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Microplastics (MPs) contamination has been reported in all environmental compartments, but very limited information is available at higher-altitude lakes. Nainital Lake, located at a high altitude in the Indian Himalayas, has various ecosystem services and is the major source of water for Nainital town, but the MP abundance is still unknown. This study presents the first evidence of the abundance and distribution of MP in Nainital Lake. Surface water and sediment samples were analysed from 16 different sites in and around the catchment area of Nainital Lake. The MP were observed in all the samples, and their abundance in surface water was 8.6–56.0 particles L−1 in the lake and 2.4–88.0 particles L−1 in hotspot sites. In the surface sediment, MP abundance ranged from 0.4–10.6 particles g−1, while in the hotspot sediment, the mean abundance was 0.6 ± 0.5 particles g−1. Fibers were the dominant MP, while 0.02–1 mm were the predominant size of MP particles. The results of chemical characterization showed the presence of six polymers, among which high-density polyethylene was the most abundant. The Polymer Hazard Index assessment classified the identified polymers as low-to high-risk categories, with a higher abundance of low- (polypropylene) and medium- (polyethylene)-risk polymers. Tourist activities and run-off catchments can be considered the major sources of MP, which can affect the ecosystem. Minimal concentrations of MP were observed in the tube well and drinking water, which depicts the direct risks to humans and, thus, the need for remedial measures to prevent MP contamination in drinking water. This study improves the knowledge of MP contamination in the higher-altitude freshwater lake, which can be the major pathway for the transport of MP to the rivers, and also emphasizes the need for waste management in Nainital town. [Display omitted] • This is the first evidence of microplastics in the Nainital Lake in the Indian Himalayas. • The study observed that there is a significant amount of microplastic particles in and around Nainital Lake. • The chemical composition of microplastics was determined by SEM-EDX. • The possible sources were identified as domestic discharge and tourist activities. • The lake provides drinking water, and its contamination causes human health risks. [ABSTRACT FROM AUTHOR]

Abstract: Dye sensitized solar cells are commonly fabricated using expensive platinum as a counter electrode material. We demonstrate for the first time the use of CuSbS2 as a replacement for platinum in dye sensitized solar cells. The performance of solar cells using CuSbS2 is found to be comparable with that using platinum counter electrode. [Copyright &y& Elsevier]

Abstract: Ultra-thin (<1.0nm) nanorods or nanowires of β-In2S3were synthesized from the thermolysis of the indium(III) complex of 1,1,5,5-tetra-iso-propyl-2-thiobiuret in hot oleylamine. [Copyright &y& Elsevier]

Despite the recent introduction of new therapies for multiple myeloma (MM), it remains an incurable disease. As MM progresses, patients experience cycles of relapse and remission, with remission periods becoming increasingly shorter as the disease becomes less treatment-sensitive. The treatment of relapsed refractory MM (RRMM) remains a significant clinical challenge. Patients with RRMM are a highly heterogeneous group and choosing the most appropriate treatment requires careful consideration. Furthermore, the number of treatment options for MM is continually growing with no definitive consensus to guide treating clinicians. The emergence of second-generation proteasome inhibitors (e.g., carfilzomib and ixazomib), immunomodulatory drugs (e.g., pomalidomide) and monoclonal antibodies (e.g., isatuximab) has expanded an already complex treatment landscape. This review provides a clear summary of the available treatments for MM and discusses how to tailor treatments to individual patients' needs. Novel treatments currently under clinical development, including venetoclax, melflufen and CAR T-cell therapies, are also discussed. [ABSTRACT FROM AUTHOR]

Multiple myeloma (MM) is associated with high healthcare resource utilisation and increasing hospitalisation rates. The aim of this study was to characterise the hospital use by patients with MM in the English National Health Service (NHS). Routinely-collected aggregate data about all NHS-funded hospital admissions of patients with MM were analysed. Data were obtained from the English Hospital Episodes Statistics on admissions between 1 April 2014 and 31 March 2018. A total of 754,345 admissions were reported over four years, equivalent to a mean of 188,586 admissions per year. Of the 41,845 patients admitted during this period, 42% were women and 58% men. From the total admissions, 90% were elective and 10% unplanned. Mean annual estimated costs over the period were £46 million for elective and £56 million for unplanned admissions. The number of elective admissions increased by 4.5% with costs increasing 1.5% per year; for unplanned admissions, these figures were 4.1% and 9.0%, respectively. MM is associated with a significant number of hospital admissions and NHS costs. The majority of the hospital admissions are elective, but the highest burden in terms of costs relates to unplanned admissions, with numbers increasing over time. [ABSTRACT FROM AUTHOR]

• Mass spectrometry has an advantage over serum protein electrophoresis at screening. • Additional monoclonal proteins seen by mass spectrometry may be clinically relevant. • Higher sensitivity when screening for monoclonal gammopathies has clinical utility. • Mass spectrometry should be investigated at all stages of monoclonal gammopathies. Mass spectrometry has recently been proposed as a novel sensitive screening tool for monoclonal gammopathies. In a small study we have tested the ability of quantitative immunoprecipitation mass spectrometry (QIP-MS) to identify low level monoclonal immunoglobulins not currently detected by the initial serum protein electrophoresis (SPEP) screen. QIP-MS positively identified the primary monoclonal immunoglobulins in all 11 patient samples alongside additional monoclonal immunoglobulins in a subset of patient samples. We conclude that QIP-MS has clinical utility as a first-line screening tool for monoclonal gammopathy investigation, identifying monoclonality in patients with higher sensitivity and resolution compared to the current standard methods. [ABSTRACT FROM AUTHOR]

Multiple myeloma (MM) remains an incurable malignancy. Approximately 37% of patients with plasma cell myeloma are over the age of 75 and the median age of diagnosis is 70. The management approach to over 70s differs from younger patients, as treatment goals may vary and underlying co-morbidities and expected treatment related toxicities have to be taken into account. Individualisation of management is important, aiming to achieve the best response whilst minimising adverse events. A proportion of patients will be unable to tolerate any treatment with palliation being appropriate. Age alone should not be a barrier to treatment however, with some fit patients over the age of 70 potentially benefitting from intensive treatment options including high dose chemotherapy with autologous stem cell rescue. Comprehensive geriatric assessment is indicated in the over 70s; this should be employable in a clinic outpatient setting to make it feasible. Outcomes of this assessment potentially help physicians’ choice of therapy. For decades the combination of Melphalan and prednisolone was the standard of care for older MM patients. Over the last ten years, newer drugs and combinations have improved therapeutic options for patients but are yet to demonstrate vast improvement in overall survival in this cohort. [ABSTRACT FROM AUTHOR]

Multiple myeloma (MM) is a progressive plasma cell malignancy, with a range of clinical features including bone lesions, renal insufficiency, anaemia, and hypercalcaemia. Novel agents have significantly improved patient survival, however most patients will suffer multiple relapses. Although clinical challenges and economic costs of relapse are recognised, the psychological impact of relapse is not fully appreciated. Additionally, there is little information on how physicians perceive the impact of relapse on their patients’ emotional state and how this might affect patient management. Through face-to-face interviews with 50 relapsed and/or refractory MM patients and 30 haematologists across ten countries, we have used real-world evidence to explore and characterise the burden of living with MM, particularly the impact of relapsed disease. This exploratory study illustrates the impact of the disease on friends and family, and the physical and emotional burden experienced by the patient resulting from both MM and its treatment. Haematologists feel poorly equipped to deal with the emotional aspects of patient relapse, lacking the time and resources to adequately deal with these issues. Focused educational and support tools/resources targeted at both physicians and patients are required to facilitate physician–patient communication to help reduce the emotional burden of living with MM. [ABSTRACT FROM AUTHOR]

Consolidation with high-dose chemotherapy and autologous stem cell transplantation (ASCT) is the standard of care for transplantation-eligible patients with multiple myeloma, based on randomized trials showing improved progression-free survival with autologous transplantation after combination chemotherapy induction. These trials were performed before novel agents were introduced; subsequently, combinations of immunomodulatory drugs and proteasome inhibitors as induction therapy have significantly improved rates and depth of response. Ongoing randomized trials are testing whether conventional autologous transplantation continues to improve responses after novel agent induction. Although these results are awaited, it is important to review strategies for improving outcomes after ASCT. Conditioning before ASCT with higher doses of melphalan and combinations of melphalan with other agents, including radiopharmaceuticals, has been explored. Tandem ASCT, consolidation, and maintenance therapy after ASCT have been investigated in phase III trials. Experimental cellular therapies using ex vivo–primed dendritic cells, ex vivo–expanded autologous lymphocytes, Killer Immunoglobulin Receptor (KIR)-mismatched allogeneic natural killer cells, and genetically modified T cells to augment ASCT are also in phase I trials. This review summarizes these strategies and highlights the importance of exploring strategies to augment ASCT, even in the era of novel agent induction. [ABSTRACT FROM AUTHOR]