Short-Term Memory Deficit Associates with miR-153-3p Upregulation in the Hippocampus of Middle-Aged Mice

The early stages of ageing are a critical time window in which the ability to detect and identify precocious molecular and cognitive markers can make the difference in determining a healthy vs unhealthy course of ageing. Using the 6-different object task (6-DOT), a highly demanding hippocampal-dependent recognition memory task, we classified a population of middle-aged (12-month-old) CD1 male mice in Impaired and Unimpaired based on their short-term memory. This approach led us to identify a different microRNAs expression profile in the hippocampus of Impaired mice compared to Unimpaired ones. Among the dysregulated microRNAs, miR-153-3p was upregulated in the hippocampus of Impaired mice and appeared of high interest for its putative target genes and their possible implication in memory-related synaptic plasticity. We showed that intra-hippocampal injection of the miR-153-3p mimic in adult (3-month-old) mice is sufficient to induce a short-term memory deficit similar to that observed in middle-aged Impaired mice. Overall, these findings unravel a novel role for hippocampal miR-153-3p in modulating short-term memory that could be exploited to prevent early cognitive deficits in ageing.

Predicting the Splash of a Drop Impacting a Thin Liquid Film

An experimental study is carried out to investigate droplet-film interactions when a drop impinges on a thin stagnant film of the same liquid. The impacting drop causes either liquid deposition or splash, consisting of prompt generation of secondary drops or a delayed process. By varying the drop diameter and impact velocity, measurements are made to characterize the phenomena using five different liquids that are chosen to cover a wide range of liquid properties (viscosity and surface tension). The drop impact dynamics are captured with a high-speed digital camera with real-time, high-resolution image processing. The drop-splash threshold is found to scale with inertial and viscous forces, or Reynolds number (Re), as well as capillary forces, as described by the balance of gravitational and interfacial tension forces, or Bond number (Bo); fluid properties are described by their Morton number (Mo). A correlation, functionally expressed as Re = ϕ(Bo,Mo), is devised to determine the splash/no-splash (or deposition) boundary, and the predictions for the splash/no-splash outcomes agree well with the experimental outcomes as well as those readily available in the literature.

Environmental remediation of hazardous pollutants using MXene-perovskite-based photocatalysts: A review

Photocatalysis utilizing semiconductors offer a cost-effective and promising solution for the removal of pollutants. MXene and perovskites, which possess desirable properties such as a suitable bandgap, stability, and affordability, have emerged as a highly promising material for photocatalytic activity. However, the efficiency of MXene and perovskites is limited by their fast recombination rates and inadequate light harvesting abilities. Nonetheless, several additional modifications have been shown to enhance their performance, thereby warranting further exploration. This study delves into the fundamental principles of reactive species for MXene-perovskites. Various methods of modification of MXene-perovskite-based photocatalysts, including Schottky junction, Z-scheme and S-scheme are analyzed with regard to their operation, differences, identification techniques and reusability. The assemblance of heterojunctions is demonstrated to enhance photocatalytic activity while also suppressing charge carrier recombination. Furthermore, the separation of photocatalysts through magnetic-based methods is also investigated. Consequently, MXene-perovskite-based photocatalysts are seen as an exciting emerging technology that necessitates further research and development.

High referral accuracy for oral cancers and oral potentially malignant disorders using telemedicine

OBJECTIVE

To evaluate the accuracy of MeMoSA®, a mobile phone application to review images of oral lesions in identifying oral cancers and oral potentially malignant disorders requiring referral.

SUBJECTS AND METHODS

A prospective study of 355 participants, including 280 with oral lesions/variants was conducted. Adults aged ≥18 treated at tertiary referral centres were included. Images of the oral cavity were taken using MeMoSA®. The identification of the presence of lesion/variant and referral decision made using MeMoSA® were compared to clinical oral examination, using kappa statistics for intra-rater agreement. Sensitivity, specificity, concordance and F1 score were computed. Images were reviewed by an off-site specialist and inter-rater agreement was evaluated. Images from sequential clinical visits were compared to evaluate observable changes in the lesions.

RESULTS

Kappa values comparing MeMoSA® with clinical oral examination in detecting a lesion and referral decision was 0.604 and 0.892, respectively. Sensitivity and specificity for referral decision were 94.0% and 95.5%. Concordance and F1 score were 94.9% and 93.3%, respectively. Inter-rater agreement for a referral decision was 0.825. Progression or regression of lesions were systematically documented using MeMoSA®.

CONCLUSION

Referral decisions made through MeMoSA® is highly comparable to clinical examination demonstrating it is a reliable telemedicine tool to facilitate the identification of high-risk lesions for early management.

Ex Situ In Vivo Technique of Spleen-Preserving Splenic Hilar Lymph Node Dissection in Operable Proximal Gastric Adenocarcinoma

D2 gastrectomy is the globally accepted standard surgical procedure for operable gastric cancer, and lymph node (LN) dissection is considered as the critical part of radical surgery and closely related to the prognosis. The splenic hilar LN (SHLN) or level 10 are to be removed during standard D2 total gastrectomy. In situ and ex situ spleen-preserving lymphadenectomies have been the most common dissection approaches for SHLNs. No study exists which compares the outcomes of these techniques in Indian population. This study is aimed to analyse the operative outcomes of ex situ in vivo technique of spleen-preserving splenic hilar lymph node dissection in patients who underwent D2 total gastrectomy for operable proximal gastric cancer in comparison with in situ in vivo technique of splenic hilar lymph node dissection. We reviewed prospectively collected data from 17 patients with operable proximal gastric cancer between September 2016 and April 2019 who underwent D2 total gastrectomy with splenic hilar lymph node dissection and studied the preoperative demographic factors, operative and postoperative outcomes comparing the different operative techniques. Patients with oesophago-gastric junction involvement, direct splenic or other adjacent organ invasion requiring multivisceral resection and gastric stump carcinoma were excluded. Overall, 17 patients underwent D2 total gastrectomy for operable gastric cancer. Mean age of presentation was 54.7 years including 13 males and 4 females. Five patients had middle third and 12 patients had upper third cancer. All patients had splenic hilar nodal clearance as follows: in situ - 14 and ex situ - 3 patients. R0 resection was achieved in all patients. Lymph node harvest tends to be higher with lower operative time and blood loss in patients with ex situ technique compared to in situ technique with similar morbidity. Ex situ in vivo technique of spleen-preserving splenic hilar lymph node dissection can be considered as both safe and feasible procedure for operable proximal gastric cancer patients in experienced centres to achieve better lymph node yield with no significant increase in morbidity.

Household Catastrophic Health Expenditure from Oral Potentially Malignant Disorders and Oral Cancer in Public Healthcare of Malaysia

OBJECTIVE

Oral cancer causes a significant disease burden and financial distress, especially among disadvantaged groups. While Malaysia has achieved universal health coverage via its highly subsidized public healthcare, patient and family expenditure for treatment of oral potentially malignant disorders (OPMD) and oral cancer remains a concern in the equitability of care. This study thus aims to estimate household out-of-pocket (OOP) expenditures and the extent of catastrophic healthcare expenditure (CHE) while identifying its predictors.

METHODS

This three-part study consists of a cross-sectional survey to collect sociodemographic and health utilization data of patients, a retrospective medical record abstraction to identify resources consumed, and cost modeling to simulate expenditures in two tertiary public hospitals. Loss of productivity was calculated based on absenteeism related to disease management in the hospital. OOP payments for transport, care in public healthcare facilities, and other healthcare expenditures were tallied. A CHE was defined as OOP spendings of more than 10% from total annual household income. Multivariable logistic regression was further applied to identify the association between sociodemographic factors and the incidence of CHE.

RESULTS

A total of 52 patients with OPMD and 52 with oral cancer were surveyed and medical records were abstracted. A Kruskal-Wallis test showed a statistically significant difference in OOP share over household income between OPMD, early- and late-stage cancer, χ2(2)=51.05, p<0.001, with the mean percentage of 9%, 22%, and 65% respectively. This study found that the prevalence of CHE in the first year of diagnosis was 86.5% for oral cancer and 19.2% for OPMD. Indian ethnicity (OR=6.24, p=0.046) and monthly income group 'less than USD 2,722' (OR=14.32, p=0.023) were shown as significant predictors for CHE.

CONCLUSIONS

Our study demonstrated the provision of subsidies may not be adequate to shield the more vulnerable group from CHE when they are diagnosed with OPMD and oral cancer.

Image collection and annotation platforms to establish a multi-source database of oral lesions

OBJECTIVE

To describe the development of a platform for image collection and annotation that resulted in a multi-sourced international image dataset of oral lesions to facilitate the development of automated lesion classification algorithms.

MATERIALS AND METHODS

We developed a web-interface, hosted on a web server to collect oral lesions images from international partners. Further, we developed a customised annotation tool, also a web-interface for systematic annotation of images to build a rich clinically labelled dataset. We evaluated the sensitivities comparing referral decisions through the annotation process with the clinical diagnosis of the lesions.

RESULTS

The image repository hosts 2474 images of oral lesions consisting of oral cancer, oral potentially malignant disorders and other oral lesions that were collected through MeMoSA^® UPLOAD. Eight-hundred images were annotated by seven oral medicine specialists on MeMoSA^® ANNOTATE, to mark the lesion and to collect clinical labels. The sensitivity in referral decision for all lesions that required a referral for cancer management/surveillance was moderate to high depending on the type of lesion (64.3%-100%).

CONCLUSION

This is the first description of a database with clinically labelled oral lesions. This database could accelerate the improvement of AI algorithms that can promote the early detection of high-risk oral lesions.

Barriers to early detection and management of oral cancer in the Asia Pacific region

Objective

Oral cancer is amenable to early detection but remains a prominent cause of mortality in the Asia Pacific region. This study aimed to identify barriers to early detection and management of oral cancer in the Asia Pacific region.

Methods

A mixed-methods approach was employed triangulating findings from a survey and focus groups. The survey was conducted among seven representative members of the Asia Pacific Oral Cancer Network (APOCNET) across six countries. Focus groups were conducted to gain deeper insights into the findings of the survey.

Results

The identified barriers were a lack of national cancer control strategies and cancer registries and the limited availability of trained health care professionals. Overcoming these challenges in the Asia Pacific region where resources are scarce will require collaborative partnerships in data collection and novel approaches for continuous professional training including eLearning. Further, to overcome the lack of trained health care professionals, innovative approaches to the management of oral potentially malignant lesions and oral cancer including telemedicine were suggested.

Conclusion

The findings of this study should be taken into account when charting national cancer control plans for oral cancer and will form the basis for future collaborative studies in evaluating effective measures to improve oral cancer detection and management in low- and middle-income countries.

Provider cost of treating oral potentially malignant disorders and oral cancer in Malaysian public hospitals

Oral cancer has been recognized as a significant challenge to healthcare. In Malaysia, numerous patients frequently present with later stages of cancers to the highly subsidized public healthcare facilities. Such a trend contributes to a substantial social and economic burden. This study aims to determine the cost of treating oral potentially malignant disorders (OPMD) and oral cancer from a public healthcare provider’s perspective. Medical records from two tertiary public hospitals were systematically abstracted to identify events and resources consumed retrospectively from August 2019 to January 2020. The cost accrued was used to estimate annual initial and maintenance costs via two different methods- inverse probability weighting (IPW) and unweighted average. A total of 86 OPMD and 148 oral cancer cases were included. The initial phase mean unadjusted cost was USD 2,861 (SD = 2,548) in OPMD and USD 38,762 (SD = 12,770) for the treatment of cancer. Further annual estimate of initial phase cost based on IPW method for OPMD, early and late-stage cancer was USD 3,561 (SD = 4,154), USD 32,530 (SD = 12,658) and USD 44,304 (SD = 16,240) respectively. Overall cost of late-stage cancer was significantly higher than early-stage by USD 11,740; 95% CI [6,853 to 16,695]; p< 0.001. Higher surgical care and personnel cost predominantly contributed to the larger expenditure. In contrast, no significant difference was identified between both cancer stages in the maintenance phase, USD 700; 95% CI [-1,142 to 2,541]; p = 0.457. A crude comparison of IPW estimate with unweighted average displayed a significant difference in the initial phase, with the latter being continuously higher across all groups. IPW method was shown to be able to use data more efficiently by adjusting cost according to survival and follow-up. While cost is not a primary consideration in treatment recommendations, our analysis demonstrates the potential economic benefit of investing in preventive medicine and early detection.

Complete resection of the iliac vascular system during pelvic exenteration: an evolving surgical approach to lateral compartment excision

Tumour infiltration of the lateral pelvic compartment has previously been associated with the highest rate of involved resection margins and carries significant risk of morbidity. In this study, consecutive patients undergoing pelvic exenteration at a single centre between 1994 and 2019 who required en bloc resection of the common or external iliac artery or vein were included.The results demonstrate that complete resection of the iliac vascular system, including resection and reconstruction of the common and external iliac vessels, can be performed safely during pelvic exenteration with oncological outcomes comparable to more central tumours.

Effect of varietal attributes on the adoption of an orange-fleshed sweetpotato variety in Upper East and Northern Ghana

Despite sustained economic growth and reduction in some of forms of malnutrition, Ghana still faces a national prevalence rate of 20.8% vitamin A deficiency (VAD) among for children 6-59 months old. Orange-fleshed sweetpotato (Ipomoea batatas L.) (OFSP) can significantly improve vitamin A intake and contribute toward reducing VAD, especially in Northern Ghana where VAD is 31% among young children. Several poverty and nutrition projects in Ghana have promoted the use of OFSP for its health benefits. This study assesses the effect of three varietial attributes on adoption of the first released OFSP variety in Northern Ghana namely, Apomuden. The study concluded that sweetness, taste and dry matter have joint significant effects on adoption of an OFSP variety. The positive and negative traits highlighted will inform the on-going breeding effort.

Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study

BACKGROUND

This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery.

METHODS

This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery.

RESULTS

A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498).

CONCLUSION

There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.

Influence of Ni Doping in SnO₂ Nanoparticles with Enhanced Visible Light Photocatalytic Activity for Degradation of Methylene Blue Dye

In this article, Nickel doped rutile structure tin oxide (SnO₂) nanoparticles have been prepared by simple chemical co-precipitation method and prepared samples were characterized by Powder X-ray Diffraction, Fourier transform infrared Spectroscopy, Microraman analysis, Photoluminescene Spectroscopy, UV-Visible Spectroscopy, Energy dispersive analysis and Field emission scanning electron microscope. XRD studies revealed the single phase tetragonal rutile structure with space group of P42/mnm. The average crystallite size of the particles was decreased from 27 to 22 nm with increasing Ni doping concentration. FTIR spectra confirmed the presence of various bands such as O-H, C-H, Sn-O-Sn. Raman modes E_g, A_1g and B_2g were assigned at 478, 630 and 740 cm^-1 which confirmed the single phase of pure and Ni doped SnO₂ nanoparticles. The photoluminescence spectra confirmed that the defect related emissions increased with increasing of Ni concentration. The UV absorption spectra showed that the absorption of the particles decreased with increasing Ni concentration and the band gap values decreased from 3.7 to 3.4 eV. EDX spectra confirmed the presence of Sn, Ni, O in pure and doped samples. The photocatalytic activity of the pure and Ni doped SnO₂ nanoparticles were analyzed by using methylene blue dye under visible light irradiation. It is concluded Ni (7%) doped SnO₂ nanoparticles have higher degradation efficiency compared to pure SnO₂ nanoparticles.

Type B choledochocele vs duodenal duplication cyst: a diagnostic dilemma and its management: a case report

INTRODUCTION

Duplication cyst of the alimentary tract is a rare congenital anomaly. Duodenal duplication cyst accounts for less than 5% overall. These entities rarely present in adults. They are often mistaken as choledochoceles. Management is most often complete excision, but it is individualized to the particular case.

CASE PRESENTATION

A 22-year-old woman was admitted to our hospital with a history of intermittent colicky right hypochondrial pain not relieved by any medications for the past 3 months. Initially, she was given proton pump inhibitors, but her pain was not relieved. Further evaluation was done, and preoperative imaging showed a cyst in the second part of the duodenum. Magnetic resonance imaging revealed it as a choledochocele, but duodenal duplication cyst was kept in the differential diagnosis. Further ultrasound identified it to be a duplication cyst. After failed endotreatment, the patient was successfully managed with partial excision and marsupialization.

CONCLUSION

Duodenal duplication cyst is uncommon and rarely diagnosed in adults. Duplications in the duodenum should always be a part of the differential diagnosis, especially in cystic lesions. Ultrasonogram of the cyst might lead to the proper diagnosis. Surgery is the treatment of choice if endotherapy is not successful.

Caudal regression syndrome in a fetus of a glucokinase-maturity-onset diabetes of the young pregnancy

BACKGROUND

Glucokinase-maturity-onset diabetes of the young (GCK-MODY) is a form of diabetes caused by heterozygous inactivating mutations in the GCK gene. Affected individuals maintain their fasting glucose levels at a higher set point (5.4-8.3 mmol/l) than the general population. Hyperglycaemia in women with Type 1 or Type 2 diabetes is known to confer increased risk of fetal congenital abnormalities. The association between GCK-MODY and congenital abnormalities, however, remains uncertain.

CASE REPORT

A 35-year-old woman in her third pregnancy was diagnosed with gestational diabetes at 13 weeks' gestation (fasting blood glucose 6.0 mmol/L, 1-h blood glucose 9.2 mmol/l, 2-h blood glucose 7.3 mmol/l). The morphology scan at 19+2 weeks' gestation showed a Type III sacral agenesis. The woman elected to terminate the pregnancy. Her postpartum oral glucose tolerance test was suggestive of GCK-MODY (fasting blood glucose 7.4 mmol/l, 1-h blood glucose 9.3 mmol/l, 2-h blood glucose 7.3 mmol/l). Mutation analysis of the GCK gene identified a novel heterozygous GCK missense mutation, p.V199M, classified as likely pathogenic, providing molecular confirmation of the suspected GCK-MODY diagnosis.

DISCUSSION

Sacral agenesis is a rare form of sacral abnormality affecting 0.005% to 0.1% of pregnancies. It is a subtype of the caudal regression sequence, a cardinal feature of diabetic embryopathy. This case raises the question as to whether hyperglycaemia in GCK-MODY may increase the risk of fetal caudal regression syndrome as reported in women with pre-existing diabetes mellitus. Improved diagnostic rates of GCK-MODY, and MODY registers that include pregnancy outcomes, are important to further elucidate risk of congenital abnormalities in GCK-MODY.

Hydronephrotic kidney with multiple extra-renal calyces

Extra-renal calyces are a rare anomaly of the renal collecting system, characterised by the presence of calyces and pelvis outside the renal parenchyma. It may also be associated with other anomalies, such as renal ectopia, fusion and malrotation. We describe an unusual case of extra-renal calyces with six long calyces arising from a suspected multicystic dysplastic kidney that was successfully managed laparoscopically.

RNA interference in mosquito: understanding immune responses, double-stranded RNA delivery systems and potential applications in vector control

RNA interference (RNAi) refers to the process of post-transcriptional silencing of cellular mRNA by the application of double-stranded RNA (dsRNA). RNAi strategies have been widely employed to regulate gene expression in plants and animals including insects. With the availability of the full genome sequences of major vector mosquitoes, RNAi has been increasingly used to conduct genetic studies of human pathogens in mosquito vectors and to study the evolution of insecticide resistance in mosquitoes. This review summarizes the recent progress in our understanding of mosquito-pathogen interactions using RNAi and various methods of dsRNA delivery in mosquitoes at different stages. We also discuss potential applications of this technology to develop novel tools for vector control.

Lithium Ion Conduction in PVdC-co-AN Based Polymer Blend Electrolytes Doped with Different Lithium Salts

Polymer electrolytes prepared by the complexation of lithium salts with poly(ethylene oxide) (PEO) and poly(vinylidene chloride-co-acrylonitrile) (PVdC-co-AN) will be of great use as separators in lithium polymer batteries. The amorphous nature of the blend electrolyte shows that the conductivity increases by the addition of lithium salts. The presence of C≡N and C=N in PVdC-co-AN are confirmed from the Fourier transform infrared studies. Among the various lithium salts studied, lithium trifluoro methane sulfonoimide [LiN(CF3SO2)2] based electrolyte exhibits the highest ionic conductivity of the order of 0.265 × 10−5 Scm−1 at room temperature. The sample having a maximum ionic conductivity PEO(80 wt%)/PVdC-co-AN(20 wt%)/LiN(CF3SO2)2(8 wt%) is supported by the lower optical band gap in UV-Visible analysis and low intensity in luminescence studies. Two and three dimensional topographic images of the above sample reveal the presence of micropores. Thermal stability of the prepared electrolytes is studied by thermo gravimetric/differential thermal analysis. Using differential scanning calorimetric analysis, the minimum glass transition temperature (30°C) is observed for the sample doped with LiN(CF3SO2)2. The cyclic voltammetric studies reveal the strong capacitive behavior of the prepared polymer electrolytes. The electrochemical stability windows for the prepared samples are observed using linear sweep voltammetry.

FT-IR and DSC studies of poly(vinylidene chloride-co-acrylonitrile) complexed with LiBF4

Poly(vinylidene chloride-co-acrylonitrile) (PVdC-co-AN) based solvent free electrolytes were prepared for different compositions of PVdC-co-AN and LiBF4 using solution casting technique. The ionic conductivity, thermal behavior, complexation and structure of polymer electrolytes have been investigated as a function of LiBF4 content at different weight ratios. DSC studies revealed that the glass transition temperature Tg decreases with the increase of salt concentration up to an optimum level. The change in the glass transition temperature (Tg) with respect to the LiBF4 concentration is reflected in the bulk resistance of the electrolytes and the sample containing 6 wt.% of LiBF4 exhibited minimum bulk resistance compared to other samples. FT-IR studies confirm the interaction of polymer and salt which is mainly between Li-cation and nitrogen atom of C≡N group. The crystalline phase of polymer host is completely changed on the addition of Li salt.

Primary antiphospholipid syndrome in monozygotic twins

Monozygotic twins, 27 years old, with primary anti-phospholipid syndrome have been described. The first of the twins had obstetric morbidities (one miscarriage at 12 weeks and premature birth of a growth-restricted fetus at 27 weeks secondary to pre-eclampsia) and the second had venous thrombosis. Lupus anticoagulant was present in both and anti-cardiolipin antibodies were present in high titres when re-tested at appropriate intervals. Development of clinical features of APS in monozygotic twins points to an underlying genetic basis in the pathogenesis of anti-phospholipid syndrome.