Fragmentary Data Research Articles

Pediatric Bone Tumors: Location and Age Distribution of 420 Cases

Background/Objectives: One of the most important diagnostic tools in bone tumors is X-rays. Preliminary and, in the case of some benign lesions, definitive diagnoses are formed using this basic tool. Part of the decision making in this stage is based on statistical probability using the patient’s age, as well as the incidence and predilection sites of different entities. The information used today is based on older and fragmented data. To verify the underlying principles, we retrospectively evaluated all bone tumors in children and adolescents treated by our tertiary center in the last 20 years. Methods: For this retrospective study, patients under the age of 18 years suffering from histopathologically verified bone tumors were evaluated. Data were retrieved from our local musculoskeletal tumor database. Results: We were able to include 420 children treated for bone tumors in our tertiary center. The cohort consisted of 335 benign and 85 malignant lesions. The most common lesions were 137 osteochondromas; the malignant tumors consisted mainly of osteosarcomas (53) and Ewing’s sarcomas (28). The primary predilection sites were the metaphyses of long bones. Conclusions: We were able to confirm and supplement the fragmentary data of these rare diseases using our own cohort.

Recurrent pericarditis in older adults: Clinical and laboratory features and outcome.

Current guidelines for the diagnosis and treatment of pericarditis refer to the general adult population. Few and fragmentary data regarding recurrent pericarditis in older adults exist. Given the absence of specific data in scientific literature, we hypothesized that there might be clinical, laboratory and outcome differences between young adults and older adults affected by idiopathic recurrent pericarditis. We performed an international multicentric retrospective cohort study analyzing data from patients affected by recurrent pericarditis (idiopathic or post-cardiac injury) and referring to tertiary referral centers. Clinical, laboratory, and outcome data were compared between patients younger than 65 years (controls) and patients aged 65 or older. One hundred and thirty-three older adults and 142 young adult controls were enrolled. Comorbidities, including chronic kidney diseases, atrial fibrillation, and diabetes, were more present in older adults. The presenting symptom was dyspnea in 54.1% of the older adults versus 10.6% in controls (p < 0.001); pain in 32.3% of the older adults versus 80.3% of the controls (p < 0.001). Fever higher than 38°C was present in 33.8% versus 53.5% (p = 0.001). Pleural effusion was more prevalent in the older adults (55.6% vs 34.5%, p < 0.001), as well as severe pericardial effusion (>20 mm) (24.1% vs 12.7%, p = 0.016) and pericardiocentesis (16.5% vs 8.5%, p = 0.042). Blood leukocyte counts were significantly lower in the older adults (mean + SE: 10,227 + 289/mm3 vs 11,208 + 285/mm3, p = 0.016). Concerning therapies, NSAIDS were used in 63.9% of the older adults versus 80.3% in the younger (p = 0.003), colchicine in 76.7% versus 87.3% (p = 0.023), corticosteroids in 49.6% versus 26.8% (p < 0.001), and anakinra in 14.3% versus 23.9% (p = 0.044). Older adults affected by recurrent pericarditis show a different clinical pattern, with more frequent dyspnea, pleural effusion, severe pericardial effusion, and lower fever and lower leukocyte count, making the diagnosis sometimes challenging. They received significantly less NSAIDs and colchicine, likely due to comorbidities; they were also treated less commonly with anti-IL1 agents, and more frequently with corticosteroids.

On the Occurrence of Pelusios gabonensis in the Taï National Park (Côte d'Ivoire)

ABSTRACTMany species of terrestrial and freshwater chelonians are at risk of extinction, particularly rainforest species due to massive habitat loss. Therefore, the presence of peripheral and isolated populations can have considerable conservation value. This article confirms the presence of Pelusios gabonensis in an area of mature forest in western Côte d'Ivoire for which fragmentary data existed in the literature. It would therefore be important to study the conservation status and the genetics of the Ivorian populations given their huge geographic distance with conspecifics from the Lower Guinean forests.

Pleistocene and modern distribution of the subterranean rodent Myospalax myospalax (Rodentia, Myospalacidae) in response to environmental factors

The question of the modern and past distribution of Siberian zokor Myospalax myospalax (Laxmann, 1773) continues to be an unresolved puzzle. This Western Siberian endemic species belongs to the family Myospalacidae, a group of subterranean rodents. The distribution of M. myospalax went through dramatic changes due to mass hunting in the first half of the 20th century and later development of agriculture. Because of this, data from various studies executed in different years do not always match, making it difficult to determine the natural limiting factors in the distribution of Siberian zokors. In turn, paleontological data from different regions are fragmentary and have not been summarized in a single study. We aimed to review the past and modern distribution of M. myospalax and examine its relationship with environmental factors such as climate and soils distribution. We hypothesized that this species may be a good indicator of past environmental conditions because of its special habitat characteristics. We gathered and revised published data to reconstruct the distribution before the anthropogenic influence of the 20th century and during the Pleistocene and Holocene epochs. The modern preanthropogenic range was compared with the distribution of soil complexes and provinces. We also examined M. myospalax molars from Late Pleistocene – Holocene localities and compared them with the modern population. The Siberian zokor distribution data provided herein will be useful for researchers from other regions who use fragmentary or doubtful data on the topic. We also identified climatic and soil parameters of M. myospalax habitat. These parameters can be used to reconstruct past environmental conditions from paleontological findings of the Siberian zokor.

Mobile Health App and Web Platform (eDOL) for Medical Follow-Up of Patients With Chronic Pain: Cohort Study Involving the French eDOL National Cohort After 1 Year.

Chronic pain affects approximately 30% of the general population, severely degrades quality of life and professional life, and leads to additional health care costs. Moreover, the medical follow-up of patients with chronic pain remains complex and provides only fragmentary data on painful daily experiences. This situation makes the management of patients with chronic pain less than optimal and may partly explain the lack of effectiveness of current therapies. Real-life monitoring of subjective and objective markers of chronic pain using mobile health (mHealth) programs could better characterize patients, chronic pain, pain medications, and daily impact to help medical management. This cohort study aimed to assess the ability of our mHealth tool (eDOL) to collect extensive real-life medical data from chronic pain patients after 1 year of use. The data collected in this way would provide new epidemiological and pathophysiological data on chronic pain. A French national cohort of patients with chronic pain treated at 18 pain clinics has been established and followed up using mHealth tools. This cohort makes it possible to collect the determinants and repercussions of chronic pain and their evolutions in a real-life context, taking into account all environmental events likely to influence chronic pain. The patients were asked to complete several questionnaires, body schemes, and weekly meters, and were able to interact with a chatbot and use educational modules on chronic pain. Physicians could monitor their patients' progress in real time via an online platform. The cohort study included 1427 patients and analyzed 1178 patients. The eDOL tool was able to collect various sociodemographic data; specific data for characterizing pain disorders, including body scheme; data on comorbidities related to chronic pain and its psychological and overall impact on patients' quality of life; data on drug and nondrug therapeutics and their benefit-to-risk ratio; and medical or treatment history. Among the patients completing weekly meters, 49.4% (497/1007) continued to complete them after 3 months of follow-up, and the proportion stabilized at 39.3% (108/275) after 12 months of follow-up. Overall, despite a fairly high attrition rate over the follow-up period, the eDOL tool collected extensive data. This amount of data will increase over time and provide a significant volume of health data of interest for future research involving the epidemiology, care pathways, trajectories, medical management, sociodemographic characteristics, and other aspects of patients with chronic pain. This work demonstrates that the mHealth tool eDOL is able to generate a considerable volume of data concerning the determinants and repercussions of chronic pain and their evolutions in a real-life context. The eDOL tool can incorporate numerous parameters to ensure the detailed characterization of patients with chronic pain for future research and pain management. ClinicalTrials.gov NCT04880096; https://clinicaltrials.gov/ct2/show/NCT04880096.

Reflections on the regulatory field covering the development of paediatric medicinal products: a brief overview of current status and challenges.

Many medicinal products are initially developed and tested in adults, and often, only a limited amount of data on their safety and efficacy in children exist. Consequently, paediatric healthcare providers sometimes need to make informed decisions about using medicinal products in children based on available fragmentary data. Ethical guidelines emphasise the importance of protecting children and ensuring they receive safe and effective medical treatments. Paediatric clinical trials should be conducted to provide evidence-based care with specific attention to minimise risks to children. This highlights the dilemma of finding a balance between protecting children and adolescents (and avoiding unnecessary clinical trials) and obtaining reliable, robust and justified data to treat them adequately and not in an off-label manner with unknown risks. For years, paediatricians maintained that children and adolescents are not treated based on up-to-date scientific knowledge and justification. The slogan "children are not small adults" summarised the concerns in a catch phrase. Different stakeholders have taken a variety of actions to address this concern.

Risk factors, Clinical presentation and In-hospital Outcome of Acute Myocardial Infarction in Elderly Patients

Background: Coronary artery disease (CAD) is the leading cause of mortality, morbidity in the developed and developing country. Ageing is important risk factor for coronary artery disease. The role of conventional cardiovascular risk factors in older persons is incompletely understood because only fragmentary and inadequate data are available in most instance and manifestations of acute myocardial infarction are generally believed to be atypical in the elderly. The aim of the study was to find out the clinical presentation, common risk factors and In-hospital Outcome of Acute Myocardial Infarction in Elderly Patients. Methods: An observational study in tertiary level hospital. Study protocol was approved by ethical review committee of Sir Salimullah Medical College &amp; Mitford Hospital, Dhaka. Sample was selected from the population by purposive sampling technique. Detail demographic data were collected from the subject and recorded in structured case report form. Researcher makes contact with patient and patients caregiver, and describe them about study aim-objective, and then informed consent was taken. All collected questionnaire checked very carefully to identify the error in the data. Data processing work were consisting of registration of schedules, editing, coding and computerization, preparation of dummy tables, analysis and matching data. Result: In this series, the maximum number of patients (57.0%) was between 60-69 years age group, with mean value 67.21 ± 9.05 years. Out of 100 cases (62%) cases were male and (38%) were female (Figure 1). Male – female ratio was 1.63:1. Large numbers of respondents came from urban area (58%). Among the patients the poor class (44%) comprising the major percentage of the myocardial infarction patients. In this study majority (58%) of the patients had sedentary lifestyle before the onset of myocardial infarction. Among all the risk factors hypertension was the most common risk factor, present in 62% cases; next common risk factors were Diabetes mellitus 56%, dyslipidemia 32%, obesity 22%, smoking 40%. In this study majority of patients (56%) presented with shortness of breath as predominant symptoms. Besides typical chest pain others important atypical symptoms were atypical chest pain (31%), upper abdominal pain (18%), giddiness (4%) and confusional state (3%). In this study many of the patients had developed acute LVF (34%), arrhythmia (17%), cardiogenic shock (8%). Conclusion: We concluded that the manifestations of AMI are more subtle in the elderly, with different risk factors. The elderly subjects are under thrombolysed and have higher complication rate. Bangladesh J Medicine 2024; 35(1): 9-14

Fragmentary data and scattered lands: a recording protocol for a comparative archaeothanatological analysis based on archaeological illustrations

Cet article examine le traitement des morts dans trois cimetières de l’âge du Bronze en Grèce continentale, par rapport à six cimetières de la même période dans les Cyclades. L’étude présentée a été entreprise en vue d’explorer si et à quel point il y a des divergences identifiables entre ces deux régions en ce qui concerne les pratiques mortuaires, question liée à une discussion plus large à propos de la présence d’objets et d’architecture d’origine ou d’influence cycladique dans certains cimetières de la Grèce continentale. Cette étude vise à reconstituer les pratiques mortuaires en mettant au point un protocole pour enregistrer les os humains à partir des illustrations de fouille (photos, dessins). Le protocole est basé sur des principes de l’archéothanatologie et il est structuré à l’aide d’un arbre de décision, assurant ainsi sa comparabilité et répétabilité. Les résultats montrent des différences entre Tsepi, Aghios Kosmas (Grèce continentale) et les Cyclades, impliquant des pratiques mortuaires différentes : les tombes de Tsepi et éventuellement d’Aghios Kosmas étaient remplies de terre après chaque interaction, alors que celles des Cyclades ne l’étaient pas ; des différences sont aussi observées dans la structure architecturale des interférences secondaires. Néanmoins, l’interprétation de Manika, en Eubée, est plus nuancée, étant donné qu’elle présente à la fois des similarités avec les cas d’étude cycladiques et avec ceux de la Grèce continentale.

Hospitals’ financial performance across European countries: a scoping review protocol

IntroductionHospitals remain the cornerstone of health systems in European countries. Therefore, the financial sustainability of hospitals constitutes an important determinant of healthcare provision security. The fragmentary data available indicate that...

Belarusization in the Smolensk Region from the Pages of the Newspaper «Rabochiy Put’», 1920–1930s

The article presents the practice of Belarusization in the Smolensk region in the 1920s – the first half of the 1930s in the format of its reflection on the pages of the newspaper «Rabochiy Put’», as the press organ of the Smolensk Gubernatorial Committee of the RCP (b) – the CPSU (b) and the Gubernatorial Executive Committee, and since 1929 – the main printing body of the Western region with the administrative center in Smolensk.&#x0D; The materials of the «Rabochiy Put’» do not form the reader's holistic perception of the policy of Belarusization in the Smolensk region, as in one of the Russian regions with a compact Belarusian population. There were no Belarusian collective farms or Belarusian village councils in the province, as was the case, for example, among Latvians and Jews. Therefore, the main direction of Belarusization has become the education system, i.e. the introduction of the Belarusian language and the course of Belarusian studies in individual schools, as well as attempts to transmit a number of schools into the Belarusian language.&#x0D; At the same time, even fragmentary data from newspaper materials of different genres and volumes indicate that neither the provincial authorities (virtually at all levels up to village councils), nor the titular and even the Belarusian&#x0D; population itself have become active supporters of the policy of Belarusization, only formally participating in this process, as in one of the many socio-political campaigns of thаt period.

CONCENTRATION TETRAHEDRON OF THE Li–Mn–Eu–O SYSTEM

Based on fragmentary experimental data, an isothermal concentration tetrahedron of the Li–Mn–Eu–O system was constructed for the first time by the method of topological modeling, which describes possible solid-state transformations in the system occurring at a constant temperature with a change in pressure. Thirty-two equilibria involving four crystalline phases have been identified.

Global shortfalls of knowledge on anuran tadpoles

Despite the amount of data on different aspects of biodiversity, such as species distributions, taxonomy, or phylogenetics, there are still significant gaps and biases in the available information. This is particularly true for life history traits, with fragmentary data for most taxa, especially those with complex life cycles. Anurans (frogs and toads) show larval (premetamorphic) stages that are in general radically decoupled from adult forms in most biological aspects. Our understanding of this group is highly uneven, as the main wide-scope investigations focus on adult specimens and larval stages remain unknown for a significant part of the anuran tree. The main purpose of this work was to estimate the extent of knowledge gaps regarding the diversity of tadpoles, interpret their biological and geographical patterns, and discuss possible explanations and implications for other large-scale analyses. Our findings show that more than half of the anuran species described to date still lack information on their embryonic/larval stages. Furthermore, knowledge varies among taxonomic groups, larval ecomorphological guilds, and world ecoregions. Description percentages generally decrease in lineages with a higher proportion of species known or suspected to have endotrophic development. Also, geographic areas with the highest levels of ignorance in larval biology (Tropical Andes and New Guinea) coincide with the highest diversity of endotrophic guilds. Among exotrophic larvae, generalized lentic-lotic tadpoles have the widest distribution and levels of knowledge, whereas specialized lotic, fossorial, and terrestrial forms are more taxonomically and geographically restricted. Further large-scale analyses on tadpole biology are crucial for their impact in varied scientific disciplines including anuran conservation. At a conceptual level, the discussion of the anuran biphasic life cycle is pertinent in the context of shortfalls of biodiversity knowledge and their interrelationships.

FragmGAN: generative adversarial nets for fragmentary data imputation and prediction

Modern scientific research and applications very often encounter ‘fragmentary data’ which brings big challenges to imputation and prediction. By leveraging the structure of response patterns, we propose a unified and flexible framework based on Generative Adversarial Nets (GAN) to deal with fragmentary data imputation and label prediction at the same time. Unlike most of the other generative model based imputation methods that either have no theoretical guarantee or only consider Missing Completed At Random (MCAR), the proposed FragmGAN has theoretical guarantees for imputation with data Missing At Random (MAR) while no hint mechanism is needed. FragmGAN trains a predictor with the generator and discriminator simultaneously. This linkage mechanism shows significant advantages for predictive performances in extensive experiments.

ANEMONYMS — EPISTEMOLOGICAL BASIS FOR CATEGORIZING THE NAMES OF NATURAL PHENOMENA AS A CATEGORY OF ONOMASTIC VOCABULARY

The article is devoted to anemonyms — proper names of natural disasters. The relevance of the study is due to the scanty, fragmentary data on anemonyms in Russian onomastics that hardly correlate with the results of foreign studies, while before our eyes the anemonym has transformed from a marginal onomastic implicature into an independent onymic unit that performs functions inherent to all categories of proper names. In connection with the climate crisis, the number of natural disasters is growing, not only causing enormous damage to the global economy, but also threatening survival. The linguo-pragmatic conditions for the choice of names, the origins and modern forms of anthropomorphism of anemonyms are revealed. It has been established that anemonyms are formed from anthroponyms (female and male personal names), toponyms, agionyms, caronyms, onyms from the sphere of biota, as well as on the basis of similarity in form.

Record-matching of STR profiles with fragmentary genomic SNP data.

In many forensic settings, identity of a DNA sample is sought from poor-quality DNA, for which the typical STR loci tabulated in forensic databases are not possible to reliably genotype. Genome-wide SNPs, however, can potentially be genotyped from such samples via next-generation sequencing, so that queries can in principle compare SNP genotypes from DNA samples of interest to STR genotype profiles that represent proposed matches. We use genetic record-matching to evaluate the possibility of testing SNP profiles obtained from poor-quality DNA samples to identify exact and relatedness matches to STR profiles. Using simulations based on whole-genome sequences, we show that in some settings, similar match accuracies to those seen with full coverage of the genome are obtained by genetic record-matching for SNP data that represent 5-10% genomic coverage. Thus, if even a fraction of random genomic SNPs can be genotyped by next-generation sequencing, then the potential may exist to test the resulting genotype profiles for matches to profiles consisting exclusively of nonoverlapping STR loci. The result has implications in relation to criminal justice, mass disasters, missing-person cases, studies of ancient DNA, and genomic privacy.

Exploring the Role of Hsp60 in Alzheimer's Disease and Type 2 Diabetes: Suggestion for Common Drug Targeting.

Heat shock protein 60 (Hsp60) is a member of the chaperonin family of heat shock proteins (HSPs), primarily found in the mitochondrial matrix. As a molecular chaperone, Hsp60 plays an essential role in mediating protein folding and assembly, and together with the co-chaperon Hsp10, it is thought to maintain protein homeostasis. Recently, it has been found to localize in non-canonical, extra-mitochondrial sites such as cell membranes or extracellular fluids, particularly in pathological conditions. Starting from its biological function, this review aims to provide a comprehensive understanding of the potential involvement of Hsp60 in Alzheimer's disease (AD) and Type II Diabetes Mellitus (T2DM), which are known to share impaired key pathways and molecular dysfunctions. Fragmentary data reported in the literature reveal interesting links between the altered expression level or localization of this chaperonin and several disease conditions. The present work offers an overview of the past and more recent knowledge about Hsp60 and its role in the most important cellular processes to shed light on neuronal Hsp60 as a potential common target for both pathologies. The absence of any effective cure for AD patients makes the identification of a new molecular target a promising path by which to move forward in the development of new drugs and/or repositioning of therapies already used for T2DM.

Sage, Rosemary, and Bay Laurel Hydrodistillation By-Products as a Source of Bioactive Compounds

Essential oils from Mediterranean wild plants are widely used, but the hydrodistillation residues produced in parallel with these essential oils are significantly understudied and underexploited. Since there are only fragmentary data in the literature, we have, for the first time, systematically analyzed the chemical composition of the by-products obtained after hydrodistillation of sage, bay laurel, and rosemary leaves, i.e., hydrolates, water residues, and solid residues. The chemical composition of the hydrolates changed compared to their respective essential oils towards the dominance of more hydrophilic, oxygenated compounds, such as camphor in sage, 1,8-cineole in bay laurel, and berbenone in rosemary. However, some compounds, mostly sesquiterpenes, which were present in considerable amounts in essential oils, were absent or only present in very small amounts in the hydrolates. Furthermore, both the water and the solid residues were rich in polyphenols, such as procyanidins in bay laurel and rosmarinic acid in rosemary and sage. In conclusion, we demonstrate the valuable chemical composition of sage, rosemary, and bay laurel hydrodistillation by-products and discuss a wide range of their possible applications.

Time series clustering-enabled geological condition perception in tunnel boring machine excavation

For automatic geology perception, this paper develops a DTW-Kmedoids-enabled time series clustering framework to gain a clear insight into the geological condition ahead of the tunnel boring machine (TBM) head. The core idea of DTW-Kmedoids is to incorporate dynamic time warping (DTW) as a distance metric into a popular clustering algorithm Kmedoids, aiming to aggregate time series data reflecting similar conditions of surrounding geology into the same cluster. It has been verified in a sequence dataset recording 377 operational rings from a TBM tunneling project in Singapore. Results indicate that the proposed DTW-Kmedoids algorithm outperforms Kmedoids and softDTW-Kmedoids in partitioning the whole dataset into four meaningful clusters on behalf of four geological conditions. Moreover, it shows merits in great robustness to handle varying-length temporal sequences and even fragmentary data instead of the full observations. Furthermore, an online clustering mechanism is well designed to adaptively update the cluster center, which can accomplish the dynamic recognition of the forward geological circumstances ring by ring. In short, the practical value behind the hybrid time series clustering is to automatically and quickly perceive lithology categories along the designed tunnel trail with no requirement of data labeling, possibly allowing for further inference of geological risk and guidance in safe excavation.

Molecular Weight Distribution of Humic Acids Isolated from Buried Soils and Yedoma Sediments

The soils of cold regions store up to 60% of all organic carbon on the planet. As a result of climate change, this organic matter can be biodegraded by microorganisms and thereby make an additional contribution to carbon balance. Nowadays, there are fragmentary data on organic C stocks in high-latitude soils and single works on the analysis of the quality of buried organic matter. This paper presents the first data on the molecular weight distributions of humic acids (HAs) extracted from soils and sediments in Yedoma. Molecular weight distributions of HAs preparations were obtained on an AKTAbasic 10 UPS chromatographic system (Amersham Biosciences, Sweden) using a SuperdexTM 200 10/300 GL column (with cross-linked dextran gel, fractionation range for globular proteins 10–600 kDa). As a result of the study, it was found that the buried soil horizons are characterized by the highest content of low molecular weight fraction (with molecular mass (Mr) 1.4–1.9 kDa and molar fraction in the range of 54.3–67.1%). The high molecular weight fraction is concentrated mainly in the superficial horizons and decreases with depth (with Mr 299–346 kDa and molar fraction in the range of 3.4–9.8%). In the Yedoma sediments, the maximum content of the medium-molecular fraction is observed (with Mr 24.6 kDa and 39.6% of the molar fraction), which may indicate a low rate of organic matter transformation in the permafrost. The data obtained serve as a database of analysis in terms of modeling the global carbon cycle in the cold regions of the planet.

Bioactive phytocompounds for oral cancer prevention and treatment: A comprehensive and critical evaluation.

The high incidence of oral cancer combined with excessive treatment cost underscores the need for novel oral cancer preventive and therapeutic options. The value of natural agents, including plant secondary metabolites (phytochemicals), in preventing carcinogenesis and representing expansive source of anticancer drugs have been established. While fragmentary research data are available on antioral cancer effects of phytochemicals, a comprehensive and critical evaluation of the potential of these agents for the prevention and intervention of human oral malignancies has not been conducted according to our knowledge. This study presents a complete and critical analysis of current preclinical and clinical results on the prevention and treatment of oral cancer using phytochemicals. Our in-depth analysis highlights anticancer effects of various phytochemicals, such as phenolics, terpenoids, alkaloids, and sulfur-containing compounds, against numerous oral cancer cells and/or in vivo oral cancer models by antiproliferative, proapoptotic, cell cycle-regulatory, antiinvasive, antiangiogenic, and antimetastatic effects. Bioactive phytochemicals exert their antineoplastic effects by modulating various signaling pathways, specifically involving the epidermal growth factor receptor, cytokine receptors, toll-like receptors, and tumor necrosis factor receptor and consequently alter the expression of downstream genes and proteins. Interestingly, phytochemicals demonstrate encouraging effects in clinical trials, such as reduction of oral lesion size, cell growth, pain score, and development of new lesions. While most phytochemicals displayed minimal toxicity, concerns with bioavailability may limit their clinical application. Future directions for research include more in-depth mechanistic in vivo studies, administration of phytochemicals using novel formulations, investigation of phytocompounds as adjuvants to conventional treatment, and randomized clinical trials.