HYPOalert: Designing Mobile Technology for Hypoglycemic Detection and Monitoring--Based on Human Breath

Hypoglycemia (HYPO) is characterized by low blood glucose (BG)--leading to complications such as sweating, weakness, passing-out, coma, and even death. Effective HYPO management is required to avoid complications and to increase quality of life. Recently, a noninvasive smart breathing sensor was developed for detection of HYPO in human breath (HYPOalert). The device has the ability to deliver data (via Bluetooth) to a mobile application--with the intent to support Type 1 and 2 diabetics with the self-management of their hypoglycemia. This paper presents the first two (prototype) design iterations of research and testing of HYPOalert. Twelve Type 1 and 2 diabetics were interviewed to deduce user requirements and to understand their perception and level of interest in the proposed mobile system. Outcomes informed a human-centered design process of the interactive prototype, currently under final testing. Results were positive--showing that users were very interested in HYPOalert's use of visualization, as well as its HYPO monitoring and alert system that supports diabetes patients' healthy lifestyle management

A Correlation of Tumor Budding and Tumor Stroma Ratio with Clinicopathological Factors in Oral Squamous Cell Carcinoma

Background: Squamous cell carcinoma is the most common carcinoma in the head and neck region. Both tumor budding and tumor stroma ratio are being studied in the recent years in various solid tumors for their role as a prognostic marker, however the studies in oral squamous cell carcinoma are limited. Methods: A total of 50 patients of oral squamous cell carcinoma proved histologically were included in the study over a period of 4 months (July 2022-October 2022). Tumor budding(TB) and Tumor stroma ratio (TSR) were evaluated on routine hematoxylin and eosin stained sections and these were correlated with clinicopathological parameters. Statistical analysis was done using Chi-square test and p value <.05 considered significant. Result: The mean age was 52.72 +_ 13.16 and M: F of 7.1:1. Most of the tumors were located on tongue (46%) followed by buccal mucosa (26%), gingivobuccal sulcus (12%) and retromolar trigone (8%). Palate and alveolus were the other sites involved constituting 4% each. Both TB and TSR were found to be significantly associated with grade of the tuumor, lymph node metastasis and size of the tumor. A highly significant correlation was also found between Tb and TSR with a p value <.001. Conclusion: Both TB and TSR can be easily evaluated on routine H&E sections and are highly reproducible and found to be reliable independent prognostic markers in OSCC. Thus, this simple and cost-effective method of prognostification which is currently lacking will help in identifying patients with poor prognosis and thus, individualise the treatment plan. Keywords: Tumor Budding, Oral squamous cell carcinoma, Tumor stroma ratio

Human heterochromatin protein 1 isoforms HP1(Hsα) and HP1(Hsβ) interfere with hTERT-telomere interactions and correlate with changes in cell growth and response to ionizing radiation

Telomeres are associated with the nuclear matrix and are thought to be heterochromatic. We show here that in human cells the overexpression of green fluorescent protein-tagged heterochromatin protein 1 (GFP-HP1) or nontagged HP1 isoforms HP1(Hsα) or HP1(Hsβ), but not HP1(Hsγ), results in decreased association of a catalytic unit of telomerase (hTERT) with telomeres. However, reduction of the G overhangs and overall telomere sizes was found in cells overexpressing any of these three proteins. Cells overexpressing HP1(Hsα) or HP1(Hsβ) also display a higher frequency of chromosome end-to-end associations and spontaneous chromosomal damage than the parental cells. None of these effects were observed in cells expressing mutants of GFP-ΔHP1(Hsα), GFP-ΔHP1(Hsβ), or GFP-ΔHP1(Hsγ) that had their chromodomains deleted. An increase in the cell population doubling time and higher sensitivity to cell killing by ionizing radiation (IR) treatment was also observed for cells overexpressing HP1(Hsα) or HP1(Hsβ). In contrast, cells expressing mutant GFP-ΔHP1(Hsα) or GFP-ΔHP1(Hsβ) showed a decrease in population doubling time and decreased sensitivity to IR compared to the parental cells. The effects on cell doubling times were paralleled by effects on tumorigenicity in mice: overexpression of HP1(Hsα) or HP1(Hsβ) suppressed tumorigenicity, whereas expression of mutant HP1(Hsα) or HP1(Hsβ) did not. Collectively, the results show that human cells are exquisitely sensitive to the amount of HP1(Hsα) or HP1(Hsβ) present, as their overexpression influences telomere stability, population doubling time, radioresistance, and tumorigenicity in a mouse xenograft model. In addition, the isoform-specific effects on telomeres reinforce the notion that telomeres are in a heterochromatinized state

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Utility of fibronectin in immuocytochemial differentiation of reactive mesothelial cells from metastatic malignant cells in serous effusions

Cytological evaluation of serous effusions often poses difficulties to the pathologists. This study was designed to assess the utility of fibronectin as a mesothelial cell marker and evaluate its use along with carcinoembryonic antigen (CEA) as a short panel to aid in the differentiation of reactive mesothelial cells from metastatic adenocarcinoma cells in serous effusions. Forty serous effusion cases from clinically benign cases and forty from clinically malignant cases with a known primary were included in the study. After routine cytological evaluation, the cases were categorized as benign, suspicious and malignant. All the cases were studied for fibronectin and CEA immunostaining using APAAP technique. In the present study, fibronectin emerged as a 100% specific and 93.4% sensitive marker for mesothelial cells. CEA immunostaining was seen in 80% cases of metastatic adenocarcinoma in serous effusions. Mesothelial cells did not show any CEA positivity. Short panel of CEA and fibronectin aided in reaching a correct diagnosis in three out of five cytologically suspicious cases

Modified Faden operation –A new surgical technique

Faden operation was first described in 1912. It weakens the muscle in its field of action without much slackening and alteration in the primary position. When combined with recession the weakening effect is more. It is a useful surgery in esotropia with high accommodative convergence, nystagmus blockage syndrome, dissociated vertical deviation, Duane's retraction syndrome with up or downshoots, and in sixth nerve paresis, where it is performed on the contralateral normal yoke muscle to increase the field of binocular vision. The conventional procedure is cumbersome due to small working space, entanglement of sutures, and posterior location of Faden site which is not easily accessible. We have modified the Faden operation by using a single 5-0 double-armed polyester suture, which is much easier and simpler to perform, and have done it in a series of small angle esotropias combined with recession. This paper demonstrates the surgical technique so that this surgery can be performed with ease by more surgeons

Complexes of Tin(IV) & Organotin(IV) Chlorides with Schiff Bases Derived from Thiocarbohydrazide

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Correlation of ultrasonographic measurements, histopathological grading, and clinical staging in oral submucous fibrosis

Aims and Objectives: To evaluate the presence and thickness of submucosal fibrosis in oral submucous fibrosis (OSMF) patients ultrasonographically and to correlate these findings with the clinical stage and histological grade of OSMF. Materials and Methods: Forty participants (twenty cases and twenty controls) were included in the study. The patients diagnosed clinically as having OSMF and consented for biopsy were included in the cases, and completely healthy individuals with no habit history or oral lesions were included in the control group after matching the body mass index. After clinically staging, the patients' transcutaneous ultrasonography (USG) was performed and after that punch biopsy was taken and the specimen was graded histopathologically. Results: The data were statistically analyzed using Mann–Whitney test and Spearman's rank correlation. The cases showed increased submucosal thickness as compared to the controls. The USG measurements statistically correlated with the clinical stage and histopathological grade of OSMF. Conclusion: USG proves to be a valuable adjunctive modality in diagnosing, staging and also evaluating the prognosis of OSMF

Pigmented basal cell carcinoma: Cytological diagnosis and differential diagnoses

Pigmented basal cell carcinoma is a rare cutaneous neoplasm with only a few cases reported so far. Review of the literature yielded only an occasional fine-needle aspiration report of the cytologic features of the tumor.We report a rare case of pigmented basal cell carcinoma occurring on the thigh of a 55-year-old woman. The cytological features are described with discussion over the possible differential diagnoses