulating; it remains unclear which is best. We aimed to compare 5-year outcomes between static and dynamic spacers. Methods: One hundred and seventy-six patients with infected TKA requiring two-stage revision were enrolled. Patients were organized based on the type of spacer used during the first-stage revision. One hundred and four patients received articulating spacers, and 72 received static spacers. At 5 years, postoperative range of motion (ROM), Short Form 12 (SF-12), Knee Society Score (KSS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were recorded. Reinfection and revisions were also tracked. Results: Eradication of infection was similar in both groups, with 83.7% in the articulating group and 86.1% in the nonarticulating spacer group (P = .234). Articulating spacers resulted in significantly improved ROM (111 vs 82 degrees, P < .001), SF-12 physical component score (35.2 vs 31.0, P = .01), KSS (145.2 vs 113.7, P < .001), and WOMAC function scores (60.1 vs 51.1, P = .03) as compared to the static spacer group. Conclusions: Treatment with an articulating spacer as opposed to a static spacer resulted in improved ROM, SF-12 physical component score, KSS, and WOMAC function scores at the final follow-up visit. There was no significant difference in reinfection rates. Patients requiring staged revision for infected TKA may benefit from an articulating spacer.

Purpose: To study the antifungal susceptibility of common corneal pathogenic fungi to antifungal agents in the North Indian population. Methods: Prospective study of the antifungal sensitivity testing (natamycin, amphotericin B, voriconazole, itraconazole, fluconazole, posaconazole, caspofungin, micafungin) of fungal isolates from 50 cases of culture positive fungal keratitis by using E test method. Details noted included demographic data, visual acuity, clinical details, grade of keratitis, healing time, and success in medical management. Results: Of 50 patients with fungal keratitis (mean age: 40.28 ± 16.77 years), 12 eyes healed within 3 weeks, 14 had a delayed healing response, and 24 had chronic keratitis. Among the 15 cases of Fusarium isolates, 93.3% were sensitive to natamycin, while 40% to amphotericin B; 66.6% to voriconazole, 13.4% to itraconazole and fluconazole each. 80% of Fusarium cases (n = 12) showed susceptibility to posaconazole. Among Aspergillus flavus isolates, 53.4% (n = 8) were sensitive to natamycin, with only 40% (n = 7) showing sensitivity to amphotericin B and good susceptibility to azoles. MIC against susceptible Fusarium spp. for natamycin was 3–16 μg/mL, amphotericin B: 1–8 μg/mL, voriconazole: 0.5–1.5 μg/mL, itraconazole: 0.5–12 μg/mL, posaconazole: 0.094–1.5 μg/mL. MIC against Aspergillus flavus was natamycin: 8–32 μg/mL, amphotericin B: 0.5–16 μg/mL, voriconazole: 0.025–4 μg/mL, itraconazole: 0.125–8 μg/mL, posaconazole: 0.047–0.25 μg/mL; against Aspergillus niger isolates, to natamycin was 6 μg/mL (n=1), amphotericin B 8–12 μg/mL (n = 3), voriconazole: 0.125–0.19 μg/mL (n = 3), itraconazole: 0.38–0.75 μg/mL, posaconazole: 0.064–0.19 μg/mL and against Aspergillus fumigatus (n = 1), was natamycin4 μg/mL, amphotericin B - 8 μg/mL, voriconazole 0.25 μg/mL, itraconazole 1 μg/mL, and posaconazole 0.19 μg/mL. MIC against susceptible Acremonium spp. for natamycin was 1.5–16 μg/mL, amphotericin B: 0.5–8 μg/mL, voriconazole: 0.19–3 μg/mL, itraconazole: 0.125 μg/mL, posaconazole: 0.125–0.5 μg/mL and against susceptible Curvularia was natamycin 0.75–4 μg/mL, amphotericin B 0.5–1 μg/mL, voriconazole 0.125–0.19 μg/mL, itraconazole 0.047–0.094 μg/mL, posaconazole 0.047–0.094 μg/mL. MIC against Mucor spp.+ Rhizopus spp. (n = 1) was natamycin: 8 μg/mL, amphotericin B: 0.75 μg/mL, posaconazole: 1.5 μg/mL. MIC against of Alternaria (n = 1) was voriconazole: 0.19 μg/mL, posaconazole: 0.094 μg/mL. MIC against Penicillium (n=1) was natamycin: 8 μg/mL, voriconazole: 0.25 μg/mL, itraconazole: 0.5 μg/mL, and Posaconazole: 0.125 μg/mL. Conclusion: Our observations highlight the variations in susceptibility to antifungal agents. Posaconazole seems to be effective with low MIC against common corneal pathogenic fungal isolates.

Introduction: Shoulder pain is a common presentation in both hospitals and the community. Shoulder pain can result from a number of different pathologies and to manage the shoulder pain, an accurate diagnosis is needed. Method: An accurate diagnosis can often be made following a detailed history and examination. Investigations, such as imaging and blood tests may also be required. In this study, we provide an algorithmic approach to shoulder pain that can be used in the clinical setting. Summary: This algorithm can be used in hospitals and the community to help identify and manage the different causes of shoulder pain.

Background: Coronavirus disease-19 (COVID-19), produced by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic, giving rise to a serious health threat globally. Many countries have seen a two-wave pattern in there reported cases during the period of pandemic. Similarly, our country has reported the first peak between March and October 2020 followed by the second peak between April and June 2021. Objectives: The objective of this study was conducted to describe the spatiotemporal patterns and early epidemiological features of COVID-19 cases from November 2020 to May 2021 in the central (Majha) region of Punjab state of India which was considered as the epicenter of the infection. Methods: The multiplexed real-time reverse transcription–polymerase chain reaction (RT-PCR) method was used to detect SARS-CoV-2, with co-amplification of specific target genes using real-time PCR kits. Results: During the second wave, test positivity rate for COVID-19 in our laboratory (the central region of Punjab) was recorded as 4.8%. The study revealed that an increased sustained proportion of COVID-19 incidence is present in young adult age group (20–39 years) with 8.65% positive rate followed by the older age group and least in young ones. It was observed that during the second wave, more symptomatic individuals are positive (10.26%) alongside it was also observed that male population (5.61%) was more prone to infection in comparison to females (3.78%). Whole-genome sequencing carried out on 120 random samples selected from all the districts of Majha region of Punjab state showed two prominent strains, namely alpha variant (95 cases) and delta variant (19 cases). Conclusion: A higher positivity rate in the second wave demonstrates the rapid spread of the new emerging virus variants and warrants the implementation of strict vaccination regimes and quarantine in the affected region.

To support the massive connectivity in Internet of Things (IoT), several promising techniques like cognitive radio (CR) and non-orthogonal multiple access (NOMA) enables the user to share spectrum resources. This work aims to achieve fairness among secondary users (SUs) in IoT cooperative NOMA-based CR transmission. We design a power allocation algorithm, an independent battery constraint at each node is considered, and power gap among transmissions of two NOMA users is applied for successive interference cancellation. The simulation results show that the proposed framework provides excellent performance and for sufficient available transmission power perfect fairness is achieved.

Background and Aims: Gastrointestinal (GI) symptoms occur among patients diagnosed with coronavirus disease 2019 (COVID-19), and there is clear evidence that SARS-CoV-2, the causative pathogen, infects the GI tract. In this large, multicenter cohort study, we evaluated variations in gastrointestinal and hepatic manifestations of COVID-19 throughout the United States (US). Methods: Patients hospitalized with a positive COVID-19 test prior to October 2020 were identified at 7 US academic centers. Demographics, presenting symptoms, laboratory data, and hospitalization outcomes were abstracted. Descriptive and regression analyses were used to evaluate GI manifestations and their potential predictors. Results: Among 2031 hospitalized patients with COVID-19, GI symptoms were present in 18.9%; diarrhea was the most common (15.2%), followed by nausea and/or vomiting (12.6%) and abdominal pain (6.0%). GI symptoms were less common in the Western cohort (16.0%) than the Northeastern (25.6%) and Midwestern (26.7%) cohorts. Compared to nonintensive care unit (ICU) patients, ICU patients had a higher prevalence of abnormal aspartate aminotransferase (58.1% vs 37.3%; P < .01), alanine aminotransferase (37.5% vs 29.3%; P = .01), and total bilirubin (12.7% vs 9.0%; P < .01). ICU patients also had a higher mortality rate (22.7% vs 4.7%; P < .01). Chronic liver disease was associated with the development of GI symptoms. Abnormal aspartate aminotransferase or alanine aminotransferase was associated with an increased risk of ICU admission. Conclusion: We present the largest multicenter cohort of patients with COVID-19 across the United States. GI manifestations were common among patients hospitalized with COVID-19, although there was significant variability in prevalence and predictors across the United States.

Context: Sexually transmitted infections (STIs) are a problem of increasing concern among men and women. They can affect fertility, increase maternal and neonatal morbidity, and can become a burden on both physical and emotional health. Owing to lack of awareness and partly due to the social stigma attached, couples do not come forward for screening. Antenatal testing for STIs is an effective strategy recommended to detect STIs in this subset of the population. Aims: To estimate the seroprevalence of four STIs (hepatitis B, hepatitis C virus, HIV, and syphilis) in pregnant women, to evaluate its correlation with sociodemographic characteristics and sexual behavior, and to check awareness regarding STIs. Settings and Design: It was an observational study on 500 pregnant women attending an antenatal clinic at a tertiary care hospital in rural Haryana, India. Methods and Material: Pregnant women were screened for four STIs – hepatitis B, hepatitis C virus, HIV, and syphilis. Statistical Analysis Used: The sample size was calculated considering the mean reported seroprevalence of infections in pregnant women in previous studies. The power of the study was kept 80% and the alpha error was 0.05. Results: Seroprevalence for STIs in pregnancy was 5.2% – hepatitis C virus (2.6%), hepatitis B (2.4%), and syphilis (0.4%). Conclusions: Viral STIs are more prevalent among pregnant women. Antenatal screening is an effective strategy for the detection of STIs in pregnant women.

This publication summarizes the basic concepts of three most-used NO3-N leaching quantification methods in field conditions. Written by Bibek Acharya, Vivek Sharma, Charles Barrett, Sudeep Singh Sidhu, Lincoln Zotarelli, and Michael D. Dukes, and published by the UF/IFAS Department of Agricultural and Biological Engineering, December 2022.

Histoplasmosis occurs predominantly in immunocompromised hosts and typically presents with mild constitutional symptoms, weight loss, weakness, fatigability, hepatosplenomegaly, and lymphadenopathy. The diagnosis is generally delayed and is based upon isolating the organism in blood cultures or by identifying intracellular organisms in tissues. Disseminated Histoplasmosis is well described in HIV patients but Histoplasmosis myositis is a rare manifestation and has not been reported in seronegative patients till date. We here address a case of a pharmacologically immunosuppressed patient with extensive Histoplasmosis myositis invading almost all the skeletal muscles of body (including plantar foot muscles) with no evidence of dissemination to other organ-systems. Clinical examination and investigations co-related with infiltrative muscle disease and skeletal muscle biopsy revealed Histoplasma capsulatum. This patient illustrates a distinctive clinical presentation of fungal infection with subtle constitutional symptoms and isolated muscle weakness which added to the diagnostic challenge. Hence, differential diagnosis of fungal infection must always be considered as a cause of myopathy in any pharmacologically immunosuppressed patient.

Abstract We report new genetic diagnoses of Dravet syndrome in a group of adults with complex epilepsy of unknown cause, under follow‐up at a tertiary epilepsy center. Individuals with epilepsy and other features of unknown cause from our unit underwent whole‐genome sequencing through the 100 000 Genomes Project. Virtual gene panels were applied to frequency‐filtered variants based on phenotype summary. Of 1078 individuals recruited, 8 (0.74%) were identified to have a pathogenic or likely pathogenic variant in SCN1A. Variant types were as follows: nonsense (stopgain) in five (62.5%) and missense in three (37.5%). Detailed review of childhood history confirmed a phenotype compatible with Dravet syndrome. Median age at genetic diagnosis was 44.5 years (range 28‐52 years). Tonic‐clonic seizures were ongoing in all despite polytherapy including valproate. All had a history of fever sensitivity and myoclonic seizures, which were ongoing in two (25%) and three (37.5%) individuals, respectively. Salient features of Dravet syndrome may be less apparent in adulthood, making clinical diagnosis difficult. Regardless of age, benefits of a genetic diagnosis include access to syndrome‐specific treatment options, avoidance of harmful drugs, and monitoring for common complications.

Abstract Suppressor of cytokine signaling (SOCS)2 protein is a key negative regulator of the growth hormone (GH) and Janus kinase (JAK)-Signal Transducers and Activators of Transcription (STAT) signaling cascade. The central SOCS2-Src homology 2 (SH2) domain is characteristic of the SOCS family proteins and is an important module that facilitates recognition of targets bearing phosphorylated tyrosine (pTyr) residues. Here we identify an exosite on the SOCS2-SH2 domain which, when bound to a non-phosphorylated peptide (F3), enhances SH2 affinity for canonical phosphorylated ligands. Solution of the SOCS2/F3 crystal structure reveals F3 as an α-helix which binds on the opposite side of the SH2 domain to the phosphopeptide binding site. F3:exosite binding appears to stabilise the SOCS2-SH2 domain, resulting in slower dissociation of phosphorylated ligands and consequently, enhances binding affinity. This biophysical enhancement of SH2:pTyr binding affinity translates to increase SOCS2 inhibition of GH signaling.

Patients with atrial fibrillation (AF) were largely excluded from the major clinical trials of cardiac resynchronization therapy (CRT), despite the presence of AF in up to 40% of patients receiving CRT in clinical practice. AF appears to attenuate the response to CRT, by the combination of a reduction in biventricular pacing and the loss of atrioventricular synchrony. In addition, remodeling secondary to CRT may influence the progression of AF. Management options for patients with AF and CRT include rate control, with drugs or atrioventricular node ablation, or rhythm control, with electrical cardioversion and antiarrhythmic therapy, or AF catheter ablation. The evidence for these therapies in patients with CRT is largely limited to observational studies or inferred from randomized studies in the general heart failure population. In this review, we explore the complex interaction between AF, heart failure, and CRT and discuss the evidence for the treatment options in this difficult patient cohort.

Abstract The subgingival microbiome is one of the most stable microbial ecosystems in the human body. Alterations in the subgingival microbiome have been associated with periodontal disease, but their variations over time and between different subgingival sites in periodontally healthy individuals have not been well described. We performed extensive, longitudinal sampling of the subgingival microbiome from five periodontally healthy individuals to define baseline spatial and temporal variations. A total of 251 subgingival samples from 5 subjects were collected over 6–12 months and deep sequenced. The overall microbial diversity and composition differed significantly between individuals. Within each individual, we observed considerable differences in microbiome composition between different subgingival sites. However, for a given site, the microbiome was remarkably stable over time, and this stability was associated with increased microbial diversity but was inversely correlated with the enrichment of putative periodontal pathogens. In contrast to microbiome composition, the predicted functional metagenome was similar across space and time, suggesting that periodontal health is associated with shared gene functions encoded by different microbiome consortia that are individualized. To our knowledge, this is one of the most detailed longitudinal analysis of the healthy subgingival microbiome to date that examined the longitudinal variability of different subgingival sites within individuals. These results suggest that a single measurement of the healthy subgingival microbiome at a given site can provide long term information of the microbial composition and functional potential, but sampling of each site is necessary to define the composition and community structure at individual subgingival sites.

Psyllium husk (Plantago ovata Forssk.), is an excellent source of natural soluble fiber. Arabic flatbread formulation standardized in a laboratory was scaled up for production in a commercial bakery. The water holding capacity (WHC) of wholegrain wheat flour (WGF), white wheat flour (WWF) and psyllium husk (PS) were found to be 2.9, 2.3 and 59.2 g water/g dry matter, respectively. The total dietary fiber (TDF) for WWF control bread (3.20 ± 0.23%) increased significantly to 5.62 ± 0.16 and 7.56 ± 0.18% with the addition of 3% and 5% psyllium, respectively. The corresponding soluble dietary fiber (SDF) values for these samples were 1.31 ± 0.13, 3.02 ± 0.16 and 4.15 ± 0.14%, respectively. The WWF Arabic flatbread samples also followed a similar trend for TDF and SDF contents with the addition of psyllium husk. At a level of 5% psyllium, the WWF test bread had a puncture force of 2.97 ± 0.16 N (much softer) compared with 3.40 ± 0.35 N for the WWF control bread (0% psyllium), whereas the WGF with 5% psyllium addition had a puncture force of 3.05 ± 0.19 N at the zero day of storage compared to that of 3.94 ± 0.19 N for WGF bread with no psyllium added. The major objective of this study was not only to enhance the soluble dietary fiber content in Arabic flatbread, but also to improve the consumer acceptability of this staple food of this region. Incorporation of psyllium husk did not adversely affect the objective color of crumb or overall consumer acceptability, and produced Arabic flatbread with softer texture, better flexibility (folding) and superior eating quality.

Lutein is a yellow plant pigment belonging to the xanthophyll family of carotenoids and widely present in marigold flowers. Lutein is an effective antioxidant that may be utilized in foods as a natural coloring pigment and functional food ingredient. The present study evaluated the effect of lutein in two types of marigold flowers belonging to the Tagetes erecta and Tagetes patula species on selected functional properties of baked pan bread. Marigold flowers dried by three different methods (oven, vacuum, freeze-drying) were incorporated into white wheat flour (WWF) and wholegrain wheat flour (WGF) bread recipes. Lutein content in marigold flower petals and baked breads were quantified using Ultra-Fast Liquid Chromatography (UFLC). Texture and color properties of baked bread crust and crumb were determined. Tagetes erecta marigold flower showed significantly higher amount of lutein, and freeze-drying process was found to be the best technique for preserving lutein in the baked products. The freeze-dried African marigold and French marigold petals had lutein content of 150.98 ± 26.87 ppm and 78.26 ± 0.66, respectively. The L* value and whiteness of baked breads decreased which led to decreasing lightness of WWF bread crumb after addition of MFP. The total color difference, ∆E, and the redness index, RI, between control WWF bread crumb and WGF bread crumb increased as the level of MFP increased in the bread formulations. The data suggest that lutein-rich ground marigold may be used as a functional food ingredient to enhance color as well as antioxidant properties of bread.