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Use of medicinal plants for the biosynthesis of nanoparticles offers several advantages over other synthesis approaches.

Introduction: Colorectal cancer (CRC) is the third most common cancer in the world. The liver is the most common site of metastasis with 15 to 25% of patients presenting with synchronous colorectal liver metastasis (CRLM). This study is aimed at evaluating the long- and short-term outcomes of laparoscopic and robotic CRLM surgery, and directly comparing their respective effectiveness. Methodology: A literature search was performed and all studies that reported on operative characteristics, oncological outcomes for CRLM, morbidity or mortality and cost-effectiveness on robotic or laparoscopic surgery were included. The study design was in keeping with the PRISMA guidelines. Results: From the initial 606 manuscripts identified, 19 studies were included in the final qualitative analysis. A total of 1340 patients with 1194 LLR (Laparoscopic Liver Resection) and 146 RLR (Robotic Liver Resection) cases were analysed. Within the LLR group, the average tumour size excised was 32.1 mm compared to the RLR group of 33.8 mm. The average operative time in the LLR was 193 min, CI of 95% (147.4 min to 238.6 min) compared to RLR 257 min, CI of 95% (201.5 min to 313.8 min) with a p-value < 0.0001. Estimated blood loss was lower in the RLR group (210 mL) compared with the LLR group (246 mL). Conclusion: Despite the higher operative cost, RLRs do not result in statistically better treatment outcomes, with the exception of lower estimated blood loss and excision of larger CRLMs. Operative time and total complication rate are significantly more favourable with LLRs. Our study has shown that robotic liver surgery is safe and feasible in well-selected patients.

Goat is one of the most valued and cost-effective household animals serving humanity by providing its meat, milk, fiber, skin and manure. Particularly, meat and milk production depends on the physical traits of the animals e.g., large body-size/skeletal frame. Previous studies has shown that theLCORLgene is associated with the subject traits in humans and many other animal species. So, the current study is aimed to investigate the genetic variability/association of rs657074013A>AT variant within diverse goats from Pakistan. By using ARMS-PCR, a total of 51 samples were genotyped with allele-specific primer-set, results of the current study depicted that, 27% population is homozygous wild-type (A/A), 24% homozygous-mutant (AT/AT) and 49% is heterozygous (A/AT). Hardy Weinberg Equilibrium (HWE) analysis revealed that our overall sampled population obeys this principle withχ2(2,N= 51) = 0.046,p= 0.9730. Similarly, a significant genetic association was also envisioned by Chi-square statisticsp= 9.60 × 10−5using the PLINK data analysis toolset. Furthermore, alternative allele frequencies of 0.68 and 0.28 were also calculated within cases (n=25) and control (n=26) cohorts respectively along with an odds ratio of 5.242. As a nutshell, this pilot study improved our genomic insight by observing the variability and association of the subjectLCORLgenetic variant (c.828_829insA) in the Pakistani goat population, which may be used to improve this economically important trait by adopting marker-assisted breeding strategies and further investigated within other livestock species as well.

The immune system plays a critical role in modulating cancer development and progression. Polymorphisms in key genes involved in immune responses are known to affect susceptibility to cancer. Here, we analyzed 35 genes to evaluate the association between variants of genes involved in immune responses and prostate cancer risk. Thirty-five genes were analyzed in 47 patients with prostate cancer and 43 healthy controls using next-generation sequencing. Allelic and genotype frequencies were calculated in both cohorts, and a generalized linear mixed model was applied to test the relationship between prostate cancer risk and nucleotide substitution. Odds ratios were calculated to describe the association between each single nucleotide polymorphism (SNP) and prostate cancer risk. Significant changes in allelic and genotypic distributions were observed for IL4R, IL12RB1, IL12RB2, IL6, TMPRSS2, and ACE2. Furthermore, a generalized linear mixed model identified statistically significant associations between prostate cancer risk and SNPs in IL12RB2, IL13, IL17A, IL4R, MAPT, and TFNRS1B. Finally, a statistically significant association was observed between IL2RA and TNFRSF1B and Gleason scores, and between SLC11A1, TNFRSF1B and PSA values. We identified SNPs in inflammation and two prostate cancer-associated genes. Our results provide new insights into the immunogenetic landscape of prostate cancer and the impact that SNPs on immune genes may have on affecting the susceptibility to prostate cancer.

Nano-elicitation is one among the prioritised strategies considered globally for sustainable and uniform production of industrially important medicinal compounds. Ocimum basilicum (Thai basil), a renowned medicinal species is a reservoir of commercially vital metabolites and proved for its health assuring effects in cancer, diabetes, microbial and cardiovascular diseases. However, its consumption and industrial demand raised intent to divert towards better alternates for ensuring sustainable production of medicinal compounds. Herein, we investigated the comparative potential of metal oxide [copper oxide (CuO) and manganese oxide (MnO)] nanoparticles to elicit the biosynthesis of bioactive metabolites and antioxidative capacity of O.basilicum callus cultures. Results showed that callus grown on MS media supplemented with 10 mg/L CuO-NPs resulted in the highest biomass accumulation (FW: 172.8 g/L, DW: 16.7 g/L), phenolic contents (TPC: 27.5 mg/g DW), and flavonoid contents (TFC: 9.1 mg/g DW) along with antioxidant activities (DPPH: 94%, ABTS: 881 μM TEAC, FRAP: 386 μM TEAC) compared with MnO-NPs and control. Likewise, the Superoxide dismutase (SOD: 1.28 nM/min/mg FW) and Peroxidase (POD: 0.48 nM/min/mg FW) activities were also recorded maximum in CuO-NPs elicited cultures than MnO-NPs and control. Moreover, the HPLC results showed that rosmarinic acid (11.4 mg/g DW), chicoric acid (16.6 mg/g DW), eugenol (0.21 mg/g DW) was found optimum in cultures at 10 mg/L CuO-NPs. Overall, it can be concluded that CuO nanoparticles can be effectively used as a elicitor for biosynthesis of metabolites in callus cultures of O. basilicum (Thai basil). The study is indeed a contribution to the field that will help decoding the mechanism of action of CuO NPs. However, further molecular investigations are needed to fully develop understanding about the metabolic potential of O. bascillicum and scalling up this protocol for bulkup production of bioactive compounds.

Aim COVID had an unprecedented effect on the NHS elective surgical care. To overcome the deficit created due to the pandemic, the concept of a ‘COVID protected zone’ gave birth to the ‘hospital within the hospital’. This included 9 elective theatres, 28 ring fenced elective beds, a surgical enhanced care unit, a canteen and a separated entrance. Of the fundamentals of the model were enhanced infection control and PPE guidance for staff. The aim of our study was to evaluate the recovery of elective activity brought about by this elective centre. Methods Theatre activity data was collected weekly (7/20 to 1/21) through the business informatics system. This was used to compare the activity achieved during the recovery phase from COVID after the first and subsequent wave. Results Pre COVID-19, 11 theatres were operating. These managed an average of 263 cases were per week. In the first week of operation of elective centre, 31% of theatre capacity was achieved. By week 7, 106% of pre COVID was recorded and 130% by week 11. During the 2nd wave the capacity was reduced to 42% as opposed to 0% during the first wave. This was only possible due to our model elective centre. Conclusion This model elective centre has enabled elective care to return to above normal levels, with increased efficiencies. This has not only shortened patient waiting times and cleared the back-log but also delivered training to surgical trainees without compromising safety.

Antibiotics are crucial in pharmaceuticals that are used against a broad range of bacteria to reduce their growth in living organisms. Antibiotics have been known for the last 30 years approximately according to their function and classification as antibiotics have been around for a lot longer!!. In working, antibiotics act as part of immune system and target bacterial cells specifically. Similarly, on detection of certain immune signals within living cells, antibiotics detect harmful pathogens and act against them. Broad-spectrum antibiotics affect both gram-positive and gram-negative bacteria, causing serious illnesses in human beings. But gradually, with passage of time, such bacteria have become resistant to these antibiotics, resulting in prolonged bacterial infection and diseases. Resistance in bacteria is caused generally by means of self-medication, genetic variations, or mutations in bacteria and also by phenotypic variation such as β-lactams. As antibiotics are specific to their targets, bacteria secrete certain enzymes to cleave chemical bonds within antibiotic structure. Furthermore, alteration in membrane permeability, antibiotic target modifications in bacteria, and resistant gene transfer to next generations also cause resistance to antibiotics and, hence, bacteria such as Staphylococcus aureus and Neisseria gonorrhea, etc. have become resistant and cause lethal diseases in human beings. To avoid such resistance, molecular methods are to be adopted such as RNA-mediated gene silencing, biosynthetic gene cluster (BSG) control mechanism, and most importantly, nanomedicines are key developments in this area.

Background The adenoma detection rate (ADR) is an important quality indicator in colonoscopy. The aim of this study was to evaluate the changes in visual gaze patterns (VGPs) with increasing polyp detection rate (PDR), a surrogate marker of ADR. Methods 18 endoscopists participated in the study. VGPs were measured using eye-tracking technology during the withdrawal phase of colonoscopy. VGPs were characterized using two analyses – screen and anatomy. Eye-tracking parameters were used to characterize performance, which was further substantiated using hidden Markov model (HMM) analysis. Results Subjects with higher PDRs spent more time viewing the outer ring of the 3 × 3 grid for both analyses (screen-based: r = 0.56, P = 0.02; anatomy: r = 0.62, P Conclusion This study defined distinct VGPs that are associated with expert behavior. These data may allow introduction of visual gaze training within structured training programs, and have implications for adoption in higher-level assessment.

Background: Eye-tracking technology is an established research tool within allied industries such as advertising, psychology and aerospace. This review aims to consolidate literature describing the evidence for use of eye-tracking as an adjunct to traditional teaching methods in medical education. Methods: A systematic literature review was conducted in line with STORIES guidelines. A search of EMBASE, OVID MEDLINE, PsycINFO, TRIP database, and Science Direct was conducted until January 2017. Studies describing the use of eye-tracking in the training, assessment, and feedback of clinicians were included in the review. Results: Thirty-three studies were included in the final qualitative synthesis. Three studies were based on the use of gaze training, three studies on the changes in gaze behavior during the learning curve, 17 studies on clinical assessment and six studies focused on the use of eye-tracking methodology as a feedback tool. The studies demonstrated feasibility and validity in the use of eye-tracking as a training and assessment method. Conclusions: Overall, eye-tracking methodology has contributed significantly to the training, assessment, and feedback practices used in the clinical setting. The technology provides reliable quantitative data, which can be interpreted to give an indication of clinical skill, provide training solutions and aid in feedback and reflection. This review provides a detailed summary of evidence relating to eye-tracking methodology and its uses as a training method, changes in visual gaze behavior during the learning curve, eye-tracking methodology for proficiency assessment and its uses as a feedback tool.

Body interrelated complex system maintain body hemostasis but severe vascular injury reprehensible for thrombus formation. Fibrinogen is a prime protein in fibrinolysis. Complex cascade pathway involves in conversion of plasminogen to plasmin to perform fibrinolysis and plasminogen activating inhibitor (PAI) cease this pathway. The genetic and acquired factors influence clot formation while it curbs by factor VIII. This review aims to illustrate significance of fibrinolytic enzymes, Nattokinase, Urokinase, Staphylokinase and streptokinase as therapeutic agent to control myocardial infraction, venous stroke and pulmonary clotting.

There is a changing dynamic in research that aims to increase the participation of patients in its design and implementation. Patient and public involvement (PPI) is essential for achieving valid, clinically applicable results. A systematic review by Brett et al 1 demonstrated the potential benefits of PPI in establishing and undertaking research, and writing-up and disseminating results. Eye tracking is an innovative technology used extensively in allied fields such as psychology and aerospace.2 It is increasingly used in surgical research,3 particularly assessment and training. Despite the growing popularity of the technology, there are no data investigating the patient's experience and views relating to this technology. This study aims to elicit the perception of patients' involvement in eye tracking research in order to improve their experience and the overall quality of the research. This was a cross-sectional, qualitative study of participants concurrently involved in eye tracking research for two different ongoing clinical studies at Imperial …