Sequential graph convolutional network and DeepRNN based hybrid framework for epileptic seizure detection from EEG signal

Automated epileptic seizure detection from ectroencephalogram (EEG) signals has attracted significant attention in the recent health informatics field. The serious brain condition known as epilepsy, which is characterized by recurrent seizures, is typically described as a sudden change in behavior caused by a momentary shift in the excessive electrical discharges in a group of brain cells, and EEG signal is primarily used in most cases to identify seizure to revitalize the close loop brain. The development of various deep learning (DL) algorithms for epileptic seizure diagnosis has been driven by the EEG's non-invasiveness and capacity to provide repetitive patterns of seizure-related electrophysiological information. Existing DL models, especially in clinical contexts where irregular and unordered structures of physiological recordings make it difficult to think of them as a matrix; this has been a key disadvantage to producing a consistent and appropriate diagnosis outcome due to EEG's low amplitude and nonstationary nature. Graph neural networks have drawn significant improvement by exploiting implicit information that is present in a brain anatomical system, whereas inter-acting nodes are connected by edges whose weights can be determined by either temporal associations or anatomical connections. Considering all these aspects, a novel hybrid framework is proposed for epileptic seizure detection by combined with a sequential graph convolutional network (SGCN) and deep recurrent neural network (DeepRNN). Here, DepRNN is developed by fusing a gated recurrent unit (GRU) with a traditional RNN; its key benefit is that it solves the vanishing gradient problem and achieve this hybrid framework greater sophistication. The line length feature, auto-covariance, auto-correlation, and periodogram are applied as a feature from the raw EEG signal and then grouped the resulting matrix into time-frequency domain as inputs for the SGCN to use for seizure classification. This model extracts both spatial and temporal information, resulting in improved accuracy, precision, and recall for seizure detection. Extensive experiments conducted on the CHB-MIT and TUH datasets showed that the SGCN-DeepRNN model outperforms other deep learning models for seizure detection, achieving an accuracy of 99.007%, with high sensitivity and specificity.

Calotropis procera (L.) mediated synthesis of AgNPs and their application to control leaf spot of Hibiscus rosa-sinensis (L.)

Abstract Nature is gifted with a wide range of ornamental plants, which beautify and clean the nature. Due to its great aesthetic value, there is a need to protect these plants from a variety of biotic and abiotic stresses. Hibiscus rosa-sinensis (L.) is an ornamental plant and it is commonly known as China rose or shoeblack plant. It is affected by several fungal and bacterial pathogens. Current study was designed to isolate leaf spot pathogen of H. rosa-sinensis and its control using silver nanoparticles (AgNPs). Based on molecular and morphological features, the isolated leaf spot pathogen was identified as Aspergillus niger. AgNPs were synthesized in the leaf extract of Calotropis procera and characterized. UV-vis spectral analysis displayed discrete plasmon resonance bands on the surface of synthesized AgNPs, depicting the presence of aromatic amino acids. Fourier transform infrared spectroscopy (FTIR) described the presence of C-O, NH, C-H, and O-H functional groups, which act as stabilizing and reducing molecules. X-ray diffraction (XRD) revealed the average size (~32.43 nm) of AgNPs and scanning electron microscopy (SEM) depicted their spherical nature. In this study, in vitro and in vivo antifungal activity of AgNPs was investigated. In vitro antifungal activity analysis revealed the highest growth inhibition of mycelia (87%) at 1.0 mg/ml concentration of AgNPs. The same concentration of AgNPs tremendously inhibited the spread of disease on infected leaves of H. rosa-sinensis. These results demonstrated significant disease control ability of AgNPs and suggested their use on different ornamental plants.

Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry

AIMS

The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation.

METHODS AND RESULTS

Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin.

CONCLUSION

The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.

Dynamic right ventricular structural and functional changes in acute decompensated heart failure, new insights from serum sST2 and speckle-tracking echocardiography imaging

Background

Right ventricular (RV) mechanics are affected by volume/pressure overload in acute decompensated heart failure (ADHF) which can be detected using biomarkers and echocardiography. ST2 (suppression of tumorigenicity 2) is a biomarker of myocardial fibrosis and remodeling, that has been studied in patients with ADHF. Although baseline serum soluble ST2 (sST2) values at ADHF admission have been proved to predict outcomes, serial measurements are even of greater value.

Purpose

To evaluate the right ventricular dynamic structural and functional changes in ADHF patients during hospitalization, using serum sST2 and speckle-tracking echocardiography imaging.

Methods

We prospectively enrolled 61 ADHF patients with LV ejection fraction less than 50% and serum NT-proBNP more than 900 pg/ml. All patients received intravenous diuretics and did not require inotropic support during hospital stay. Blood samples were collected to measure serum sST2 levels on hospital admission and discharge. All patients underwent serial conventional and speckle tracking echocardiography on admission, at 48 hours and on hospital discharge. RV speckle tracking echocardiography analysis was done using 2D Cardiac Performance Analysis version 4.6.

Results

Serum sST2 had significant strong positive correlation with serum NT-proBNP on admission (r=0.84, P<0.0001) and showed significant reduction from 2.47 (1.27–4.05) ng/ml on admission to 1.86 (1.06–3.24) ng/dl at hospital discharge (P<0.0001) denoting successful decongestion. There was significant decrease in inferior vena cava diameter (P<0.0001) and estimated pulmonary artery systolic pressure (EPASP) (P=0.002) throughout hospital stay, however this was not associated with significant change in RV dimensions (P>0.05) or contractility assessed by trans-annular plane systolic excursion (TAPSE) (P=0.09) and S-wave velocity at lateral tricuspid annulus (P=0.9). There was significant improvement in RV free wall strain (RVFWS) (P=0.005) assessed by speckle tracking echocardiography which was mainly noticed after the first 48 hours till discharge, but RV 4-chamber strain (RV4CS) did not change significantly (P=0.06).

Conclusions

RVFWS assessed by speckle tracking echocardiography can detect improvement in RV systolic function not detected by other conventional echocardiographic parameters in ADHF patients. Improvement in RVFWS together with decline in serum sST2 levels can be used as marker of improved cardiac mechanics and successful decongestion.

Funding Acknowledgement

Type of funding sources: None.

Seed priming with gibberellic acid induces high salinity tolerance in Pisum sativum through antioxidants, secondary metabolites and up-regulation of antiporter genes

Salinity is one of the major abiotic stresses that limit productivity of pulse crops all over the world. Seed priming with phytohormone(s) is one of the most promising, authentic and cost-effective methods to mitigate the deleterious effect of salinity. The study was conducted to investigate potential of seed priming with gibberellic acid (GA3 ) to cope up with the adverse effects of salinity (0, 100, 200 and 300 mm NaCl) in pea (Pisum sativum L.) seedlings. There were different responses to salinity, which induced oxidative stress, higher accumulation of Na+ in shoots and roots and inhibition of photosynthetic traits. However, seed priming with GA3 showed promising effects on physiological traits under salinity stress and alleviated the adverse effects of salinity by inducing the antioxidant system, proline production, total phenol and flavonoid content and regulating ion homeostasis, along with up-regulation of Na+ /H+ antiporters (SOS1 and NHX1). Plants adapt and prevent high salt accumulation by inducing expression of Na+ /H+  antiporter (SOS1 and NHX1) proteins that enhance Na+ sequestration. Thus, seed priming with GA3 is important in alleviation of high salinity stress and can be used as a criterion for developing salt-tolerant cultivars.

Deliberating Performance Targets: Follow-on workshop discussing PM10, NO2, CO, and SO2 air sensor targets

The use of air sensor technology is increasing worldwide for a variety of applications, however, with significant variability in data quality. The United States Environmental Protection Agency held a workshop in July 2019 to deliberate possible performance targets for air sensors measuring particles with aerodynamic diameters of 10 μm or less (PM10), nitrogen dioxide (NO2), carbon monoxide (CO), and sulfur dioxide (SO2). These performance targets were discussed from the perspective of non-regulatory applications and with the sensors operating primarily in a stationary mode in outdoor environments. Attendees included representatives from multiple levels of government organizations, sensor developers, environmental nonprofits, international organizations, and academia. The workshop addressed the current lack of sensor technology requirements, discussed fit-for-purpose data quality needs, and debated transparency issues. This paper highlights the purpose and key outcomes of the workshop. While more information on performance and applications of sensors is available than in past years, the performance metrics, or parameters used to describe data quality, vary among the studies reports and there is a need for more clear and consistent approaches for evaluating sensor performance. Organizations worldwide are increasingly considering, or are in the process of developing, sensor performance targets and testing protocols. Workshop participants suggested that these new guidelines are highly desirable, would help improve data quality, and would give users more confidence in their data. Given the wide variety of uses for sensors and user backgrounds, as well as varied sensor design features (e.g., communication approaches, data tools, processing/adjustment algorithms and calibration procedures), the need for transparency was a key workshop theme. Suggestions for increasing transparency included documenting and sharing testing and performance data, detailing best practices, and sharing data processing and correction approaches.

Digging out insights and behavioral correlates of false and true femininity in borderline personality disorder patients attending four-step integrative model group psychotherapy

Introduction

The four-step integrative model of psychotherapy is concerned with individual's needs, wants, rights and decisions in that order. It may carry a promise for deep and changing vision for patients with borderline personality disorder (BPD).

Objectives

The study of the illuminating and changing effect of dealing with BPD patients in view of their needs, wants, rights and decisions.

Aims

To evaluate the effect of group work through the hierarchy of the four-step integrative model with BPD patients and to help them explore false and true elements of their femininity.

Methods

Forty-three female patients (age range: 19-37) diagnosed according to DSM-IV diagnostic criteria for BPD were enrolled in a dynamic psychotherapy group. Their progress was evaluated using Borderline evaluation of severity over time (BEST) and they wrote down detailed comments about their experience quarterly.

Results

Results of regular attendants for 2 years were included (35 = 81.4%). The results of BEST showed a significant reduction of BPD severity at the end of 1 and 2 years. During psychotherapy sessions and within their quarterly comments, patients expressed their change in terms of moving from a state of cunning, manipulation, aggression, arrogance, envy and rejection (as stemming from their false femininity) into wisdom, confrontation, patience, pride, healthy competition and containment respectively (as stemming from their true femininity).

Conclusions

Patients with BPD may gain a better insight and genuine change as they realize what is false and what is true about their femininity in the context of attending four-step integrative model group psychotherapy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Expression analysis of genes associated with sucrose accumulation and its effect on source-sink relationship in high sucrose accumulating early maturing sugarcane variety

Sucrose synthesis/accumulation in sugarcane depends on the source-sink communication wherein source responds to sink demand for photoassimilate supply. Sucrose in stalk (sink) acts as signal, and sends feedback to restrain further synthesis of sucrose by regulating photosynthetic efficiency of leaves (source). Hence sucrose synthesis/accumulation is controlled by many genes and regulatory sequences including 3 invertases (SAI, CWI, NI), sucrose synthase (SuSy) and sucrose phosphate synthase (SPS). SPS and invertase play key role in enhancing sink strength which ultimately promotes greater sucrose accumulation in the sink tissues. In present study, a significant positive correlation was found between sucrose% of source and sink tissues which was greater in the top (R ² = 0.679) than middle (R ² = 0.580) and bottom (R ² = 0.518) internodes, depicting that sucrose accumulation in the stalk bears a direct relation with sucrose translocation efficiency from source. Results indicated an increased sucrose% with maturity, while reducing sugar content decreased with crop growth. qRT-PCR results exhibited an elevated expression of invertase in immature sink tissues depicting increased sink requirement, which declined with maturity. Similarly, increased PEP carboxylase gene expression as observed supported the fact that higher sink demand results in enhanced photosynthetic rate and thus influences the source activity. SPS was found active at initial stage of cane development indicating its role in sucrose synthesis. Thus by studying expression patterns of the different genes both, in source and sink tissues, a better understanding of the sucrose accumulation pathway in sugarcane is possible, which in turn can help in elucidating ways to enhance sucrose concentration in sink.

Implications of telomeres and telomerase in endometrial pathology

BACKGROUND

Eukaryotic chromosomal ends are linear and are protected by nucleoprotein complexes known as telomeres. The complex structural anatomy and the diverse functions of telomeres as well as the unique reverse transcriptase enzyme, telomerase that maintains telomeres are under intensive scientific scrutiny. Both are involved in many human diseases including cancer, but also in ageing and chronic disease such as diabetes. Their intricate involvement in many cellular processes and pathways is being dynamically deciphered in many organs including the endometrium. This review summarizes our current knowledge on the topic of telomeres and telomerase and their potential role in providing plausible explanations for endometrial aberrations related to common gynaecological pathologies.

OBJECTIVE AND RATIONALE

This review outlines the recent major findings in telomere and telomerase functions in the context of endometrial biology. It highlights the contemporary discoveries in hormonal regulation, normal endometrial regeneration, stem cells and common gynaecological diseases such as endometriosis, infertility, recurrent reproductive failure and endometrial cancer (EC).

SEARCH METHODS

The authors carried out systematic PubMed (Medline) and Ovid searches using the key words: telomerase, telomeres, telomere length, human telomerase reverse transcriptase, telomeric RNA component, with endometrium, hormonal regulation, endometrial stem/progenitor cells, endometrial regeneration, endometriosis, recurrent miscarriage, infertility, endometrial hyperplasia, EC and uterine cancer. Publications used in this review date from 1995 until 31st June 2016.

OUTCOMES

The human endometrium is a unique somatic organ, which displays dynamic telomerase activity (TA) related to the menstrual cycle. Telomerase is implicated in almost all endometrial pathologies and appears to be crucial to endometrial stem cells. In particular, it is vital for normal endometrial regeneration, providing a distinct route to formulate possible curative, non-hormonal therapies to treat chronic endometrial conditions. Furthermore, our current understanding of telomere maintenance in EC is incomplete. Data derived from other malignancies on the role of telomerase in carcinogenesis cannot be extrapolated to EC because unlike in other cancers, TA is already present in proliferating healthy endometrial cells.

WIDER IMPLICATIONS

Since telomerase is pivotal to endometrial regeneration, further studies elucidating the role of telomeres, telomerase, their associated proteins and their regulation in normal endometrial regeneration as well as their role in endometrial pathologies are essential. This approach may allow future development of novel treatment strategies that are not only non-hormonal but also potentially curative.

Stress perceived by houseman in a hospital in northern Malaysia

INTRODUCTION

Being a houseman in Malaysian hospitals can be very stressful. Stress can affect decision making to a great extent while addressing the needs of the patient in an emergency setting. This necessitated a study to find out the main sources of stress among housemen.

METHODS

This was a cross-sectional descriptive study carried out among 55 housemen using a questionnaire on sources of stress. The data was analysed using SPSS version 17.

RESULTS

A total of 16 factors leading to stress were studied among the housemen. Poor work and social life balance, annoying non-clinical personnel and medico-legal threats were among the top causes of stress.

CONCLUSION

The factors leading to stress among housemen should be considered for effective working of the hospital and improving the workplace atmosphere for the housemen.

Evaluation of recruitment methods for a trial targeting childhood obesity: Families for Health randomised controlled trial

BACKGROUND

Recruitment to trials evaluating the effectiveness of childhood obesity management interventions is challenging. We report our experience of recruitment to the Families for Health study, a randomised controlled trial evaluating the effectiveness of a family-based community programme for children aged 6-11 years, versus usual care. We evaluated the effectiveness of active recruitment (contacting eligible families directly) versus passive recruitment (informing the community through flyers, public events, media).

METHODS

Initial approaches included passive recruitment via the media (newspapers and radio) and two active recruitment methods: National Child Measurement Programme (letters to families with overweight children) and referrals from health-care professionals. With slow initial recruitment, further strategies were employed, including active (e.g. targeted letters from general practices) and passive (e.g. flyers, posters and public events) methods. At first enquiry from a potential participant, families were asked where they heard about the study. Further quantitative (questionnaire) and qualitative data (one-to-one interviews with parents/carers), were collected from recruited families at baseline and 3-month follow-up and included questions about recruitment.

RESULTS

In total, 194 families enquired about Families for Health, and 115 (59.3 %) were recruited and randomised. Active recruitment yielded 85 enquiries, with 43 families recruited (50.6 %); passive recruitment yielded 99 enquiries with 72 families recruited (72.7 %). Information seen at schools or GP surgeries accounted for over a quarter of enquiries (28.4 %) and over a third (37.4 %) of final recruitment. Eight out of ten families who enquired this way were recruited. Media-led enquiries were low (5 %), but all were recruited. Children of families recruited actively were more likely to be Asian or mixed race. Despite extensive recruitment methods, the trial did not recruit as planned, and was awarded a no-cost extension to complete the 12-month follow-up.

CONCLUSIONS

The higher number of participants recruited through passive methods may be due to the large number of potential participants these methods reached and because participants may see the information more than once. Recruiting to a child obesity treatment study is complex and it is advisable to use multiple recruitment strategies, some aiming at blanket coverage and some targeted at families with children who are overweight.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN45032201 (Date: 18 August 2011).

Magnetic resonance imaging features of hip disorders in an Egyptian pediatric population

Hip disorders in a pediatric population are a diagnostic challenge. The aim of the study is to assess the role of magnetic resonance imaging (MRI) in the evaluation of non-traumatic hip disorders in a series of Egyptian patients and to review the literature on the most common hip conditions. Seventy two consecutive patients [40 males (55.6%) and 32 females (44.4)] with acute onset of hip complaints unrelated to trauma or falls were recruited. All patients underwent an initial full clinical assessment and blood tests as well as contrast enhanced MRI of both hips. The most common diagnosis in this group of Egyptian patients was transient synovitis in 29 (40.3%) cases, followed by seronegative enthesopathy and arthropathy syndrome in 8 (11.1%), septic arthritis in 10 (13.9%), tuberculous arthritis in 4 (5.6%), sickle-cell disease in 7 (9.7%), complicated with septic arthritis in 3 (4.2%), transient bone marrow edema (BME) in 3 (4.2%), osteomyelitis in 2 (2.8%), osteosarcoma in 2 (2.8%), sciatic nerve injury in 1 (1.4%), leukemia with BME in 1 (1.4%), coxa vara of both hips and L5/S1 facet joint ankylosis in 1 (1.4%), and a benign bone cyst in 1 (1.4%). MRI studies showed hip effusion in a total of 51 patients (70.8%), joint space narrowing in 9 (12.5%), and BME in 15(20.8%). MRI is a sensitive tool for assessing hip disorders in a pediatric population and can play an important role in both diagnosis and management of different hip disorders, irrespective of the underlying pathology.

Genetics of human isolated hereditary nail disorders

Human hereditary nail disorders constitute a rare and heterogeneous group of ectodermal dysplasias. They occur as isolated and/or syndromic ectodermal conditions where other ectodermal appendages are also involved, and can occur associated with skeletal dysplasia. 'Nail disorder, nonsyndromic congenital' (OMIM; Online Mendelian Inheritance in Man) is subclassified into 10 different types. The underlying genes identified thus far are expressed in the nail bed and play important roles in nail development and morphogenesis. Here, we review the current literature on nail disorders and present a coherent review on the genetics of nail disorders. This review will pave the way to identifying putative genes and pathways involved in nail development and morphogenesis.

A systematic review and meta-analysis comparing intravitreal ranibizumab with bevacizumab for the treatment of myopic choroidal neovascularisation

Intravitreal injections of ranibizumab (IVR) and bevacizumab (IVB) have both been used as treatments for myopic choroidal neovascularisation. We aimed to produce a meta-analysis of published literature comparing IVR with IVB for the treatment of myopic choroidal neovascularisation, by searching electronic databases from January 1950 to March 2013. Our search produced three suitable studies that reported on 117 patients in total. The results of the meta-analysis demonstrated that the mean number of lines improvement after IVR appeared better compared with IVB [fixed effects model: SMD = 0.46, 95% CI (0.09, 0.83), z = 2.44, p = 0.01]. The number of patients who had a greater than 3 line improvement was similar between groups [fixed effects model: RR = 0.95, 95% CI (0.67, 1.32), z = 0.33, p = 0.74]. At follow up there was no difference in number of those who had an absence of leakage [fixed effects model: RR = 1.04, 95% CI (0.93, 1.16), z = 0.64, p = 0.52]. There was no statistical significance between the two groups in relation to the number of injections [random effects model: SMD = −0.25, 95% CI (−1.12, 0.61), z = 0.57, p = 0.57]. Early evidence therefore suggests that intravitreal injections of ranibizumab are comparable to intravitreal injections of bevacizumab in the treatment of myopic choroidal neovascularisation. Both treatments result in a statistically significant increase in visual acuity with high numbers of patients maintaining stable vision. Further studies are still needed to strengthen results.

Facilitating and securing offline e-medicine service through image steganography

E-medicine is a process to provide health care services to people using the Internet or any networking technology. In this Letter, a new idea is proposed to model the physical structure of the e-medicine system to better provide offline health care services. Smart cards are used to authenticate the user singly. A very unique technique is also suggested to verify the card owner's identity and to embed secret data to the card while providing patients' reports either at booths or at the e-medicine server system. The simulation results of card authentication and embedding procedure justify the proposed implementation.

Twenty-Four-Month Results of Intravitreal Bevacizumab in Macular Edema Secondary to Branch Retinal Vein Occlusion

PURPOSE

The aim of this study is to evaluate the long-term efficacy of intravitreal bevacizumab (IVB) in macular edema (ME) due to branch retinal vein occlusion (BRVO) in a real clinical practice setting at a tertiary referral center.

METHODS

A retrospective analysis of a final total number of 35 eyes of 35 patients with a 24-month follow-up was performed.

RESULTS

At 24 months, mean best-corrected visual acuity improved by 0.09 LogMAR units from baseline (95% CI: -0.03-0.24, p = 0.0674). The mean CFT decreased by 75 microns (95% CI: 27-123, p = 0.0026). The median number of injections was 6 (IQR: 3-9). Macular edema showed complete resolution in 12 eyes (34.3%), responded partially in six eyes (17%), recurred in eight eyes (23%), and remained persistent in nine eyes (25.7%, three eyes at six months, one eye at 12 months, three eyes at 18 months and two eyes at 24 months).

CONCLUSION

Our study shows that treatment with IVB in patients with ME due to BRVO during a period of 24 months provided complete resolution of the ME in more than one-third of patients. In one-third of the cases, ME resolved partially or recurred and in less than one-third of patients ME remained persistent. Visual acuity increased significantly in 23% of patients and remained stable in the majority of patients. However, a median number of six injections was necessary to maintain a lasting beneficial effect. Further long-term prospective studies are required comparing intravitreal bevacizumab with other treatment modalities.

Repellent effect of alphacypermethrin-treated netting against Bemisia tabaci (Hemiptera: Aleyrodidae)

For > 20 yr, Bemisia tabaci Gennadius persists as a begomovirus vector and is a serious problem in tomato production in many parts of the world. In tropical countries, the use of netting to protect horticultural crops has proven to be an effective and sustainable tool against Lepidoptera but not against small insects. This study evaluated the repellent effect of AgroNet 0.9T, a 0.9-mm pore diameter and 40-mesh size netting treated with alphacypermethrin insecticide against B. tabaci. This pyrethroid insecticide is known to have toxic and repellent effects against mosquitoes and has been used for treatment of mosquito nets. Two nontreated netting materials were used as control: AgroNet 0.9NT with 0.9-mm pore diameter and 40-mesh size and AgroNet 0.4NT with 0.4-mm pore diameter and 80-mesh size. The behavior of B. tabaci and its parasitoid Encarsia formosa Gahan as they progressed through the treated netting was studied in the laboratory in choice and no-choice tests. The development of wild B. tabaci population on tomato plants protected by the same nets was followed in two field trials implemented in Njoro, Kenya. Results obtained with the no-choice tests showed a significant reduction of movement on the treated net with 40-mesh (19%) compared with nontreated netting (35 and 46% with 80- and 40-mesh, respectively). The mortality of B. tabaci was significantly higher (two-fold) in the test tube containing only the treated netting compared with the nontreated one. The repellent effect of the treated netting was also demonstrated against E. formosa, but it did not have this toxic effect. Unlike for B. tabaci, the treated and nontreated nets appeared to have a similar repellent effect on E. formosa in the choice test, which suggests a learning behavior of the parasitoid. In both field tests, B. tabaci population was significantly lower on tomato protected by the treated net compared with the same nontreated net. However there was no significant difference in B. tabaci population between the treated 0.9-pore diameter and the nontreated 0.4-pore diameter. We discussed these findings and their implications for the use of repellent netting in integrated pest management in horticulture and more specifically in vegetable production.

Systematic review with network meta-analysis: pharmacological prophylaxis against post-ERCP pancreatitis

BACKGROUND

The efficacy of many pharmacological agents for preventing post-ERCP pancreatitis (PEP) has been evaluated in randomised controlled trials (RCTs), but it is unclear which agent(s) should be used in clinical practice. Network meta-analyses of RCTs are used to simultaneously compare several agents to determine their relative efficacy and identify priority agents for comparison in future RCTs.

AIM

To evaluate pharmacological agents for the prevention of PEP by conducting a network meta-analysis of RCTs.

METHODS

We searched MEDLINE, EMBASE and Cochrane Library databases for RCTs that evaluated the efficacy of agents for preventing PEP. RCTs were simultaneously analysed using random-effects network meta-analysis under the Bayesian framework to identify the best agents. The efficacy of agents was ordered according to the probability of being ranked as any of the top three best performing agents.

RESULTS

The network meta-analysis included 99 RCTs evaluating 16 agents in 25 313 patients. Topical epinephrine (adrenaline) was the most efficacious agent with 85.9% probability of ranking among the top three agents, followed by nafamostat (51.4%), antibiotics (44.5%) and NSAIDs (42.8%). However, in a sensitivity analysis including only rectal NSAIDs, NSAIDs moved from fourth rank to second (58.1%). Patients receiving topical epinephrine, compared with placebo, had a 75% reduced risk of PEP (OR 0.25, 95% probability interval 0.06-0.66).

CONCLUSIONS

Topical epinephrine and rectal NSAIDs are the most efficacious agents for preventing post-ERCP pancreatitis, based on existing RCTs. Combinations of these agents, which act on different steps in the pathogenesis of post-ERCP pancreatitis, should be evaluated in future trials.

Social isolation stress reduces hippocampal long-term potentiation: effect of animal strain and involvement of glucocorticoid receptors

BACKGROUND

Depressive patients show cognitive impairments that are strongly associated with cortisol levels and hippocampus functioning that interact via unknown mechanisms. In addition, a relation between depression and hippocampal synaptic plasticity was described.

METHODS

In the first experiment, strain-dependent effects of 72-h social isolation on long-term potentiation (LTP) in the CA1 area of the in vitro hippocampus, was determined. Extracellular field excitatory postsynaptic potentials were recorded and a brief high-frequency stimulation (100 Hz, 1s) was applied and recording resumed after the high frequency stimulation (HFS) for 30 min to determine the effect of HFS. In the second experiment we investigated the effect of 72 h of corticosterone treatment and the involvement of glucocorticoid receptors (GRs) in the effect of 72 h of social isolation on LTP in the CA1 area of hippocampus, in vitro.

RESULTS

Genetic background has a major effect on the level of hippocampal LTP impairment in mice following social isolation. Data showed that the potentiation levels in socially housed (SH) A/J mice were significantly higher than the SH C57BL/6J mice (224.88 ± 16.65, 131.56 ± 6.25% of the baseline values, t(9)=2.648, p=0.026). However, both strains showed depressed induction of potentiation when reared in an isolated environment for 72 h, and no significant difference was recorded between the two (112.88 ± 16.65%, and 117.91 ± 3.23% of the baseline values, respectively, t(10)=0.618, p=0.551). Social isolation increased corticosterone levels significantly and chronic corticosterone infusion in SH phenocopied the LTP impairments observed in socially isolated mice. Infusion of the GR antagonist RU38486 rescued the LTP-impairments following social isolation.

CONCLUSIONS

These findings support the notion that increased levels of stress hormone act via the GR on hippocampal functioning and that, in this way, the cognitive deficits in mood disorders may be restored.

A repellent net as a new technology to protect cabbage crops

Floating row covers or insect-proof nets with fine mesh are effective at protecting vegetable crops against aphids but negatively impact plant health, especially under warm conditions. Furthermore, in control of cabbage insect pests, aphid parasitoids cannot enter the fine-mesh nets, leading to frequent aphid outbreaks. To surmount these difficulties, a 40-mesh-size repellent net treated with alphacypermethrin was studied in laboratory and field tests. Results showed both irritant and repellent effects of the alphacypermethrin-treated net on Myzus persicae (Sulzer) (Hemiptera: Aphididae) and its parasitoid Aphidius colemani (Haliday) (Hymenoptera: Braconidae). Under field conditions, there were no pests on cabbage protected with the repellent net. The repellent net allowed combining a visual and repellent barrier against aphids. Because of this additive effect, repellent nets allowed covering cabbage permanently with adequate protection against all pests.

Treatment adherence with vildagliptin compared to sulphonylurea as add-on to metformin in Muslim patients with type 2 diabetes mellitus fasting during Ramadan

OBJECTIVE

To assess treatment adherence to dipeptidyl peptidase-4 inhibitor vildagliptin compared with sulphonylureas (SU) in Muslim patients with type 2 diabetes mellitus who were fasting during Ramadan in the UK.

RESEARCH DESIGN AND METHODS

This prospective, observational cohort study was conducted in four UK centres. Patients already taking vildagliptin (50 mg twice a day) or an SU as add-on therapy to metformin were followed up for ≤16 weeks. They were asked to record all missed doses of anti-diabetes medications.

RESULTS

Of the 72 patients enrolled (vildagliptin, n = 30; SU, n = 41; not allocated to treatment, n = 1), 59 (81.9%) completed the study (vildagliptin, n = 23; SU, n = 36), including one patient in the SU arm who completed but failed to provide information on missed doses; all patients in the SU arm were taking gliclazide. In the vildagliptin arm one patient (4.3%) missed a total of four doses while in the SU arm 10 patients (27.8%) missed a total of 266 doses (mean [SD] number of doses missed per patient: 26.6 [16.5]). The mean (SD) proportions of doses missed during fasting were 0.2% (0.9) and 10.4% (21.7) in the vildagliptin and SU arms, respectively, with a significant mean between-group difference of -10.2% (95% CI: -19.3%, -1.1%; p = 0.0292). There were no patients in the vildagliptin arm who missed more than 20% of OAD doses compared with 19.4% in the SU arm (p = 0.0358). Of the patients receiving an SU, 15 (42%) collectively reported 34 hypoglycaemic events (HEs) and one grade 2 HE; of these, fewer were non-adherent (n = 6, 40%) than adherent (n = 9, 60%). No patients reported HEs in the vildagliptin arm.

CONCLUSION

During Ramadan fasting, treatment with vildagliptin resulted in better treatment adherence compared with SU in Muslim patients with type 2 diabetes mellitus. Study limitations are the sample size and the lack of diet and exercise data.

Production of melanin pigment from Pseudomonas stutzeri isolated from red seaweed Hypnea musciformis

Hypnea musciformis red seaweed is popularly known to produce carrageenan was collected from the Gulf of Mannar, India. Strain HMGM-7 [MTCC 11712] was isolated from the surface of this seaweed, which was capable of producing an extracellular black-coloured polymeric pigment. Based on phenotypic characterization and 16S rDNA sequencing, the strain HMGM-7 was identified as Pseudomonas stutzeri. Biophysical characterization by UV-visible, FT-IR, EPR and XRD spectroscopic studies confirmed the pigment as melanin. Further chemical characterization showed that it was acid-resistant, alkali-soluble and alkali-insoluble in most of the organic solvents and distilled water. To our knowledge, this is a first report on a marine Pseudomonas stutzeri strain producing significant amounts of melanin of about 6·7 g l(-1) without L-tyrosine supplementation in the sea-water production medium.

SIGNIFICANCE AND IMPACT OF THE STUDY

This investigation reports a marine Pseudomonas stutzeri strain HMGM-7 [MTCC 11712] that produces significant quantities of melanin (6·7 g l(-1) ) in sea-water medium without the supplementation of L-tyrosine. The confirmation of the produced melanin was carried out by various chemical and physical characterization studies. The isolated melanin may find potential application for use in cosmetic and/or pharmaceutical industries.

Abstract 4947: Inhibition of Rapamycin induced AKT activation elicits differential anti-tumor response in head and neck cancers

The PI3K/AKT/mTOR pathway is an important signaling axis that is perturbed in majority of cancers. Biomarkers such as pS6RP, GLUT1 and tumor FDG uptake are being evaluated in patient stratification for mTOR pathway inhibitors. In the absence of a clear understanding of the underlying mechanisms in tumor signaling, the biomarker strategy for patient stratification is of limited use. Here, we show that no discernible correlation exists between FDG uptake and the corresponding Ki67, GLUT1, pS6RP expression in tumor biopsies from Head and Neck Cancer (HNC) patients. Correlation between GLUT1 and pS6RP levels in tumors was observed but elevated pS6RP was noticed even in the absence of concomitant AKT activation, suggesting other downstream molecules of PI3K/AKT and/or other pathways upstream of mTOR, are active in these tumors. Using an ex-vivo platform, we identified putative responders to Rapamycin, an mTOR inhibitor in these tumors. However, Rapamycin did not induce anti-tumor effect in the majority of tumors with activated mTOR, potentially attributable to the observation that Rapamycin induces feedback activation of AKT. Accordingly, treatment of these tumors with an AKT inhibitor and Rapamycin uniformly resulted in abrogation of mTOR inhibition induced AKT activation in all tumors but failed to induce anti-tumor response in a subset. Phosphoproteomic profiling of tumors resistant to dual AKT/mTOR inhibitors revealed differential activation of multiple pathways involved in proliferation and survival. Collectively, our data suggest that in addition to biomarker based segregation, functional assessment of patient tumor prior to treatment with mTOR/AKT inhibitors might be useful for patient stratification.

Citation Format: Padhma Radhakrishnan, Ulaganathan Baraneedharan, Muthu Dhandapani, Allen Thyakumar, Dency Pinto, Arun Prasath, Ayyappan Velu, A Kamal, Nilesh Brijwani, Rohini Nair, R Basavaraja, Misti Jain, Saravanan Thiyagarajan, Biswanath Majumder, Mallik Sundaram, Prasad Narayanan, Vikram D. Kekatpure, Pradip K. Majumder. Inhibition of Rapamycin induced AKT activation elicits differential anti-tumor response in head and neck cancers. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4947. doi:10.1158/1538-7445.AM2013-4947

Abstract 3191: Primary human tumor-derived Oncoprint platform predicts molecular mechanism of sensitivity and resistance to anti-EGFR in colorectal cancer: A step towards personalized cancer medicine

Colorectal cancer (CRC) continues to have a dismal prognosis (overall five year survival is 11%). Majority of patients with CRC are either over-treated or under-treated as there is no technology in use for predicting treatment outcome. Currently, monoclonal antibodies that target EGFR have been approved for the treatment of metastatic CRC. However, only 10% to 20% of patients with metastatic CRC clinically benefit from anti-EGFR therapy. This indicates that molecular alterations other than EGFR are associated with their response. The aim of the present study is to use Oncoprint- our integrated platform technology that combines functional assays with molecular profiling to predict the clinical outcome to anti-cancer agents including anti-EGFR therapies. Forty tumors were obtained from patients with primary CRC and local metastasis with due informed consent. Tumors were sectioned and cultured in customized 96 well plates coated with CRC specific extracellular matrix (ECM) in the presence of their respective autologous ligands and were treated with anti-EGFR agent. Pharmacodynamic analysis of anti-EGFR agents was determined by phospho-EGFR and phospho-ERK immunohistochemistry. Tumor cell viability was assessed by WST, cellular proliferation was measured by Ki-67 and cell death was assessed by TUNEL and activated caspase-3. Tumor cell content and tumor/stroma ratio was evaluated using histopathological analysis. Mutations of KRAS/BRAF pathway and global microarray data were used to understand the molecular basis of response and non-response to anti-EGFR in these patient tumors. Functional read-out from Oncoprint platform showed that 30% of these tumors are responsive to anti-EGFR treatment. Molecular profiling of these tumors showed that they were wild type for K-RAS and B-RAF. Microarray data also suggest that RAS gene signature is a predictor of response. Mutation of either KRAS (codon 12/13/61/146) or BRAF (V600E) confers non-response to anti-EGFR treatment. However, wild type KRAS/BRAF was observed in ∼40% of non-responders. RAS gene signature was conspicuously absent in these patients. Clinical follow-up of these patients is under progress. Collectively these findings indicate that there are factors other than K-RAS mutation that may be indicative of the true response or non-response of anti-EGFR treatments under clinical setting. Oncoprint platform may be able to predict the true clinical response of anti cancer therapies including anti-EGFR treatments. Further, molecular profiling of individual tumor along with the efficacy analyses by Oncoprint would be beneficial for the identification of driver mutations and the selection of appropriate treatment options for these patients.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3191. doi:1538-7445.AM2012-3191

Primary intravitreal ranibizumab for myopic choroidial neovascularisation

Myopic chorodial neovascularisation (mCNV) is an important cause of visual loss in high myopia with almost 10% of eyes with pathological myopia developing mCNV. Intravitreal anti-VEGF agents have recently been documented to be effective in mCNV. However, controversy exists regarding the optimal drug, its dose, and the frequency of administration. We performed a retrospective case review examining patients who had myopia of less than -6D and a chorodial neovascular membrane diagnosed on fundus fluorescein angiography (FFA) that were treated with 3 injections of ranibizumab (Lucentis) 5mg/0.05ml given at monthly intervals. The course was repeated if the ocular coherence tomography (OCT) continued to show intra-retinal oedema at review. We recorded logMAR visual acuities and central foveal thickness (CFT) at baseline and final review. Improvement in visual acuity was significantly improved (p = 0.049) by a mean of 0.24 logMAR (range 0 to 0.74). Every patient achieved at least visual stability. Mean CFT reduction was also significantly improved (p = 0.02) by a mean of 109 microns (range -8 to 198). Our series and current literature seem to support as primary treatment a standard dose of an anti-VEGF agent. Further, larger studies are required to clarify whether any particular injection strategy is clearly superior.

Preparation of niosomes as an ocular delivery system for naltrexone hydrochloride: physicochemical characterization

Recent reports have demonstrated that topical and systemic application of naltrexone markedly improves the characteristic signs of diabetic keratopathy; most notably, impaired corneal sensation and delayed wound repair. The aim of this study was to prepare and characterise non-ionic surfactant vesicles (niosomes) for the ocular drug delivery of naltrexone hydrochloride. The niosomes were prepared using the thin film hydration method and characterised using polarized light microscopy, cryo-scanning electron microscopy (Cryo-SEM), percent drug entrapment efficiency (EE %), laser light diffraction and differential scanning calorimetry (DSC). Two classes of non-ionic surfactants (sorbitan esters and polyoxyethylene alkyl ethers) were investigated. The results revealed that tuning of cholesterol concentrations can significantly alter the niosome's physical properties including sizes, EE% and membrane fluidity (thermo-responsiveness). The prepared vesicles were in the range of 7.0 +/- 1.0 to 14.6 +/- 0.8 microm in size. The prepared niosomes showed different abilities to accommodate cholesterol. This was highly dependent on the structure and continuity of the hydrophobic chains of the used surfactants. Span 60-based vesicles containing 30% mol/mol of cholesterol showed the highest EE%. The microstructure and lamellarity of the niosomes were studied using Cryo-SEM. Typical concentric multilayered structures (onion or rose-like) were seen suggesting the formation of multilamellar vesicles. DSC-studies conducted on Span 60-based niosomes containing 30% mol/mol cholesterol revealed liquid-gel transition (T(m) and entropy of 43.5 degrees C and 0.82 kcal/mol, respectively). Such transition reflects potential thermo-responsive properties, which is desirable for ocular delivery.

Midrapidity antiproton-to-proton ratio in pp collisons at sqrt[s]=0.9 and 7 TeV measured by the ALICE experiment

The ratio of the yields of antiprotons to protons in pp collisions has been measured by the ALICE experiment at sqrt[s]=0.9 and 7 TeV during the initial running periods of the Large Hadron Collider. The measurement covers the transverse momentum interval 0.45<p_{t}<1.05  GeV/c and rapidity |y|<0.5. The ratio is measured to be R_{|y|<0.5}=0.957±0.006(stat)±0.014(syst) at 0.9 TeV and R_{|y|<0.5}=0.991±0.005(stat)±0.014(syst) at 7 TeV and it is independent of both rapidity and transverse momentum. The results are consistent with the conventional model of baryon-number transport and set stringent limits on any additional contributions to baryon-number transfer over very large rapidity intervals in pp collisions.