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Bacillus amyloliquefaciens QST713 and B. firmus I-1582 are bacterial strains which are used as active ingredients of commercially-available soil application and seed treatment products Serenade® and VOTiVO®, respectively. These bacteria colonize plant roots promoting plant growth and offering protection against pathogens/pests. The objective of this study was to develop a qPCR protocol to quantitate the dynamics of root colonization by these two strains under field conditions. Primers and TaqMan® probes were designed based on genome comparisons of the two strains with publicly-available and unpublished bacterial genomes of the same species. An optimized qPCR protocol was developed to quantify bacterial colonization of corn roots after seed treatment. Treated corn seeds were planted in non-sterile soil in the greenhouse and grown for 28 days. Specific detection of bacteria was quantified weekly, and showed stable colonization between ~104-105 CFU/g during the experimental period for both bacteria, and the protocol detected as low as 103 CFU/g bacteria on roots. In a separate experiment, streptomycin-resistant QST713 and rifampicin-resistant I-1582 strains were used to compare dilution-plating on TSA with the newly developed qPCR method. Results also indicated that the presence of natural microflora and another inoculated strain does not affect root colonization of either one of these strains. The same qPCR protocol was used to quantitate root colonization by QST713 and I-1582 in two corn and two soybean varieties grown in the field. Both bacteria were quantitated up to two weeks after seeds were planted in the field and there were no significant differences in root colonization in either bacteria strain among varieties. Results presented here confirm that the developed qPCR protocol can be successfully used to understand dynamics of root colonization by these bacteria in plants growing in growth chamber, greenhouse and the field.

Diabetes mellitus is a growing concern all over the world. There are no many published literature available documenting the effectiveness of Ayurveda intervention on diabetes mellitus. This report is about a case in which successful reversal of diabetes mellitus was achieved in a patient who reported with glycosylated Hb percentage (HbA1C) as high as 14.87%. The patient had classical symptoms of diabetes mellitus viz. excessive thirst, fatigue and frequent urination. His fasting blood glucose level was 346 mg/dl and post prandial glucose level of 511 mg/dl. Further more his HbA1C was as high as 14.87%, thus diagnosed with diabetes mellitus. Based on his specific clinical symptoms the patient was diagnosed with kaphaja prameha. Treatment was given according to classical Ayurveda intervention for kaphaja prameha. The patient responded well to the treatment. His HbA1C reduced to 6.05% in a span of eight months. The case report shows the effectiveness of Ayurvedic intervention in diabetes mellitus. It is limited in its scope as it is a case report, nevertheless this can be taken up as an information that may lead to new research and advances in the field of clinical practice in Ayurveda.

BackgroundTransparency in physician billing practices in the United States is lacking. Often, charges may vary substantially between providers and excess charges may be passed on to the patient. In this study, we evaluate Medicare charges and payments for minimally invasive lobectomy to obtain a sense of national billing practices and evaluate for predictors of higher charges.MethodsThe 2018 Medicare Provider Utilization Data was queried to identify surgeons submitting charges for Video-Assisted Thoracoscopic Lobectomy. Excess charges were determined by each provider. Additional demographic variables were collected including geographic region for general surgery and cardiothoracic surgery training, years in practice, and current practice setting. A multivariate gamma regression was utilized to determine predictors of high billing practices.ResultsA total of 307 unique providers submitted charges ranging from $1,104 to $25,128 with a median of $4,265. The average Medicare Payment amount ranged from $163 to $1,409, with a median of $1,056. Male surgeons were estimated to charge 1.3 times more than female surgeons, while those in an academic setting were estimated to charge 1.4 times more than private practice (p < 0.01). Surgeons practicing in the South or West were estimated to charge 0.76 and 0.81 times as much as those practicing in the Northeast (p < 0.01).ConclusionsBilling practices vary widely across the United States. Charges submitted to Medicare likely represent a provider’s charges across all payers. In today's healthcare economy, it is important for patients to understand the true cost of care and for providers to be mindful of reasonable and appropriate charges.

Structural variation (SV) is typically defined as variation within the human genome that exceeds 50 base pairs (bp). SV may be copy number neutral or it may involve duplications, deletions, and complex rearrangements. Recent studies have shown SV to be associated with many human diseases. However, studies of SV have been challenging due to technological constraints. With the advent of third generation (long-read) sequencing technology, exploration of longer stretches of DNA not easily examined previously has been made possible. In the present study, we utilized third generation (long-read) sequencing techniques to examine SV in the EGFR landscape of four haplotypes derived from two human samples. We analyzed the EGFR gene and its landscape (+/- 500,000 base pairs) using this approach and were able to identify a region of non-coding DNA with over 90% similarity to the most common activating EGFR mutation in non-small cell lung cancer. Based on previously published Alu-element genome instability algorithms, we propose a molecular mechanism to explain how this non-coding region of DNA may be interacting with and impacting the stability of the EGFR gene and potentially generating this cancer-driver gene. By these techniques, we were also able to identify previously hidden structural variation in the four haplotypes and in the human reference genome (hg38). We applied previously published algorithms to compare the relative stabilities of these five different EGFR gene landscape haplotypes to estimate their relative potentials to generate the EGFR exon 19, 15 bp canonical deletion. To our knowledge, the present study is the first to use the differences in genomic architecture between targeted cancer-linked phased haplotypes to estimate their relative potentials to form a common cancer-linked driver mutation.

Asian, Native Hawaiian, and Pacific Islanders (ANHPI) have a higher prevalence of type II diabetes compared to the non-Hispanic White (NHW) population. However, the incidence of type II diabetes among ANHPI lung cancer survivors is unknown. The aim of this study is to investigate the risk of newly diagnosed type II diabetes among older ANHPI lung cancer survivors compared to older NHW lung cancer survivors. We identified 3920 ANHPI and 11,760 NHW lung cancer survivors diagnosed from 2000 to 2017 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of type II diabetes, adjusting for potential confounding factors. Older ANHPI lung cancer survivors had an increased risk of incident type II diabetes compared to older NHW lung cancer survivors > 1 year after cancer diagnosis. For specific ANHPI subgroups, increased risks of type II diabetes were observed among Asian Indian and Pakistani (HR, 5.14; 95% CI 2.10, 12.60) compared to NHW patients, followed by Native Hawaiian and Pacific Islander (NHPI) (HR, 4.38; 95% CI 1.22, 15.74), Vietnamese (HR, 2.32; 95% CI 1.29, 4.18), Korean (HR, 2.26; 95% CI 1.13, 4.54), Filipino (HR, 1.78; 95% CI 1.00, 3.16), and Chinese (HR, 1.75; 95% CI 1.10, 2.79) lung cancer survivors. Older ANHPI lung cancer survivors had a higher risk of type II diabetes compared to older NHW lung cancer survivors. Further research is needed to examine the underlying causes of health disparities in diabetes risk among ANHPI lung cancer survivors. These findings suggest that increasing surveillance on type II diabetes and monitoring body weight for older ANHPI lung cancer patients may be beneficial.

There is a paucity of health policy relevant data for chronic liver disease from India, impeding formulation of an interventional strategy to address the issue. A prospective, multicentric study to delineate the etiology and clinical profile of chronic liver disease in India is reported here. A centrally coordinated and monitored web-based data repository was developed (Feb, 2010 to Jan, 2013) and analyzed. Eleven hospitals from different parts of India participated. Data were uploaded into a web based proforma and monitored by a single centre according to a standardized protocol. 1.28% (n = 266621) of all patients (n = 20701383) attending the eleven participating hospitals of India had liver disease. 65807 (24·68%) were diagnosed for the first time (new cases). Of these, 13014 (19·77%, median age 43 years, 73% males) cases of chronic liver disease were finally analyzed. 33.9% presented with decompensated cirrhosis. Alcoholism (34·3% of 4413) was the commonest cause of cirrhosis while Hepatitis B (33·3%) was predominant cause of chronic liver disease in general and non-cirrhotic chronic liver disease (40·8% out of 8163). There was significant interregional differences (hepatitis C in North, hepatitis B in East and South, alcohol in North-east, Non-alcoholic Fatty Liver Disease in West) in the predominant cause of chronic liver disease. Hepatitis B (46·8% of 438 cases) was the commonest cause of hepatocellular Cancer.11·7% had diabetes. Observations of our study will help guide a contextually relevant liver care policy for India and could serve as a framework for similar endeavor in other developing countries as well.

Isolated Colonic tuberculosis (TB) is an infrequently diagnosed condition in the developed world. With expanding globalization and an unprecedented increase in travel worldwide, considering tuberculosis in the differential of atypical lesions in the colon could prove worthwhile. We report a rare case of intestinal TB in a 70- year old male who presented with intractable abdominal discomfort and was subsequently found to have a malignant appearing mass in the hepatic flexure of the colon. He underwent right hemicolectomy with ileo-colic anastomosis and histopathology revealed both caseating and non-caseating granulomas. Ziehl-Neelsen staining was positive for acid-fast bacilli (AFB). He was later discharged on a four-drug anti-TB regimen consisting of Rifampin, Isoniazid, Ethambutol and Pyrazinamide.

We have established Meloidogyne hapla as a tractable model plant-parasitic nematode amenable to forward and reverse genetics, and we present a complete genome sequence. At 54 Mbp, M. hapla represents not only the smallest nematode genome yet completed, but also the smallest metazoan, and defines a platform to elucidate mechanisms of parasitism by what is the largest uncontrolled group of plant pathogens worldwide. The M. hapla genome encodes significantly fewer genes than does the free-living nematode Caenorhabditis elegans (most notably through a reduction of odorant receptors and other gene families), yet it has acquired horizontally from other kingdoms numerous genes suspected to be involved in adaptations to parasitism. In some cases, amplification and tandem duplication have occurred with genes suspected of being acquired horizontally and involved in parasitism of plants. Although M. hapla and C. elegans diverged >500 million years ago, many developmental and biochemical pathways, including those for dauer formation and RNAi, are conserved. Although overall genome organization is not conserved, there are areas of microsynteny that may suggest a primary biological function in nematodes for those genes in these areas. This sequence and map represent a wealth of biological information on both the nature of nematode parasitism of plants and its evolution.

Loneliness may exacerbate poor health outcomes particularly among cancer survivors during the COVID-19 pandemic. Little is known about the risk factors of loneliness among cancer survivors. We evaluated the risk factors of loneliness in the context of COVID-19 pandemic-related prevention behaviors and lifestyle/psychosocial factors among cancer survivors. Cancer survivors (n = 1471) seen at Huntsman Cancer Institute completed a survey between August–September 2020 evaluating health behaviors, medical care, and psychosocial factors including loneliness during COVID-19 pandemic. Participants were classified into two groups: ‘lonely’ (sometimes, usually, or always felt lonely in past month) and ‘non-lonely’ (never or rarely felt lonely in past month). 33% of cancer survivors reported feeling lonely in the past month. Multivariable logistic regression showed female sex, not living with a spouse/partner, poor health status, COVID-19 pandemic-associated lifestyle factors including increased alcohol consumption and marijuana/CBD oil use, and psychosocial stressors such as disruptions in daily life, less social interaction, and higher perceived stress and financial stress were associated with feeling lonely as compared to being non-lonely (all p < 0.05). A significant proportion of participants reported loneliness, which is a serious health risk among vulnerable populations, particularly cancer survivors. Modifiable risk factors such as unhealthy lifestyle behaviors and psychosocial stress were associated with loneliness. These results highlight the need to screen for unhealthy lifestyle factors and psychosocial stressors to identify cancer survivors at increased risk of loneliness and to develop effective management strategies.