Results of in situ fixation of Andersson lesion by posterior approach in 35 cases

STUDY OBJECTIVE

Due to the rarity of the Andersson lesion (AL), the literature is ambiguous regarding the type of surgical fixation, need for debridement and deformity correction. The purpose of this retrospective study is to evaluate the efficacy, feasibility and functional outcome of posterior fixation in AL.

MATERIALS AND METHODS

This study included 35 patients having thoracolumbar AL operated for in situ fixation and fusion with minimum of 24-month follow-up. VAS (Visual Analogue Score) back pain, ODI (Oswestry Disability Index), Frankel's grade were compared and analyzed. Union status was noted with complications.

RESULTS

The mean age of 35 patients was 56.34(± 11.3) years with average follow-up of 51.49 months. Two patients had AL at two levels. 27/37 AL were at discal level. Average estimated blood loss (EBL) was 276.43 ml and duration of surgery was 130.43 min. On an average, operated segments needed 7.77 screws. There were ten minor complications without long-term sequel. Neurological improvement was noted in 30 patients. Average preoperative VAS score improved from 8.69 to 3.14, ODI score improved from 68.76 to 18.77 at final follow-up which were significant (p < 0.05). There was significant improvement in Frankel's grading (Z = - 4.354, P = 0.00).

CONCLUSIONS

Surgical management of AL by posterior approach and posterior stabilization can give satisfactory results without the need of extensive anterior reconstruction, bone grafting or deformity correction procedures without added morbidity and complications.

A rare polyoxometalate cluster [NiW12O44]14- based solid as a pre-catalyst for efficient and long-term oxygen evolution

Polyoxometalates (POMs) are an eminent class of metal oxide anionic clusters of early transition metals with huge structural diversity. Herein, a [NiW₁₂O₄₄]^14- cluster based solid, (C₅H₇N₂)₆[NiW₁₂O₄₄], has been reported (PS-78). The [NiW₁₂O₄₄]^14- cluster bridges the missing gap of 1 : 12 hetero-POMs of Keggin and Silverton together with a coordination number of 8 of the central heteroatom (Ni). Furthermore PS-78 has been explored as an efficient and highly sustained oxygen evolution pre-catalyst in alkaline medium with an overpotential of 347 mV to attain a current density of 10 mA cm^-2 and long-term stability up to 96 hours. Furthermore, mechanistic investigation showed that in situ generated NiO and WO _x (x = 1, 2) species act as active species for the oxygen evolution reaction. This study will open up new avenues for exploring POMs' new topologies and the potential of POMs as effective pre-catalysts in electrocatalytic applications.

Crossing N=28 Toward the Neutron Drip Line: First Measurement of Half-Lives at FRIB

New half-lives for exotic isotopes approaching the neutron drip-line in the vicinity of N∼28 for Z=12-15 were measured at the Facility for Rare Isotope Beams (FRIB) with the FRIB decay station initiator. The first experimental results are compared to the latest quasiparticle random phase approximation and shell-model calculations. Overall, the measured half-lives are consistent with the available theoretical descriptions and suggest a well-developed region of deformation below ^{48}Ca in the N=28 isotones. The erosion of the Z=14 subshell closure in Si is experimentally confirmed at N=28, and a reduction in the ^{38}Mg half-life is observed as compared with its isotopic neighbors, which does not seem to be predicted well based on the decay energy and deformation trends. This highlights the need for both additional data in this very exotic region, and for more advanced theoretical efforts.

Bioformulation Containing Cohorts of Ensifer adhaerens MSN12 and Bacillus cereus MEN8 for the Nutrient Enhancement of Cicer arietinum L

Here we examine the effects of different carrier based bioinoculants on the growth, yield and nutritional value of chickpea and on associated soil nutrients. A consortium of two taxonomically distinct endophytic bacteria-Ensifer adhaerens MSN12 and Bacillus cereus MEN8-have promising plant growth promoting (PGP) attributes. We demonstrate their delivery from the laboratory to the field via the formulation of an effective bioinoculant with economic and accessible carriers. Sugarcane straw ash (SCSA) was found to be an efficient carrier and bioformulation for enhancing viability and shelf-life of strains up to 12 months. A bioformulation containing an SCSA-based consortium (MSN12 + MEN8) increased seed germination by 7%, plant weight by 29%, length by 17%, seed-yield by 12%, harvesting index by 14% and proximate nutritional constituents by 20% over consortium treatment without SCSA. In addition, the bioformulation of post-harvest treated soil improved the physico-chemical properties of the soil in comparison to a pre-sowing SCSA-based bioformulation treated crop, being fortified in different proximate nutritional constituents including dry matter (30%), crude protein (45%), crude fiber (35%), and ether extract (40%) in comparison to the control. Principal component analysis and scattered matrix plots showed a positive correlation among the treatments, which also validates improvement in the soil nutrient components and proximate constituents by T6 treatment (MSN12 + MEN8 + SCSA). The above results suggest efficiency of SCSA not only as a carrier material but also to support microbial growth for adequate delivery of lab strains as a substitute for chemi-fertilizers.

Relationship of Tubule Formation, Indian File Pattern and Apocrine Change With Estrogen and Progesterone Receptors and HER2 Immunostaining

Objectives: In breast carcinomas, histomorphological features like low-grade and lobular differentiation are associated with estrogen receptor (ER) and progesterone receptor (PR) expression. Apocrine carcinoma is associated with human epidermal growth factor receptor 2 (HER2) positivity. Studies have not emphasized the association between other histological features like tubule formation, Indian file pattern and apocrine change (which may be found in all grades of tumors or as a part of a mixed pattern of no special type) and immunohistochemistry (IHC). The study was designed to find the association between these morphological factors and ER, PR and HER2 status.

Materials and methods: The presence or absence of tubule formation, Indian file pattern and apocrine change was correlated with ER, PR and HER2 expression in core biopsies of 102 invasive breast carcinomas.

Statistical analysis: Fisher exact test with median unbiased odds ratio was used.

Results: Tubule formation and/or Indian file pattern were significantly associated with ER in all tumors (P-value <0.001), as well as separately for grade II, grade III, HER2-negative and HER2-positive tumors. Comparable results were obtained for their association with PR. Apocrine change was significantly associated with HER2 in all tumors (P-value <0.001), as well as separately for grade III, ER-positive and ER-negative tumors.

Conclusion: These histomorphological patterns are modest predictors of IHC status in breast carcinomas, even in tumors of higher grade. Knowledge of these morphological correlates of ER, PR and HER2 in breast cancer may serve as an aid in the quality management of breast carcinoma reporting.

Neurological evolution of patients in coma at 72 hours after out-of-hospital cardiac arrest

Introduction

Establishing neurological prognosis after out-of-hospital cardiac arrest (OHCA) safely and early in those patients who remain in a coma at 72 hours of admission.

Purpose

To analyze the prognostic performance of neuron-specific enolase (NSE), Somatosensory evoked potentials (SSEPs) and electroencephalogram (EEG) in these patients.

Methods

Prospective and observational study, including all OHCAs admitted to a Cardiovascular Intensive Care Unit (CICU) of a tertiary hospital. Neurological stratification was performed at 72 hours with NSE (poor prognosis &gt;60 ng/mL), SSEP (poor prognosis in the absence of N20) and EEG (poor prognosis). The sensitivity and specificity of each test for poor prognosis were calculated, as well as the three tests together.

Results

Between 03/17/2013 and 02/24/2022, 422 OHCAs were registered, of which 170 patients remained in a coma at 72 hours. The EEG had a sensitivity of 84% and a specificity of 89% due to poor prognosis. SSEPs had a sensitivity of 68% and a specificity of 98% due to poor prognosis. The NSE had a sensitivity of 67% and a specificity of 100% due to poor prognosis. The three tests were able to be performed on 110 patients, the sensitivity for poor prognosis of the three combined tests was 49% and the specificity was 100%.

Conclusions

In patients in a coma at 72 hours of OHCA, the most specific test to establish a poor prognosis was SSEP and the most sensitive was EEG. The combination of the three had a specificity of 100%.

Funding Acknowledgement

Type of funding sources: None.

The influence of anastomotic techniques on postoperative anastomotic complications: Results of the Oesophago-Gastric Anastomosis Audit

BACKGROUND

The optimal anastomotic techniques in esophagectomy to minimize rates of anastomotic leakage and conduit necrosis are not known. The aim of this study was to assess whether the anastomotic technique was associated with anastomotic failure after esophagectomy in the international Oesophago-Gastric Anastomosis Audit cohort.

METHODS

This prospective observational multicenter cohort study included patients undergoing esophagectomy for esophageal cancer over 9 months during 2018. The primary exposure was the anastomotic technique, classified as handsewn, linear stapled, or circular stapled. The primary outcome was anastomotic failure, namely a composite of anastomotic leakage and conduit necrosis, as defined by the Esophageal Complications Consensus Group. Multivariable logistic regression modeling was used to identify the association between anastomotic techniques and anastomotic failure, after adjustment for confounders.

RESULTS

Of the 2238 esophagectomies, the anastomosis was handsewn in 27.1%, linear stapled in 21.0%, and circular stapled in 51.9%. Anastomotic techniques differed significantly by the anastomosis sites (P < .001), with the majority of neck anastomoses being handsewn (69.9%), whereas most chest anastomoses were stapled (66.3% circular stapled and 19.3% linear stapled). Rates of anastomotic failure differed significantly among the anastomotic techniques (P < .001), from 19.3% in handsewn anastomoses, to 14.0% in linear stapled anastomoses, and 12.1% in circular stapled anastomoses. This effect remained significant after adjustment for confounding factors on multivariable analysis, with an odds ratio of 0.63 (95% CI, 0.46-0.86; P = .004) for circular stapled versus handsewn anastomosis. However, subgroup analysis by anastomosis site suggested that this effect was predominantly present in neck anastomoses, with anastomotic failure rates of 23.2% versus 14.6% versus 5.9% for handsewn versus linear stapled anastomoses versus circular stapled neck anastomoses, compared with 13.7% versus 13.8% versus 12.2% for chest anastomoses.

CONCLUSIONS

Handsewn anastomoses appear to be independently associated with higher rates of anastomotic failure compared with stapled anastomoses. However, this effect seems to be largely confined to neck anastomoses, with minimal differences between techniques observed for chest anastomoses. Further research into standardization of anastomotic approach and techniques may further improve outcomes.

Generation and validation of pX-UASTattB for dose-dependent misexpression studies in Drosophila

The GAL4-UAS binary gene expression system has benefited genetic studies tremendously. However, tools for effective control over the expression levels of transgenes are largely limited. We report a new series pUASTattB-based plasmids. These plasmids preserve the features of pUASTattB but contain a varying number of UAS sites. The expression levels and biological outcomes of a transgene showed a dosage-dependency with the number of UAS sites when using Dscam1 as a transgene and axon arborization of Drosophila sensory neurons as a biological function. Our new plasmids provide novel and useful tools for Drosophila genetic studies.

Dual Leucine Zipper Kinase Regulates Dscam Expression through a Noncanonical Function of the Cytoplasmic Poly(A)-Binding Protein

Dual leucine zipper kinase (DLK) plays a pivotal role in the development, degeneration, and regeneration of neurons. DLK can regulate gene expression post-transcriptionally, but the underlying mechanism remains poorly understood. The Drosophila DLK, Wallenda (Wnd), regulates the expression of Down syndrome cell adhesion molecule (Dscam) to control presynaptic arbor growth. This regulation is mediated by the 3' untranslated region (3'UTR) of Dscam mRNA, which suggests that RNA binding proteins (RBPs) mediate DLK function. We performed a genome-wide cell-based RNAi screen of RBPs and identified the cytoplasmic poly(A)-binding protein, pAbp, as an RBP that mediates Wnd-induced increase in Dscam expression. Genetic analysis shows that Wnd requires pAbp for promoting presynaptic arbor growth and for enhancing Dscam expression. Our analysis revealed that Dscam mRNAs harbor short poly(A) tails. We identified a region in Dscam 3'UTR that specifically interacts with pAbp. Removing this region significantly reduced Wnd-induced increase in Dscam expression. These suggest that a noncanonical interaction of PABP with the 3'UTR of target transcripts is essential for DLK functions.SIGNIFICANCE STATEMENT The kinase DLK plays key roles in a multitude of neuronal responses, including axon development, neurodegeneration, and nerve injury. Previous studies show that DLK acts via mRNAs to regulate protein synthesis, but how DLK does so is poorly understood. This study demonstrates that DLK regulates the synthesis of Dscam through the poly(A)-binding protein PABP-C. Whereas PABP-C is known as a general translational activator, our study shows that DLK-mediated Dscam expression involves a noncanonical interaction between PABP-C and the Dscam mRNA, which leads to a selective regulation of Dscam translation by PABP-C. Thus, our study provides novel insights into the mechanisms that underlie the function of DLK and regulation of gene expression of PABP-C.

Azadirachta indica Seed Derived Carbon Nanocapsules: Cell Imaging, Depolarization of Mitochondrial Membrane Potential, and Dose-Dependent Control Death of Breast Cancer

In this work, a series of mesoporous carbon nanocapsules (mCNS) of size below 10 nm have been prepared from Azadirachta indica seeds with a very easy and cost-effective approach. These nanocapsules can emit red and green light and are effective for cell imaging. Further, these carbon nanocapsules are biocompatible toward the normal healthy cells, however, they possess modest cytotoxicity against the MCF-7 (human breast cancer) and triple-negative breast cancer (TNBC) (MDA- MB-231 breast cancer cells), and the rate of killing cancer cells strongly depends on the dose of mCNCs. Further, the mitochondrial membrane potential and apoptosis assay were performed to analyze the therapeutic significance of these nanocapsules to kill breast cancer. Results showed that these carbon nanocapsules can depolarize the mitochondrial membrane potential alone (without using conventional drugs) and can change the physiological parameters and cellular metabolic energy of the cancer cells and kill them. The apoptosis results confirmed the death of breast cancer cells in the form of apoptosis and necrosis. Moreover, the results suggested that the porous carbon nanocapsules (mCNCs) reported herein can be used as a potential candidate and useful for the theranostic applications such as for cancer cell detection and therapy without using any conventional drugs.

P-707 RCT of Dual-Triger (GnRH-Agonist &amp; hCG) versus hCG-Trigger alone for Normal Responders in IVF-ICSI Cycles

Study question

Does Dual Triger with GnRH-Agonist with hCG in IVF-ICSI cycles in normal responders improve oocyte quality and pregnancy outcome compared to Triger with hCG alone?

Summary answer

Yes, Dual Triger with GnRH-Agonist with hCG in IVF-ICSI cycles in normal responders improve oocyte quality and pregnancy outcome compared to Triger with hCG alone.

What is known already

Dual-Triggering for final oocyte maturation combining GnRH-Agonist with hCG can improve clinical outcomes in high responders during IVF–ICSI cycles. .

However, there is insufficient evidence regarding the impact of a Dual-Trigger on the reproductive outcome in normal responders.

Some studies reported a significantly improved ongoing pregnancy rate and live-birth rate in fresh-embryo-transfer cycles for a dual-trigger group compared with the hCG-trigger group in normal responders . By contrast, several studies have demonstrated that dual trigger of oocyte maturation was not associated with a change in the live-birth rate in FET cycles for normal ovarian responders .

Study design, size, duration

RCT of 214 patients of IVF-ICSI Cycles between 2016 - 2020 were included in the study .The inclusion criteria in the study were: Age &lt; 40 years, AMH &gt;1 ng/ml, AFC : 07-20 and FSH &lt;10 IU/l.

The exclusion criteria were Poor-Ovarian-Reserve (Low-AMH &lt;1 ng/ml) and patients at high-risk of developing OHSS (High-AMH &gt;07 or AFC &gt;20). Recombinant-FSH dose was adjusted according to E2 levels and follicular monitoring along with a flexible GnRH-Antagonist-Protocol.

Participants/materials, setting, methods

RCT of 214 patients of IVF-ICSI Cycles between 2016-2020 were included in the study and were divided in two groups.

Administration of the GnRH-antagonist was initiated based on a flexible protocol and final oocyte-maturation was triggered either by hCG alone (contol group) or by combining GnRH-Agonist with hCG (2000 IU) (study group).Data on number of oocytes retrieved, number of mature (MII) oocytes, embryos and blastocysts and clinical pregnancy rate were assessed and compared.

Main results and the role of chance

The Implantation-Rate (16% versus 33%) and the Clinical-Pregnancy-Rate per patient (18% versus 38%) were significantly higher in the Dual Triger of GnRH-Agonist with hCG study group, compaired to contol group of Triger with hCG alone.

Dual-trigger approach appears superior to an hCG trigger alone with regard to the number of top-quality embryos produced.

Final oocyte maturation is the key step in ART cycles and Human-Chorionic-Gonadotropin (hCG) alone has been used for final oocyte maturation for many years and has been demonstrated to promote an increased pregnancy rate. However, the administration of hCG for final oocyte maturation results in supraphysiologic steroid levels in the luteal phase due to its long half-life and is consequently associated with an increased risk of OHSS. The hCG trigger may have negative impacts on endometrial receptivity and embryo quality .

The GnRH-Agonist trigger benefits the induction of both an FSH and an LH surge and the possibility of retrieving more mature MII oocytes than is expected with an hCG trigger . Drawback of a GnRHa trigger was LH depletion and the withdrawal of LH support of the corpus luteum , however this problem has been overcome with intensive luteal phase support (LPS) and luteal-phase hCG administration .

Limitations, reasons for caution

The present study did not include a third arm of patients who were triggered with GnRH-Agonist alone.

If we had added the third arm, we would have been able to test whether it was the administration of GnRH-Agonist or the co-administration of GnRH-Agonist and hCG that improved the outcome .

Wider implications of the findings

We conclude that using the dual trigger for final follicular maturation in normal responder increases the number of good quality mature MII oocytes and top-quality blastocysts compared to triggering with hCG alone.

The increase in the number of good quality blastocysts improved the outcome of the IVF-CSI cycle in normal responders.

Trial registration number

not applicable

Artificial neural network (ANN) and response surface methodology (RSM) algorithm-based improvement, kinetics and isotherm studies of electrocoagulation of oily wastewater

The work reported here focuses on the oil and grease removal from wastewater by the electrocoagulation process and using modeling and optimization for obtaining the results considering four major operating parameters, viz. current density, pH, electrode distance and reaction time. 31 experiments were designed by design of experiments (DOE) of response surface methodology (RSM) and the analysis of variance (ANOVA) studies confirmed the agreement of the experimental results. Artificial neural network (ANN) was also utilized to determine predicted response using neural networks for 4-10-1 arrangement. Both the responses predicted by RSM and ANN were in alignment with the experimental results. Maximum removal of 78% was attained under the working parameters of 80 A m^-2, 3.6 pH, electrode distance of 0.005 m and reaction time of 20 min.