First Observation of an Attractive Interaction between a Proton and a Cascade Baryon

This Letter presents the first experimental observation of the attractive strong interaction between a proton and a multistrange baryon (hyperon) Ξ^{-}. The result is extracted from two-particle correlations of combined p-Ξ^{-}⊕p[over ¯]-Ξ[over ¯]^{+} pairs measured in p-Pb collisions at sqrt[s_{NN}]=5.02  TeV at the LHC with ALICE. The measured correlation function is compared with the prediction obtained assuming only an attractive Coulomb interaction and a standard deviation in the range [3.6, 5.3] is found. Since the measured p-Ξ^{-}⊕p[over ¯]-Ξ[over ¯]^{+} correlation is significantly enhanced with respect to the Coulomb prediction, the presence of an additional, strong, attractive interaction is evident. The data are compatible with recent lattice calculations by the HAL-QCD Collaboration, with a standard deviation in the range [1.8, 3.7]. The lattice potential predicts a shallow repulsive Ξ^{-} interaction within pure neutron matter and this implies stiffer equations of state for neutron-rich matter including hyperons. Implications of the strong interaction for the modeling of neutron stars are discussed.

Measurement of neutron induced 86Sr(n, 2n)85Sr reaction cross sections at different neutron energies

The cross-sections for ⁸⁶Sr (n, 2n)⁸⁵Sr reaction are measured at neutron energies 19.44 ± 1.02 MeV and 16.81 ± 0.85 MeV wherein there is scarcity of data. The standard neutron activation analysis technique and offline gamma ray spectroscopy have been employed for measurement and analysis of the data. The results are compared with experimental data available in EXFOR database, JEFF-3.3, JENDL-4.0, TENDL-2017 and ENDF/B-VIII.0 evaluated data. The theoretical prediction was incorporated using nuclear modular codes TALYS 1.8 and EMPIRE 3.2.2. A detailed comparative study of experimental results with the theoretical models and various major evaluations has been presented.

Long-term outcomes of biological mesh repair following extra levator abdominoperineal excision of the rectum: an observational study of 100 patients

Background

Current evidence suggests that pelvic floor reconstruction following extralevator abdominoperineal excision of rectum (ELAPER) may reduce the risk of perineal herniation of intra-abdominal contents. Options for reconstruction include mesh and myocutaneous flaps, for which long-term follow-up data is lacking. The aim of this study was to evaluate the long-term outcomes of biological mesh (Surgisis^®, Biodesign™) reconstruction following ELAPER.

Methods

A retrospective review of all patients having ELAPER in a single institution between 2008 and 2018 was perfomed. Clinic letters were scrutinised for wound complications and all available cross sectional imaging was reviewed to identify evidence of perineal herniation (defined as presence of intra-abdominal content below a line between the coccyx and the lower margin of the pubic symphysis on sagittal view).

Results

One hundred patients were identified (median age 66, IQR 59–72 years, 70% male). Median length of follow-up was 4.9 years (IQR 2.3–6.7 years). One, 2- and 5-year mortality rates were 3, 8 and 12%, respectively. Thirty three perineal wounds had not healed by 1 month, but no mesh was infected and no mesh needed to be removed. Only one patient developed a symptomatic perineal hernia requiring repair. On review of imaging a further 7 asymptomatic perineal hernias were detected. At 4 years the cumulative radiologically detected perineal hernia rate was 8%.

Conclusions

This study demonstrates that pelvic floor reconstruction using biological mesh following ELAPER is both safe and effective as a long-term solution, with low major complication rates. Symptomatic perineal herniation is rare following mesh reconstruction, but may develop sub clinically and be detectable on cross-sectional imaging.

Gepirone hydrochloride: a novel antidepressant with 5-HT1A agonistic properties

Depression is a neuropsychiatric disorder that affects more than 350 million people all over the world. There are psychological and pharmacological treatments for depression which mainly focus on monoaminergic neurotransmission theory. The main concern regarding available antidepressants is the lag period and other side effects, such as sexual dysfunction. Gepirone is a drug of the azapirone group which is a 5-HT1A receptor agonist belonging to the buspirone family. Gepirone is under clinical development and has been shown to be more effective than selective serotonin reuptake inhibitors (SSRIs), as this drug treats the psychiatric disorders without causing sexual dysfunction, which limits the use of SSRIs. It possesses greater selectivity for the 5-HT1A receptor than SSRIs. Clinical studies have shown that gepirone has differential action at pre- and postsynaptic 5-HT1A receptors. Gepirone extended-release tablets (gepirone ER, Travivo) showed promising effects in adult outpatients for the treatment of major depressive disorder (MDD) in a double-blind, randomized, placebo-controlled clinical study. Gepirone also showed an antianxiety effect in a placebo-controlled trial in generalized anxiety disorder. Absorption of gepirone is increased when administered with food as there is no substantial change in Cmax and half-life but it significantly increases AUC and mean residence time. Gepirone undergoes first-pass metabolism and its major metabolites are 1- (2-pyrimidinyl)-piperazine (1-PP) and 3-OH-gepirone, both of which are pharmacologically active. In addition to its better efficacy, gepirone is well tolerated and the major adverse effects observed have been nausea, dizziness and lightheadedness. Evidence from preclinical and clinical studies revealed that gepirone could be a breakthrough therapeutic agent in the treatment of anxiety and MDD.

Variations in the retromandibular approach to the condyle-transparotid versus anteroparotid transmasseteric - a prospective clinical comparative study

BACKGROUND

The management of mandibular condylar fracture remains controversial many surgeons still favour the open reduction and internal fixation (ORIF) which provides good result and immediate functioning as compared to closed reduction. With proven consensus for ORIF, dilemma remains in choosing the surgical approach to condyle due to proximity of complex and important anatomic structure. Various extra-oral surgical approaches are available for ORIF including preauricular, submandibular, retromandibular, transmasseteric anteroparotid etc. Variations in retromandibular approach such as transparotid, retro-parotid and anteroparotid are reported in literature. In our study we compared the retromandibular transparotid and retromandibular anteroparotid transmasseteric variations.

METHODOLOGY

Thirty condylar fracture in 26 patients, 15 in each group (group A - Retromandibular transparotid approach & group B - Retromandibular anteroparotid approach) were treated under general anaesthesia with naos-tracheal intubation and by the same surgeon having 20 years of experience in maxillofacial surgeries. We evaluated time taken for the procedure, amount of bone exposure, intra-operative haemorrhage. Postoperative presence of infection, sinus and fistula formation at the incision site, parotid fistula formation, facial nerve functioning using House-Brackman scale in immediate postoperative period, 3^rd month postoperatively and 6 month postoperatively.

RESULT

The mean average time taken for group A was 78.2minutes and mean average time taken for group B was 64.8minutes. None of the patient had haemorrhage intra-operatively in both the groups. Exposure was sufficient in both the groups with same length of the incision. None of the patient suffered from postoperative infection in both the groups. Parotid fistula formation was present in 2 patients in group A while none of the patient had parotid fistula in group B. Three patients out of 15 had the transient facial nerve weakness in group A which got resolved in 6 month while none of the patient had facial nerve weakness in group B. All patients had adequate mouth opening with no occlusal discrepancies.

CONCLUSION

Retromandibular anteroparotid approach as described in this study has proven to be an extremely useful approach provides good access, and associated with minimal complications and morbidity compare to retromandibular transparotid approach. It is hence safe to say that this approach is relatively useful for an inexperienced and novice surgeon as well.

Acinetobacter sp. mediated synthesis of AgNPs, its optimization, characterization and synergistic antifungal activity against C. albicans

AIMS

To synthesize silver nanoparticles (AgNPs) with cell free extract of Acinetobacter sp. and evaluate antifungal activity against planktonic and biofilm of Candida. Also, to study mechanism of antifungal action of AgNPs.

METHODS AND RESULT

Acinetobacter spp were screened for synthesis of AgNPs. Physio-chemical parameters were optimized to obtained monodispersed nanoparticles. Optimized nanoparticles were characterized using spectroscopic, microscopic and diffraction techniques. Antifungal and biofilm disruption activity of AgNPs (10 ± 5 nm) were investigated against C. albicans. Mechanism of antifungal activity of nanosilver was deduced by growth curve, reactive oxygen species generation, thiol interaction and microscopic analysis. Acinetobacter sp. GWRFH 45 gave maximum synthesis of AgNPs. At optimized condition monodispersed, spherical nanoparticles were obtained which were crystalline with negative surface charge. AgNPs exhibited antifungal activity against planktonic cells and biofilm of Candida. AgNPs showed synergistic effect with amphotericin B as well as fluconazole against biofilm disruption. AgNPs were found to affect growth of Candida, generate reactive oxygen species and disrupt cellular morphology.

CONCLUSIONS

Cell free extract of A. calcoaceticus GWRFH 45 has ability to synthesize AgNPs. AgNPs alone and in combination with drugs have potential to inhibit C. albicans.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is the first report of bacteriogenic AgNPs used in combination with antifungal drugs against Candida.

Evaluation of contingency management as a strategy to improve HCV linkage to care and treatment in persons attending needle and syringe programs: A pilot study

BACKGROUND

A greater proportion of HCV-infected people who inject drugs (PWID) need to be linked to care for HCV antiviral treatment. This study sets out to evaluate the efficacy of contingency management (CM) for improving HCV linkage to care, treatment initiation, adherence, and cure for PWID recruited from a needle and syringe program.

METHODS

Between March 2015 and April 2016, 20 participants were enrolled into the CM arm, and then subsequently enrolled 20 participants in the enhanced standard of care (eSOC) arm. Participants in the eSOC arm received an expedited appointment and a round-trip transit card. Participants enrolled in the CM arm received eSOC plus $25 for up to ten HCV clinical visits and $10 for each returned weekly medication blister pack. Adherence was measured via electronic blister packs.

RESULTS

Overall the median age was 47 years; most were men (67%) and Hispanic (69%). There were no significant differences in demographic characteristics between participants in the study arms. In the CM arm 74% were linked to HCV care, compared to 30% in the eSOC arm (p = 0.01). In the CM arm, 75% (9/12) of treatment eligible participants initiated treatment, compared to 100%(4/4) in the eSOC arm (p = 0.53). All patients (9/9) achieved cure in the CM arm, as compared to 75% (3/4) of patients in the eSOC arm. There were no differences in adherence between study arms.

CONCLUSIONS

In this pilot study, contingency management led to higher rates of HCV linkage to care for PWID, as compared to standard of care. CM should be considered as a possible intervention to improve the HCV treatment cascade for PWID.

In vitro assessment of gentamicin and azithromycin-based combination therapy against Neisseria gonorrhoeae isolates in India

PURPOSE

The public health burden of infections caused by Neisseria gonorrhoeae is magnified due to high rates of resistance to traditional antimicrobials. The aim of this study was to evaluate the in vitro efficacy of an alternative dual therapy comprising gentamicin and azithromycin.

METHODOLOGY

The E-test method was used to determine the minimum inhibitory concentrations (MICs) of gentamicin and azithromycin individually prior to testing in combination using the cross or 90^o angle formation method. A total of 70 clinical isolates of N.gonorrhoeae displaying varying ceftriaxone MICs along with 2 reference strains (WHO K and P) and 1 ceftriaxone-resistant QA isolate were examined. The fractional inhibitory concentration index (FICI) was calculated and the results were interpreted using the following criteria: synergy, FICI ≤0.5; indifference or additive, FICI >0.5 to ≤4.0; and antagonism, FICI >4.0.

RESULTS

A total of 54 (77.1 %) isolates displayed indifference, while 16 (22.9 %) demonstrated synergy. When azithromycin was tested alone, the MICs ranged from 0.016 to 2 µg ml^-1 . However, in combination with gentamicin, the mean MIC value of all isolates decreased from 0.275 µg ml^-1 to 0.090 µg ml^-1 (P=0.05).When gentamicin was tested alone, the MICs ranged from 0.25 to 8 µg ml^-1, with a mean MIC of 4.342 µg ml^-1, whereas in combination with azithromycin it decreased significantly to 2.042 µg ml^-1 (P=0.04).

CONCLUSION

No antagonism was observed in this combination, suggesting that it could be a future treatment option as we prepare for a post-cephalosporin era. However, comprehensive in vivo evaluations are warranted and recommendations should be made based on clinical trials.

TP2-4 The impact of social deprivation upon global traumatic brain injury outcome

Objectives

The aim of this study was to assess the impact of social deprivation upon global TBI outcome.

Design

The study was a prospective observational study.

Subjects

1332 consecutive adult TBI patients were recruited into the study. 131 study participants were lost within the study.

Methods

All patients were assessed by the acute TBI team at the point of their injuries. Both injury and demographic data was collated at this point including: age, gender, medical comorbidities and GCS. The measure of social deprivation used, was the Indices of Multiple Deprivation (IMD) Score. The outcome measure, conducted at 12 months post-injury, was the GOSE. Univariate analyses were conducted prior to the final Multinomial Regression, between the GOSE score and injury factors.

Results

With regard to the representation of IMD deciles, the study population and the general population are two independent groups, but the standard deviation is sufficiently similar for them to be considered pooled (equal variance)(t-test p=0.139). Within the univariate analyses statistically significant relationships were noted between IMD and GOSE (p≤0.00). There was no relationship noted between IMD and GCS at the time of injury (p=0.409), or medical co-morbidity (p=0.682). The multinominal regression revealed a significant relationship between between worsening GOSE and IMD, Age, Medical Comorbidity and GCS (p≤0.00).

Conclusions

There is a statically significant relationship between increasing social deprivation and worsening global TBI outcomes.

Olecranon Osteotomy Approach for Complex AO-13C Fractures of Distal Humerus: A Prospective Analysis of 24 Cases

Introduction: Olecranon osteotomy is well described approach for complex intra-articular distal humeral fractures. In this study, we investigated the usefulness and complications of olecranon osteotomy approach for such fractures. We hypothesise that outcome is comparable in young adults and middle age group and also functional outcome is independent of fracture subtype following surgical fixation.

Materials and Methods: Between December 2012 and September 2015, twenty-four adult patients (male: 15, female: 9) having mean age of 41.4 years with closed intra-articular fracture (AO-13C) were surgically managed using olecranon osteotomy approach and were followed-up for a mean of 28.5 months (range: 22-35 months). Functional outcome was measured using Mayo Elbow Performance Score (MEPS) and complications were observed. Statistical analysis was done using Student t-test and Kruskal Wallis test.

Results: All fractures united by the end of three months. Mean elbow flexion achieved was 123°, mean extension lag was 9° and mean active arc of motion was 114°. Mean MEPS was 87 (excellent: 8, good: 14, fair: 1 and poor: 1). Post-operative transient ulnar nerve palsy was noted in two cases, heterotopic ossification (HO) was in one case, infection in two cases, implant prominence in five and elbow stiffness in three cases. Motion arc was higher in young adults and MEPS was comparable in both age group. Functional outcome was also dependent on fracture subtype. Conclusion: The olecranon osteotomy approach for distal humerus fractures had good functional outcome with fewer complications. Joint congruity and fixation could easily be assessed intraoperatively.

Medically Tailored Meal Delivery for Diabetes Patients with Food Insecurity: a Randomized Cross-over Trial

BACKGROUND

Food insecurity, defined as inconsistent food access owing to cost, leads to poor health.

OBJECTIVE

To test whether a medically tailored meal delivery program improved dietary quality in individuals with type 2 diabetes and food insecurity.

DESIGN

Randomized cross-over clinical trial.

PARTICIPANTS

Forty-four adults with diabetes, hemoglobin A1c > 8.0%, and food insecurity (defined as at least one positive item on the two-item "Hunger Vital Sign").

INTERVENTION

In the Community Servings: Food as Medicine for Diabetes cross-over clinical trial (NCT02426138), conducted from June 2015 to July 2017, we randomly assigned the order of "on-meals" (home delivery of 10 meals/week for 12 weeks delivered by Community Servings, a non-profit organization) and "off-meals" (12 weeks usual care and a Choose MyPlate healthy eating brochure) periods.

MAIN MEASURES

The primary outcome was Healthy Eating Index 2010 score (HEI), assessed by three 24-h food recalls in both periods. Higher HEI score (range 0-100; clinically significant difference 5) represents better dietary quality. Secondary outcomes included food insecurity and self-reported hypoglycemia.

KEY RESULTS

Mean "on-meal" HEI score was 71.3 (SD 7.5) while mean "off-meal" HEI score was 39.9 (SD 7.8) (difference 31.4 points, p < 0.0001). Participants experienced improvements in almost all sub-categories of HEI score, with increased consumption of vegetables, fruits, and whole grains and decreased solid fats, alcohol, and added sugar consumption. Participants also reported lower food insecurity (42% "on-meal" vs. 62% "off-meal," p = 0.047), less hypoglycemia (47% "on-meal" vs. 64% "off-meal," p = 0.03), and fewer days where mental health interfered with quality of life (5.65 vs. 9.59 days out of 30, p = 0.03).

CONCLUSIONS

For food-insecure individuals with diabetes, medically tailored meals improved dietary quality and food insecurity and reduced hypoglycemia. Longer-term studies should evaluate effects on diabetes control (e.g., hemoglobin A1c) and patient-reported outcomes (e.g., well-being).

Azimuthal Anisotropy of Heavy-Flavor Decay Electrons in p-Pb Collisions at sqrt[s_{NN}]=5.02 TeV

Angular correlations between heavy-flavor decay electrons and charged particles at midrapidity (|η|<0.8) are measured in p-Pb collisions at sqrt[s_{NN}]=5.02  TeV. The analysis is carried out for the 0%-20% (high) and 60%-100% (low) multiplicity ranges. The jet contribution in the correlation distribution from high-multiplicity events is removed by subtracting the distribution from low-multiplicity events. An azimuthal modulation remains after removing the jet contribution, similar to previous observations in two-particle angular correlation measurements for light-flavor hadrons. A Fourier decomposition of the modulation results in a positive second-order coefficient (v_{2}) for heavy-flavor decay electrons in the transverse momentum interval 1.5<p_{T}<4  GeV/c in high-multiplicity events, with a significance larger than 5σ. The results are compared with those of charged particles at midrapidity and those of inclusive muons at forward rapidity. The v_{2} measurement of open heavy-flavor particles at midrapidity in small collision systems could provide crucial information to help interpret the anisotropies observed in such systems.

Abstract OT1-13-02: Molecular testing for minority patients with or at high risk for cancer

PURPOSE: Meharry Medical College is a participant in eMERGE (Electronic Medical Records and Genomics); a multicenter network sponsored by NHGRI/NIMHD with the primary goal to develop, disseminate, and apply approaches to research that combine biorepositories with electronic medical records (EMR) for genomic discovery and medicine implementation research. The consortium also focuses on ethical issues involving privacy, confidentiality, and interaction with the broader community. Individual institutions created protocols around research questions individualized to their populations.

METHODS: We enrolled 500 African Americans with or at high-risk for the four most common cancers (prostate, colorectal, breast, lung) to examine possible genetic and proteomic differences to account for health disparities in this population. We will perform DNA, RNA, and proteomics analyses pertinent to these cancers and obtain corresponding clinical history from the EMR with planned long-term follow up.

RESULTS: 500 subjects (211 female) were enrolled over 11 months from Nashville General Hospital including the following cancer/at-risk participants (Breast 59/37; Colorectal 17/128; prostate 31/136; lung 16/76). Most individuals stated that they participated for potential benefit to themselves, family members, or humankind and only 11 percent of potential participants declined. Little concern has been voiced for providing samples for genetic analysis. A genetic counselor will meet with the participants that are found to have pathogenic or likely pathogenic mutations while study investigators will share results with those that are not found to have mutations. Participants will be queried regarding understanding of the genetic testing results and followed for one year to evaluate if they underwent recommended testing and to follow for cancer outcomes.

CONCLUSION: The inclusion of diverse groups in genomic research is critical to identify possible reasons for health disparities and to study the understanding of genetic testing and ethical issues surrounding this topic. In this study, African-Americans are participating willingly in clinical research to examine possible genetic and/or social bases for cancer disparities.

ACKNOWLEDGEMENT: NIMHD (U54MD007593) to the Meharry Translational Research Center (MeTRC); National Human Genome Research Institute (NHGRI); National Institute of Allergy and Infectious Disease (NIAID).

Citation Format: Singh R, Bayan MA, Kadari S, Nganteh MN, Jacksonm M, Woodson LM, Shamsuddin AS, Lemus BY, Pratap S, Murray JJ, Adunyah SE, Lammers PE. Molecular testing for minority patients with or at high risk for cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT1-13-02.

Abstract P3-12-13: Comparison of accelerated partial breast irradiation (APBI) with whole breast irradiation (WBI) using 3D conformal external beam radiation therapy (3D CRT)

Purpose:

To compare accelerated partial breast irradiation with whole breast irradiation in post breast conservation surgery (BCS) women with breast cancer.

Material and methods:

Women &gt;35 years of age with invasive or noninvasive breast cancer ≤4 cm treated by BCS were randomized to 3D CRT APBI (34 Gy in 10 fractions given twice daily) or WBI (40 Gy in 16 fractions given once daily ± boost irradiation).The primary outcome was ipsilateral breast tumour recurrence and important secondary outcomes were adverse cosmetic outcome (fair or poor on a HARVARD/NSABP/RTOG breast cosmesis grading scale) and toxicity using the RTOG scores and LENT SOMA scale. Radiation toxicities and cosmesis was assessed directly by radiation oncologist during radiotherapy and in follow up.Patient and tumour characteristics, locoregional recurrence and distant metastases rates were compared using Fisher's exact tests.All statistical tests were two sided p values less than 0.05 were considered statistically significant.

Results:

Between June 2011 and December 2015, 133 women were randomized to 3D CRT APBI or WBI. Patient characteristics were balanced between two arms. There was an increased rate of acute grade 2 dermatitis in WBI arm(p=0.33). Median follow up was 60 months(range 9-84 months). Grades 1 and 2 late radiation toxicities were higher in the WBI arm compared to the APBI arm; pigmentation, fibrosis and breast shrinkage were significantly more in the WBI arm. Grades 3 and 4 late toxicity was not seen in any of the treatment arms. Adverse cosmesis at last follow up was significantly higher in patients treated with WBI, 32% as compared to 6% with APBI (p=&lt;0.001). Local recurrence with APBI was 3% as compared to 1.5% with WBI and distant metastasis rate was high in WBI arm as compared with APBI, 5.9% vs 3% respectively; both not statisticaly significant.

Table 1.Patient and tumor characteristicsCharacteristicsAPBI(n=65)WBI(n=68)p-valueMean age(range)50(36-75)(36-75)50(37-67)(37-67)0.13T- Stage   T134(52)37(54) T228(43)28(41)0.96T33(5)3(4) N stage   N057(88)59(87) N17(11)28(41)1.00N21(1)1(1) Grade   114(22)12(18) 237(56)40(59)0.5314(22)16(23) Surgical margins   Negative60(92)61(90)0.79Positive5(8)7(10) LVI   No56(86)55(81)0.49Yes9(14)13(19) ER   Positive42(65)45(66) Negative19(29)21(31)1.00Unknown5(6)2(3) PR   Positive38(58)39(57) Negative23(35)25(37)1.0Unknown4(7)4(6) Her2-neu   Positive7(11)6(9)0.78Chemotherapy   Yes35(54)52(76)0.78No30(46)16(24) Hormone therapy   Yes49(75)49(72)0.78No16(25)19(28) Trastuzumab   Yes3(43)3(50)1.00No4(57)3(50) 

Conclusion:

In women with BCS, APBI was associated with better cosmetic outcome and late radiation toxicities compared to WBI. Local recurrence and distant metastasis was comparable in both the arms.

Citation Format: Yadav BS, L S, Sharma SC, Singh R, Dahiya D. Comparison of accelerated partial breast irradiation (APBI) with whole breast irradiation (WBI) using 3D conformal external beam radiation therapy (3D CRT) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-12-13.

Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study

BACKGROUND

Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery.

METHODS

This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy.

RESULTS

Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI.

CONCLUSIONS

After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.

Sodium chloride incites reactive oxygen species in green algae Chlorococcum humicola and Chlorella vulgaris: Implication on lipid synthesis, mineral nutrients and antioxidant system

In the present study, microalgae Chlorococcum humicola and Chlorella vulgaris were grown in different concentrations of NaCl (25-1000 mM) to elucidate its impact on morphology, lipid synthesis, minerals status and antioxidative responses. Scanning Electron microscopy showed distorted cell morphology and increased cell size by 33.52% (C. humicola) and 27.79% (C. vulgaris) at 100 mM NaCl. Energy Dispersive Spectroscopy data revealed reduction in mineral contents (C, S, Fe, Mg, Si, Mn and Zn) by 14-54% in both algae. Further, C. humicola was found to have high lipid content than C. vulgaris under NaCl regime. The activities of superoxide dismutase, catalase and glutathione reductase were increased by 2.5-5 folds in both algae as compared to control. The increased level of ascorbate, cysteine and proline in both algae indicated tolerance against salinity. Thus, C. humicola and C. vulgaris may exhibit dual benefits viz., high lipid production and reclamation of sodic soil.

High-resolution melting curve analysis of heat shock protein 65 for identification of mycobacterial isolates

Infections caused by non-tuberculous mycobacteria (NTM) often escape detection on traditional diagnostics. We evaluated the ability of heat shock protein 65 (hsp65) polymerase chain reaction and high-resolution melting curve (HRMC) analysis to identify and differentiate Mycobacterium tuberculosis complex (MTC) from NTM in 150 clinical mycobacterial isolates from extra-pulmonary sites. A hundred MTC and 50 NTM isolates were identified. We were able to simultaneously differentiate between seven mycobacterial species using HRMC analysis; a concordance of 100% between hsp65 HRMC analysis, polymerase chain reaction + restriction analysis and hsp65 sequencing was observed.

Non-destructive position measurement of coasting beam using Schottky signals

The beam position appears in the transverse Schottky signal spectra of coasting beams at revolution frequency and its harmonics. In this contribution, we utilize this signal for beam position monitoring using regular shoe-box monitors at heavy ion synchrotron GSI SIS-18. Position resolution below 1 mm at 1 kHz rate for 10 mA current was obtained. These results demonstrate the feasibility of non-destructive position monitoring of unbunched beams in synchrotrons and storage rings using capacitive pick-up data with appropriate signal processing.

Reduction in polyamine catabolism leads to spermine-mediated airway epithelial injury and induces asthma features

BACKGROUND

Airway epithelial injury is a crucial component of acute and severe asthma pathogenesis and a promising target for treatment of refractory asthma. However, the underlying mechanism of epithelial injury remains poorly explored. Although high levels of polyamines, mainly spermine, have been found in asthma and comorbidity, their role in airway epithelial injury and the cause of their altered levels in asthma have not been explored.

METHODS

We measured key polyamine metabolic enzymes in lung samples from normal and asthmatic subjects and in mice with OVA-induced allergic airway inflammation (AAI). Polyamine metabolism was modulated using pharmacologic/genetic modulators. Epithelial stress and apoptosis were measured by TSLP levels and TUNEL assay, respectively.

RESULTS

We found loss of the polyamine catabolic enzymes spermidine/spermine-N (1)-acetyltransferase-1 (SAT1) and spermine oxidase (SMOX) predominantly in bronchial epithelial cells (BECs) of human asthmatic lung samples and mice with AAI. In naïve mice, SAT1 or SMOX knockdown led to airway hyper-responsiveness, remodeling, and BEC apoptosis. Conversely, in mice with AAI, overexpression of either SAT1 or SMOX alleviated asthmatic features and reduced TSLP levels and BEC apoptosis. Similarly, while pharmacological induction of SAT1 and SMOX using the polyamine analogue bis(ethyl)norspermine (BENSPM) alleviated asthmatic features with reduced TSLP levels and BEC apoptosis, pharmacological inhibition of these enzymes using BERENIL or MDL72527, respectively, worsened them. Spermine accumulation in lungs correlated with BEC apoptosis, and spermine treatment caused apoptosis of human BEAS-2B cells in vitro.

CONCLUSIONS

Spermine induces BEC injury. Induction of polyamine catabolism may represent a novel therapeutic approach for asthma via reversing BEC stress.