Oral rehydration therapy versus intravenous rehydration therapy in the first 12 h following hospitalization for hyperemesis gravidarum: A randomized controlled trial

OBJECTIVE

To evaluate oral rehydration therapy (ORT) compared with intravenous rehydration therapy (IVT) in the early inpatient management of hyperemesis gravidarum (HG).

METHODS

A total of 124 women hospitalized for HG from February 10, 2021 till January 6, 2023 were randomized to ORT (n = 61) or IVT (n = 63) for an initial 12 h. Inclusion criteria includes women older than 18 years, with a viable intrauterine pregnancy less than 14 weeks at their first hospitalization for HG with ketonuria of at least 2+. Primary outcomes were (1) satisfaction score with allocated intervention, (2) weight change, and (3) ketonuria change at 12 h. Secondary outcomes included vomiting frequency, nausea score, serial vital signs, hematocrit and electrolyte levels at 12 h, deviation from treatment protocol (cross-over therapy), participant recommendation of allocated treatment to a friend, and length of hospital stay.

RESULTS

Primary outcomes of (1) participant satisfaction score (on a 0-10 visual numerical rating scale) was 7 (interquartile range [IQR] 5-8) versus 9 (IQR 8-10), P < 0.001; (2) weight gain was 293 ± 780 g versus 948 ± 758 g, P < 0.001; and (3) ketonuria improvement was 50/61 (82.0%) versus 49/63 (77.8%) (relative risk [RR] 1.05, 95% confidence interval [CI] 0.88-1.26, P = 0.561) for ORT versus IVT, respectively. For secondary outcomes, vomiting frequency was 2.6 ± 2.7 versus 1.1 ± 1.4 episodes (P < 0.001), participant cross-over rate to opposing treatment 20/61 (32.8%) versus 0/63 (0%) (P < 0.001) (in the 12-h study period) and participant recommendation of allocated treatment to a friend rate 24/61 (39.3%) versus 61/63 (96.8%) (RR 0.41, 95% CI 0.30-0.56, P < 0.001) for ORT versus IVT, respectively. By hospital discharge, 31/61 (50.8%) of women allocated to ORT had required IVT. Other secondary outcomes of serial assessments of nausea score and vital signs, hematocrit and electrolyte levels, and length of hospital stay were not different.

CONCLUSIONS

ORT was inferior to IVT in two primary outcomes and three secondary outcomes. Cross-over rate to intravenous therapy from oral therapy was 50.8% by hospital discharge. Intravenous rehydration therapy should remain as first-line rehydration therapy in the early inpatient treatment of HG.

CLINICAL TRIAL REGISTRATION

The present study was registered in ISRCTN registry on December 6, 2020 with trial identification number: ISRCTN 40152556 (https://doi.org/10.1186/ISRCTN40152556). The first participant was recruited on February 10, 2021.

An analog-AI chip for energy-efficient speech recognition and transcription

Models of artificial intelligence (AI) that have billions of parameters can achieve high accuracy across a range of tasks1,2, but they exacerbate the poor energy efficiency of conventional general-purpose processors, such as graphics processing units or central processing units. Analog in-memory computing (analog-AI)3-7 can provide better energy efficiency by performing matrix-vector multiplications in parallel on 'memory tiles'. However, analog-AI has yet to demonstrate software-equivalent (SWeq) accuracy on models that require many such tiles and efficient communication of neural-network activations between the tiles. Here we present an analog-AI chip that combines 35 million phase-change memory devices across 34 tiles, massively parallel inter-tile communication and analog, low-power peripheral circuitry that can achieve up to 12.4 tera-operations per second per watt (TOPS/W) chip-sustained performance. We demonstrate fully end-to-end SWeq accuracy for a small keyword-spotting network and near-SWeq accuracy on the much larger MLPerf8 recurrent neural-network transducer (RNNT), with more than 45 million weights mapped onto more than 140 million phase-change memory devices across five chips.

Genotypic characteristics of Uropathogenic Escherichia coli isolated from complicated urinary tract infection (cUTI) and asymptomatic bacteriuria-a relational analysis

Background

Uropathogenic Escherichia coli (UPEC) is the predominant agent causing various categories of complicated urinary tract infections (cUTI). Although existing data reveals that UPEC harboured numerous virulence determinants to aid its survival in the urinary tract, the reason behind the occurrence of differences in the clinical severity of uninary tract infections (UTI) demonstrated by the UPEC infection is poorly understood. Therefore, the present study aims to determine the distribution of virulence determinants and antimicrobial resistance among different phylogroups of UPEC isolated from various clinical categories of cUTI and asymptomatic bacteriuria (ASB) E. coli isolates. The study will also attempt a relational analysis of the genotypic characteristics of cUTI UPEC and ASB E. coli isolates.

Methods

A total of 141 UPEC isolates from cUTI and 160 ASB E. coli isolates were obtained from Universiti Malaya Medical Centre (UMMC). Phylogrouping and the occurrence of virulence genes were investigated using polymerase chain reaction (PCR). Antimicrobial susceptibility of the isolates to different classes of antibiotics was determined using the Kirby Bauer Disc Diffusion method.

Results

The cUTI isolates were distributed differentially among both Extraintestinal Pathogenic E. coli (ExPEC) and non-ExPEC phylogroups. Phylogroup B2 isolates were observed to possess the highest average aggregative virulence score (7.17), a probable representation of the capability to cause severe disease. Approximately 50% of the cUTI isolates tested in this study were multidrug resistant against common antibiotics used to treat UTI. Analysis of the occurrence of virulence genes among different cUTI categories demonstrated that UPEC isolates of pyelonephritis and urosepsis were highly virulent and had the highest average aggregative virulence scores of 7.80 and 6.89 respectively, compared to other clinical categories. Relational analysis of the occurrence of phylogroups and virulence determinants of UPEC and ASB E. coli isolates showed that 46.1% of UPEC and 34.3% of ASB E. coli from both categories were distributed in phylogroup B2 and had the highest average aggregative virulence score of 7.17 and 5.37, respectively. The data suggest that UPEC isolates which carry virulence genes from all four virulence genes groups studied (adhesions, iron uptake systems, toxins and capsule synthesis) and isolates from phylogroup B2 specifically could predispose to severe UTI involving the upper urinary tract. Therefore, specific analysis of the genotypic characteristics of UPEC could be further explored by incorporating the combination of virulence genes as a prognostic marker for predicting disease severity, in an attempt to propose a more evidence driven treatment decision-making for all UTI patients. This will go a long way in enhancing favourable therapeutic outcomes and reducing the antimicrobial resistance burden among UTI patients.

New development and photocatalytic performance and antimicrobial activity of α-NH4(VO2)(HPO4) nanosheets

α-NH₄(VO₂)(HPO₄) nanosheets were developed by hydrothermal method. Furthermore, it's determined by the several analyses like XRD, Raman, FESEM, TEM, UV-Visible spectroscopy, TGA and DRS UV-Visible spectroscopy studies. The orthorhombic crystalline phase of α-NH₄(VO₂)(HPO₄) nanosheets were recognized by XRD analysis. The α-NH₄(VO₂)(HPO₄) nanosheets functional groups identification was investigated by Raman spectroscopy. Thermal gravimetric analysis of α-NH₄(VO₂)(HPO₄) nanosheets were identified and its attain for three decomposition stages. The nanosheets of the α-NH₄(VO₂)(HPO₄) was clearly evaluated by FESEM and TEM measurements. α-NH₄(VO₂)(HPO₄) nanomaterial band gap energy was determined by DRS UV Visible spectroscopy analysis and the calculated bandgap energy is 1.83 eV. Hence, it was more convenient way for the dye degradation applications. These α-NH₄(VO₂)(HPO₄) nanosheets was will be tested in the photocatalytic and antimicrobial applications. In this case, antimicrobial study was not encouraged in the catalyst. Consequently, this material has more encouraging for electrostatic interaction with enhanced for the applications.

Arterioectatic Spinal Angiopathy of Childhood: Clinical, Imaging, Laboratory, Histologic, and Genetic Description of a Novel CNS Vascular Pathology

Pediatric patients with myelopathy expressing intradural spinal vascular ectasia without arteriovenous shunting were studied at four tertiary referral neuropediatric centers. Patients were identified by retrospective review of institutional records and excluded if spinal vascular pathology could be classified into a previously described category of spinal vascular malformation. Four patients meeting the study criteria were enrolled in the study. Clinical, magnetic resonance imaging, catheter-directed angiography, laboratory, histological and genetic data were analyzed to characterize the disease process and elucidate underlying pathomechanisms. Our study revealed a highly lethal, progressive multi-segmental myelopathy associated with a unique form of non-inflammatory spinal angiopathy featuring diffuse enlargement and tortuosity of spinal cord arteries, spinal cord hyperemia, and spinal cord edema (Arterioectatic Spinal Angiopathy of Childhood). The condition was shown to mimic venous congestive myelopathy associated with pediatric spinal cord arteriovenous shunts on MRI but to have distinct pathognomonic findings on catheter-directed angiography. Clinicopathological, genetic, and neuroimaging features, which are described in detail, closely overlap with those of mitochondrial disease.

Global popularization of CuNiO2 and their rGO nanocomposite loveabled to the photocatalytic properties of methylene blue

New advancements of photocatalytic activity with higher efficiency, low price are most important, which is challenging in industrialized and many fields. We have introduced CuNiO₂ and CuNiO₂/rGO nanocomposite was generally prepared by the hydrothermal treatment and tested to the photocatalytic studies. Photocatalytic measurements of CuNiO₂ with different weight percentages CuNiO₂/rGO (25/75), (50/50), and (75/25) are achieved to the efficiency under visible light, in this case, CuNiO₂/rGO (50/50) composite have the highest performance is scrutinized. This was obeyed for a synergistic effect between CuNiO₂ nanoparticles and rGO composites. Furthermore, the CuNiO₂, CuNiO₂/rGO (25/75), (50/50), and (75/25) nanocomposite were tested by several analyses like XRD, FT-IR, DRS UV Visible spectroscopy, Raman spectroscopy, and FESEM & HRTEM investigations. In this regard all measurements are very clear and satisfied; therefore we are encouraged for future developing environmental applications.

Okur-Chung neurodevelopmental syndrome-linked CK2α variants have reduced kinase activity

The Okur-Chung neurodevelopmental syndrome, or OCNDS, is a newly discovered rare neurodevelopmental disorder. It is characterized by developmental delay, intellectual disability, behavioral problems (hyperactivity, repetitive movements and social interaction deficits), hypotonia, epilepsy and language/verbalization deficits. OCNDS is linked to de novo mutations in CSNK2A1, that lead to missense or deletion/truncating variants in the encoded protein, the protein kinase CK2α. Eighteen different missense CK2α mutations have been identified to date; however, no biochemical or cell biological studies have yet been performed to clarify the functional impact of such mutations. Here, we show that 15 different missense CK2α mutations lead to varying degrees of loss of kinase activity as recombinant purified proteins and when mutants are ectopically expressed in mammalian cells. We further detect changes in the phosphoproteome of three patient-derived fibroblast lines and show that the subcellular localization of CK2α is altered for some of the OCNDS-linked variants and in patient-derived fibroblasts. Our data argue that reduced kinase activity and abnormal localization of CK2α may underlie the OCNDS phenotype.

CS/Au/MWCNT nanohybrid as an efficient carrier for the sustained release of 5-FU and a study of its cytotoxicity on MCF-7

The chemical reduction method has been used to adeptly synthesize a CS/Au/MWCNT nanocomposite, to be used as a carrier for the effectual delivery of the anticancer drug 5-Fluorouracil. The work aims at utilizing the less investigated ternary nanocomposite system containing chitosan (CS), gold (Au) and MWCNT's to attain higher encapsulation efficiency and to enable a more sustained and prolonged release of 5-FU. This system has improved cytotoxicity when compared to the CS/Au binary system. The prepared sample has been characterized using various techniques that confirm the formation of the nanocomposite, encapsulation of 5-FU into the nanocomposite, the structure of 5-FU and Au in the nanocomposite and the formation of the polymer matrix nanocomposite. An increase in the encapsulation efficiency to 98% and loading efficiency to 43% is observed when compared to the binary composite, elucidating the importance of incorporation of carbon nanotubes into the nanocomposite. A reduction in the release percentage of 5-FU by 40% indicates a more prolonged release, which will enable a reduction of the number of dosages that need to be administered. This in turn leads to a reduction in the side effects posed by the drug 5-FU. Moreover, the effectiveness of the drug loaded nanocomposite system towards the inhibition of breast cancer cells, apparent from the attainment of 50% cell viability while taking sample concentrations as low as 25 μg ml⁻¹, makes this ternary nanocomposite superior and significant.

The chemical reduction method has been used to adeptly synthesize a CS/Au/MWCNT nanocomposite, to be used as a carrier for the effectual delivery of the anticancer drug 5-Fluorouracil.

Enhanced Photocatalytic Performance of Sn6SiO8 Nanoparticles and Their Reduced Graphene Oxide (rGO) Nanocomposite

Photocatalysts provide excellent potential for the full removal of organic chemical pollutants as an environmentally friendly technology. It has been noted that under UV-visible light irradiation, nanostructured semiconductor metal oxides photocatalysts can degrade different organic pollutants. The Sn₆SiO₈/rGO nanocomposite was synthesized by a hydrothermal method. The Sn₆SiO₈ nanoparticles hexagonal phase was confirmed by XRD and functional groups were analyzed by FT-IR spectroscopy. The bandgap of Sn₆SiO₈ nanoparticles (NPs) and Sn₆SiO₈/GO composites were found to be 2.7 eV and 2.5 eV, respectively. SEM images of samples showed that the flakes like morphology. This Sn₆SiO₈/rGO nanocomposite was testing for photocatalytic dye degradation of MG under visible light illumination and excellent response for the catalysts. The enhancement of photocatalytic performance was mainly attributed to the increased light absorption, charge separation efficiency and specific surface area, proved by UV-vis DRS. Further, the radical trapping experiments revealed that holes (h⁺) and superoxide radicals (·O^-₂) were the main active species for the degradation of MG, and a possible photocatalytic mechanism was discussed.

Visible-Light Driven Effective Photocatalytic Degradation of Methylene Blue Dye Using Perforated Curly Zn0.1Ni0.9O Nanosheets

Herein, we report the facile synthesis, characterization and visible-light-driven photocatalytic degradation of perforated curly Zn_0.1Ni_0.9O nanosheets synthesized by hydrothermal process. The X-ray diffraction (XRD) and scanning electron microscopy (SEM) studies confirmed the cubic phase crystalline structure and growth of high density perforated curly Zn_0.1Ni_0.9O nanosheets, respectively. As a photocatalyst, using methylene blue (MB) as model pollutant, the synthesized nanosheets demonstrated a high degradation efficiency of ~76% in 60 min under visible light irradiation. The observed results suggest that the synthesized Zn_0.1Ni_0.9O nanosheets are attractive photocatalysts for the degradation of toxic organic waste in the water under visible light.

Facile Synthesis of Phase Tunable MoO₃ Nanostructures and Their Electrochemical Sensing Properties

MoO₃ nanostructures with tunable phases such as α-MoO₃, β-MoO₃ and their mixed phases were synthesized via a simple solid state decomposition method and employed as electrocatalyst for the detection of biomolecule. The phase and crystal structure of the synthesized MoO₃ nanostructures were confirmed through X-ray diffraction (XRD) studies. The MoO₃ nanostructures were also characterized by Fourier transform infrared spectroscopy (FT-IR), Raman spectroscopy, X-ray photoelectron spectroscopy (XPS), and UV-Vis spectroscopy for their structural, chemical state and optical properties, respectively. The observed results confirmed the successful formation of phase tunable MoO₃ nanostructures. The surface texture and morphology of the samples was characterized by field emission scanning electron microscopy (FE-SEM) and transmission electron microscopy (TEM). The obtained images showed the formation of hexagons, cubes and rods morphology of MoO₃. The synthesized MoO₃ nanostructures were used to modify the surface of glassy carbon electrode (GCE) to detect biomolecule (quercetin).

Cerebral white matter microstructural changes in isolated maxillofacial trauma and associated neuropsychological outcomes

Isolated traumatic maxillofacial injury without concomitant brain injury may cause delayed post-concussive symptoms. Early identification allows optimal diagnosis, prognostication, and therapeutic intervention. The aim of this prospective observational study was to investigate longitudinal microstructural changes of the white matter (WM) tracts based on diffusion tensor imaging (DTI) indices in patients with isolated maxillofacial injuries, immediately and 6 months post-trauma, and to correlate these DTI indices with neuropsychological changes observed. Twenty-one patients with isolated maxillofacial injuries and 21 age-matched controls were recruited. DTI was performed and indices were calculated for 50 WM tracts. The neuropsychological evaluation was done using the screening module of the Neuropsychological Assessment Battery. Patients were subjected to repeat DTI and neuropsychological evaluation at 6 months post-trauma. Reduced fractional anisotropy (FA) and increased median (MD) and radial diffusivity (RD) in the acute phase were seen in major association, projection, and commissural fibre bundles, indicative of vasogenic oedema. These changes correlated with attention and executive function deficits in the acute phase, as well as improvement in memory and visuospatial function in the chronic phase. Isolated maxillofacial trauma patients develop WM microstructural damage, which may impair cognitive performance acutely and over time. DTI indices can serve as predictive imaging biomarkers for long-term cognitive deficits in isolated maxillofacial injuries.

Enhanced Photocatalytic Behavior of (GO/Cu₂O) Composite with Cu₂O Being Synthesized Through Green Route

Graphene oxide/Cuprous oxide (GO/Cu₂O) composite is a visible light photocatalyst for the degradation of dyes. A simple and efficient approach for preparing GO/Cu₂O composite adopted in this study involves reducing cuprous oxide precursors in the presence of graphene oxide using an aqueous solution of pulp derived from banana fruit. The GO/Cu₂O composite was characterized by Fourier transform infrared spectroscopy (FT-IR), Diffused reflectance Ultraviolet visible spectroscopy (DRS UV-Vis), Raman spectroscopy and Field Emission Scanning electron microscopy (FE-SEM). Cu₂O particles were distributed randomly on the graphene oxide sheets due to the template effect of GO. The results showed higher photocatalytic activity for the composite (band gap 2.13 eV), for the degradation of the organic dyes (Methylene blue and Rhodamine-B). The enhanced photocatalytic activity is due to effective charge transfer from GO to Cu₂O, and high specific surface area which improves the effective separation of the generated electron-hole pairs. Our present study is inspired by a facile, low cost, green production of (GO/Cu₂O) composite whose photocatalytic activity can be extended to degradation of all other water-born textile dyes.

Fabrication of Ag@Co-Al Layered Double Hydroxides Reinforced poly(o-phenylenediamine) Nanohybrid for Efficient Electrochemical Detection of 4-Nitrophenol, 2,4-Dinitrophenol and Uric acid at Nano Molar Level

In this paper, Co-Al layered double hydroxides (LDHs), Co-Al LDHs/poly(o-phenylenediamine) (PoPD) and Ag nanoparticles decorated Co-Al LDHs/PoPD (Ag@Co-Al LDH/PoPD) samples were prepared. The as-prepared samples were characterized by XRD, Raman, XPS, FT-IR, DRS-UV-Vis, PL and TGA techniques. The salient features of morphology and size of the samples were determined using FESEM, and HR-TEM. Then, the samples were coated on glassy carbon electrode (GCE) and employed for sensing of 4-nitrophenol (4-NP), 2,4-dinitrophenol (2,4-DNP)) and uric acid (UA). It was found that Ag@Co-Al LDH/PoPD/GCE showed superior electrochemical sensing behaviour than other modified electrodes. It exhibits the detection limit (DL) of 63 nM, 50 nM and 0.28 µM for 4-NP, 2,4-DNP and UA respectively.

Bifunctional hexagonal Ni/NiO nanostructures: influence of the core-shell phase on magnetism, electrochemical sensing of serotonin, and catalytic reduction of 4-nitrophenol

Ni⁰/NiO (nickel/nickel oxide) core-shell nanostructures were synthesized through a facile combustible redox reaction. Remarkably, the hetero-phase boundary with different crystalline orientations offered dual properties, which helped in bifunctional catalysis. Presence of a metallic Ni phase changed physicochemical properties and some emerging applications (magnetic properties, optical conductivity, electrochemical sensitivity, catalytic behaviour) could be foreseen. Moreover, formation of a NiO layer on metal surface prevented magnetism-induced aggregation, arrested further oxidation by hindering oxygen diffusion, and acted as a good sorbent to enhance the surface adsorption of the analyte. Hexagonal Ni/NiO nanostructures manifested well-defined ferromagnetic behavior and the catalyst could be collected easily at the end of the catalytic reduction. Ni/NiO core-shell catalysts at the nanoscale had outstanding catalytic performance (reduction of 4-nitrophenol to 4-aminophenol) compared with pure NiO catalysts beyond a reaction time of ∼9 min. The estimated sensitivity, limit of detection and limit of quantification towards the electrochemical sensing of serotonin were 0.185, 0.43 and 1.47 μM μA^-1, respectively. These results suggest that a bifunctional Ni/NiO nanostructure could be a suitable catalyst for electrochemical detection of serotonin and reduction of 4-nitrophenol.

Role of extra oral monofocal distractor device in the correction of the facial asymmetry, sleep apnoea, and quality of life associated with TMJ ankylosis

OBJECTIVES

The purpose of this study is to evaluate the role of primary osteo-distraction prior to ankylosis release in patients, diagnosed with sleep apnoea, facial asymmetry, and reduced quality of life secondary to temporomandibular joint (TMJ) ankylosis.

METHODS

Ten patients in the age group of 13-40 years with TMJ ankylosis underwent primary osteo-distraction for mandibular advancement. They were evaluated pre- and post-operatively using radiographs, various questionnaires, and subjective evaluation of facial asymmetry, sleep apnoea, and quality of life (QOL).

RESULTS

All the ten patients showed significant improvement in their sleep apnoea symptoms with a mean of 6.20 ± 1.39 (P < 0.05). The mean advancement of the mandible in all the ten patients (both bilateral and unilateral ankylosis) was 15.8 mm (P < 0.05). The quality of life showed marked improvement from very poor to very satisfactory (P < 0.001).

CONCLUSION

Primary mandibular distraction is an effective method of correction of facial asymmetry, sleep apnoea, and quality of life in patients with TMJ ankylosis.

Signal and noise extraction from analog memory elements for neuromorphic computing

Dense crossbar arrays of non-volatile memory (NVM) can potentially enable massively parallel and highly energy-efficient neuromorphic computing systems. The key requirements for the NVM elements are continuous (analog-like) conductance tuning capability and switching symmetry with acceptable noise levels. However, most NVM devices show non-linear and asymmetric switching behaviors. Such non-linear behaviors render separation of signal and noise extremely difficult with conventional characterization techniques. In this study, we establish a practical methodology based on Gaussian process regression to address this issue. The methodology is agnostic to switching mechanisms and applicable to various NVM devices. We show tradeoff between switching symmetry and signal-to-noise ratio for HfO₂-based resistive random access memory. Then, we characterize 1000 phase-change memory devices based on Ge₂Sb₂Te₅ and separate total variability into device-to-device variability and inherent randomness from individual devices. These results highlight the usefulness of our methodology to realize ideal NVM devices for neuromorphic computing.

A strategy to promote the electroactive platform adopting poly(o-anisidine)-silver nanocomposites probed for the voltammetric detection of NADH and dopamine

A study on the voltammetric detection of NADH (β-nicotinamide adenine dinucleotide), Dopamine (DA) and their simultaneous determination is presented in this work. The electrochemical sensor was fabricated with the hybrid nanocomposites of poly(o-anisidine) and silver nanoparticles prepared by simple and cost-effective insitu chemical oxidative polymerization technique. The nanocomposites were synthesized with different (w/w) ratios of o-anisidine and silver by increasing the amount of o-anisidine in each, by keeping silver at a fixed quantity. The XRD patterns revealed the semi-crystalline nature of poly(o-anisidine) and the face centered cubic structure of silver. The presence of silver in its metallic state and the formation of nanocomposite were established by XPS analysis. Raman studies suggested the presence of site-selective interaction between poly(o-anisidine) and silver. HRTEM studies revealed the formation of polymer matrix type nanocomposite with the embedment of silver nanoparticles. The sensing performance of the materials were studied via cyclic voltammetry, differential pulse voltammetry and chronoamperometry techniques. Fabricated sensor with 3:1 (w/w) ratio of poly(o-anisidine) and silver exhibited good catalytic activity towards the detection of NADH and DA in terms of potential and current response, when compared to others. Several important electrochemical parameters regulating the performance of the sensor have been evaluated. Under the optimum condition, differential pulse voltammetry method exhibited the linear response in the range of 0.03 to 900μM and 5 to 270μM with a low detection limit of 0.006μM and 0.052μM for NADH and DA, respectively. The modified electrodes exhibited good sensitivity, stability, reproducibility and selectivity with well-separated oxidation peaks for NADH and DA in the simultaneous determination of their binary mixture. The analytical performance of the nanocomposite as an electrochemical sensor was also established for the determination of NADH in human urine and water samples and DA in pharmaceutical dopamine injections with satisfactory coverage.

Facile solvothermal decomposition synthesis of single phase ZnBi38O60 nanobundles for sensitive detection of 4-nitrophenol

We have developed the facile solvothermal decomposition route to fabricate a single phase zinc bismuthate (ZnBi₃₈O₆₀) binary composite nanostructure.

An atypical presentation of ACAD9 deficiency: Diagnosis by whole exome sequencing broadens the phenotypic spectrum and alters treatment approach

Acyl-CoA dehydrogenase 9 (ACAD9), linked to chromosome 3q21.3, is one of a family of multimeric mitochondrial flavoenzymes that catalyze the degradation of fatty acyl-CoA from the carnitine shuttle via β-oxidation (He et al. 2007). ACAD9, specifically, is implicated in the processing of palmitoyl-CoA and long-chain unsaturated substrates, but unlike other acyl-CoA dehydrogenases (ACADs), it has a significant role in mitochondrial complex I assembly (Nouws et al. 2010 & 2014). Mutations in this enzyme typically cause mitochondrial complex I deficiency, as well as a mild defect in long chain fatty acid metabolism (Haack et al. 2010, Kirby et al. 2004, Mcfarland et al. 2003, Nouws et al. 2010 & 2014). The clinical phenotype of ACAD9 deficiency and the associated mitochondrial complex I deficiency reflect this unique duality, and symptoms are variable in severity and onset. Patients classically present with cardiac dysfunction due to hypertrophic cardiomyopathy. Other common features include Leigh syndrome, macrocephaly, and liver disease (Robinson et al. 1998).

We report the case of an 11-month old girl presenting with microcephaly, dystonia, and lactic acidosis, concerning for a mitochondrial disorder, but atypical for ACAD9 deficiency. Muscle biopsy showed mitochondrial proliferation, but normal mitochondrial complex I activity. The diagnosis of ACAD9 deficiency was not initially considered, due both to these findings and to her atypical presentation. Biochemical assay for ACAD9 deficiency is not clinically available. Family trio-based whole exome sequencing (WES) identified 2 compound heterozygous mutations in the ACAD9 gene. This discovery led to optimized treatment of her mitochondrial dysfunction, and supplementation with riboflavin, resulting in clinical improvement.

There have been fewer than 25 reported cases of ACAD9 deficiency in the literature to date. We review these and compare them to the unique features of our patient. ACAD9 deficiency should be considered in the differential diagnosis of patients with lactic acidosis, seizures, and other symptoms of mitochondrial disease, including those with normal mitochondrial enzyme activities. This case demonstrates the utility of WES, in conjunction with biochemical testing, for the appropriate diagnosis and treatment of disorders of energy metabolism.

Chitosan stabilized Ag-Au nanoalloy for colorimetric sensing and 5-Fluorouracil delivery

Fluorescent CS/Ag-Au (chitosan/silver-gold) nanocomposite containing different weight percentage of Ag and Au was synthesized using the chemical reduction method. 5-Fluorouracil (5-FU) encapsulated nanocomposite was also synthesized and its cytotoxicity towards breast cancer cell lines (MCF-7) studied. The XRD pattern of the nanocomposite shows peaks of chitosan, silver and gold. The peaks corresponding to gold and silver indicate the face centered cubic structure of silver and gold nanoparticles. The polymer matrix nanocomposite structure with chitosan as the matrix and silver-gold as the filler phase is evident from the high resolution transmission electron microscopy (HRTEM) images and an increase in particle size from∼5nm to about 12nm is noticeable on encapsulation of 5-Fluorouracil (5-FU). The presence of fluorine in the case of 5-FU encapsulated nanocomposite and the presence of reflections corresponding to 5-FU in the SAED pattern confirms the encapsulation of 5-FU into the nanocomposite, which is also confirmed by elemental mapping. The presence of a single surface plasmon resonance (SPR) peak in the case of the nanocomposite in a position in between the SPR bands of pure silver and gold nanoparticles confirms the formation of Ag-Au alloy and the elemental mapping results obtained for the nanocomposite also supports the UV-vis results. The photoluminescence (PL) spectrum clearly shows an emission peak in the near infrared region (700-900nm), which makes the nanocomposite suitable for use in cellular imaging. The application of the nanocomposite as a colorimetric sensor was also studied and it was found to be useful for the specific detection of mercury (Hg) without much interference and the detection limit was found to be 5.0×10^-8M.

Human bronchial and parenchymal fibroblasts display differences in basal inflammatory phenotype and response to IL-17A

BACKGROUND

Chronic inflammation, typified by increased expression of IL-17A, together with airway and parenchymal remodelling are features of chronic lung diseases. Emerging evidence suggests that phenotypic heterogeneity of repair and inflammatory capacities of fibroblasts may contribute to the differential structural changes observed in different regions of the lung.

OBJECTIVE

To investigate phenotypic differences in parenchymal and bronchial fibroblasts, either in terms of inflammation and remodelling or the ability of these fibroblasts to respond to IL-17A.

METHODS

Four groups of primary fibroblasts were used: normal human bronchial fibroblast (NHBF), normal human parenchymal fibroblast (NHPF), COPD human bronchial fibroblast (CHBF) and COPD human parenchymal fibroblast (CHPF). Cytokine and extracellular matrix (ECM) expression were measured at baseline and after stimulation with IL-17A. Actinomycin D was used to measure cytokine mRNA stability.

RESULTS

At baseline, we observed higher protein production of IL-6 in NHPF than NHBF, but higher levels of IL-8 and GRO-α in NHBF. IL-17A induced a higher expression of GRO-α (CXCL1) and IL-6 in NHPF than in NHBF, and a higher level of IL-8 expression in NHBF. IL-17A treatment decreased the mRNA stability of IL-6 in NHBF when compared with NHPF. CHPF expressed higher protein levels of fibronectin, collagen-I and collagen-III than CHBF, NHBF and NHPF. IL-17A increased fibronectin and collagen-III protein only in NHPF and collagen-III protein production in CHBF and CHPF.

CONCLUSIONS AND CLINICAL RELEVANCE

These findings provide insight into the inflammatory and remodelling processes that may be related to the phenotypic heterogeneity of fibroblasts from airway and parenchymal regions and in their response to IL-17A.