New record of Philometra species from the marine edible fish Terapon jarbua collected from the Sindh, Arabian Sea, Pakistan

Diseases in fish due to helminth parasites, especially Philometra species, are the primary worry in aquaculture. Philometra are responsible for health problem in fishes they directly affect fish growth and population parameters. A comprehensive survey was conducted involving the examination of the marine fish species Terapon jarbua, gathered from the coastal waters of Sindh, Pakistan In this research different Philometra species from marine fish Terapon jarbua during 2021 and 2022. Philometra nematodes, belonging to the family Philometridae, are common parasitic organisms inhabiting both marine and freshwater environments. Their prevalence, particularly when existing in high numbers within host organisms, can lead to severe and potentially lethal consequences. Employing light microscopy techniques, diverse species of Philometra were identified, including Philometra teraponi, P. jarbuai, P. arabiai, P. karachii, and P. awarii, localized primarily within the ovaries of the host fish. A total of 140 fish samples were examined and 76 were infected. The intensity of infected fish was 54.28%. The identification process encompassed meticulous analysis of crucial parameters, such as body size, esophagus length, positioning of the nerve ring, dimensions of the ventriculus, and ligament size. Intriguingly, the parasites were found in varying contexts; while some were free within the ovaries, others were embedded within tissues, inducing severe muscular dystrophy. This research presents novel findings of Philometra nematodes in the marine waters of Pakistan, extending their host and geographical distribution records. Future studies are needed to better evaluate and describe the dynamics and the epidemiology of Philometra infection in wild and cultured fish species.

Size at sexual maturity estimation for 36 species captured by bottom and mid-water trawls from the marine habitat of Balochistan and Sindh in the Arabian Sea, Pakistan, using maximum length (Lmax) and logistic (L50) models

Abstract The aim of this study was to estimate the size at first sexual maturity (Lm) for 36 species belonging to 24 families from the marine habitat of Balochistan and Sindh in Arabian Sea, Pakistan through maximum length based an empirical and logistic model using commercial catch during June 2020 to May 2021. Individual total length (TL) was noted up to 0.1 cm using measuring broad. The Lm was calculated using two formulae; (i) log (Lm) = - 0.1246 + 0.9924 * log (Lmax) for Elasmobranchs and (ii) log (Lm) = -0.1189 + 0.9157* log (Lmax) for ray-finned fishes. The minimum Lm was recorded as 10.27 cm TL for Caranx malabaricus and 108.38 cm TL for Isurus oxyrinchus, respectively. Around Lm with 58.33% species were ranges from 19.00 cm to 25.00 cm TL. This study was estimated 16 newly Lm which is globally absent and rest 20 Lm are absent in the Arabian Sea (Pakistan coastal habitats). Therefore, the results will be helpful for the sustainable management and conservation of these marine fishes through the establishment of mesh size of trawl nets based on the size at sexual maturity (Lm).

Copenhagen Psychosocial "Work Organization and Job Content" as a Higher-Order Construct in Relation to Workers' Health: The Moderating Role of Leadership Quality

Originality/Purpose

The current study aims to investigate the novel approach of utilizing work organization and job content (WOJC) as a higher-order construct that is one of the domains of the Copenhagen Psychosocial Questionnaire (COPSOQ), examining its relationship with sleeping troubles and somatic stress, while also exploring the moderating effect of leadership quality.

Sample/methods

Snowball sampling technique was used to collect the data in this study, with a population consisting of 360 workers employed in hazardous work environments at poultry feed mills. The structural equation modelling technique was applied to achieve the range of outcomes.

Results

The results reveal that WOJC has a significant negative impact on both psychological (sleeping troubles) and physiological (somatic stress) health factors among poultry workers. Although leadership quality did not moderate the relationship between WOJC and physiological health factors, it did moderate the relationship between WOJC and psychological health factors.

Conclusion/Implications

This study has significant implications for researchers, poultry feed mill owners, policymakers, and regulatory bodies. Additionally, the methodological contribution of utilizing WOJC as a higher-order construct provides unique insights for researchers.

Limitations

Due to COVID-19 restrictions, the data was collected online from one province only; future studies should spread the sampling framework to all provinces with different domains of COPSOQ.

Toilet plume bioaerosols in health care and hospitality settings: A systematic review

BACKGROUND

The spread of some respiratory and gastro-intestinal infections has been linked to the exposure to infectious bioaerosols released after toilet flushing. This represents a health hazard and infection risk for immunocompromised patients, health workers and the public, particularly within the health care and hospitality settings. This systematic review provides current knowledge and identifies gaps in the evidence regarding toilet plume bioaerosols and the potential contributory role in spreading infections in health care and hospitality settings.

METHODS

The PRISMA guidelines were used. Searches were run in PubMed, Scopus, and Google Scholar from 1950 to 30th June 2021. Searches of global and regional reports and updates from relevant international and governmental organizations were also conducted.

RESULTS AND CONCLUSION

The search yielded 712 results, and 37 studies were finally selected for this review. There is a lack of national and international bioaerosol sampling and exposure standards for health care and hospitality settings. Toilet plume bioaerosols are complex in nature, thus, measured bioaerosol concentrations in these settings depend on many variables and may differ for every pathogen responsible for a particular infectious disease. The contact and airborne transmission risks posed by toilet plume bioaerosols also remain unquantified. They are an important pathway that can increase the exposure to enteric and airborne pathogens. Hence, quantitative risk assessment and related research are needed to investigate these transmission risks.

Psychosocial safety climate and self-efficacy: Moderating role of job-related expectations in Pakistani private-sector employees during the COVID-19 pandemic

The labor force in Pakistan comprises 59.8 million individuals. The employees have faced major changes in work dynamics and psychosocial safety climate during the COVID-19 pandemic. The purpose of the current study is to find the relationship between psychosocial safety climate, self-efficacy, and job-related expectations. It explores the moderating role of job-related expectations on the relationship between psychosocial safety climate and self-efficacy. It was hypothesized that there is likely to be a significant relationship between psychosocial safety climate, self-efficacy, and job-related expectations, job-related expectations are likely to moderate the relationship between psychosocial safety climate and self-efficacy, and there are likely to be differences between married and unmarried employees; men and women; satisfied and unsatisfied employees with respect to psychosocial safety, self-efficacy, and job-related expectations. A correlational research design and a convenience sampling strategy were used. A total of 281 employees (M = 30.74 years, SD = 10.99) of the private-sector (including educational, industrial, and IT) organizations during the COVID-19 pandemic were part of the study. Results show that psychosocial safety climate had a positive significant relationship with job-related expectations and self-efficacy. Job expectations also significantly correlated with self-efficacy. There were significant differences in measures of study variables with respect to gender, marital status, and employee satisfaction. This research has implications for administration, managers, policymakers, and organizational psychologists.

Personality assessment in military - Bright and dark sides of the assessment measures: A review

BACKGROUND

Personality assessment has its own bright and dark sides, especially in the military setting. It is at play since the emergence of clinical psychology and its application in the recruitment process during World War I and II. Change in personality assessment trends, the evolution of complex personality traits, and changing geopolitical settings across the world necessitate the development of cost-effective, time-efficient, and reliable assessment measures that overcome issues in current assessment measures and fulfil the needs of present timesOBJECTIVE:The objective of this paper is to explore the evolution of personality assessment measures and their uses in military settings along with the comparison of self-report and non-self-report measures. It would give directions for the development of new measures to overcome the issues and drawbacks associated with current measures of research.

METHODS

The research question was formulated using the most valid SPIDER technique for a comprehensive search. PubMed, Google Scholar, and PsycNet databases were searched. 19 articles were selected based on inclusion and exclusion criteria out of 775 articles.

RESULTS

Thematic analyses show that personality assessment in the military is done to a) detect psychopathology, b) detect aberrant responses, c) recruit new personnel, d) predict training and performance outcomes, and e) predict leadership. The research contributes to the body of knowledge by showing an integrated picture of the most widely used assessment tools and the purpose it serves.

CONCLUSION

There is a need to develop assessment measures that are culture free and can assess more complex personality attributes.

Team-based self-directed learning enhanced students' learning experience in undergraduate surgical teaching

INTRODUCTION

To evaluate the effectiveness of team-based self-directed learning (SDL) in the teaching of the undergraduate Year 5 surgical posting.

MATERIALS AND METHODS

A quasi-experimental study was conducted to develop and administer a team-based SDL versus a conventional SDL to teach undergraduate surgical topics. One hundred and seventy-four medical students who underwent the Year 5 surgical posting were recruited. They were assigned to two groups receiving either the teambased SDL or the conventional SDL. Pre- and post-SDL assessments were conducted to determine students' understanding of selected surgical topics. A selfadministered questionnaire was used to collect student feedback on the team-based SDL.

RESULTS

The team-based SDL group scored significantly higher than the conventional SDL group in the post-SDL assessment (74.70 ± 6.81 vs. 63.77 ± 4.18, t = -12.72, p < 0.01). The students agreed that the team-based SDL method facilitated their learning process.

CONCLUSION

The study demonstrated that the use of a teambased SDL is an effective learning strategy for teaching the Year 5 surgical posting. This method encouraged peer discussion and promoted teamwork in completing task assignments to achieve the learning objectives.

Tuberculosis detection from raw sputum samples using Au-electroplated screen-printed electrodes as E-DNA sensor

Tuberculosis (TB) remains a leading cause of death globally, especially in underdeveloped nations. The main impediment to TB eradication is a lack of efficient diagnostic tools for disease diagnosis. In this work, label free and ultrasensitive electrochemical DNA biosensor for detecting Mycobacterium tuberculosis has been developed based on the electrodeposition of gold nanoparticles on the surface of carbon screen-printed carbon electrode (Zensors) for signal amplification. Particularly, screen-printed electrodes were modified by electrochemical deposition of Au to enhance the conductivity and facilitate the immobilization of ssDNA probes via Au-S bonds. The electrochemically modified SPEs were characterized using Scanning electron microscopy/Energy Dispersive X-Ray Analysis (SEM/EDX) and X-Ray Diffraction (XRD). Cyclic voltammetry (CV) and differential pulse voltammetry (DPV) techniques were used to investigate the DNA hybridization between single-stranded (ssDNA) probe and target DNA (tDNA). Under the ideal conditions, DPV exhibited a correlation coefficient R2 = 0.97, when analyzed with different tDNA concentrations. The proposed DNA biosensor exhibits a good detection range from 2 to 10 nm with a low detection limit of 1.91 nm, as well as high selectivity that, under ideal conditions, distinguishes non-complementary DNA from perfectly matched tDNA. By eliminating the need for DNA purification, this work paves the path for creating disposable biosensors capable of detecting DNA from raw sputum samples.

Life orientation and psychological distress in COVID recovered patients-the role of coping as a mediator

The coronavirus disease (COVID-19) pandemic has not only brought the risk of death but has brought unbearable psychological pressures to the people. Mental health of COVID patients is expected to be affected by the continuous spread of the pandemic. This study aims to find the mediating role of coping styles in the relationship between life orientation and psychological distress among COVID recovered patients. It was hypothesized that: life orientation is likely to have a relationship with coping; coping is likely to have a relationship with psychological distress and coping is likely to mediate the relationship between life orientation and psychological distress among patients recovered from COVID. For this purpose, 378 COVID-10 recovered patients’ men (190) and women (188). Urdu translations of the Life Orientation scale revised, Brief Coping Orientation to Problem Experienced (COPE) and Impact of event scales were used to collect data. Results show that emotion-focused and avoidant coping mediate the relationship between life orientation and psychological distress. The research has implications for mental health practitioners and individuals dealing with health-related issues.

The sensitivity and specificity of methylene blue dye as a single agent in sentinel lymph node biopsy for early breast cancer

INTRODUCTION

Axillary lymph node dissection (ALND), although associated with significant morbidity, has been the standard procedure for axillary staging for breast cancer in many hospitals in Malaysia. The limited resources for radioisotope tracer and nuclear medicine service, coupled with insufficient number of trained surgeons, have been the major obstacles to perform sentinel lymph node biopsy (SLNB).

MATERIALS AND METHODS

This study looks into the application of 1% methylene blue dye (MBD) as a single agent for SLNB and observes the outcome and any associated complication. Thirty-four patients with early breast cancer were enrolled. Two millilitres (ml) of 1% MBD was diluted with saline to a total volume of 5 ml. After induction of general anaesthesia, 3 ml of the diluted 1% MBD is injected subdermally at the upper outer quadrant of the breast followed by 5 minutes of massage. Sentinel nodes are identified as blue nodes or lymph nodes with a blue-stained lymphatic channel and were surgically removed. All patients then underwent tumour excision, either mastectomy or breast-conserving surgery, and ALND. The sentinel nodes were categorized to positive or negative for metastases and were compared with axillary lymph nodes for diagnostic value assessment.

RESULTS

Identification rate of sentinel nodes was 91.2%. The mean number of removed sentinel nodes was 2 (SD=1) and the mean number of axillary nodes was 16 (SD=6). Sentinel node metastasis was found in 13 (41.9%) cases. There were two false-negative cases, resulting in a sensitivity of 86.7% (95%CI: 62.1-96.3). The negative predictive value of sentinel nodes to predict axillary metastasis was 88.9% (95%CI: 67.2- 96.9). There were no complications observed.

CONCLUSION

Although inferior to the standard dual-tracer technique, the usage of MBD as a single agent in SLNB for early breast cancer still offers favourable accuracy and identification rate. With continuous training and improved surgeons experience, performing SLNB with blue dye alone is feasible in order to reduce the risks and morbidities associated with ALND.

Pre-clinical evaluation of a third generation absorbable antibacterial envelope

Funding Acknowledgements

Type of funding sources: Private company. Main funding source(s): Medtronic

Background

An absorbable antibacterial envelope (TYRX), which stabilizes cardiac implantable electronic devices (CIEDs) was shown to significantly reduce infections in a large randomized controlled trial (WRAP-IT). A 3rd generation envelope (T3) is being developed to improve the implanter experience and enable smoother device insertion with a redesigned, multifilament mesh, an enhanced form factor, and identical polymer coating and antibiotic concentrations as the currently available 2nd generation envelope (T2).

Purpose

To compare drug elution profiles of T3 vs T2 and evaluate the efficacy of T3 against bacteria commonly known to be associated with CIED infections.

Methods

The T3 drug elution profile was assessed in vitro by evaluating the amount of each drug, minocycline and rifampin, released at a given timepoint using an accelerated dissolution method. For comparative analysis with T2, elution curve equivalency was based on similarity factor values (f2) of ≥50 per FDA guidance. An in vivo elution study was also conducted (per the Principles of Laboratory Animal Care [NIH Publication no. 85-23 revised 1985]) to ensure drug concentrations met the minimal inhibitory concentration (MIC) through 7 days. Substantial equivalence was defined as rifampin and minocycline concentrations above MIC at 2hr post-implant and sustained through 7 days. In a further animal model, 12 pockets were created in 6 rabbits, for CIED insertion with and without T3 envelopes, to evaluate efficacy against gram+ and gram- bacteria. At day 7, implant sites were evaluated for signs of infection via macroscopic observations and microbial recovery procedures. A Fisher’s Exact Test was used for comparisons.

Results

The T3 envelope showed a similar elution profile to T2 in vitro (Figure) with f2 &gt;50 (range 76-84). In the in vivo assessment, the T3 envelope eluted both antibiotics above the MIC at 2hr post-implant with sustained elution through 7 days, consistent with historical T2 performance. Further bacterial challenge studies in vivo showed a statistically significant reduction (p&lt;0.05) in infections with 0/6 infected pockets in the CIED + T3 group vs 6/6 infected pockets in the CIED only group consistent with T2 performance (Table).

Conclusion

The 3rd generation absorbable antibacterial envelope demonstrated equivalent pre-clinical performance compared to the 2nd generation envelope as antibiotic elution curves were equivalent, elution was sustained at concentrations above MIC for 7 days, and infection rates were significantly reduced compared to no envelope. These results suggest equivalent clinical performance could be expected with the newly designed envelope.

Fear of COVID-19 and stress in university students: mediating role of cyberchondria and moderating role of creative coping and social supports

Objective: To find the moderating role of social support and creative coping, and the mediating role of cyberchondria in relationship between fear of coronavirus disease-2019 and stress in university students. Method: The correlational study was conducted at the Lahore Garrison University, Lahore, Pakistan, between May and September 2020, and comprised students regardless of gender and age from different public and private universities across Pakistan. Data was collected online using Fear of Coronavirus Disease-2019 Scale, Cyberchondria Severity Scale, Creative Coping Strategies Scale, Social Support Survey, Perceived Stress Scale and Perception of Academic Stress Scale. Data was analysed using SPSS 22. Results: Of the 205 subjects, 83(40.5%) were males and 122(59.5%) were females. The overall mean age was 21.22+/-1.84 years. Fear of coronavirus disease-2019 had significant positive relationship with cyberchondria, and cyberchondria had significant positive relationship with creative coping and academic stress (p<0.05). Social support had significant negative relationship with general stress (p<0.05). There was significant interaction among fear of coronavirus disease-2019, creative coping, social support and cyberchondria in predicting general stress (p<0.05). Fear of coronavirus disease-2019 alone did not predict stress (p>0.05), but it significantly predicted cyberchondria which, in turn, predicted stress (p<0.05). Creative coping and social support significantly moderated the relationship involving fear of coronavirus disease-2019, cyberchondria and general stress (p<0.05). The female subjects utilised more creative coping strategies, received more social support, and had higher levels of general stress compared to the males (p<0.05), while the male subjects had more mistrust on medical professionals (p<0.05). ---Continue

Jejunal gastrointestinal stromal tumour masquerading as an ovarian cancer: A case report

A 60-year-old lady presented with lower abdominal discomfort and a huge palpable intra-abdominal mass for 4 months, with significant weight loss over half a year. Transvaginal ultrasonography and computed tomography (CT) abdomen showed a large right solid cystic mass likely ovarian in origin. The CA-125 was raised. With the provisional diagnosis of ovarian cancer patient underwent laparotomy at Hospital Umum Sarawak, Malaysia. However intraoperative findings showed that uterus and both ovaries were normal. The tumour was arising from the jejunum and adherent to the dome of the urinary bladder and right broad ligament. The tumour was resected and final diagnosis was jejunal gastrointestinal stromal tumour (GIST). We described this case which was misinterpreted as an ovarian cancer.

Right ureteric reconstruction with vascularised interpositional appendix graft in retroperitoneal leiomyosarcoma

We present here a case of a 66-year-old lady who was diagnosed with right iliac fossa retroperitoneal leiomyosarcoma at Hospital Umum Sarawak. The challenge in this case was the extension of tumour with the involvement of her right ureter causing proximal hydroureter and hydronephrosis. After resection of tumour en-block with the involved segment of ureter, it was not possible to repair the ureteric defect directly. We used interpositional vascularized appendix graft to repair this large (7 cm) ureteric defect. We describe here this uncommon technique of ureter reconstruction.

Degradation of highly chlorinated pesticide, lindane, in water using UV/persulfate: kinetics and mechanism, toxicity evaluation, and synergism by H2O2

Sulfate radical-advanced oxidation processes (SR-AOPs) are emerging technologies for decomposing organic pollutants in water. This study investigated the efficiency of UV/persulfate (UV/S₂O₈^2-) process to degrade lindane in water, showing 93.2% lindane removal ([lindane]₀ = 3.43 μM, [S₂O₈^2-]₀ = 100 μM) at a UV fluence of 720 mJ/cm². The lindane degradation followed first order kinetics and mechanistic studies suggested H-abstraction by SO₄^•- and Cl removal via C-Cl bond cleavage by UV-C light. Toxicity assessment using ECOSAR program showed toxicity gradually decreased and eventually no significant toxicity remained when all by-products vanished at high UV dose. Removal efficiency of lindane decreased from 93.2% to 38.4, 45.5, 56.0, 84.3 and 88.6%, by adding 1.0 mg/L humic acid or 1.0 mM CO₃^2-, HCO₃^-, Cl^- or SO₄^2-, respectively. Coupling of H₂O₂ with UV/S₂O₈^2- showed a significant synergistic effect with 99.0% lindane removal at a UV fluence of 600 mJ/cm², using [S₂O₈^2-]₀ = [H₂O₂]₀ = 50 μM while UV/H₂O₂ resulted in only 36.6% lindane removal ([lindane]₀ = 3.43 μM, [H₂O₂]₀ = 100 μM) at a UV fluence of 720 mJ/cm². The results indicate that SR-AOP has potential for consideration as a remedial technology to treat persistent chlorinated pesticides such as lindane in contaminated water.

Intestinal knotting: A case report and brief literature review

Ileo-ileal knotting is a rare cause of intestinal obstruction. In this condition, one bowel loop makes a knot with an adjacent bowel loop, resulting in mechanical obstruction and even gangrene of the bowel. We present a case of a young girl with ileo-ileal knotting resulting in a closed-loop obstruction and gangrene of the small bowel loop. This is a difficult condition to diagnose; a high index of suspicion and early surgical intervention are essential to reduce morbidity and mortality.

Synthesis, crystal structure, and characterization of cyclohexylammonium tetraisothiocyanatocobaltate(II): A single-source precursor for cobalt sulfide and oxide nanostructures

We successfully synthesized 3D supramolecular structure of cyclohexylammonium tetraisothiocyanatocobaltate(II) complex, (C₆H₁₁NH₃)₂[Co(NCS)₄], in almost a quantitative yield by using metathesis and ligand addition reactions. The new complex was characterized by various techniques such as FTIR, UV-Visible, PXRD, SXRD, and CV electrochemical analysis to investigate mainly its structure. Based on the results of these techniques, the formation of the desired complex was confirmed. The TGA for this complex indicated the utilization of this complex as a single-source precursor for the synthesis of cobalt sulfide (CoS) under helium atmosphere and tricobalt tetraoxide (Co₃O₄) under air. Investigation of pyrolysis products by PXRD proved the formation of CoS and Co₃O₄. Furthermore, morphology studies by SEM and TEM displayed the formation of CoS and Co₃O₄ nanoparticles with various shapes.

Understanding the critical success factors for delivery of megaprojects in Colombia

By their very nature, megaprojects have significant short- and longer-term impacts on the socio-economic, technical, environmental and political landscapes of the host country, but many are delivered with time and cost overruns and sometimes with quality discrepancies. This paper examines the critical success factors for megaprojects in Colombia – from the project definition stage to successful handover – from the perspective of professionals involved in the delivery of megaprojects in that country. It applies a mixed approach of quantitative and qualitative data collection and analysis to rank 34 factors identified in literature sources as being critical to the success of megaprojects. Analysis shows that inadequate information at the tender stage, design changes during the construction phase and limited availability and supply of materials have had a major negative influence on the delivery of megaprojects in Colombia. In contrast, adverse weather conditions and lack of prior experience with similar projects have had the least impact. This paper recommends approaches to mitigate the risks associated with the factors investigated.

Comparative evaluation of conventional and microwave hydrothermal carbonization of human biowaste for value recovery

This paper compares conventional and microwave hydrothermal carbonization (HTC) of human biowaste (HBW) at 160 °C, 180 °C and 200 °C as a potential technology to recover valuable carbonaceous solid fuel char and organic-rich liquor. Also discussed are the influence of HTC heating methods and temperature on HBW processing conversion into solid fuel char, i.e. yield and post-HTC management, dewaterability rates, particle size distribution and the carbon and energy properties of solid fuel char. While HTC temperatures influenced all parameters investigated, especially yield and properties of end products recovered, heating source effects were noticeable on dewatering rates, char particle sizes and HBW processing/end product recovery rate and, by extension, energy consumed. The microwave process was found to be more efficient for dewatering processed HBW and for char recovery, consuming half the energy used by the conventional HTC method despite the similarity in yields, carbon and energy properties of the recovered char. However, both processes reliably overcame the heterogeneity of HBW, converting them into non-foul end products, which were easily dewatered at <3 seconds/g total solids (TS) (c.f. 50.3 seconds/g TS for a raw sample) to recover energy-densified chars of ≈17 MJ/kg calorific value and up to 1.4 g/l of ammonia concentration in recovered liquor.

Microwaving human faecal sludge as a viable sanitation technology option for treatment and value recovery - A critical review

The prolonged challenges and terrible consequences of poor sanitation, especially in developing economies, call for the exploration of new sustainable sanitation technologies. Such technologies must be: capable of effectively treating human faecal wastes without any health or environmental impacts; scalable to address rapid increases in population and urbanization; capable of meeting environmental regulations and standards for faecal management; and competitive with existing strategies. Further and importantly, despite its noxiousness and pathogenic load, the chemical composition of human faecal sludge indicates that it could be considered a potentially valuable, nutrient-rich renewable resource, rather than a problematic waste product. New approaches to faecal sludge management must consequently seek to incorporate a 'valuable resource recovery' approach, compatible with stringent treatment requirements. This review intends to advance the understanding of human faecal sludge as a sustainable organic-rich resource that is typically high in moisture (up to 97 per cent), making it a suitable candidate for dielectric heating, i.e. microwave irradiation, to promote faecal treatment, while also recovering value-added products such as ammonia liquor concentrate (suitable for fertilizers) and chars (suitable for fuel) - which can provide an economic base to sustain the technology. Additionally, microwaving human faecal sludge represents a thermally effective approach that can destroy pathogens, eradicate the foul odour associated human faecal sludge, while also preventing hazardous product formations and/or emissions, aside from other benefits such as improved dewaterability and heavy metals recovery. Key technological parameters crucial for scaling the technology as a complementary solution to the challenges of onsite sanitation are also discussed.

Characterization of Solid Fuel Chars recovered from Microwave Hydrothermal Carbonization of Human Biowaste

Microwave hydrothermal carbonization (M-HTC) is reported in this study as a viable sanitation technology that can reliably overcome the heterogeneous nature of human faecal biowaste (HBW) and realize its intrinsic energy value. Solid chars produced from the M-HTC process at 180°C and 200°C were characterized to further the understanding of the conversion pathways and their physicochemical, structural and energetic properties. The study revealed solid chars recovered were predominantly via a solid-solid conversion pathway. In terms of yield, more than 50% of solid chars (dry basis) can be recovered using 180°C as a benchmark. Additionally, the carbonized solid chars demonstrated enhanced carbon and energy properties following the M-HTC process: when compared to unprocessed HBW, the carbon content in the solid chars increased by up to 52%, while the carbon densification factor was greater than 1 in all recovered chars. The calorific values of the chars increased by up to 41.5%, yielding heating values that averaged 25MJ.kg^-1. Thermogravimetric studies further revealed the solid fuel chars exhibited greater reactivity when compared with unprocessed HBW, due to improved porosity. This work strengthens the potential of the M-HTC sanitation technology for mitigating poor sanitation impacts while also recovering energy, which can complement domestic energy demands.

Development of a simple chromatographic method for the determination of piracetam in human plasma and its pharmacokinetic evaluation

OBJECTIVE

The objective of study was to develop an accurate and reproducible HPLC method for determination of piracetam in human plasma and to evaluate pharmacokinetic parameters of 800 mg piracetam.

METHODS

A simple, rapid, accurate, precise and sensitive high pressure liquid chromatography method has been developed and subsequently validated for determination of piracetam. This study represents the results of a randomized, single-dose and single-period in 18 healthy male volunteers to assess pharmacokinetic parameters of 800 mg piracetam tablets. Various pharmacokinetic parameters were determined from plasma for piracetam and found to be in good agreement with previous reported values. The data was analyzed by using Kinetica® version 4.4 according to non-compartment model of pharmacokinetic analysis and after comparison with previous studies, no significant differences were found in present study of tested product.

RESULTS

The major pharmacokinetic parameters for piracetam were as follows: t1/2 was (4.40 ± 0.179) h; Tmax value was (2.33 ± 0.105) h; Cmax was (14.53 ± 0.282) µg/mL; the AUC(0-∞) was (59.19 ± 4.402) µg · h/mL. AUMC(0-∞) was (367.23 ± 38.96) µg. (h)(2)/mL; Ke was (0.16 ± 0.006) h; MRT was (5.80 ± 0.227) h; Vd was (96.36 ± 8.917 L).

CONCLUSIONS

A rapid, accurate and precise high pressure liquid chromatography method was developed and validated before the study. It is concluded that this method is very useful for the analysis of pharmacokinetic parameters, in human plasma and assured the safety and efficacy of piracetam, can be effectively used in medical practice.

The real-time intra-operative evaluation of sentinel lymph nodes in breast cancer patients using One Step Nucleic Acid Amplification (OSNA) and implications for clinical decision-making

INTRODUCTION

One Step Nucleic Acid Amplification (OSNA) method for the intraoperative analysis of sentinel lymph nodes (SLNs) in breast cancer, obviates a second operation to the axilla and thereby expedites progression to adjuvant therapy. Recent NICE guidelines have approved OSNA as a method of sentinel node diagnosis to support the above case.(1) METHOD: This is a single centre prospective cohort analysis of all patients undergoing breast cancer surgery including sentinel node biopsy from February 2010 to June 2012. Patients with negative SLN(s) on OSNA had no further axillary surgery. A validation phase was performed prior to using OSNA routinely. Those with micrometastases underwent a level 1 clearance, and >one SLN with macrometastases, underwent treatment by level 2 axillary dissection. The length of time from sentinel node retrieval to OSNA result was recorded.

RESULTS

Four hundred and forty nodes were analysed in 212 patients with a mean age of 55 years (range 24-98). The sensitivity and specificity of OSNA was 93% and 94% respectively in cases of macrometastases. The process required additional median anaesthesia time of 20 min (range -48 to +65 min). Non-sentinel node positivity was 5% and 48% for micrometastasis and macrometastasis respectively.

CONCLUSION

OSNA identified 62 of 212 patients with at least one positive sentinel node, thereby sparing 29% from a second procedure to clear the axilla subsequently. The median waiting time of 20 min for node results from completion of breast procedure is acceptable and allows for an efficient operating list. OSNA can be incorporated into routine practice and with improved methods of imaging preoperatively, can be an excellent adjunct to the breast cancer patient pathway of care.

Genetic diversity in merozoite surface protein-1 and 2 among Plasmodium falciparum isolates from malarious districts of tribal dominant state of Jharkhand, India

INTRODUCTION

The genetic make-up of malaria parasite is potent for understanding the parasite virulence, designing antimalarial vaccine and evaluating the impact of malaria control measures. There is a paucity of information on genetic structure of Plasmodium falciparum in Jharkhand, India where malaria is rampant and this study aimed to establish molecular characterization of P. falciparum field isolates from Jharkhand measured with two highly polymorphic genetic markers, i.e. the merozoite surface proteins (MSPs) 1 and 2.

METHODS

The genetic diversity of P. falciparum population from low transmission area, Ranchi, Bokaro and Hazaribagh and highly malarious area, Latehar and Palamau districts of Jharkhand were evaluated by polymerase chain reaction-sequencing analyzing msp-1 and msp-2 genes to explore the genetic structure of parasite from this understudied region.

RESULTS

A total of 134 P. falciparum isolates were analyzed by polymorphic regions of msp-1 and msp-2 and classified according to prevalence of allelic families. The majority of patients from all the five sites had mean monoclonal infections of 67·1 and 60·4% of P. falciparum for msp-1 and msp-2, respectively, whereas, mean multiple genotypes of 32·8 and 39·5% for msp-1 and msp-2, respectively. Interestingly, we observed higher multiclonal infection in low transmission area as compared to highly malarious area in the case of msp-1 genotypes, whereas in msp-2 higher multiclonal infection was observed in highly malarious area compared to low transmission area. The overall multiplicities of infection of msp-1 and msp-2 were 1·38 and 1·39, respectively.

CONCLUSION

This is the first report on molecular characterization of P. falciparum field isolates from Jharkhand. The genetic diversity and allelic distribution found in this study is somewhat similar to other reports from India and Southeast Asian countries. However, P. falciparum infection can be highly complex and diverse in these disease-endemic regions of Jharkhand, suggesting continual genetic mixing that could have significant implications for the use of antimalarial drugs and vaccines.

P5-07-01: Novel Alternative Splice Variants of HER2 in Invasive Breast Cancer

Background: The Human Epidermal Growth Factor Receptor 2 (HER2) is an oncogene expressed in 25–30% of invasive breast cancers. HER2 shares extensive homology with other members of the HER family (HER1, HER3 and HER4), and is constitutively active as an homo- and heterodimer. The HER2 gene encodes an 185kDa transmembrane protein with tyrosine kinase activity. Gene amplification or protein expression of HER2 is a predictor of poor clinical outcome and decreased survival in women with breast cancer, and also indicates a favourable response to Trastuzumab (Herceptin) therapy, or a combinational therapy comprising Herceptin plus chemotherapy. However, resistance to Trastuzumab remains the case in approximately 50% of HER2 amplified/overexpressing tumours. Understanding the molecular mechanisms of Trastuzumab resistance and identifying more effective therapies, is critical in the treatment of patients whose breast cancers express this aggressive disease phenotype. In this study, it is postulated that the abnormal generation of mRNA splice variants may be responsible for the continued tumour growth and progression.

Aims: The aim of this study is to increase our understanding of the role of HER-2 splice variants in the development and progression of breast cancer. This will inform the development of more sophisticated and effective therapies that target specific HER-2 isoforms, rather than Herceptin, which targets just the generic wild type HER-2 protein. Materials and Methods: The entire coding region of HER-2 cDNA was PCR amplified using 12 sets of HER-2 specific primers in HER-2 positive cell lines (SKOV-3, SKBR-3, MDA-MB-453 and MDA-MB-361).

Results: RT-PCR results showed multiple bands in various regions of the HER2 mRNA. Sequencing of these bands revealed novel alternative splice variants with deletions in exons 13 and 18 of the HER2 gene expressed in addition to the wild type HER2. Bioinformatic analysis of the deletions revealed a cassette exon deletion in exon 13, and a loss of 42 base pairs in the 3’ end of exon 18 compared to the full length HER2. Both the full length HER2 sequence and the sequence containing the deletions were translated using the ExPASy Translate Tool. This revealed an in-frame deletion of 14 amino acids and revealed a novel splice isoform with a deletion in the HER2 protein which encompasses the entire ATP binding pocket. This was determined by analysis using UniProtKB to identify the composition of amino acids for each domain of HER2. Discussion: Our studies have identified novel splice variants in the tyrosine-kinase domain of the HER-2 gene using HER-2 positive cell lines. The loss of an ATP binding site in the HER2 gene may lead to a less active HER2 isoform which may play a significant role in prognosis. Current work is being carried out to study the regulation of these splice variants and to study the role of splice factors ASF/SF2 and SRPK1 in the regulation of HER2 splicing, and to elucidate any significant changes in the HER2 signalling pathways. In addition, the expression of these isoforms are currently being investigated in tissues from formalin fixed, paraffin embedded and frozen breast tumours.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-07-01.

Adult pyloric stenosis masquerading as acute renal failure

Gastric outlet obstruction and in particular, pyloric stenosis, is relatively common in developing countries. Acute clinical presentation is often the manifestation of biochemical and electrolyte changes. The presence of metabolic alkalosis in combination with acute renal failure should alarm us to the possibility of adult pyloric stenosis. We report a case of adult pyloric stenosis that presented as acute renal failure and discuss its pathophysiology.

European infrastructure procurement through PPP

European countries are introducing changes to their legislation and institutions that enable infrastructure procurement through public–private partnerships (PPPs). The purpose of this paper is to survey the legislation and institutions for infrastructure procurement through PPPs across Europe. Procurement procedures have no defined status in the regulatory framework of the European Union (EU); as a consequence, each member state has developed its own PPP legal and institutional framework. As such the process of procurement varies widely between the member states. The legislative frameworks for PPPs are discussed with reference to central and eastern Europe. This paper finds that effective legal, regulatory and contractual conditions perform successfully when they are based on and supported by the institutional framework of a country. A majority of European countries have realised this necessity and have developed various institutional framework models accordingly. These models are defined according to the degree of centralisation of PPP institutions in a country's overall state structure; the models are: highly centralised (western newly independent states); highly decentralised (France and Portugal); and mixed centralised and decentralised (Ireland, the UK, Italy and the Netherlands). The changing institutional framework in new member states is described with reference to the Czech Republic, Hungary and Poland.

Technical limitations of lymph node mapping in pancreatic cancer

AIM

The high incidence of lymphatic and peri-neural invasion in pancreatic cancer results in poor loco-regional control. Radical pancreatico-duodenectomy may achieve better loco-regional control, but is accompanied by increasing morbidity. Our hypothesis was that if intra-operative mapping of pathological lymph nodes (LN) is technically feasible in pancreatic cancer, it would allow for selective radical resection.

METHODS

In an ethically approved and statistically powered feasibility study of 72 (stopped after 20% enrollment) patients with suspected pancreatic cancer undergoing resection, we injected methylene blue dye peri- and intra-tumorally and studied its progress to identify putative 'sentinel lymph node(s)'. The Kausch-Whipple procedure (or total pancreatectomy, if required) was carried out in addition to radical LN dissection, which was evaluated histopathologically according to the Japanese criteria.

RESULTS

Over 18 months, 14/16 patients prospectively recruited underwent lymph node mapping and a mean of 20 (range 11-37) LNs per patient were harvested. Methylene blue dye injection identified blue LN(s) in 4/14 patients, none of which were positive for malignant deposits, whilst 10/14 patients had LN metastases. The commonest stations for LN metastasis were 17A or B (9/10), 8A (2/10) and 6 (3/10). The median survival for the 13 patients with cancer was 22.3 months (IQR: 10.4-30 months).

CONCLUSION

Sentinel lymph node mapping is not technically feasible in pancreatic cancer.

Oligonucleotide scanning arrays: application to high-throughput screening for effective antisense reagents and the study of nucleic acid interactions

Oligonudeotide scanning arrays are useful tools in the study of nucleic acid interaction. Such arrays of oligonucleotides, corresponding to a full set of complements of a known sequence, can be readily made in a single series of coupling reactions, adding each nudeotide in the complement of the target sequence in turn. The synthesis is carried out on the surface of a solid substrate such as glass or polypropylene that has been modified to allow nucleotide coupling. A mask is used to apply the DNA synthesis reagents in a defined area and is moved by a fixed step size after each coupling reaction so that consecutive couplings overlap a portion of the previous one. The size of the mask and the displacement at each coupling determine the length of the oligonucleotides. A radiolabeled or fluorescently tagged target sequence is hybridised to a scanning array and its interaction with the complementary oligonudeotides is displayed as a hybridisation signal. It is thus possible to determine the exact sequence and lengths of large numbers of interacting sequences in a single hybridisation experiment. The array image is analysed using a computer program (xvseq) that calculates quantitative measurements of the binding strengths. We have found scanning arrays a useful tool not only to find effective antisense reagents, but also to study RNA folding and the mechanisms of heteroduplex formation. In this article, we discuss the format of these arrays, the technology used to fabricate and to read them, and their applications.

New B-type cyclin synthesis is required between meiosis I and II duringXenopusoocyte maturation

Progression through meiosis requires two waves of maturation promoting factor (MPF) activity corresponding to meiosis I and meiosis II. Frog oocytes contain a pool of inactive ‘pre-MPF’ consisting of cyclin-dependent kinase 1 bound to B-type cyclins, of which we now find three previously unsuspected members, cyclins B3, B4 and B5. Protein synthesis is required to activate pre-MPF, and we show here that this does not require new B-type cyclin synthesis, probably because of a large maternal stockpile of cyclins B2 and B5. This stockpile is degraded after meiosis I and consequently, the activation of MPF for meiosis II requires new cyclin synthesis, principally of cyclins B1 and B4, whose translation is strongly activated after meiosis I. If this wave of new cyclin synthesis is ablated by antisense oligonucleotides, the oocytes degenerate and fail to form a second meiotic spindle. The effects on meiotic progression are even more severe when all new protein synthesis is blocked by cycloheximide added after meiosis I, but can be rescued by injection of indestructible B-type cyclins. B-type cyclins and MPF activity are required to maintain c-mos and MAP kinase activity during meiosis II, and to establish the metaphase arrest at the end of meiotic maturation. We discuss the interdependence of c-mos and MPF, and reveal an important role for translational control of cyclin synthesis between the two meiotic divisions.

Antisense oligonucleotides selected by hybridisation to scanning arrays are effective reagents in vivo

Transcripts representing mRNAs of three Xenopus cyclins, B1, B4 and B5, were hybridised to arrays of oligonucleotides scanning the first 120 nt of the coding region to assess the ability of the immobilised oligonucleotides to form heteroduplexes with their targets. Oligonucleotides that produced high heteroduplex yield and others that showed little annealing were assayed for their effect on translation of endogenous cyclin mRNAs in Xenopus egg extracts and their ability to promote cleavage of cyclin mRNAs in oocytes by RNase H. Excellent correlation was found between antisense potency and affinity of oligonucleotides for the cyclin transcripts as measured by the array, despite the complexity of the cellular environment.

Solid and papillary epithelial neoplasm arising in heterotopic pancreatic tissue of the mesocolon

AIM

Solid and papillary epithelial neoplasm (SPEN) is an uncommon pancreatic tumour. Very rarely it has also been described outside the pancreas, usually arising from heterotopic pancreatic tissue. This report summarises all the published extrapancreatic SPENs and documents the sixth such case arising from heterotopic pancreatic tissue of the transverse mesocolon in a 15 year old girl.

METHODS/RESULTS

Histological and immunohistochemical examination revealed typical papillary and solid areas composed of columnar, cuboidal, and round cells, which were focally positive for vimentin, cytokeratin, neurone specific enolase, carcinoembryonic antigen, alpha1-antitrypsin, alpha1-antichymotrypsin, and negative for neuroendocrine markers (neurofilament, PGP 9.5, chromogranin A, synaptophysin, and S100), p53, and oestrogen and progesterone receptors. Electron microscopy showed scant zymogen but no neurosecretory granules. In agreement with the flow cytometric result s of diploidy, comparative genomic hybridisation (CGH) did not reveal loss or gain of genetic material, and the in situ hybridisation analysis of the RB1 and p53 genes revealed no abnormality in the 13q and 17p arms.

CONCLUSIONS

Immunohistochemical and electron microscopic data support exocrine differentiation. The CGH and the flow cytometric results suggest a subtle, yet unknown genetic change, rather than a large genetic alteration. RB1 and p53 in situ hybridisation ruled out the role of deletion at these sites in the pathogenesis of SPEN. Interestingly, review of the published and the present heterotopic pancreatic SPENs identified the mesocolon as the most common anatomical site (four of six), despite the very rare occurrence of ectopic pancreatic tissue at this site.

Magnetic resonance imaging of the primary site in stage I cervical carcinoma: A comparison of endovaginal coil with external phased array coil techniques at 0.5T

OBJECTIVE

To compare endovaginal with pelvic phased array coil magnetic resonance imaging (MRI) in detection of Stage I cervical carcinoma by correlating the findings with histopathology.

PATIENTS AND METHODS

Forty consecutive patients with Stage I cervical carcinoma confirmed histologically were studied using an endovaginal coil alone immediately followed by a pelvic phased array coil. T1-W transverse and T2-W FSE sagittal images made with each coil were analyzed independently by two radiologists noting the presence and size of a mass within the cervix and any parametrial extension or involvement of adjacent organs. Tumor volumes were measured using the electronic calliper to compute tumor area on each slice and multiplying by the slice thickness. Thirty patients underwent radical hysterectomy, one a trachylectomy, one simple hysterectomy and four extended cone biopsies. Four patients had radiotherapy to the primary tumor. Following surgery, histopathologic findings were recorded and tumor volumes measured.

RESULTS

Tumor volumes ranged from 0-106 cm(3)(median 1.4 cm(3), mean 9 +/- 19.4 cm(3)). Thirty-six patients had correlation of the primary site with the surgical specimen. Agreement between observers was excellent for both endovaginal (k = 0.90) and pelvic phased array (k = 0.96) techniques. Combined sensitivity and specificity for both observers of endovaginal MR imaging for detection of tumor was 96% and 70%, respectively; for pelvic phased array imaging sensitivity was substantially less at 54%. Specificity was higher at 83.7%, probably because small abnormalities were seldom visible. In patients treated surgically, early parametrial involvement in four women on endovaginal MRI was confirmed histologically in two. Pelvic phased array imaging showed early parametrial involvement in four women and was confirmed in one.

CONCLUSION

Endovaginal MRI adds substantially to information from pelvic phased array images in the preoperative assessment of patients with early cervical cancer. J. Magn. Reson. Imaging 2000;12:1020-1026.