Exorbitant signatures of pesticides and pharmaceuticals in municipal solid wastes (MSWs): Novel insights through risk analysis, dissolution dynamics, and model-based source identification

Studies on the occurrence and fates of emerging organic micropollutants (EOMPs) like pharmaceuticals and pesticides in MSWs are scarce in the literature. Therefore, MSWs were sampled from 20 Indian landfills and characterized for five widely consumed EOMPs (chlorpyrifos, cypermethrin, carbofuran, carbamazepine, and sodium diclofenac), physicochemical, and biological properties. The pesticide (median: 0.17-0.44 mg kg-1) and pharmaceutical (median: 0.20-0.26 mg kg-1) concentrations significantly fluctuated based on landfill localities. Eventually, principal component and multi-factor (MFA) models demonstrated close interactions of EOMPs with biological (microbial biomass and humification rates) and chemical (N, P, K, Ca, S, etc.) properties of MSWs. At the same time, the MFA resolved that EOMPs' fates in MSWs significantly differ from bigger cosmopolitan cities to smaller rural townships. Correspondingly, the concentration-driven ecological risks were high in 15 MSWs with EOMP-toxicity ranks of diclofenac > carbofuran = chlorpyrifos > cypermethrin > carbamazepine. The EOMPs' dissolution dynamics and source apportionments were evaluated using the positive matrix factorization (PMF) model for the first time on experimental data, extracting four anthropogenic sources (households, heterogeneous business centers, agricultural, and open drains). The most significant contribution of EOMPs to MSWs was due to heterogeneous business activity. Notably, the aging of soluble chemical fractions seems to influence the source characteristics of EOMPs strongly.

Impact of Age-related change in Caval Flow Ratio on Hepatic Flow Distribution in Fontan

Background

The Fontan operation is a palliative technique for patients born with single ventricle heart disease. The superior vena cava (SVC), inferior vena cava (IVC), and hepatic veins are connected to the pulmonary arteries in a total cavopulmonary connection by an extracardiac (EC) conduit or a lateral tunnel (LT) connection. A balanced hepatic flow distribution (HFD) to both lungs is essential to prevent pulmonary arteriovenous malformations and cyanosis. HFD is highly dependent on the local hemodynamics.

Objective

The effect of age-related changes in caval inflows on HFD was evaluated using cardiac MRI (CMR) data and patient-specific computational fluid dynamics (CFD) modeling.

Methods

SVC and IVC flow from 414 Fontan patients were collected to establish a relationship between SVC:IVC flow ratio and age. CFD modeling was performed in 60 (30 EC and 30 LT) patient models to quantify the HFD that corresponded to patient ages of 3, 8, and 15 years, respectively.

Results

SVC:IVC flow ratio inverted at ∼8 years of age, indicating a clear shift to lower body flow predominance. Our data showed that variation of HFD in response to age-related changes in caval inflows (SVC:IVC = 2,1, and 0.5 corresponded to ages 3, 8, and 15+ respectively) was not significant for EC but statistically significant for LT cohorts. For all three caval inflow ratios, a positive correlation existed between the IVC flow distribution to both the lungs and the HFD. However, as the SVC:IVC ratio changed from 2→0.5 (age 3→15+), the correlation's strength decreased from 0.87→0.64, due to potential flow perturbation as IVC flow momentum increased.

Conclusion

Our analysis provided quantitative insights into the impact of the changing caval inflows on Fontan's long-term HFD, highlighting the importance of including SVC:IVC variations over time to understand Fontan's long-term hemodynamics. These findings broaden our understanding of Fontan hemodynamics and patient outcomes.

Clinical Perspective

With improvement in standard of care and management of single ventricle patients with Fontan physiology, the population of adults with Fontan circulation is increasing. Consequently, there is a clinical need to comprehend the impact of patient growth on Fontan hemodynamics. Using CMR data, we were able to quantify the relationship between changing caval inflows and somatic growth. We then used patient-specific computational flow modeling to quantify how this relationship affected the distribution of long-term hepatic flow in extracardiac and lateral tunnel Fontan types. Our findings demonstrated the significance of including SVC:IVC changes over time in CFD modeling to learn more about the long-term hemodynamics of Fontan. Fontan surgical approaches are increasingly planned and optimized using computational flow modeling. For a patient undergoing a Fontan procedure, the workflow presented in this study that takes into account the variations in Caval inflows over time can aid in predicting the long-term hemodynamics in a planned Fontan pathway.

Characterization of Polycyclic Aromatic Hydrocarbons (PAHs) associated with fine aerosols in ambient atmosphere of high-altitude urban environment in Sikkim Himalaya

Polycyclic Aromatic Hydrocarbons (PAHs) compounds are ubiquitous in ambient air due to their persistence, carcinogenicity, and mutagenicity. Gangtok being one of the cleanest cities in India located in Eastern Himalayan region, witnesses high developmental activities with enhanced urbanization affecting the ambient air quality. The present study aims to measure PM_2.5 and PAHs in the ambient atmosphere of the Sikkim Himalaya to understand the influence of natural and anthropogenic activities on aerosol loading and their chemical characteristics. The PM_2.5 samples were collected and analysed for the duration from Jan 2020 to Feb 2021.The seasonal mean concentrations of PM_2.5 and PAHs were observed to be high during autumn and low during summer season. Overall, the annual mean concentration of PM_2.5 was found higher than the prescribed limit of World Health Organization and National Ambient Air Quality Standards. The concentration of the 16 individual PAHs were found to be highest during autumn season (55.26 ± 37.15 ng/m³). Among the different PAHs, the annual mean concentration of fluorene (3.29 ± 4.07 ng/m³) and naphthalene (1.15 ± 3.76 ng/m³) were found to be the highest and lowest, respectively. The Molecular Diagnostic Ratio (MDR) test reveals higher contribution from heavy traffic activities throughout the winter and autumn seasons. The other possible sources identified over the region are fossil fuel combustion, and biomass burning. The multivariate statistical analysis (Multifactor Principal Component Analysis) also indicates a strong association between PM_2.5 /PAHs and meteorological variables across the region in different seasons. The precipitation and wind pattern during the study period suggests that major contribution of the PM_2.5 and PAHs were from local sources, with minimal contribution from long-range transport. The findings are important for comprehending the trends of PAH accumulation over a high-altitude urban area, and for developing sustainable air quality control methods in the Himalayan region.

38. Effect of Chlorhexidine Rinsed Blood Contamination on Bond Strength of Brackets Bonded with Self-etch Primer- An in Vitro Study

The present invitro type of study has done to check the effect of blood contamination & chlorhexidine combination on the bond strength of brackets bonded with self-etch primer technique. The study consisted of ninety sound human upper premolars (extracted for orthodontic purpose) fixed in a self-cure acrylic block and segregated into three groups of 30 samples each. 0.022 slot metal MBT brackets (Gemini series-3M unitek) were bonded with self-etch primer using Transbond XT composite, CA, USA and light cure for 40 seconds) on clean buccal surface. Teeth were divided into 3 groups-Group A/Control group, Group B, Group C. A computer was used to record the force applied to debond the bonded bracket in the unit of Newton. The analysis of variance indicated that there were significant differences (F value = 6.891, p value=0.002) in bond strengths between the various groups tested. The highest value of shear bond strength occurred when chlorhexidine (Group C) was used to remove the blood contamination (mean=15.874 MPa). When bonding was done in ideal condition (Group A), shear bond strength obtained was slightly lower (mean=14.497 MPa) as compared to Group C. On the other hand, lowest shear bond strength among all three groups occurred when blood contamination (Group B) was removed with water (mean=11.059 MPa). Analysis of the study showed that shear bond strength of orthodontic brackets to enamel significantly decreased during bonding with self-etch primer in blood contamination condition. Self-etch primer displayed considerably superior performance with the use of chlorhexidine instead of water to wash the blood contamination.

Stability and numerical analysis of the generalised time-fractional Cattaneo model for heat conduction in porous media

This work investigates the generalised time-fractional Cattaneo model. The homotopy perturbation transform technique is used to get the numerical solution of this model. The stability is analysed using the Lyapunov function, also the error analysis is discussed. Finally, the effectiveness of the proposed technique is illustrated by calculating the L 2 and L ∞ error and comparing it with the existing techniques.

Combined strategy for tuning sensor-less brushless DC motor using SEPIC converter to reduce torque ripple

The brushless DC motor (BLDCM) is widely used in computer numerical control (CNC) machines, aerospace applications and auto industry applications in the field of robotics. But it is still affected by the transmission torque ripple, which mostly depends on the speed and the transient line current at the transmission interval. This manuscript proposes a combined approach for tuning sensor-less brushless DC (BLDC) motors using a single-ended primary-inductor converter (SEPIC). The proposed technique is a combination of Golden Eagle Optimization (GEO) and Radial Basis Function Neural Network (RBFNN), hence it is called GEO-RPFNN. The control of speed and torque is to reduce the torque ripple in the motor. Here, the modified bridgeless single-ended primary-inductor converter is proposed to improve speed and torque control. The proposed method is used to adjust the parameters of proportional integral derivative (PID) controller and to improve the performance of PID controller. Therefore, the GEO-RBFNN technique is proposed to recover the control loop function. The proposed algorithm is explored to control the speed and torque error as BLDC motor. Nevertheless, the output of the proposed approach is subject to the input of speed and torque controllers. The proposed method is executed in MATLAB Simulink site. The performance of the proposed system is compared with existing FA and PSO methods. As per the state of comparison outcomes, the GEO-RBFNN gives better result than the existing techniques which has higher ability to conquer the related issues. The THD in stator current, power factor and torque ripple gives the value using proposed method is 1.26%, 0.9951 and 7.4.

Ventricular-arterial coupling predicts outcomes in adults with a systemic right ventricle

Background

Patients with a systemic right ventricle (SRV) and biventricular circulation experience high incidence of cardiovascular morbidities and decreased survival [1]. Non-invasive measures of subclinical ventricular dysfunction are needed to appropriately identify patients at increased risk for adverse outcomes. Ventricular-arterial coupling (VAC), the ratio between the effective arterial elastance (Ea) and ventricular end-systolic elastance (Ees), may predict clinical outcomes in patients with SRV [2].

Objectives

To assess VAC in adults with SRV and evaluate its correlation with clinical outcomes.

Methods

Consecutive cardiovascular magnetic resonance (CMR) examinations of adults with D-loop transposition of great arteries (TGA) after atrial switch operation and L-loop TGA performed at Boston Children's Hospital between 2005 and 2019 were analyzed. VAC was calculated as Ea/Ees (Ea = mean arterial blood pressure (MBP)/ventricular stroke volume; Ees = MBP/end-systolic volume). Global myocardial strain was measured by feature tracking analysis on cine steady-state free precession sequences. Cox proportional hazards regression analysis was performed to assess the association of SRV functional parameters with clinical outcomes. The analysis was adjusted for age, sex, and body mass index. The primary outcome was defined as a composite of death, cardiovascular arrest, hospitalizations for heart failure (HF); the secondary outcome as atrial arrhythmias; the tertiary outcome included other causes of cardiovascular hospitalizations (percutaneous or surgical interventions, device implantation, other cardiovascular disease). Cumulative incidence of the study outcomes was estimated using Kaplan-Meier method.

Results

One hundred sixty-seven adults (mean age 32±10 years, 59% men) with SRV were analyzed. Patients with HF (n=48, 29%) had higher VAC values as compared to those without HF (1.4±0.8 vs. 1.1±0.5, p=0.01). Over a mean follow-up of 6.5±4.2 years, 15 over 139 patients (11%) experienced the primary outcome with an incidence rate of 1.7 per 100 patient-years (95% confidence interval (CI), 1.04–2.85). Higher VAC values were significantly associated with an increased risk of the primary outcome (p for trend = 0.01, Figure 1). VAC was the only functional parameter associated with the primary outcome (hazard ratio (HR) 1.99, 95% CI: 1.06–3.73, p=0.031), secondary outcome (HR 2.33, 95% CI: 1.12–4.82, p=0.023) and tertiary outcome (HR 1.63, 95% CI: 1.09–2.44, p=0.018) in the adjusted analysis (Table 1). Ejection fraction (EF) was not associated with the study outcomes in the adjusted analysis (p>0.05, Table 1) whereas global circumferential and radial strain showed an association limited to the tertiary endpoint (p=0.004, Table 1).

Conclusions

CMR-derived VAC is associated with adverse outcomes in SRV patients and may improve risk stratification of this unique population.

Funding Acknowledgement

Type of funding sources: None.

Numerical analysis of fractional coronavirus model with Atangana-Baleanu derivative in Liouville-Caputo sense

The novel coronavirus which emerged at the end of the year 2019 has made a huge impact on the population in all parts of the world. The causes of the outbreak of this deadliest virus in human beings are not yet known to the full extent. In this paper, an investigation is carried out for a new convergent solution of the time-fractional coronavirus model and a reliable homotopy perturbation transform method (HPTM) is used to explore the possible solution. In the presented model, the Atangana-Baleanu derivative in the Liouville-Caputo sense is used. The variations of the susceptible, the exposed, the infected, the quarantined susceptible (isolated and exposed), the hospitalized and the recovered population with time are presented through figures and are further discussed. The effects of selected parameters on the population with the time are also shown through figures. The convergence of solution by the HPTM is shown through tables. The results reveal that the HPTM is efficient, systematic, very effective, and easy to use in getting a solution to this new time-fractional mathematical model of coronavirus disease.

Targeting DJ-1 for cardioprotection

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The National Medical Research Council (NMRC)

Background

Additional protection beyond timely reperfusion is still needed as more patients who have survived an acute myocardial infarction (AMI) developed heart failure (HF)1. DJ-1 was recently reported as a cytoprotective protein that preserves mitochondrial complex I activity and subsequently inhibits mitochondrial reactive species (ROS) production2. DJ-1 downregulation dramatically increases the susceptibility to cell death after myocardial infarction in mice. A substantial reduction in total DJ-1 protein levels in left ventricular tissue has been identified in patients at the end-stage of human HF3, suggesting that DJ-1 protects the myocardium against AMI cell death and is essential in the remodelling process post-infarct. Purpose: The translation of cardioprotection to clinical practice has been difficult, and it remains a challenge between the bench and the bedside. Nanotechnology has shown significant improvements in the settings of AMI. Given the protective effect observed with DJ-1, we designed ND-13, a new cell-permeable 13- fragment of the DJ-1 amino acid sequence. Then, we loaded it into nanoparticles (ND-13NPs) to achieve cardioprotective outcomes against IRI. Methods: We tested the efficacy and efficiency of our new ND-13NPs to reduce infarct size in the ex vivo heart perfused IRI model and the in vivo AMI-murine model. Results: Naked ND-13 (20µM) continuously perfused for the first 15 minutes of reperfusion significantly improved LV pressure and systolic function. Afterwards, we tested 60 mg/Kg of the naked peptide injected 5 minutes before reperfusion in the in vivo model. ND-13 reduced 35% of the infarct size (non-treated, 49 ± 6.4% vs. treated, 32 ± 5 %). Fluorescently loaded ND-13NPs were intravenously injected into infarcted mice to assess their distribution in cardiac tissue. The ND-13NPs were abundantly detected in the infarct border and minimally detected in the remote myocardium. 20mg/Kg of ND-13 loaded into NPs reduced 45% the infarct size compared with 60mg/Kg and 20mg/Kg of naked ND-13 (27 ± 6% vs. 32 ± 5% and 44 ± 8%, respectively). We demonstrated that NPs improved the delivery and efficacy of ND-13 in the ischemic heart following AMI. We observed a robust antioxidative effect when the infarcted heart was treated with ND-13NPs (90 ± 1.5% vs 39 ± 9%, respectively). The activation of the myocardial reperfusion injury salvage kinase (RISK) and the survivor activating factor enhancement (SAFE) pathway at reperfusion protects the mitochondria against IRI. Therefore, we addressed whether ND-13NPs impact mitochondrial function. Can ND-13 protect beyond a cardioprotective pathway, or has the threshold of protection already been achieved by activating a direct effect on mitochondria? Conclusion: Intravenously injected ND-13NPs selectively accumulated in the infarct area and protects the myocardium from IRI via the ROS-mitochondria effect. This new drug may potentially bridge the gaps between basic and clinical research.

Service Evaluation of the Impact of Capnography on the Safety of Procedural Sedation

Background

Capnography has been associated with a reduced incidence of events related to respiratory compromise during procedural sedation.

Methods

A prospective service evaluation was conducted at a large United Kingdom (UK) teaching hospital to assess the impact of capnography on patient safety within four speciality services: bronchoscopy, endoscopy, interventional cardiology, and interventional radiology. Events were defined as provided by the World Society of Intravenous Anaesthesia. One thousand four hundred one patients were enrolled in the evaluation, with 666 patients before and 735 after implementation of capnography. Data was entered as a convenience sample on site in an offline data-collection tool. Results were assessed for the relative reduction in the incidence and resulting adjusted odds ratio for the combined incidence of oxygen desaturation (75–90% for <60s), severe oxygen desaturation (<75% at any time) or prolonged oxygen desaturation (<90% for >60s), bradycardia (>25% from baseline) and tachycardia (>25% from baseline). The adjusted odds ratio was controlled for both procedure and patient characteristics.

Results

After implementation of capnography, a significant reduction (43.2%, p ≤ 0.05) in adverse events was observed: 147 adverse events occurred during 666 procedures without capnography compared with 93 adverse events that occurred during 735 procedures with capnography. The adjusted odds ratio for the occurrence of the target adverse events was 0.57 (95% CI: 0.42–0.77). Multivariable linear regression indicated that capnography was a significant predictor (p 0.001) of reduced adverse events.

Conclusion

These results suggest improved patient safety following capnography implementation.

Cephalometric evaluation of the cervical spine posture following fixed functional therapy with Forsus™ appliance

BACKGROUND

To investigate whether fixed functional therapy for mandibular advancement with the Forsus™ appliance would produce any changes in the cervical spine posture.

MATERIALS AND METHODS

This prospective clinical exploratory study was conducted on 12 patients (six females and six males) with a mean age of 15 ± 1.3 years, having mandibular retrusion, Class II malocclusion, who were treated with the Forsus™ appliance. Lateral cephalogram was taken twice, once at the baseline (T1) before the commencement of the treatment and once following termination of fixed functional treatment (T2). Eleven measurements representing the vertical and the sagittal craniofacial proportions, and the head posture, were taken into account. Data were analyzed using SPSS version 22. The variations between before and after treatment measurements were collated using paired t-test. P < 0.05 was considered statistically significant.

RESULTS

No significant differences were noticed in the angle linking the horizontal lines of the head and the superior crest of the spinal column before and after the treatment, with P = 0.73. The cervical curvature angle also failed to show any significant difference with P = 0.14.

CONCLUSION

Fixed functional therapy with the Forsus™ device resulted in dentoalveolar and soft tissue alterations alone but did not alter the cervical spine posture.

Assessment of prescribing pattern of drugs and completeness of prescriptions as per the World Health Organization prescribing indicators in various Indian tertiary care centers: A multicentric study by Rational Use of Medicines Centers-Indian Council of Medical Research network under National Virtual Centre Clinical Pharmacology activity

OBJECTIVE

The rational use of medicines as per the World Health Organization (WHO) should be practiced globally. However, data regarding the completeness of the prescriptions and their rational use is lacking from developing countries like India. Thus, the aim of this study was to assess the prescribing patterns of drugs and completeness of prescriptions as per WHO core drug use and complementary indicators to provide real-life examples for the Indian Council of Medical Research (ICMR) online prescribing skill course for medical graduates.

METHODS

Prescriptions of the patients, fulfilling inclusion criteria, attending Outpatient Departments of various specialties of tertiary care hospitals, were collected by thirteen ICMR Rational use of medicines centers located in tertiary care hospitals, throughout India. Prescriptions were evaluated for rational use of medicines according to the WHO guidelines and for appropriateness as per standard treatment guidelines using a common protocol approved by local Ethics committees.

RESULTS

Among 4838 prescriptions, an average of about three drugs (3.34) was prescribed to the patients per prescription. Polypharmacy was noted in 83.05% of prescriptions. Generic drugs were prescribed in 47.58% of the prescriptions. Further, antimicrobials were prescribed in 17.63% of the prescriptions and only 4.98% of prescriptions were with injectables. During the prescription evaluation, 38.65% of the prescriptions were incomplete due to multiple omissions such as dose, duration, and formulation.

CONCLUSION

Most of the parameters in the present study were out of the range of WHO-recommended prescribing indicators. Therefore, effective intervention program, like training, for the promotion of rational drug use practice was recommended to improve the prescribing pattern of drugs and the quality of prescriptions all over the country.

A qualitative interview study to explore adolescents' experience of alopecia areata and the content validity of sign/symptom patient-reported outcome (PRO) measures

BACKGROUND

The content validity (appropriateness and acceptability) of patient-reported outcome (PRO) measures for scalp hair loss, eyebrow loss, eyelash loss, nail damage and eye irritation has been demonstrated in adults with alopecia areata (AA) but not adolescents.

OBJECTIVE

To explore the content validity of the suite of AA PRO measures and accompanying photoguides in an adolescent sample.

METHODS

Semi-structured, 90-minute, combined concept elicitation and cognitive interviews were conducted face-to-face with adolescents who experienced ≥50% AA-related scalp hair loss. Transcripts underwent thematic and framework analysis.

RESULTS

Eleven adolescents (age 12-17 years, 55% female, 45% non-Caucasian/white) diagnosed with AA for 5.9 years (mean) participated. Participants had 69.6% scalp hair (mean) and current eyebrow (82%), eyelash loss (82%) and/or nail involvement (36%). Adolescents reported scalp, eyebrow and eyelash hair loss as their top three most bothersome signs/symptoms. Despite mostly accepting their AA, impacts related to visible areas of hair loss were prominent. Participants demonstrated good understanding and appropriate use of the PRO measures, and advocated including hair loss percentages alongside descriptive categories in the Scalp Hair Assessment PRO™. Results confirmed treatment success thresholds established with adults: achievement of ≤20% scalp hair loss, no/minimal eyebrow and eyelash loss, no/a little nail damage and eye irritation (PRO categories 0 or 1).

CONCLUSIONS

The Scalp Hair Assessment PRO™, PRO Measure for Eyebrows™, PRO Measure for Eyelashes™, PRO Measure for Nail Appearance™ and PRO Measure for Eye Irritation™ and accompanying photoguides are fit-for-purpose self-reported measures of AA signs/symptoms that are impactful to adolescents with AA.

347 Read the First Page: An Audit on Medicine Reconciliation in General Surgery Inpatients at London District General Hospital

Aim

Medication-related incidents occur more frequently when medicine reconciliation happens more than 24 hours after admission. The National Institute for Health and Care Excellence recommends a complete reconciliation within 24 hours of admission. General Surgery is a busy specialty with a high patient turnover rate. Hence, this audit was conducted to assess the extent of a problem and mitigate it.

Method

Every adult General Surgery inpatient who were admitted for over 24 hours were included. Patients on intensive care or high dependency unit were excluded. Drug charts were reviewed every Thursday for nine weeks between October and December 2020. Data from the first three weeks were used to establish baseline. Three interventions were introduced, each lasting two weeks. Any significant harm to patients due to incomplete reconciliation was recorded.

Results

At baseline (n = 100), 38.0% of patients had incomplete reconciliation. This significantly reduced to 23.4% (n = 64, p-value=0.037) between Weeks 4 and 5 after baseline data was presented at a team meeting and posters were put up. Allowing pharmacists to flag up missing medications on a daily job’s list did not significantly reduce the incompletion rate (23.0%, n = 74, p-value&gt;0.999). Finally, performing a medicine reconciliation ward round on Weeks 8 and 9 further reduced the incompletion rate to 2.8% (n = 74, p-value=0.001). One significant harm was noted on Week 1.

Conclusions

Medicine reconciliation is a vital aspect of patient safety. Raising awareness of the issue significantly reduced the incompletion rate. However, the most effective intervention is conducting a medicine reconciliation ward round.

Differential gene expression in liver of colored broiler chicken divergently selected for residual feed intake

Feed constitutes about 60-70% of the total cost of poultry production. So maximizing the feed efficiency will reduce production cost. The rapid growth in the juvenile period is essential to achieve higher body weight. Therefore, identifying the genes and pathways involved in rapid growth at an early age with a lesser requirement of feed is of utmost importance to further economize the broiler production. The efficiency of feed utilization was measured using RFI (residual feed intake). The present study aimed to estimate the RFI (0-5 week) in a population of indigenously developed colored broiler sire line chicken as well as identifying the differentially expressed genes influencing RFI in high and low RFI groups. The liver samples of high and low RFI broiler chicken aged 35 days were used for microarray analysis. A total of 2798 differentially expressed genes (DEGs) were identified, out of which 913 genes were downregulated and 1885 were upregulated. The fold change varied from - 475.17 to 552.94. A subset of genes was confirmed by qRT-PCR, and outcomes were matched well with microarray data. In the functional annotation study of DEGs, the highest significant GO (Gene Ontology) terms in the biological process included protein transport, protein localization, regulation of apoptosis, and mitochondrial transport. Gene network analysis of these DEGs plays an important role to understand the interaction among genes. Study of the important genes which were differentially expressed and the related molecular pathways in this population may hold the potential for future breeding strategies for augmenting feed efficiency.

Ecosystem-centric business continuity planning (eco-centric BCP): A post COVID19 new normal

This article views the COVID-19 pandemic as an opportunity leading to a significant reduction in pollution levels, clean waters in rivers, improved visibility, and other tangible benefit to humanity and the environment. In Post-COVID scenario, to restore the margins and regain the lost production, industries are likely to increase their production leading to a quantum jump in the pollution levels. Having precedence of such a scenario in 2008-09, this article looks at what are the possible avenues to engage the city government and business houses through an a new normal ECO-BCP concept for long term sustainability. All economic stimulus needs to be tied down with the stringent reduction in the emission norms. The Ten Principles for the Eco-centric BCP guide the reopening of MSMEs after lockdown period called to check the spread of the COVID-19 pandemic. The Eco-centric BCP model will help the MSMEs to adopt the new-normal business strategies to align with the country-specific commitments to SDGs, SFDRR and Paris declaration.

Evaluation of regeneration of semitendinosus tendon using ultrasound imaging and isokinetic strength testing after graft harvest for arthroscopic anterior cruciate ligament reconstruction

Background

A lot of the research has been done worldwide evaluating the capacity of the semitendinosus tendon to regenerate which has not been conducted in the Indian population.

Study design

31 patients who underwent unilateral ACL reconstruction with hamstrings were taken into study. All patients underwent ultrasonography imaging of both knees and bilateral isokinetic flexion strength assessment at a one-year postoperative period. Images were obtained at three levels and their dimensions are compared with normal side. Isokinetic testing of the knee is done to evaluate the flexion deficit and is compared to the uninvolved knee.

Results

Out of a total of 31 patients, 14 patients showed no regeneration, 17 showed regeneration at various levels. On isokinetic testing patients with no regeneration showed the highest mean flexion deficit.

Conclusion

The semitendinosus tendon and its regeneration can be visualized well using ultrasonography. After semitendinosus harvesting, the flexion strength will be decreased as compared to the normal knee. The flexion strength in patients who have a regenerated tendon will be higher as compared to those who have no regeneration.

Morbidity profile of communities in Bhopal city (India) vis-à-vis distance of residence from Union Carbide India Limited plant and drinking water usage pattern

Objective:

A cross-sectional study was undertaken to assess the prevalence of morbidities in communities residing at variable distances from the closed down insecticide manufacturing plant premises of Union Carbide India Limited (UCIL), Bhopal, India and to determine association of morbidities, if any, with their drinking water usage pattern and distance of localities from the UCIL plant.

Materials and Methods:

A total of 10,827 individuals belonging to 2,184 families, residing within 0-1 km (Stratum I) and 2.5-5.0 km (Stratum II) radial distances from UCIL plant were surveyed and 9,306 of them (86%) were clinically examined. Data were analyzed to examine the association between the groups of morbidities, likely due to biological and chemical water contamination, and the distance of locality from the UCIL plant. Multiple logistic regression was used to explore the risk factors for morbidities.

Results:

Nearly similar prevalence (25.3% in stratum I, 25.8% in stratum II) and the trend of all-cause morbidities were recorded in the two strata. While morbidities related to gastrointestinal tract system (P < 0.05), auditory system (P < 0.01), neoplasm/cancers (P < 0.01) and congenital anomalies (P < 0.01) were significantly higher in stratum I, the prevalence of hypertension (6.4% stratum II, 4.7% stratum I; P < 0.01) and diabetes mellitus (3.4% stratum II, 2.0% stratum I; P < 0.001) was found significantly higher in stratum II. No association (P > 0.05) was observed between the prevalence of morbidities, likely due to the consumption of biologically or chemically contaminated drinking water, and the distance of locality/stratum from the UCIL plant.

Discussion and Conclusion:

By and large similar pattern of morbidities were recorded in the two strata suggesting that the communities, irrespective of the distance of their residences from UCIL plant or sources of their drinking water, are equally vulnerable to various morbidities.

Quantifying Argonaute 2 (Ago2) expression to stratify breast cancer

BACKGROUND

Argonaute-2 (Ago2) is an essential component of microRNA biogenesis implicated in tumourigenesis. However Ago2 expression and localisation in breast cancer remains undetermined. The aim was to define Ago2 expression (mRNA and protein) and localisation in breast cancer, and investigate associations with clinicopathological details.

METHODS

Ago2 protein was stained in breast cancer cell lines and tissue microarrays (TMAs), with intensity and localization assessed. Staining intensity was correlated with clinicopathological details. Using independent databases, Ago2 mRNA expression and gene alterations in breast cancer were investigated.

RESULTS

In the breast cancer TMAs, 4 distinct staining intensities were observed (Negative, Weak, Moderate, Strong), with 64.2% of samples stained weak or negatively for Ago2 protein. An association was found between strong Ago2 staining and, the Her2 positive or basal subtypes, and between Ago2 intensity and receptor status (Estrogen or Progesterone). In tumours Ago2 mRNA expression correlated with reduced relapse free survival. Conversely, Ago2 mRNA was expressed significantly lower in SK-BR-3 (HER2 positive) and BT-20 (Basal/Triple negative) cell lines. Interestingly, high levels of Ago2 gene amplification (10-27%) were observed in breast cancer across multiple patient datasets. Importantly, knowledge of Ago2 expression improves predictions of breast cancer subtype by 20%, ER status by 15.7% and PR status by 17.5%.

CONCLUSIONS

Quantification of Ago2 improves the stratification of breast cancer and suggests a differential role for Ago2 in breast cancer subtypes, based on levels and cellular localisation. Further investigation of the mechanisms affecting Ago2 dysregulation will reveal insights into the molecular differences underpinning breast cancer subtypes.

First case report of spontaneous posterior fossa subdural hemorrhage - A rare cause of neonatal encephalopathy

Posterior fossa subdural hemorrhage (PFSDH) in term neonates is rare and unknown in the absence of obvious trauma. Its management is challenging and decided case to case basis. Here we report two cases of posterior fossa subdural hemorrhage in term babies with normal transition at birth and presenting later with neonatal encephalopathy. First baby was born by elective caesarean section and the second baby by assisted vaginal delivery. They presented at 60 h and 48 h respectively. Both babies had similar clinical presentation in the form of poor feeding, shrill cry and posturing. But they had contrasting clinical course with features of brainstem compression in the first baby requiring ventilation. Coagulation workup was normal in the first baby but fibrinogen level was low in the second baby. Magnetic resonance imaging of the first baby showed PFSDH with tonsillar herniation while in the second baby, there was no midline shift or herniation associated with the PFSDH. Management was tailor made to suit the clinical course and imaging findings. Craniotomy and clot evacuation was done in the first case and in the second baby, management was conservative. Neurological examination was normal at discharge. Both are developmentally normal on follow up. There is no evidence of hydrocephalus in both. Management of PFSDH depends on clinical course and MRI findings. Timely intervention leads to good outcome.

"Similar query was answered earlier": processing of patient authored text for retrieving relevant contents from health discussion forum

Online remedy finders and health-related discussion forums have become increasingly popular in recent years. Common web users write their health problems there and request suggestion from experts or other users. As a result, these forums became a huge repository of information and discussions on various health issues. An intelligent information retrieval system can help to utilize this repository in various applications. In this paper, we propose a system for the automatic identification of existing similar forum posts given a new post. The system is based on computing similarity between two patient authored texts. For computing the similarity between the current post and existing posts, the system uses a hybrid strategy based on template information, topic modelling, and latent semantic indexing. The system is tested using a set of real questions collected from a homeopathy forum namely abchomeopathy.com. The relevance of the posts retrieved by the system is evaluated by human experts. The evaluation results demonstrate that the precision of the system is 88.87%.

A study on use of the web for automatic answering of remedy finding questions of common users

BACKGROUND

The World Wide Web has become a huge repository of knowledge in many domains, including health problems and remedy. An intelligent system, having the capability of mining the relevant information from the web, can provide instant guidance in our basic health problems.

OBJECTIVE

The first objective is to convert the free-form long user query into a structured summary. The second objective is to provide an advice for a health query posed by a user. The suggestion can be in the form of names of medicines and related information or a warning to indicate that the situation is a medical emergency.

METHODS

First, a set of template information is extracted from the user question. A search query is formed to retrieve relevant pages from a set of trusted websites. The retrieved pages are processed in various levels to extract the remedy and related information.

RESULTS AND CONCLUSION

The system is tested using a set of real questions collected from various relevant websites. The system generated suggestions are evaluated by experts. Evaluation results show that the system provides relevant results in 92.92% cases.

Miniscrews-assisted Lacebacks in Forsus to Minimize Lower Incisor Proclination

Forsus is a Class II corrector appliance used in growing as well as in young adults. Proclination and forward movement of lower incisor is the major drawback reported using this appliance. Forsus results in Class II correction mainly through dentoalveolar effect and minimal skeletal effect. We used a new innovation incorporating miniscrew assisted laceback to minimize lower incisor proclination. Utilization of miniscrew assisted laceback effectively reduces the unfavorable proclination and allows additional skeletal effects. This method applies a distal driving force on the lower anteriors, which minimizes lower incisor proclination. It is proven to be effective method in controlling the lower incisor flaring.

Enigma of Fixed Retainers

Fixed retainers are a reliable form of retention for avoiding relapse and maintaining dental arch shape. They function regardless of patient cooperation, and they fulfill high esthetic expectations. Teeth have tendency to return to their former position, as time required for retaining the treatment result. The most appropriate mode of retention for the post-treatment situation should be used, based on a careful evaluation of the patient’s pretreatment diagnostic records, habits, cooperation, growth pattern, and age. Retention after orthodontic intervention is as important part of the therapy as the active treatment. Age and maturity of the patients, result of the orthodontic intervention, origin and character of the anomaly, type of the retainer, compliance of the patients; all can influence the chance of relapse. The retention period should be twice longer than the active orthodontic treatment. This article covers various aspect of fixed retention in detail

The Importance of Flexion MRI in Hirayama Disease with Special Reference to Laminodural Space Measurements

BACKGROUND AND PURPOSE

Hirayama disease is a benign focal amyotrophy of the distal upper limbs involving C7, C8, and T1 segmental myotomes with sparing of the brachioradialis and proximal muscles of the upper limb innervated by C5-6 myotomes. The objective of the present study was to study the utility of MR imaging in young patients presenting with weakness and wasting of the distal upper extremity and to evaluate the importance of the laminodural space during flexion cervical MR imaging.

MATERIALS AND METHODS

This was a prospective cross-sectional study conducted from January 2014 to July 2017 in a tertiary care center from Northeast India. Forty-five patients with clinically definite Hirayama disease underwent electrophysiologic evaluation followed by MR imaging of the cervical spine.

RESULTS

The mean age at recruitment was 22.8 ± 5.5 years. Forty patients (88.9%) had unilateral and 5 (11.1%) had bilateral upper extremity involvement. Cervical cord T2-weighted hyperintensities were demonstrated in 16 patients (35.6%), of which 15 (33.3%) had anterior horn cell hyperintensities. Flexion MR imaging showed loss of the posterior dural attachment, forward shifting of the posterior dural sac with postcontrast enhancement, and prominent posterior epidural venous plexus in all patients. The laminodural space at maximum forward shifting of the posterior dural sac ranged from 3 to 9.8 mm, with a mean distance of 5.99 mm (95% confidence interval, 5.42-6.57 mm).

CONCLUSIONS

Flexion cervical MR imaging is a very useful investigation in diagnosing Hirayama disease. The increase in the laminodural space and the presence of cervical cord flattening during flexion are essential for diagnosis.

Rare Cause of Hyperkalemia in the Newborn Period: Report of Two Cases of Pseudohypoaldosteronism Type 1

Pseudohypoaldosteronism (PHA) Type 1 is characterized by mineralocorticoid resistance, manifesting as neonatal salt wasting, hypotension, hyperkalemia, hyponatremia, and metabolic acidosis in spite of elevated aldosterone levels and plasma renin activity. It is important to differentiate children with systemic PHA from renal PHA, as these children are likely to decompensate even with mild symptoms. Here, we report two neonates with PHA that presented to us with multiorgan involvement.

Chemical characterization and source apportionment of aerosol over mid Brahmaputra Valley, India

Aerosol samples (as PM_10, n = 250) were collected from three rural/remote receptor locations in the mid Brahmaputra plain region and were chemically characterized for metals (Al, Fe, Co, Cu, Cr, Cd, Mn, Ni, Pb), ions (Ca²⁺, Mg²⁺, Na⁺, K⁺, NH₄⁺, F^-, Cl^-, NO₃^-, SO₄^2-), and carbon. Vital ratios like NO₃^-/SO₄^2-, EC/OC, K⁺/EC, K⁺/OC, enrichment factors and inter-species correlations were exploited to appreciate possible sources of aerosol. These empirical analyses pointed towards anthropogenic contributions of aerosol, particularly from biomass burning, vehicular emission, and road dust. The chemically characterized concentration data were subsequently fed into two receptor models viz. Principal Component Analysis-Multiple Linear Regression (PCA-MLR) and Chemical Mass Balance (CMB) for apportionment of sources of aerosol. The PCA-MLR estimates identified that the combustion sources together accounted for ∼42% of aerosol and the contribution of secondary formation to be 24%. Road and crustal dusts have been well apportioned by PCA-MLR, which together accounts for ∼26% of the aerosol. The CMB model estimates explained that the combustion sources taken together contributed ∼47% to the aerosol, which includes biomass burning (27%), vehicular emission (13%), coal (1%), kerosene (4%), and petroleum refining (2%). Other major sources that were apportioned were road dust (15%), crustal dust (26%), and construction dust (6%). There are inherent limitations in the source strength estimations because of uncertainty present in the source emission profiles that have been applied to the remote location of India. However, both the models (PCA-MLR and CMB) estimated the contribution of combustion sources to 42 and 47% respectively, which is comparable.

Improved Tapaswini having four BB resistance genes pyramided with six genes/QTLs, resistance/tolerance to biotic and abiotic stresses in rice

Rice, a major food crop, is grown in a wide range of ecological conditions and suffers significant yield losses as it is constantly exposed to a wide range of environmental and biotic stresses. The prevalence of different biotypes/strains has necessitated assembling of numerous resistance genes/QTLs into elite genotypes to confer a broader scale of resistance. The current study reports successful pyramiding of genes/QTLs that confer tolerance/resistance to submergence (Sub1), salinity (Saltol), blast (Pi2, Pi9) and gall midge (Gm1, Gm4) to supplement the four bacterial blight resistance genes (Xa 4, xa5, xa13, Xa21) present in Improved Tapaswini, an elite cultivar. The precise transfer of genes/QTLs was accomplished through effective foreground selection and suitable gene pyramids were identified. Background selection was practiced using morphological and grain quality traits to enhance the recovery of the recurrent parental genome. In the bioassays, the pyramids exhibited higher levels of resistance/ tolerance against the target stresses. The novel feature of the study was successful pyramidization and demonstration of the function of ten genes/QTLs in a new genotype. This success can stimulate several such studies to realize the full potential of molecular plant breeding as the foundation for rice improvement.

Understanding of multi-level resistive switching mechanism in GeOx through redox reaction in H2O2/sarcosine prostate cancer biomarker detection

Formation-free multi-level resistive switching characteristics by using 10 nm-thick polycrystalline GeO_x film in a simple W/GeO_x/W structure and understanding of switching mechanism through redox reaction in H₂O₂/sarcosine sensing (or changing Ge°/Ge⁴⁺ oxidation states under external bias) have been reported for the first time. Oxidation states of Ge⁰/Ge⁴⁺ are confirmed by both XPS and H₂O₂ sensing of GeO_x membrane in electrolyte-insulator-semiconductor structure. Highly repeatable 1000 dc cycles and stable program/erase (P/E) endurance of >10⁶ cycles at a small pulse width of 100 ns are achieved at a low operation current of 0.1 µA. The thickness of GeO_x layer is found to be increased to 12.5 nm with the reduction of polycrystalline grain size of <7 nm after P/E of 10⁶ cycles, which is observed by high-resolution TEM. The switching mechanism is explored through redox reaction in GeO_x membrane by sensing 1 nM H₂O₂, which is owing to the change of oxidation states from Ge⁰ to Ge⁴⁺ because of the enhanced O^2- ions migration in memory device under external bias. In addition, sarcosine as a prostate cancer biomarker with low concentration of 50 pM to 10 µM is also detected.