Multi-Institutional Clinical Outcomes of Biopsy Gleason Grade Group 5 Prostate Cancers Treated With Contemporary High-Dose Radiation and Long-Term Androgen Deprivation Therapy

AIMS

This multicentric retrospective study reports long-term clinical outcomes of non-metastatic grade group 5 prostate cancers treated with external beam radiotherapy (EBRT) alone with long-term androgen deprivation therapy (ADT).

MATERIALS AND METHODS

Patients treated across 19 institutions were studied. The key endpoints that were evaluated were 5-year biochemical recurrence-free survival (bRFS), metastases-free survival (MFS), overall survival, together with EBRT-related acute and late toxicities. The impact of various prognostic factors on the studied endpoints was analysed using univariate and multivariate analyses.

RESULTS

Among the 462 patients, 88% (405) had Gleason 9 disease and 31% (142) had primary Gleason pattern 5. A prostate-specific membrane antigen positron emission tomography-computed tomography scan was used for staging in 33% (153), 80% (371) were staged as T3/T4 and 30% (142) with pelvic nodal disease. The median ADT duration was 24 months; 66% received hypofractionated EBRT and 71.4% (330) received pelvic nodal irradiation. With a median follow-up of 56 months, the 5-year bRFS, MFS and overall survival were 73.1%, 77.4% and 90.5%, respectively. Primary Gleason pattern 5 was associated with worse bRFS, MFS and overall survival with hazard ratios of 0.51 (95% confidence interval 0.35 to 0.73, P < 0.001), 0.64 (95% confidence interval 0.43 to 0.96, P = 0.031) and 0.52 (95% confidence interval 0.28 to 0.97, P = 0.040), respectively, whereas pelvic nodal disease was associated with worse bRFS (hazard ratio 0.67, 95% confidence interval 0.46 to 0.98, P = 0.039) and MFS (hazard ratio 0.56, 95% confidence interval 0.37 to 0.85, P = 0.006). The acute and late radiation-related toxicities were low overall and pelvic nodal irradiation was associated with higher toxicities.

CONCLUSION

Contemporary EBRT and long-term ADT led to excellent 5-year clinical outcomes and low rates of toxicity in this cohort of non-metastatic grade group 5 prostate cancers. Primary Gleason pattern 5 and pelvic node disease portends inferior clinical outcomes.

Comparative analysis of contraceptive use in Punjab and Manipur: exploring beyond women's education and empowerment

Background

Women’s education and empowerment are important predictors of contraceptive use across countries. However, two of the Indian states, namely, Punjab and Manipur, showed large variations in contraceptive use, despite the similar level of women’s educational attainment and empowerment. Therefore, this paper attempts to understand variation in contraceptive use between these states, despite having similar level of educational attainment and empowerment among the married women.

Methods

This study primarily used cross-sectional data of the National Family Health Survey (NFHS) 2015–16 and to some extent the District Level Household Survey (DLHS) 2012–13 data. The analytical sample includes 13,730 currently married women in Punjab and 8,872 in Manipur. Modern contraceptive prevalence rate (mCPR) is the key outcome variable of this study. Bivariate, multivariate, and multilevel regression analysis are applied to understand the differences in mCPR between these states and its determinants.

Results

Mean years of schooling was about 8 years among women of both the states, and about 34% of the women in Punjab and 27% of the women in Manipur have high level of autonomy. Despite this, use of modern method was 66% in Punjab and only 13% in Manipur. Coverage of family planning program indicators were significantly lower in Manipur than Punjab – frontline workers’ (FLWs) outreach for family planning was only 18% in Manipur compared to 52% in Punjab. Similarly, only 11% of the public health facilities in Manipur compared to 50% of the health facilities in Punjab were ready to provide at least one clinical method of family planning.

Conclusion

Despite the similar level of individual level characteristics across the two states, poor coverage of family planning programs – low outreach of FLWs, low level of facility readiness, as well as sociocultural norms discouraging contraceptive use – might be responsible for lower contraceptive use in Manipur than Punjab. This implies for strengthening the health system for family planning in Manipur to meet the contraception needs of women by addressing sociocultural barriers in the state.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13147-3.

Engineered Electroactive Solutions for Electrochemical Detection of Tuberculosis-Associated Volatile Organic Biomarkers

Rapid screening of tuberculosis by evaluation of associated volatile organic biomarkers in breath is a promising technology that is significantly faster and more convenient than traditional sputum culture tests. Methyl nicotinate (MN) and methyl p-anisate (MPA) have been isolated as potential biomarkers for mycobacterium tuberculosis and have been found in the breath of patients with active pulmonary tuberculosis. A novel approach to detection of these biomarkers in liquid droplets (e.g. from breath condensate) using inexpensive screen-printed electrodes is presented. Previous modelling studies suggest that these biomarkers complex with certain transition metals of particular valence state. This interaction can be exploited by mixing the biomarker sample into an electroactive solution (EAS) containing the functional metal ion and observing the change electrochemically. The study focuses on low biomarker concentrations, determined to be clinically relevant based on preliminary GC-MS studies of the levels found in patient breath. It was found that both the cyclic voltammogram and square wave voltammogram of copper(II) change significantly when as little as 0.1 mM MN is added to the solution, with analysis times of less than 2 min. Copper(II) exhibits three separate peaks during square wave voltammetry. The location and area of each peak are affected differently as the concentration of MN increases, suggesting a reaction with specific oxidation states of the metal. In this way, a "fingerprint" method can be used to identify biomarkers once their known interaction is established.

Drudgery assessment and ergonomic evaluation of pedal operated Ragi (Eleusine Coracana) thresher

BACKGROUND

Ragi (Eleusine Coracana) is a major food crop for the tribal population of India.

OBJECTIVE

This study emphasizes the need to consider ergonomics aspects in the design and development of a pedal operated ragi thresher (PORT) for tribal people, and assesses the drudgery as well as ergonomic evaluation of a developed thresher against the conventional practice.

METHODS

Thirty subjects (male = 15 and female = 15) from the tribal region were evaluated ergonomically. The physiological responses of the subjects were studied and their performance was compared.

RESULTS

The results revealed that the working heart rate, oxygen consumption rate and overall discomfort rating were significantly higher in case of traditional threshing as compared to those in case of PORT. Postural analysis identified the traditional method as the most fatigue one as the person has to lift the hand above shoulder level repeatedly and has to sit in a squatting posture for long period.

CONCLUSION

The drudgery and occupational hazards to public health involved in the traditional method of threshing was reduced by using the PORT. Furthermore, the traditional method involved continuous stressed actions across the entire body, whereas the PORT involved only the lower limbs.

Plasmonic Photocatalytic Enhancement of L-Cysteine Self-Assembled Gold Nanoparticle Clusters for Fenton Reaction Catalysis

Plasmon-enhanced photocatalysis has the potential to reduce activation energies and decrease temperature requirements, which increases catalyst stability and lowers process operating costs. The near-field enhancement that occurs at junctions between plasmonic nanoparticle clusters (i.e., hot spots) has been well-studied for sensing applications (e.g., Raman scattering). However, experimental insight into the effect of nanoparticle cluster hot spots on plasmon-enhanced photocatalysis is lacking. We demonstrate that catalytic activity is increased when clusters of gold nanoparticles (AuNPs) are formed relative to isolated particles using the same catalyst loading. Through experimental controls, we conclude that this catalytic enhancement is most likely due to the formation of plasmonic hot spots. Clusters of AuNPs were formed by adding L-cysteine to an AuNP dispersion, and a 20 ± 12% enhancement in the photocatalytic dye degradation rate was observed using a Fenton process. While this report may be a modest enhancement relative to the spectacular near-field electromagnetic field enhancements predicted by simulation at the nanoparticle junction, this finding supports the recent work of Srimanta et al. that plasmonic hot spots contribute to catalytic rate enchantments. It is anticipated that further self-assembly strategies to optimize interparticle orientations and cluster size distributions will improve the enhancement due to the formation of hot spots, and careful control will be required. For example, excess L-cysteine addition revealed extensive aggregation and subsequent rate reductions.

Status of pesticide residues in water, sediment, and fishes of Chilika Lake, India

Chilika Lake is the largest coastal lagoon in Asia and the second largest in the world covering an area of 1100 km² and spread over three districts of Odisha state of India. It is the first Indian wetland designated as a wetland of international importance under the Ramsar Convention in 1981. The lake ecosystem sustains large and diversified resources of plants and animals including fisheries. Pollution of the ecosystem caused by residues of pesticides originating from different sources was assessed through multiple sampling from 2012 to 2016 from three potential sites of contamination, viz., Palur Bridge, Daya River Estuary, and Makara River. Incidence of organochlorinated (OC) pesticide residues was noticed in about 25% water samples. HCH (α, γ&δ), DDD (op^|), DDE (op^|&pp.^|) and heptachlor were the OCs detected in concentration varying from 0.025 to 23.4 μg/l. None of the eight targeted synthetic pyrethroid (SP) pesticides was found in water, but among the organophosphates (OP), chlorpyrifos (0.019-2.73 μg/l), and dichlorvos (0.647 μg/l) were recorded. In sediment samples, residues of OC or OP pesticides were not present, but one SP pesticide was recorded. Fish samples were contaminated to the extent of 55%, mostly with residues of OCs and OPs and less with SPs. However, their concentrations were below the permissible limit, so there was no direct threat of health hazards to humans.

Detection of Four Distinct Volatile Indicators of Colorectal Cancer using Functionalized Titania Nanotubular Arrays

Screening of colorectal cancer is crucial for early stage diagnosis and treatment. Detection of volatile organic compounds (VOCs) of the metabolome present in exhaled breath is a promising approach to screen colorectal cancer (CRC). Various forms of volatile organic compounds (VOCs) that show the definitive signature for the different diseases including cancers are present in exhale breathe. Among all the reported CRC VOCs, cyclohexane, methylcyclohexane, 1,3-dimethyl- benzene and decanal are identified as the prominent ones that can be used as the signature for CRC screening. In the present investigation, detection of the four prominent VOCs related to CRC is explored using functionalized titania nanotubular arrays (TNAs)-based sensor. These signature biomarkers are shown to be detected using nickel-functionalized TNA as an electrochemical sensor. The sensing mechanism is based on the electrochemical interaction of nickel-functionalized nanotubes with signature biomarkers. A detailed mechanism of the sensor response is also presented.

Development of a field enhanced photocatalytic device for biocide of coliform bacteria

A field enhanced flow reactor using bias assisted photocatalysis was developed for bacterial disinfection in lab-synthesized and natural waters. The reactor provided complete inactivation of contaminated waters with flow rates of 50mL/min. The device consisted of titanium dioxide nanotube arrays, with an externally applied bias of up to 6V. Light intensity, applied voltage, background electrolytes and bacteria concentration were all found to impact the device performance. Complete inactivation of Escherichia coli W3110 (~8×10(3)CFU/mL) occurred in 15sec in the reactor irradiated at 25mW/cm(2) with an applied voltage of 4V in a 100ppm NaCl solution. Real world testing was conducted using source water from Emigration Creek in Salt Lake City, Utah. Disinfection of natural creek water proved more challenging, providing complete bacterial inactivation after 25sec at 6V. A reduction in bactericidal efficacy was attributed to the presence of inorganic and organic species, as well as the increase in robustness of natural bacteria.

Electrochemical capacitance of iron oxide nanotube (Fe-NT): effect of annealing atmospheres

The effect of annealing atmosphere on the supercapacitance behavior of iron oxide nanotube (Fe-NT) electrodes has been explored and reported here. Iron oxide nanotubes were synthesized on a pure iron substrate through an electrochemical anodization process in an ethylene glycol solution containing 3% H2O and 0.5 wt.% NH4F. Subsequently, the annealing of the nanotubes was carried out at 500 °C for 2 h in various gas atmospheres such as air, oxygen (O2), nitrogen (N2), and argon (Ar). The morphology and crystal phases evolved after the annealing processes were examined via field emission scanning electron microscopy, x-ray diffraction, Raman spectroscopy, and x-ray photoelectron spectroscopy. The electrochemical capacitance properties of the annealed Fe-NT electrodes were evaluated by conducting cyclic voltammetry (CV), galvanostatic charge-discharge, and electrochemical impedance spectroscopy tests in the Li2SO4 electrolyte. Based on these experiments, it was found that the capacitance of the Fe-NT electrodes annealed in air and O2 atmospheres shows mixed behavior comprising both the electric double layer and pseudocapacitance. However, annealing in N2 and Ar environments resulted in well-defined redox peaks in the CV profiles of the Fe-NT electrodes, which are therefore attributed to the relatively higher pseudonature of the capacitance in these electrodes. Based on the galvanostatic charge-discharge studies, the specific capacitance achieved in the Fe-NT electrode after annealing in Ar was about 300 mF cm(-2), which was about twice the value obtained for N2-annealed Fe-NTs and three times higher than those annealed in air and O2. The experiments also demonstrated excellent cycle stability for the Fe-NT electrodes with 83%-85% capacitance retention, even after many charge-discharge cycles, irrespective of the gas atmospheres used during annealing. The increase in the specific capacitance was discussed in terms of increased oxygen vacancies as a result of the enhanced transformation of the hematite (α-Fe2O3) phase to the magnetite (Fe3O4) phase for the electrodes annealed in the N2 and Ar atmospheres.

Neuronal beacon

The controlled navigation of the axonal growth cone of a neuron toward the dendrite of its synaptic partner neuron is the fundamental process in forming neuronal circuitry. While a number of technologies have been pursued for axonal guidance over the past decades, they are either invasive or not controllable with high spatial and temporal resolution and are often limited by low guidance efficacy. Here, we report a neuronal beacon based on light for highly efficient and controlled guidance of cortical primary neurons.

Fiber-optic two-photon optogenetic stimulation

Optogenetic stimulation of genetically targeted cells is proving to be a powerful tool in the study of cellular systems, both in vitro and in vivo. However, most opsins are activated in the visible spectrum, where significant absorption and scattering of stimulating light occurs, leading to low penetration depth and less precise stimulation. Since we first (to the best of our knowledge) demonstrated two-photon optogenetic stimulation (TPOS), it has gained considerable interest in the probing of cellular circuitry by precise spatial modulation. However, all existing methods use microscope objectives and complex scanning beam geometries. Here, we report a nonscanning method based on multimode fiber to accomplish fiber-optic TPOS of cells.

Redox-induced enhancement in interfacial capacitance of the titania nanotube/bismuth oxide composite electrode

Bismuth oxide (Bi2O3) decorated titania nanotube array (T-NT) composite materials were synthesized by a simple, yet versatile electrodeposition method. The effects of deposition current density and time on morphology evolution of the bismuth oxide phase were analyzed. It was found that an optimum deposition condition in terms of current density and time could be reached to achieve uniform and equiaxed crystal morphology of the deposited oxide phase. The morphology, shape, size distribution, and crystal structure of the bismuth oxide phase were evaluated using scanning electron microscopy (SEM), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), and Raman spectroscopic techniques. The electrochemical capacitance of the T-NT/Bi2O3 composites was studied by conducting cyclic voltammetry and galvanostatic charge-discharge experiments. These studies indicated that the capacitance behavior of the composite material was dependent on the morphology and distribution of the bismuth oxide phase. The capacitance was greatly enhanced for the composite having equiaxed and uniformly distributed bismuth oxide particles. The maximum interfacial capacitance achieved in this study was approximately 430 mF cm(-2). Galvanostatic charge-discharge experiments conducted on the composite materials suggested stable capacitance behavior together with excellent capacitance retention even after 500 cycles of continuous charge-discharge operation.

Sorting single satellite cells from individual myofibers reveals heterogeneity in cell-surface markers and myogenic capacity

Traditional cell-screening techniques such as FACS and MACS are better suited for large numbers of cells isolated from bulk tissue and cannot easily screen stem or progenitor cells from minute populations found in their physiological niches. Furthermore, these techniques rely upon irreversible antibody binding, potentially altering cell properties, including gene expression and regenerative capacity. To address these challenges, we have developed a novel, label-free stem-cell analysis and sorting platform capable of quantifying cell-surface marker expression of single functional organ stem cells directly isolated from their micro-anatomical niche. Using our unique platform, we have discovered a remarkable heterogeneity in both the regenerative capacity and expression of CXCR4, β1-integrin, Sca-1, M-cadherin, Syndecan-4, and Notch-1 in freshly isolated muscle stem (satellite) cells residing on different, single myofibers and have identified a small population of Sca-1(+)/Myf5(+) myogenic satellite cells. Our results demonstrate the utility of our single-cell platform for uncovering and functionally characterizing stem-cell heterogeneity in the organ microniche.

Light-assisted anodized TiO₂ nanotube arrays

Self-assembled arrays of titania nanotubes are synthesized via electrochemical anodization of Ti foils under the presence of UV-vis irradiation. Compared to control samples (anodized without light), the light-assisted anodized samples exhibit larger diameters as well as thicker nanotube walls, whereas the length of the nanotubes remains the same under otherwise similar synthesis conditions. Enhanced photoelectrochemical performance with light-assisted anodized samples under simulated AM 1.5 irradiation is observed by an increase in photocurrent density of 45-73% at 1.23 V (RHE). The enhanced photoelectrochemical performance is correlated to improved charge separation analyzed by Mott-Schottky. A mechanism on the photoeffect during anodization is presented. The morphology and improved properties obtained from the synthesis methodology may also find application in other fields such as sensing and catalysis.

Site-specific and patterned growth of TiO2 nanotube arrays from e-beam evaporated thin titanium film on Si wafer

Growth of TiO(2) nanotubes on thin Ti film deposited on Si wafers with site-specific and patterned growth using a photolithography technique is demonstrated for the first time. Ti films were deposited via e-beam evaporation to a thickness of 350-1000 nm. The use of a fluorinated organic electrolyte at room temperature produced the growth of nanotubes with varying applied voltages of 10-60 V (DC) which remained stable after annealing at 500 °C. It was found that variation of the thickness of the deposited Ti film could be used to control the length of the nanotubes regardless of longer anodization time/voltage. Growth of the nanotubes on a SiO(2) barrier layer over a Si wafer, along with site-specific and patterned growth, enables potential application of TiO(2) nanotubes in NEMS/MEMS-type devices.

An integrated μLED optrode for optogenetic stimulation and electrical recording

In this letter, we developed an integrated neural probe prototype for optogenetic stimulation by microscale light-emitting diode (μLED) and simultaneous recording of neural activities with microelectrodes on a single-polyimide platform. Optogenetics stimulates in vivo neural circuits with high-cellular specificity achieved by genetic targeting and precise temporal resolution by interaction of light-gated ion channels with optical beam. In our newly developed optrode probe, during optogenetic stimulation of neurons, continuous sensing of neuronal activities in vicinity of the activation site can provide feedback to stimulation or examine local responses in signal pathways. In the device, focusing the light from the μLED was achieved with an integrated photo-polymerized lens. The efficacy of the optrode for cortical stimulation and recording was tested on mice visual cortex neurons expressing channelrhodopsin-2. Stimulation intensity and frequency-dependent spiking activities of visual cortex were recorded. Our device has shown advantages over fiber-coupled laser-based optrode in terms of closed-loop integration, single-implant compactness and lower electrical power requirements, which would be clinically applicable for future prosthetic applications in personalized medicine.

Growth and characterization of TiO2 nanotubes from sputtered Ti film on Si substrate

In this paper, we present the synthesis of self-organized TiO2 nanotube arrays formed by anodization of thin Ti film deposited on Si wafers by direct current (D.C.) sputtering. Organic electrolyte was used to demonstrate the growth of stable nanotubes at room temperature with voltages varying from 10 to 60 V (D.C.). The tubes were about 1.4 times longer than the thickness of the sputtered Ti film, showing little undesired dissolution of the metal in the electrolyte during anodization. By varying the thickness of the deposited Ti film, the length of the nanotubes could be controlled precisely irrespective of longer anodization time and/or anodization voltage. Scanning electron microscopy, atomic force microscopy, diffuse-reflectance UV-vis spectroscopy, and X-ray diffraction were used to characterize the thin film nanotubes. The tubes exhibited good adhesion to the wafer and did not peel off after annealing in air at 350 °C to form anatase TiO2. With TiO2 nanotubes on planar/stable Si substrates, one can envision their integration with the current micro-fabrication technique large-scale fabrication of TiO2 nanotube-based devices.

New method for synthesis of Pt nanoparticles embedded in a carbon matrix

Platinum (Pt) nanoparticles embedded in a carbon matrix were synthesized for the first time in benzene by an electric plasma discharge generated in the cavitation field of benzene due to an ultrasonic horn. Transmission electron microscopy (TEM) and X-ray diffraction (XRD) were used to study the particle size, structure and morphology of the synthesized nanoparticles. The Pt nanoparticles have FCC bulk Pt crystal structure. On the average Pt nanoparticle diameter ranged from 8 nm to 40 nm when synthesized at 4.1 kV and from 5 nm to 25 nm when synthesized at 3.4 kV. X-ray photoelectron Spectroscopy (XPS) and Energy dispersive X-ray Spectroscopy (EDX) were used to study the chemical composition of the synthesized nanoparticles. A cost effective new method for carbon supported Pt nanoparticles will be of potential interest in fuel cell and catalysis applications.

An unusual case of bilateral renal enlargement due to primary renal lymphoma

Primary renal lymphoma is an uncommon variant of extranodal non-Hodgkin’s lymphoma. Manifestations are usually nonspecific hematuria, fever, flank pain, and renal insufficiency. Pathological data are scanty; few reports indicate it has a very poor prognosis. We describe a child with bilateral symmetrically palpable kidneys, low-grade pyrexia, and arthralgia. Clinically, diagnosis was missed partly due to the fact that bilateral large renal tumors commonly produce asymmetric renal swelling, renal dysfunction, and hematuria which were absent in this case and partly due to rarity of the condition. However, radiological investigations combined with renal histology helped in establishing diagnosis in the present case.

An accessible micro-capillary electrophoresis device using surface-tension-driven flow

We present a rapidly fabricated micro-capillary electrophoresis chip that utilizes surface-tension-driven flow for sample injection and extraction of DNA. Surface-tension-driven flow (i.e. passive pumping) [G. M. Walker et al., Lab. Chip. 2002, 2, 131-134] injects a fixed volume of sample that can be predicted mathematically. Passive pumping eliminates the need for tubing, valves, syringe pumps, and other equipment typically needed for interfacing with microelectrophoresis chips. This method requires a standard micropipette to load samples before separation, and remove the resulting bands after analysis. The device was made using liquid phase photopolymerization to rapidly fabricate the chip without the need of special equipment typically associated with the construction of microelectrophoresis chips (e.g. cleanroom) [A. K. Agarwal et al., J. Micromech. Microeng. 2006, 16, 332-340; S. K. Mohanty et al., Electrophoresis 2006, 27, 3772-3778]. Batch fabrication time for the device presented here was 1.5 h including channel coating time to suppress electroosmotic flow. Devices were constructed out of poly-isobornyl acrylate and glass. A standard microscope with a UV source was used for sample detection. Separations were demonstrated using Promega BenchTop 100 bp ladder in hydroxyl ethyl cellulose (HEC) and oligonucleotides of 91 and 118 bp were used to characterize sample injection and extraction of DNA bands. The end result was an inexpensive micro-capillary electrophoresis device that uses tools (e.g. micropipette, electrophoretic power supplies, and microscopes) already present in most labs for sample manipulation and detection, making it more accessible for potential end users.

Organization of microscale objects using a microfabricated optical fiber

We demonstrate the use of a single fiber-optic axicon device for organization of microscopic objects using longitudinal optical binding. Further, by manipulating the shape of the fiber tip, part of the emanating light was made to undergo total internal reflection in the conical tip region, enabling near-field trapping. Near-field trapping resulted in trapping and self-organization of long chains of particles along azimuthal directions (in contrast to the axial direction, observed in the case of large tip cone angle far-field trapping).

Cell characterization using a protein-functionalized pore

We demonstrate a highly-sensitive and label-free method for characterizing cells based on cell-surface receptors. The method involves measuring a current pulse generated when an individual cell passes through an artificial pore. When the pore is functionalized with proteins, specific interactions between a cell-surface marker and the functionalized proteins retard the cell, thus leading to an increased pulse duration that indicates the presence of that specific biomarker. For proof-of-principle, we successfully screened murine erythroleukemia cells based on their CD34 surface marker in both a single and mixed population of cells. Further, we developed a unified constrained statistical model for estimating the ratios of cells in a mixed population. Finally, we demonstrated our ability to screen a small number of cells (hundreds or less) with high accuracy and sensitivity. Overall, our pore-based method is broadly applicable and, in the future, could provide a full range of in vitro cell-based assays.

Consent and coercion: examining unwanted sex among married young women in India

CONTEXT

Although there is a growing body of research examining the issue of nonconsensual sex among adolescents, few studies have looked at coerced sex within marriage in settings where early marriage is common, or at sex that may not be perceived as forced, but that is unwanted.

METHODS

A cross-sectional study, using both survey research and in-depth interviews, was conducted among 1,664 married young women in Gujarat and West Bengal, India. Descriptive data and multinomial logistic regression were used to identify the prevalence and risk factors for occasional and frequent unwanted sex. Qualitative data were analyzed to examine the context in which unwanted sex takes place.

RESULTS

Twelve percent of married young women experienced unwanted sex frequently; 32% experienced it occasionally. The risk of experiencing unwanted sex was lower among women who knew their husband fairly well at the time of marriage, regularly received support from their husband in conflicts with other family members or lived in economically better-off households. Frequent unwanted sex was associated with not yet having had a child or having become pregnant, with lower education and with agreeing with norms that justify wife beating.

CONCLUSION

For married young women, sex is not always consensual or wanted. Further research is required to determine the effects of unwanted sex on sexual and reproductive health outcomes and to help programs develop the best strategies for dealing with coerced sex within marriage.

Hybrid polymer/thin film impedance system for label free monitoring of cells

Impedance measurements (capacitive cytometry) have been used to perform label-free analysis of cells. Two devices were constructed using a simple liquid photopolymerization technique known as muFluidicTectonics. This platform has made it possible to rapidly fabricate with great ease and without the use of traditional MEMS technology a cell impedance measurement system. Measurements were made using not only a single 1 kHz frequency but also a frequency sweep from 50 Hz to 20 kHz. Single frequency measurements on SP2 mouse cells showed show that there is a strong, linear relationship between the DNA content of individual cells and their dielectric (or capacitance) response to a 1 kHz field. Frequency sweeps were conducted on SF9 cells as means to perform diagnostic measurements of the device when different number of cells are present.

Do-it-yourself microelectrophoresis chips with integrated sample recovery

We present a microelectrophoresis chip that is simple to fabricate using the microfluidic tectonics (microFT) platform (Beebe, D. J. et al., Proc. Natl. Acad. Sci. USA 2000, 97, 13488-13493; Agarwal, A. K. et al.,. J. Micromech. Microeng. 2006, 16, 332-340). The device contains a removable capillary insert (RCI) for easy sample collection after separation (Atencia, J. et al.,. Lab Chip 2006, DOI: 10. 1039/b514068d). Device construction is accomplished in less than 20 min without specialized equipment traditionally associated with microelectrophoresis chip construction. microFT was used to build a PAGE device utilizing two orthogonal microchannels. One channel performs standard separations, while the second channel serves as an access point to remove bands of interest from the chip via the RCI. The RCI contains an integrated electrode that facilitates the removal of bands using electrokinetic techniques. The device was characterized using prestained proteins (Pierce BlueRanger and TriChromRanger). Samples were loaded into the microelectrophoresis device via a standard micropipette. An electrical field of 40 V/cm was used to separate and collect the proteins. The microPAGE device is simple to fabricate, benefits from microscale analysis, and includes an on-chip collection scheme that interfaces the macroworld with the microworld.

Optical Micromanipulation Methods for Controlled Rotation, Transportation, and Microinjection of Biological Objects

The use of laser microtools for rotation and controlled transport of microscopic biological objects and for microinjection of exogenous material in cells is discussed. We first provide a brief overview of the laser tweezers-based methods for rotation or orientation of microscopic objects. Particular emphasis is placed on the methods that are more suitable for the manipulation of biological objects, and the use of these for two-dimensional (2D) and 3D rotations/orientations of intracellular objects is discussed. We also discuss how a change in the shape of a red blood cell (RBC) suspended in hypertonic buffer leads to its rotation when it is optically tweezed. The potential use of this approach for the diagnosis of malaria is also illustrated. The use of a line tweezers having an asymmetric intensity distribution about the center of its major axis for simultaneous transport of microscopic objects, and the successful use of this approach for induction, enhancement, and guidance of neuronal growth cones is presented next. Finally, we describe laser microbeam-assisted microinjection of impermeable drugs into cells and also briefly discuss possible adverse effects of the laser trap or microbeams on cells.

Management of Vascular Injuries in a Forward Hospital

BACKGROUND

Management of vascular injuries poses a challenging problem under warlike conditions. Several authorities recommend limb revascularisation only within first 6-8 hours, as the outcome after delayed revascularisation is poor.

METHODS

A retrospective analysis of 61 consecutive patients with vascular injury in a forward hospital over a 25- month period was carried out.

RESULTS

Vascular injuries constituted 3.1% of all injuries. The mean injury to treatment delay (lag time) was 11 hours, and 10 patients received treatment after 12 hours. The overall amputation rate was 15%, but only 6.5% for those revascularised within 12 hours and 44% for those undergoing surgery after 12 hours (Chi-square 4.59, p < 0.05). Presence of associated fractures was associated with an adverse outcome (Chi-square 4.24, p < 0.05), as was ligation in comparison to revascularisation (Chi-square 7.86, p < 0.005). Popliteal injuries were associated with a high amputation rate.

CONCLUSIONS

Failure to revascularise (ligation of artery), presence of associated fracture, and restoration of circulation beyond 12 hours are associated with a high amputation rate.

Optical trapping and transportation of carbon nanotubes made easy by decorating with palladium

Individual carbon nanotubes being substantially smaller than the wavelength of light, are not much responsive to optical manipulation. Here we demonstrate how decorating single-walled carbon nanotubes with palladium particles makes optical trapping and manipulation easier. Palladium decorated nanotubes (Pd/SWNTs) have higher effective dielectric constant and are trapped at much lower laser power level with greater ease. In addition, we report the transportation of Pd/SWNTs using an asymmetric line trap. Using this method carbon nanotubes can be transported in any desired direction with high transportation speed.

Serous effusions: diagnosis of malignancy beyond cytomorphology. An analytic review

In this brief review, the role of various ancillary techniques to detect malignancy in effusion fluid are evaluated and discussed. The data were collected from a large number of research articles published in various medical journals. The role of these techniques to increase the diagnostic accuracy in serous effusions is emphasised.

Treatment of Casualties in a Forward Hospital of Indian Army : Nine year Experience

BACKGROUND

To analyze the outcome of the management of casualties in a level II trauma centre of a forward hospital of Armed Forces over a nine year period. Retrospective analysis of all casualties received in a single forward hospital of Indian Army was carried out.

METHOD

During 9 years (1990-1998), a total of 5737 casualties were received in a single level II zonal hospital of the Army in a forward area. Majority of the injuries were caused by bullets, or by fragments of improvised explosive devices. A policy of aggressive resuscitation and early primary repair of injuries was followed. General surgeons routinely performed craniotomies, thoracotomies, laparotomies, stabilization of fractures by fixators and repair of vascular injuries.

RESULT

38% of patients had injuries to several body parts (polytrauma), resulting in a total of 8578 injuries. Region-wise distribution of injuries was as follows : 14.2% head and neck injuries, 13.3% chest wounds, 13.5% abdominal injury and 59% extremity wounds. The overall mortality rate was 3.6%. The complication rate was about 7% with infection as the major complication. The results of primary repair of colonic injuries were similar to those of staged repairs. The results after primary closure of war wounds were better than those treated with delayed primary closure in selected cases.

CONCLUSION

Prompt evacuation, speedy resuscitation and early definitive repair of war injuries results in low mortality and morbidity. A motivated and dedicated team and adequate availability of blood and ancillary services adds to the excellent outcome. The policy of primary repair of colonic and selected soft tissue injuries appears justified in selected cases.

Multi-layer plastic/glass microfluidic systems containing electrical and mechanical functionality

This paper describes an approach for fabricating multi-layer microfluidic systems from a combination of glass and plastic materials. Methods and characterization results for the microfabrication technologies underlying the process flow are presented. The approach is used to fabricate and characterize multi-layer plastic/glass microfluidic systems containing electrical and mechanical functionality. Hot embossing, heat staking of plastics, injection molding, microstenciling of electrodes, and stereolithography were combined with conventional MEMS fabrication techniques to realize the multi-layer systems. The approach enabled the integration of multiple plastic/glass materials into a single monolithic system, provided a solution for the integration of electrical functionality throughout the system, provided a mechanism for the inclusion of microactuators such as micropumps/valves, and provided an interconnect technology for interfacing fluids and electrical components between the micro system and the macro world.