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Purpose: Despite advances in various treatment modalities, surgical resection for pancreatic ductal adenocarcinoma (PDA) remains the only curative treatment. Data remains limited regarding survival rates for resectable PDA when managed by a multidisciplinary pancreas conference (MDPC). The aim of this study is to assess survival rates, identify significant predictors of mortality, and assess the benefits of adjuvant chemotherapy for resectable PDA following presentation at a MDPC. Methods: All patients presented from April 2013 to August 2016 with resectable PDA were discussed at a MDPC at a tertiary care center and were followed prospectively until November 2017. Survival analysis was performed using Kaplan-Meier for age, tumor size, tumor differentiation, T-stage, lymph node status, and completion of adjuvant chemotherapy cycles. Independent predictors of survival were determined using multivariate Cox regression modeling. Results: After MDPC consensus and exclusions, total of 64 patients underwent successful surgery. Amongst this cohort, 1-, 2-, and 3-year survival was 78.13%, 46.30%, and 27.27%, respectively. A total of 37 patients (58%) initiated and 16 patients (25%) finished chemotherapy following surgery. Log-rank analysis revealed that tumor size, age, surgical margins, lymph node status, and number of adjuvant chemotherapy cycles received significantly influenced post-operative survival. Tumor size (p < 0.001), lymph node status (p = 0.035), and number of adjuvant chemotherapy cycles (p = 0.041) remained significant after multivariate Cox regression model. Conclusions: Our results suggest that patients with PDA with tumor size > 50 mm and/or lymph node involvement have poor outcomes despite being surgically resectable. Successful completion of adjuvant chemotherapy has better survival outcomes as compared with incomplete or no adjuvant chemotherapy. The role of alternative management such as down-staging with neoadjuvant therapy should be considered. [ABSTRACT FROM AUTHOR]

Human gut microbiome studies are increasing at a rapid pace to understand contributions of the prokaryotic life to the innate workings of their eukaryotic host. Majority of studies focus on the pattern of gut microbial diversity in various diseases, however, understanding the core microbiota of healthy individuals presents a unique opportunity to study the microbial fingerprint in population specific studies. Present study was undertaken to determine the core microbiome of a healthy population and its imputed metabolic role. A total of 8990, clone library sequences (> 900 bp) of 16S rRNA gene from fecal samples of 43 individuals were used. The core gut microbiota was computed using QIIME pipeline. Our results show the distinctive predominance of genus Prevotella and the core composition of genera Prevotella, Bacteroides, Roseburia and Megasphaera in the Indian gut. PICRUSt analysis for functional imputation of the microbiome indicates a higher potential of the microbiota for carbohydrate metabolism. The presence of core microbiota may indicate key functions played by these microbes for the human host. [ABSTRACT FROM AUTHOR]

Grid-interactive power converters are normally synchronized with the grid using phase-locked loops (PLLs). The performance of the PLLs is affected by the non-ideal conditions in the sensed grid voltage such as harmonics, frequency deviations and the dc offsets in single-phase systems. In this paper, a single-phase PLL is presented to mitigate the effects of these non-idealities. This PLL is based on the popular second order generalized integrator (SOGI) structure. The SOGI structure is modified to eliminate the effects of input dc offsets. The resulting SOGI structure has a high-pass filtering property. Hence, this PLL is termed as a high-pass generalized integrator based PLL (HGI-PLL). It has fixed parameters which reduces the implementation complexity and aids in the implementation in low-end digital controllers. The HGI-PLL is shown to have the lowest resource utilization among the SOGI based PLLs with dc cancelling capability. Systematic design methods are evolved leading to a design that limits the unit vector THD to within 1% for given non-ideal input conditions in terms of frequency deviation and harmonic distortion. The proposed designs achieve the fastest transient response. The performance of this PLL has been verified experimentally. The results agree with the theoretical prediction. [ABSTRACT FROM AUTHOR]

Starting-up of photovoltaic (PV) inverters involves pre-charging of the input dc bus capacitance. Ideally, direct pre-charging of this capacitance from the PV modules is possible as the PV modules are current limited. Practically, the parasitic elements of the system such as the PV module capacitance, effective wire inductance and resistance determine the start-up transient. The start-up transient is also affected by the contactor connecting the PV modules to the inverter input dc bus. In this work, the start-up current and voltages are measured experimentally for different parallel and series connections of the PV modules. These measurements are used to estimate the stray elements, namely the PV module capacitance, effective inductance and resistance. The estimation is based on a linear small-signal model of the start-up conditions. The effect of different connections of the PV modules and the effect of varying irradiation on the scaling of the values of the stray elements are quantified. The System model is further refined by inclusion of connecting cable capacitance and contactor resistance. Dynamics of the resulting fifth-order model are seen to be consistent with those of the simplified third-order model. The analysis of this paper can be used to estimate the expected peak inrush current in PV inverters. It can also be used to arrive at a detailed modelling of PV modules to evaluate the transient behaviour. [ABSTRACT FROM AUTHOR]

Purpose: To develop transferrin (Tf)-targeted delivery systems for the pro-apoptotic drug, NCL-240, and to evaluate the efficacy of this delivery system in ovarian cancer NCI/ADR-RES cells, grown in vitro in a 3D spheroid model. Methods: Tf-targeted PEG-PE-based micellar and ePC/CHOL-based liposomal delivery systems for NCL-240 were prepared. NCI/ADR-RES cells were used to generate spheroids by a non-adhesive liquid overlay technique. Spheroid growth and development were monitored by size (diameter) analysis and H&E staining. The targeted formulations were compared to untargeted ones in terms of their degree of spheroid association and penetration. A cell viability analysis with NCL-240-loaded micelles and liposomes was performed to assess the effectiveness of Tf-targeting. Results: Tf-targeted polymeric micelles and Tf-targeted liposomes loaded with NCL-240 were prepared. NCI/ADR-RES cells generated spheroids that demonstrated the presence of a distinct necrotic core along with proliferating cells in the spheroid periphery, partly mimicking in vivo tumors. The Tf-targeted micelles and liposomes had a deeper spheroid penetration as compared to the untargeted delivery systems. Cell viability studies using the spheroid model demonstrated that Tf-mediated targeting markedly improved the cytotoxicity profile of NCL-240. Conclusion: Transferrin targeting enhanced delivery and effectiveness of micelles and liposomes loaded with NCL-240 against NCI/ADR-RES cancer cells in a 3D spheroid model. [ABSTRACT FROM AUTHOR]

Purpose: To develop a multifunctional nanoparticle system carrying a combination of pro-apoptotic drug, NCL-240, TRAIL [tumor necrosis factor-α (TNF-α)-related apoptosis-inducing ligand] and anti-survivin siRNA and to test the combination preparation for anti-cancer effects in different cancer cells. Methods: Polyethylene glycol-phosphoethanolamine (PEG-PE) - based polymeric micelles were prepared carrying NCL-240. These micelles were used in combination with TRAIL-conjugated micelles and anti-survivin siRNA-S-S-PE containing micelles. All the micelles were characterized for size, zeta potential, and drug encapsulation efficiency. Different cancer cells were used to study the cytotoxicity potential of the individual as well as the combination formulations. Other cell based assays included cellular association studies of transferrin-targeted NCL-240 micelles and study of cellular survivin protein downregulation by anti-survivin siRNA-S-S-PE containing micelles. Results: NCL-240 micelles and the combination NCL-240/TRAIL micelles significantly increased cytotoxicity in the resistant strains of SKOV-3, MCF-7 and A549 as compared to free drugs or single drug formulations. The NCL-240/TRAIL micelles were also more effective in NCI/ADR-RES cancer cell spheroids. Anti-survivin siRNA micelles alone displayed a dose-dependent reduction in survivin protein levels in A2780 cells. Treatment with NCL-240/TRAIL after pre-incubation with anti-survivin siRNA inhibited cancer cell proliferation. Additionally, a single multifunctional system composed of NCL-240/TRAIL/siRNA PM also had significant cytotoxic effects in vitro in multiple cell lines. Conclusion: These results demonstrate the efficacy of a combination of small-molecule PI3K inhibitors, TRAIL, and siRNA delivered by micellar preparations in multiple cancer cell lines. [ABSTRACT FROM AUTHOR]

Background: Peroral endoscopic myotomy (POEM) has been performed as a novel endoscopic procedure to treat achalasia with favorable outcome. The objective of this study was to assess the outcome of POEM in our initial series and to assess the safety and efficacy of POEM in a variety of esophageal motility-related clinical problems.Methods: This is a retrospective cross-sectional study involving all patients with esophageal motility disorders defined by the Chicago classification, who had undergone consideration for POEM at our institution. Validated questionnaires such as gastroesophageal reflux disease health-related quality of life (GERD-HRQL), reflux symptom index (RSI) and achalasia disease-specific health-related quality of life were obtained pre- and postoperatively.Results: From January 2013 to October 2014, a total of 35 POEMs (achalasia n = 25, non-achalasia n = 10) were performed on 33 patients (female n = 20, male n = 13, mean age 56.9 years). There was no mortality. The rate of inadvertent mucosotomy was 17.1%. The rate of complications requiring interventions was 5.7%. During a mean follow-up period of 7 months (range 0.5-17), 92% of patients with achalasia and 75% of those with non-achalasia motility disorders had a symptomatic improvement in dysphagia. Chest pain was completely resolved in all patients with achalasia (8/8) and 80% of patients with non-achalasia (4/5). The GERD-HRQL, RSI and dysphagia scores significantly improved after POEM in patients with achalasia. There was a significant improvement in GERD-HRQL and RSI scores, and a trend toward lower dysphagia score in patients with non-achalasia.Conclusions: The outcome of POEM to treat achalasia and non-achalasia motility disorders is consistent with previous studies. Potential benefit of POEM includes not only its flexibility to adjust the length and location of myotomy but also the ability to extend myotomy proximally without thoracoscopy or thoracotomy. POEM can be combined with laparoscopic procedures and used as "salvage" for localized esophageal dysmotility. [ABSTRACT FROM AUTHOR]

Presents research which studied how accurately the head-related transfer function (HRTF) must be reproduced to achieve three-dimensional perception of auditory signals in anechoic space. Perception of sounds heard over headphones compared with real sound sources; Location-dependent filtering in perception; Effect of smoothing HRTFs in frequency; Distinguishing real from virtual sources.

An abstract of the article "Cutaneous Tuberculosis Associated with Infliximab Treatment" by Sumir Patel, Abhijit Kulkarni, Rad Agrawal, and Arezo Shahwali is presented.

An abstract of the article "Monolobar Caroli's Disease: A Case Report" by Sumir Patel, Abhijit Kulkarni, Rad Agrawal, and Girija Nathan is presented.