Gingival crevicular fluid (GCF) is an interesting biofluid reflecting the physiological and pathological states of a single dental element. Due to this unique feature, in recent years, metabolomic analysis of GCF has gained attention as a biometric tool for the diagnosis and therapy of periodontal disease. Traditional methods are, however, too slow, cumbersome and expensive for a health-care routine. Surface enhanced Raman scattering (SERS) can offer rapid and label-free detailed molecular fingerprints that can be used for biofluid analysis. Here we report the first SERS characterization of GCF using an easy and quick sample preparation. The dominant features in the SERS spectrum of GCF are ascribed to very few metabolites, in particular to uric acid, hypoxanthine, glutathione and ergothioneine. Additionally, we succeeded in differentiating between the SERS signal of GCF collected from healthy volunteers and the one collected from patients with periodontal disease.Given the ubiquitous role of porphyrins in natural systems, these molecules and related derivatives such as phthalocyanines are fascinating building units to achieve functional porous materials. Porphyrin-based MOFs have been developed over the past three decades, yet chemically robust frameworks, necessary for applications, have been achieved much more recently and this field is expanding. This progress is partially driven by the development of porphyrins and phthalocyanines bearing alternative coordinating groups (phosphonate, azolates, phenolates…) that allowed moving the related MOFs beyond metal-carboxylates and achieving new topologies and properties. In this perspective article we first give a brief outline of the synthetic pathways towards simple porphyrins and phthalocyanines bearing these complexing groups. The related MOF compounds are then described; their structural and textural properties are discussed, as well as their stability and physical properties. An overview of the resulting nets and topologies is proposed, showing both the similarities with metal-carboxylate phases and the peculiarities related to the alternative coordinating groups. Eventually, the opportunities offered by this recent research topic, in terms of both synthesis pathways and modulation of pore size and shape, stability and physical properties, are discussed.

The Government of Bihar (GoB) in India, the Bill and Melinda Gates Foundation and several non-governmental organisations launched the

program aimed to support the GoB to improve reproductive, maternal, newborn and child health and nutrition (RMNCHN) statewide. Here we summarise changes in indicators attained during the initial two-year pilot phase (2012-2013) of implementation in eight focus districts of approximately 28 million population, aimed to inform subsequent scale-up.

The quasi-experimental impact evaluation included statewide household surveys at two time points during the pilot phase January-April 2012 (“baseline”) including an initial cohort of beneficiaries and January-April 2014 (“midline”) with a new cohort. The two arms were 1) eight intervention districts, and 2) a comparison arm comprised of the remaining 30 districts in Bihar where

interventions were not implemented. We analysed changes in indicators across the RMNCHN continuum of care from baseline to midline in intervention and approaches can help elucidate causality and better explain pathways through which supply- and demand-side interventions contribute to changes in behaviour among the actors involved in the production of population-level health outcomes. Evidence from Bihar indicates that deep structural constraints in health system organisation and delivery of interventions pose substantial limitations on behaviour change among health care providers and beneficiaries.

ClinicalTrials.gov number NCT02726230.

ClinicalTrials.gov number NCT02726230.

The

program in Bihar implemented household and community-level interventions to improve reproductive, maternal, newborn and child health and nutrition (RMNCHN) in two phases a first phase of intensive ancillary support to governmental implementation and innovation testing by non-government organisation (NGO) partners in eight focus districts (2012-2014), followed by a second phase of state-wide government-led implementation with techno-managerial assistance from NGOs (2014 onwards). This paper examines trends in RMNCHN indicators in the program’s implementation districts from 2012-2017.

Eight consecutive rounds of cross-sectional Community-based Household Surveys conducted by CARE India in 2012-2017 provided comparable data on a large number of indicators of frontline worker (FLW) performance, mothers’ behaviours, and facility-based care and outreach service delivery across the continuum of maternal and child care. Logistic regression, considering the complex survey design and sample weights generated with a decline in the levels of 13 other indicators.

Improvements in indicators were conditional on implementation support to program activities at a level of intensity that was higher than what could be achieved at scale so far. Successes during the pilot phase of intensive support suggests that RMNCHN can be improved statewide in Bihar with sufficient investments in systems performance improvements.

ClinicalTrials.gov number NCT02726230.

ClinicalTrials.gov number NCT02726230.

Refractory venous leg ulcers (VLUs) often require extended time to heal, and they carry a high risk of recurrence. This case study describes our experiences with a patient with a VLU refractory to multiple treatment strategies who was successfully treated with Manuka honey.

Mr S. was a 76-year-old man with multiple comorbid conditions and hypersensitivity to silver-based compounds, who developed 3 VLUs of his right lower extremity. He experienced 90 days of unsuccessful treatments using an iodized cadexomer ointment, hydrodetersive fiber dressings, hydrocolloid meshes, compression therapy, and antibiotic treatment without progression toward wound healing. We then initiated treatment with Manuka honey and continued compression therapy. His primary VLU was completely epithelialized within 38 days, and an adjacent VLU also showed progression toward healing. Mr S. Selleck RGFP966 reported clinically relevant improvement in wound-related pain at 17 days.

The use of Manuka honey proved effective in this patient with a VLU refractory to other treatment strategies.