Valorisation of Agri-Food Waste for Bioactive Compounds: Recent Trends and Future Sustainable Challenges

Worldwide, a massive amount of agriculture and food waste is a major threat to the environment, the economy and public health. However, these wastes are important sources of phytochemicals (bioactive), such as polyphenols, carotenoids, carnitine, coenzymes, essential oils and tocopherols, which have antioxidant, antimicrobial and anticarcinogenic properties. Hence, it represents a promising opportunity for the food, agriculture, cosmetics, textiles, energy and pharmaceutical industries to develop cost effective strategies. The value of agri-food wastes has been extracted from various valuable bioactive compounds such as polyphenols, dietary fibre, proteins, lipids, vitamins, carotenoids, organic acids, essential oils and minerals, some of which are found in greater quantities in the discarded parts than in the parts accepted by the market used for different industrial sectors. The value of agri-food wastes and by-products could assure food security, maintain sustainability, efficiently reduce environmental pollution and provide an opportunity to earn additional income for industries. Furthermore, sustainable extraction methodologies like ultrasound-assisted extraction, pressurized liquid extraction, supercritical fluid extraction, microwave-assisted extraction, pulse electric field-assisted extraction, ultrasound microwave-assisted extraction and high hydrostatic pressure extraction are extensively used for the isolation, purification and recovery of various bioactive compounds from agri-food waste, according to a circular economy and sustainable approach. This review also includes some of the critical and sustainable challenges in the valorisation of agri-food wastes and explores innovative eco-friendly methods for extracting bioactive compounds from agri-food wastes, particularly for food applications. The highlights of this review are providing information on the valorisation techniques used for the extraction and recovery of different bioactive compounds from agricultural food wastes, innovative and promising approaches. Additionally, the potential use of these products presents an affordable alternative towards a circular economy and, consequently, sustainability. In this context, the encapsulation process considers the integral and sustainable use of agricultural food waste for bioactive compounds that enhance the properties and quality of functional food.

Stem Rot of Pearl Millet Prevalence, Symptomatology, Disease Cycle, Disease Rating Scale and Pathogen Characterization in Pearl Millet-Klebsiella Pathosystem

The oldest and most extensively cultivated form of millet, known as pearl millet (Pennisetum glaucum (L.) R. Br. Syn. Pennisetum americanum (L.) Leeke), is raised over 312.00 lakh hectares in Asian and African countries. India is regarded as the significant hotspot for pearl millet diversity. In the Indian state of Haryana, where pearl millet is grown, a new and catastrophic bacterial disease known as stem rot of pearl millet spurred by the bacterium Klebsiella aerogenes (formerly Enterobacter) was first observed during fall 2018. The disease appears in form of small to long streaks on leaves, lesions on stem, and slimy rot appearance of stem. The associated bacterium showed close resemblance to Klebsiella aerogenes that was confirmed by a molecular evaluation based on 16S rDNA and gyrA gene nucleotide sequences. The isolates were also identified to be Klebsiella aerogenes based on biochemical assays, where Klebsiella isolates differed in D-trehalose and succinate alkalisation tests. During fall 2021-2023, the disease has spread all the pearl millet-growing districts of the state, extending up to 70% disease incidence in the affected fields. The disease is causing considering grain as well as fodder losses. The proposed scale, consisting of six levels (0-5), is developed where scores 0, 1, 2, 3, 4, and 5 have been categorized as highly resistant, resistant, moderately resistant, moderately susceptible, susceptible, and highly susceptible disease reaction, respectively. The disease cycle, survival of pathogen, and possible losses have also been studied to understand other features of the disease.

Deciphering the biochemical and functional characterization of rice straw cultivars for industrial applications

As an agricultural state, Haryana (India) produces about six million metric tons (mt) of rice straw every year from rice cultivation. Currently, rice straw is either burned or ploughed into the field without being turned into a functional product. Burning of paddy straw release green house gases and particulate matter (2.5 and 10 μm), which leads to air pollution and considerable loss of soil property viz. nutrients, organic matter, productivity and biodiversity, and on and off-farm humans and animals' health. The biochemically and functionally specified potential for optimal alternative use of the rice straw of 13 most widely produced rice varieties from Haryana's eastern and western agro-climate zones was undertaken. Pusa-1401 variety had the highest cellulose (46.55%) and silica content (13.70%), while Pusa-1718 had hemicellulose (28.25%) and lignin (11.60%), respectively. Maximum nitrogen (0.81%), phosphorus (0.32%) and potassium (2.78%) were found in rice variety Pusa-1509, Pusa-1401 and Rice-6129. The findings seemed to be statistically significant (p < 0.05). The biochemical profiles of rice straw cultivars were classified into distinct structural groups (C-H alkalanes, O-H alcohol, C[bond, double bond]O, C-H alkanes) based on the FTIR spectrum in order to find the best alternative possibilities for bioethanol and compost production. According to the study, these rice straw varieties could be used to make lucrative industrial products.

The level and distribution of selected organochlorine pesticides in water of River Satluj Pakistan

The study was aimed to identify different environmental factors (selected organochlorine pesticides) affecting the river water of Satluj. River Sutlej is about 1400 kilometers long and its water is extensively used for irrigation in Punjab, located both in India and Pakistan, which was also a reason of dispute between both countries for its water share. The study area was divided into four zones, Sulemanki Zone, Islam Zone, Mailsi Syphone Zone and Panjnad Zone. Liquid Liquid Extraction (LLE) technique was used for the collected water samples followed by high performance liquid chromatography (HPLC) UV-Visible detector The current finding revealed that aldrin was not detected during summer period in water samples of SZ-1 (Sulemanki Barrage), SZ-2 and SZ-3 (Maisli Siphon) of the study area. Lindane and DDE were found more in the samples of sediments from the study area at SZ-4 ranging from 2.238-8.226 ppb and 4.234-6.876 ppb, respectively. Heaptachlor (in sediments) was found to be0.032-234 ppb only at SZ-4.Endosulfan concentrations in water (winter) at SZ-3 was 0.06 ppb and at SZ-4,it was 0.05 ppb; dieldrin in water (winter) at SZ-4 was 0.0314 ppb and heptachlor was detected at SZ-1 (0.0315 ppb) and SZ-2 (0.0310 ppb) in water during winter season, were reaching to the Maximum Concentrations Limits (MCL), while all other residues investigated were found below the MCLin all the compartments of the study area set by various agencies like WHO/FAO- Codex Alimenterious. Present findings revealed that although the organochlorine pesticides are banned for agricultural use in many countries, including Pakistan, their presence in various samples might be due to illegal use of these pesticides in the study area and its neighboring regions. The overall study area comprises of mainly urban, suburban and agricultural land being the largest cotton growing area of the country. There is a need to take serious steps to minimize water pollution caused by pesticides to achieve a healthy lifestyle.

Presence of selected organochlorine pesticides (OCPs) in sediments and biota of River Satluj, Pakistan: first report

Abstract In the developed countries, the use of OCPs (organochlorine pesticides) has been banned. However, in South Asia several of them are still in use. In Pakistan and India a constant addition of OCPs into the atmosphere has been indicated by various researchers. In this study levels of selected organochlorine pesticide residues were assessed in sediment and biota collected from four (4) water reservoirs (3 Barrages & 1 Siphon) on the River Satluj Pakistan, along 231 miles (372 km) of River stretch which was further divided into 12 sampling sites. It was aimed to find out the levels of organochlorine pesticide (OCPs) residues in sediments and from selected fish species (Labeo rohita, Wallagu attu, Cyprinus carpio) of the River Satluj Pakistan. The Organochlorine residues (seven pesticides) present in samples of sediments and biota were investigated through multi residue method, using Gas Chromatograph (GC-ECD).In the current study, the concentration of DDT, was investigated in Wallago attu (0.786-3.987 ppb), Labeo rohita (0.779-4.355 ppb) and Cyprinus carpio (1.234-5.654 ppb). DDE was also found in Cyprinus carpio (1.244-6.322 ppb), Wallag attu (0.877-4.221 ppb) and Labeo rohita (2.112-5.897 ppb). Aldrin was not observed in Labeo rohita and Wallago attu. Currently, lindane and DDE was found predominately high in the sediments of study area at SZ-4 (Panjnad Barrage) ranging (2.238-8.226 ppb) and (4.234-6.876 ppb), respectively. Heaptachlor was found only at SZ-4 (Panjnad Barrage) from the sediments with concentration ranging (0.032-234 ppb). In short all other residues investigated were found below the MCL (maximum concentration level) in all the compartments of the study area set by various agencies like WHO/FAO- Codex Alimenterious.

Superabsorbent Polymers as a Soil Amendment for Increasing Agriculture Production with Reducing Water Losses under Water Stress Condition

With an increasing population, world agriculture is facing many challenges, such as climate change, urbanization, the use of natural resources in a sustainable manner, runoff losses, and the accumulation of pesticides and fertilizers. The global water shortage is a crisis for agriculture, because drought is one of the natural disasters that affect the farmers as well as their country's social, economic, and environmental status. The application of soil amendments is a strategy to mitigate the adverse impact of drought stress. The development of agronomic strategies enabling the reduction in drought stress in cultivated crops is, therefore, a crucial priority. Superabsorbent polymers (SAPs) can be used as an amendment for soil health improvement, ultimately improving water holding capacity and plant available water. These are eco-friendly and non-toxic materials, which have incredible water absorption ability and water holding capacity in the soil because of their unique biochemical and structural properties. Polymers can retain water more than their weight in water and achieve approximately 95% water release. SAP improve the soil like porosity (0.26-6.91%), water holding capacity (5.68-17.90%), and reduce nitrogen leaching losses from soil by up to 45%. This review focuses on the economic assessment of the adoption of superabsorbent polymers and brings out the discrepancies associated with the influence of SAPs application in the context of different textured soil, presence of drought, and their adoption by farmers.

Incisional hernia following colorectal cancer surgery according to suture technique: Hughes Abdominal Repair Randomized Trial (HART)

BACKGROUND

Incisional hernias cause morbidity and may require further surgery. HART (Hughes Abdominal Repair Trial) assessed the effect of an alternative suture method on the incidence of incisional hernia following colorectal cancer surgery.

METHODS

A pragmatic multicentre single-blind RCT allocated patients undergoing midline incision for colorectal cancer to either Hughes closure (double far-near-near-far sutures of 1 nylon suture at 2-cm intervals along the fascia combined with conventional mass closure) or the surgeon's standard closure. The primary outcome was the incidence of incisional hernia at 1 year assessed by clinical examination. An intention-to-treat analysis was performed.

RESULTS

Between August 2014 and February 2018, 802 patients were randomized to either Hughes closure (401) or the standard mass closure group (401). At 1 year after surgery, 672 patients (83.7 per cent) were included in the primary outcome analysis; 50 of 339 patients (14.8 per cent) in the Hughes group and 57 of 333 (17.1 per cent) in the standard closure group had incisional hernia (OR 0.84, 95 per cent c.i. 0.55 to 1.27; P = 0.402). At 2 years, 78 patients (28.7 per cent) in the Hughes repair group and 84 (31.8 per cent) in the standard closure group had incisional hernia (OR 0.86, 0.59 to 1.25; P = 0.429). Adverse events were similar in the two groups, apart from the rate of surgical-site infection, which was higher in the Hughes group (13.2 versus 7.7 per cent; OR 1.82, 1.14 to 2.91; P = 0.011).

CONCLUSION

The incidence of incisional hernia after colorectal cancer surgery is high. There was no statistical difference in incidence between Hughes closure and mass closure at 1 or 2 years.

REGISTRATION NUMBER

ISRCTN25616490 (http://www.controlled-trials.com).

EP-415 The use of gastrografin in the management of adhesive small bowel obstruction

Background

Adhesive small bowel obstruction (aSBO) is a common surgical emergency causing high morbidity and even some mortality. The adhesions causing such small bowel obstructions (SBO) are typically the footprints of previous abdominal surgeries. The National Audit of Small bowel Obstruction (NASBO) recommended that in patients not needing emergency surgery for aSBO, gastrografin should be embedded in clinical management. An audit was undertaken to see our adherence to best practice in the management of aSBO.

Methods

Data of all patients who were admitted with SBO between April and October 2020 were obtained. This list was filtered carefully to extract patients who had aSBO. Data was collected on signs of intestinal ischaemia, administration of gastrografin and progression, need for surgery and length of stay.

Results

26 patients were admitted with aSBO in the above period. Half of all patients needed an emergency operation. Only 30% (8) received gastrografin. Conservative management was successful in 62% (5/8) of patients who received gastrografin. 38% (3/8) needed surgery as they either had signs of intestinal ischaemia or gastrografin failed to pass through. More than half of all patients (55%) who did not receive gastrografin (10/18) required surgery. The average length of stay was significantly higher in patients who did not receive gastrografin.

Conclusion

From the limited data it is evident that the use of gastrografin in patients with aSBO reduces the duration of stay and need for surgery. We have now developed and implemented a local protocol for managing such patients and we aim to re-audit in 6 months.

Antibacterial and antifungal activity of methanolic extracts of Salix alba L. against various disease causing pathogens

The present study was aimed to manifest the antibacterial and antifungal activity of methanolic extracts of Salix alba L. against seven Gram-positive and Gram-negative bacterial pathogens e.g. Streptococcus pyogenes, Staphylococcus aureus (1), S. aureus (2), Shigella sonnei, Escherichia coli (1), E. coli (2) and Neisseria gonorrhoeae and three fungal isolates from the air such as Aspergillus terreus, A. ornatus, and Rhizopus stolonifer. Two different serotypes of S. aureus and E. coli were used. The agar well-diffusion method results showed the dose-dependent response of plant extracts against bacterial and fungal strains while some organisms were found resistant e.g. E. coli (1), S. sonnei, A. terreus and R. stolonifer. The highest antibacterial activity was recorded at 17.000±1.732 mm from 100 mg/mL of leaves methanolic extracts against S. pyogenes while the activity of most of the pathogens decreased after 24 h of incubation. The highest antifungal activity was reported at 11.833±1.0 mm against A. ornatus at 50 mg/mL after 48 h of the incubation period. These experimental findings endorse the use of S. alba in ethnopharmacological formulations and suggest the use of methanolic extracts of the said plant to develop drugs to control the proliferation of resistant disease causing pathogenic microbes.

Organic Farming and Bio-Nanomaterial Conflux: A Way Forward for Sustainable Agriculture

Increasing population pressure and decreasing cultivable land brought the agricultural sector at an alarming situation of food production particularly in the developing countries. To feed the burgeoning population, the agriculture sector needs to become more productive and diversified while facing the adversity of climate change and limitations of natural resources. During 1960-70, the improved irrigation facilities, the use of fertilizers and pesticides in the cultivation of high yielding varieties of cereals successfully led to the Green revolution in India. In the present scenario, the low irrigation and fertilizer use efficiencies, poor pesticide application and delivery are amongst the important issues in developing countries that need to be addressed for getting higher productivity. Also, fertilizer and pesticide usage also had severe associated environmental consequences like eutrophication, resistance and resurgence in pest, toxicity to non-target organisms, residues in food and feed, accumulation in the environment, etc. In such conditions, organic farming, a traditional practice coupled with the exploration of bio-nanoparticles to achieve a sustainable production system seems to be a better option. This review focuses on current research developments in the areas of bio-nano-enabled crop nutrition, protection, post-harvest management, and the possibility of bio-nanomaterials and organic farming confluence to revolutionize the agricultural sector by ensuring sustainable food security for coming generations.

28 Shifting to Virtual MDT in the COVID-19 Era and Beyond

Aim

The COVID19 pandemic has accelerated the need for staff to work remotely. Our aim was to demonstrate how a next-generation digital platform could be used to create a virtual MDT ecosystem in order to manipulate holographic 2D and 3D images in real-time.

Method

This study involved setting up a mock virtual MDT using de-identified DICOM files from a patient who had been treated for colorectal cancer and then subsequently found to have a liver metastasis. The image file was segmented and converted into a 2D and 3D format for visualisation within Microsoft HoloLens 2 ® (smart glasses) using Holocare Solutions ® (Mixed Reality software).

Results

A seamless cross-border pipeline was developed that involved "clinician" training, DICOM segmentation and virtual connection. We successfully performed a virtual MDT with participants able to visualise and manipulate a virtual 3D organ in real-time. The digital network remotely connected sites in England and Norway. The streaming quality was stable and HIPAA compliant. Each participant could observe others as "avatars" interacting with images within the virtual ecosystem allowing image characteristics to be highlighted.

Conclusions

We successfully conducted a virtual MDT using novel hardware and software. Our intention is to conduct a large-scale study to assess the platform's effectiveness in “Real World" MDTs.

Dissipation and decontamination behavior of pre-mix formulation of tebuconazole and rifloxystrobin fungicides in okra

The present study was done to assess the dissipation behavior, decontamination, and half-life time of ready-mix formulation of trifloxystrobin (25% w/w) and tebuconazole (50% w/w) in okra and soil under the crop after foliar spray at fruiting stage. Samples of okra and soil were collected periodically, i.e., zero (2 h after spray), 1, 3, 5, 7, 10, 15, 20, and 25 days after third application at a 7-day interval. Residues of these fungicides were determined by gas liquid chromatography (GLC) equipped with electron capture detector (ECD) and gas chromatography-tandem mass spectrometry (GCMS-triple quadruple). The limits of quantification (LOQ) and detection (LOD) for both the fungicides were 0.01 and 0.003 mg kg^-1, respectively. Washing alone with faucet water was found successful in minimizing the residues. Soil was free from residual contamination at fifth day after spraying in case of both the fungicides and at both the doses.

Persistence and decontamination studies of chlorantraniliprole in Capsicum annum using GC-MS/MS

Chlorantraniliprole, a new systemic insecticide of anthranilic diamide class gaining popularity among farmers for its effective control of Lepidoptera pest particularly in vegetables. Thus monitoring of chlorantraniliprole (CAP) leftover in vegetables is required and to this end eco-friendly, cost effective, selective and accurate method was developed and validated for quantification of its left over in chilli fruit using gas chromatography-tandem mass spectrometry (GC-MS/MS) in SCAN/MRM mode with a triple Quadrupole analyzer. Two MS-MS transitions were acquired to ensure the reliable quantification and confirmation of the analyte. All calibration curve showed a good linear relationship (r > 0.99) with in test ranges (0.005-0.5 µg ml^-1). To study its persistence, half-life, waiting period and decontamination behavior the field trial were performed at recommended dose and its double by Central Insecticide Board and Registration Committee (CIBRC). Initial deposits of CAP at recommended (T1) and double (T2) the recommended doses revealed 3.16 and 4.18 mg kg^-1 with their respective half-lives 1.18 and 2.05 days respectively. According to maximum residual limit i.e. 0.03 mg kg^-1 by FSSAI, residues persists up to 7th and 15th day if sprayed at fruit setting stage. The extent of removal of CAP using simple decontamination approach showed 62-67% reduction on maximum residue.

OVERVIEW OF NEUTRON MEASUREMENTS IN JET FUSION DEVICE

The design and operation of ITER experimental fusion reactor requires the development of neutron measurement techniques and numerical tools to derive the fusion power and the radiation field in the device and in the surrounding areas. Nuclear analyses provide essential input to the conceptual design, optimisation, engineering and safety case in ITER and power plant studies. The required radiation transport calculations are extremely challenging because of the large physical extent of the reactor plant, the complexity of the geometry, and the combination of deep penetration and streaming paths. This article reports the experimental activities which are carried-out at JET to validate the neutronics measurements methods and numerical tools used in ITER and power plant design. A new deuterium-tritium campaign is proposed in 2019 at JET: the unique 14 MeV neutron yields produced will be exploited as much as possible to validate measurement techniques, codes, procedures and data currently used in ITER design thus reducing the related uncertainties and the associated risks in the machine operation.

Alopecia areata is characterized by expansion of circulating Th2/Tc2/Th22, within the skin-homing and systemic T-cell populations

BACKGROUND

Characterizing blood profile of alopecia areata (AA) is important not only for treatment advancements, but also for possibly identifying peripheral biomarkers that will eliminate the need for scalp biopsies. We aimed to compare frequencies of skin homing (CLA⁺ ) vs systemic (CLA^- ) "polar" CD4⁺ and CD8⁺ and activated T-cell subsets in AA vs atopic dermatitis (AD) and control blood.

METHODS

Flow cytometry was used to measure IFN-γ, IL-13, IL-9, IL-17, and IL-22 cytokines in CD4⁺ and CD8⁺ T cells. Inducible co-stimulator molecule (ICOS) and HLA-DR were used to define mid- and long-term T-cell activation. We compared peripheral blood from 32 moderate-to-severe AA adults with 43 moderate-to-severe AD patients and 30 age-matched controls.

RESULTS

AA patients had increased CLA⁺ /CLA^- Th2 (P < .007), CLA⁺ Tc2 (P = .04), and CLA⁺ Th22 (P < .05) frequencies than controls. Except of CLA^- Tc1 cells (P = .03), IFN-γ levels were mostly similar between AA, AD, and controls (P > .1). ICOS and HLA-DR activation were significantly higher in AA than controls (P < .05). T regulatory cells were significantly decreased in AA patients than controls (P < .01) and were correlated with activated CD8⁺ T cells and with multiple cytokine subsets (P < .05). While Th2 and Tc2 clustered with disease severity, IFN-γ producing cells were linked with AA duration.

CONCLUSIONS

Alopecia areata is accompanied by Th2/Tc2 activation in skin-homing and systemic subsets, correlating with disease severity, while IFN-γ is linked to disease chronicity. These data hint for a possible role of diverse T-cells subsets in disease pathogenesis and emphasize the systemic nature of AA supporting the need for systemic therapeutic strategies in severe patients.

Pneumatic Balloon Dilatation for Achalasia Cardia; Early & late results, a single center study

Objective:

Achalasia Cardia is treated by Pneumatic balloon dilatation, Heller’s Myotomy and recently, by Peroral Esophagaeal Myotomy. This study reports the efficacy of pneumatic balloon dilatation as a non-surgical motility in achieving relief of dysphagia, clinical improvement and recurrence. Long-term complications were reported.

Methods:

Eight hundred ninety two adult achalasia patients of both genders were treated from January 1988 till December 2011, with pneumatic balloon (Rigiflex Microvasive^®) dilatation, under fluoroscopy Barium swallow was obtained prior to and five minutes after dilatation to evaluate for efficacy of dilatation as well as for complications. Patients not responding to 30 mm balloon had repeat dilatation with 35 mm balloon after 8 weeks. All patients were enrolled in regular follow up at one, six months and yearly intervals up to a period of five years. Recurrence was defined as an increase in symptom score at 8 weeks greater than 50% of their baseline value. These patients were treated with 35 mm balloon or referred for surgical intervention.

Results:

Of 892 patients, follow up was obtained in 50% for 5 years, 9.2% for 4-years), 9.3% for 3-years, 10% for 2-years and 21.5% for 1-year of patients. One patient died after repeat dilatation. Eighty-eight patients were excluded from this analysis (20 died due to non-procedure related causes and another 68 were lost during follow up). Statistically significant improvement was noted in reduction in height and width of barium column and symptom score coupled with weight gain during follow up. Forty-eight patients were subjected to repeat dilatation with 35 mm balloon, two of these developed post-procedure perforations with one mortality. Three non-responsive patients required surgical laparoscopic myotomy. No carcinoma of esophagus was reported during follow up. One patient post dilatation, developed esophageal bezoar. A single pneumatic dilatation achieved a remission rate of 93% at four years, 90% at three years, 95% at two years and 92% at one year post dilatation.

Conclusion:

Achalasia of esophagus can be effectively and safely treated with balloon dilatation to achieve adequate short and long-term symptomatic relief with a low complication rate.

AAA Syndrome, Case Report of a Rare Disease

Triple A (Allgrove) syndrome, an autosomal recessive disease is characterized by achalasia, alacrimia and ACTH-resistant adrenal failure with progressive neurological syndrome including central, peripheral and autonomic nervous system impairment, and mild mental retardation. The triple A syndrome gene, designated AAAS, localized on chromosome 12q 13 encodes for a 546 amino acid protein called ALADIN (Alacrimia-Achlasia-Adrenal Insufficiency and Neurologic disorder). This report relates to two sisters, aged 8 and 12 years, who had vomiting, muscle weakness, alacrimia, excessive fatigue and dysphagia. Abdominal sonography, esophago-gastroduodenoscopy, barium swallow, esophageal manometry, CT scan abdomen and brain, biochemical profiles, as well as neurologic and ophthalmic evaluations were consistent with Allgrove's syndrome. Management consisted of pneumatic balloon dilatation for achalasia and initiation of cortisone therapy with successful resolution of dysphagia and other symptoms.

Epidural steroid injections: update on efficacy, safety, and newer medications for injection

The best evidence for epidural injection appears to be in the setting of radicular pain with epidural steroid and non-steroid injections more efficacious than non-epidural injections. Studies showed the efficacy of non-particulate steroid to approach the efficacy of particulate steroid and very limited comparisons demonstrated no significant difference between epidural steroid and epidural non-steroid (local anesthetic) injection. Preliminary studies evaluating epidural injection of disease modifying anti-rheumatic drugs such etanercept and tocilizumab showed conflicting results and had significant limitations. Randomized studies support better efficacy of transforaminal injection due to greater incidence of ventral epidural spread of injectate when compared to interlaminar injection. Thus, the transforaminal approach is recommended when unilateral radicular pain is limited to one nerve root. However, the transforaminal approach is associated with greater incidence of central nervous system injury, including paraplegia, attributed to embolization of the particulate steroid. Recent studies showed that non-particulate steroids potentially last as long as particulate steroids. Therefore non-particulate steroid should be used in initial transforaminal epidural injection. Future studies should look into the role of adjunct diagnostic aids, including digital subtraction angiography, in detecting intravascular injection and the ideal site of needle placement, whether it is the safe triangle or the triangle of Kambin. Finally, the role of epidural disease -modifying antirheumatic drugs in the management of back pain needs to be better elucidated.

Pretreated rice straw as an improved fodder for ruminants-An overview

Rice straw, a by-product of the rice production is mainly used as a source of feed for ruminant livestock is the major forage in rice-producing areas in India. The disposal of the rice straw is a serious problem in areas where it is the major agricultural product. It is rich in polysaccharides and has a high lignin and silica content, limiting voluntary intake and reducing degradability by rumen microbes. By rice straw treatment, its quality and digestibility can be improved and enhanced the protein content. Several methods have been used to improve the utilization of rice straw by ruminants or supplemented by other ingredients to increase digestibility and nutrient value before it can be considered a suitable animal feed. In recent years, biological treatments have been investigated for improvement in nutritional value of rice straw. The use of ligninolytic fungi and their extracellular ligninolytic enzymes for treatment of rice straw results in degrading cellulose and hemicelluloses contents which improve its nutritional value. The use of fungi and enzyme treatments is expected to be a practical, cost-effective and environmental-friendly approach for enhancing the nutritive value and digestibility of rice straw. Therefore, the treated rice straw has a good potential as feed for ruminants.

Amelogenesis imperfecta: an introduction

Amelogenesis imperfecta (AI) is an inherited disorder that is associated with mutations in five genes (AMEL; ENAM; MMP20; KLK4 and FAM83H) with a wide range of clinical presentations (phenotypes). It affects the structure and appearance of enamel of all teeth, both in the primary and secondary dentition. In this review paper, we look at the epidemiology, classification, aetiology, clinical description and diagnosis of AI. In the following three papers of this series, we aim to describe the role of paediatric dentists, orthodontists and restorative dentists in the clinical management of patients with AI.

Long-range epigenetic silencing of chromosome 5q31 protocadherins is involved in early and late stages of colorectal tumorigenesis through modulation of oncogenic pathways

Loss of tumour suppressor gene function can occur as a result of epigenetic silencing of large chromosomal regions, referred to as long-range epigenetic silencing (LRES), and genome-wide analyses have revealed that LRES is present in many cancer types. Here we utilize Illumina Beadchip methylation array analysis to identify LRES across 800 kb of chromosome 5q31 in colorectal adenomas and carcinomas (n=34) relative to normal colonic epithelial DNA (n=6). This region encompasses 53 individual protocadherin (PCDH) genes divided among three gene clusters. Hypermethylation within these gene clusters is asynchronous; while most PCDH hypermethylation occurs early, and is apparent in adenomas, PCDHGC3 promoter methylation occurs later in the adenoma-carcinoma transition. PCDHGC3 was hypermethylated in 17/28 carcinomas (60.7%) according to methylation array analysis. Quantitative real-time reverse transcription-polymerase chain reaction showed that PCDHGC3 is the highest expressed PCDH in normal colonic epithelium, and that there was a strong reciprocal relationship between PCDHGC3 methylation and expression in carcinomas (R=-0.84). PCDH LRES patterns are reflected in colorectal tumour cell lines; adenoma cell lines are not methylated at PCDHGC3 and show abundant expression at the mRNA and protein level, while the expression is suppressed in hypermethylated carcinoma cell lines (R=-0.73). Short-interfering RNA-mediated reduction of PCDHGC3 led to a decrease of apoptosis in RG/C2 adenoma cells, and overexpression of PCDHGC3 in HCT116 cells resulted in the reduction of colony formation, consistent with tumour suppressor capabilities for PCDHGC3. Further functional analysis showed that PCDHGC3 can suppress Wnt and mammalian target of rapamycin signalling in colorectal cancer cell lines. Taken together, our data suggest that the PCDH LRES is an important tumour suppressor locus in colorectal cancer, and that PCDHGC3 may be a strong marker and driver for the adenoma-carcinoma transition.

Characterization and optimization of conditions for biodegradation of sella-rice mill effluent

The sella-rice mill effluent is a major environmental pollutant requiring proper treatment before disposal. The present study has been conducted to isolate and characterize micro-organisms capable of growing on sella-rice effluent and to optimize conditions for its rapid bioremediation. Using three different types of media (LB, YEPDA and PDA), a total of 139 isolates were isolated from effluent samples collected from three different locations. Out of these, 45 isolates were found to utilize starch on starch medium, eight isolates showing high efficiency. For the optimization of conditions for maximum utilization of starch by selected isolates, parameters such as effect of addition of carbon and nitrogen sources, effect of growth factors, temperature and pH were studied. Maximum growth (absorbance of 2.10) and starch-utilization (varying in the range of 2.33 to 3.62) was observed on starch medium supplemented with peptone and yeast extract at 30 degrees C with a pH of 6.0. These bacterial isolates also reduced the amount of starch (80.10%), BOD (64.24%) and COD (75.0%) of sella-rice mill effluent after 15 days of incubation. On the basis of morphological and biochemical characteristics, the selected isolates were found to belong to the genera Lactobacillus and Micrococcus.

Pulsed radiofrequency: a critical review of its efficacy

Pulsed radiofrequency is a growingly popular pain treatment modality. However, its clinical efficacy remains controversial. In this review, the available literature on pulsed radiofrequency is critically analysed to determine its clinical efficacy. Our search of the literature for pulsed radiofrequency yielded 341 citations; after reviewing the abstracts we found 51 relevant articles. There were 4 review articles: 44 articles pertained to the application of pulsed radiofrequency by an electrode placed in the vicinity of a neural structure. Of these only two were randomised controlled trials. Of the remaining 42 articles, one was a non-randomised controlled trial, three were prospective uncontrolled trials: there were six retrospective studies, 11 case reports, eight laboratory studies, two position papers, five editorials and seven items of correspondence, while one publication reported two studies. Three articles pertained to transcutaneous application of pulsed radiofrequency. Of the two randomised controlled trials, one reported efficacy of the pulsed radiofrequency while the other reported it to be ineffective. The majority of the uncontrolled and observational studies reported clinical efficacy of pulsed radiofrequency, however many of these studies had limitations. Further randomised controlled clinical trials are recommended in order for the practising pain physician to clearly understand the role of pulsed radiofrequency in the treatment of various chronic pain syndromes.

Achalasia esophagus; presenting as acute air way obstruction

Acute airway obstruction from mega-esophagus is a rare presentation of achalasia. Mega-esophagus is generally considered when the transverse width of the esophagus is more than 7 cm. A 78 year old lady presented with longstanding history of productive cough and nocturnal dyspnoea. She was seen in the emergency department with acute exacerbation of dyspnoea after a bout of vomiting, containing semi-solid food with foetid smell. Her respiratory status deteriorated rapidly with onset of stridor, and cyanosis. Chest x-ray showed widening of mediastinum due to dilated esophagus with air-fluid level. Prompt, repeated, upper respiratory tract suction was carried out. A wide bore nasogastric tube was introduced, esophagus was decompressed with a gush of air and fluid, relieving the respiratory distress. This case illustrates an unusual presentation of achalasia underscoring the need for urgent, life-saving esophageal decompression. Hypotheses, regarding the mechanism of airway compromise, as well as, treatment options are reviewed.

Treatment of multilevel degenerative disc disease with intradiscal electrothermal therapy

Intradiscal electrothermal therapy is a frequently performed procedure for the pain of internal disc disruption. It is typically performed on one to two discs; the discal treatment is followed by a long period of rest and rehabilitation. In patients with multilevel disc disease, intradiscal electrothermal therapy is either not contemplated or only one to two discs are treated at a time. This approach therefore either denies these patients the potential benefits of intradiscal electrothermal therapy or significantly prolongs the period of pain and disability. A 25-year-old female patient presented with internal disc disruption at four lumbar disc levels, diagnosed by provocative discography and post discography CT scan. All these discs were treated simultaneously by intradiscal electrothermal therapy. The patient tolerated the procedure well and responded favourably with significant and prolonged decrease in her symptoms. She reported sustained reduction in her pain and showed no clinical evidence of early neurological or infectious complications during 18 months of follow-up. This report indicates that intradiscal electrothermal therapy can be performed at multiple levels at a single sitting, compared to intradiscal electrothermal therapy performed at one to two discs at a time, this approach may obviate the need for surgery and may reduce the duration of pain and disability incurred. However, the influence of multilevel intradiscal electrothermal therapy on long-term complications or outcome is not known.

Genotype-phenotype correlation in a family with late onset CMT and an MPZ lys236del mutation

An in frame, lys236 deletion in the intracytoplasmic domain of myelin protein zero (MPZ) has recently been designated as a mutation possibly associated with Charcot-Marie-Tooth disease (CMT) but requiring further documentation. In this report we present a detailed clinical, electrophysiological, and genotype correlation in three generations of a family with the MPZ lys236del mutation and provide further evidence that this mutation is associated with CMT. The MPZ lys236del mutation is associated with an autosomal dominant, adult onset CMT phenotype, with variable penetrance ranging from an asymptomatic state to foot deformities, pedal numbness, and muscle cramps. Nerve conduction studies disclose intermediate range, somewhat non-uniform slowing of motor nerve conduction, which is accentuated in forelimb rather than distal nerve segments. Based on the contrasting finding of entirely normal conduction velocities (CV) in a genetically affected 15 year old in this family, it remains to be established whether CV slowing with this mutation is progressive in life, a pattern that would contrast with CMT1a (PMP22 gene duplication).

The validation of self-reported smoking status by analysing cotinine levels in stimulated and unstimulated saliva, serum and urine

OBJECTIVES

Cotinine, a nicotine metabolite, can be used to measure exposure to tobacco smoke. The aim of this study was to compare cotinine levels in different biological fluids collected from both smokers and non-smokers and to relate the findings to self-reported smoking status. Data were also collected concerning the acceptability of the differing methods of sample collection.

MATERIAL AND METHOD

Patients recruited to the study were asked to provide samples of urine, blood and saliva (both stimulated and unstimulated). Data collected from patients by questionnaire included information on smoking behaviour such as daily number of cigarettes and environmental exposure to smoke. After the sample collection, patients were asked to rate the acceptability of each sampling method. Samples were analysed using enzyme immunoassay (EIA) kits.

RESULTS

In total, 80 patients participated, with 49 being smokers and 31 being non-smokers. There was clear differentiation between smokers and non-smokers (P < 0.001) for all the different samples in terms of cotinine. A significant relationship was seen between cotinine and daily number of cigarettes for both salivas and urine (all P < 0.001) but not for serum. Participants found serum and urine collection methodologies 'very acceptable' (67 and 66%, respectively) whereas 9% found collection of stimulated saliva 'not at all acceptable'.

CONCLUSION

Cotinine, whatever the collection method and analysed by EIA kits, shows good differentiation between smokers and non-smokers. Salivary samples have the advantage of being non-invasive, although collection methodology is important, as cotinine levels may vary.

The new RENT family of repetitive elements in Nicotiana species harbors gene regulatory elements related to the tCUP cryptic promoter

The tCUP cryptic constitutive promoter was discovered in the tobacco genome by T-DNA (transfer DNA) tagging with a promoterless GUS-nos gene. Here, we show that the portion of the tCUP sequence containing a variety of cryptic gene regulatory elements is related to a new family of moderately repetitive sequences (10(2) copies), the RENT (repetitive element from Nicotiana tabacum) family. The RENT family is found only in certain Nicotiana species. Five RENT elements were cloned and sequenced. The RENT elements are a minimum of 5 kb in length and share 80-90% sequence similarity throughout their length. The 5' termini are the same in the isolated RENT family members and are characterized by a conserved border sequence (TGTTGA(T or C)ACCCAATTTT(T or C)). The 3' ends of RENT sequence similarity vary in location and sequence. The tCUP cryptic promoter originated from a unique truncated RENT element that interrupts a phytochelatin synthase-like gene that may have undergone rearrangements prior to or resulting from T-DNA insertion. No evidence was found for expressed coding regions within the RENT elements; however, like the cryptic gene regulatory elements within the tCUP sequence, the isolated RENT elements possess promoter activity and translational enhancer activity.

Wilms' tumor: a paradigm for the new genetics

Carcinogenesis can be triggered by a diverse range of molecular lesions, a variety of which can be illustrated by Wilm's tumor (WT), a pediatric kidney cancer. Molecular defects observed in WTs include several independent targets and mechanisms best exemplified by changes on the short arm of chromosome 11. This article will review the molecular pathology of WT and emphasize the broader ramifications for cancer genetics. Consideration will be given to carcinogenic pathways, novel cellular molecules, and technologies that will assist in the rapid interpretation and assimilation of DNA sequence data arising from the sequencing of the human genome.

A constitutive gene expression system derived from the tCUP cryptic promoter elements

A limited number of constitutive promoters have been used to direct transgene expression in plants and they are often derived from non-plant sources. Here, we describe novel gene-regulatory elements which are associated with a cryptic constitutive promoter from tobacco, tCUP, and modifications that were made to create a strong gene-expression system that is effective across all living cell types from a wide range of plant species, including several important crops ( Arabidopsis, canola, flax, alfalfa, tobacco). The tCUP 5' untranslated region was mutated to eliminate translational interference by upstream ATGs, and the influence of the Kozak consensus sequence on the levels of a beta-glucuronidase (GUS) reporter gene activity was demonstrated. These modifications resulted in expression that was greatly enhanced in all organs. A TATA consensus sequence was added to the core promoter to complement an existing Initiator (Inr) sequence. Although this addition was known to elevate core promoter activity by 3-fold the additive effect on the overall gene-expression system was marginal in all of the transgenic plants tested. Two transcriptional enhancers were identified and the region containing them were oligomerized, yielding a significant increase in marker gene-expression in some but not all plant species. In general, the enhanced tCUP gene-expression system generated levels of GUS activity which exceeded that of the 35S promoter in most plant species and the elevation in activity occurred uniformly among the various plant organs. The potential benefit of cryptic elements for the construction of gene-expression systems for crop species is discussed