Residual ctDNA after treatment predicts early relapse in patients with early-stage non-small cell lung cancer

BACKGROUND

Identification of residual disease in patients with localized non-small cell lung cancer (NSCLC) following treatment with curative intent holds promise to identify patients at risk of relapse. New methods can detect circulating tumour DNA (ctDNA) in plasma to fractional concentrations as low as a few parts per million, and clinical evidence is required to inform their use.

PATIENTS AND METHODS

We analyzed 363 serial plasma samples from 88 patients with early-stage NSCLC (48.9%/28.4%/22.7% at stage I/II/III), predominantly adenocarcinomas (62.5%), treated with curative intent by surgery (n = 61), surgery and adjuvant chemotherapy/radiotherapy (n = 8), or chemoradiotherapy (n = 19). Tumour exome sequencing identified somatic mutations and plasma was analyzed using patient-specific RaDaR™ assays with up to 48 amplicons targeting tumour-specific variants unique to each patient.

RESULTS

ctDNA was detected before treatment in 24%, 77% and 87% of patients with stage I, II and III disease, respectively, and in 26% of all longitudinal samples. The median tumour fraction detected was 0.042%, with 63% of samples <0.1% and 36% of samples <0.01%. ctDNA detection had clinical specificity >98.5% and preceded clinical detection of recurrence of the primary tumour by a median of 212.5 days. ctDNA was detected after treatment in 18/28 (64.3%) of patients who had clinical recurrence of their primary tumour. Detection within the landmark timepoint 2 weeks to 4 months after treatment end occurred in 17% of patients, and was associated with shorter recurrence-free survival [hazard ratio (HR): 14.8, P <0.00001] and overall survival (HR: 5.48, P <0.0003). ctDNA was detected 1-3 days after surgery in 25% of patients yet was not associated with disease recurrence. Detection before treatment was associated with shorter overall survival and recurrence-free survival (HR: 2.97 and 3.14, P values 0.01 and 0.003, respectively).

CONCLUSIONS

ctDNA detection after initial treatment of patients with early-stage NSCLC using sensitive patient-specific assays has potential to identify patients who may benefit from further therapeutic intervention.

Prevalence of mouthpart sensilla and protease producing symbiotic gut bacteria in the forensic fly Chrysomya megacephala (Fabricius, 1794): Insight from foraging to digestion

The blow fly, Chrysomya megacephala (Fabricius, 1794) is a globally prevalent forensically important species that helps to estimate accurate postmortem interval since the death. This fly occasionally causes cutaneous myiasis and transmits several pathogenic bacteria. To understand their ability of corpse detection and digestion of protein-rich meal, the present study describes the mouthpart sensilla and assessment of protease producing symbiotic gut bacteria. Scanning electron microscopy (SEM) showed the prevalence of trichoid sensilla (Tr), basiconic sensilla (Ba) and microtrichia (Mr) on labellar lobes, haustellum and maxillary palps of mouthparts. Bacterial particles of both rod (small and large) and spherical shaped were detected in the gut of C. megacephala using SEM. The bacterial density was higher on the foregut and midgut in comparison to the hindgut. From 72 bacterial isolates, 10 isolates from the foregut region showed considerable protease-producing efficacy ranging between 3.98 - 6.83 GHR and 9.73 - 34.68 U/ml protease. Among these, the most promising protease-producing bacterial isolate showed 16S rDNA sequence similarity (99.85%) with Chryseobacterium artocarpi DNA. This bacterium was the first report from flies. The findings of the study might help in better understanding of the role of sensilla in host perception and foregut symbiotic bacterial association in protein digestion in C. megacephala.

Remediation of Cd and Cu contaminated water and soil using novel nanomaterials derived from sugar beet processing- and clay brick factory-solid wastes

Producing nanomaterials from hazardous wastes for water and soil treatment is of great concern. Here, we produced and fully characterized two novel nanomaterials from sugar beet processing (SBR)- and brick factory-residuals (BFR) and assed their ability for Cd and Cu sorption in water and reducing metal availability in a contaminated soil. The SBR removed up to 99% of Cu and 91% of Cd in water, and exhibited a significantly faster and higher sorption capacity (q_max (g kg^-1) = 1111.1 for Cu and 33.3 for Cd) than BFR (q_max (g kg^-1) = 33.3 for Cu and 10.0 for Cd), even at acidic pH. Soil metal availability was significantly reduced by SBR (up to 57% for Cu and 86% for Cd) and BFR (up to 36% for Cu and 68% for Cd) compared to the unamended soil. The higher removal efficacy of SBR over BFR could be attributed to its higher alkalinity (pH = 12.5), carbonate content (82%), and specific surface area, as well as the activity of hydroxyl -OH and Si-O groups. The nano-scale SBR and BFR, the former particularly, are novel, of low cost, and environmental friendly amendments that can be used for the remediation of metal-contaminated water and soil.

Chitosan as a Tool for Sustainable Development: A Mini Review

New developments require innovative ecofriendly materials defined by their biocompatibility, biodegradability, and versatility. For that reason, the scientific society is focused on biopolymers such as chitosan, which is the second most abundant in the world after cellulose. These new materials should show good properties in terms of sustainability, circularity, and energy consumption during industrial applications. The idea is to replace traditional raw materials with new ecofriendly materials which contribute to keeping a high production rate but also reducing its environmental impact and the costs. The chitosan shows interesting and unique properties, thus it can be used for different purposes which contributes to the design and development of sustainable novel materials. This helps in promoting sustainability through the use of chitosan and diverse materials based on it. For example, it is a good sustainable alternative for food packaging or it can be used for sustainable agriculture. The chitosan can also reduce the pollution of other industrial processes such as paper production. This mini review collects some of the most important advances for the sustainable use of chitosan for promoting circular economy. Hence, the present review focuses on different aspects of chitosan from its synthesis to multiple applications.

A series of xanthenes inhibiting Rad6 function and Rad6-Rad18 interaction in the PCNA ubiquitination cascade

Ubiquitination of proliferating cell nuclear antigen (PCNA) triggers pathways of DNA damage tolerance, including mutagenic translesion DNA synthesis, and comprises a cascade of reactions involving the E1 ubiquitin-activating enzyme Uba1, the E2 ubiquitin-conjugating enzyme Rad6, and the E3 ubiquitin ligase Rad18. We report here the discovery of a series of xanthenes that inhibit PCNA ubiquitination, Rad6∼ubiquitin thioester formation, and the Rad6–Rad18 interaction. Structure-activity relationship experiments across multiple assays reveal chemical and structural features important for different activities along the pathway to PCNA ubiquitination. The compounds that inhibit these processes are all a subset of the xanthen-3-ones we tested. These small molecules thus represent first-in-class probes of Rad6 function and the association of Rad6 and Rad18, the latter being a new inhibitory activity discovered for a small molecule, in the PCNA ubiquitination cascade and potential therapeutic agents to contain cancer progression.

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Alpha-based HTS for PCNA ubiquitination modulators

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Target-based characterization of hits

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A series of xanthenes that inhibit Rad6 functions and Rad6–Rad18 interaction

Adequacy in pleural effusion: What is the minimum volume required for detection of malignant cells?

BACKGROUND

Adequacy criteria of pleural fluid volume for optimal reporting are contentious, and very little literature is available to date. This problem has not been addressed in the novel International System for Reporting Serous Fluid Cytology.

MATERIALS AND METHODS

A retrospective analysis was performed on 939 pleural fluid samples. Five volume bins were created: 0-9.9 ml, 10-19.9 ml, 20-34.9 ml, 35-69.9 ml, and > 70 ml and included 203, 222, 314, 174, and 26 samples, respectively. Volume bins were compared across various categories using a Chi-square test. A malignancy fraction was used to assess diagnostic accuracy. Descriptive statistics for categorical variables were done with median and interquartile range. A ROC curve was constructed to find if pleural fluid volume can be used to detect malignancy. A cut-off volume was found which can detect malignancy with optimum sensitivity.

RESULTS

The area under the Receiver Operating Characteristic curve showed that 55% of the time, the pleural volume can detect malignancy correctly. From the coordinates of the curve it was found that for a sensitivity of 81% and specificity of 40%, a cut-off volume of 13.5 ml of pleural fluid is sufficient to detect malignancy.

CONCLUSIONS

We recommend 13.5 ml as the minimum volume cut-off for a satisfactory pleural effusion cytology report. Below this volume, the false-negative rates increase, and the specimen may be deemed as limited for a conclusive diagnosis. As the volume rises above this threshold volume, the false negativity rate decreases but does not significantly improve malignant cells' detection.

Association of injection Tocilizumab and inflammatory markers in COVID19

The coronavirus disease 2019 (COVID-19) virus has spread all over the world. Scientists are trying to discover drugs as effective treatment for patients with COVID-19. So far about 30 drugs have been introduced that one of them is Tocilizumab. Some reports showed a positive effect of Tocilizumab on Saturation of Peripheral Oxygen (SPO2) but results of CT scan in patients in different. In some patients, CT scan showed reduced infiltration, however in other no change was observed. Unfortunately, until now there has been no definitive and effective treatment for patients with COVID-19. Based on evidence of the Tocilizumab's effect on the SARS COV 2, researchers hope this drug will make effective and promising treatment to improve lung tissue inflammation in patients with the fatal COVID-19 virus. The present study provides an overview of respiratory inflammation with COVID-19 and probable effect of Tocilizumab on SARS-COV 2.

MATERIAL

A Case Series was conducted on 30 patients, RT-PCR confirmed COVID-19 cases; admitted and kept under observation in medicine ward, ICU or dedicated COVID-19 wards of RNT Medical College and associated group of Hospitals for a duration of 30 days after getting approval from institutional ethics committee if they met inclusion and exclusion criteria. Data was collected from records at the time of admission of these cases.

OBSERVATION

In our study on day 1 mean of IL6 was 248.3 and on day 3 after giving injection Tocilizumab mean of IL6 was 138.7 and p value was 0.205 and on day1 mean of serum ferritin was 474.2 and on day 3 after giving injection Tocilizumab mean of serum ferritin was 415.2 and p value was 0.649 and on day 1 mean of LDH was 652 and on day 3 after giving injection Tocilizumab mean of LDH was 389.6 and p value was 0.006 and on day 1 mean of CRP was 100 and on day 3 after giving injection Tocilizumab mean of CRP was 35.95 and p value was 0.006 and out of 30 patient 22 patients were discharged and 8 patients declared death.

CONCLUSION

In present study it was interpreted that injection Tocilizumab play an important role in reducing inflammation in COVID 19disease. Tocilizumab have significant role in reducing mortality from COVID 19.

Umbilical Nodule Metastasis from Unknown Primary: Diagnostic and Therapeutic Dilemma

Umbilical nodule metastasis is not a common presentation of carcinoma of unknown primary. It may be the presenting symptom of a primary malignancy or as metastatic site of previously diagnosed cancer and is considered to be a poor prognostic finding. We here report a case of young male who presented with umbilical mass, but the primary could not be localized even after thorough investigations and work up. Also, there existed therapeutic dilemma because immunohistochemistry did not favor one site, and so he was considered for combination chemotherapy in view of unresectable disease.

Gum Acacia-Crosslinked-Poly(Acrylamide) Hydrogel Supported C3N4/BiOI Heterostructure for Remediation of Noxious Crystal Violet Dye

Herein, we report the designing of a C₃N₄/BiOI heterostructure that is supported on gum acacia-crosslinked-poly(acrylamide) hydrogel to fabricate a novel nanocomposite hydrogel. The potential application of the obtained nanocomposite hydrogel to remediate crystal violet dye (CVD) in an aqueous solution was explored. The structural and functional analysis of the nanocomposite hydrogel was performed by FTIR (Fourier transform infrared spectroscopy), X-ray diffraction (XRD), transmission electron microscopy (TEM), and scanning electron microscopy (SEM). The different reaction parameters, such as CVD concentration, nanocomposite hydrogel dosage, and working pH, were optimized. The C₃N₄/BiOI heterostructure of the nanocomposite hydrogel depicts Z-scheme as the potential photocatalytic mechanism for the photodegradation of CVD. The degradation of CVD was also specified in terms of COD and HR-MS analysis was carried to demonstrate the major degradation pathways.

Use of covered stent (CGuard) in the treatment of post-traumatic internal carotid artery pseudoaneurysm

Post-traumatic internal carotid artery pseudoaneurysm (ICA PSA) is a rare occurrence with high mortality rates, and with the advent of endovascular therapy, its treatment has shown drastic improvement in clinical as well as radiological outcomes. Here we are describing our experience with the CGuard embolic protection system (InspireMD, Tel Aviv, Israel) for the treatment of post-traumatic left ICA PSA in a 49-year-old male. New improved biomechanics and navigability have proven it to be a safe and efficient treatment modality for ICA PSA. However, a multicentric large-scale randomized trial is recommended to support this modality.

Mutants of Helicobacter pylori IMPDH: Kinetics and in silico Studies to Determine the Structural and Functional Role of Key Amino Acids

The emergence of antibiotic-resistant strains of Helicobacter pylori necessitates the development of novel therapeutic strategies to fight against its infection. Recently, the enzyme inosine-5'-monophosphate dehydrogenase (IMPDH) has emerged as a promising target to treat bacterial infections due to its crucial role in the de novo purine biosynthesis pathway. The differences between the prokaryotic and eukaryotic IMPDHs, in the NAD + binding domain and flap region, allow the identification of pathogen-specific inhibitors. In the present study, seven point mutants of wild type Helicobacter pylori IMPDH are constructed by site-directed mutagenesis, and characterized using in silico and kinetic studies. Point mutations in the NAD + binding domain and the flap region are shown to impart significant changes in the enzyme's structure and function. In addition, the product inhibition characteristics of the Arg396-Tyr397 dyad (RY dyad) show that both the residues are important for water activation in the reaction. The results obtained are beneficial for the design and development of small molecule inhibitors, capable of species-specific inhibition.

Pattern of sudden cardiac deaths

BACKGROUND AND OBJECTIVE

Sudden cardiac death can be defined as a sudden, unexpected death caused by loss of heart function. Notwithstanding major developments in the diagnosis and treatment of heart disease, it remains the major contributing factor for deaths. This considers the pattern of sudden cardiac deaths.Methodology: This prospective study was conducted on all cases subjected to medico-legal autopsy in the forensic medicine department at a tertiary care hospital for a period of 18 months. All sudden cardiac deaths satisfying the WHO criteria were included. Unknown cases and bodies in advanced stage of decomposition were excluded.

RESULTS

Sudden cardiac deaths accounted for 55% (82 cases) of 149 cases of sudden natural deaths and 6.5% of total autopsies conducted. The age group most commonly affected by sudden cardiac death ranged from 31 to 50 years. The majority of the cadavers had 90-95% degree of stenosis of left anterior descending artery, 70-80% of right coronary artery and 60-70% left circumflex artery. Coronary insufficiency was the major cause for sudden cardiac deaths with a total of 53 (64.63%) cases.

CONCLUSION

Sudden cardiac deaths accounted for 6.5% of all the autopsies conducted and males outnumbered females with M:F ratio of 10.7:1, with mean age of 44.5 ± 12.63 years. The largest number - 60.97% - were aged between 31 and 50 years. Coronary insufficiency accounted for 64.63% of sudden cardiac deaths.

Epidural spinal stimulation enables global sensorimotor and autonomic function recovery after complete paralysis: 1st study from India

While the loss of sensorimotor and autonomic function often occurs due to multiple trauma and pathologies, spinal cord injury is one of the few traumatic pathologies that severely affects multiple organ systems both upstream and downstream of the injury. Current standard of care therapies primarily maintains health and avoids secondary complications. They do not address the underlying neurological condition. Multiple modalities including spinal neuromodulation have shown promise as potential therapies. The objective of this study was to demonstrate the impact of activity-based neurorehabilitation in presence of epidural spinal stimulation to enable simultaneous global recovery of sensorimotor and autonomic functions in patients with complete motor paralysis due to spinal cord injury. These data are unique in that it quantifies simultaneously changes multiple organ systems within only 2 months of intense activity-based neurorehabilitation when also delivering epidural stimulation consisting of sub-motor threshold stimulation over a period of 12-16 hours/day to enable 'self-training' in 10 patients. Finally, these studies were done in a traditional neurorehabilitation clinical in India using off-the-shelf electrode arrays and pulse generators, thus demonstrating the feasibility of this approach in simultaneously enabling recoveries of multiple physiological organ systems after chronic paralysis and the ability to perform these procedures in a standard, well-controlled clinical environment.

Intracranial Myopericytoma: A Rare Benign Tumor at an Extremely Rare Location

A 50-year-old female presented with a history of seizures, headache, nausea, and vomiting. On imaging, parafalcine meningioma with mass effect features was rendered. She underwent right frontal tumor excision and craniotomy. Pathological examination showed a tumor composed of syncytial aggregates of round to plump fusiform cells forming whorls around prominent branching congested vessels. The tumorous cells expressed α-smooth actin and heavy-chain caldesmon and were negative for epithelial membrane antigen, protein S100, HMB45, CD34, calponin, and desmin, thus providing the final diagnosis of intracranial myopericytoma.

The rarity of this benign tumor at an extremely rare location prompted this study. As preoperative radiological investigations are nonspecific in such cases, a detailed and comprehensive pathological examination is mandatory to come to a definitive diagnosis.

Precipitation of (Mg/Fe-CTAB) - Layered double hydroxide nanoparticles onto sewage sludge for producing novel sorbent to remove Congo red and methylene blue dyes from aqueous environment

Preparation of new sorbent from precipitation of nano-sized (Mg/Fe-CTAB)- layered double hydroxide (LDH) on the surfaces of sewage sludge byproduct to remove the anionic and cationic dyes was the focal point of this work. The presence of nanoparticles and enlarged of interlayers by CTAB intercalation have increased the sludge surface area from 5.34 to 10.32 m²/g. The CTAB mass 0.03 g/50 mL, sludge dosage 1 g/50 mL and (Mg/Fe) molar ratio 2 were the best preparation conditions required to obtain effective sorbent with efficiencies exceeded 93% for MB and CR dyes. These efficiencies were obtained under operational conditions for batch study of 0.5 g coated sludge per 50 mL colored dye solution, initial pH 3 (for CR) and 12 (for MB), and time 3 h for 10 mg/L dyes at 200 rpm. Models of Langmuir and pseudo second-order have a high capability in the representation of sorption records with maximum capacities of adsorption 163.6 and 132.6 mg/g for CR and MB dye, respectively. The X-ray diffraction analysis proved that the calcite occurred mainly at 2θ = 29.8° while quartz corresponded to the 21, 26.6, 36.4, 36.9, 50.1, 60.01 and 68.4°. Characterization tests showed that nano-sized particles of magnesium/iron were precipitated on the sludge due to the formation of hydrotalcite-like compounds with an increase in the percentages of Mg and Fe from 0.87 and 1.36 to 4.25 and 3.03%, respectively. The results showed that the electrostatic attraction, intra-particle diffusion and hydrogen bonding were predominant mechanisms for removal of CR and MB onto coated sludge.

MXenes based nano-heterojunctions and composites for advanced photocatalytic environmental detoxification and energy conversion: A review

Extensive research is being done to develop multifunctional advanced new materials for high performance photocatalytic applications in the field of energy production and environmental detoxification, MXenes have emerged as promising materials for enhancing photocatalytic performance owing to their excellent mechanical properties, appropriate Fermi levels, and adjustability of chemical composition. Numerous experimental and theoretical research works implied that the dimensions of MXenes have a significant impact on their performance. For photocatalysis to thrive in the future, we must understand the current state of the art for MXene in different dimensions. Using MXene co-catalysts in widely used in photocatalytic applications such as CO₂ reduction, hydrogen production and organic pollutant oxidation, this study focuses on the most recent developments in MXenes based materials, structural modifications, innovations in reaction and material engineering. It has been reported that using 5 mg of CdS-MoS₂-MXene researchers were able to generate as high as 9679 μmol/g/h hydrogen under visible light. The MXenes based heterojunction photocatalyst Co₃O₄/MXene was utilized to degrade 95% bisphenol A micro-pollutant in just 7 min. Numerous novel materials, their preparations and performances have been discussed. Depending upon the nature of MXene-based materials, the synthesis techniques and photocatalytic mechanism of MXenes as co-catalyst are also summarized. Finally, some final thoughts and prospects for developing highly efficient MXene-based photocatalysts are provided which will indeed motivate researchers to design novel hybrid materials based on MXenes for sustainable solutions to energy and pollution issues.

Nano to rescue: repository of nanocarriers for targeted drug delivery to curb breast cancer

Breast cancer is a heterogeneous disease with different intrinsic subtypes. The conventional treatment of surgical resection, chemotherapy, immunotherapy and radiotherapy has not shown significant improvement in the survival rate of breast cancer patients. The therapeutics used cause bystander toxicities deteriorating healthy tissues. The breakthroughs of nanotechnology have been a promising feat in selective targeting of tumor site thus increasing the therapeutic gain. By the application of nanoenabled carriers, nanomedicines ensure targeted delivery, stability, enhanced cellular uptake, biocompatibility and higher apoptotic efficacy. The present review focuses on breakthrough of nanoscale intervention in targeted drug delivery as novel class of therapeutics. Nanoenabled carriers like polymeric and metallic nanoparticles, dendrimers, quantum dots, liposomes, solid lipid nanoparticles, carbon nanotubes, drug-antibody conjugates and exosomes revolutionized the targeted therapeutic delivery approach. These nanoassemblies have shown additional effect of improving the solubility of drugs such as paclitaxel, reducing the dose and toxicity. The present review provides an insight on the different drug conjugates employed/investigated to curb breast cancer using nanocarrier mediated targeted drug delivery. However, identification of appropriate biomarkers to target, clearer insight of the biological processes, batch uniformity, reproducibility, nanomaterial toxicity and stabilities are the hurdles faced by nanodrugs. The potential of nano-therapeutics delivery necessitates the agglomerated efforts of research community to bridge the route of nanodrugs for scale-up, commercialization and clinical applications.

Mechanism of Zinc Transport through the Zinc Transporter YiiP

Zinc is an essential transition metal ion that plays as a structural, functional (catalytic), and a signaling molecule regulating cellular function. Unbalanced levels of zinc in cells can result in various pathological conditions. In the current work, all-atom molecular dynamics simulations were used to study the structure-function correlation between different YiiP states embedded in a lipid bilayer. This study enabled us to develop a hypothesis on the zinc efflux mechanism of YiiP. We have created six different models of YiiP representing the stages of the ion-transport process. We found that zinc ion plays a crucial role in restraining the transmembrane domains (TMDs) of the protein. In addition, H153, located in the TMD, has been proposed to guide the zinc ion toward the ZnA site of the YiiP transporter. Understanding the molecular-level Zn²⁺-transport process sheds light on the strategies affecting intracellular transition-metal ion concentrations in order to treat diseases like diabetes and cancer.

Six-minute walk test and its predictability in outcome of COVID-19 patients

BACKGROUND

The world is worsely hit by the COVID-19 pandemic resulting in increased morbidity and mortality. Increased mortality has been observed in older adults with multiple comorbidities. Six-minute walk distance (6MWD) at admission can help us to guide the requirement of oxygen during hospital stay that can be used to determine which patient can be managed at home.

MATERIALS AND METHODS

This study was a prospective observational study conducted on COVID-19 patients admitted at AIIMS, New Delhi, from October to December 2020. Patients aged more than 60 years were included in the study and underwent 6-min walk tests. Polypharmacy and multimorbidity were also assessed along with dyspnea which was measured on BORG scale. P < 0.05 was considered statistically significant. Statistical software STATA (version 14.2) was used for all the analyses.

RESULTS

The mean age of the study population was 68.76 (7.4). Oxygen saturation prior to the 6-MWT was normal and has significantly higher than the post test (P ≤ 0.001). 6MWD was significantly correlated with pre values of oxygen saturation. 6MWD was observed more in patients who did not require oxygen during hospital stay. Self-reported dyspnea, pulse rate, oxygen saturation, and systolic blood pressure were significantly associated with the patients who had an oxygen requirement during the hospital stay.

CONCLUSION

Self-reported dyspnea after 6MWT was found to be associated with oxygen requirement during hospital stay. Patients who have covered more distance in 6-min walk test have less oxygen requirement during hospital stay hence can be managed at home. This will reduce the health-care burden and will help to tackle the outburst during the ongoing pandemic.

Entinostat decreases immune suppression to promote anti-tumor responses in a HER2+ breast tumor microenvironment

Therapeutic combinations to alter immunosuppressive, solid tumor microenvironments (TMEs), such as in breast cancer, are essential to improve responses to immune checkpoint inhibitors (ICIs). Entinostat, an oral histone deacetylase inhibitor (HDACi), has been shown to improve responses to ICIs in various tumor models with immunosuppressive TMEs. The precise and comprehensive alterations to the TME induced by entinostat remain unknown. Here, we employed single-cell RNA-sequencing on HER2-overexpressing breast tumors from mice treated with entinostat and ICIs in order to fully characterize changes across multiple cell types within the TME. This analysis demonstrates that treatment with entinostat induced a shift from a pro-tumor to an anti-tumor TME signature, characterized predominantly by changes in myeloid cells. We confirmed myeloid-derived suppressor cells (MDSCs) within entinostat-treated tumors associated with a less suppressive granulocytic (G)-MDSC phenotype and exhibited altered suppressive signaling that involved the NFkB and STAT3 pathways. In addition to MDSCs, tumor-associated macrophages were epigenetically reprogrammed from a pro-tumor M2-like phenotype toward an anti-tumor M1-like phenotype, which may be contributing to a more sensitized TME. Overall, our in-depth analysis suggests that entinostat-induced changes on multiple myeloid cell types reduce immunosuppression and increase anti-tumor responses, which, in turn, improve sensitivity to ICIs. Sensitization of the TME by entinostat could ultimately broaden the population of patients with breast cancer who could benefit from ICIs.

A comprehensive review on the removal of noxious pollutants using carrageenan based advanced adsorbents

Rapid industrial development is associated with high discharge of toxic pollutants into the environment. The industries discharge their wastewater containing organic pollutants directly into the water system without treating them that has posed many serious threats to environmental protection. The use of bioadsorbents for the removal of such toxic pollutants from the waste water due to its simple synthesis, easy operation, effectiveness, and economic viability have emerged a new dimension in the wastewater treatment approaches. Various adsorbents have been prepared to examine their adsorption capacity against different adsorbates, but, to attain sustainability, biocompatibility, and biodegradation, bio-adsorbents have been found to won the battle. Seaweed derived polysaccharide; Carrageenan (CR) has been proven to be an excellent adsorbent for the wastewater treatment. It has been successfully modified with various components to form CR based-magnetic composites, hydrogels, nanoparticle modified CR composites and many others to enrich and diversify its properties. In this review, we have explained the adsorption behaviour of various carrageenan based adsorbents for the removal of different dyes. The influence of various parameters such as the effect of initial concentration, adsorbent dosage, contact time, pH, temperature, and ion concentration on dye adsorption is well explained. This paper also summarizes the structure, morphology, swelling ability, and thermal stability of carrageenan. The data also expounds on the adsorption capacity, kinetic model, isotherm model, and nature of the adsorption process. Different types of solvents are used for the regeneration and reusability of carrageenan adsorbents and their regeneration studies and desorption efficiency is well-explained. The adsorption mechanism of dyes onto carrageenan based adsorbents has been well described in this review. This review provides a deep insight about the use of carrageenan based adsorbents for the wastewater treatment.

Adsorption of cationic dyes onto carrageenan and itaconic acid-based superabsorbent hydrogel: Synthesis, characterization and isotherm analysis

Polysaccharide-based hydrogels offer a great overlook for environmental applications and help in the elimination of various noxious pollutants from the water system. Novel carrageenan and itaconic acid-based superadsorbent hydrogel having appreciable swelling properties and adsorption capacity towards Methylene blue (MB), Crystal violet (CV), and Methyl Red (MR) was synthesized by suspension polymerization technique. The swelling study showed the dependency upon the temperature in which the swelling rate increased with increasing temperature with a maximum swelling rate of 417% at 318 K. For ascertaining the maximum adsorption capacity, various influential parameters such as contact time, adsorbent dose, dye concentration, and temperature were systematically studied. Maximum adsorption capacity as calculated from the Langmuir isotherm was 2439.02, 1111.11, and 666.68 mg/g for MB, CV, and MR, respectively. Thermodynamic studies revealed the spontaneous nature of the undertaken dye adsorption experiment. Overall, the present study reveals that the synthesized superadsorbent hydrogel can be used as an efficient adsorbent for the removal of dyes from an aqueous solution.

Selective binding of small molecules to Vibrio cholerae DsbA offers a starting point for the design of novel antibacterials

DsbA enzymes catalyze oxidative folding of proteins that are secreted into the periplasm of Gram‐negative bacteria, and they are indispensable for the virulence of human pathogens such as Vibrio cholerae and Escherichia coli. Therefore, targeting DsbA represents an attractive approach to control bacterial virulence. X‐ray crystal structures reveal that DsbA enzymes share a similar fold, however, the hydrophobic groove adjacent to the active site, which is implicated in substrate binding, is shorter and flatter in the structure of V. cholerae DsbA (VcDsbA) compared to E. coli DsbA (EcDsbA). The flat and largely featureless nature of this hydrophobic groove is challenging for the development of small molecule inhibitors. Using fragment‐based screening approaches, we have identified a novel small molecule, based on the benzimidazole scaffold, that binds to the hydrophobic groove of oxidized VcDsbA with a K_D of 446±10 μM. The same benzimidazole compound has ∼8‐fold selectivity for VcDsbA over EcDsbA and binds to oxidized EcDsbA, with K_D>3.5 mM. We generated a model of the benzimidazole complex with VcDsbA using NMR data but were unable to determine the structure of the benzimidazole bound EcDsbA using either NMR or X‐ray crystallography. Therefore, a structural basis for the observed selectivity is unclear. To better understand ligand binding to these two enzymes we crystallized each of them in complex with a known ligand, the bile salt sodium taurocholate. The crystal structures show that taurocholate adopts different binding poses in complex with VcDsbA and EcDsbA, and reveal the protein‐ligand interactions that stabilize the different modes of binding. This work highlights the capacity of fragment‐based drug discovery to identify inhibitors of challenging protein targets. In addition, it provides a starting point for development of more potent and specific VcDsbA inhibitors that act through a novel anti‐virulence mechanism.

CRISPR/Cas9: A Molecular Tool for Ovarian Cancer Management beyond Gene Editing

Ovarian cancer manifests with early metastases and has an adverse outcome, impacting the health of women globally. Currently, this malignancy is often treated with cytoreductive surgery and platinum-based chemotherapy. This treatment option has a limited success rate due to tumor recurrence and chemoresistance. Consequently, the fundamental objective of ovarian cancer treatment is the development of novel treatment approaches. As a new robust tool, the CRISPR/Cas9 gene-editing system has shown immense promise in elucidating the molecular basis of all the facets of ovarian cancer. Due to the precise gene editing capabilities of CRISPR-Cas9, researchers have been able to conduct a more comprehensive investigation of the genesis of ovarian cancer. This gained knowledge can be translated into the development of novel diagnostic approaches and newer therapeutic targets for this dreadful malignancy. There is encouraging preclinical evidence that suggests that CRISPR/Cas9 is a powerful versatile tool for selectively targeting cancer cells and inhibiting tumor growth, establishing new signaling pathways involved in carcinogenesis, and verifying biomolecules as druggable targets. In this review, we analyzed the current research and progress made using CRISPR/Cas9-based engineering strategies in the diagnosis and treatment, as well as the challenges in bringing this method to clinics. This comprehensive analysis will lay the basis for subsequent research in the future for the treatment of ovarian cancer.

Will open waste burning become India's largest air pollution source?

India struggles with frequent exceedances of the ambient air quality standard for particulate matter and benzene. In the past two decades, India has made considerable progress in tackling indoor air pollution, by phasing out kerosene lamps, and pushing biofuel using households towards Liquefied Petroleum Gas (LPG) usage. In this study, we use updated emission inventories and trends in residential fuel consumption, to explore changes in the contribution of different sectors towards India's largest air pollution problem. We find that residential fuel usage is still the largest air pollution source, and that the <10% households using cow dung as cooking fuel contribute ∼50% of the residential PM_2.5 emissions. However, if current trends persist, residential biofuel usage in India is likely to be phased out by 2035. India's renewable energy policies are likely to reduce emissions in the heat and electricity sector, and manufacturing industries, in the mid-term. PM_2.5 emissions from open waste burning, on the other hand, hardly changed in the decade from 2010 to 2020. We conclude that without strong policies to promote recycling and upcycling of non-biodegradable waste, and the conversion of biodegradable waste to biogas, open waste burning is likely to become India's largest source of air pollution by 2035. While our study is limited to India, our findings are of relevance for other countries in the global South suffering from similar waste management challenges.

Umbilical artery systolic/diastolic ratio and amniotic fluid index in prediction of adverse perinatal outcome in term pregnancies

Background:

Antenatal fetal surveillance is a field of increasing importance in modern obstetrics. It is based on fetal heart rate monitoring using nonstress test and contraction stress test, ultrasound biometry and amniotic fluid assessment, Doppler blood flow studies of fetal and uteroplacental circulation, and an evaluation of biophysical fetal parameters. The combination of these methods leads to improvements in fetal morbidity and mortality.

Aim:

The present study aimed to assess the sensitivity, specificity, and positive and negative predictive values of umbilical artery (UA) systolic/diastolic (S/D) ratio, and amniotic fluid index (AFI) in term pregnancies for the prediction of perinatal outcome and their relation with perinatal outcome.

Methods:

This study was conducted at a tertiary care hospital on 100 pregnant women where all the term singleton pregnancies (37–42 weeks) admitted in maternity were subjected to color Doppler for UA S/D ratio assessment and AFI estimation. Further, management of patients was done according to color Doppler findings and their relation with perinatal outcome.

Results:

Out of 100 pregnant women, 68% had AFI >8 (normal), while 32% of women had AFI <8 (abnormal), with the mean AFI being 9.39 ± 2.55 cm, whereas70% had S/D ratio <3 (normal) and 30% of women had S/D ratio >3 (abnormal), with the mean S/D ratio of 2.61 ± 0.450. UA S/D ratio had better performance values (i.e., sensitivity, specificity, and positive and negative predictive value) than AFI in predicting adverse perinatal outcomes.

Conclusion:

AFI and UA S/D ratio are important for predicting low appearance, pulse, grimace, activity, and respiration score, meconium, respiratory complications, and perinatal mortality in high as well as low-risk pregnancy cases. However, UA S/D ratio is a better predictor of perinatal outcome in high-risk pregnancies.

Immunohistochemical Characterisation of Cell of Origin in Diffuse Large B-cell Lymphoma and its Association with the Double Expressor Phenotype: A Retrospective Study

Introduction: Diffuse Large B-cell Lymphoma (DLBCL) is the most common type of Non Hodgkin Lymphoma (NHL) and is categorised into the Germinal Centre B-cell (GCB) and Activated B-cell (ABC/Non GCB) subtypes as per the Cell Of Origin (COO) model with the help of gene expression profiling/ immunohistochemistry. The non GCB subtype has been found to associate with the Double Expressor (DE) phenotype (i.e., co-expression of BCL-2 and c-myc by IHC and this association was substantiated and proven to be statistically significant in the present study. Aim: To categorise all DLBCL cases into GCB and Non GCB and further into DE and Non-DE by using Hans and Choi IHC alogrithm. Materials and Methods: A retrospective study of 50 patients was carried out with the help of archival material filed in the Department of Anatomic Pathology at Dharamshila Narayana Superspeciality Hospital, New Delhi, India from 1st January 2019 to 30th June 2020. The study was approved by Instituitional Ethics Committee (IEC). Chi-square test and Yates correction were used for statistical analysis. Results: The study cohort was divided into two Groups- group-A with nodal presentation and group-B with extranodal presentation. By using the Hans and Choi IHC algorithms, the cases were categorised into the GCB and non GCB subtypes in both the groups. The DE phenotype was determined in each case by the co-expression of c-myc (>40%) and BCL-2 (>50%) by IHC. By using the statistical chi-square test analysis and Yates correction, the association of DE was found to be statistically significant with non GCB type lymphomas and non DE with GCB lymphomas with p-value being 0.0005 and 0.00168, respectively. Conclusion: Due to the heterogeneity inherent in DLBCL, prediction of the DE phenotype and the COO by IHC is a sensitive tool and helps in the prognostication and therapeutic triage of patients. Hence, in all the cases diagnosed as DLBCL, a detailed morphological and IHC work up is mandatory to determine prognosis and possibly tailor therapy according to COO and DE phenotype.

Role of the Tumor Microenvironment and the Influence of Epigenetics on the Tumor Microenvironment in Oral Carcinogenesis: Potential Implications

Oral cancer has become a significant problem throughout the world, particularly in countries that are still developing. Recent literature supports the contribution of components of the tumor microenvironment (TME) and the effect of epigenetic changes happening in the cells of the TME on oral cancer development and progression. In this review, we comprehensively examine the significance of TME in the development of OC along with the current understanding of the epigenetic modifications that regulate the TME and their cohesive impact on tumor traits and their potential as therapeutic targets.

Sexual dimorphism of inferior alveolar canal location: A record- based CBCT Study in Eastern India

BACKGROUND

Sex determination from unidentified skeletal remains a daunting task in forensic odontology. The mandible is the strongest and most durable of bones available for post-mortem profiling and its morphometric characteristics have been investigated. Less explored is the location of the mandibular canal which in a few populations has shown gender dimorphism.

AIM

The present cross-sectional study explores sexual dimorphism in an eastern Indian population of Odisha from an analysis of cone-beam CT system (CBCT) images for the relative position of the mandibular canal and its foramina.

METHOD AND MATERIALS

A total of 120 CBCT images from either gender (1:1 ratio) of adult dentate individuals aged 18-60 years were analysed for the relative position of the mandibular canal. Ten measurements (8- coronal and 2- from axial slices) concerning the mandibular canal; at the level of the mandibular foramen, mandibular first molar and mental foramen were performed. Unpaired Student's t-test was employed to compare variables between the sexes at P < 0.05 level of significance.

RESULTS

The results revealed statistically significant differences (P < 0.05) between the genders in most of the variables (8/10), with higher mean values in males compared to females except in the distance between mandibular foramen and anterior border of the ramus (2.648 ± 0.67 mm in females, 2.527 ± 0.75 mm in males) and in the distance between the canal and lingual cortical plate in the region of the first molar (14.515 ± 1.33 mm in females, 14.288 ± 2.01 mm in males).

CONCLUSION

The relative position of the mandibular canal and its associated foramina show sexual dimorphism in an adult eastern Indian population.

Accelerated charge transfer in well-designed S-scheme Fe@TiO2/Boron carbon nitride heterostructures for high performance tetracycline removal and selective photo-reduction of CO2 greenhouse gas into CH4 fuel

Designing and fabrication of smart hybrid multifunctional materials for energy/fuel production and environmental detoxification is indeed of great significance for sustainable development. Herein, we synthesized a new well-structured S-scheme heterostructure Fe@TiO₂/Boron Carbon nitride (FT/BCN) with high performance tetracycline degradation and selective CO₂ photo-reduction to CH₄. Under visible light irradiation, 96.3% tetracycline was degraded in 60 min using best performing FT30/BCN sample with a high 83.2% total organic carbon removal in 2 h. The tetracycline degradation rate for FT30/BCN composite catalyst was ∼7 times than bare boron carbon nitride (BCN). The impact of reaction parameters as pH, presence of interfering electrolytes, light source and water matrix was also investigated. The FT30/BCN photocatalyst shows dramatic improvement in CO₂ photoreduction as exhibited in 24.7 μmol g^-1 h^-1 CH₄ and 2.4 μmol g^-1 h^-1 CO evolutions with optimal 91.1% CH₄ selectivity. Pure BCN shows a poor 39.1% selectivity. Further, effect of alkali activation, CO₂/H₂O feed ratio, reducing agent and light source onto CH₄ production and selectivity was also investigated. The CH₄ evolution and selectivity was improved because of enhanced visible light absorption, high adsorption potential, charge carrier separation and high reducing power of photogenerated electrons induced by an effective S-scheme heterojunction between Fe@TiO₂ and boron carbon nitride. An S-scheme (step-scheme) charge transfer mechanism is here operative both during tetracycline removal and CO₂ reduction. The drug degradation route and photocatalytic mechanism for antibiotic removal and CO₂ reduction was also predicted.

Fabrication and Characterization of Xanthan Gum-cl-poly(acrylamide-co-alginic acid) Hydrogel for Adsorption of Cadmium Ions from Aqueous Medium

The present research demonstrates the facile fabrication of xanthan gum-cl-poly(acrylamide-co-alginic acid) (XG-cl-poly(AAm-co-AA)) hydrogel by employing microwave-assisted copolymerization. Simultaneous copolymerization of acrylamide (AAm) and alginic acid (AA) onto xanthan gum (XG) was carried out. Different samples were fabricated by changing the concentrations of AAm and AA. A sample with maximum swelling percentage was chosen for adsorption experiments. The structural and functional characteristics of synthesized hydrogel were elucidated using diverse characterization tools. Adsorption performance of XG-cl-poly(AAm-co-AA) hydrogel was investigated for the removal of noxious cadmium (Cd(II)) ions using batch adsorption from the aqueous system, various reaction parameters optimized include pH, contact time, temperature, and concentration of Cd(II) ions and temperature. The maximum adsorption was achieved at optimal pH 7, contact time 180 min, temperature 35 °C and cadmium ion centration of 10 mg·L-1. The XG-cl-poly(AAm-co-AA) hydrogel unveiled a very high adsorption potential, and its adsorption capacities considered based on the Langmuir isotherm for Cd(II) ions was 125 mg·g-1 at 35 °C. The Cd(II) ions adsorption data fitted nicely to the Freundlich isotherm and pseudo-first-order model. The reusability investigation demonstrated that hydrogel retained its adsorption capacity even after several uses without significant loss.

Spatial Variation of Trace Metals between Industrial and Rural Dwelling Birds of India

A large quantity of trace metals has been continuously polluting the environment as a result of increasing urbanization and industrial processes. In 2016-2017, the metal (Cd, Cu, Cr, Ni, Pb, and Zn) levels were determined in fecal pellets of Blue Rock Pigeon (Columba livia) at Bais Godam (industrial location) in Jaipur and Chittora (rural location) in Rajasthan, India. Fecal pellets in industrial regions which are under higher anthropogenic influence exhibited higher metal concentrations when compared with the fecal pellets of the same species in rural area which have minimal anthropogenic input, with statistically significant industrial-rural differences in the metal concentrations except for Ni. Results obtained in this study, as well as the comparison with literature data, indicated that concentrations of Cr and Cu were high in fecal pellets of Blue Rock Pigeon in the industrial region of the present study. Furthermore, many significant correlations were also observed between metal levels in the industrial region which could be attributed to a similar source. Moreover, contamination levels of pigeon excrement serve as one of the most compelling indicators in terrestrial systems for the monitoring of metal pollution levels.

Functional outcome in patients with Charcot neuropathy with almost complete loss of talus treated by tibio-talo calcaneal nail: A cross-sectional study

INTRODUCTION

Tibio-talo-calcaneal (TTC) fusion is a successful surgery for Charcot neuropathy affecting the hindfoot. A case series of Charcot neuropathy is presented with almost complete loss affecting hindfoot treated with tibio-talo-calcaneal nail.

MATERIAL AND METHODS

Seven patients with Charcot neuropathy of the hindfoot having varying degrees of talus loss underwent tibio-talo-calcaneal nailing between January 2014 and Feb 2016 at a tertiary care hospital by a single surgeon. All the patients were type 3a as per Brodsky classification. Patients with active infection, fractures and avascular necrosis of talus was excluded from the study. The final outcome was measured using the AOFAS and FADI scores at the end of 2 years.

RESULTS

The mean duration of diabetes was 8.16 ± 3.12 years. Two patients (28.6%) had total and 5 (71.4%) patients had subtotal talus loss. Anterior approach was used in four, and lateral approach was used in three cases respectively. The talus was reconstructed by using the iliac crest or the graft from the distal fibula wherever appropriate. The average surgical duration was 93.28 ± 4.84 min. One patient had deep infection, 2 years after the surgery which was treated by implant removal and antibiotics. No patients had non-union. The pre-operative AOFAS scores improved from 32.2 ± 2.58 to 73.4 ± 3.36 at 2-year follow-up (p < 0.0001). Similarly, the pre-operative FADI scores were 31.74 ± 1.98 which improved to 65.94 ± 3.68 at the end of 2 years (p < 0.0001).

CONCLUSION

Retrograde tibio-talo-calcaneal nail is a good option for limb salvage in patients with severe talus loss with good functional outcome.

LEVEL OF EVIDENCE

Therapeutic IV.

Impact of Personal Protective Equipment on the Performance of Emergency Pediatric Tasks

OBJECTIVES

Personal protective equipment (PPE) is worn by health care providers (HCPs) to protect against hazardous exposures. Studies of HCPs performing critical resuscitation tasks in PPE have yielded mixed results and have not evaluated performance in care of children. We evaluated the impacts of PPE on timeliness or success of emergency procedures performed by pediatric HCPs.

METHODS

This prospective study was conducted at 2 tertiary children's hospitals. For session 1, HCPs (medical doctors and registered nurses) wore normal attire; for session 2, they wore full-shroud PPE garb with 2 glove types: Ebola level or chemical. During each session, they performed clinical tasks on a patient simulator: intubation, bag-valve mask ventilation, venous catheter (IV) placement, push-pull fluid bolus, and defibrillation. Differences in completion time per task were compared.

RESULTS

There were no significant differences in medical doctor completion time across sessions. For registered nurses, there was a significant difference between baseline and PPE sessions for both defibrillation and IV placement tasks. Registered nurses were faster to defibrillate in Ebola PPE and slower when wearing chemical PPE (median difference, -3.5 vs 2 seconds, respectively; P < 0.01). Registered nurse IV placement took longer in Ebola and chemical PPE (5.5 vs 42 seconds, respectively; P < 0.01). After the PPE session, participants were significantly less likely to indicate that full-body PPE interfered with procedures, was claustrophobic, or slowed them down.

CONCLUSIONS

Personal protective equipment did not affect procedure timeliness or success on a simulated child, with the exception of IV placement. Further study is needed to investigate PPE's impact on procedures performed in a clinical care context.

Efficacy and acceptability of pharmacotherapy for comorbid anxiety symptoms in bipolar disorder: A systematic review and meta-analysis

OBJECTIVE

Anxiety symptoms are highly prevalent among individuals with bipolar disorder (BD) but there is little guidance on pharmacotherapy for these symptoms. The objective of this systematic review and meta-analysis was to evaluate the available evidence for pharmacotherapy of comorbid anxiety symptoms in BD.

METHODS

Completed randomized clinical trials (RCTs) of medications for BD published prior to December 2020 were identified through a systematic search of MEDLINE, Embase, PsycInfo, Web of Science, clinicaltrials.gov, and the ISRCTN. Data from RCTs measuring anxiety symptoms at baseline and endpoint and all-cause discontinuation were pooled to compare the efficacy and acceptability of medications with control conditions.

RESULTS

Thirty-seven RCTs met our inclusion criteria; 13 placebo-controlled RCTs with 2175 participants had sufficient data to be included in the meta-analysis assessing anxiety symptoms. Compared with placebo, the overall effect size of medications (primarily atypical antipsychotics) on anxiety symptoms was small with a standardized mean difference (SMD) = -0.22 (95% CI: -0.34 to -0.11). Study heterogeneity was low (I²  = 26%). The acceptability of these medications was comparable with placebo with odds ratio of discontinuation from all causes = 0.98 (95% CI: 0.91-1.06).

CONCLUSION

There is limited evidence for a small anxiolytic effect and good acceptability of pharmacotherapy (primarily atypical antipsychotics) in the treatment of comorbid anxiety symptoms in BD. These results highlight the need for further research on medications other than atypical antipsychotics.

A real-world study of wearable sensors in Parkinson's disease

Most wearable sensor studies in Parkinson's disease have been conducted in the clinic and thus may not be a true representation of everyday symptoms and symptom variation. Our goal was to measure activity, gait, and tremor using wearable sensors inside and outside the clinic. In this observational study, we assessed motor features using wearable sensors developed by MC10, Inc. Participants wore five sensors, one on each limb and on the trunk, during an in-person clinic visit and for two days thereafter. Using the accelerometer data from the sensors, activity states (lying, sitting, standing, walking) were determined and steps per day were also computed by aggregating over 2 s walking intervals. For non-walking periods, tremor durations were identified that had a characteristic frequency between 3 and 10 Hz. We analyzed data from 17 individuals with Parkinson's disease and 17 age-matched controls over an average 45.4 h of sensor wear. Individuals with Parkinson's walked significantly less (median [inter-quartile range]: 4980 [2835-7163] steps/day) than controls (7367 [5106-8928] steps/day; P = 0.04). Tremor was present for 1.6 [0.4-5.9] hours (median [range]) per day in most-affected hands (MDS-UPDRS 3.17a or 3.17b = 1-4) of individuals with Parkinson's, which was significantly higher than the 0.5 [0.3-2.3] hours per day in less-affected hands (MDS-UPDRS 3.17a or 3.17b = 0). These results, which require replication in larger cohorts, advance our understanding of the manifestations of Parkinson's in real-world settings.

Co-Polarized [1-13C]Pyruvate and [1,3-13C2]Acetoacetate Provide a Simultaneous View of Cytosolic and Mitochondrial Redox in a Single Experiment

Cellular redox is intricately linked to energy production and normal cell function. Although the redox states of mitochondria and cytosol are connected by shuttle mechanisms, the redox state of mitochondria may differ from redox in the cytosol in response to stress. However, detecting these differences in functioning tissues is difficult. Here, we employed ¹³C magnetic resonance spectroscopy (MRS) and co-polarized [1-¹³C]pyruvate and [1,3-¹³C₂]acetoacetate ([1,3-¹³C₂]AcAc) to monitor production of hyperpolarized (HP) lactate and β-hydroxybutyrate as indicators of cytosolic and mitochondrial redox, respectively. Isolated rat hearts were examined under normoxic conditions, during low-flow ischemia, and after pretreatment with either aminooxyacetate (AOA) or rotenone. All interventions were associated with an increase in [P_i]/[ATP] measured by ³¹P NMR. In well-oxygenated untreated hearts, rapid conversion of HP [1-¹³C]pyruvate to [1-¹³C]lactate and [1,3-¹³C₂]AcAc to [1,3-¹³C₂]β-hydroxybutyrate ([1,3-¹³C₂]β-HB) was readily detected. A significant increase in HP [1,3-¹³C₂]β-HB but not [1-¹³C]lactate was observed in rotenone-treated and ischemic hearts, consistent with an increase in mitochondrial NADH but not cytosolic NADH. AOA treatments did not alter the productions of HP [1-¹³C]lactate or [1,3-¹³C₂]β-HB. This study demonstrates that biomarkers of mitochondrial and cytosolic redox may be detected simultaneously in functioning tissues using co-polarized [1-¹³C]pyruvate and [1,3-¹³C₂]AcAc and ¹³C MRS and that changes in mitochondrial redox may precede changes in cytosolic redox.

Comparative study of endometrial & subendometrial angiogenesis in unexplained infertile versus normal fertile women

Background & objectives:

Local angiogenesis in endometrium has been shown to be an essential pre-requisite for endometrial receptivity needed for implantation and gestation. Recently, numerous diagnostic gears have been projected to ‘measure’ or ‘estimate’ the endometrial receptivity relying upon angiogenic factors helping throughout implantation. This study evaluated the endometrial and subendometrial blood flow and the local endometrial gland vascular endothelial growth factor (EG-VEGF) expression as markers of local angiogenesis.

Methods:

The present study was done to give quantitative assessment of endometrial thickness (ET), endometrial blood flow and subendometrial blood flow colour Doppler indices with endometrial vascular zones. Endometrial biopsy was taken and with VEGF stained and scored with immunohistochemistry.

Results:

The mean ET for fertile women was 9.41 mm, while in unexplained infertile women it was around 7.90 mm. Upon comparison of ET with EG-VEGF which is considered as a gold standard with correlation coefficient, the present study suggested a positive correlation of EG-VEGF with ET, endometrial pulsatility index (PI), and subendometrial PI also the vascular zones were considered as significant. However, a strong negative correlation was seen with subendometrial resistivity index and PI.

Interpretation & conclusions:

The present study suggests that uterine ultrasound, uterine colour Doppler and EG-VEGF are parameters which can be used as markers of local angiogenesis for endometrial receptivity in the evaluation of women with unexplained infertility.