Gene Selection in Disease: Review

In utilizing AI algorithms to investigate expression patterns, genetic factors are a significant problem for objective aggregates. Numerous genetic characteristics exist, but just a few have substantial relationships with a specific aggregate. For example, a two-way malignant growth/non-disease investigation involves the identification of fifty of these genetic variables. Three distinct techniques are as follows. A system based on affiliation rules and half-fluffy dynamic trees has been developed for disease detection using data mining technologies. The primary approach proposes an effective half-and-half strategy for reducing the number of exceptions. Anomaly detection is an interesting topic of research in data mining. Due to the usage of bunching strategies, anomalies that do not fit into any of the groups are discovered. Nonetheless, a few ambiguous features may be included in the group. To completely purge the dataset of superfluous data, it is required to identify and purge data that has converged with the groups. This approach depends on two distinct types of data mining algorithms to discover anomalies in a dataset: multilayer neural networks (MLN) and thickness-based K-implies. Affiliation rules are established, and the effect % of everything derived from the standard upon which the fluffy guidelines are based is calculated in the manner illustrated below.

Stakeholder Engagement in Planning the Design of a National Needs Assessment for Cardiovascular Disease Prevention and Management in Nepal

BACKGROUND

There is growing support for stakeholder engagement in health research, but the actual impact of such engagement has not been well established.

OBJECTIVES

This paper describes the stakeholder engagement process and evaluation during the planning of the national needs assessment for cardiovascular disease in Nepal.

METHODS

We used personal and professional networks to identify relevant stakeholders within the 7Ps framework (Patients and the Public, Providers, Purchasers, Payers, Public Policy Makers and Policy Advocates, Product Makers and the Principal Investigators) to develop a plan for assessing cardiovascular health needs in Nepal. We consulted 40 stakeholders through 2 meetings in small groups and a workshop in a large group to develop the study methods, conceptual framework, and stakeholder engagement process. We interviewed 33 stakeholders to receive feedback on the stakeholder engagement process.

RESULTS

We engaged 80% of the targeted stakeholders through small group discussions and a workshop. Three of 5 recommendations from the small group discussion were aimed at improving the stakeholder engagement process and 2 were aimed to improve the research methods. Eleven of 27 recommendations from the workshop aimed to improve the research methods, 4 aimed to improve stakeholder engagement, and 2 helped to expand the scope of dissemination. Ten were irrelevant or could not be incorporated due to resource limitation. Most stakeholders noted that the workshop provided an open platform for a multisectoral group to colearn from one another and share ideas. Others highlighted that the discussion generated insights to enhance research by incorporating expertise and ideas from different perspectives. The major challenges discussed were about committing the time for engagement.

CONCLUSIONS

The stakeholder engagement process positively affected the design of our research. This study provides important insights for future researchers that aim to engage stakeholders in national-level assessment programs in the health care system in the context of Nepal.

Anti-quorum sensing and antibiofilm potential of Alternaria alternata, a foliar endophyte of Carica papaya, evidenced by QS assays and in-silico analysis

In the present study, secondary metabolites from an endophytic fungus, Alternaria alternata, colonizing Carica papaya, demonstrated antiquorum sensing properties against Pseudomonas aeruginosa. This study reports the antagonistic effects of fungal crude extract of A. alternata against the various quorum sensing (QS) associated virulent factors such as percentage decrease in production of pyocyanin, alginate, chitinase and rhamnolipid; significant decrease in proteases activity such as LasA protease activity, staphylolytic activity, Las B elastase; and a marked decrease in biofilm formation and associated factors such as exopolysaccharide (EPS) production and cell surface hydrophobicity (CSH). Further, motility pattern i.e., swimming and swarming was also found to be inhibited. This down regulation of QS and associated factors are further supported by in-silico analysis of interaction between QS receptor LasR and bioactive molecules viz., sulfurous acid, 2-propyl tridecyl ester and 1,2-benzenedicarboxylic acid, bis(2-methylpropyl) ester present in fungal crude extract, found based on GCMS analysis, sketches the modulating ability of QS expression. This is the first report on an endophytic fungus of C. papaya having a role in QS inhibition against P. aeruginosa and lays a platform to explore further the endophytes for potent therapeutic agents in QS.

A comparative study of odontogenic keratocyst and orthokeratinized odontogenic cyst using Ki67 and α smooth muscle actin

Aim

This study aimed to demonstrate and evaluate the expression of stromal myofibroblasts (MFs) and epithelial cell proliferation using α-smooth muscle actin (α-SMA) and Ki67 markers, respectively, in odontogenic keratocyst (OKC) and orthokeratinized odontogenic cyst (OOC) to correlate their aggressive behavior.

Materials and Methods

Twenty cases of OKC and twenty cases of OOC were stained with α-SMA and Ki67 markers for demonstration of stromal MFs and epithelial cell proliferation, respectively, and ten cases of well-differentiated squamous cell carcinoma were used as positive control. Assessment of the number of α-SMA-positive stromal cells and Ki67-positive epithelial cells determined by MFs and proliferative epithelial cell frequency in 10 high-power fields (×400) was presented as the mean number of positive cells per field.

Statistical Analysis

Kruskal-Wallis and Mann-Whitney test were used to analyze the difference in the mean number of α-SMA- and Ki67-positive cells per field between OKC and OOC.

Results

The mean number of positively stained cells for α-SMA and Ki67 is significantly higher in OKC compared to OOC.

Conclusion

Impression is that, the different behaviors of these two entities are compatible with their immunohistochemical view. The high value of stromal MFs and proliferative epithelial cells in OKC in comparison to OOC indicates its aggressiveness and potential for recurrence.

Immunomorphological assessment of regional lymph nodes for predicting metastases in oral squamous cell carcinoma

BACKGROUND

Oral squamous cell carcinoma is the most common neoplasm and comprises of approximately 80% of the cancers occurring in the oral cavity. The role of the host response to this neoplasm has been recognized, and for many years the regional lymph node in tumor-bearing hosts has been considered as an anatomic barrier to the systematic dissemination of tumor cells. Morphological evaluation of the regional nodes has aided in understanding the immune response.

AIM

The current study was carried out to observe the morphological changes occurring in the regional lymph nodes and to evaluate whether these features could be helpful in assessing the immunological status of the patient, and thereby, the prognosis of the patient.

MATERIALS AND METHODS

The study was based on lymph nodes from 63 patients with oral squamous cell carcinoma, who underwent radical neck dissection or modified neck dissection. In the lymph node, four morphological patterns were observed that included lymphocyte predominance, germinal center predominance, mixed pattern (sinus Histiocytosis), and an unstimulated pattern. The cases were then divided into four groups according to the predominant immunoreactivity pattern based on the World Health Organization (WHO) standardized system for reporting human lymph node morphology.

RESULTS

Revealed that risk of metastases to cervical lymph nodes in patients with lymphocyte predominance was less (28.6%) when compared to the high risk of metastases with germinal center predominance (68%), and these results were statistically significant (P < 0.05). Patients with a mixed pattern showed less risk of metastases (45.4%), while those with an unstimulated pattern had increased risk of metastases (66.6%), but the results were not statistically significant. It was also found that in the positive nodes, germinal center hyperplasia (50.2%) was the predominant pattern.

CONCLUSION

The present study revealed that patients with lymphocyte predominance had less risk of metastases and patients with germinal center predominance had a high risk of metastases to the lymph node.

Unravelling the retention of proliferation and differentiation potency in extensive culture of human subcutaneous fat-derived mesenchymal stem cells in different media

OBJECTIVES

This study has intended to investigate longevity of subcutaneous fat-derived mesenchymal stem cells (SF-MSCs) under extensive culturing. It has also focused on optimization of culture media for them over prolonged periods in vitro.

MATERIALS AND METHODS

We evaluated SF-MSCs with reference to phenotypic characterization, proliferative ability, karyotype stability and differentiation potency with early (P3) and late passage (P20) conditions, using four different media, DMEM-LG, ALPHA-MEM, DMEM-F12 and DMEM-KO.

RESULTS

This study unravels retention of SF-MSC characteristics in facets of phenotypic expression profile (CD 90, CD 105, CD 73, CD 34, CD 29, CD 54, CD 49d, CD 117, HLA-DR, CD 166, CD 31, CD 44), proliferative characteristics, karyotyping and differentiation potency prolonged culturing to P25 in all media. Population doubling time (PDT) in Alpha MEM, DMEM LG, DMEM F 12, DMEM KO were identified to be (1.81, 1.84, 1.9, 2.08 days) at early passage and (2.93, 2.94, 3.12, 3.06 days) at late passage. As a corollary, Alpha MEM and DMEM LG serve as appropriate basal media for SF-MSC when proliferative potency is considered.

CONCLUSIONS

In research, it is imperative that SF-MSC uphold their expansion potency in the aforesaid attributes in all media over extensive culturing, thereby transforming their colossal in vitro potency, with the aim of curing a wide horizon of diseases.

Combined spinal epidural anesthesia for cesarean section in a patient with left lung agenesis

Agenesis of the lung is a rare developmental defect characterized by complete absence of one lung, or hypoplasia of one or both lungs. The majority of reported cases have been associated with other congenital anomalies. It is usually detected in childhood as a result of either pulmonary symptoms or associated anomalies. Although pulmonary agenesis has been reported in adults, there is no report of the management of a pregnant patient for cesarean section in the anesthetic literature. We report the management of a 23-year-old pregnant female at 36 weeks' gestation with oligohydramnios and left lung agenesis for elective cesarean section. She presented with a history of repeated chest infection and was found to have restrictive lung function. She had no other congenital anomalies. Combined spinal epidural anesthesia was administered for cesarean section. The intraoperative course was uneventful except for bradyarrhythmias followed by tachyarrhythmias on manipulation of the uterus. She was given low dose epidural morphine with local anesthetic and intramuscular diclofenac for postoperative analgesia. We believe that normal pregnancy can safely be undertaken in the presence of left lung agenesis. In view of associated congenital anomalies in more than 50% of the cases, anesthetic management should include a particularly careful survey of other systems. The patient should otherwise be managed like any patient with limited pulmonary reserve. Combined spinal epidural anesthesia is safe and appropriate for such patients.