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Purpose: Increased glucocorticoid receptor (GR) signaling is a proposed compensatory mechanism of resistance to androgen receptor (AR) inhibition in metastatic castration-resistant prostate cancer (mCRPC). ORIC-101 is a potent and selective orally-bioavailable GR antagonist., Patients and Methods: Safety, pharmacokinetic/pharmacodynamic, and antitumor activity of ORIC-101 in combination with enzalutamide were studied in patients with mCRPC progressing on enzalutamide. ORIC-101 doses ranging from 80 to 240 mg once daily were tested in combination with enzalutamide 160 mg once daily. Pharmacokinetics/pharmacodynamics was assessed after a single dose and at steady state. Disease control rate (DCR) at 12 weeks was evaluated at the recommended phase 2 dose (RP2D)., Results: A total of 41 patients were enrolled. There were no dose-limiting toxicities and the RP2D was selected as 240 mg of ORIC-101 and 160 mg of enzalutamide daily. At the RP2D, the most common treatment-related adverse events were fatigue (38.7%), nausea (29.0%), decreased appetite (19.4%), and constipation (12.9%). Pharmacokinetic/pharmacodynamic data confirmed ORIC-101 achieved exposures necessary for GR target engagement. Overall, for 31 patients treated at the RP2D, there was insufficient clinical benefit based on DCR (25.8%; 80% confidence interval: 15.65-38.52) which did not meet the prespecified target rate, leading to termination of the study. Exploratory subgroup analyses based on baseline GR expression, presence of AR resistance variants, and molecular features of aggressive variant prostate cancer suggested possible benefit in patients with high GR expression and no other resistance markers, although this would require confirmation., Conclusions: Although the combination of ORIC-101 and enzalutamide demonstrated an acceptable tolerability profile, GR target inhibition with ORIC-101 did not produce clinical benefit in men with metastatic prostate cancer resistant to enzalutamide., (©2024 American Association for Cancer Research.)

Spatio-temporal variation in phytoplankton community dynamics in a temporarily open/closed Swarnamukhi river estuary (SRE), located on the South East coast of India was investigated and correlated to that of the adjacent coastal waters. Understanding the seasonal variability of the phytoplankton community and influencing factors are essential to predicting their impact on fisheries as the river and coastal region serve as the main source of income for the local fishing communities. Downstream before the river meets the sea, an arm of the Buckingham Canal (BC), carrying anthropogenic inputs empties into the Swarnamukhi River (SR1). The impact of anthropogenic effects on the phytoplankton community at BC was compared to other estuarine stations SR2 (upstream), SR1 (downstream), SRM (river mouth) and coastal station (CS). In BC station, harmful algal blooms (HABs) of Chaetoceros decipiens (2940 × 10 3 cells L -1 ) and Oscillatoria sp. (1619 × 10 3  cells L -1 ) were found during the southwest monsoon and winter monsoon, respectively. These HABs can be linked to the anthropogenic input of increased nutrients and trace metals. The HABs of Oscillatoria sp. were shown to be induced by elevated concentrations of nitrate (10.18 µM) and Ni (3.0 ppm) compared to ambient, while the HABs of C. decipiens were caused by elevated concentrations of silicate (50.35 µM), nitrite (2.1 µM), and phosphate (4.37 µM). Elevated nutrients and metal concentration from the aquaculture farms, and other anthropogenic inputs could be one of the prime reasons for the recorded bloom events at BC station. During this period, observed bloom species density was found low at other estuarine stations and absent at CS. The formation of bloom events during the closure of the river mouth could be a major threat to the coastal ecosystem when it opens. During the Osillatoria sp. bloom, both the Cu and Ni levels were higher at BC. The elevated concentration of nutrients and metals could potentially affect the coastal ecosystem and in turn fisheries sector in the tropical coastal ecosystem., (© 2023. The Author(s).)

Human pathogenic diseases received much attention recently due to their uncontrolled spread of antimicrobial resistance (AMR) which causes several threads every year. Effective alternate antimicrobials are urgently required to combat those disease causing infectious microbes. Halophilic actinobacteria revealed huge potentials and unexplored cultivable/non-cultivable actinobacterial species producing enormous antimicrobials have been proved in several genomics approaches. Potential gene clusters, PKS and NRPKS from Nocardia , Salinospora , Rhodococcus , and Streptomyces have wide range coding genes of secondary metabolites. Biosynthetic pathways identification via various approaches like genome mining, In silico, OSMAC (one strain many compound) analysis provides better identification of knowing the active metabolites using several databases like AMP, APD and CRAMPR, etc. Genome constellations of actinobacteria particularly the prediction of BGCs (Biosynthetic Gene Clusters) to mine the bioactive molecules such as pigments, biosurfactants and few enzymes have been reported for antimicrobial activity. Saltpan, saltlake, lagoon and haloalkali environment exploring potential actinobacterial strains Micromonospora , Kocuria , Pseudonocardia, and Nocardiopsis revealed several acids and ester derivatives with antimicrobial potential. Marine sediments and marine macro organisms have been found as significant population holders of potential actinobacterial strains. Deadly infectious diseases (IDs) including tuberculosis, ventilator-associated pneumonia and Candidiasis, have been targeted by halo-actinobacterial metabolites with promising results. Methicillin resistant Staphylococus aureus and virus like Encephalitic alphaviruses were potentially targeted by halophilic actinobacterial metabolites by the compound Homoseongomycin from sponge associated antinobacterium. In this review, we discuss the potential antimicrobial properties of various biomolecules extracted from the unexplored halophilic actinobacterial strains specifically against human infectious pathogens along with prospective genomic constellations., Competing Interests: Conflict of interestOn behalf of all the authors, the corresponding author states that there is no conflict of interest., (© King Abdulaziz City for Science and Technology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Sodium alginate based (SA) hydrogel supplemented Cerium Oxide nanoparticles (CeO 2 NPs) was produced to fabricate an antimicrobial thin film using an aqueous extract of G. salicornia (Gs). The Gs-CeO 2 NPs were characterized via SEM, FT-IR, EDX, XRD and DLS, the particle size was 200 nm, agreed with XRD. Gs-SA powder was extracted and incorporated with CeO 2 NPs. The Gs-SA and its composite thin film (Gs-CeO 2 NPs-SATF) were characterized including viscosity, FT-IR, TGA, and SEM. The adhesion of Gs-SA coating around Gs-CeO 2 NPs confirmed via FTIR. The antimicrobial properties of Gs-CeO 2 NPs and CeO 2 NPs-SATF were proved in MICs for E. coli and Candida albicans at 62.5 and 250.0 μg/mL. The biofilm inhibition efficiency of CeO 2 NPs-SATF was 74.67 ± 0.98% and 65.45 ± 0.40% for E. coli and Candida albicans. The CeO 2 NPs-SATF was polydisperse in nature and film structure gets fluctuated with NPs concentration. Increased NPs into SATF enhances pore size of gel and corroborated with viscous behaviour. The cytotoxicity of Gs-CeO 2 NP-SA in Artemia salina at higher concentration 100 μg/mL provides less lethal effect into the adult. The antioxidant activity of Gs-CeO 2 NP-SA in DPPH assay was noticed at 0.6 mg ml -1 with radical scavenging activity at 65.85 ± 0.81%. Thus the Gs-CeO 2 NP-SATF would be suitable in antimicrobial applications., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Purpose: Inguinal lymph nodes are a rare but recognised site of metastasis in rectal adenocarcinoma. No guideline or consensus exists for the management of such cases. This review aims to provide a contemporary and comprehensive analysis of the published literature to aid clinical decision-making., Methods: Systematic searches were performed using the PubMed, Embase, MEDLINE and Scopus and Cochrane CENTRAL Library databases from inception till December 2022. All studies reporting on the presentation, prognosis or management of patients with inguinal lymph node metastases (ILNM) were included. Pooled proportion meta-analyses were completed when possible and descriptive synthesis was utilised for the remaining outcomes. The Joanna Briggs Institute tool for case series was used to assess the risk of bias., Results: Nineteen studies were eligible for inclusion, encompassing 18 case series and one population-based study using national registry data. A total of 487 patients were included in the primary studies. The prevalence of ILNM in rectal cancer is 0.36%. ILNM are associated with very low rectal tumours with a mean distance from the anal verge of 1.1 cm (95% CI 0.92-1.27). Invasion of the dentate line was found in 76% of cases (95% CI 59-93). In patients with isolated inguinal lymph node metastases, modern chemoradiotherapy regimens in combination with surgical excision of inguinal nodes are associated with 5-year overall survival rates of 53-78%., Conclusion: In specific subsets of patients with ILNM, curative-intent treatment regimens are feasible, with oncological outcomes akin to those demonstrated in locally advanced rectal cancers., (© 2023. The Author(s).)

In this study, a one-step hydrothermal approach was used to make pure magnetic copper ferrite (CuFe 2 O 4 ) and copper ferrite-graphene oxide (CuFe 2 O 4 -rGO) nanocomposites (NCs) and spinel structure CuFe 2 O 4 with a single phase of tetragonal CuFe 2 O 4 -rGO-NCs was confirmed by the XRD. Then, characterization of CuFe 2 O 4 -rGO-NCs was done using ng Raman spectroscopy, FT-IR, TGA-DTA, EDS, SEM, and TEM. The synthesized NCs was exposed to UV light to evaluate its photocatalytic activity for the degradation of methylene blue (MB) and rhodamine B (RhB) with CuFe 2 O 4 and CuFe 2 O 4 -rGO-NCs, respectively. The catalyst CuFe 2 O 4 -rGO-NCs provided higher degradation of MB (94%) than for RhB (86%) under UV light irradiation compared to CuFe 2 O 4 . Further, the antibacterial activities of CuFe 2 O 4 -NPs and CuFe 2 O 4 -rGO-NCs were tested against Gram-negative and -positive bacterial pathogens such as Vibrio cholera (V. cholera); Escherichia coli (E. coli); Pseudomonas aeruginosa (P. aeruginosa); Bacillus subtilis (B. subtilis); Staphylococcus aureus (S. aureus); and Staphylococcus epidermidis (S. epidermidis) by well diffusion method. At 100 μg/mL concentrations of CuFe 2 O 4 -rGO-NCs, maximal growth inhibition was shown against E. coli (18 mm) and minimum growth inhibition against S. epidermidis (12 mm). This study suggests that CuFe 2 O 4 -rGO-NCs as a high-efficacy antibacterial material and plays an important role in exhibiting higher sensitivity depending on concentrations. The results encourage that the synthesized CuFe 2 O 4 -rGO-NCs can be used as a promising material for the antibacterial activity and also for dye degradation in the water/wastewater treatment plants., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Staphylococcus gallinarum FCW1 was isolated from naturally fermented coconut-water and identified by biochemical and molecular methods. Probiotic characterization and safety assessment were conducted through a series of in vitro tests. A high survival rate was observed when the strain was tested for resistance to bile, lysozyme, simulated gastric and intestinal fluid, phenol, and different temperature and salt concentrations. The strain showed antagonism against some pathogens, was susceptible to all antibiotics tested except penicillin, and showed no hemolytic and DNase activity. Hydrophobicity, autoaggregation, biofilm formation, and antioxidation tests indicated that the strain possessed a high adhesive and antioxidant ability. Enzymatic activity was used to evaluate the metabolic capacities of the strain. In-vivo experiment on zebrafish was performed to check its safety status. The whole-genome sequencing indicated that the genome contained 2,880,305 bp with a GC content of 33.23%. The genome annotation confirmed the presence of probiotic-associated genes and genes for oxalate degradation, sulfate reduction, acetate metabolism, and ammonium transport in the FCW1 strain, adding to the theory that this strain may be helpful in treating kidney stones. This study revealed that the strain FCW1 might be an excellent potential probiotic in developing fermented coconut beverages and treating and preventing kidney stone disease., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Multidrug-resistant strains (MDRs) are becoming a major concern in a variety of settings, including water treatment and the medical industry. Well-dispersed catalysts such as BiPO 4 , ZnO nanoparticles (NPs), and different ratios of BiPO 4 /ZnO nanocomposites (NCs) were synthesized through hydrothermal treatments. The morphological behavior of the prepared catalysts was characterized using XRD, Raman spectra, PL, UV-Vis diffuse reflectance spectroscopy (UV-DRS), SEM, EDX, and Fe-SEM. MDRs were isolated and identified by the 16s rDNA technique as belonging to B. flexus , B. filamentosus , P. stutzeri , and A. baumannii . The antibacterial activity against MDRs and the photocatalytic methylene blue (MB) dye degradation activity of the synthesized NPs and NCs were studied. The results demonstrate that the prepared BiPO 4 /ZnO-NCs (B1Z4-75:300; NCs-4) caused a maximum growth inhibition of 20 mm against A. baumannii and a minimum growth inhibition of 12 mm against B. filamentosus at 80 μg mL -1 concentrations of the NPs and NCs. Thus, NCs-4 might be a suitable alternative to further explore and develop as an antibacterial agent. The obtained results statistically justified the data ( p ≤ 0.05) via one-way analysis of variance (ANOVA). According to the results of the antibacterial and photocatalytic study, we selected the best bimetallic NCs-4 for the photoexcited antibacterial effect of MDRs, including Gram ve + and Gram ve - strains, via UV light irradiation. The flower-like NCs-4 composites showed more effectiveness than those of BiPO 4 , ZnO, and other ratios of NCs. The results encourage the development of flower-like NCs-4 to enhance the photocatalytic antibacterial technique for water purification.

Plasticizers increase the flexibility of plastics. As environmental leachates they lead to increased water and soil pollution, as well as to serious harm to human health. This study was set out to explore various web applications to predict the toxicological properties of plasticizers. Web-based tools (e.g., BOILED-Egg, LAZAR, PROTOX-II, CarcinoPred-EL) and VEGA were accessed via an 5th-10th generation computer in order to obtain toxicological predictions. Based on the LAZAR mutagenicity assessment was only bisphenol F predicted as mutagenic. The BBP and DBP in RF; DEHP in RF and XGBoost; DNOP in RF and XGBoost models were predicted as carcinogenic in the CarcinoPred-EL web application. From the bee predictive model (KNN/IRFMN) BPF, di-n-propyl phthalate, diallyl phthalate, dibutyl phthalate, and diisohexyl phthalate were predicted as strong bee toxicants. Acute toxicity for fish using the model Sarpy/IRFMN predicted 19 plasticizers as strong toxicants with LC50 values of less than 1 mg/L. This study also considered plasticizer effects on gastrointestinal absorption and other toxicological endpoints., (© 2022. The Author(s).)

Methicillin-resistant Staphylococcus aureus (MRSA) infections are increasingly causing morbidity and mortality; thus, drugs with multifunctional efficacy against MRSA are needed. We extracted a novel compound from the halophilic Pseudomonas aeruginosa using an ethyl acetate (HPAEtOAcE). followed by purification and structure elucidation through HPLC, LCMS, and 1 H and 13 C NMR, revealing the novel 5-(1 H -indol-3-yl)-4-pentyl-1,3-oxazole-2-carboxylic acid (Compound 1 ). Molecular docking of the compound against the MRSA PS (pantothenate synthetase) protein was confirmed using the CDOCKER algorithm in BDS software with specific binding to the amino acids Arg (B:188) and Lys (B:150) through covalent hydrogen bonding. Molecular dynamic simulation of RMSD revealed that the compound-protein complex was stabilized. The proficient bioactivities against MRSA were attained by the HPAEtOAcE, including MIC and MBCs, which were 0.64 and 1.24 µg/mL, respectively; 100% biomass inhibition and 99.84% biofilm inhibition were observed with decayed effects by CLSM and SEM at 48 h. The hla , IrgA , and SpA MRSA genes were downregulated in RT-PCR. Non-hemolytic and antioxidant potential in the DPPH assay were observed at 10 mg/mL and IC 50 29.75 ± 0.38 by the HPAEtOAcE. In vitro growth inhibition assays on MRSA were strongly supported by in silico molecular docking; Lipinski's rule on drug-likeness and ADMET toxicity prediction indicated the nontoxic nature of compound.

Introduction: Small intestinal neuroendocrine tumors (SI-NETs) often present with metastatic disease. An ongoing debate exists on whether to perform primary tumor resection (PTR) in patients with stage IV SI-NETs, without symptoms of the primary tumor and inoperable metastatic disease., Objective: The aim of this study was to compare a treatment strategy of upfront surgical resection versus a surveillance strategy of watch and wait., Methods: This was a retrospective cohort study of patients with stage IV SI-NETs at diagnosis, between 2000 and 2018, from two tertiary referral centers (Netherlands Cancer Institute [NKI] and Aintree University Hospital [AUH]) who had adopted contrasting treatment approaches: upfront surgical resection and watch and wait, respectively. Patients without symptoms related to the primary tumor were included. Multivariable intention-to-treat (ITT), per-protocol (PP), and instrumental variable (IV) analyses using 'institute' as an IV were performed to assess the influence of PTR on disease-specific mortality (DSM)., Results: A total of 557 patients were identified, with 145 patients remaining after exclusion of stage I-III disease or symptoms of the primary tumor (93 from the NKI and 52 from AUH). The cohorts differed in performance status (PS; p = 0.006) and tumor grade (p < 0.001). PTR was independently associated with reduced DSM irrespective of statistical methods employed: ITT hazard ratio [HR] 0.60, p = 0.005; PP HR 0.58, p < 0.001; and IV HR 0.07, p = 0.019. Other factors associated with DSM were age, PS, high chromogranin A, and somatostatin analog treatment., Conclusion: Taking advantage of contrasting institutional treatment strategies, this study identified PTR as an independent predictor of DSM. Future prospective studies should aim to validate these results., (© 2022. Society of Surgical Oncology.)

Microbial pathogens that cause severe infections and are resistant to drugs are simultaneously becoming more active. This urgently calls for novel effective antibiotics. Organisms from extreme environments are known to synthesize novel bioprospecting molecules for biomedical applications due to their peculiar characteristics of growth and physiological conditions. Antimicrobial developments from hypersaline environments, such as lagoons, estuaries, and salterns, accommodate several halophilic microbes. Salinity is a distinctive environmental factor that continuously promotes the metabolic adaptation and flexibility of halophilic microbes for their survival at minimum nutritional requirements. A genetic adaptation to extreme solar radiation, ionic strength, and desiccation makes them promising candidates for drug discovery. More microbiota identified via sequencing and 'omics' approaches signify the hypersaline environments where compounds are produced. Microbial genera such as Bacillus , Actinobacteria , Halorubrum and Aspergillus are producing a substantial number of antimicrobial compounds. Several strategies were applied for producing novel antimicrobials from halophiles including a consortia approach. Promising results indicate that halophilic microbes can be utilised as prolific sources of bioactive metabolites with pharmaceutical potentialto expand natural product research towards diverse phylogenetic microbial groups which inhabit salterns. The present study reviews interesting antimicrobial compounds retrieved from microbial sources of various saltern environments, with a discussion of their potency in providing novel drugs against clinically drug-resistant microbes.

Purpose: Emergency colonic surgery carries a high mortality rate. In the UK, strategies to improve outcomes in emergency general surgery recommend a consultant surgeon to be physically present during all operations involving a patient with a predicted mortality > 5%. To test the assertion of the consultant surgeon's presence in theatre as a determinate of improved outcome, we assessed patients following an emergency colonic resection and the effect of operator seniority., Methods: A retrospective analysis was undertaken for all patients undergoing an emergency colonic resection during a 4-year period between 2013 and 2017. Patient's pre-operative risk was assessed using P-POSSUM score and ASA grade. Outcomes assessed were post-operative morbidity (recorded using Clavien-Dindo classification), 30 day/inpatient mortality and length of stay (LOS). Outcomes were then compared between consultant and trainee led cases using univariate logistic regression techniques with results presented in terms of odds ratios (95% confidence intervals). A p value of 0.05 is used to determine statistical significance., Results: A total of 130 patients were identified over the 4-year study period. 65% had their operation performed by a consultant and 35% by a trainee. Pre-operative P-POSSUM scores were the same between the groups (9.4% [5.0-25.2] vs 9.4% [4.9-28.6] p 0.75). There was no significant difference in post-operative complication rates between consultant and trainee led cases for minor (OR 1.58 [0.76-3.20] p 0.27) or major complications (OR 1.08 [0.50-2.31] p 0.84). Overall post-operative mortality was 14% with a trend for higher mortality rates in consultant led cases (15% vs 9%) albeit not statistically significant (p 0.57). Despite similar complication rates, trainee led operations were associated with slightly longer LOS at 19 (IQR 12-38) vs 15 (IQR 9-23) days (p 0.56)., Conclusion: Emergency colonic surgery remains associated with a high level of morbidity and mortality. However, consultant presence at the operating table does not appear to be the sole determinant of outcome following an emergency colonic resection., (© 2020. Springer-Verlag GmbH Germany, part of Springer Nature.)

Extreme environments are hostile for most organisms, but such habitats represent suitable settings to be inhabited by specialized microorganisms. A marine shallow-water hydrothermal vent field is located offshore in northeast Taiwan, near the shallow shore of the southeast of Kueishantao Island (121°55' E, 24°50' N). Research on extremophilic microorganisms makes use of the biotechnological potential associated with such microorganisms and their cellular products. With the notion that extremophiles are capable of surviving in extreme environments, it is assumed that their metabolites are adapted to function optimally under such conditions. As extremophiles, they need specific culture conditions, and only a fraction of species from the original samples are recovered in culture. We used different non-selective and selective media to isolate bacterial species associated with the hydrothermal vent crab Xenograpsus testudinatus and the sediments of its habitat. The highest number of colonies was obtained from Zobell marine agar plates with an overall number of 29 genetically distinct isolates. 16sRNA gene sequencing using the Sanger sequencing method revealed that most of the bacterial species belonged to the phylum Firmicutes and the class Bacilli. The present study indicates that hydrothermal vent bacteria and their secondary metabolites may play an important role for the reconstruction of the evolutionary history of the phylum Procaryota.

Aim: The aim was to describe changes in incidence and mortality from colorectal cancer (CRC) in England by analysing data available from the National Cancer Registration and Analysis Service (NCRAS, 2001-2017)., Methods: Data analysis was undertaken to interpret trends and patterns in age-standardized incidence and death rates from CRC, including sub-analyses by six age groups (0-24, 25-49, 50-59, 60-69, 70-79, 80+) and three sites of cancer-colonic, rectosigmoid and rectal., Results: Overall CRC incidence remained relatively stable-70.1 cases per 100 000 individuals (95% CI 69.3-71.0) in 2001 and 68.8 cases (95% CI 68.0-69.5) in 2017. Sub-analysis demonstrates a quarter fewer incidence of rectosigmoid cancer (-27%). This is counterbalanced by a 3% rise in colon cancers. The age-standardized incidence rate of CRC increased by 59% in the 25-49 age group. In the over 50s, CRC incidence remained stable, with reductions seen in rectosigmoid cancer (50-59 years, -19%; 60-69, -26%; 70-79, -39%; 80+, -27%). Overall, mortality improved (-18.7%), primarily as a result of the reduction in deaths from colon (-31.6%) and rectal cancers (-25.1%). Deaths from the small incident number of rectosigmoid cancers, however, demonstrated a significant increase overall (+166.7%). Grouped age-standardized death rate analyses showed increasing death rates in the under 50s (+28.3%) compared to declining rates in the over 50s (-15.8%)., Conclusions: There is a clear trend in increased incidence and mortality in individuals under 50 years old. There is also a trend to increased mortality from rectosigmoid cancer. These findings should have implications for national screening programme extension to under 50s and a call to arms for appropriate identification, staging and treatment of rectosigmoid cancers., (© 2021 The Association of Coloproctology of Great Britain and Ireland.)

Background: Congenital hand differences (CHD) exhibit enormous diversity and heterogeneity. Surgeons and parents often have different concepts of severity, making things difficult during parental consultation. This study aims to align surgeon/parental views on the severity of the child's CHD using a novel severity classification. Methods: Parents of affected children were asked to score the severity of their child's abnormality pre- and post-consultation using a subjective scale (1-4) without any explanation. Furthermore, parents were asked to rate their concerns about the future function and appearance of their child's hand condition using a similar scale of 1-4. They were then asked to rate the severity of the CHD post-consultation and three months post-operatively following explanation of the 4-point scale, as follows: 1 = treatment possible to normal; 2 = treatment possible to near normal; 3 = treatment possible but always some hand differences; 4 = treatment not possible. The surgeon also independently scored all children using his perception of the scale. Results: Forty-three children with a range of CHD were recruited into the sample. Linear weighted kappa analyses comparing inter-rater agreement showed no agreement between surgeon and parents during the initial scoring without any explanations. However, with explanations added, agreement rose significantly (kappa = 0.437 post-consultation and kappa = 0.706 three months post-op). No correlation was found between severity with both appearance and function (r = 0.277 and r = -0.184, respectively). Conclusions: This study demonstrated that the use of a simple scoring system was able to improve parental understanding of the severity and prognosis of CHD. The system demonstrated a good correlation between surgeon and parents. Such a scoring system can be easily utilised in the outpatient department to manage expectations and reduce anxiety.

Dimensions of character are often overlooked in professional practice at the expense of the development of technical competence and operational efficiency. Drawing on philosophical accounts of virtue ethics and positive psychology, the present work attempts to elevate the role of 'good' character in the professional domain. A 'good' professional is ideally one that exemplifies dimensions of character informed by sound judgement. A total of 2340 professionals, from five discrete professions, were profiled based on their valuation of qualities pertaining to character and judgement. Profile differences were subsequently examined in the self-reported experience of professional purpose towards a wider societal 'good'. Analysis of covariance, controlling for stage of career, revealed that professionals valuing character reported higher professional purpose than those overweighting the importance of judgement or valuing neither character nor judgement, F (3, 2054) = 7.92, p  < .001. No differences were found between the two groups valuing character, irrespective of whether judgement was valued simultaneously. This profiling analysis of entry-level and in-service professionals, based on their holistic character composition, paves the way for fresh philosophical discussion regarding what constitutes a 'good' professional and the interplay between character and judgement. The empirical findings may be of substantive value in helping to recognise how the dimensions of character and judgement may impact upon practitioners' professional purpose., Competing Interests: Conflict of interestAll the authors declare they have no conflict of interest, financial or personal, (© The Author(s) 2019.)

Background: Patients with colorectal cancer deemed to be high-risk may be denied an elective laparoscopic resection due to subjective reasons. A comparison of the 30-day outcomes in true functional high-risk patients who underwent either open or laparoscopic colorectal resection was undertaken. Materials and Methods: A retrospective cohort of all functional high-risk patients as assessed by cardiopulmonary exercise test between July 2015 and April 2018 were identified. Anaerobic threshold of <11 mL/kg/minute was used as a physiologic indicator to determine a high-risk patient. Adherence to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was ensured. P values were computed via two-sided Fisher's exact test, and the exact Mann-Whitney U-test. Forest plots for relative risks with 95% confidence intervals were displayed on a log scale. Results: One hundred forty-six patients were identified as high-risk. Outcomes demonstrated a trend to laparoscopic benefit in all Clavien-Dindo grades of postoperative complications, but especially in severe complications of grades 3-4 (3.5% versus 10.2%). Readmissions demonstrated a trend to laparoscopic surgery benefit (7% versus 11.8%), as did mortality (1.7% versus 3.4%). The rate of surgery-site complications was higher after open surgery (42.1% versus 22.4%, P  = .0201). Wound infections were observed more frequently after open surgery (12.5% versus 1.72%, P  = .0280). The estimated risk of all-grade complications was significantly higher after open anterior rectal resection (63.0% versus 29.6%, P  = .0281) and there was significantly shorter stay after laparoscopic right colectomy (5 v. 7 days, P  = .0490). Conclusions: Laparoscopic approach for colorectal resections in high-risk patients is safe and beneficial compared to open surgery, especially in patients undergoing laparoscopic resection of the rectum and right colon.

Background and Aim: Oncologists play a vital role in the interpretation of radiographic results in glioblastoma patients. Molecular pathology and information on radiation treatment protocols among others are all important for accurate interpretation of radiology images. One important issue that may arise in interpreting such images is the phenomenon of tumor "pseudoprogression"; oncologists need to be able to distinguish this effect from true disease progression.Exact knowledge about the location of high-dose radiotherapy region is needed for valid determination of pseudoprogression according to RANO (Response Assessment in Neuro-Oncology) criteria in neurooncology. The aim of the present study was to evaluate the radiologists' understanding of a radiotherapy high-dose region in routine clinical practice since radiation oncologists do not always report 3-dimensional isodoses when ordering follow up imaging., Methods: Eight glioblastoma patients who underwent postresection radiotherapy were included in this study. Four radiologists worked with their pre-radiotherapy planning MR, however, they were blinded to RT target volumes which were defined by radiation oncologists according to current guidelines. The aim was to draw target volume for high dose RT fields (that is the region, where they would consider that there may be a pseudoprogression in future MRI scans). Many different indices describing structure differences were analyzed in comparison with original per-protocol RT target volumes., Results: The median volume for RT high dose field was 277 ccm (range 218 to 401 ccm) as defined per protocol by radiation oncologist and 87 ccm (range 32-338) as defined by radiologists (median difference of paired difference 31%, range 15-112%). The Median Dice index of similarity was 0.46 (range 0.14 - 0.78), the median Hausdorff distance 25 mm., Conclusion: Continuing effort to improve education on specific procedures in RT and in radiology as well as automatic tools for exporting RT targets is needed in order to increase specificity and sensitivity in response evaluation.

This paper charts the development of spectrally efficient forms of optical orthogonal frequency division multiplexing (OFDM) that are suited for intensity-modulated direct detection systems, such as wireless optical communications. The journey begins with systems using a DC-bias to ensure that no parts of the signal that modulates the optical source are negative in value, as negative optical intensity is unphysical. As the DC-part of the optical signal carries no information, it is wasteful in energy; thus asymmetrically clipped optical OFDM was developed, removing any negative-going peaks below the mean. Unfortunately, the clipping causes second-order distortion and intermodulation, so some subcarriers appear to be unusable, halving spectral efficiency; this is similar for unipolar and flipped optical OFDM. Thus, a considerable effort has been made to regain spectral efficiency, using layered techniques where the clipping distortion is mostly cancelled at the receiver, from a knowledge of one unpolluted layer, enabling one or more extra 'layers/paths/depths' to be received on the previously unusable subcarriers. Importantly, for a given optical power and high-order modulation, layered methods offer the best spectral efficiencies and need the lowest signal-to-noise ratios, especially if diversity combining is used. Thus, they could be important for high-bandwidth optical fibre systems. Efficient methods of generating all layers simultaneously, using fast Fourier transforms with their partial calculations extracted, are discussed, as are experimental demonstrations in both wireless and short-haul communications links. A musical analogy is also provided, which may point to how orchestral and rock music is deciphered in the brain. This article is part of the theme issue 'Optical wireless communication'.

Antimicrobial peptide crustin was isolated and purified from Penaeus semisulcatus using Sephadox G-100 column gel filtration chromatography. P. semisulcatus crustins was observed as a single band with 14 kDa of molecular weight on SDS-PAGE and the retention time of 46 min in RP-HPLC. Circular dichroism spectra of P. semisulcatus crustin showed alpha helices in its secondary structure followed by random coils. Crystalline nature and functional groups arrangement were investigated by X-Ray Diffraction (XRD) and Fourier Transform Infra-Red spectroscopy (FTIR). P. semisulcatus crustin showed the effective antibacterial activity against Gram positive strains B. thuringienisis (4 μg/ml) and B. pumilis (6 μg/ml) when compare to Gram negative strains. Biofilm Inhibitory Concentration (BIC) were determined for these strains and percentage of biofilm inhibition was confirmed and visualized through in sit microscopic analysis. Hence, we reported the effect of crustin on biofilm inhibition and eradication at low concentrations by using crystal violet staining and confocal microscopic observations. In addition, haemolytic activity of this purified crustin also analysed using human RBCs. The results of this study, suggests that this bio peptide crustin is a potential and promising therapeutic agent to treat drug resistant bacteria and biofilm-related infections., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Insufficient receiver bandwidth destroys the orthogonality of Nyquist-shaped pulses, generating inter-symbol interference (ISI). We propose using an optical pre-sampler to alleviate the requirement on the receiver bandwidth through pulse re-shaping. Experiments and simulations using an optically shaped 40-Gbaud Nyquist-shaped on-off-keying signal (N-OOK) show receiver sensitivity improvements of 4- and 7.1-dB under 18- and 11-GHz receiver electrical bandwidths, respectively.

There is a scarcity of pharmacological tools to interrogate protein kinase function in Plasmodium parasites, the causative agent of malaria. Among Plasmodium's protein kinases, those characterized as atypical represent attractive drug targets as they lack sequence similarity to human proteins. Here, we describe takinib as a small molecule to bind the atypical P. falciparum protein kinase 9 (PfPK9). PfPK9 phosphorylates the Plasmodium E2 ubiquitin-conjugating enzyme PfUBC13, which mediates K63-linkage-specific polyubiquitination. Takinib is a potent human TAK1 inhibitor, thus we developed the Plasmodium-selective takinib analog HS220. We demonstrate that takinib and HS220 decrease K63-linked ubiquitination in P. falciparum, suggesting PfPK9 inhibition in cells. Takinib and HS220 induce a unique phenotype where parasite size in hepatocytes increases, yet high compound concentrations decrease the number of parasites. Our studies highlight the role of PK9 in regulating parasite development and the potential of targeting Plasmodium kinases for malaria control., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Localized, metastasis-directed stereotactic body radiation therapy (SBRT) of oligometastatic disease (OD) is currently rapidly evolving standard of care in many institutions. Further reports of outcomes are required to strengthen the level of evidence in the absence of comparative trials evaluating different practical procedures. The aim of this prospective single institutional study is to analyse, in unselected cohort of patients from real-world clinical practice, the long-term survival, tumor control outcomes and safety of SBRT in OD (radical ablative radiotherapy with biological equivalent dose BED10>100 Gy). In addition to standard toxicity and survival parameters, we report unique outcomes as FFWD - Freedom from widespread dissemination, FFNT - Freedom from the need of subsequent treatment and functional survival with Karnofsky performance status higher than 70%. A total of 110 patients were prospectively evaluated, 60% and 40% were treated for lung and liver oligometastatic disease, respectively. No grade 3 or 4 acute toxicities (CTCAE) were reported. With median follow up of 22.2 months and 2-year overall survival of 88.3%, four patients (6.1%) experienced local progression in the lung SBRT cohort. In the liver SBRT cohort, median follow up was 33 months, 2-year overall survival was 68.5% and 11 patients (25%) experienced local and 36 (81.8%) distal progression. Higher BED10 of 150-170 Gy compared to 100-150 Gy was an independent positive prognostic factor for local progression-free survival for all patients with hazard ratio 0.25. This confirms SBRT ablative radiobiology effects to be independent of OD primary histology and location. The best outcomes in terms of FFNT were observed in the multivariable analysis of patients with 1-2 lung OD compared to both the liver OD cohort and patients with more than 2 lung metastases. Better FFNT in the liver SBRT cohort was observed in patients with 1-2 liver metastases and in patients whose liver OD was irradiated by higher BED10. In conclusion, SBRT is a suitable option for patients who are not surgical candidates; with approximately 30% of patients not requiring subsequent treatment 2 years after SBRT. We believe that this treatment represents a safe and effective option for oligometastatic involvement in patients with various primary tumors.

We propose a novel scheme with a "time-lens"-based partial optical Fourier transform (OFT) and coherent sampling for high-speed complex orthogonal frequency-division multiplexing (OFDM) signal detection. Compared with all-optical OFDM demultiplexing with a matched optical filter, our proposed method replaces specialized optical filters with commercially available equipment, which relaxes stringent manufacturing and operational requirements. Our simulation shows that even with a partial OFT, theoretically, close to inter-channel interference-free performance is possible. In addition, we performed a proof-of-concept experiment of 16×10  Gbaud quadrature phase-shift keying (QPSK) all-optical OFDM detection, with all the bit error rates far below the 7% hard-overhead forward error correction limit.

Schizophrenia (SCZ) is one of the brain disorders which affects the thinking and behavioral skills of patients. This disorder comes along with an overproduction of kynurenic acid in the cerebrospinal fluid and the prefrontal cortex of SCZ patients. In this study, marine bacterial compounds were screened for their suitability as antagonists against human kynurenine aminotransferase (hKAT-1) which causes the synthesis of kynurenic acid downstream which ultimately causes the SCZ disorder according to the kynurenic hypothesis of SCZ. The marine actinobacterial compound bonactin shows more promising results than other tested marine compounds such as the histamine H2 blocker famotidine and indole-3-acetic acid (IAC) from docking and in silico toxicological studies carried out here. The obtained results of the Grid-based Ligand Docking with Energetics (Glide) scores of extra-precision (XP) Glide against the target protein hKAT-1 on IAC, famotidine, and bonactin were - 6.581, - 6.500 and - 7.730 kcal/mol where Glide energies were - 29.84, - 28.391, and - 47.565 kcal/mol, respectively. Bonactin is known as an antibacterial and antifungal compound being extracted from a marine Streptomyces sp. Comparing tested compounds against the drug target hKAT-1, bonactin alone showed the best Glide score and Glide energy on the target protein hKAT-1.

Turbinaria ornata (TO) extract was tested as green corrosion inhibitor on mild steel (MS) coupons in conc. HCl medium with an efficiency of 100% at 25 g l -1 during 5 min exposure. Antibacterial efficacy performed against 16 S rDNA identified marine biofilming bacteria (MBB) and human pathogenic bacteria (HPB). Maximum inhibition growth was 16 mm on MBB observed in Bacillus megaterium (MBF14 - AB894827) and 20 mm on HPB in Escherichia coli (B5 - NCIM 2931). Similarly, minimum of 10 mm on MBB witnessed in Pseudomonas sp., (MBF9 - AB894829). Toxicity studies proved 50.0% LC 50 at 500 μg ml -1 in 24 hrs, whereas Balanus amphitrite resulted in 100% mortality within 12 hrs. Results including weight loss, potentiodynamic polarization and electrochemical impedance spectroscopy, FT-IR and GC-MS confirm 10-Octadecaonic acid as a major corrosion inhibitor from T. ornata and is discovered as a novel antifoulant. Anticorrosion formulation will become available soon.

We propose and experimentally demonstrate an all-optical digital-to-analog converter based on cross-phase modulation with temporal integration. The scheme is robust for driving signal noise due to the low-pass filtering feature of the temporal integrator. The proof-of-concept experiment demonstrates the generation of pulse-amplitude modulation (PAM) sequences up to eight levels. The performance of random PAM 2 and PAM 4 signals with different optical signal-to-noise ratios of the binary driving signal is also investigated. The scheme is scalable for high-speed operation with an appropriate dispersion profile of the nonlinear medium.

We propose and experimentally validate a blind phase recovery algorithm based on tracking low-frequency components of the phase noise, which we call "filtered carrier-phase estimation (F-CPE)." Tracking only the low-frequency components allows F-CPE to reduce the computational complexity by using a frequency-domain equalizer and to simplify the partitioning of a 16 quadrature amplitude modulation (16QAM) constellation. Further, this approach eliminates cycle slips by suppressing the impact of amplified spontaneous emission on phase noise estimation. The experimental results demonstrate cycle-slip-free operation for 15 and 32 GBd 16QAM signals. Additionally, the proposed method showed similar or better sensitivity compared with the blind-phase-search algorithm, near standard forward error correction thresholds of modern wavelength division multiplexing systems.

Objective: Trabectedin demonstrated significantly improved disease control in leiomyosarcoma and liposarcoma patients in a global phase 3 trial (NCT01343277). A post hoc analysis was conducted to assess the efficacy and safety of trabectedin or dacarbazine in women with uterine leiomyosarcoma (uLMS), the largest subgroup of enrolled patients (40%)., Methods: Of 577 patients randomized 2:1 to receive trabectedin 1.5mg/m 2 by 24-hour IV infusion or dacarbazine 1g/m 2 by 20-120-minute IV infusion once every three weeks, 232 had uLMS (trabectedin: 144; dacarbazine: 88). The primary endpoint was overall survival (OS); secondary endpoints were progression-free survival (PFS), objective response rate (ORR), clinical benefit rate (CBR: complete responses+partial responses+stable disease [SD] for at least 18weeks), duration of response (DOR), and safety., Results: PFS for trabectedin was 4.0months compared with 1.5months for dacarbazine (hazard ratio [HR]=0.57; 95% CI 0.41-0.81; P=0.0012). OS was similar (trabectedin 13.4months vs. dacarbazine 12.9months, HR=0.89; 95% CI 0.65-1.24; P=0.51) between groups. ORR was 11% with trabectedin vs. 9% with dacarbazine (P=0.82). CBR for trabectedin was 31% vs. 18% with dacarbazine (P=0.05); median DOR was 6.5months for trabectedin vs. 4.1months for dacarbazine (P=0.32). Grade 3/4 treatment-emergent adverse events observed in ≥10% of patients in the trabectedin group included transient aminotransferase (aspartate/alanine) elevations, anemia, leukopenia, and thrombocytopenia., Conclusions: In this post hoc subset analysis of patients with uLMS who had received prior anthracycline therapy, trabectedin treatment resulted in significantly longer PFS versus dacarbazine, with an acceptable safety profile. There was no difference in OS., (Copyright © 2017. Published by Elsevier Inc.)

Phase-coded radio frequency (RF) pulses are widely adopted for radar systems as an effective signal format to enable high-range resolution. However, generating such signals conventionally requires high-speed electronics and complex RF circuitry that impose burdens on the system cost and power consumption. In particular, modern radar systems desire features such as high frequencies, e.g., in the millimeter-wave region, high compactness, and high system flexibility, which pose great challenges for the conventional all-electronics solutions. In contrast, integrated microwave photonics opens a way to solutions that are able to provide those features simultaneously, together with potential for full integration and low cost fabrication. Here, we present an integrated microwave photonic method of a binary-phase-coded millimeter-wave signal generation. The core device is a silicon microring modulator with a device size of 0.13  mm×0.32  mm and a modulation bandwidth of 23 GHz. Using RF seed frequencies of 17.5 GHz and 20 GHz, respectively, we experimentally demonstrated the generation of binary-phase-coded signals at 35 GHz and 40 GHz using our proposed approach, the performance of which was verified by a pulse compression ratio of 94 and 106, respectively. The result of this work points to the realization of a chip-scale flexible millimeter-wave signal generator.

Introduction: Achieving primary fascial closure after damage control laparostomy can be challenging. A number of devices are in use, with none having yet emerged as best practice. In July 2013, at Westmead Hospital, we started using the abdominal reapproximation anchor (ABRA; Canica Design, Almonte, Ontario, Canada) device. We report on our experience., Methods: A retrospective review of medical records for patients who had open abdomens managed with the ABRA device between July to December 2013 was done. Data extracted included age, sex, body mass index (BMI), reason for the open abdomen, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, number of laparostomies prior to ABRA placement, duration of placement, device complications, length of hospital and intensive care unit (ICU) stay, and outcomes., Results: Four cases of open abdomens managed using the ABRA device were identified, with 3 a consequence of intra-abdominal sepsis and 1 a consequence of penetrating trauma. Mean BMI was 33.5 kg/m 2 , APACHE II score was 14.5, duration with open abdomen prior to ABRA placement was 11.75 days, duration with ABRA in situ was 9 days, duration of hospital stay was 64.25 days, and ICU stay was 37.75 days. Three patients (75%) achieved fascial closure, and 1 achieved skin closure. No incidences of enterocutaneous fistulae occurred., Conclusion: The ABRA is a unique emerging alternative to aid in achieving fascial closure in patients managed with open abdomens. Our case series demonstrates that it can be used effectively in selected patients. Studies are needed to compare its efficacy with more traditional methods.

We propose and demonstrate by simulations a novel Nyquist-WDM (N-WDM) superchannel transmitter based on an arrayed waveguide grating router (AWGR). This approach can generate Nyquist pulses at multiple wavelengths using a single AWGR. Results for a 3-channel 960-Gbit/s QPSK superchannel system show that a 10% guard band reduces the inter-channel interference (ICI) sufficiently. The design introduces less than 0.16-dB penalty when the waveguide loss is 2 dB/cm and 0.73-dB penalty when the standard deviation of phase error is 10°. Such Nyquist pulse shapers can be realised on a chip scale using photonic integrated circuits technology, and could be compactly integrated with other functional components to create single-chip N-WDM superchannel transmitters.

We propose a banded all-optical orthogonal frequency division multiplexing (AO-OFDM) transmission system based on synthesising a number of truncated sinc-shaped subcarriers for each sub-band. This approach enables sub-band by sub-band reception and therefore each receiver's electrical bandwidth can be significantly reduced compared with a conventional AO-OFDM system. As a proof-of-concept experiment, we synthesise 6 × 10-Gbaud subcarriers in both conventional and banded AO-OFDM systems. With a limited receiver electrical bandwidth, the experimental banded AO-OFDM system shows 2-dB optical signal to noise ratio (OSNR) benefit over conventional AO-OFDM at the 7%-overhead forward error correction (FEC) threshold. After transmission over 800-km of single-mode fiber, ≈3-dB improvement in Q-factor can be achieved at the optimal launch power at a cost of increasing the spectral width by 14%.

We report the first experimental demonstration of a compact on-chip optical pulse timing discriminator that is able to provide an output voltage proportional to the relative timing of two 60-ps input pulses on separate paths. The output voltage is intrinsically low-pass-filtered, so the discriminator forms an interface between high-speed optics and low-speed electronics. Potential applications include timing synchronization of multiple pulse trains as a precursor for optical time-division multiplexing, and compact rangefinders with millimeter dimensions.

The polymer-cobalt(III) complexes, [Co(bpy)(dien)BPEI]Cl3 · 4H2O (bpy = 2,2'-bipyridine, dien = diethylentriamine, BPEI = branched polyethyleneimine) were synthesized and characterized. The interaction of these complexes with human serum albumin (HSA) and bovine serum albumin (BSA) was investigated under physiological conditions using various physico-chemical techniques. The results reveal that the fluorescence quenching of serum albumins by polymer-cobalt(III) complexes took place through static quenching. The binding of these complexes changed the molecular conformation of the protein considerably. The polymer-cobalt(III) complex with x = 0.365 shows antimicrobial activity against several human pathogens. This complex also induces cytotoxicity against MCF-7 through apoptotic induction. However, further studies are needed to decipher the molecular mode of action of polymer-cobalt(III) complex and for its possible utilization in anticancer therapy., (Copyright © 2015 John Wiley & Sons, Ltd.)

The interaction of surfactant-cobalt(III) complexes [Co(bpy)(dien)TA](ClO4)3 · 3H2O (1) and [Co(dien)(phen)TA](ClO4)3 · 4H2O (2), where bpy = 2,2'-bipyridine, dien = diethylenetriamine, phen = 1,10-phenanthroline and TA = tetradecylamine with human serum albumin (HSA) under physiological conditions was analyzed using steady state, synchronous, 3D fluorescence, UV/visabsorption and circular dichroism spectroscopic techniques. The results show that these complexes cause the fluorescence quenching of HSA through a static mechanism. The binding constant (Kb ) and number of binding-sites (n) were obtained at different temperatures. The corresponding thermodynamic parameters (∆G°, ∆H° and ∆S°) and Ea were also obtained. According to Förster's non-radiation energy transfer theory, the binding distance (r) between the complexes and HSA were calculated. The results of synchronous and 3D fluorescence spectroscopy indicate that the binding process has changed considerably the polarity around the fluorophores, along with changes in the conformation of the protein. The antimicrobial and anticancer activities of the complexes were tested and the results show that the complexes have good activities against pathogenic microorganisms and cancer cells., (Copyright © 2015 John Wiley & Sons, Ltd.)

Asymmetrically clipped optical orthogonal frequency-division multiplexing (ACO-OFDM) is a technique that sacrifices spectral efficiency in order to transmit an orthogonally frequency-division multiplexed signal over a unipolar channel, such as a directly modulated direct-detection fiber or free-space channel. Several methods have been proposed to regain this spectral efficiency, including: asymmetrically clipped DC-biased optical OFDM (ADO-OFDM), enhanced U-OFDM (EU-OFDM), spectral and energy efficient OFDM (SEE-OFDM), Hybrid-ACO-OFDM and Layered-ACO-OFDM. This paper presents simulations up to high-order constellation sizes to show that Layered-ACO-OFDM offers the highest receiver sensitivity for a given optical power at spectral efficiencies above 3 bit/s/Hz. For comparison purposes, white Gaussian noise is added at the receiver, component nonlinearities are not considered, and the fiber is considered to be linear and dispersion-less. The simulations show that LACO-OFDM has a 7-dB sensitivity advantage over DC-biased OFDM (DCO-OFDM) for 1024-QAM at 87.5% of DCO-OFDM's spectral efficiency, at the same bit rate and optical power. This is approximately equivalent to a 4.4-dB advantage at the same spectral efficiency of 87.7% if 896-QAM were to be used for DCO-OFDM.

Turbinaria ornata mediated silver nanoparticles (TOAg-NPs) were evaluated for antibacterial activity against 15 biofilm forming bacterial isolates. A field study in natural seawater for 60 days showed antifouling activity of TOAg-NPs on stainless steel coupons (SS-304) coated with Apcomin zinc chrome (AZC) primer. Though TOAg-NPs showed broad spectrum of antibacterial activity, the maximum zone of inhibition was with Escherichiacoli (71.9%) and a minimum with Micrococcus sp. (40%) due to the EPS secretion from Gram-positive bacteria. Compared to control coupons (18.9 [ × 10(3)], 67.0 [× 10(3)], 13.5 [ × 10(4)] and 24.7 [ × 10(4)]CFU/cm(2)), experimental biocide coupons (71.0 [ × 10(2)], 32.0 [ × 10(3)], 82.0 [ × 10(3)] and 11.3 [ × 10(4)]CFU/cm(2)) displayed lesser bacterial population density. Toxicity studies revealed 100% mortality for Balanus amphitrite larvae at 250 μg ml(-1) concentration within 24h, while 56.6% recorded for Artemia marina at the same concentration indicating less toxicity to non target species. It proved that AZC+TOAg-NPs prevent biofouling by its Ag-NS affinity and antimicrobial effectivity., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Over the past 30 years, treatment advances and the addition of neoadjuvant chemotherapy have led to improved 5-year survival in patients with osteosarcoma. More recent literature suggests the overall prognosis remains highly variable, with little improvement since the introduction of neoadjuvant chemotherapy. Tumor necrosis is an important predictor of patient prognosis. Necrosis of more than 90% correlates with overall survival (OS) approaching 75%. We reviewed the history of osteosarcoma treatment and survival and performed a meta-analysis of the 2000-2011 literature. Forty articles were included in the study. Five-year OS was 63% (95% confidence interval, 60%-66%) in studies that included patients with metastatic and nonmetastatic disease and 71% (95% confidence interval, 67%-76%) in studies that included only patients with nonmetastatic disease. Fifty percent of the patients in the studies of those with nonmetastatic osteosarcoma achieved 90% necrosis on histology. Five-year OS and number of patients achieving 90% necrosis are consistent with previous reports. Research is needed to improve treatment regimens and patient outcomes.

Time-lenses provide a promising platform for novel, broadband optical signal processing. However, in order to minimize system penalties, design constraints must be adequately taken into account. We investigate the impact of third-order-dispersion and nonlinear distortion on the performance of time-lens-based communication systems for the first time. Here, we propose a novel application of time-lenses - temporal compression and time-division multiplexing of optical OFDM channels, to provide a 1 Tb/s superchannel. Time-lens system performance degradations are investigated in our proposed system and the results are applicable to all four wave mixing based time-lens systems. Our work can help to optimize time-lens based communication systems.

Polarization dependent loss (PDL) causes imbalanced optical signal to noise ratio (OSNR) of the two polarizations, thus remains one of the major bottlenecks for next-generation polarization-division-multiplexed (PDM) coherent optical transmission systems. In this paper, we investigate Pairwise Coding for adaptive PDL mitigation in PDM coherent optical systems. By pre-coding across two polarizations, the PDL-induced performance degradation can be largely mitigated without any coding overhead. We present details of the coding and de-coding design, and also derive the analytical symbol/bit error rate of the Polarization Pairwise Coding scheme, which can be used to predict the performance gain as well as for optimal rotation angle calculation. Simulation results verify that Pairwise Coding achieves substantial system performance gains over a wide range of PDL values. Compared with other digital coding techniques, Polarization Pairwise Coding shows improved performance than Walsh-Hadamard transform since it maximizes the coordinate diversity; and also Pairwise Coding is computationally much simpler to decode compared with the Golden and Silver Codes, therefore is practical for current 100-Gb/s and future 400-Gb/s and 1-Tb/s digital coherent transceivers.

Orthogonal time division multiplexing (OrthTDM) interleaves sinc-shaped pulses to form a high baud-rate signal, with a rectangular spectrum suitable for multiplexing into a Nyquist WDM (N-WDM)-like signal. The problem with generating sinc-shaped pulses is that they theoretically have infinite durations, and even if time bounded for practical implementation, they still require a filter with a long impulse response, hence a large physical size. Previously a method of creating chirped-orthogonal frequency division multiplexing (OFDM) pulses with a chirped arrayed waveguide (AWG) filter, then converting them into interleaved quasi-sinc pulses using dispersive fiber (DF), has been proposed. This produces a signal with a wider spectrum than the equivalent N-WDM signal. We show that a modification to the scheme enables the spectral extent to be reduced for the same data rate. We then analyse the key factors in designing an OrthTDM transmitter, and relate these to the performance of a N-WDM system. We show that the modified transmitter reduces the required guard band between the N-WDM channels. We also simulate a simpler scheme using an unchirped finite-impulse response filter of similar size, which directly creates truncated-sinc pulses without needing a DF. This gives better system performance than either chirped scheme.

The Wadley Loop is a method of down-converting RF signals over a wide frequency range using a low-quality widely-tunable oscillator and a high-stability frequency comb reference. Together the widely tunable oscillator and high-stability comb source provide a widely-tunable high-stability receiver. In this paper, we demonstrate an electro-optic version of the Wadley Loop that is able to provide a widely-tunable, high phase stability coherent receiver. This could have applications in Quadrature Amplitude Modulation (QAM) receivers with high constellation sizes, optical OFDM receivers with long symbol durations, and wide-range high spectral resolution optical spectrum analysers.

Importance: Quality assessment is an important instrument to ensure optimal surgical outcomes, particularly during the adoption of new surgical technology. The use of the robotic platform for complex pancreatic resections, such as the pancreaticoduodenectomy, requires close monitoring of outcomes during its implementation phase to ensure patient safety is maintained and the learning curve identified., Objective: To report the results of a quality analysis and learning curve during the implementation of robotic pancreaticoduodenectomy (RPD)., Design, Setting, and Participants: A retrospective review of a prospectively maintained database of 200 consecutive patients who underwent RPD in a large academic center from October 3, 2008, through March 1, 2014, was evaluated for important metrics of quality. Patients were analyzed in groups of 20 to minimize demographic differences and optimize the ability to detect statistically meaningful changes in performance., Exposures: Robotic pancreaticoduodenectomy., Main Outcomes and Measures: Optimization of perioperative outcome parameters., Results: No statistical differences in mortality rates or major morbidity were noted during the study. Statistical improvements in estimated blood loss and conversions to open surgery occurred after 20 cases (600 mL vs 250 mL [P = .002] and 35.0% vs 3.3% [P < .001], respectively), incidence of pancreatic fistula after 40 cases (27.5% vs 14.4%; P = .04), and operative time after 80 cases (581 minutes vs 417 minutes [P < .001]). Complication rates, lengths of stay, and readmission rates showed continuous improvement that did not reach statistical significance. Outcomes for the last 120 cases (representing optimized metrics beyond the learning curve) included a mean operative time of 417 minutes, median estimated blood loss of 250 mL, a conversion rate of 3.3%, 90-day mortality of 3.3%, a clinically significant (grade B/C) pancreatic fistula rate of 6.9%, and a median length of stay of 9 days., Conclusions and Relevance: Continuous assessment of quality metrics allows for safe implementation of RPD. We identified several inflexion points corresponding to optimization of performance metrics for RPD that can be used as benchmarks for surgeons who are adopting this technology.

Little is known about the recovery trajectory from small to moderate spills (<1000 t), particularly in the sub-tropics. On 11 March 2009 the MV Pacific Adventurer spilt 270 t of bunker fuel oil 13 km off Moreton Island, Australia, impacting wetlands, sandy beaches and rocky shores. This study examines the recovery of the rocky shore community four years after the spill. Results indicate that recovery on Moreton Island is taking longer than the 3-4 years suggested by the literature. The upper shore is recovering faster than the mid shore and is nearly recovered while the mid shore is still in the recovery process. These results indicate that small to moderate sized spills can have environmental impacts on par with much larger spills and emphasizes the need for a clear definition of a recovery endpoint. Long term studies are required to gain a full understanding of trajectories of recovery after oil spill impacts., (Copyright © 2015 Elsevier Ltd. All rights reserved.)