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Infective endocarditis (IE) is a disease with high morbidity and mortality rate, but diagnosis is confounded by diverse clinical presentations, which mimic other pathologies. A history of illicit intravenous drug use, previous cardiac valve surgery, and indwelling intracardiac devices increases the risk for developing infective endocarditis. The modified Duke criteria serve as the standard diagnostic tool, though its accuracy is reduced in certain cases. Radiologists in the Emergency Room setting reading body CT may be the first to identify the secondary extra-cardiac complications and facilitate expeditious management by considering otherwise unsuspected infective endocarditis. This review highlights common extracardiac complications of IE and their corresponding CT findings in the chest, abdomen, pelvis, and brain. If IE is suspected radiologists should suggest further investigation with echocardiography. [ABSTRACT FROM AUTHOR]

This review article discusses the most common benign biliary disorders and the various radiological findings on multiple modalities. A broad spectrum of diseases including various congenital disorders, infective and parasitic etiologies, immunological pathologies such as primary sclerosing cholangitis, and immunoglobulin G4-related sclerosing cholangitis are discussed along with obstructive diseases and ischemic cholangitis. The article emphasized the imaging differential diagnosis of the above lesions as well as clinical correlates those that are most relevant to radiologists. The article briefly touched upon management and intervention where relevant. [ABSTRACT FROM AUTHOR]

For all its importance to the Green Revolution, groundwater is India's most valuable and vulnerable natural resource. This is especially true in Punjab and Haryana, two of India's most agriculturally advanced states. Between 2004 and 2017, groundwater levels in Punjab and Haryana fell by 7 and 5 m, respectively. This study aims to evaluate regional groundwater extraction trends and assess the productivity of groundwater irrigation for rice and wheat, the two most significant crops in Punjab and Haryana. The results indicate significant disparities in groundwater irrigation and economic productivity in both inter-state and intra-state settings. [ABSTRACT FROM AUTHOR]

Aim: There is significant practice variation with respect to the use of bowel preparation to reduce surgical site infection (SSI) following colon surgery. Although intravenous antibiotics + mechanical bowel preparation + oral antibiotics (IVA + MBP + OA) has been shown to be superior to IVA + MBP and IVA, there are insufficient high‐quality data from randomized controlled trails (RCTs) that directly compare these options. This is an important question, because if IVA + OA has similar effectiveness to IVA + MBP + OA, mechanical bowel preparation can be safely omitted, and the associated side effects avoided. The aim of this work is to compare rates of SSI following IVA + OA + MBP (MBP) versus IVA + OA (OA) for elective colon surgery. Method: This is a multicentre, parallel, two‐arm, noninferiority RCT comparing IVA + OA + MBP versus IVA + OA. The primary outcome is the overall rate of SSI 30 days following surgery. Secondary outcomes are length of stay and 30‐day emergency room visit and readmission rates. The planned sample size is 1062 subjects with four participating high‐volume centres. Overall SSI rates 30 days following surgery between the treatment groups will be compared using a general linear model. Secondary outcomes will be analysed with linear regression for continuous outcomes, logistic regression for binary outcomes and modified Poisson regression for count data. Conclusion: It is expected that IVA + OA will work similarly to IVA + MBP + OA and that this work will provide definitive evidence showing that MBP is not necessary to reduce SSI. This is highly relevant to both patients and physicians as it will have the potential to significantly change practice and outcomes following colon surgery in Canada and beyond. [ABSTRACT FROM AUTHOR]

Improvement in genetic gains of crops could be achieved by phenomics' characterization of agronomic, physiological and stress-related traits. Molecular and strategic breeding programmes require broad range of foreground and background phenotypic information for crop improvement. The current experiment was performed on 123 advanced soybean (Glycine max L.) genotypes including seven local lines belongs to four different maturity groups (000-lV) to estimate the endogenous potential of various yield-related traits. The experimental trial was repeated for two cropping seasons. Four traits out of six, yield per plant (YPP), number of seeds per plant, number of pods per plant and plant height (PH), showed maximum variation (CV%) that directly correlate with variability in the subjected population. PH, number of pods, 100-seed weight and YPP showed strong positive correlation in both years. Among the principal components, factors 1 and 2 showed maximum contribution in phenotypic variability ranges from 19 to 48.5% and 26 to 47.7% in the first and second years, respectively. Number of pods showed significant positive correlation with genotypes in both years. Dendrogram showed two distinct groups of soybean genotypes. Genetic variation and association among the accessions is indispensable for effective conservation and utilization of germplasm. Principal component analysis helps to identify the diverse genotypes that will be used as a parent for various breeding programmes. These phenotypic data will be used for detection of heat stress-related quantitative trait loci with genotypic data in genome-wide association studies experiments. [ABSTRACT FROM AUTHOR]

The present study was conducted to determine the reading habits of students at Punjabi University Patiala. The focus of this paper is to ascertain the average time of reading of students and their choice of reading material. A questionnaire was developed to collect the primary data and distributed among the students via Google form. The data was analysed by simple percentage method and presented in bar charts. Book remain the most preferred reading material for the students, followed by newspaper, class notes, journals, magazines, and thesis / dissertation. The majority of students read general knowledge books followed by subject related books. A large number of students read from both paper and digital. Respondents prefer to reading in the morning time. The Library is the preferred place by the respondents for reading. The majority of the respondents are motivation from the teachers for reading. Major hindrance to reading habit by the students is less time and more use of social media. [ABSTRACT FROM AUTHOR]

Objective: The objective of our study is to estimate the prevalence of endometrial cavity fluid (ECF) in Assisted Reproductive Techniques (ART) cycles and analyze its effects on pregnancy outcome in such cycles. Data sources: PubMed, Cochrane Central, Scopus, and clinicaltrials.gov were searched for articles. The reference lists of relevant publications were explored for other studies. Study eligibility criteria: Studies that had assessed the pregnancy outcome in ART cycles and had commented on ECF accumulation were included. Pregnancy outcomes were assessed in all ART cycles where ECF was observed and were compared to the non-ECF cycles. Results: A total of nine studies were included in the meta-analysis for a total of 28,210 cycles. Pooled analysis of the prevalence of ECF cycles out of total cycles in females undergoing ART using a fixed effect model showed that it was 14% (95% CI is 13% to 14%; I2 = 99%, p = < 0.01). The random effect model prevalence of ECF cycles was around 7% (95% CI: 4% to 10%). There was a statistically significant (25%) decrease in pregnancy rates per cycle transfer in the ECF cycle versus the non-ECF cycle group during ART [OR = 0.75, 95% CI = 0.67–0.84), p < 0.001; moderate quality evidence]. When ECF size was compared, there was a statistically significant increase in pregnancy rates if ECF size was less than 3.5 mm versus greater than or equal to 3.5 mm [OR = 13.67, 95% CI = 1.43–130.40), p = 0.02; high quality evidence]. Sub-group analysis revealed that the ECF present at the time of embryo transfer significantly decreased the pregnancy rates by 26% as compared to the group where the ECF was not present at the time of embryo transfer [OR = 0.74, 95% CI = 0.65–0.85), p < 0.001]. Conclusions: This meta-analysis proposes that the presence of ECF significantly decreases the implantation and pregnancy rates of ART cycles, and even more so if its size is greater than 3.5 mm. Interventions to decrease ECF formation or treat it have enhanced the pregnancy outcome in ART cycles. Prospero registration: Date: 17th September 2020; Number: CRD42020182262. [ABSTRACT FROM AUTHOR]

Objectives To explore prognostic and predictive markers of SSc-associated interstitial lung disease (SSc-ILD) outcomes in a phase 3 trial (focuSSced) and prognostic markers in a real-world cohort (SMART). Methods The focuSSced SSc-ILD subgroup included 68 of 106 placebo-treated and 68 of 104 tocilizumab-treated patients. The SMART cohort included 505 patients with SSc-ILD. Linear mixed-effect models were used to identify factors associated with change in forced vital capacity (FVC). Kaplan–Meier estimation and Cox regression were used for time-to-event analyses. Results In placebo-treated focuSSced patients, sex was a significant prognostic factor for FVC decline; males had increased risk for absolute decline ≥10% in percent-predicted FVC (ppFVC) and 0.22% faster weekly FVC decline than females (P   =  0.0001). FVC was 9.8% lower in patients with CRP >6 mg/ml vs those with CRP ≤6 mg/ml (P  = 0.0059). Tocilizumab reduced the risk for ≥10% decline in ppFVC in patients who were male, had earlier disease (<2 years duration), had IL-6 levels <10 pg/ml, or had anti-topoisomerase antibodies (ATA). In the SMART cohort, prognostic factors for ppFVC <70% were male sex, ATA, and low baseline FVC. Males had 3.3% lower FVC 1 year after disease onset (P  < 0.001) and 0.6% faster yearly decline (P  = 0.03) than females. Conclusion Prognostic markers in SSc-ILD were similar between focuSSced and SMART. Male sex and inflammatory markers were associated with lower FVC but IL-6 ≥10 pg/ml was not predictive of response to tocilizumab. Trial Registration ClinicalTrials.gov: NCT02453256. [ABSTRACT FROM AUTHOR]

In this study, an attempt is made to evaluate the academic and research support services of Central University of Jammu, Jammu which is divided into five sections: Introduction of the study, Review of literature, Research methodology, Data analysis and interpretation and Conclusion of the study. In this study, non-probability sampling technique was used. Null hypothesis of the study is “there is no significance difference of awareness and satisfaction regarding library resources and services among the user of Central University of Jammu”. The present study was based on primary data. The data was collected through a questionnaire. Data was analysed with the help of SPSS and Chi-Square test used for hypothesis testing. The study found that majority of the respondents was male, and they visited the library on daily basis for issue or return the books and to update them. It was also observed that most of the respondents preferred both printed and electronic resources, were fully satisfied with the assistance of library staff and with the library’s print as well as e-resources. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore correlations between spasticity and motor impairments in the upper and lower limbs in ambulatory chronic stroke survivors. Design: We performed clinical assessments in 28 ambulatory chronic stroke survivors with spastic hemiplegia (female: 12; male: 16; mean ages = 57.8 ±11.8 yrs; 76 ± 45 mos after stroke). Results: In the upper limb, spasticity index and Fugl-Meyer Motor Assessment showed a significant correlation. spasticity index for the upper limb showed a significant negative correlation with handgrip strength of the affected side (r = -0.4, P = 0.035) while Fugl-Meyer Motor Assessment for the upper limb had a significant positive correlation (r = 0.77, P < 0.001). In the LL, no correlation was found between SI&lowbar;LL and FMA&lowbar;LL. There was a significant and high correlation between timed up and go test and gait speed (r = 0.93, P < 0.001). Gait speed was positively correlated with Spasticity index for the lower limb (r = 0.48, P = 0.01), and negatively correlated with Fugl-Meyer Motor Assessment for the lower limb (r = -0.57, P = 0.002). Age and time since stroke showed no association in analyses for both upper limb and lower limb. Conclusions: Spasticity has a negative correlation on motor impairment in the upper limb but not in the lower limb. Motor impairment was significantly correlated with grip strength in the upper limb and gait performance in the lower limb of ambulatory stroke survivors. [ABSTRACT FROM AUTHOR]

Background: There is ongoing research to find an optimum modality to predict male fertility potential. Aims: To compare the semen parameters, sperm DNA damage and seminal metal levels of Zinc, Lead and Aluminium among the male partners of couples with unexplained infertility and men with proven fertility. Settings and Design: Prospective case-control study at a tertiary level teaching hospital. Materials and Methods: One hundred male partners of couples with unexplained subfertility and 50 men with proven fertility were included in the study. Male partners of unexplained infertility couples and fertile men were compared for their semen parameters, sperm DNA Fragmentation Index (DFI) and seminal metal levels in semen. Statistical Analysis Used: Chi-square test, Student's t-test, sensitivity and specificity analysis, binomial logistic regression analysis. Results: Fertile men had statistically significantly higher mean progressive sperm motility than male partners of unexplained infertility (53.12 ± 9.89% vs. 44.81 ± 19.47%, P = 0.005). Semen volume and sperm concentration were comparable among the cases and control population. The mean sperm DFI was significantly lower among fertile men (10.83 ± 6.28 vs. 21.38 ± 10.28, P < 0.0001). Plotting the receiver-operating characteristic curve the threshold for discrimination was calculated to be 18% DFI. The sensitivity specificity and overall accuracy were 43%, 84% and 56.67%, respectively when the DFI cut-off was set at 18%. Zinc concentration in the semen had a strong positive correlation (Point Biserial correlation coefficient = 0.831) with fertility, whereas lead and aluminium had a moderate negative correlation. Conclusion: Conventional semen analysis had limited differentiating ability for unexplained infertility. The sperm DFI may be employed for explanatory purposes among couples with unexplained subfertility. A lower discriminatory threshold of DFI (18%) has better overall accuracy as opposed to a 30% cutpoint for unexplained subfertility. Among metals, Zinc was strongly correlated with fertility status. [ABSTRACT FROM AUTHOR]

Thoracic surgeries involving resection of lung tissue pose a risk of severe postoperative pulmonary complications, including acute respiratory distress syndrome (ARDS) and respiratory failure. Lung resections require one-lung ventilation (OLV) and, thus, are at higher risk of ventilator-induced lung injury (VILI) attributable to barotrauma and volutrauma in the one ventilated lung, as well as hypoxemia and reperfusion injury on the operated lung. Further, we also aimed to assess the differences in localized and systemic markers of tissue injury/inflammation in those who developed respiratory failure after lung surgery versus matched controls who did not develop respiratory failure. We aimed to assess the different inflammatory/injury marker patterns induced in the operated and ventilated lung and how this compared to the systemic circulating inflammatory/injury marker pattern. A case–control study nested within a prospective cohort study was performed. Patients with postoperative respiratory failure after lung surgery (n = 5) were matched with control patients (n = 6) who did not develop postoperative respiratory failure. Biospecimens (arterial plasma, bronchoalveolar lavage separately from ventilated and operated lungs) were obtained from patients undergoing lung surgery at two timepoints: (1) just prior to initiation of OLV and (2) after lung resection was completed and OLV stopped. Multiplex electrochemiluminescent immunoassays were performed for these biospecimen. We quantified 50 protein biomarkers of inflammation and tissue injury and identified significant differences between those who did and did not develop postoperative respiratory failure. The three biospecimen types also display unique biomarker patterns. [ABSTRACT FROM AUTHOR]

Non-invasive classification of focal cortical dysplasia (FCD) subtypes remains challenging from a radiology perspective. Quantitative imaging biomarkers (QIBs) have the potential to distinguish subtypes that lack pathognomonic features and might help in defining the extent of abnormal connectivity associated with each FCD subtype. A key motivation of diagnostic imaging is to improve the localization of a "lesion" that can guide the surgical resection of affected tissue, which is thought to cause seizures. Conversely, surgical resections to eliminate or reduce seizures provided unique opportunities to develop magnetic resonance imaging (MRI)-based QIBs by affording long scan times to evaluate multiple contrast mechanisms at the mesoscale (0.5 mm isotropic voxel dimensions). Using ex vivo hybrid diffusion tensor imaging on a 9.4 T MRI scanner, the grey to white matter ratio of scalar indices was lower in the resected middle temporal gyrus (MTG) of two neuropathologically confirmed cases of FCD compared to non-diseased control postmortem fixed temporal lobes. In contrast, fractional anisotropy was increased within FCD and also adjacent white matter tracts. Connectivity (streamlines/mm3) in the MTG was higher in FCD, suggesting that an altered connectivity at the lesion locus can potentially provide a tangible QIB to distinguish and characterize FCD abnormalities. However, as illustrated here, a major challenge for a robust tractographical comparison lies in the considerable differences in the ex vivo processing of bioptic and postmortem samples. Mesoscale diffusion MRI has the potential to better define and characterize epileptic tissues obtained from surgical resection to advance our understanding of disease etiology and treatment. [ABSTRACT FROM AUTHOR]

Background: Low colorectal anastomoses carry a high anastomotic leak (AL) rate (up to 20%) and thus are commonly diverted. Much less is known about mid-to-high colorectal anastomosis, which carries a leak rate of 2-4%. The objective of this study was to determine our AL rate after mid-to-high colorectal anastomosis and associated risk factors. Methods: A single center retrospective cohort study of patients undergoing left colonic resections with mid-to-high colorectal anastomosis (≥7 cm from the anal verge) from January 2008 to October 2017 was utilized. Main outcome, AL, defined as clinical suspicion supported by radiological or intraoperative findings, was calculated and risk factors assessed using multivariable logistic regression analysis. Results: 977 patients were included; 487 (49.9%) were male, with a mean age of 59.8 (+/−12.1) years. Mean BMI was 27.5 (+/−5.5) kg/m2. Diverticular disease (67.5%), malignancy (17.4%), and inflammatory bowel disease (2.2%) were the main indications for resection. Mean length of stay was 6.7 (+/−4.5) days. 455 (46.8%) colonic resections were performed by laparoscopy, 283 (29.1%) by hand assisted surgery, 219 (22.5%) by laparotomy, and 16 (1.6%) by robotics. Majority of patients had complete donuts (99.6%) and a negative air leak test (97.7%). 149 patients (15.3%) underwent construction of a diverting stoma. The overall AL rate was 2.1% (n = 20). Increased BMI (>30 kg/m2), P =.02, was an independent risk factor for AL and a trend observed for positive air leak tests (P =.05), with other factors failing to achieve statistical significance. Conclusions: Patients with mid-to-high colorectal anastomosis have a 2% AL risk. Increased BMI was a risk factor for AL. [ABSTRACT FROM AUTHOR]

Background: As the population ages emergency surgeries among the elderly population, including colonic resections, is also increasing. Data regarding the short- and long-term outcomes in this population is scarce. Methods: A retrospective study was performed to investigate mortality and mortality risk factors associated with emergent colectomies in older compared to younger patients in a single university affiliated tertiary hospital. Patients with metastatic disease, colectomy due to trauma or index colectomy within 30 days prior to emergent surgery were excluded. Results: Operative outcomes compared among age groups, included 30-day mortality, mortality risk-factors and long-term survival. 613 eligible patients were included in the cohort. Mean age was 69.4 years, 45.1% were female. Patients were divided into four age groups: 18–59, 60–69, 70–79 and ≥80-years. Thirty-day mortality rates were 3.2%, 11%, 29.3% and 37.8%, respectively and 22% for the entire cohort. Risk-factors for perioperative death in the younger group were related to severity of ASA score and WBC count. In groups 60–69, 70–79, main risk-factors were ADL dependency and ASA score. In the ≥80 group, risk-factors affecting perioperative mortality, included ASA score, pre-operative albumin, creatinine, WBC levels, cancer etiology, ADL dependency, and dementia. Long-term survival differed significantly between age groups. Conclusion: Perioperative mortality with emergency colectomy increases with patients' age. Patients older than eighty-years undergoing urgent colectomies have extremely high mortality rates, leading to a huge burden on medical services. Evaluating risk-factors for mortality and pre-operative discussion with patients and families is important. Screening the elderly population for colonic pathologies can result in early diagnosis potentially leading to elective surgeries with decreased mortality. [ABSTRACT FROM AUTHOR]

3D with volume rendering and the more recently described technique of cinematic rendering are post-processing techniques that create reconstructions of cross sectional imaging data which enhance image interpretation. This review illustrates the potential applications of volume rendering, 3D, and cinematic rendering in the evaluation of abdominopelvic pathology in the peripartum period. These techniques show promise in improving visualization of pelvic structures, vascular mapping, highlighting textural differences between tissues, and improving understanding of spatial relationships. [ABSTRACT FROM AUTHOR]

Hysterosalpingography (HSG) is the first-line investigation in infertility assessment to assess tubal patency. Clinicians use various instruments, including the Leich-Wilkinson cannula, Rubin cannula, Jorcho's cannula, Whitehead cannula, and foley's catheter, to instill the dye in the uterus. We randomly allocated 60 patients planned for hysterosalpingography to evaluate tubal patency as part of fertility workup to either Intra-uterine foley's catheter arm or Leich-Wilkinson cannula arm. The research team measured and compared immediate and delayed numerical pain scores in both arms. We observed significantly lower pain scores in Foley's catheter arm as compared to the Leich-Wilkinson arm for both early (5.7 ± 3.01 vs. 7.8 ± 1.95) and delayed (0.15 ± 0.37 vs. 0.40 ± 0.50) evaluation. We established that using a Foley catheter for the HSG procedure was associated with lesser pain to the patient, with no evident difference regarding imaging of the uterus and tubes. [ABSTRACT FROM AUTHOR]

Aim: Ileostomy complications have been reported in >70% of cases. Older studies have shown ileostomy revision to be required in 23%–38% of patients over a 5–10 year period. There is a paucity of recent data addressing ileostomy revision surgery. We aimed to review end ileostomy revisions in a tertiary centre and analyse indications, procedures performed, outcomes and risks for such surgery. Methods: This was a retrospective review in a single institution colorectal referral practice. All patients aged >17 years who underwent a revision of an ileostomy at our institution from 2008 to 2019 were included. Indication for ileostomy revision, operative technique (parastomal vs. intra‐abdominal) and outcomes including length of stay, readmission rates, wound complications, medical complications and rate of stoma re‐revision were assessed. Results: Fifty‐three patients who underwent 72 end ileostomy revision procedures were included; 20 (27.8%) were re‐revision procedures. The majority (76.4%) had their original ileostomy created for inflammatory bowel disease. Indications for ileostomy revision were stoma retraction (36.1%), prolapse (22.2%), stenosis (18.1%) and parastomal hernia (29.2%). Of stoma revisions, 55.6% were performed by a parastomal approach vs. 44.4% by an intra‐abdominal approach. Procedures were a combination of laparotomy, laparoscopy or both. The average length of stay was statistically significantly lower in the parastomal approach revision group (2.3 days) compared to the intra‐abdominal approach revision group (10.3 days) (P < 0.001). Readmission and wound complication rates were 6.9% and 15.3%, respectively, in the intra‐abdominal approach group alone. Medical complication rates were 20.8%. Conclusions: End ileostomy complications are common and surgical treatment may result in significant morbidity, readmission and reoperation. Patients should be counselled about these possibilities. [ABSTRACT FROM AUTHOR]

Intracerebral cell therapy (CT) is emerging as a new therapeutic paradigm for stroke. However, the impact of physical therapy (PT) on implanted cells and their ability to promote recovery remains poorly understood. To address this translational issue, a clinical-grade neural stem cell (NSC) line was implanted into peri-infarct tissue using MRI-defined injection sites, two weeks after stroke. PT in the form of aerobic exercise (AE) was administered 5 × per week post-implantation using a paradigm commonly applied in patients with stroke. A combined AE and CT exerted sub-additive therapeutic effects on sensory neglect, whereas AE suppressed CT effects on motor integration and grip strength. Behavioral testing emerged as a potentially major component for task integration. It is expected that this study will guide and inform the incorporation of PT in the design of clinical trials evaluating intraparenchymal NSCs implantation for stroke. [ABSTRACT FROM AUTHOR]

This paper critically examines the evolution and transition of Punjab agriculture from diversified to unsustainable wheat-paddy crop rotation. The main focus is on the fast depleting water-table due to the paddy-water-energy nexus. It has been found that Punjab agriculture is not going to be sustainable for long under the business as usual mode. As such, there is a dire need for crop-diversification in favour of less water guzzling crops. However, shifting a substantial area currently under paddy would require an appropriate government policy mix similar to that which created an enabling environment for the successful implementation of the Green Revolution. The farmers would also need to be assured of at least the same amount of net per hectare income from alternative crops which they are getting from wheat-paddy crop rotation. [ABSTRACT FROM AUTHOR]

Purpose: Postoperative urinary retention (POUR) is a known morbidity after colorectal surgery. This study investigated the effect of prophylactic tamsulosin on urinary retention rates after colorectal surgery. Methods: A retrospective cohort study of male patients 50 years or older undergoing elective colonic and rectal resections from May 2014 to November 2019 was performed. The intervention assessed was prophylactic tamsulosin use. POUR, defined by requiring intermittent or reinsertion of urinary catheter, was compared using chi-squared analysis. Results: A total of 332 patients were included, 131 received no tamsulosin, and 201 received prophylactic tamsulosin. Overall POUR was significantly reduced (16.8% vs. 9.5%, p = 0.047). Subgroup analysis for age 50–59 revealed no difference (9.1% vs. 9.4%, p = 0.96), but POUR risk was significantly lower in age 60 and older (20.7% vs. 9.5%, p = 0.02). No significant difference was found in rectal resections alone (18.2% vs. 13.2%, p = 0.34). Conclusion: Prophylactic tamsulosin reduced POUR after colorectal surgery with the greatest effect in men 60 years or older and colonic resections. [ABSTRACT FROM AUTHOR]

Congenital overinflation of lung is underdiagnosed prenatally as the imaging features of the same are not well described. We describe a very rare case of central variety of congenital overinflation, secondary to right mainstem bronchial stenosis, not previously described in our knowledge, which presented as an enlarged homogenous echogenic/hyperintense lung with cardio-mediastinal shift and was misdiagnosed as congenital pulmonary airway malformation (CPAM). We reviewed imaging features helpful in prenatal diagnosis of this condition on ultrasound and magnetic resonance imaging and discussed an approach for differential diagnosis. The congenital central overinflation may be considered in prenatal detected echogenic lung lesions with the absence of cysts or systemic arterial supply and presence of hypervascularity or dilated bronchi within the lesion. [ABSTRACT FROM AUTHOR]

Surgical site infections (SSI) pose significant morbidity after colorectal surgery. We sought to document current practices in colorectal surgery SSI prevention in British Columbia (BC). Reporting the current provincial landscape on SSI prevention helps to understand the foundation upon which improvements can take place. We surveyed all BC surgeons performing elective colon and rectal resections, and 97 surveys were completed (60% response rate). Eighty-six per cent of respondent hospitals tracked SSI rates. The reported superficial SSI was less than 5% and the anastomotic leak/organ space rate was less than 10%. All respondents gave preoperative prophylactic antibiotics, with 24% continuing antibiotics postoperatively; 62% are using oral antibiotics (OAB) and mechanical bowel preparation (MBP) and 29% use MBP without OAB. Areas for improvement include OAB with MBP and discontinuing prophylactic antibiotics postoperatively, as recommended by the World Health Organization. [ABSTRACT FROM AUTHOR]

Aim: To describe the microbiological composition of subgingival dental plaque and molecular profile of gingival crevicular fluid (GCF) of periodontal furcation‐involved defects. Materials and Methods: Fifty‐seven participants with periodontitis contributed with a degree II–III furcation involvement (FI), a non‐furcation (NF) periodontal defect and a periodontally healthy site (HS). Subgingival plaque was analysed by sequencing the V3–V4 region of the 16S rRNA gene, and a multiplex bead immunoassay was carried out to estimate the GCF levels of 18 GCF biomarkers. Aiming to explore inherent patterns and the intrinsic structure of data, an AI‐clustering method was also applied. Results: In total, 171 subgingival plaque and 84 GCF samples were analysed. Four microbiome clusters were identified and associated with FI, NF and HS. A reduced aerobic microbiota (p =.01) was detected in FI compared with NF; IL‐6, MMP‐3, MMP‐8, BMP‐2, SOST, EGF and TIMP‐1 levels were increased in the GCF of FI compared with NF. Conclusions: This is the first study to profile periodontal furcation defects from a microbiological and inflammatory standpoint using conventional and AI‐based analyses. A reduced aerobic microbial biofilm and an increase of several inflammatory, connective tissue degradation and repair markers were detected compared with other periodontal defects. [ABSTRACT FROM AUTHOR]

Background: Kono-S anastomosis has gained increasing interest although evaluation of its impact on reducing Crohn's recurrence shows conflicting results. This study aimed to evaluate the short- and long-term outcomes for patients with Crohn's disease requiring surgery with Kono-S compared to conventional anastomosis. Methods: A systematic review and meta-analysis included patients with Crohn's disease treated with bowel resection and Kono-S anastomosis reconstruction versus a comparator arm of conventional anastomosis technique. Recurrence outcomes examined were endoscopic recurrence rates, mean postoperative Rutgeerts score, surgical recurrence, clinical recurrence, and postoperative biologics use. Short-term postoperative outcomes include anastomotic leaks, surgical site infection, postoperative ileus, and mean operative time. Results: A total of 873 studies were identified with 15 remaining after abstract review encompassing 1501 patients, 765 with Kono-S and 736 with conventional anastomosis. Recurrence was significantly lower in the Kono-S arm, with endoscopic recurrence rates of 41% vs 48% (RR 0.86, 95% CI 0.73–1.00, p = 0.05) and surgical recurrence rates of 2.7% vs 21.0% (RR 0.13, 95% CI 0.06–0.30, p < 0.001). There was a significantly lower anastomotic leak rate in the Kono-S arm when compared to conventional anastomosis, 1.7% vs 4.9% (RR 0.37, 95% CI 0.19–0.74, p = 0.005). Mean operative time was similar between both groups. Conclusions: Kono-S is a safe and feasible anastomotic technique with lower rates of endoscopic and surgical postoperative recurrence. While we await further trials to substantiate this benefit, Kono-S anastomosis should be considered as an important tool in the armamentarium of a surgeon in anastomotic construction to reduce recurrence. [ABSTRACT FROM AUTHOR]

This study was conducted to determine the effect of different nutrient levels [No nutrients absolute control, RDF (recommended dose of fertilizer) (N:P:K 150:26.22), 150%RDF (225:39.33), 150%RDF + FYM (Farm Yard Manure) (225:39:33 + 15 t ha−1), & 200%RDF (300:52.44 NPK kg ha−1) and application of growth regulators, i.e., water spray, CCC (chlormequat chloride) 0.2%, tebuconazole (0.1%), and tank-mixed application of chlormequat chloride + tebuconazole at first node and flag leaf stage on growth, lodging, yield, and quality of wheat with three replications. Application of 150%RDF + FYM and 200%RDF recorded significantly higher plant height, dry matter accumulation, and tiller density. Lodging percent and score recorded in 150%RDF + FYM was similar to 200%RDF, but sіgnіfіcаntly higher than оthеr levels. The application of chlormequat chloride + tebuconazole recorded the lowest plant height, lodging percent and lodging score. Application of chlormequat chloride + tebuconazole recorded higher 1000-grain weight and grain yield than control, chlormequat chloride, and tebuconazole. In RDF (N:P:K 150:26.22), exogenous application of chlormequat chloride alone was sufficient to reduce lodging. However, at higher nutrient level of 150%RDF or 150%RDF + FYM, both chlormequat chloride + tebuconazole were most promising for reducing lodging and enhancing the wheat productivity. [ABSTRACT FROM AUTHOR]

Aim: The aim of this work was to evaluate whether normalized carcinoembryonic antigen (CEA) following neoadjuvant chemoradiation predicts the prognosis following curative resection in locally advanced rectal cancer. Method: Patients who underwent neoadjuvant chemoradiation and curative resection for locally advanced rectal cancer between 2010 and 2015 were divided into three groups: Group A (n = 119, normal‐to‐normal): normal CEA before and after neoadjuvant chemoradiation; Group B (n = 37, high‐to‐normal): elevated CEA before and normal CEA after neoadjuvant chemoradiation; Group C (n = 36, high‐to‐high): elevated CEA before and after neoadjuvant chemoradiation. Overall and disease‐free survival were compared. Univariate and multivariate analyses identified potential predictors for recurrence. Results: One hundred and ninety two patients [median age 59 years (range 31–87), 65.1% male] were identified: 54.7% had low rectal cancer: 12.5% were clinical stage T4 and 70.3% were clinically node positive; 21.9% achieved complete pathological response; 24.5% had abdominoperineal resection (APR); and 70.3% underwent adjuvant chemotherapy following curative resection. Significantly more patients in Group C underwent APR (p = 0.0209), had advanced pathological T stage (P = 0.0065) and a higher prevalence of perineural invasion (p = 0.0042). Overall and disease‐free survival were significantly higher for Group A than for Group C [hazard ratio (HR) = 4.32, 95% CI = 1.66–11.21, p = 0.0026 and HR=2.68, 95% CI = 1.33–5.40, p = 0.0057, respectively]. No significant difference was noted between Groups A and B for overall (p = 0.0591) or disease‐free (p = 0.2834) survival. Another risk factor associated with recurrence and death was clinical T4 stage; nodal positivity was a risk factor only for recurrence. Conclusion: Elevated CEA after neoadjuvant chemoradiation and clinical stage T4 disease were unfavourable predictors for overall and disease‐free survival. Normalized CEA during neoadjuvant chemoradiation may serve as a prognosticator, although pretreatment CEA may significantly affect survival. [ABSTRACT FROM AUTHOR]

Introduction: Administration of chemotherapeutic regimens such as FOLFOX or CAPEOX with chemoradiation in the neoadjuvant setting, termed total neoadjuvant treatment (TNT), was introduced in recent years. By increasing the complete pathologic and clinical responses, patients with locally advanced rectal cancer may have better oncologic outcomes and potentially abstain from undergoing a proctectomy.Methods: All patients who underwent TNT at a single National Accreditation Program for Rectal Cancer accredited referral center were included. A retrospective analysis was performed using a computerized Institutional Review Board-approved database. Patient demographics, diagnostic workup, treatment regimens, and surgical and pathological reports were reviewed. Complete pathological response was the primary outcome. Univariable and multivariable logistic regression analyses were performed to identify potential factors predisposing to complete pathological response.Results: Thirty patients met the inclusion criteria, 14(46.6%) of whom had complete pathologic response. There was no difference in baseline demographic characteristics between patients who achieved complete pathological response and those who did not. Pathology revealed a 92% intact mesorectum rate in the complete pathologic response group and a mean of 24 harvested lymph nodes in the entire study cohort. Both univariable and multivariable logistic regression analyses failed to demonstrate statistically significant factors predicting complete pathologic response, magnetic resonance imaging (MRI) tumor size, and posttreatment MRI lymph node positivity.Conclusion: TNT is safe and efficient for patients with locally advanced rectal cancer. It increases complete pathological and clinical response rates and may more widely evolve to be the treatment of choice in this group of patients in the near future. [ABSTRACT FROM AUTHOR]

Mucormycosis is a fungal infection caused by fungi of order mucorales. It is most commonly seen in patients with an impaired immune system due to any cause. Gastrointestinal mucormycosis is the least frequent type and may be a primary disease or a feature of generalized mucormycosis. Angioinvasion is the hallmark feature of mucormycosis, leading to bowel infarction which is the responsible for the most common clinical complaint of pain, and is also responsible for most of the imaging findings in this disease. The stomach is most commonly involved organ in the gastrointestinal tract and pneumatosis and lack of gastric wall enhancement are the most common imaging findings. Areas of bowel wall thickening and/ or lack of enhancement are seen in small bowel mucor and perforation can occur due to ischemia. Colonic mucor can present with mural thickening, or complete lack of definition or 'disappearance' of bowel wall with associated air containing collections. Mucormycosis affecting the bowel has a high mortality rate and early recognition and intervention may improve patient outcomes significantly. It should be suspected in immunosuppressed patients with imaging findings of unexplained bowel ischemia, infarction and/or pneumatosis without any obvious visible vascular thrombus. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the bacterial etiology of exudative pleural effusion. METHODOLOGY: A cross-sectional study on newly diagnosed patients of Exudative Pleural Effusion was conducted at medicine department of Dow University Hospital, Karachi from August 2019 to January 2020. Out of 177 patients of age 18-75 years were enrolled by consecutive non-probability sampling technique. Patients of Tuberculosis, heart failure, chronic liver disease, chronic renal failure or patients on diuretic therapy were excluded. Pleural fluid was detected via chest x-ray followed by diagnostic thoracentesis for bacterial confirmation. RESULTS: Out of 177 Exudative Pleural Effusion patients, male patients were 106 (59.9%) and female patients were 71 (40.1%). Bacterial microorganisms were detected in 67 (37.9%) patients, among which most common were Staphylococcus Aureus 13 (19.4%) and Escherichia Coli 13 (19.4%) followed by Acetobacter Baumannii 12 (17.9%), Streptococcus pneumonia 9 (13.4%), Staphylococcus Epidermidis 6(9.0%), Pseudomonas Aeruginosa 5 (7.5%), Enterococcus Spp 5 (7.5%) and Enterobacter Aerogenes 4 (6.0%). CONCLUSION: Frequency of bacterial microorganisms in Exudative Pleural Effusion was high among adult patients. Escherichia Coli, Staphylococcus Aureus and Acetobacter Baumannii were commonly detected pathogens from Exudative Pleural Effusion. [ABSTRACT FROM AUTHOR]

• Assembly of neural stem cells and endothelial cells in an implantable microsphere. • Biomechanical characterization of implantation procedure on microsphere integrity. • Minimally invasive delivery of microspheres to small cortical or large cortical + striatal tissue cavities. • Suspension of microspheres in extracellular matrix-based hydrogel improved retention and distribution. • Dramatically improved delivery of neural stem cells to stroke-damaged tissues. Intracerebral implantation of neural stem cells (NSCs) to treat stroke remains an inefficient process with <5% of injected cells being retained. To improve the retention and distribution of NSCs after a stroke, we investigated the utility of NSCs' encapsulation in polyethylene glycol (PEG) microspheres. We first characterized the impact of the physical properties of different syringes and needles, as well as ejection speed, upon delivery of microspheres to the stroke injured rat brain. A 20 G needle size at a 10 μL/min flow rate achieved the most efficient microsphere ejection. Secondly, we optimized the delivery vehicles for in vivo implantation of PEG microspheres. The suspension of microspheres in extracellular matrix (ECM) hydrogel showed superior retention and distribution in a cortical stroke caused by photothrombosis, as well as in a striatal and cortical cavity ensuing middle cerebral artery occlusion (MCAo). Thirdly, NSCs or NSCs + endothelial cells (ECs) encapsulated into biodegradable microspheres were implanted into a large stroke cavity. Cells in microspheres exhibited a high viability, survived freezing and transport. Implantation of 110 cells/microsphere suspended in ECM hydrogel produced a highly efficient delivery that resulted in the widespread distribution of NSCs in the tissue cavity and damaged peri-infarct tissues. Co-delivery of ECs enhanced the in vivo survival and distribution of ∼1.1 million NSCs. The delivery of NSCs and ECs can be dramatically improved using microsphere encapsulation combined with suspension in ECM hydrogel. These biomaterial innovations are essential to advance clinical efforts to improve the treatment of stroke using intracerebral cell therapy. [ABSTRACT FROM AUTHOR]

Candida albicans infections range from superficial to systemic and are one of the leading causes of fungus-associated nosocomial infections. The innate immune responses during these various infection types differ, suggesting that the host environment plays a key role in modulating the host–pathogen interaction. In addition, C. albicans is able to remodel its cell wall in response to environmental conditions to evade host clearance mechanisms and establish infection in niches, such as the oral and vaginal mucosa. Phagocytes play a key role in clearing C. albicans, which is primarily mediated by Pathogen Associated Molecular Pattern (PAMP)–Pattern Recognition Receptor (PRR) interactions. PRRs such as Dectin-1, DC-SIGN, and TLR2 and TLR4 interact with PAMPs such as β-glucans, N-mannan and O-mannan, respectively, to trigger the activation of innate immune cells. Innate immune cells exhibit distinct yet overlapping repertoires of PAMPs, resulting in the preferential recognition of particular Candida morphotypes by them. The role of phagocytes in the context of individual infection types also differs, with neutrophils playing a prominent role in kidney infections, and dendritic cells playing a prominent role in skin infections. In this review, we provide an overview of the key receptors involved in the detection of C. albicans and discuss the differential innate immune responses to C. albicans seen in different infection types such as vulvovaginal candidiasis (VVC) and oral candidiasis. [ABSTRACT FROM AUTHOR]

Aim: Surgical site infections are disproportionately common after colorectal surgery and may be largely preventable. The objective of this retrospective cohort study was to determine the effect of oral antibiotics and mechanical bowel preparation on surgical site infections. Method: A retrospective study of a consecutive series of elective colonic and rectal resections following an Enhanced Recovery After Surgery pathway, which also included mechanical bowel preparation, from 1 September 2014 to 30 September 2017. The addition of oral antibiotics (neomycin and metronidazole) to the mechanical bowel preparation procedure was assessed. Development of surgical site infections within 30 days was the main outcome measured. The secondary outcome was assessment of possible surgical site infection predictors. Results: Seven‐hundred thirty‐two patients were included: 313 (43%) preintervention (mechanical bowel preparation only); and 419 (57%) postintervention (mechanical bowel preparation plus oral antibiotics). Surgical site infection rates preintervention and. postintervention were: overall, 20.8% vs 10.5%, P < 0.001; superficial, 10.9% vs 4.3%, P < 0.001; and organ space, 9.9% vs 6.2%, P = 0.03. Subgroup analysis of colonic resections revealed a significant reduction in overall (17.1% vs 6.8%), superficial (10.7% vs 4.3%) and organ space (6.4% vs. 2.6%) infections. Rectal resections had significant reduction in overall (26.2% vs 15.3%) and superficial (11.1% vs 4.4%) infection rates but not in organ space infections (15.1% vs 10.9%). Multivariate regression analysis revealed open vs minimally invasive surgery (P < 0.001) and omission of oral antibiotics (P = 0.004) as independent predictors of surgical site infections. Conclusion: Administration of oral antibiotics resulted in significant reduction of superficial and organ space infections after colonic resection; after rectal resection, significant reduction only of superficial infections was found. [ABSTRACT FROM AUTHOR]

Objective(s): Current evidence suggests that endometrial injury improves clinical pregnancy rate while having no effect on miscarriages in women undergoing IVF/ICSI. However, there is no substantial evidence to advocate the use of endometrial injury to benefit the outcomes of IUI treatment. Additionally, there is no clear consensus about the ideal timing, underlying mechanism and optimum intensity of endometrial injury required. The study examines the effect of intentional endometrial injury/scratch in the early proliferative phase of stimulated cycle on reproductive outcomes (clinical and ongoing pregnancy rates and miscarriage occurrence) of intra-uterine insemination treatment (IUI).Study Design, Size, Duration: This prospective, randomized control interventional study was conducted in a tertiary level teaching institution from April 2018 to February 2020. 150 eligible couples requiring IUI treatment who agreed to participate were randomly allocated on 1:1 basis to either control or intervention group. The trial participants received up to 3 cycles ovulation induction with clomiphene citrate and intra-uterine insemination. In addition, women in intervention group were subjected to endometrial scratch injury on day 6-7 of their stimulated cycle. 154 cycles in control arm and 128 cycles in intervention group were analyzed for clinical pregnancy, miscarriages and pain experienced by the women during endometrial scratch injury using the statistical package SPSS (version 21).Result: Similar cumulative clinical pregnancy rates (12.5% Vs 13.6%, RR 1.21, 95% CI 0.44-3.37, p = 0.713), biochemical pregnancy rates (17.1% vs 22.9%, RR 1.43, CI 0.59-3.47, p = 0.421) and ongoing pregnancy rates (10.93% Vs 11.47%, RR 1.05, CI 0.35-3.21, p = 924) were observed in control and intervention arms. Likewise, the relative risk of miscarriage occurrence in the intervention arm was 1.32 (95% CI 0.39-4.32, p = 1.000) which was not statistically different from control group. Mean pain score of 6.93 on numerical pain rating scale was experienced by women whilst having endometrial scratch injury.Conclusions: There is insufficient evidence to defend the use of endometrial scratch injury in intra-uterine insemination treatment, as it is moderately painful and have uncertain beneficial influence on reproductive outcomes. [ABSTRACT FROM AUTHOR]

Seasonal breeding in buffalo is influenced by exogenous (photoperiod, climate, nutrition, management) and endogenous (hormones, genotype) factors. Buffalo are negatively photoperiodic and show a natural increase in fertility during decreasing day length. The hormone melatonin is produced by the pineal gland and has a fundamental role in photoperiodic time measurement within the brain. This drives annual cycles of gonadotropin secretion and gonadal function in buffaloes. Some melatonin is released into the systemic circulation and, together with peripherally produced melatonin, acts at somatic tissues. In the ovaries and testes of buffalo, melatonin acts as an antioxidant and scavenges oxygen free radicals to reduce both oxidative stress and apoptosis. This has beneficial effects on gametogenesis and steroidogenesis. Female buffalo treated with melatonin show an improved response to estrus synchronization protocols in out-of-season breeding. Melatonin acts through melatonin receptors MT 1 and MT 2 and the gene for MT 1 (MTNR1A) is polymorphic in buffaloes. Single nucleotide polymorphisms (SNPs) in gene MTNR1A have been associated with fertility in female buffalo. The knowledge and tools are available to lift the reproductive performance of buffalo. This is highly important as the global demand for nutritious buffalo food products has undergone a sharp rise, and continues to grow. Buffalo can make an important contribution to affordable, nutritious animal protein. This will help address global nutritional security. • Buffalo are important livestock in global food security and in the livelihood of smallholder farmers. • Seasonal breeding in buffalo is determined by exogenous (photoperiod, climate, nutrition, management) and endogenous (hormones, genotype) factors. • Melatonin influences seasonal reproduction through photoperiodic time measurement in the brain and by direct actions at the ovaries and testes. [ABSTRACT FROM AUTHOR]

Polyurethane bentone coatings were prepared using high shear homogenizer (HSH@4000rpm, a high shear instrument), mixer (M@40rpm) along with ultrasonicator bath(USB), to visualize the impact of the processing instruments on the structure, properties, performance of polyurethane/bentone 38 coatings. We also alter the sequencing of the instruments i.e. parallel and series sequencing of USB and HSH, USB and M, tried to visualize the impact of shear of the instruments. We replaced bentone 38 with C20A and studied the effect of different organoclays on mechanical properties of PU/Clay coatings. Morphology of the coatings was studied using XRD and TEM, mechanical properties were evaluated by nanoindentation. Performance of the coatings was evaluated by flame retardancy and water absorption studies. [ABSTRACT FROM AUTHOR]

The characteristics of opioid prescribing and administration in cancer centers include large quantities and less restrictive regulatory mandates governing cancer-related pain, which may increase the risk of drug diversion by staff members. The purpose of this article is to provide a framework for creating respectful investigative processes for staff suspected of drug diversion. Organizations, including cancer centers, need to engage in careful oversight of potential drug diversions while simultaneously promoting a psychologically safe work environment for individuals to successfully seek help. [ABSTRACT FROM AUTHOR]

We consider the problem of jumbled matching where the objective is to find all permuted occurrences of a pattern in a text. Besides exact matching we study approximate matching where each occurrence is allowed to contain at most k wrong or superfluous characters. We present online algorithms applying bit-parallelism to both types of jumbled matching. Two of our algorithms are filtration methods applying SIMD (Single Instruction Multiple Data) computation. Most of the other new algorithms are variations of earlier methods. We show by practical experiments that our algorithms are competitive with previous solutions. [ABSTRACT FROM AUTHOR]

Background: Adolescent and young adult (AYA) women undergoing multiagent chemotherapy are at risk for heavy menstrual bleeding (HMB). There is a paucity of data on the experiences with menses of AYA women with cancer, their risk for HMB, and how they perceive menstrual suppression. Objective: This study aimed to (1) describe the attitudes and experiences of AYA women with a history of cancer regarding their menses and menstrual suppression and to (2) investigate facilitators and barriers to improve this aspect of oncologic care. Design/Methods: AYA women with a history of cancer completed individual semistructured interviews regarding their experiences, attitudes, and preferences around menstrual health. Two independent reviewers conducted a thematic analysis of transcribed interviews to elicit major themes. Results: We interviewed 20 young women with a history of cancer (mean age 19.9 years) who were treated with chemotherapy within the past 5 years. Themes included the following: (1) negative feelings and worry about menstrual bleeding; (2) positive attitudes toward menstrual suppression; (3) misconceptions about menstrual health; and (4) desire for tailored discussions about menstrual suppression. Conclusions: AYA women with a cancer history elucidate clear opinions regarding menstruation during chemotherapy, and many hold misconceptions regarding menses and menstrual suppression. Enhanced patient–provider communication and patient educational resources around menstrual health and menstrual suppression are needed to improve comprehensive oncologic care during chemotherapy. [ABSTRACT FROM AUTHOR]

Postmenopausal bleeding is one of the common presenting complaints in the gynecological outpatient department. The common causes of which are atrophic endometritis, vaginitis, estrogen therapy, cancer endometrium, and cancer cervix. Hereby, we present a rare case of a 65-year-old female presented with postmenopausal bleeding who had history of trauma 1 year back with pelvic bone fracture. The cause of postmenopausal bleeding, in this case, is abnormal bony protrusion secondary to malunited pelvic fracture causing laceration of the right lateral vaginal wall. The case was managed by local osteotomy and vaginal wall repair. [ABSTRACT FROM AUTHOR]

Medicinal plants used for wound healing and skin diseases are key to unlocking the doors to combating resistance of pathogens to pharmaceuticals and allopathic management. This study was aimed at screening the antioxidant effects, the anti-inflammatory activity and wound healing capacity of traditional medicinal plants used in the treatment of skin conditions and wound healing in KwaZulu-Natal, South Africa. Eleven plant species were selected and separated into different plant parts (bulbs, roots and leaves) and extracted using 50% aqueous methanol. The extracts were assessed for their anti-inflammatory activity using the nitric oxide release and lipoxygenase inhibition assays. Almost all plant species exhibited some degree of anti-inflammatory activity. The observed antioxidant results (DPPH, FRAP, CLAMS) were significant for many of the extracts. The LOX revealed that five of the medicinal plant extracts, Bulbine natalensis , Eucomis autumnalis , Hypericum aethiopicum , Tetradenia riparia and Zantedeschia aethiopica were effective as anti-inflammatory agents with IC 50 values below the quercetin control and ranged from 3.55 ± 0.11 to 9.52 ± 0.11 μg/mL. The results of the wound healing assay/protein precipitating activity were significantly excellent for the three Aloe species, two Bulbine species and support scientific evidence from previous research. The protein-precipitating capacity as a wound healing model was significant for Haworthia limifolia 82.71 ± 0.74% while the rest of the plant extracts had moderate to low values. In addition, medicinal plant extracts from E. autumnalis , H. limifolia , H. aethiopicum , T. riparia , and Z. aethiopica demonstrated promising and beneficial results for potential use in the treatment of skin diseases and wound healing. Antioxidant assays as well as anti-inflammatory assays (nitric oxide release and lipoxygenase inhibition assays) and wound healing assays support the dermatological and wound healing usage of these traditional medicinal plants and warrants further investigations and possible isolation of bioactive principles. Overall, the results from this multi-dimensional medicinal plant study provide extensive information on the 11 plant species and their various plant parts. • Bulbine natalensis , E. autumnalis , H. aethiopicum , T. riparia and Z. aethiopica effective anti-inflammatory agents. • Haworthia limifolia showed excellent wound healing properties. • E. autumnalis , H. limifolia , H. aethiopicum , T. riparia , and Z. aethiopica important for dermatological conditions. [ABSTRACT FROM AUTHOR]

Objective: To describe the imaging features of plexiform fibrohistiocytic tumor and its associated clinical findings.Materials and Methods: An institutional database was searched to identify all patients with a pathological diagnosis of plexiform fibrohistiocytic tumor. The electronic medical record was reviewed for relevant clinical data. Radiologic images of the primary tumor site were reviewed by two radiologists to assess primary, residual, or recurrent tumor with respect to tumor location, size, morphology, MR signal characteristics and enhancement, and involvement of adjacent structures.Results: Thirteen patients with imaging of the primary tumor site were identified [eight female, five male; mean age, 15.9 years (range, 3-41 years)]. Plexiform fibrohistiocytic tumor typically manifested as a solitary, painless, firm, slow-growing lesion centered in the subcutaneous tissues, with a predilection for the upper extremity or head and neck region. Most tumors had a purely plaque-like or infiltrative morphology at MRI; some demonstrated no round or oval mass. Tumors were predominantly isointense to muscle on T1-weighted imaging and hyperintense on fluid-sensitive imaging, and enhanced after gadolinium contrast administration. Five patients (38%) had residual tumor after initial surgery, resembling postoperative changes. No patient had recurrent tumor. One patient (8%) developed metastases to local lymph nodes and to the lung. No patient died from plexiform fibrohistiocytic tumor.Conclusions: Plexiform fibrohistiocytic tumor often manifests as a plaque-like or infiltrative process, sometimes without a round or oval mass, most commonly in the subcutaneous tissues of the upper extremity or head and neck region. Residual tumor is often present after initial surgery, and may be indistinguishable from postoperative changes. [ABSTRACT FROM AUTHOR]

Thrombosis is a hallmark of the fatal fungal infection mucormycosis. Yet, the platelet activation pathway in response to mucormycetes is unknown. In this study we determined the platelet aggregation potential of Mucor circinelloides (M. circinelloides) NRRL3631, characterized the signaling pathway facilitating aggregation in response to fungal spores, and identified the influence of the spore developmental stage upon platelet aggregation potential. Using impedance and light-transmission aggregometry, we showed that M. circinelloides induced platelet aggregation in whole blood and in platelet-rich plasma, respectively. The formation of large spore-platelet aggregates was confirmed by light-sheet microscopy, which showed spores dispersed throughout the aggregate. Aggregation potential was dependent on the spore's developmental stage, with the strongest platelet aggregation by spores in mid-germination. Inhibitor studies revealed platelet aggregation was mediated by the low affinity IgG receptor FcγRIIA and integrin αIIbβ3; Src and Syk tyrosine kinase signaling; and the secondary mediators TxA2 and ADP. Flow cytometry of antibody stained platelets showed that interaction with spores increased expression of platelet surface integrin αIIbβ3 and the platelet activation marker CD62P. Together, this is the first elucidation of the signaling pathways underlying thrombosis formation during a fungal infection, highlighting targets for therapeutic intervention. [ABSTRACT FROM AUTHOR]

Abstract The osteoporosis-resistant nature of skull bones implies inherent differences exist between their cellular responses and those of other osteoporosis-susceptible skeletal sites. Phenotypic differences in calvarial and femoral osteoblastic responses to induction of osteogenesis, mechanical loading, estrogen, growth factor and cytokine stimulation were investigated. Primary rat calvarial and femoral adult male osteoblasts were cultured and osteoblastic mineralisation and maturation determined using Alizarin Red staining and expression of osteogenic marker genes assessed. Expression of known mechanically-responsive genes was compared between sites following loading of scaffold-seeded cells in a bioreactor. Cell proliferation and differentiation following growth factor and estrogen stimulation were also compared. Finally expression of estrogen receptors and associated genes during osteogenic differentiation were investigated. Calvarial osteoblasts exhibited delayed maturation (45d. vs 21d.) and produced less mineralised matrix than femoral osteoblasts when osteogenically induced. PDGF-BB and FGF2 both caused a selective increase in proliferation and decrease in osteoblastic differentiation of femoral osteoblasts. Mechanical stimulation resulted in the induction of the expression of Ccl2 and Anx2a selectively in femoral osteoblasts, but remained unchanged in calvarial cells. Estrogen receptor beta expression was selectively upregulated 2-fold in calvarial osteoblasts. Most interestingly, the estrogen responsive transcriptional repressor RERG was constitutively expressed at 1000-fold greater levels in calvarial compared with femoral osteoblasts. RERG expression in calvarial osteoblasts was down regulated during osteogenic induction whereas upregulation occurred in femoral osteoblasts. Bone cells of the skull are inherently different to those of the femur, and respond differentially to a range of stimuli. These site-specific differences may have important relevance in the development of strategies to tackle metabolic bone disorders. Highlights • Adult-derived skull and limb osteoblasts exhibit phenotypic heterogeneity. • Skull osteoblasts have reduced mineralisation capacity and loading responsiveness. • Estrogen responsive gene Rerg selectively highly expressed in skull osteoblasts. • Rerg gene silencing reduced estrogen pathway signalling in skull osteoblasts only. [ABSTRACT FROM AUTHOR]

Despite having defects, amorphous titanium dioxide ( ) have attracted significant scientific attention recently. Pristine, as well as various doped catalysts, have been proposed as the potential photocatalysts for hydrogen production. Taking one step further, in this work, the author investigated the molecular and dissociative adsorption of water on the surfaces of pristine and doped catalysts by using density functional theory with Hubbard energy correction (DFT+U). The adsorption energy calculations indicate that even though there is a relatively higher spatial distance between the adsorbed water molecule and the surface, pristine surface is capable of anchoring molecule more strongly than the doped as well as the rutile (1 1 0) surface. Further, it was found that unlike water dissociation on crystalline surfaces, water on pristine catalyst experience the dissociation barrier. However, this barrier reduces significantly when is doped with , providing an alternative route for the development of an inexpensive and more abundant catalyst for water splitting. [ABSTRACT FROM AUTHOR]

Objective: Evaluation of single preoperative dose of pregabalin in terms of postoperative pain after laparoscopic cholecystectomy. Study Design: Randomized controlled trial (RCT). Place and Duration of Study: Study was conducted in Surgical Department of Military Hospital Rawalpindi over a period of one year fromJan 2013 to Dec 2013. Material and Methods: One hundred patients (50 in each group) were included in this study. They were divided into two groups. Group-A was given pregabalin and group-B was given placeboafter laparoscopic cholecystectomy. Results: Mean age was 38.2 ± 11.0 years in group A and 36.9 ± 11.7 years in group B. Regarding distribution of gender, 14 patients (28.0%) in group-A and 17 patients (34.0%) in group-B were males while 36 patients (72.0%) in group-A and 33 patients (66.0%) in group-B were females. Mean visual analogue score at 24 hours was 4.98 ± 1.87 and 6.58 ± 2.03 in group-A and B, respectively. The difference between two group was statistically significant (p<0.001). Analgesia was required in 17 patients (34.0%) in group-A and 37 patients of group-B. Conclusion: A single preoperative oral dose of pregabalin 150 mg was found very effective method for reducing postoperative pain in patients undergoing laparoscopic cholecystectomy. [ABSTRACT FROM AUTHOR]

Abstract: Frustrated Lewis pairs (FLPs) created by sterically hindered Lewis acids and Lewis bases have shown their capacity for capturing and reacting with a variety of small molecules, including H2 and CO2, and thereby creating a new strategy for CO2 reduction. Here, the photocatalytic CO2 reduction behavior of defect‐laden indium oxide (In2O3−x(OH)y) is greatly enhanced through isomorphous substitution of In3+ with Bi3+, providing fundamental insights into the catalytically active surface FLPs (i.e., InOH···In) and the experimentally observed “volcano” relationship between the CO production rate and Bi3+ substitution level. According to density functional theory calculations at the optimal Bi3+ substitution level, the 6s2 electron pair of Bi3+ hybridizes with the oxygen in the neighboring InOH Lewis base site, leading to mildly increased Lewis basicity without influencing the Lewis acidity of the nearby In Lewis acid site. Meanwhile, Bi3+ can act as an extra acid site, serving to maximize the heterolytic splitting of reactant H2, and results in a more hydridic hydride for more efficient CO2 reduction. This study demonstrates that isomorphous substitution can effectively optimize the reactivity of surface catalytic active sites in addition to influencing optoelectronic properties, affording a better understanding of the photocatalytic CO2 reduction mechanism. [ABSTRACT FROM AUTHOR]