High Rate, Dendrite Free Lithium Metal Batteries of Extended Cyclability via a Scalable Separator Modification Approach

Owing to their great promise of high energy density, the development of safer lithium metal batteries (LMBs) has become the necessity of the hour. Herein, a scalable method based on conventional Celgard membrane (CM) separator modification is adopted to develop high-rate (10 mA cm‒2) dendrite-free LMBs of extended cyclability (>1000 hours, >1500 cycles with 3 mA cm‒2, the bare fails within 50 cycles) with low over potential losses. The CM modification method entails the deposition of thin coatings of (≈6.6 µm) graphitic fluorocarbon (FG) via a large area electrophoretic deposition, where it helps for the formation of a stable LiF and carbon rich solid electrolyte interface (SEI) aiding a uniform lithium deposition even in higher fluxes. The FG@CM delivers a high transport number for Li ion (0.74) in comparison to the bare CM (0.31), indicating a facile Li ion transport through the membrane. A mechanistic insight into the role of artificial SEI formation with such membrane modification is provided here with a series of electrochemical as well as spectroscopic in situ/ex situ and postmortem analyses. The simplicity and scalability of the technique make this approach unique among other reported ones towards the advancement of safer LMBs of high energy and power density.

The unexpected fast polymerization during the synthesis of a glycolated polythiophene

Conjugated polymers with ethylene glycol side chains are emerging as ideal materials for bioelectronics, particularly for application in organic electrochemical transistors (OECTs). To improve the OECT device performance, it is important to develop an efficient synthetic strategy that will provide access to novel high-performing materials besides focusing on molecular design. While a lot of efforts are being devoted to designing of new polymers by modifying the glycol side chains, understanding how their nature affects the polymerization kinetics and eventually the polymer structure and properties is not known. In this work, we have studied the influence of the content of the ethylene glycol side chain and its linkage on the formation of the active Grignard monomer species upon Grignard metathesis in three thiophene derivatives. A strong dependence of the monomer's concentration on polymerization was noted in our study indicating that for synthesizing P3MEEMT, a high-performing OECT material, by Kumada catalyst transfer polymerization (KCTP) a minimum of 0.15 M monomer is needed. Furthermore, kinetic studies by GPC show uncontrolled polymerization behavior contrary to the controlled chain growth characteristics of the KCTP.

Validating the Performance of Modified Early Obstetrics Warning Score (MEOWS) for Prediction of Obstetrics Morbidity: A Prospective Observational Study in a Tertiary Care Institute in East India

Background

An early warning score can be used to identify worsening in obstetric patients as they are more prone for deterioration. This study was conducted to evaluate and validate the performance of the modified early obstetric warning system (MEOWS) as a screening tool for early prediction of severe obstetric morbidity.

Methods

This prospective observational study was conducted at obstetrics and gynaecology department, Tata Main Hospital, Jamshedpur, Jharkhand, India. A total of 1800 patients were included over a period of 10 month, from December 2021 to September 2022. Study population included all pregnant women admitted in labour room with > 28 weeks of gestation till 6 weeks postpartum. MEOWS charts were plotted for each patient, score calculated and documented at admission. Patients were categorized based on this score for further management, and follow-up was made till discharge. Outcome assessment was done in terms of ICU admission, length of hospital stays, obstetric morbidity, and maternal mortality. Correlation of each outcome with scoring was evaluated.

Results

The sensitivity of MEOWS in predicting maternal morbidity was 72.91%, specificity 91.87%, positive predictive value 85.96%, and negative predictive value 83.24%. The area under receiver operator characteristic of MEOWS for prediction of maternal mortality was 0.79 (95% CI 0.75-0.82).

Conclusion

MEOWS helps in early recognition of obstetric morbidity even before signs, and symptoms become clinically evident. It is a useful tool for predicting adverse maternal outcome in pregnant women.

An Investigation of High-Z Material for Bolus in Electron Beam Therapy

PURPOSE/OBJECTIVE(S)

Electron beams are frequently used for superficial tumors including: primary skin cancers, surgical scars, cutaneous lymphomas and benign conditions like keloids. However, due to electron beam characteristics the surface dose is 75-95% of the prescribed dose depending on beam energy thus requiring placement of bolus to augment surface dose. Various types of boluses; wet gauge/towel, superflab, superstuff, aquaplast, 3D printed plastics, customized dot-decimal bolus, thermoshield, brass and tantalum wire mesh are commonly used in clinics with variable difficulties that are not perfect. As majority of these devices do not snug to the skin contour and create air-gap that is known to produce significant dose perturbations creating hot and cold spot. The variable dosimetry has cosmetic implications and potentially increased risk of recurrence. A new cloth-like high-Z materials; Tungsten, (Z = 74) and Bismuth, (Z = 83) impregnated with silicone gel are now commercially available which is investigated in this study for bolus purpose.

MATERIALS/METHODS

Commercially available, super soft silicone-gel based submillimeter thin Tungsten and Bismuth sheets were investigated for bolus properties in electron beams in the range of 6-12 MeV using 10x10 cm2 applicator. These materials were tested on various body contour for perfect snug without any air traps. Using parallel plate ion chamber measurements were performed in a solid water phantom on a medical linear accelerator machine. Depth dose characteristics were measured to optimize the thickness for surface dose to be 100% for selected electron therapy.

RESULTS

Surface dose for a 10x10 cm2 cone for 6, 9, 12 MeV beams were measured to be 75.1%, 80.1% and 86.2%, respectively. Silicone-gel Tungsten and Bismuth sheets produce significant electrons thus increasing surface dose. Based on measured depth dose, our data showed that Tungsten sheets of 0.14 mm, 0.18 mm and 0.2 mm and Bismuth sheets of 0.42 mm, 0.18 mm and 0.2 mm provide 100% surface dose for 6, 9 and 12 MeV beams, respectively without any changes in depth dose except increasing surface dose.

CONCLUSION

The new Tungsten and Bismuth based silicone-gel clothlike sheets are extremely soft but high tensile metallic bolus materials that can fit flawlessly on any skin contour without any air trap or variable thickness or spillage of the water as in conventionally used wet gauge. Only 0.2 mm thick sheets are needed for 100% surface dose without degradation of the depth dose characteristics. These materials are reusable and ideal for bolus in electron beam treatment. This investigation opens a new frontier in designing new bolus materials optimum for patient treatment.

Treatment of Mantle and Inverted Y Fields in Modern Era: A VMAT Approach

PURPOSE/OBJECTIVE(S)

Hodgkin's lymphoma has been treated with combined modality therapy (chemotherapy and radiation) with a very high degree of success. Total Nodal Irradiation (TNI) performed with large AP/PA mantle fields for treatment of axillary, cervical, and mediastinal lymphatics, provide adequate coverage to the mediastinum and bilateral axillae and hila, while blocking lungs. The para-aortic and pelvic lymph nodes are treated with the so called inverted-Y AP/PA fields, which often includes the spleen in cases of TNI. Multileaf Collimators (MLC) have been tried, but due to the irregular shape of the fields and necessity of island blocking in 3D treatment, they have not been successful in full elimination of Cerrobend blocks. We hypothesize that using two or three matched Volumetric Modulated Arc Therapy (VMAT) fields will not only eliminate a need for Cerrobend blocks or island blocks, but will also provide better target coverage and better organs at risk (OAR) sparing.

MATERIALS/METHODS

Under IRB study, 10 patients were retrospectively planned using two or three matched VMAT technique for mantle and inverted-Y treatments of TNI that had been previously treated using MLC and Cerrobend block combination. Pinnacle treatment planning system version 16.2.1 was used to generate plans using mantle/inverted-Y technique and corresponding VMAT plans using 2-3 arcs per isocenter (2 isocenters per plan). Optimization was performed to cover targets with the prescribed dose of 1500 cGy in 10 fractions per institutional protocol. The VMAT plans were compared with traditional 3D plans.

RESULTS

VMAT consistently provided better or similar results to traditional field arrangements. Target coverage: V15Gy - 95.45% vs 77.99% (p = 0.00017), OAR coverage: total lung V5Gy 63.7% vs 68.8% (p = 0.016), bone marrow mean dose 539.1 cGy vs 727.8 cGy (p = 0.00047), Integral Dose 464.1 mJ vs 573.9 mJ (p = 0.0026). Low isodose lines- mean volume of 5 Gy isodose line was not significantly different - 24036 cc vs 25091 cc (p = 0.271). Cord maximum dose was 40% lower for VMAT plans (p = 0.00006). Mean bladder dose was similar in VMAT plans compared to 3D plan - 821.7 cGy vs 804.9 cGy (p = 0.454). One counter-intuitive result is that the mean integral dose for 10 patients was 24% lower for VMAT plans.

CONCLUSION

VMAT based mantle fields for TNI eliminates Cerrobend blocks and improve dosimetry significantly for target volumes and all OARs; including bone marrow, which plays important role in patient's recovery after chemotherapy, radiation and often stem cell transplantation in recurrent disease. Lower integral dose for VMAT plans is explained by the large irradiated in-fields and small out-of-field volumes. The VMAT process requires minimal effort for optimization and is economical compared to the traditional planning, while improving the target coverage and decreasing dose to OARs.

Stage IIIA Non-Small Cell Lung Cancer Treatment and Outcomes: A Single Institution Retrospective Analysis

PURPOSE/OBJECTIVE(S)

Treatment of locally advanced non-small cell lung cancer (NSCLC) remains challenging, with a multitude of treatment options available for Stage III patients. We hypothesized that Stage IIIA outcomes differ by treatment received.

MATERIALS/METHODS

We performed a retrospective review of NSCLC patients ≥18 years old with Stage IIIA disease treated 1/1/2010-03/01/2022. Demographics, treatment received, treatment outcomes, and failure patterns were collected. Progression-free survival (PFS) and overall survival (OS) were assessed using Kaplan-Meier analysis. Kruskal-Wallis ANOVA was used to compare groups.

RESULTS

Of 352 patients identified, 160 had Stage IIIA NSCLC with a median follow-up of 29.1 months. Patients had a median age of 63 years, 79 (49.4%) were male, and 137 (85.6%) were current/former smokers (with 30 median pack-years). Patients were treated as follows: 17 (11%) surgery alone (S), 91 (57%) definitive radiation ± chemotherapy (CRT), 52 (33%) neoadjuvant therapy followed by surgery (Neo). 6 (12%) of the Neo group received chemoimmunotherapy, and 21 (51%) of the 41 CRT patients received adjuvant immunotherapy. Between the three groups, there were no significant differences in tumor size as measured by T-staging (p = 0.83) and baseline FEV1/FVC (p = 0.92). Median PFS was 33.5mo (95% CI 13.2-NA) for group S, 18.4mo (95% CI 12.7-42.2) for CRT, and 19.7mo (95% CI 13.9-NA) for Neo with no significant intergroup difference (p = 0.72). Median OS was 33.5mo (95% CI 13.2-NA) for S, 48.7mo (95% CI 36.0-88.9) for CRT, and 50.9mo (95% CI 41.9-NA) for Neo with no significant intergroup difference (p = 0.94). Among the 17 primary surgical patients, 11 (65%) experienced failure: 6 (35%) local, 5 (29%) regional, and 7 (41%) distant. Among the 91 CRT patients, 57 (63%) experienced failure: 40 (44%) local, 35 (38%) regional, and 28 (31%) distant. Among the 52 Neo patients, 26 (50%) experienced failure: 14 (27%) local, 15 (29%) regional, and 17 (33%) distant. There were no significant differences in rates of local failure (p = 0.26), regional failure (p = 0.59), distant failure (p = 0.79), or any failure (p = 0.41) among the three treatment groups. The most common locations for distant failure were pleural effusions (n = 15, 29%), CNS (n = 14, 27%), and bone (n = 11, 21%).

CONCLUSION

In this single institution retrospective study, we find no significant differences in PFS, OS, and failure patterns between patients with Stage IIIA NSCLC treated with definitive (chemo)radiation and neoadjuvant therapy. Numeric improvement in PFS in surgery-only patients is consistent with expected patient selection of this group. Further work in the immunotherapy era is needed.

Crowdsourcing Deep Learning Algorithms to Automatically Contour GI Luminal Organs on Serial MRIs

PURPOSE/OBJECTIVE(S)

A major barrier to a sustainable real-time adaptive MR-guided radiotherapy workflow is the time-consuming process of contouring the target and organs-at-risk (OARs) before the delivery of each fraction. While auto-contouring algorithms perform relatively well for many solid organs, the performance on luminal organs in the abdomen remain difficult due to the variability between patients and variability in daily shape and position. The purpose of this study is to evaluate the performance of crowdsourced deep learning algorithms to automatically contour GI luminal organs on serial MRIs.

MATERIALS/METHODS

The stomach, small intestines, and large intestines were manually contoured on MRIs from patients who had undergone radiotherapy on an MR-Linac by a team of radiation therapists and medical physicists and were verified by a board-certified radiation oncologist. The MRIs and the contours were de-identified and uploaded to Kaggle, an online machine learning competition platform with portion of the data open to the public as training data and the remaining data hidden as a test set. Prize money was offered to teams submitting the best auto-contouring algorithms based on the Dice coefficient and Hausdorff distance evaluation metrics. The average performance of the winning algorithm and of manual contours were compared using unpaired t-test.

RESULTS

Four hundred sixty-seven MRIs were collected from 107 patients who underwent 1-5 serial MRI sessions between 2015 and 2019. The most common anatomic site of treatment was the pancreas with 41 patients, followed by the liver with 38 patients. The manual contours of the stomach, small intestines, and large intestines on 4 representative MRIs had mean and standard deviation Dice coefficient of 0.90 +/- 0.02, 0.76 +/- 0.04, and 0.85 +/- 0.03 respectively and Hausdorff distance of 18.0 +/- 6.9, 35.5 +/- 12.6, and 32.3 +/- 12.3 mm respectively. The Kaggle competition was held from April to July 2022 and 1548 teams submitted algorithms for evaluation. The auto-contouring performance of the winning solution on the stomach, small intestines, and large intestines, when evaluated on a hold-out test set with 188 MRIs, had mean and standard deviation Dice coefficient of 0.92 +/- 0.04, 0.80 +/- 0.09, 0.85 +/- 0.08 respectively and Hausdorff distance of 15.2 +/- 11.2, 33.9 +/- 15.2, 34.8 +/- 20.3 mm respectively. Unpaired t-test was performed to compare the average performance across three organs of the human (N = 120) and of the algorithm (N = 564). The results suggest that average algorithm performance was statistically superior to manual contours for Dice (p = 0.01), yet not for Hausdorff (p = 0.64).

CONCLUSION

Crowdsourced deep learning algorithms to auto-contour GI luminal organs on serial MRIs perform superiorly compared to manual contours when using a Dice coefficient metric but not when using a Haudorff distance metric. These auto-contouring algorithms may be used to efficiently adapt radiotherapy plans according to the anatomy of the day for patients with abdominal tumors on MR-Linacs.

Bioengineered Ciprofloxacin-Loaded Chitosan Nanoparticles for the Treatment of Bovine Mastitis

Mastitis is the most devastating economic disease in dairy cattle. Mastitis in dairy cattle frequently occurs during the dry period or during early lactation. Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus)are the main causative agents of mastitis in India. S. aureus can form microabscesses in the udder and develop a subclinical form of mastitis. This bacterial property hinders an effective cure during the lactation period. Antimicrobials used for treatments have a short half-life at the site of action because of frequent milking; thereforethey are unable to maintain the desired drug concentration for effective clearance of bacteria. We demonstrated the potential of ciprofloxacin-encapsulated nanocarriersthat can improve the availability of drugs and provide an effective means for mastitis treatment. These drug-loaded nanoparticles show low toxicity and slow clearance from the site of action. Antimicrobial activity against clinical strains of E. coli and S. aureus showed that the zone of inhibition depended on the dose (0.5 mg to 2 mg/mL nanoparticle solution from 11.6 to 14.5 mm and 15 to 18 mm). These nanoparticles showed good antimicrobial activity in broth culture and agar diffusion assay against bacteria.

Interaction with Patients as a Budding Doctor: An Experience

Every medical student amidst COVID-19 missed out on an integral part of medical education which is interaction with patients as all the physical classes were postponed for months. Effective interaction with patients is the heart of medicine and it provides a synergistic effect on the delivery of high-quality care to the patient. However many medical students underestimate the art of communication. This article highlights the importance of basic communication skills; also encourages reflecting upon the whole experience and extracting the learning to apply to any further interactions.

Keywords

communication; empathy; medical students; healthcare quality.

Macrophage Cx43 Is Necessary for Fibroblast Cytosolic Calcium and Lung Fibrosis After Injury

Macrophages are paracrine signalers that regulate tissular responses to injury through interactions with parenchymal cells. Connexin hemichannels have recently been shown to mediate efflux of ATP by macrophages, with resulting cytosolic calcium responses in adjacent cells. Here we report that lung macrophages with deletion of connexin 43 (MacΔCx43) had decreased ATP efflux into the extracellular space and induced a decreased cytosolic calcium response in co-cultured fibroblasts compared to WT macrophages. Furthermore, MacΔCx43 mice had decreased lung fibrosis after bleomycin-induced injury. Interrogating single cell data for human and mouse, we found that P2rx4 was the most highly expressed ATP receptor and calcium channel in lung fibroblasts and that its expression was increased in the setting of fibrosis. Fibroblast-specific deletion of P2rx4 in mice decreased lung fibrosis and collagen expression in lung fibroblasts in the bleomycin model. Taken together, these studies reveal a Cx43-dependent profibrotic effect of lung macrophages and support development of fibroblast P2rx4 as a therapeutic target for lung fibrosis.

Triglyceride-Mimetic Prodrugs of Buprenorphine Enhance Oral Bioavailability via Promotion of Lymphatic Transport

Buprenorphine (BUP) is a potent opioid analgesic that is widely used for severe pain management and opioid replacement therapy. The oral bioavailability of BUP, however, is significantly limited by first-pass metabolism. Previous studies have shown that triglyceride (TG) mimetic prodrugs of the steroid hormone testosterone circumvent first-pass metabolism by directing drug transport through the intestinal lymphatics, bypassing the liver. The current study expanded this prodrug strategy to BUP. Here different self-immolative (SI) linkers were evaluated to conjugate BUP to the 2 position of the TG backbone via the phenol group on BUP. The SI linkers were designed to promote drug release in plasma. Lipolysis of the prodrug in the intestinal tract was examined via incubation with simulated intestinal fluid (SIF), and potential for parent drug liberation in the systemic circulation was evaluated via incubation in rat plasma. Lymphatic transport and bioavailability studies were subsequently conducted in mesenteric lymph duct or carotid artery-cannulated rats, respectively. TG prodrug derivatives were efficiently transported into the lymphatics (up to 45% of the dose in anaesthetised rats, vs. less than 0.1% for BUP). Incorporation of the SI linkers facilitated BUP release from the prodrugs in the plasma and in concert with high lymphatic transport led to a marked enhancement in oral bioavailability (up to 22-fold) compared to BUP alone. These data suggest the potential to develop an orally bioavailable BUP product which may have advantages with respect to patient preference when compared to current sublingual, transdermal patch or parenteral formulations.

Circular Discovery in Small Molecule and Conjugated Polymer Synthetic Methodology

Simple and efficient methods are a key consideration for small molecule and polymer syntheses. Direct arylation polymerization (DArP) is of increasing interest for preparing conjugated polymers as an effective approach compared to conventional cross-coupling polymerizations. As DArP sees broader utilization, advancements are needed to access materials with improved properties and different monomer structures and to improve the scalability of conjugated polymer synthesis. Presented herein are considerations for developing new methods of conjugated polymer synthesis from small molecule transformations, exploring how DArP has successfully used this approach, and presenting how emerging polymerization methodologies are developing similarly. While it is common to adapt small molecule methods to polymerizations, we demonstrate the ways in which information gained from studying polymerizations can inform and inspire greater advancements in small molecule transformations. This circular approach to organic synthetic method development underlines the value of collaboration between small molecule and polymer-based synthetic research groups.

Effect of stabilizer on optical band gap of ZnO and their performance in dye-sensitized solar cells

ABSTRACT. In dye-sensitized solar cells, transparent metal oxide working electrodes play a vital role in defining the power conversion efficiency. It was found that the size of nanoparticles influences the electrical, optical properties of these electrodes. Herein, we describe the synthesis of ZnO with zinc acetate dihydrate and different stabilizers (diethylamine and triethylamine) by using a modified solvothermal process. The obtained materials were characterized by XRD, SEM, EDX, TEM, HRTEM, UV-visible, FTIR, and Raman methods. The crystallite sizes for ZnO-1 and ZnO-2 samples were indexed as 39.0 and 40.5 nm for the highest peak intensity with diethylamine and triethylamine stabilizer, respectively. We examine the effect of stabilizers on the morphology, optical band gap, and photovoltaic performance of the prepared ZnO. We found that ZnO prepared using diethylamine stabilizer exhibiting significant efficiency of 1.45%, open-circuit voltage 0.454 V, short-circuit current density 2.128 mA/cm2, and 0.66 fill factor were achieved under 44 mW/cm2 illumination powers with dye-3.                 KEY WORDS: Dye-sensitized solar cells, ZnO, Band gap, Photovoltaic performance   Bull. Chem. Soc. Ethiop. 2022, 36(1), 209-222.                                                        DOI: https://dx.doi.org/10.4314/bcse.v36i1.17                                                      

Comparative evaluation of the analgesic efficacy of ultrasound-guided erector spinae plane block versus intrathecal morphine in patients undergoing percutaneous nephrolithotomy surgery: A prospective randomized pilot study

OBJECTIVES

Existing research on erector spinae plane block and intrathecal morphine in patients undergoing percutaneous nephrolithotomy surgery is limited.

METHODS

In this prospective, randomized study, 60 patients aged between 18 and 60 years were randomized into two groups (erector spinae plane block and intrathecal morphine). In the erector spinae plane block group, ultrasound-guided erector spinae plane block was performed, following which a mixture of 20 mL of 0.375% ropivacaine and 0.5 mcg/kg of clonidine was injected. In the intrathecal morphine group, 150 mcg preservative-free morphine with 2 mL of normal saline was administered intrathecally. The primary outcome was to evaluate the perioperative opioid consumption in the first 24 h. The secondary outcomes were to evaluate hemodynamic response to surgical stimulus, visual analogue scale score, time to first analgesic requirement, postoperative nausea and vomiting, postoperative opioid consumption, urethral irritation, and incidence of drug-related adverse effects.

RESULTS

Total perioperative opioid consumption in the erector spinae plane block group was 355.0 (265.0, 485.0) μg and 240.0 (145.0, 370.0) μg in the intrathecal morphine group (P = 0.09). However, the patients in the erector spinae plane block group had significantly greater postoperative fentanyl consumption (235.0 [120.0, 345.0] μg) compared with those in the intrathecal morphine group (105.0 [30.0, 225.0] μg). There were no statistically significant differences noted for intraoperative opioid consumption, postoperative visual analogue scale score, time to first analgesic request, postoperative nausea and vomiting, and catheter irritation between the two groups.

CONCLUSIONS

Although no statistically significant difference in intraoperative opioid consumption was seen between the erector spinae plane block and intrathecal morphine groups, postoperative opioid consumption was significantly higher in the erector spinae plane block group than in the intrathecal morphine group in patients undergoing percutaneous nephrolithotomy surgery.

Modulating α-Synuclein Liquid-Liquid Phase Separation

Liquid-liquid phase separation (LLPS) is a crucial phenomenon for the formation of functional membraneless organelles. However, LLPS is also responsible for protein aggregation in various neurodegenerative diseases such as amyotrophic lateral sclerosis, Alzheimer's disease, and Parkinson's disease (PD). Recently, several reports, including ours, have shown that α-synuclein (α-Syn) undergoes LLPS and a subsequent liquid-to-solid phase transition, which leads to amyloid fibril formation. However, how the environmental (and experimental) parameters modulate the α-Syn LLPS remains elusive. Here, we show that in vitro α-Syn LLPS is strongly dependent on the presence of salts, which allows charge neutralization at both terminal segments of protein and therefore promotes hydrophobic interactions supportive for LLPS. Using various purification methods and experimental conditions, we showed, depending upon conditions, α-Syn undergoes either spontaneous (instantaneous) or delayed LLPS. Furthermore, we delineate that the kinetics of liquid droplet formation (i.e., the critical concentration and critical time) is relative and can be modulated by the salt/counterion concentration, pH, presence of surface, PD-associated multivalent cations, and N-terminal acetylation, which are all known to regulate α-Syn aggregation in vitro. Together, our observations suggest that α-Syn LLPS and subsequent liquid-to-solid phase transition could be pathological, which can be triggered only under disease-associated conditions (high critical concentration and/or conditions promoting α-Syn self-assembly). This study will significantly improve our understanding of the molecular mechanisms of α-Syn LLPS and the liquid-to-solid transition.

Preparation and characterization of BSA as a model protein loaded chitosan nanoparticles for the development of protein-/peptide-based drug delivery system

Background

The purpose of this study was to develop protein-/peptide-loaded nanoparticle-based delivery system, which can efficiently deliver therapeutic molecules to the lung via pulmonary delivery. The chitosan nanoparticles were prepared by the ionic gelation method, and bovine serum albumin was used as a model protein. These nanoparticles were characterized for size, zeta potential, encapsulation efficiency, cell cytotoxicity, uptake study, release profile and size distribution and uniformity. The chemical interaction of chitosan and protein was studied by XRD and FTIR. The integrity assessment of encapsulated protein into nanoparticle was studied by native and SDS-PAGE gel electrophoresis.

Results

The size and zeta potential of BSA nanoparticles were 193.53 ± 44.97 to 336.36 ± 94.63 and 12.73 ± 0.41 to 18.33 ± 0.96, respectively, with PDI values of 0.35–0.45. The encapsulation efficiency was in the range of 80.73 ± 6.37% to 92.34 ± 1.72%. The cumulative release of the BSA from the nanoparticles was 72.56 ± 6.67% in 2 weeks. The BSA-loaded nanoparticles showed good uptake and no significant cytotoxicity observed into the A549 cell line. In this study, it was also observed that during nanoparticles’ synthesis protein structure and integrity is not compromised. The nanoparticles showed controlled and sustained release with initial burst release. In TEM images, it was shown that nanoparticles’ distribution is uniform within nanometre range.

Conclusion

From this study, it was concluded that nanoparticles prepared by this method are suitable to deliver protein/peptide into the cells without any degradation of protein during process of nanoparticle fabrication.

Optimizing Energy Consumption in IoT-Based Scalable Wireless Sensor Networks

In recent era of IoT, energy ingesting by sensor nodes in Wireless Sensor Networks (WSN) is one of the key challenges. It is decisive to diminish energy ingesting due to restricted battery lifespan of sensor nodes, Objective of this research is to develop efficient routing protocol/algorithm in IoT based scenario to enhance network performance with QoS parameters. Therefore, keeping this objective in mind, a QoS based Optimized Energy Clustering Routing (QOECR) protocol for IoT based WSN is proposed and evaluated. QOECR discovers optimal path for sink node and provides better selection for sub-sink nodes. Simulation has been done in MATLAB to assess the performance of QOECR with pre-existing routing protocols. Simulation outcomes represent that QOECR reduces E2E delay 30%-35%, enhances throughput 25%-30%, minimizes energy consumption 35%-40%, minimizes packet loss 28%-32%, improves PDR and prolongs network lifetime 32%-38% than CBCCP, HCSM and ZEAL routing protocols.

Indian goose berry fortified, anti-oxidant rich bael (Aegle marmelos) fermented beverage

Bael (Aegle marmelos Correa), an important fruit of Indian subtropics, traditionally utilized in the preparation of preserve, candy, squash, RTS, etc. has immense therapeutic potential. An attempt was made to develop a bael based low alcoholic sweet fermented beverage ( may be called as bael cider), anti-oxidant fortified with 0.25 per cent bael leaf or 10 per cent Indian goose berry (Emblica officinalis Gaertn.) juice in separate batches. Unfortified bael pulp based drink was kept as control. The ameliorated pulp was fermented at 30 ± 2ºC using Saccharomyces cerevisiae. The gooseberry blended bael fermented beverage had higher anti-oxidant content in the form of phenolics (323 mg/100 ml) than leaf extract added fermented beverage (265 mg/100 ml) and control (266 mg/100 ml). Sensory evaluation of product revealed that gooseberry blended fermented beverage scored higher (8.2/10) than bael leaf blended fermented beverage (7.9/10) and control (7.0/10). Twelve months maturation study of beverage revealed increase in reducing sugars and decrease in phenolic content in all the treatments. Bael fermented beverage with gooseberry blend retained highest phenolic content (257 mg/100 ml) and sensory score 7.8/10. The study inferred that an acceptable quality fermented drink could be prepared from bael-gooseberry blend, which could be stored for one year with higher antioxidant value and minimum deterioration in the quality.

Central Placenta Previa With Coexisting Central Cervical Fibroid in Pregnancy: An Obstetrician's Nightmare

Pregnancy with central placenta praevia and a coexistent cervical fibroid is infrequently encountered in clinical practice. A patient with this unusual combination is a nightmare for any clinician, especially if she presents with obstetric emergencies. In this scenario, there is a high chance of catastrophic obstetric hemorrhage during the peripartum period leading to a fatal outcome. We report a case of a 27-year-old lady at term pregnancy, who was brought to emergency in labor pain with antepartum hemorrhage. Subsequently, she was diagnosed to have central placenta praevia along with a large central cervical fibroid. An emergency cesarean section was performed to deliver the child. Intraoperatively, she had a major postpartum hemorrhage which was successfully managed with intrauterine balloon tamponade, hemostatic sutures, and uterine artery ligation. We could avoid cesarean hysterectomy by precise anticipation, meticulous planning, and step-wise protocol-driven management.

Selective Activation of MST1/2 Kinases by Retinoid Agonist Adapalene Abrogates AURKA-Regulated Septic Arthritis

Septic arthritis is a chronic inflammatory disorder caused by Staphylococcus aureus invasion of host synovium, which often progresses to impairment of joint functions. Although it is known that disease progression is intricately dependent on dysregulated inflammation of the knee joint, identification of molecular events mediating such imbalance during S. aureus-induced septic arthritis still requires detailed investigation. In this article, we report that Aurora kinase A (AURKA) responsive WNT signaling activates S. aureus infection-triggered septic arthritis, which results in inflammation of the synovium. In this context, treatment with adapalene, a synthetic retinoid derivative, in a mouse model for septic arthritis shows significant reduction of proinflammatory mediators with a simultaneous decrease in bacterial burden and prevents cartilage loss. Mechanistically, adapalene treatment inhibits WNT signaling with concomitant activation of HIPPO signaling, generating alternatively activated macrophages. Collectively, we establish adapalene as a promising strategy to suppress S. aureus-induced irreversible joint damage.

Does closed treatment of paediatric mandibular condyle fractures result in restitutional remodelling?

The treatment of paediatric mandibular condylar fracture (PMCF) is typically non-operative. The purpose of this study was to determine if non-operative management of PMCF results in a new condylar process of normal morphology to regenerate after closed treatment (restitutional remodelling). The specific aim of the study was to observe restitutional remodelling (RM) in PMCF and review the literature. The investigators designed and implemented a retrospective study on paediatric patients (age<12) with unilateral or bilateral condyle fractures treated with non-operative treatment between January 2005 and July 2015. Patients with complete records and at least 1-year follow-up were included in the study. Primary outcome variable was RM and secondary outcome variables were occlusion, maximal incisal opening (MIO), displacement, infection, facial asymmetry, and signs of temporomandibular joint ankylosis (TMJA). The study evaluated 41 patients {n=57 PMCF, (m:f-35:6)} of unilateral (n=25) and bilateral (n=16) PMCF. Fractured condyles remodelled to normal morphology in all the cases at follow-up. The Wilcoxon test revealed a statistically significant difference in MIO from the preoperative value to postoperative (p=0.001). Occlusion (except 1) was satisfactory in all cases, at follow-up with no gross facial asymmetry. There was no sign of infection at the surgical site (anterior mandible). None of the patients showed signs of TMJA at follow-up. The result of the present study demonstrates that RM of condylar fracture occurs with non-operative management. Non-operative management should be the point of care in PMCF, owing to the rapid RM, bone regeneration, and satisfactory outcome. Review of the literature also supports closed treatment.

Poultry-origin extraintestinal Escherichia coli strains carrying the traits associated with urinary tract infection, sepsis, meningitis and avian colibacillosis in India

AIM

In-depth 'One Health' risk assessment of extraintestinal pathogenic Escherichia coli (ExPEC) strains carrying the traits of urinary tract infection, sepsis, meningitis and avian colibacillosis in poultry of India.

METHODS AND RESULTS

A total of 230 E. coli isolates were recovered from chicken samples representing the different sources (faeces vs caeca), stages (poultry farms vs retails butcher shop) or environments (rural vs urban) of poultry in India. Among all poultry-origin E. coli isolates, 49 (21·1%) strains were identified as ExPEC possessing multiple virulence determinants regardless of their association with any specific phylogenetic lineages. Of particular, potentially virulent ExPEC pathotypes, that is, uropathogenic E.coli (UPEC, 20·4%), avian pathogenic E. coli (APEC, 34·6%), septicaemia-associated E. coli (SEPEC, 47·0%) and neonatal meningitis-causing E.39 coli (NMEC, 2·0%) were also detected among all ExPEC strains.

CONCLUSIONS

Our study is the first to assess ExPEC strains circulating in the different settings of poultry in India and significantly demonstrates their potential ability to cause multiple extraintestinal infections both in humans and animals.

SIGNIFICANCE AND IMPACT OF THE STUDY

The data of our study are in favour of the possibility that poultry-origin putative virulent ExPEC pathotypes consequently constitute a threat risk to 'One Health' or for food safety and a great concern for poultry production of India.

Enhancing early detection of neurological and developmental disorders and provision of intervention in low-resource settings in Uttar Pradesh, India: study protocol of the G.A.N.E.S.H. programme

INTRODUCTION

Around 9% of India's children under six are diagnosed with neurodevelopmental disorders. Low-resource, rural communities often lack programmes for early identification and intervention. The Prechtl General Movement Assessment (GMA) is regarded as the best clinical tool to predict cerebral palsy in infants <5 months. In addition, children with developmental delay, intellectual disabilities, late detected genetic disorders or autism spectrum disorder show abnormal general movements (GMs) during infancy. General Movement Assessment in Neonates for Early Identification and Intervention, Social Support and Health Awareness (G.A.N.E.S.H.) aims to (1) provide evidence as to whether community health workers can support the identification of infants at high-risk for neurological and developmental disorders and disabilities, (2) monitor further development in those infants and (3) initiate early and targeted intervention procedures.

METHODS

This 3-year observational cohort study will comprise at least 2000 infants born across four districts of Uttar Pradesh, India. Community health workers, certified for GMA, video record and assess the infants' GMs twice, that is, within 2 months after birth and at 3-5 months. In case of abnormal GMs and/or reduced MOSs, infants are further examined by a paediatrician and a neurologist. If necessary, early intervention strategies (treatment as usual) are introduced. After paediatric and neurodevelopmental assessments at 12-24 months, outcomes are categorised as normal or neurological/developmental disorders. Research objective (1): to relate the GMA to the outcome at 12-24 months. Research objective (2): to investigate the impact of predefined exposures. Research objective (3): to evaluate the interscorer agreement of GMA.

ETHICS AND DISSEMINATION

G.A.N.E.S.H. received ethics approval from the Indian Government Chief Medical Officers of Varanasi and Mirzapur and from the Ramakrishna Mission Home of Service in Varanasi. GMA is a worldwide used diagnostic tool, approved by the Ethics Committee of the Medical University of Graz, Austria (27-388 ex 14/15). Apart from peer-reviewed publications, we are planning to deploy G.A.N.E.S.H. in other vulnerable settings.

A De novo Peptide from a High Throughput Peptide Library Blocks Myosin A -MTIP Complex Formation in Plasmodium falciparum

Apicomplexan parasites, through their motor machinery, produce the required propulsive force critical for host cell-entry. The conserved components of this so-called glideosome machinery are myosin A and myosin A Tail Interacting Protein (MTIP). MTIP tethers myosin A to the inner membrane complex of the parasite through 20 amino acid-long C-terminal end of myosin A that makes direct contacts with MTIP, allowing the invasion of Plasmodium falciparum in erythrocytes. Here, we discovered through screening a peptide library, a de-novo peptide ZA1 that binds the myosin A tail domain. We demonstrated that ZA1 bound strongly to myosin A tail and was able to disrupt the native myosin A tail MTIP complex both in vitro and in vivo. We then showed that a shortened peptide derived from ZA1, named ZA1S, was able to bind myosin A and block parasite invasion. Overall, our study identified a novel anti-malarial peptide that could be used in combination with other antimalarials for blocking the invasion of Plasmodium falciparum.