Search

Tumor Treating Fields (TTFields), an approved therapy for glioblastoma (GBM) and malignant mesothelioma, employ noninvasive application of low-intensity, intermediate-frequency, alternating electric fields to disrupt the mitotic spindle, leading to chromosome missegregation and apoptosis. Emerging evidence suggests that TTFields may also induce inflammation. However, the mechanism underlying this property and whether it can be harnessed therapeutically are unclear. Here, we report that TTFields induced focal disruption of the nuclear envelope, leading to cytosolic release of large micronuclei clusters that intensely recruited and activated 2 major DNA sensors--cyclic GMP-AMP synthase (cGAS) and absent in melanoma 2 (AIM2)--and their cognate cGAS/stimulator of interferon genes (STING) and AIM2/caspase 1 inflammasomes to produce proinflammatory cytokines, type 1 interferons (T1IFNs), and T1IFN-responsive genes. In syngeneic murine GBM models, TTFields-treated GBM cells induced antitumor memory immunity and a cure rate of 42% to 66% in a STING- and AIM2-dependent manner. Using single-cell and bulk RNA sequencing of peripheral blood mononuclear cells, we detected robust post-TTFields activation of adaptive immunity in patients with GBM via a T1IFN-based trajectory and identified a gene panel signature of TTFields effects on T cell activation and clonal expansion. Collectively, these studies defined a therapeutic strategy using TTFields as cancer immunotherapy in GBM and potentially other solid tumors., Introduction Glioblastoma (GBM) is the most common and lethal brain cancer in adults and one of the least immunogenic tumors (1). Recent work has revealed striking immune dysregulation and functional [...]

A new global dataset of annually averaged ultrafine particle (UFP) concentrations at the Earth's surface for the years 2015–2017 has been developed through numerical simulations using the ECHAM/MESSy Atmospheric Chemistry model (EMAC). We present total and size-resolved concentrations along with their interannual variability. Size distributions of emitted particles from the contributing source sectors have been derived based on literature reports. The model results of UFP concentrations are evaluated using particle size distribution and particle number concentration measurements from available datasets and the literature. While we obtain reasonable agreement between the model results and observations (logarithmic-scale correlation of r=0.76 for non-remote, polluted regions), the highest values of observed, street-level UFP concentrations are systematically underestimated, whereas in rural environments close to urban areas the model generally overestimates observed UFP concentrations. As the relatively coarse global model does not resolve concentration gradients in urban centres and industrial UFP hotspots, high-resolution data of anthropogenic emissions are used to account for such differences in each model grid box, obtaining UFP concentrations with unprecedented 0.1∘×0.1∘ horizontal resolution at the Earth's surface. This observation-guided downscaling further improves the agreement with observations, leading to an increase in the logarithmic-scale correlation between observed and simulated UFP concentrations to r=0.84 in polluted environments (and 0.95 in all regions), a decrease in the root mean squared logarithmic error (from 0.57 to 0.43), and removal of discrepancies associated with air quality and population density gradients within the model grid boxes. The model results are made publicly available for studies on public health and other impacts of atmospheric UFPs, as well as for intercomparison with other regional and global models and datasets. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to compare the effectiveness of pars plana vitrectomy (PPV) and removal of the internal limiting membrane (ILM) with three, monthly, intravitreal bevacizumab (IVB) injections for refractory diabetic macular edema. Materials and Methods: This was a prospective, randomized, comparative, interventional study. Forty-four patients were enrolled and randomized in two groups. Twenty-two eyes enrolled in Group I received three IVB injections at monthly interval. Twenty-two eyes were enrolled in Group II which underwent PPV with ILM removal. The primary outcomes measured were: (1) Best corrected logMAR visual acuity (BCVA) using Snellen′s visual acuity chart. (2) Central macular thickness (CMT) on optical coherence tomography. The secondary outcome measures were: Complication rates like (1) progression of lens opacities, (2) high intraocular pressure needing further treatment/procedure, (3) development of vitreous hemorrhage related to the procedure employed, (4) retinal detachment and (5) severe inflammation/endophthalmitis. Results: In Group I (IVB): 3 (13.6%) eyes showed no change in BCVA; 3 (13.6%) eyes reported decrease in BCVA and 16 (72.8%) eyes showed improvement in BCVA; (P = 0.0181). In Group II (PPV): 4 (18.2%) eyes showed no change in BCVA; 5 (22.7%) eyes showed decrease and 13 (59.1%) eyes showed improvement in BCVA (P = 0.0281). Mean decrease in CMT in IVB group was 108.45 μ, whereas mean decrease in CMT in PPV group was 161.36 μ. No major complications were seen in either group. Conclusion: Posttreatment decrease in CMT was more in PPV group and vision improvement more in IVB group. However, no statistically significant difference between the two methods was found.

Atmospheric new particle formation (NPF) is a crucial process driving aerosol number concentrations in the atmosphere; it can significantly impact the evolution of atmospheric aerosol and cloud processes. This study analyses at least 1 year of asynchronous particle number size distributions from six different locations in India. We also analyze the frequency of NPF and its contribution to cloud condensation nuclei (CCN) concentrations. We found that the NPF frequency has a considerable seasonal variability. At the measurement sites analyzed in this study, NPF frequently occurs in March–May (pre-monsoon, about 21 % of the days) and is the least common in October–November (post-monsoon, about 7 % of the days). Considering the NPF events in all locations, the particle formation rate (JSDS) varied by more than 2 orders of magnitude (0.001–0.6 cm -3 s -1) and the growth rate between the smallest detectable size and 25 nm (GR SDS-25 nm) by about 3 orders of magnitude (0.2–17.2 nm h -1). We found that JSDS was higher by nearly 1 order of magnitude during NPF events in urban areas than mountain sites. GR SDS did not show a systematic difference. Our results showed that NPF events could significantly modulate the shape of particle number size distributions and CCN concentrations in India. The contribution of a given NPF event to CCN concentrations was the highest in urban locations (4.3 × 10 3 cm -3 per event and 1.2 × 10 3 cm -3 per event for 50 and 100 nm, respectively) as compared to mountain background sites (2.7 × 10 3 cm -3 per event and 1.0 × 10 3 cm -3 per event, respectively). We emphasize that the physical and chemical pathways responsible for NPF and factors that control its contribution to CCN production require in situ field observations using recent advances in aerosol and its precursor gaseous measurement techniques. [ABSTRACT FROM AUTHOR]

Australia has the second highest rate of non‐traumatic lower extremity amputation (LEA) globally. Australia's large geographical size is one of the biggest challenges facing limb preservation services and may be contributing to LEA. The aim of this study was to determine what factors contribute to the likelihood of LEA in people with active foot ulceration in regional Australia. This retrospective cohort study audited patients with active foot ulceration in a multidisciplinary high risk foot service (HRFS) in regional Australia. Neurological, vascular and wound characteristics were systematically extracted, along with demographic information. Participants were followed for at least 12 months until healing or LEA occurred. Correlations between LEA and clinical and demographic characteristics were assessed using the Pearson's product moment correlation coefficient and chi squared test for independence. Significant variables (p < 0.05) were included in the model. Direct logistic regression assessed the independent contribution of significantly correlated variables on the likelihood of LEA. Of note, 1876 records were hand screened with 476 participants (25%) meeting the inclusion criteria. Geographical distance from the HRFS, toe systolic pressure (TSP), diabetes and infection were all significantly correlated with LEA and included in the logistic regression model. TSP decrease of 1 mmHg (OR 1.02, 95% CI 1.01–1.03), increased geographical distance (1 km) from HRFS (OR 1.006, 95% CI 1.001–1.01) infection (OR 2.08, 95% CI 1.06–4.07) and presence of diabetes (OR 3.77, 95% CI 1.12–12.65) were all significantly associated with increased likelihood of LEA. HRFS should account for the disparity in outcomes between patients living in close proximity to their service, compared to those in rural areas. Optimal management of diabetes, vascular perfusion and control of infection may also contribute to preventing LEA in people with active foot ulceration. [ABSTRACT FROM AUTHOR]

Atmospheric new particle formation (NPF) is a crucial process driving aerosol number concentrations in the atmosphere; it can significantly impact the evolution of atmospheric aerosol and cloud processes. This study analyses at least one year of asynchronous particle number size distributions at six different locations in India. We also analyze the frequency of NPF and its contribution to cloud condensation nuclei (CCN) concentrations. We found that the NPF frequency has a considerable seasonal variability. At the measurement sites analyzed in this study, NPF frequently occurs in March-May (pre-monsoon, about 21 % of the days) and is the least common in October-November (post-monsoon, about 7 % of the days). Considering the NPF events in all locations, the particle formation rate (JNUC) varied by more than an order of magnitude (0.01-0.6 cm-3 s-1) and the growth rate (GRNUC) by about three orders of magnitude (0.2-17.2 nm h-1). We found that JNUC was higher by nearly an order of magnitude during NPF events in urban areas than mountain sites. GRNUC did not show a systematic difference. Our results showed that NPF events could significantly modulate the shape of particle number size distributions and CCN concentrations in India. The contribution of a given NPF event to CCN concentrations was the highest in urban locations (4.3 x 103 cm-3 per event and 1.2 x 103 cm-3 per event for 50 nm and 100 nm, respectively) as compared to mountain-background sites (2.7 x 103 cm-3 per event and 1.0 x 103 cm-3 per event). To better understand atmospheric NPF and its contribution to CCN concentrations, we would need long-term observational data from various diverse environments in India, aided with regional model simulations to help interpret field observations. [ABSTRACT FROM AUTHOR]

New particle formation (NPF) can influence the Earth's radiative budget when the newly formed particles grow to climate‐relevant sizes. Here, we present analysis of 21 months of continuous aerosol size distribution measurements at a background remote site in the western Himalaya and provide observational evidence that newly formed particles grow to cloud condensation nuclei (CCN)‐active sizes (i.e., >20–100 nm in diameter). Out of total 55 NPF events, 38 (66%) events occurred in the pre‐monsoon season (March–May). NPF events were classified into those with and without pollution influence as polluted and cleaner, respectively, using black carbon data. The analysis of air mass age, based on the ratio of number concentration of Aitken to accumulation mode aerosols, indicated that NPF occurred in the relatively cleaner air masses reaching to the site. The median formation rate of 10 nm particles and particle growth rates for cleaner events were three‐fold and two‐fold, respectively, higher than polluted events. We present the first estimates of the survival probability of newly formed particles to 50 and 100 nm size, which was not attempted in an Indian environment previously. The survival probability to 50 nm particles ranged from 44% to 98%, with a mean and standard deviation of 82 ± 18%. On average, ∼60% of the particles surviving to 50 nm survived to 100 nm, making the overall survival probability of 100 nm to 53 ± 31%. This indicates that the probability of nucleated particles growing to CCN‐active sizes under a large source of condensing vapor (transported from nearby lower‐altitude regions) and low pre‐existing particle concentrations (background mountain site) is high compared to the previous studies. These findings highlight the importance of the efficiency of nucleation events for producing CCN, which is a critical basis of aerosol indirect effects. Key Points: We present new measurement‐based evidence of the contribution of new particle formation (NPF) to climate‐relevant aerosols in the Western HimalayaNPF occurred frequently in the pre‐monsoon (March–May) seasonNPF rates were higher for cleaner events than polluted events [ABSTRACT FROM AUTHOR]

Keywords: critical limb ischemia (CLI); exercise testing; peripheral artery disease (PAD); toe-brachial index (TBI); vascular diagnostics EN critical limb ischemia (CLI) exercise testing peripheral artery disease (PAD) toe-brachial index (TBI) vascular diagnostics 657 659 3 12/09/21 20211201 NES 211201 Toe-brachial indices (TBI) are being integrated into international guidelines[1],[2] due to their utility as an adjunct test for peripheral artery disease (PAD), particularly in diabetes populations.[3],[4] The addition of an exercise protocol has been demonstrated to improve diagnostic accuracy of the traditional ankle-brachial index (ABI).[5] However, there has been limited investigation of the effect of exercise on the accuracy of TBI. Diagnostic accuracy of postexercise toe-brachial index for identifying peripheral artery disease (PAD): A pilot study Peripheral artery disease (PAD), critical limb ischemia (CLI), exercise testing, toe-brachial index (TBI), vascular diagnostics. [Extracted from the article]

Purpose of study: To investigate toe systolic blood pressure and/or toe-brachial pressure index in predicting healing post minor diabetic foot amputations. Key methods: A systematic search of EMBASE and PubMed (including Medline and The Cochrane Library) was conducted from database inception to 9 March 2020. Two authors independently reviewed and selected relevant studies. Quality was assessed with a modified Critical Appraisal Skill Programme checklist. Main results: Ten studies met the inclusion criteria. Nine studies investigating toe systolic blood pressure reported healing occurred at mean toe systolic blood pressure values ⩾30 mmHg, ranging between 30 and 83.6 mmHg. The meta-analysis (four studies) found toe systolic blood pressure <30 mmHg had 2.09 times the relative risk of non-healing post amputation, compared to toe systolic blood pressure ⩾30 mmHg (relative risk = 2.09, 95% confidence interval: 1.37–3.20, p = 0.001). Two studies investigating toe-brachial pressure index report successful healing where toe-brachial pressure index >0.2, with one study reporting a higher value of 0.8. Main conclusions: Successful post-amputation healing outcomes were reported at mean toe systolic blood pressure ⩾30 mmHg, and the results varied considerably between the studies. Further research should identify whether variables, including amputation level, method of wound closure and length of post-operative follow-up periods, affect the values of toe systolic blood pressure and toe-brachial pressure index observed in this review. [ABSTRACT FROM AUTHOR]

Introduction: MD-PhD training programs train physician-scientists to pursue careers involving both clinical care and research, but decreasing numbers of physician-scientists stay engaged in clinical research. We sought to identify current clinical research training methods utilized by MD–PhD programs and to assess how effective they are in promoting self-efficacy for clinical research. Methods: The US MD–PhD students were surveyed in April–May 2018. Students identified the clinical research training methods they participated in, and self-efficacy in clinical research was determined using a modified 12-item Clinical Research Appraisal Inventory. Results: Responses were received from 61 of 108 MD–PhD institutions. Responses were obtained from 647 MD–PhD students in all years of training. The primary methods of clinical research training included no clinical research training, and various combinations of didactics, mentored clinical research, and a clinical research practicum. Students with didactics plus mentored clinical research had similar self-efficacy as those with didactics plus clinical research practicum. Training activities that differentiated students who did and did not have the clinical research practicum experience and were associated with higher self-efficacy included exposure to Institutional Review Boards and participation in human subject recruitment. Conclusions: A clinical research practicum was found to be an effective option for MD–PhD students conducting basic science research to gain experience in clinical research skills. Clinical research self-efficacy was correlated with the amount of clinical research training and specific clinical research tasks, which may inform curriculum development for a variety of clinical and translational research training programs, for example, MD–PhD, TL1, and KL2. [ABSTRACT FROM AUTHOR]

We report a novel technique to synthesize fluorescent carbon dots decorated graphene oxide (CDs-GO) sheets by microwave irradiation using citric acid as the precursor and ethylenediamine as the passivation agent. The samples are characterized by X-ray diffraction (XRD), field-emission scanning electron microscopy (FESEM), transmission electron microscopy (TEM) and ultra violet-visible spectroscopy (UV-Vis). Fluorescence studies reveal strong excitation wavelength dependent fluorescence behaviour for these nanocomposites dispersed in water. Third order nonlinear optical properties of these composites are studied using Z scan technique with Q-switched nanosecond pulsed Nd: YAG laser and the measured highest nonlinear optical susceptibility is 4.624x10-10esu. The optical limiting studies of these nanocomposites yield a lower limiting threshold of 104MW/cm2 enabling them as a strong candidate for optical limiting applications. [ABSTRACT FROM AUTHOR]

Background: Continuous-wave Doppler is frequently used for detecting peripheral arterial disease in patients with diabetes; however, there is limited evidence investigating diagnostic accuracy. This study aimed to determine sensitivity and specificity of continuous-wave Doppler for detecting peripheral arterial disease in populations with, and without, diabetes and to investigate the influence of disease severity on sensitivity of continuous-wave Doppler for detecting peripheral arterial disease. Results: Data from 396 participants were included. Using colour Duplex ultrasound as reference standard (N=66), printed continuous-wave Doppler waveform analysis sensitivity was 81.75% (95% confidence interval: 76.75 to 85.88) and specificity 89.34% (95% confidence interval: 82.62 to 93.67). Printed continuous-wave Doppler waveform analysis sensitivity for peripheral arterial disease was comparable to sensitivity calculated using angiography as the reference standard (81.67%; 95% confidence interval: 69.56 to 90.48). Sensitivity and specificity were unaffected by diabetes diagnosis (n = 176), sensitivity 82.76% (95% confidence interval: 74.86 to 88.55), and specificity 88.33% (95% confidence interval: 77.82 to 94.23). Conclusion: Continuous-wave Doppler is a fair assessment tool for peripheral arterial disease in a community-based sample with suspected peripheral arterial disease. Diagnostic accuracy of continuous-wave Doppler for peripheral arterial disease is unaffected by the presence of diabetes. [ABSTRACT FROM AUTHOR]

The postexercise ankle–brachial index (ABI) is recommended in patients with normal resting ABI when peripheral artery disease (PAD) is suspected. The aims of this study were to determine the comparative diagnostic accuracy of the resting and postexercise ABI for detecting PAD, and, the effect of the presence of diabetes on these. Three methods of interpretation currently in use were also investigated: a reduction in postexercise ABI by >20% compared to resting ABI, an ABI value of ≤0.90 postexercise, or a reduction in systolic ankle pressure of >30 mmHg postexercise. This retrospective study used colour duplex ultrasound (CDU) as the reference standard. In 278 limbs (whole group), the resting ABI had an overall area under the curve (AUC) of 0.71, with the postexercise ABI yielding a similar diagnostic accuracy of AUC 0.72. In the non-diabetes group (n=171), the resting ABI had an overall AUC of 0.74 and the postexercise ABI had a similar AUC of 0.76. In the diabetes group (n=107), overall accuracy was reduced compared to the non-diabetes group, with the resting ABI having an overall AUC of 0.65 and the postexercise ABI yielding a similar accuracy with an AUC of 0.64. The overall diagnostic accuracy of the postexercise ABI for diagnosing PAD was not greatly improved compared to resting ABI. Given the lower overall diagnostic accuracy in the diabetes group, both the resting and the postexercise ABI results in diabetes populations should be interpreted with caution. There is a risk of undiagnosed disease if relying on these results alone to determine lower limb vascular status. [ABSTRACT FROM AUTHOR]

Background: The resting systolic toe pressure (TP) is a measure of small arterial function in the periphery. TP is used in addition to the ankle-brachial index when screening for peripheral arterial disease (PAD) of the lower limb in those with diabetes, particularly in the presence of lower limb medial arterial calcification. It may be used as an adjunct assessment of lower limb vascular function and as a predictor of wound healing. The aim of this study was to determine the diagnostic accuracy of TP for detecting PAD in people with and without diabetes. Methods: This was a retrospective case-control study. Two researchers extracted information from consecutive patient records, including TP measurements, colour Duplex ultrasound results, demographic information, and medical history. Measures of diagnostic accuracy were determined by receiver operating curve (ROC) analysis, and calculation of sensitivity, specificity, and positive and negative likelihood ratios. Results: Three hundred and nintey-four participants with suspected PAD were included. In the diabetes group (n = 176), ROC analysis of TP for detecting PAD was 0.78 (95%CI: 0.69 to 0.84). In the control group (n = 218), the ROC of TP was 0.73 (95%CI: 0.70 to 0.80). TP had highest sensitivity when anatomical distribution of disease was both proximal and distal (diabetes group: 79.49%, the control group: 82.61%). TP yielded highest sensitivity in mild disease (50-75% stenosis) in diabetes group, (81.82%) and moderate disease (>75% stenosis) in control group (80.77%). Conclusions: Our findings indicate that TPs are useful to assist in diagnosing PAD in clinical practice, however, results should be interpreted with caution due to the small probability of PAD being present with a negative test. [ABSTRACT FROM AUTHOR]

[Display omitted] • Non-covalently functionalized graphene-peripheral (non-peripheral) pyrene substituted phthalocyanine nanohybrids have been prepared. • These nanohybrids, possess very low linear absorption throughout a broad range of wavelengths, exhibit a good broadband optical nonlinearity. • A specific shift of 8 cm−1 for the Raman 2D peak is observed in the prepared nanohybrids, which is a clear evidence of non-covalent interaction in graphene-pyrene based material hybrids. • Nonlinear optical studies prove these nanohybrids as broadband optical limiters with low optical limiting threshold. In nonlinear optics, nanohybrids from the functionalization of graphene and organic molecules can be an interesting area of research. In this work, nanohybrid materials consisting of pyrene conjugated peripheral phthalocyanines and non-peripheral phthalocyanines, which are non-covalently attached to the graphene exhibit broadband optical characteristics and broadband limiting optical behavior through a two-photon absorption process with a high degree of transparency. For confirming non-covalent functionalization, optical as well as spectroscopic studies like UV–vis absorption, fluorescence studies, transient absorption, FTIR, XPS, Raman, AFM techniques, etc., were employed. Distinct morphologies are observed for these nanohybrids, such as -nanohybrids with a cylindrical shape in the non-peripheral case whereas a conical shaped nanohybrids in the peripheral case. Furthermore, Raman studies reveal a shift of 8 cm−1 for the 2D peak of both nanohybrids in comparison with that of graphene confirms the strong π-π interaction, which is the maximum shift in a non-covalent interaction between pyrene attached graphene. In a major finding, a donor-acceptor combination is established in these nanohybrids, which makes them important nonlinear optical materials. The nonlinear absorption coefficients of 112 ± 7 cm/GW and 228 ± 12 cm/GW were obtained for these nanohybrids. Compared to the existing reported values, these nanohybrids with the minimum linear absorption coefficient (1.15 cm−1 and 1.25 cm−1), display broadband nonlinear optical characteristics with low optical limiting thresholds (0.9 and 0.83 Jcm−2), which is achieved through the transfer of electrons from Pc core to pyrene anchored graphene, enable them standout candidates for photonic applications. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to determine what factors contribute to the likelihood of lower extremity amputation (LEA) in people with active foot ulceration in regional Australia. This retrospective study audited patients with active foot ulceration in a multidisciplinary high risk foot service (HRFS) in regional Australia. Methods: Neurological, vascular, and wound characteristics were systematically extracted, along with demographic information. Participants were followed for at least 12 months until healing or LEA occurred. Correlations between LEA and clinical and demographic characteristics were assessed using the Pearson's product moment correlation coefficient and chi squared test for independence. Direct logistic regression assessed the independent contribution of significantly correlated variables on the likelihood of LEA. Results: Of note, 1876 records were hand screened with 476 participants (25%) meeting the inclusion criteria. Geographical distance from the HRFS, toe systolic pressure (TSP), diabetes and infection were all significantly correlated with LEA and included in the logistic regression model. TSP decrease of 1 mmHg (OR 1.02, 95% CI 1.01-1.03), increased geographical distance (1 km) from HRFS (OR 1.006, 95% CI 1.001-1.01) infection (OR 2.08, 95% CI 1.06-4.07) and presence of diabetes (OR 3.77, 95%CI 1.12-12.65) were all significantly associated with increased likelihood of LEA. Conclusions: HRFS should account for the disparity in outcomes between patients living in close proximity to their service, compared to those in rural areas. Optimal management of diabetes, vascular perfusion and control of infection may also contribute to preventing LEA in people with active foot ulceration. [ABSTRACT FROM AUTHOR]

A subpopulation (60-70%) of Foxp3+ regulatory T cells (Tregs) in both mouse and man expresses the transcription factor Helios, but its role in Treg function is still unknown. We generated Treg-specific Helios-deficient mice to examine the function of Helios in Tregs. We show that the selective deletion of Helios in Tregs leads to slow, progressive systemic immune activation, hypergammaglobulinemia, and enhanced germinal center formation in the absence of organ-specific autoimmunity. Helios-deficient Treg suppressor function was normal in vitro, as well as in an in vivo inflammatory bowel disease model. However, Helios-deficient Tregs failed to control the expansion of pathogenic T cells derived from scurfy mice, failed to mediate T follicular regulatory cell function, and failed to control both T follicular helper cell and Th1 effector cell responses. In competitive settings, Helios-deficient Tregs, particularly effector Tregs, were at a disadvantage, indicating that Helios regulates effector Treg fitness. Thus, we demonstrate that Helios controls certain aspects of Treg-suppressive function, differentiation, and survival. [ABSTRACT FROM AUTHOR]

Introduction: The gold standard for evaluation of the lower extremity arterial tree is catheter angiography. Duplex arterial-occlusive imaging or duplex ultrasonography arteriography, a noninvasive technique, is used as the first-line investigation in patients with peripheral vascular disease at our centre. Based on the results of duplex imaging, patients who require angiographic intervention then proceed with simultaneous catheter arteriography and intervention. This study aimed to compare the results of duplex imaging alone as the first-line investigation against the eventual results of catheter angiography, and to assess the impact of the former on patients' clinical outcomes.Methods: All cases involving patients who underwent duplex imaging followed by angiographic intervention, from May 2008 to February 2009, were discussed at weekly interdisciplinary meetings. Only patients who underwent lower limb imaging were included in the study. Those who were involved in grafts and stent surveillance studies, as well as those with incomplete duplex images were excluded.Results: During the study period, 113 duplex imaging studies of the lower limb followed by percutaneous transluminal angioplasty were performed at our hospital for peripheral vascular disease. The iliac artery was visualised in 40 images, but could not be visualised in 73 images. There was a potential change in management in three cases due to radiological differences between the duplex images and angiography films.Conclusion: In our series, duplex imaging was found to be accurate enough to guide initial clinical management of patients with peripheral vascular disease. This modality is the preferred first-line investigation for such patients at our centre. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To study the clinical presentation, management and eventual outcome of patients with mycotic abdominal aortic aneurysms managed with aortic exclusion and extra-anatomic reconstruction. Design: A retrospective chart review of 18 cases treated at a single institution. Methods: Medical records of 18 patients admitted to our institution from October 1997 to July 2006 with a diagnosis of mycotic abdominal aortic aneurysms were reviewed. In all cases, the diagnosis was confirmed by abdominal computed tomography and empirical parenteral antibiotics were administered. Seventeen patients had surgical debridement, aneurysm exclusion, and extra-anatomic reconstruction. The antibiotics were continued in the postoperative period for 6 weeks. Results: Immunosuppression was present in 72%, with diabetes mellitus present in 56%. Salmonella sp was the causative organism in 72% of cases. Most patients presented late, with a 67% incidence of contained rupture. Seventy-two percent needed early or emergency surgery with less than 1 week of preoperative antibiotics. Disease-specific mortality was 39% (7/18). There was 1 late death during the mean follow-up period of 34 ± 26 months. One patient with an infrarenal aneurysm arising relatively close (neck, 2 cm) to the renal arteries died on table when proximal ligatures cut through the friable aortic wall, resulting in uncontrollable exanguination. One third of patients on long-term graft surveillance developed mild to moderate stenosis at the anastomotic site. Conclusions: Empirical antibiotics must be started early, aiming to achieve 1 week of antibiotics prior to surgery. In the Asian population, 3 characteristics are apparent: (1) most patients are immunocompromised; (2) patients present late in the course of disease; and (3) Salmonella is usually responsible. Extra-anatomic bypass may provide a safe option for revascularization of mycotic aneurysms of the iliac arteries and infrarenal aorta. [Copyright &y& Elsevier]

All-male monosex culture of Macrobrachium rosenbergii (De Man) has emerged as a popular practice in India, especially in the state of Andhra Pradesh. A study was conducted to compare the economics of all-male, mixed and all-female culture in 15 adjacent, rectangular ponds of 4000 m2 each by stocking juveniles previously reared in a nursery for 60 days. The experiment was conducted using a completely randomized design with three treatments; T1 (all male), T2 (mixed) and T3 (all female), and five replicates for a period of 5 months after the nursery phase. Statistical analysis showed highly significant ( P<0.01) differences among the three types of culture. The cost of production was estimated and the economic feasibility of the culture methods was evaluated by cost-return and partial budgeting analysis. The average weight, productivity and specific growth rate were the highest for all male culture, being 80.92±2.41 g, 1532 kg ha−1 and 1.97±0.02 respectively. All-female culture registered significantly higher survival (89.16±0.77%) and the best apparent feed conversion ratio of 1.26±0.02. The economic analysis revealed that all-male monosex culture of M. rosenbergii was 63.13% and 60.20% more profitable than mixed and all-female cultures respectively. [ABSTRACT FROM AUTHOR]