Plant size, latitude, and phylogeny explain within-population variability in herbivory

Interactions between plants and herbivores are central in most ecosystems, but their strength is highly variable. The amount of variability within a system is thought to influence most aspects of plant-herbivore biology, from ecological stability to plant defense evolution. Our understanding of what influences variability, however, is limited by sparse data. We collected standardized surveys of herbivory for 503 plant species at 790 sites across 116° of latitude. With these data, we show that within-population variability in herbivory increases with latitude, decreases with plant size, and is phylogenetically structured. Differences in the magnitude of variability are thus central to how plant-herbivore biology varies across macroscale gradients. We argue that increased focus on interaction variability will advance understanding of patterns of life on Earth.

Epidemiology of cancers among older adults in India: findings from the National Cancer Registry Programme

OBJECTIVE

This study describes the epidemiology, clinical extent of disease at diagnosis and treatment modalities of cancer among older adults (aged 60 years and older) in India.

STUDY DESIGN

Secondary data analysis of the National Cancer Registry Programme, which includes 28 Population-Based Cancer Registries (PBCRs) and 96 Hospital-Based Cancer Registries (HBCRs).

METHODS

PBCR data were used to estimate the incidence in terms of crude rate (CR), age-adjusted incidence rate (AAR), age-specific rate (ASpR) and cumulative risk. Trends in the AAR were calculated with the Annual Percentage Change (APC) using join-point regression. HBCR data were used to describe the clinical extent of the disease at diagnosis and the treatment modalities.

RESULTS

There is a wide heterogeneity across the country for the incidence of cancer and for the leading cancer sites among older adults. Males had a higher incidence rate compared to females in the majority of the registries. Aizawl had the highest AARs among both genders (males: 1388.8; females: 1033.0). Females had the highest ASpR at 65-69 years (482.8), whereas for males it was above 75 years (710.4). Cervical, stomach and oesophageal cancers were on the decline. The incidence of cancer among older adults was estimated to increase by 13.5% in 2025 as compared to 2020.

CONCLUSION

The increasing cancer incidence among older adults in India poses a huge burden on the health system. There is a need to increase their participation in clinical trials, advocating comprehensive geriatric assessment and strengthening geriatric oncology within programs addressing older adult's care to deal with the rising cancer burden on the health system borne by them.

Neurological Manifestations of Glutamic Acid Decarboxylase Autoimmunity in Indian Patients

Objective

To study the neurological manifestations of glutamic acid decarboxylase (GAD 65) autoimmunity in Indian patients.

Methods

Retrospective study conducted in a tertiary care referral hospital in South India. Patients who tested positive for GAD 65 antibodies from February 2013 to July 2019 were included.

Results

We identified 922 patients who underwent GAD 65 testing, of which 81 tested positive (8.78%) [mean age 55.42 years (SD 17.39, range 9-86 years, median age 57 years)]. Males (n = 47) outnumbered the females (n = 34). All the GAD values measured were <5000 IU/ml. There were 34 cases (42%) of atypical parkinsonism (16/34, 47% fulfilled the diagnostic criteria for autoimmune atypical parkinsonism) in our series forming the most common group with GAD 65 positivity, followed by autoimmune encephalitis (8 cases, 9.88%). Men were more affected with atypical parkinsonism (22/34; 64.70%), stiff person syndrome (2/3; 66.66%), and neuropathy (4/7; 57.1%) while women were more with autoimmune encephalitis (6/8; 75%). Eighteen (22.6%) had underlying autoimmunity (three had type 1 diabetes mellitus). Six (7.4%) had underlying neoplasm. Thirty-three out of 43 patients responded to immunotherapy (76.74%). Five had spontaneous improvement.

Conclusion

Glutamic acid decarboxylase65 antibody values were much lower in our study population. Male-dominant autoimmunity was seen unlike that in Western literature. The most striking was the high preponderance of atypical parkinsonism in GAD 65-positive patients. We also found that GAD 65 positivity is a useful marker for a positive response to immunotherapy in suspected autoimmune neurological syndromes irrespective of their titers.

The utility of serum amylase as a prognostic marker in multiple myeloma

Background

Ectopic production of amylase by tumor cells is known since 1951. Elevated amylase in multiple myeloma (MM) was first described in 1988. It has been postulated that translocation of chromosome 1, where amylase gene is situated, is responsible for ectopic production from the malignant plasma cells. Anecdotal reports have shown hyperamylasemia in MM to be associated with extensive bone disease, rapid progression, and shorter survival. Serum amylase estimation is a ubiquitous test. This prospective study was conducted to ascertain the degree of elevated amylase, its clinical utility, and implications in MM patients.

Materials and Methods

In an 18-month period, all consenting patients with newly diagnosed or relapsed MM were tested for serum amylase levels. The study excluded patients with elevated lipase, abnormal creatinine clearance, and evidence of intestinal obstruction or perforation. Patients with amylase value >100 U/L were designated to have "elevated amylase level" for the purpose of this study.

Results

We enrolled 58 patients with MM, of which 29.3% (n = 17) were found to have elevated serum amylase levels. The median age of patients with elevated amylase was 65 years. The male-to-female ratio was 1.9:1. There was no statistical association between age, gender, type of heavy chain class, light chain, or high-risk cytogenetics. Among patients with the International Staging System (ISS), Stages I, II, and III, 20.8% (n = 5), 31.3% (n = 5), and 41.2% (n = 7) were noted to have elevated amylase levels. A statistically significant association was noted between the presence of extramedullary disease (EMD) and elevated amylase level (P = 0.028). Higher mortality (29.4% versus 17%) and shorter mean survival of (30.2 ± 3.3 months versus 51.7 + 4.9 months) were recorded in patients with elevated amylase levels in comparison to those with normal levels.

Conclusions

Elevated serum amylase level in MM is indicative of advanced ISS stage, the presence of EMD, higher risk of mortality, and shorter survival. Serum amylase can be used as a cost-effective tool in myeloma management.

Determination of sensitivities and specificities of cerebrospinal fluid free light chains to diagnose multiple sclerosis- a multicentric case-control study

BACKGROUND

CSF free light chains help diagnose multiple sclerosis, but no data is available on the Asian population. Our objective was to study the diagnostic utility of CSF free light chains for diagnosing multiple sclerosis in Indian patients.

METHODS

Prospective multicentric case-control study. Cases included those who were tested for oligoclonal bands and fulfilled the modified McDonald criteria 2017 for multiple sclerosis and clinically isolated syndromes. Those tested for oligoclonal bands (OCB) but with other diagnoses- inflammatory and non-inflammatory were included as controls. Clinical details were collected from electronic medical records. CSF and serum kappa and lambda free light chains were measured, apart from oligoclonal bands, immunoglobulin, and albumin in paired serum and CSF samples.

RESULTS

There were 70 patients (31 cases and 39 controls). The mean age was 43.41(SD 16.073) years, and 43(61.4%) were females. CSF kappa showed highest specificity 97.4%, at a cut off 2.06 mg/L (sensitivity 71%) and highest sensitivity 90.3%, at a cut off 0.47 mg/L (specificity 79.5%). Best balance of sensitivity and specificity for CSF kappa was seen at a cut-off of ≥ 0.63 mg/L {sensitivity 87·1 (CI - 70.17-96.37), and specificity 87·18 (CI -72.57-95.70)}. The ratio of Kappa/lambda showed highest specificity of 100%(similar to OCB) with a sensitivity of 71% at a cut off of 1.72. The ratio of sum of kappa and lambda light chains, and Qalb (∑CSF FLC/Qalb), showed the highest specificity (94.87%)among the blood brain barrier corrected ratios.

CONCLUSION

This study showed that the diagnostic utility of CSF kappa was comparable to OCB to diagnose multiple sclerosis in sensitivity, but not specificity, so can be a screening test before testing for OCB in our population.

Validation of the TNM-8 AJCC classification for HPV-positive oropharyngeal cancers in patients undergoing trans-oral robotic surgery

High-risk human papillomaviruses (HPV) are associated with some oropharyngeal squamous cell carcinomas (OPSCC). HPV-OPSCC have better survival outcomes compared to HPV negative tumours. The new TNM-8 AJCC staging (2018) is based on ICON-S data with 98% of patients treated with primary chemoradiation. To validate the TNM-8 AJCC classification in HPV-OPSCC treated primarily with surgery (trans-oral robotic surgery or open). There were 102 patients with HPV-OPSCC treated between July 2009 and December 2014 at the Royal Adelaide Hospital. The median age was 57 years (range: 38-83) and mostly males (84.5%). 27.2% were active smokers and 50.5% reformed smokers. Early T-stage cancer in 72.8%. Primary treatment was surgery & adjuvant therapy (70%) while primary chemoradiation (30%). Survival analyses were performed for the 7th and 8th AJCC systems. The reclassification to the AJCC 8th edition staging system resulted in a change of 54 patients from stage 4 to stages 1 and 2. This was mainly an effect of changes with N2a and N2b nodal disease being reclassified to N1. Survival outcomes were comparable with the ICON-S data. The new TNM-8 classification is, therefore, validated in a cohort treated, predominantly, with primary surgery and adjuvant therapy.

Tetrathiafulvalene Derivatives as Hole-Transporting Materials in Perovskite Solar Cell

Over a couple of decades perovskite solar cells have become a highly promising photovoltaic technology. Choosing a dopant-free Hole-Transporting Material (HTM) that offers protection to a perovskite layer from oxidation is one of the viable strategies while addressing the stability of perovskite solar cell. In this line of interest, tetrathiafulvale (TTF) derivatives have shown promise in the past. However, studies that focus on small-molecule TTF derivatives as potential HTM options are scarce. The present study is an attempt to explore the applicability of a few TTF derivatives as HTM in a perovskite solar cell. Here four TTF derivatives, namely, TTF-1 (experimentally reported in a previous study), TTF-2, DBTTF1, and TMTSF1, were studied through electronic structure calculations. The properties concerning HTM, such as impact of adsorption on molecular structure, absorption spectra, distribution of frontier molecular orbitals, interaction energy between TTF derivative and MAPbI₃ surface, and charge transfer at an interface, were analyzed. Results show that TTF-2 has the expected energy-level alignment, transparency in the visible range of solar spectrum, and good charge-injection ability at the interface with a perovskite layer. Hence, TTF-2 could be a potential hole-transporting material for a perovskite solar cell, and it can perform better than TTF-1.

Lung Transplant for Patients with COVID-19 Bridged with VV ECMO: Initial Experience

Purpose

During the COVID-19 pandemic, veno-venous Extracorporeal Membrane Oxygenation (VV ECMO) has been used extensively for respiratory failure refractory to conventional mechanical ventilation (MV) and rescue maneuvers. However, the worldwide experience with COVID-19 patients undergoing lung transplant (LTx) with pre-LTx VV ECMO support is limited. Therefore, we sought to report our institution's early experience with COVID-19 patients who underwent LTx after VV ECMO.

Methods

We retrospectively identified 5 COVID-19 patients who underwent LTx after VV ECMO support. Patients were required to have a negative nasopharyngeal swab and a negative bronchoalveolar lavage for COVID-19 prior to LTx listing. We analyzed preoperative and operative characteristics, details of VV ECMO support and early post-transplant outcomes.

Results

The mean age of our cohort was 50 years (range 39-57 years) and all patients were male. Mean recipient BMI was 30 (range 22-37). Mean duration of VV ECMO pre-Ltx was 60 days (range 44-72 days). At the time of the LTx operation, 60% (3/5) of patients were on VV ECMO, 20% (1/5) were on mechanical ventilation (MV), and 20% (1/5) were on supplemental oxygen only. Preoperatively, 80% (4/5) had acute kidney injury and 20% (2/5) were on dialysis. LTx was performed via clamshell approach with intraoperative venoaterial ECMO support in all cases. For 60% (3/5) patients, VV ECMO support was continued after LTx and discontinued on postoperative days 0, 1 and 6, respectively. All-cause mortality was 40% (2/5), related to sepsis and multi-organ failure, and both deaths occurred an average of 115 days post-LTx. Mean length of stay for surviving patients was 59 days (range 22-117). In the first 3 months postop-LTx, grade A2 acute cellular rejection was noted in 2 patients, A1 in 2 patients, and antibody-mediated rejection in 1 patient.

Conclusion

Our early experience with LTx for COVID-19 patients supported with VV ECMO support is notable for 1) prolonged VV-ECMO duration and significant morbidity pre-LTx, and 2) early mortalities related to sepsis and multiple organ failure. These data highlight a uniquely complex patient population that carries high risk of multi-organ failure and other comorbidities dictating careful selection for transplant.

Role of fibroblast growth factor-23 (FGF-23) in the prediction of postoperative atrial fibrillation after coronary artery bypass surgery

Introduction

Fibroblast growth factor-23 (FGF-23) is a bone-derived hormone which had shown a significant association with the occurrence of atrial fibrillation (AF) in patients with chronic kidney disease. We hypothesized that FGF-23 could be a very useful predictive biomarker for atrial remodeling and in turn for postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG). We also looked at the correlation of cardiac remodeling in right atrial biopsy and its correlation with POAF and with the FGF-23 level.

Methods

This study was a single-center cross-sectional observational study. All the patients who were planned for CABG with no prior history of AF were included in the study. All the patients were tested for preoperative serum FGF-23 level. During CABG, biopsy specimen of the right atrial appendage was sent for histopathology evaluation. All patients were monitored for POAF until discharge from the hospital.

Results

This study involved 60 patients who underwent elective CABG. Multivariate analysis revealed a significant association between preoperative FGF-23 levels with the occurrence of POAF (p < 0.001). The area under the curve of FGF-23 was 0.894 with a sensitivity of 92.3% and specificity of 87.23%. The cut-off value for serum FGF-23 levels was found to be 6.50 ng/ml. Analysis of biopsy specimens revealed that the presence of hypertrophic myocytes had a significant association with the occurrence of POAF/POAE and with FGF-23.

Conclusion

Preoperative FGF-23 levels can predict the incidence of POAF in post-CABG patients. Histopathologically, the presence of hypertrophic myocytes correlated well with the occurrence of POAF.

High Prevalence of Plasminogen Activator Inhibitor-1 4G/5G Polymorphism among Patients with Venous Thromboembolism in Kerala, India

Venous thromboembolism (VTE) is a multifactorial clotting disorder in which inherited and environmental factors synergistically contribute to its pathogenesis. The aim of this case-control study was to analyze the prevalence of hereditary thrombophilic risk factors, provoking and non-provoking environmental risk factors in patients with VTE from Kerala, India. We have observed a low prevalence of factor V Leiden (7%), prothrombin G20210A (2%), and prothrombin G20030A (2%) mutations and a high prevalence of plasminogen activator inhibitor-1 (PAI-1) 4G/5G (52%), PAI-1 4G/4G (24%) genotypes in the VTE patients (n = 147). Deficiency of anticoagulants, antithrombin (3.4%), and protein C (4.1%) was relatively low. None of the risk factors were observed in 17% of the patients. Majority of VTE patients were younger than 50 years with a median age of 43 years. In conclusion, our results indicate a high prevalence of PAI-1 4G/5G polymorphism among the VTE patients which is in concordance with previous studies in the Asian population. The PAI-1 4G/5G polymorphism could be a potential biomarker for assessing VTE risk, particularly among the Indian population.

Modified fullerenes as acceptors in bulk heterojunction organic solar cells - a theoretical study

In the present study, electronic structure calculations were used to provide strategies for designing poly(3-hexylthiophene) (P3HT)-fullerene-derivative-based donor-acceptor materials for use in high-efficiency bulk heterojunction organic solar cells (BHJ OSCs). The work systematically analyses the impact of electron-donating and -withdrawing substituents on the opto-electronic properties of the fullerene structures. Parameters relating to the absorption spectra, orbital distributions, and energy ordering of the frontier molecular orbitals (FMO), the interactions between P3HT and the fullerene derivatives, and charge transfer across the interface were investigated. We found that substitution with the electron-withdrawing group NO₂ enhances the electronic coupling between the fullerene and P3HT; however, it reduces the open-circuit voltage (V_OC) of the OSC through lowering the LUMO energy level. Furthermore, the results show that substitution with an electron-withdrawing group (NO₂) and electron-donating group (OCH₃) can improve the power conversion efficiency (PCE) of the OSC, since this slightly improves the photon absorption abilities and charge transfer coupling at the interface without overly compromising V_OC relative to PC₆₁BM. Our study shows that alkyl chain modification in the PC₆₁BM acceptor is a promising strategy for improving the performances of OSCs.

Intelligent-based decision support system for diagnosing glaucoma in primary eyecare centers using eye tracker

It is quite alarming that the increase of glaucoma is due to the lack of awareness of the disease and the cost for glaucoma screening. The primary eye care centers need to include a comprehensive glaucoma screening and include machine learning models to elaborate it as decision support system. The proposed system considers the state of art of eye gaze features to understand cognitive processing, direction and restriction of visual field. There is no significant difference in global and local ratio and skewness value of fixation duration and saccade amplitude, which suggest that there is no difference in cognitive processing. The significance value of saccadic extent along vertical axis, Horizontal Vertical ratio (HV ratio), convex hull area and saccadic direction show that there is restriction in vertical visual field. The statistical measures (p < 0.05) and Spearman correlation coefficient with class label validate the results. The proposed system compared the performance of seven classifiers: Naïve Bayes classifier, linear and kernel Support Vector classifiers, decision tree classifier, Adaboost, random forest and eXtreme Gradient Boosting (XGBoost) classifier. The discrimination of eye gaze features of glaucoma and normal is efficiently done by XGBoost with accuracy 1.0. The decision support system is cost-effective and portable.

Charge Transport and Optical Absorption Properties of Dibenzocoronene Tetracarboxdiimide Based Liquid Crystalline Molecules: A Theoretical Study

Structure, optical absorption, and charge transport properties of dibenzocoronene tetracarboxdiimide (DCDI) based molecules were studied using electronic structure calculations. Based on the optimized neutral, cationic, and anionic geometries the ionized state properties, such as ionization potential, electron affinity, hole extraction potential, electron extraction potentials, and reorganization energy, were calculated. On the basis of the ground state geometry of the studied molecules, the absorption spectra were calculated using the time-dependent density functional theory (TDDFT) method at the PBE0/def-TZVP level of theory. It has been observed that the substitution of different functional groups significantly alters the absorption spectra of DCDI. The methoxy- (OCH₃-) substituted DCDI molecule has a maximum absorption wavelength of 529 nm. The charge transport parameters, such as the charge transfer integral, spatial overlap integral, and the site energy, are calculated directly from the Kohn-Sham matrix elements. The reorganization energy for the presence of excess positive and negative charges and the charge transfer rate calculated from Marcus' theory were used to find the mobility of charge carriers. The computed results show that the mobility of charge carriers is strongly influenced by the functional groups present on the DCDI molecule. The effect of intermolecular structural fluctuations on charge transport properties was studied through molecular dynamics and Monte Carlo simulations based on the polaron hopping mechanism. The calculated charge carrier mobility shows that the cyano- (CN-) substituted DCDI molecules are having n-type semiconducting property while, methoxy- (OCH₃-) and thiol- (SH-) substituted DCDI molecules exhibit ambipolar semiconducting properties.

Association of Follicular Fluid Advanced Glycation End-Products with Oocyte Response and Clinical Pregnancy in Assisted Reproduction Cycles

Context:

Advanced glycation end-products (AGEs) are toxic metabolic end-products of lipids, nucleic acids, and proteins. Their accumulation in the ovaries can alter the follicular microenvironment and affect stimulation response.

Aims:

We aimed to study the association of AGEs in follicular fluid (FF AGE) with oocyte response and clinical pregnancy in ART-Assisted Reproductive Technology cycles.

Settings and Design:

This prospective study involved 84 individuals undergoing ART.

Methods and Material:

FF was collected during oocyte retrieval, and the level of AGEs was measured by enzyme-linked immunosorbent assay. Oocyte response was grouped as below target (<7 MII oocytes) or above target response (≥7 MII).

Statistical Analysis Used:

The association of FF AGE with the oocyte response and clinical pregnancy rate was analyzed by Mann–Whitney U-test. The strength of association of FF AGE with the outcome variables was analyzed with receiver operating characteristic (ROC) curve.

Results:

The median FF AGE was 17.6 (8.5) μg/ml. It was significantly higher in the below target than the normal ovarian response group (18.5 [17.8] vs. 16.3 [7.8] μg/ml, P = 0.046). Similarly, it was significantly higher in those who did not conceive (19.9 [7.3] vs. 13.5 [5.9] μg/ml, P < 0.001). The cutoff of FF AGE obtained by ROC curve analysis was 16.5 μg/ml above which there were significantly lower oocyte response and clinical pregnancy.

Conclusions:

Elevated FF AGE can be a significant negative predictor of clinical pregnancy and ovarian response to stimulation in ART cycles. The FF AGE level above the cutoff value of 16.5 μg/ml was associated with significantly lower oocyte response and clinical pregnancy.

A hyperacute immune map of ischaemic stroke patients reveals alterations to circulating innate and adaptive cells

Systemic immune changes following ischaemic stroke are associated with increased susceptibility to infection and poor patient outcome due to their role in exacerbating the ischaemic injury and long-term disability. Alterations to the abundance or function of almost all components of the immune system post-stroke have been identified, including lymphocytes, monocytes and granulocytes. However, subsequent infections have often confounded the identification of stroke-specific effects. Global understanding of very early changes to systemic immunity is critical to identify immune targets to improve clinical outcome. To this end, we performed a small, prospective, observational study in stroke patients with immunophenotyping at a hyperacute time point (< 3 h) to explore early changes to circulating immune cells. We report, for the first time, decreased frequencies of type 1 conventional dendritic cells (cDC1), haematopoietic stem and progenitor cells (HSPCs), unswitched memory B cells and terminally differentiated effector memory T cells re-expressing CD45RA (TEMRA). We also observed concomitant alterations to human leucocyte antigen D-related (HLA-DR), CD64 and CD14 expression in distinct myeloid subsets and a rapid activation of CD4+ T cells based on CD69 expression. The CD69+ CD4+ T cell phenotype inversely correlated with stroke severity and was associated with naive and central memory T (TCM) cells. Our findings highlight early changes in both the innate and adaptive immune compartments for further investigation as they could have implications the development of post-stroke infection and poorer patient outcomes.

Regulation of Thiamine (Vitamin B1)-Dependent Metabolism in Mammals by p53

Transcriptional factor p53 is a master regulator of energy metabolism. Energy metabolism strongly depends on thiamine (vitamin B1) and/or its natural derivatives. Thiamine diphosphate (ThDP), which is a major thiamine derivative, affects p53 binding to DNA. In order to elucidate the mechanism of regulation of thiamine-dependent metabolism by p53, we assessed putative p53-binding sites near transcription starting points in genes coding for transporters and enzymes, whose function is associated with thiamine and/or its derivatives. The predictions were validated by studying cell metabolic response to the p53 inducer cisplatin. Expression of p53 and its known target, p21, has been evaluated in cisplatin-treated and control human lung adenocarcinoma A549 cells that possess functional p53 pathway. We also investigated the activity of enzymes involved in the thiamine-dependent energy metabolism. Along with upregulating the expression of p53 and p21, cisplatin affected the activities of metabolic enzymes, whose genes were predicted as carrying the p53-binding sites. The activity of glutamate dehydrogenase GDH2 isoenzyme strongly decreased, while the activities of NADP+-dependent isocitrate dehydrogenase (IDH) and malic enzymes, as well as the activity of 2-oxoglutarate dehydrogenase complex at its endogenous ThDP level, were elevated. Simultaneously, the activities of NAD+-dependent IDH, mitochondrial aspartate aminotransferase, and two malate dehydrogenase isoenzymes, whose genes were not predicted to have the p53-binding sequences near the transcription starting points, were upregulated by cisplatin. The p53-dependent regulation of the assayed metabolic enzymes correlated with induction of p21 by p53 rather than induction of p53 itself.

The influence of the shape and configuration of sensitizer molecules on the efficiency of DSSCs: a theoretical insight

The sensitizer is an active component of dye sensitized solar cell (DSSC) technology, which is highly influential for the performance of DSSCs. The present study attempts to investigate the relationship between the shape of the sensitizer molecule and efficiency of DSSCs. Specifically, 17 different structures were investigated, and classified into four categories based on the shape of the dye molecule, namely L-shaped (linear), V-shaped, X-shaped and Y-shaped, and into two different categories based on the donor moiety. The five of studied structures contained a triphenylamine (TPA) donor moiety, and twelve structures contained carbazole (CAR) donor moiety. Parameters related to the performance of DSSCs such as absorption spectra, intramolecular charge transfer indices, frontier molecular orbitals, light harvesting efficiency, excited-state lifetime, exciton binding energy, electrostatic potential, charge transfer and electron injection ability were studied using results obtained from electronic structure calculations. The analysis of these various parameters showed that the linear-shaped and V-shaped sensitizers possess better photon absorption ability, and the V-shaped structure is best suited shape for applications in high performance DSSCs.

Numerous studies have reported that the shape of a sensitizer matters for DSSC performance, while the present study investigates why and how it matters.

Students Perception of their Educational Environment in a Medical College in India- A Survey using DREEM Questionnaire

Introduction: Educational plays an important role in the achievement of student’s academic success. Understanding the perception of students towards their educational environment helps to identify the lacunae in the curriculum and make the changes accordingly. Aim: To assess the perceptions of the students towards medical education using Dundee Ready Educational Environment Measure (DREEM) questionnaire as a tool. Materials and Methods: This was a cross-sectional study done at NRI Medical College, Guntur, Andhra Pradesh, India, from September 2020 to December 2020. A total of 414 students participated in the study. The DREEM questionnaire was used to collect the data. The questionnaire consists of five components with 50 statements assessed on five-point Likert scale (0-4). Data were expressed as mean and standard deviation, frequency, and percentages. Independent t-test and one-way Analysis of Variance (ANOVA) were used for comparing the groups. Results: Out of 600 students, 414 filled in the forms and submitted them (response rate was 69%). 266 (64.2%) were female and 148 (35.8%) were males. Age of the students ranged from 17 to 25 years with mean age 22.64±2.62 years. The mean DREEM score of study population was 130±6.7/200 which indicated a more positive than negative perception of learning. Subscale scores for student’s perception of learning, perceptions of teachers, academic self-perceptions, perceptions of atmosphere and social self-perceptions were 30.9±2.4, 28.9±1.5, 22.4±3.1, 30.8±2.3 and 16.9±1.7 respectively. Conclusion: There was a positive perception of students towards their educational environment. Strong areas were student’s confidence, teacher’s knowledge, and curricular relevance. Weak areas were identified as the inability to provide constructive criticism by teachers, the teachers were authoritarian and necessary steps can be taken for the improvement.

Somatic mutation detection efficiency in EGFR: a comparison between high resolution melting analysis and Sanger sequencing

Background

High resolution melting curve analysis is a cost-effective rapid screening method for detection of somatic gene mutation. The performance characteristics of this technique has been explored previously, however, analytical parameters such as limit of detection of mutant allele fraction and total concentration of DNA, have not been addressed. The current study focuses on comparing the mutation detection efficiency of High-Resolution Melt Analysis (HRM) with Sanger Sequencing in somatic mutations of the EGFR gene in non-small cell lung cancer.

Methods

The minor allele fraction of somatic mutations was titrated against total DNA concentration using Sanger sequencing and HRM to determine the limit of detection. The mutant and wildtype allele fractions were validated by multiplex allele-specific real-time PCR. Somatic mutation detection efficiency, for exons 19 & 21 of the EGFR gene, was compared in 116 formalin fixed paraffin embedded tumor tissues, after screening 275 tumor tissues by Sanger sequencing.

Results

The limit of detection of minor allele fraction of exon 19 mutation was 1% with sequencing, and 0.25% with HRM, whereas for exon 21 mutation, 0.25% MAF was detected using both methods. Multiplex allele-specific real-time PCR revealed that the wildtype DNA did not impede the amplification of mutant allele in mixed DNA assays. All mutation positive samples detected by Sanger sequencing, were also detected by HRM. About 28% cases in exon 19 and 40% in exon 21, detected as mutated in HRM, were not detected by sequencing. Overall, sensitivity and specificity of HRM were found to be 100 and 67% respectively, and the negative predictive value was 100%, while positive predictive value was 80%.

Conclusion

The comparative series study suggests that HRM is a modest initial screening test for somatic mutation detection of EGFR, which must further be confirmed by Sanger sequencing. With the modification of annealing temperature of initial PCR, the limit of detection of Sanger sequencing can be improved.

Cross validated serum small extracellular vesicle microRNAs for the detection of oropharyngeal squamous cell carcinoma

BACKGROUND

Oropharyngeal squamous cell carcinoma (OPSCC) is often diagnosed at an advanced stage because the disease often causes minimal symptoms other than metastasis to neck lymph nodes. Better tools are required to assist with the early detection of OPSCC. MicroRNAs (miRNAs, miRs) are potential biomarkers for early head and neck squamous cell cancer diagnosis, prognosis, recurrence, and presence of metastatic disease. However, there is no widespread agreement on a panel of miRNAs with clinically meaningful utility for head and neck squamous cell cancers. This could be due to variations in the collection, storage, pre-processing, and isolation of RNA, but several reports have indicated that the selection and reproducibility of biomarkers has been widely affected by the methods used for data analysis. The primary analysis issues appear to be model overfitting and the incorrect application of statistical techniques. The purpose of this study was to develop a robust statistical approach to identify a miRNA signature that can distinguish controls and patients with inflammatory disease from patients with human papilloma virus positive (HPV +) OPSCC.

METHODS

Small extracellular vesicles were harvested from the serum of 20 control patients, 20 patients with gastroesophageal reflux disease (GORD), and 40 patients with locally advanced HPV + OPSCC. MicroRNAs were purified, and expression profiled on OpenArray™. A novel cross validation method, using lasso regression, was developed to stabilise selection of miRNAs for inclusion in a prediction model. The method, named StaVarSel (for Stable Variable Selection), was used to derive a diagnostic biomarker signature.

RESULTS

A standard cross validation approach was unable to produce a biomarker signature with good cross validated predictive capacity. In contrast, StaVarSel produced a regression model containing 11 miRNA ratios with potential clinical utility. Sample permutations indicated that the estimated cross validated prediction accuracy of the 11-miR-ratio model was not due to chance alone.

CONCLUSIONS

We developed a novel method, StaVarSel, that was able to identify a panel of miRNAs, present in small extracellular vesicles derived from blood serum, that robustly cross validated as a biomarker for the detection of HPV + OPSCC. This approach could be used to derive diagnostic biomarkers of other head and neck cancers.

Impact of Synthesis Technique on Lanthanum Doped Copper Oxide Nanocrystals, an Alternative Counter Electrode for Pt-Free Dye-Sensitized Solar Cells

The ascendancy of a counter electrode (C.E) in a dye-sensitized solar cell (DSSC) has an unrivaled impact on the performance of the dye-sensitized solar cell, where the Pt-based C.E has set up a phenomenal benchmark against its counterparts. Due to the high cost of such noble metals, an operative and a much cost effective replacement were greatly in demand to gratify this need. To address this issue, monoclinic lanthanum doped copper oxide (CuO) nanoparticles were prepared by solution combustion and co-precipitation techniques respectively as they possess highly superior optoelectronic, catalytic and charge transfer properties. The effect of incorporating lanthanum (La) ions and the variation of synthesis technique on their structural, optical, photo-thermal and morphological properties are empirically investigated by XRD, FTIR, TEM, UV-Vis, Raman and Photoacoustic Spectroscopy (PAS). The X-ray diffraction pattern revealed the formation of La-doped CuO nanoparticles. The finger-print vibrational modes of the as-synthesized samples are confirmed by the FTIR spectra. The required optical properties of the as-synthesized nanocrystals were confirmed using UV-Vis absorption spectra, from which the bandgap was determined by Kubelka-Munk plot. The Raman modes were determined using Raman spectra, further a multi-phonon band was revealed, which was formed due to the plasmon-phonon coupling. The photothermal phenomenon was revealed using the photoacoustic spectra. The morphological investigation by TEM found the change in the morphology of the material as the synthesis route is varied. The power conversion efficiency results unveiled that the combustion-derived C.E posted a promising efficiency (η) of 0.20% and the co-precipitation derived C.E posted an efficiency of 0.02%. Overall results suggest that the combustion derived La doped CuO nanostructures exhibited substantive properties with deeper implication and also stood out to be a viable, cost-effective and self-exemplifying replacement for Pt as C.E in DSSC's.

A systematic review and meta-analysis of cancer patients affected by a novel coronavirus

BACKGROUND

Cancer patients with COVID-19 disease have been reported to have double the case fatality rate of the general population.

MATERIALS AND METHODS

A systematic search of PubMed/MEDLINE, Embase, Cochrane Central, Google Scholar, and MedRxiv was done for studies on cancer patients with COVID-19. Pooled proportions were calculated for categorical variables. Odds ratio and forest plots were constructed for both primary and secondary outcomes. The random-effects model was used to account for heterogeneity between studies.

RESULTS

This systematic review of 31 studies and meta-analysis of 181,323 patients from 26 studies involving 23,736 cancer patients is the largest meta-analysis to the best of our knowledge assessing outcomes in cancer patients affected by COVID-19. Our meta-analysis shows that cancer patients with COVID-19 have a higher likelihood of death (odds ratio, OR 2.54), which was largely driven by mortality among patients in China. Cancer patients were more likely to be intubated, although ICU admission rates were not statistically significant. Among cancer subtypes, the mortality was highest in hematological malignancies (OR 2.43) followed by lung cancer (OR 1.8). There was no association between receipt of a particular type of oncologic therapy and mortality. Our study showed that cancer patients affected by COVID-19 are a decade older than the normal population and have a higher proportion of co-morbidities. There was insufficient data to assess the association of COVID-directed therapy and survival outcomes in cancer patients. Despite the heterogeneity of studies and inconsistencies in reported variables and outcomes, these data could guide clinical practice and oncologic care during this unprecedented global health pandemic.

CONCLUSION

Cancer patients with COVID-19 disease are at increased risk of mortality and morbidity. A more nuanced understanding of the interaction between cancer-directed therapies and COVID-19-directed therapies is needed. This will require uniform prospective recording of data, possibly in multi-institutional registry databases.

Investigation on Elastic, Magnetic, Optical and Electrical Impedance Properties of Dysprosium Doped Nickel Ferrite Nanocrystals

Rare earth dysprosium (Dy) doped nickel ferrite nanoparticles were synthesized via economically viable co-precipitation technique and studied for its elastic, structural, magnetic and electrical properties. X-ray diffraction analysis shows the formation of cubic spinel phase with a slight inclination in the cell parameters with respect to the concentration of dopant convivial. The crystallite size and strain of the nanoparticles were determined using Scherrer formula and the Williamson-Hall (W-H) technique. In addition, the theoretical parameters viz., cation distribution, bond length, oxygen positional parameters, etc., have been embrasured. The strength and types of interionic bonds in the nano ferrites were determined utilizing Fourier Transform Infrared spectral analysis. The magnetic properties were analysed using vibrating sample magnetometer at room temperature, it was found that as the dopant concentration increases, the coercivity and magnetic saturation decreases. This result is partially explained by the bridge networking of Dy³⁺-Fe³⁺ ions which is equated by Fe²⁺- Fe³⁺ ion interaction. This paper deals with the itinerant electron model to determine the distribution of cations by magnetization analysis. The optical properties of the samples were studied utilizing UV-Vis spectral analysis and the optical band gap was evaluated from Kubelka-Munk plot. Electrical impedance was analysed as a function of frequencies at room temperature. This analysis depicts the dielectric constant and loss factor tends to decline with applied frequency and AC conductivity elicits its semiconducting characteristic by obeying Jonscher's law.

Effect of Non-Surgical Periodontal Therapy on the Serum Sialic Acid Levels in Diabetic Patients with Periodontitis

Sialic acid (SA), a family of acetylated derivatives of neuraminic acid, an acute phase reactant by itself. It usually occurs as a terminal component at the non-reducing end of carbohydrate chains of glycoproteins and glycolipids. SA participates in multiple physiological functions, such as cell-to-cell interactions, cell migration and proliferation. Diabetes mellitus (DM) is a chronic metabolic disorder characterized by rise in blood glucose level. Periodontitis is a chronic inflammatory disease of the periodontal tissue, leading to destruction of bone surrounding the tooth and ultimately tooth loss. There is a two way relationship between diabetes mellitus and periodontitis. Periodontitis is the sixth complication of diabetes along with retinopathy, nephropathy, neuropathy, macrovascular disease, and altered wound healing. Inflammatory mediators like interleukin-6 and tumor necrosis factor-alpha produced during periodontal inflammation can interfere with the actions of insulin receptors and worsen the glycemic control of diabetic patients. Periodontitis is a major cause of tooth loss, affecting over 300 million people and bacteria associated with periodontitis are also linked with systemic problems like endocarditis, atherosclerosis. Recent work has highlighted a major role for the host sugar sialic acid in the biofilm physiology and host-pathogen interactions of T. forsithya, a key periodontal pathogen. There exists a need for a biomarker, for early detection of disease evolution and more robust therapy efficacy measurements. Serum sialic acids were estimated in Indian population by diphenylamine method and Thiobarbituric acid method. The average values were 68 ± 2.6 mg percent by DPA method and 56 ± 5 mg percent by TBA (thiobarbituric acid assay) method. Age and sex showed no influence on serum sialic acid level. Objectives of the present study was to compare (TSSA) level in healthy subjects, subjects with (CMP) with and without (NIDDM) and its effect on non-surgical periodontal therapy. In the present study, the participants were divided into three groups: Group A, B and C. Group A consists of systemically healthy subjects, Group B consists of subjects with (CMP) while Group C consists of subjects with (CMP) with (NIDDM) and results of this study indicated that, at baseline, there were significant differences between Group A, B and Group C with respect to all the clinical parameters, including (GI), (OHI-S), (PPD), (CAL), (TSSA) and (HbA1c) levels. Thus (TSSA) level could be considered as novel biomarker in the progression of periodontal disease and diabetic status. Periodontitis could be considered as a potential, modifiable, and independent risk factor for the development of diabetes. Early detection of elevated (TSSA) level may help in interpreting the progression of periodontitis, risk of development of diabetes mellitus in future and also to prevent complications.

Malignant Transformation of Hypertrophic Lichen Planus in a Young Pregnant Woman: A Case Report

In this article, we report a case of hypertrophic lichen planus transforming into cutaneous squamous cell carcinoma in a 24-year-old Indian woman at 34 weeks of gestational age. We hypothesize that immunologic alterations during pregnancy could transform a long-standing hypertrophic lichen planus into cutaneous neoplasm.

OS12.4 In vivo dynamics and targeting of vessel co-option in glioma

BACKGROUND

Gliomas comprise heterogeneous malignant glial and stromal cells. While blood vessel co-option is a potential mechanism to escape anti-angiogenic therapy, the relevance of glial phenotype in this process is unclear.

MATERIAL AND METHODS

Here, we intravitally study preclinical syngenetic models of glioma as well as patient-derived cells transplanted orthotopically. Moreover, we profoundly confirm our preclinical results with histological studies on patient specimens.

RESULTS

We show that Olig2+ oligodendrocyte precursor-like glioma cells invade by single-cell vessel co-option and preserve the blood-brain barrier (BBB). Conversely, Olig2-negative glioma cells form dense perivascular collections and promote angiogenesis and BBB breakdown, leading to innate immune cell activation. Experimentally, Olig2 promotes Wnt7b expression, a finding that correlates in human glioma profiling. Targeted Wnt7a/7b deletion or pharmacologic Wnt inhibition blocks Olig2+ glioma single-cell vessel co-option and enhances responses to temozolomide. Finally, Olig2 and Wnt7 become upregulated after anti-VEGF treatment in preclinical models and patients.

CONCLUSION

Here, we show that glioma is able to employ vessel co-option, i.e. the movement of tumor cells towards and along the pre-existing vasculature.

Glioma oligodendrocyte-like (OPCL) cells express Wnt7 that is necessary for vessel co-option and Wnt inhibitors significantly improve survival with temozolomide. Moreover, we demonstrated that anti-VEGF-treatment of glioma selects for Olig2/Wnt7+ cells