Fracture toughness and fractal analysis of ceramic benchmark materials

Previous studies have reported various methods of measuring the fracture toughness of brittle ceramics. The purpose of the present research was to use a new method of fractal dimension measurement on benchmark materials (silica glass, Viosil SX, Shin-Etsu, n = 13, and silicon nitride standard reference material, SRM2100, NIST, n = 10), to compare the fracture toughness calculated using different methods, and to study the effect of noise filtering on the fractal dimension and fracture surface roughness. Fracture toughness was determined using surface crack in flexure method according to ASTM C1421 and fractal analysis method. Fractal dimension was determined using the Minkowski Cover algorithm on atomic force microscope scans of epoxy replicas of fracture surfaces. The mean ± standard deviation of fracture toughness using surface crack in flexure method and fractals method were 0.97 ± 0.18 MPa·m1/2 and 1.03 ± 0.07 MPa·m1/2 for silica glass and 4.62 ± 0.14 MPa·m1/2 and 2.54 ± 0.07 MPa·m1/2 for silicon nitride, respectively. The mean ± standard deviation of fractal dimension was 2.17 ± 0.03 for silica glass and 2.13 ± 0.01 for silicon nitride. The mean ten-point roughness (Rz) before and after noise filtering was 89 ± 102 nm and 87 ± 101 nm for silica glass and 355 ± 132 nm and 357 ± 134 nm for silicon nitride, respectively. Noise filtering had no significance on the fracture surface roughness of the two materials. The newly developed fractal analysis method can be used to predict the baseline fracture toughness of specimens with unknown failure stress.

AB1421 IMPACT OF HOSPITALIZATION ON CLINICAL OUTCOMES IN PATIENTS WITH CONNECTIVE TISSUE DISEASE ASSOCIATED INTERSTITIAL LUNG DISEASE (CTD-ILD) - A SINGLE CENTER OBSERVATIONAL STUDY

Background

Interstitial lung disease(ILD) is major cause of morbidity and mortality in patients with connective tissue disease (CTD). Hospitalization is being increasingly recognized as poor prognostic indicator in these patients.

Objectives

The objective of our study was to assess the impact of hospitalization on clinical outcomes in patients with CTD-ILD.

Methods

We conducted a retrospective chart review of patients with radiologically or biopsy proven ILD associated with rheumatologist diagnosed CTD who were seen at Montefiore Medical Center between January 2007 and December 2018. Patients with age>18 years who had either 2 CT scans of the chest and/or 2 sets of pulmonary function tests (PFT) atleast 6 months apart were included in the study. Clinical demographics, cause of hospitalization, length of stay, use of immunosuppression and mortality were identified. Patients were stratified into 2 cohorts; non-hospitalized and hospitalized patients. The latter cohort was further sub-stratified into patients with cardiopulmonary vs. non-cardiopulmonary hospitalization (Figure 1). Two-sample t-tests and Wilcoxon’s rank sum tests were used for comparing the continuous variables. Chi-square tests and Fisher’s exact tests were used for comparing the categorical variables as appropriate. Kaplan-Meier method was used for calculating the survival probabilities, and log-rank tests were used to compare differences between the groups.

Results

During the study period, we identified 213 patients with CTD-ILD using ICD 9/10 code. Of the 213 patients, 96 met our inclusion criteria and 73 (76%) had at least 1 hospitalization (Figure 1). Both groups were similar in baseline clinical characteristics but we identified significantly higher transplant referrals in the hospitalized group(23.9%) vs. non-hospitalized group(0%) (Table 1). Overall rheumatoid arthritis (29.2%) was the most common CTD associated ILD followed by inflammatory myositis (21.9%) and scleroderma (14.6%). Median time from diagnosis of ILD to first hospitalization was 1.42 years.

Table 1.

Baseline Characteristics of patients with CTD-ILD

CharacteristicEntire Cohort (n = 96)Patients with CTD-ILD and hospitalization (n = 73)Patients with CTD-ILD and no hospitalization (n = 23)p-valueAge(mean ± SD)54.15 ± 13.9754.82 ± 13.7752.00 ± 14.710.40Female, n (%)76 (79.2)56 (76.7)20 (87.0)0.39Race, % (n)0.10 Black38 (39.6)31 (42.5)7 (30.4) White4 (4.2)3 (4.1)1 (4.4) Others54 (56.2)39(53.4)15(65.3)Ethnicity, % (n) (Hispanic)44 (53.7)35 (53.0)9 (56.3)0.82Former or active smoker, % (n)41 (42.7)34 (46.6)7 (30.4)0.17Pulmonary hypertension, % (n)28 (31.1)24 (33.3)4 (22.2)0.36FVC, n (%)0.37Moderately severe(47.1-64.2)37 (44.6)26 (40.6)11 (57.9)Severe(24.3-47.0)7 (8.4)6 (9.4)1 (5.3)DLCO, n(%)0.30Moderate26(31.7)23(37.1)3(15.0)Severe25(30.5)17(27.4)8(40.0)Immunosuppression, n(%)78 (81.3)59 (80.8)19 (82.6)1.00Transplant referral, n(%)17 (18.3)17 (23.9)0 (0)0.01

The patients hospitalized for cardiopulmonary cause were significantly older(57.2 ±13.1 years) than those admitted with non-cardiopulmonary cause(49.2±14.8 years)(Mean±SD). Older age (HR 1.95, p=0.02) and length of stay greater than 7 days for cardiopulmonary cause(HR 4.82,p=0.01) was associated with higher risk of mortality.

Kaplan Meier curve analysis showed that hospitalization (p-value=0.02) was associated with statistically significant increased risk of death.

Conclusion

-Hospitalization in CTD-ILD patients especially length of stay more than 7 days due to cardiopulmonary causes was associated with statistically significant increased risk of death.

Male gender and older age was associated with a worse prognosis in patients who were hospitalized.

References

[1]Ratwani AP, Ahmad KI, Barnett SD, Nathan SD, Brown AW. Connective tissue disease-associated interstitial lung disease and outcomes after hospitalization: A cohort study. Respiratory Medicine. 2019;154:1-5. doi:10.1016/j.rmed.2019.05.020

Disclosure of Interests

None declared

Effect of restrictions imposed due to COVID-19 pandemic on the antenatal care and pregnancy outcomes: a prospective observational study from rural North India

OBJECTIVES

To assess the difficulties faced by the pregnant women in seeking appropriate antenatal care due to the restrictions imposed during the COVID-19 pandemic; assess the difficulties encountered during delivery and postpartum period; the suitability of the teleconsultation services offered; effect of COVID-19 infection on pregnancy outcomes and the effect of restrictions on the nutrition profile of the pregnant women.

DESIGN

Prospective observational study.

SETTING AND PARTICIPANTS

We included 1374 pregnant women from the rural areas of three districts of Punjab, India registered at government health centres before the implementation of lockdown due to the COVID-19 pandemic on 24 March 2020.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was the difficulties faced by the women during their pregnancies due to restrictions imposed during the lockdown. The secondary outcomes included the effect of COVID-19 infections on pregnancy outcomes, satisfaction from the telemedicine services and restrictions on the nutrition profile of the pregnant women.

RESULTS

One-third of the women (38.4%) considered their last pregnancy unplanned. Women faced difficulties due to the restrictions in getting adequate nutrition (76.5%), accessing transportation facilities (35.4%), consultations from doctors (22.4%) or getting an ultrasonography scan (48.7%). One-fifth (21.9%) of women could not access safe abortion services. Only 3.6% of respondents ever took any teleconsultation services offered by the government. Most of them felt unsatisfied compared with routine visits (77.5%). COVID-19-infected women were primarily asymptomatic (76.1%), but there was a high incidence of preterm birth (42.8%). Frontline workers could visit 64.3% of the women in the postpartum period despite restrictions.

CONCLUSIONS

Lockdown compromised the antenatal care in our study area while the frontline workers attempted to minimise the inconvenience. Telemedicine services did not prove to be of many benefits to pregnant women and should only work as a supplement to the existing protocols of antenatal care.

Bis-Indole Alkaloids Isolated from the Sponge Spongosorites calcicola Disrupt Cell Membranes of MRSA

Antimicrobial resistance (AMR) is a global health challenge with methicillin resistant Staphylococcus aureus (MRSA), a leading cause of nosocomial infection. In the search for novel antibiotics, marine sponges have become model organisms as they produce diverse bioactive compounds. We investigated and compared the antibacterial potential of 3 bis-indole alkaloids—bromodeoxytopsentin, bromotopsentin and spongotine A—isolated from the Northeastern Atlantic sponge Spongosorites calcicola. Antimicrobial activity was determined by MIC and time-kill assays. The mechanism of action of bis-indoles was assessed using bacterial cytological profiling via fluorescence microscopy. Finally, we investigated the ability of bis-indole alkaloids to decrease the cytotoxicity of pathogens upon co-incubation with HeLa cells through the measurement of mammalian cell lysis. The bis-indoles were bactericidal to clinically relevant Gram-positive pathogens including MRSA and to the Gram-negative gastroenteric pathogen Vibrio parahaemolyticus. Furthermore, the alkaloids were synergistic in combination with conventional antibiotics. Antimicrobial activity of the bis-indole alkaloids was due to rapid disruption and permeabilization of the bacterial cell membrane. Significantly, the bis-indoles reduced pathogen cytotoxicity toward mammalian cells, indicating their ability to prevent bacterial virulence. In conclusion, sponge bis-indole alkaloids are membrane-permeabilizing agents that represent good antibiotic candidates because of their potency against Gram-positive and Gram-negative bacterial pathogens.

Lewis Acid-Catalyzed Halonium Generation for Morpholine Synthesis and Claisen Rearrangement

We disclose here practical strategies toward the synthesis of morpholines and Claisen rearrangement products based on the divergent reactivity of a common halonium intermediate. These reactions employ widely available alkenes in a Lewis acid-catalyzed halo-etherification process that can then transform them into the desired products with exceptional regioselectivity for both activated and unactivated olefins. Our mechanistic probe reveals an interesting regiochemical kinetic resolution process.

Development of a New Tool to Assess the Quality of Life of Patients with Hand-Foot Syndrome Receiving Capecitabine-Based Therapy: A Pilot Study

Background  Hand–foot syndrome (HFS) can result in significant deficits in health-related quality of life (HRQOL) and can lead to poor compliance, dose reduction, or interruption. This study was performed to assess the HRQOL with HFS on physical, psychological, social, and sexual aspects of patients receiving capecitabine-based chemotherapy with gastrointestinal cancer along with validating and assessing the reliability score of the questionnaire.

Patients and Methods  HFS-related QOL (HF-QOL) questionnaire was developed and validated in a sample of 30 patients randomly selected for this pilot study. The internal consistency of the tool was tested by calculating the Cronbach's α coefficient, while content and construct validity were assessed by Pearson's correlation. Statistical analyses were performed using SPSS version 25.0.

Results  Out of 30, 22 (73%) patients were males, mean age was 44 ± 13 years; 21 (70%) patients had grade 1 HFS, while 6 (20%) and 3 (10%) patients had grades 2 and 3 HFS, respectively. Cronbach's α coefficient was high for physical (0.79) and sexual scales (0.79), while it was moderately low for psychological (0.65) and social (0.53) domains. The average HF-QOL scores were 70.6 ± 13.2 in physical domain and 71.3 ± 23.7 in sexual domain indicating poor quality of life (QOL), while it was 50.9 ± 9.9 in social domain indicating moderately worse QOL. Grades 2 and 3 of HFS were found to have statistical significance on physical (0.0001), psychological (0.05), and social (0.02) domains, whereas sexual domain did not have any statistical significance (0.594).

Conclusion  This pilot study showed the feasibility of use and validity of a new patient-reported instrument, the HF-QOL, which measures the effect of HFS on daily activities (physical, psychological, social, and sexual domains) after capecitabine-based chemotherapy.

A case report of sciatic hernia as a cause of sciatica and lower back pain: Diagnostic dilemma for family physicians

Degenerative changes in lumbosacral spine or disc bulges impinging on the thecal sac are the usual causes of sciatica. However peripheral compression of sciatic nerve in pelvis or lower limb presenting as sciatica is an uncommon entity. The sciatic hernia is a rare type of hernia. Due to the deep location of this pathology, the clinical examination would add little and imaging plays a pivotal role in diagnosis. We present a case of sciatica diagnosed with giant gluteal lipoma presenting as sciatic notch hernia and compressing sciatic nerve in the greater sciatic notch. Less than 100 cases are reported in the literature so far. The possibility of this rare diagnosis should be kept in mind by family physicians while evaluating patients of sciatica with no significant imaging findings in lumbosacral spine.

Variations of cannabis-related adverse mental health and addiction outcomes across adolescence and adulthood: A scoping review

INTRODUCTION

Evidence supporting associations between cannabis use and many health outcomes is growing, however it remains unclear how such associations vary across the lifespan. We therefore aim to answer the following questions: (1) Are the risks of cannabis's adverse effects on mental health and addiction-related outcomes different in adolescents than in adults? (2) What are the relationships between these cannabis's adverse effects and (a) an individual's age at first cannabis use, (b) age at assessment, and (c) duration of cannabis use?

METHODS

We searched Medline, Embase, CINAHL, and PsychINFO from inception to 18 October 2021. Two reviewers independently screened studies and descriptively synthesized results.

RESULTS

We included 140 studies. Cannabis effects on mental health and addiction-related outcomes were worse in adolescents, early cannabis initiators and cannabis users who consumed for longest periods. Evidence of worse long-term adverse effects in adolescents was substantial for psychosis, cannabis, and nicotine use disorders; mixed for depression, suicidality, other substance use and disorders; and limited for anxiety. Additionally, acute cannabis exposure had the opposite trend with adults more often reporting adverse effects than adolescents.

CONCLUSION

The available evidence suggests that cannabis use should be delayed as late as possible in adulthood and shortened in duration across the lifespan to decrease the risk of negative outcomes, while emphasizing the need for adapted harm reduction approaches. This scoping review provides evidence on the role of age and duration of exposure as determinants of cannabis-related adverse effects, which may inform prevention and harm reduction strategies.

SYSTEMATIC REVIEW REGISTRATION

https://doi.org/10.17605/OSF.IO/BYG72.

High-resolution chest computed tomography findings of coronavirus disease 2019 (COVID-19) - A retrospective single center study of 152 patients

Introduction:

Coronavirus disease 2019 (COVID-19) pandemic has engulfed the world, within a short span of time crippling many health systems. The disease in its ever-evolving course is exhibiting a myriad of symptoms and imaging manifestations. This retrospective study was conducted to generate evidence from the chest computed tomography (CT) findings of patients with COVID-19 pneumonia to aid in the diagnosis and disease management.

Methods:

This retrospective study included all patients with reverse transcriptase polymerase chain reaction confirmed COVID-19 disease who underwent chest CT between 1^st June to 31^st December 2020 at a tertiary care institute of North India. Anonymized data of 152 COVID-19 positive patients was used for the evaluation of the clinical profile and imaging findings.

Results:

The common presenting clinical symptoms were fever, cough, myalgia and sore throat. The most frequent CT imaging feature consisted of ground-glass opacities (GGOs), consolidation and crazy paving distributed bilaterally, peripherally in subpleural location with a predilection for the posterior parts of lungs. Reverse halo sign was observed in 12 patients and halo sign in 3 patients. Dilated pulmonary vessels with mild bronchiolectasis were observed in the involved lung parenchyma. Less common findings included pleural effusion, mediastinal lymphadenopathy, and pericardial effusion. The mean CT severity score gradually increased with increasing age.

Conclusion:

The predominant imaging finding of COVID-19 pneumonia was peripheral GGO's distributed bilaterally in peripheral subpleural region and having predilection for the posterior parts of the lungs which gradually evolve into organizing pneumonia patterns. Although COVID-19 shares imaging findings with other viral pneumonias, however in the context of the current pandemic, we must keep COVID-19 a differential diagnosis, in all patients with fever and respiratory symptoms.

Mental Health Status of Incarcerated Women in India: A Perspective from a Social Worker

Women constitute a growing segment of the incarcerated population across the world, presenting unique issues for social workers in correctional settings. In this article, based on a study conducted in Mandoli Jail, New Delhi, India, we address the need to broaden the scope and quality of social work provided for women inmates, specifically highlighting the potential role of social workers in promoting their mental health. Our study revealed that the mean age of women inmates was 39.43 years, indicating that most of the women were in their reproductive age and therefore prone to specific health issues. On an average, they were overweight, with only 42.22% women inmates being active, while remaining were inactive (15.56%), moderately inactive (22.22%) or moderately active (20.00%). Of greater concern were the mental health findings: 87.8% experienced distress (45.57% moderately elevated, 54.43% strongly elevated), 73.3% depression (34.85% moderately elevated, 65.15% strongly elevated), 77.78% anxiety (41.43% moderately elevated, 58.57% strongly elevated) and 82.22% somatisation (43.24% moderately elevated, 56.76% strongly elevated). Our study, consequently, identified the mental health of women inmates as a strategic priority for social workers. In this article, we explore the mutuality of various social work practice principles at different levels of intervention and the roles that social workers, as human rights-based professionals, may engage in to improve the mental health of incarcerated women.

Phytohormones: Key players in the modulation of heavy metal stress tolerance in plants

Heavy metal (HM) stress in plants has received considerable global attention as it threatens sustainable growth in agriculture worldwide. Hence, desperate efforts have been undertaken for combating the effects of this stress in plants. Interestingly, the use of phytohormones in reducing the impact of HM toxicity has gained much momentum in the recent past. Phytohormones act as chemical messengers that improve the HM stress resistance in plants, thus allowing them to retain their growth and developmental plasticity. Their exogenous application as well as manipulation of endogenous levels through precise targeting of their biosynthesis/signaling components is a promising approach for providing a protective shield against HM stress in plants. However, for the successful use of phytohormones for field plants exposed to HM toxicity, in-depth knowledge of the key pathways regulated by them is of prime importance. Hence, the present review mainly summarizes the key conceptual developments on the involvement of phytohormones in the mitigation of HM stress in plants. The role of various genes, proteins, and signaling components involved in phytohormones associated HM stress tolerance and their modulation has also been discussed. Thus, this update will pave the way for improving HM stress tolerance in plants with the advent of phytohormones for sustainable agriculture growth in the future.

Visible light bromide catalysis for oxazoline, pyrrolidine, and dihydrooxazine syntheses via Csp3-H functionalizations

A catalytic benzylic C_sp³-H functionalization protocol is described here. This visible light-mediated process is centered on the utilization of a bromide catalyst and oxidant to generate a nitrogen (N)-centered radical for a site-selective hydrogen atom transfer (HAT) process. This strategy enabled the unconventional syntheses of a number of N-heterocycles dependent on the amide identity. We also discovered a nucleophilicity-dependent kinetic resolution for stereochemical differentiation of C_sp³-H bonds that enabled the stereoselective synthesis of cis- and trans-oxazolines.

Correlation of Surrogate Markers of Insulin Resistance with Fasting Insulin in Type 2 Diabetes Mellitus Patients: A Study of Malwa Population in Punjab, India

Context Insulin resistance (IR) and abnormal insulin secretion play a key role for the development of type 2 diabetes mellitus (DM). Aims We investigated the surrogate markers of IR, i.e., Homeostasis Model Assessment (HOMA), Quantitative Insulin Sensitivity Check Index (QUICKI), McAuley, and Fasting Insulin Resistance Index (FIRI) in type 2 DM patients. Also, fasting insulin (FI) levels were estimated in type 2 diabetics. Further, the correlation of FI with other surrogate markers of IR in type 2 DM was done. Settings and Design A hundred newly diagnosed patients with type 2 DM from Malwa population, Punjab, were considered for evaluation. Another 100 healthy individuals (age and sex-matched) were examined as controls. Methods and Material Fasting blood glucose, FI, and lipid profile were estimated, and IR was calculated using McAuley index (McA), HOMA, QUICKI, and FIRI. Statistical Analysis Used The statistical analysis was performed on the above-mentioned clinical interpretations. The Cohen's kappa test was used to affirm the agreement. Results FI levels in patients with type 2 diabetes were significantly higher (20.8 ± 9.05 µIU/L) than controls (7.93 ± 1.01 µIU/L). IR by surrogate markers was found significant in the study group. The 76% patients with type 2 diabetes ended up as resistant to insulin by FI measurement, almost equivalent to McA, 80%; HOMA, 88%; FIRI, 88%; and QUICKI, 90%. A notable correlation was highlighted between FI and McA manifesting IR ( p < 0.01, r = -0.85). We calculated the statistical correlation of FI with HOMA, QUICKI, and FIRI indices ( p < 0.01, r = 0.93; p < 0.01 r = -0.92; and p < 0.01, r = +0.93, respectively). The agreement visible from Cohen's kappa test also affirms the same ( k = 0.9 for McA). Conclusion We concluded that all the surrogate markers for IR were specific when compared with FI, but in terms of sensitivity McA was found to be more sensitive as it includes markers of dyslipidemia, which is the precipitating factor of metabolic derangements so as the IR in type 2 DM.

Bull's eye sign - A diagnostic clinch in COVID-19 pneumonia

Although typical imaging findings of COVID-19 pneumonia has been described it may be difficult at times to distinguish it from other viral pneumonias. In the following case series, we describe a typical sign i.e. Bull's-eye sign in COVID-19 pneumonia. As this sign is not associated with any known pulmonary disease, so its presence may help radiologists to differentiate COVID-19 pneumonia from its mimics.

Reducing mortality in mucormycosis of the head and neck in diabetic patients: A CARE case series

INTRODUCTION

Rhinocerebral mucormycosis is extremely fatal, with mortality rates ranging from 85-93% despite the best treatment in immunocompromised patients. We emphasize the importance of early diagnosis, repeated debridement, and aggressive antifungal treatment to reduce mortality.

CASE SUMMARY

We report six cases (five male and one female), with a mean age of 51 years who were diagnosed to have mucormycosis from 2017 to 2019. All patients were diabetic. Intracranial involvement and orbital involvement were found in four cases. Facial nerve palsy was seen in two cases, one without any apparent otological involvement. Aggressive serial debridement and amphotericin B was started. Posaconazole was added subsequently to the treatment in two cases. One patient succumbed to the disease five months after discharge. The other five patients are on regular follow-up for a mean duration of 14 months at the end of which two had residual disease which was under control.

DISCUSSION

Repeated surgical debridement with an early aggressive and combination antifungal therapy can result in good outcomes even in advanced mucormycosis. Concurrent management of the underlying pathology, monitoring of liver and kidney functions, and therapeutic drug monitoring are useful to ensure smooth and effective treatment.

Dengue and COVID-19 Coinfection- A Double Trouble

COVID 19 since its onset in Wuhan in 2019 has overburdened our existing health resources and infrastructure. Dengue virus has been endemic in Asian countries since decades. Both being viruses with similar clinical profile and overlapping laboratory parameters has posed a great challenge for Asian countries to combat a co epidemic, creating a double burden. We, as clinicians must be more vigilant in diagnosing the patients so that dengue is not missed in this covid pandemic era and does not progress to life threatening dengue shock syndrome. More importantly, we should emphasize on preventive measures for prevention of dengue so that we can reduce the burden on health care system.

Morphological Analysis, Protein Profiling and Expression Analysis of Auxin Homeostasis Genes of Roots of Two Contrasting Cultivars of Rice Provide Inputs on Mechanisms Involved in Rice Adaptation towards Salinity Stress

Plants remodel their root architecture in response to a salinity stress stimulus. This process is regulated by an array of factors including phytohormones, particularly auxin. In the present study, in order to better understand the mechanisms involved in salinity stress adaptation in rice, we compared two contrasting rice cultivars—Luna Suvarna, a salt tolerant, and IR64, a salt sensitive cultivar. Phenotypic investigations suggested that Luna Suvarna in comparison with IR64 presented stress adaptive root traits which correlated with a higher accumulation of auxin in its roots. The expression level investigation of auxin signaling pathway genes revealed an increase in several auxin homeostasis genes transcript levels in Luna Suvarna compared with IR64 under salinity stress. Furthermore, protein profiling showed 18 proteins that were differentially regulated between the roots of two cultivars, and some of them were salinity stress responsive proteins found exclusively in the proteome of Luna Suvarna roots, revealing the critical role of these proteins in imparting salinity stress tolerance. This included proteins related to the salt overly sensitive pathway, root growth, the reactive oxygen species scavenging system, and abscisic acid activation. Taken together, our results highlight that Luna Suvarna involves a combination of morphological and molecular traits of the root system that could prime the plant to better tolerate salinity stress.

Antiproliferative and Oxidative Damage Protection Activities of Endophytic Fungi Aspergillus fumigatus and Chaetomium globosum from Moringa oleifera Lam

The current study was conducted to evaluate the antiproliferative and oxidative damage protection potential of endophytic fungi Aspergillus fumigatus and Chaetomium globosum isolated from Moringa oleifera. The chloroformic extract (CE) of both the fungi showed dose dependent antiproliferative activity against human prostate adenocarcinoma (PC-3) cell line with (IC₅₀) value of 0.055 mg/ml and 0.008 mg/ml, respectively. Further, CE of both the fungi was studied for their ability to induce apoptosis in PC-3 cell line. Various deformities in the cancerous cells treated with CE of both the fungi have been observed by confocal microscopy which indicates the cell death by apoptosis. Further apoptosis inducing ability of CE of both the fungi was observed using various flow cytometric studies. The chloroformic extract of both the fungi showed slight increase in the level of reactive oxygen species to induce apoptosis. It also showed arrest of cancerous cells at G0/G1 phase of cell cycle to induce apoptosis. The externalization of phosphatidylserine (PS) to induce apoptosis was also observed when analysed using Annexin V-FITC/PI double staining assay where the CE of A. fumigatus and C. globosum showed the total apoptosis of 94.2% and 90.3%, respectively, at the highest tested concentration of GI₇₀. The CE of both the fungi further showed the protective behaviour for plasmid DNA pBR322, when tested for their effect against the oxidative stress caused by the Fenton's reagent. Thus, the studies demonstrated a good antiproliferative and oxidative damage protection potential of the endophytic fungi.

Tissue Collection and RNA Extraction from the Human Osteoarthritic Knee Joint

Osteoarthritis (OA) is a chronic and degenerative joint disease most often affecting the knee. As there is currently no cure, total knee arthroplasty (TKA) is a common surgical intervention. Experiments using primary human OA tissues obtained from TKA provide the capability to investigate disease mechanisms ex vivo. While OA was previously thought to impact mainly the cartilage, it is now known to impact multiple tissues in the joint. This protocol describes patient selection, sample processing, tissue homogenization, RNA extraction, and quality control (based on RNA purity, integrity, and yield) from each of seven unique tissues to support disease mechanism investigation in the knee joint. With informed consent, samples were obtained from patients undergoing TKA for OA. Tissues were dissected, washed, and stored within 4 h of surgery by flash freezing for RNA or formalin fixation for histology. Collected tissues included articular cartilage, subchondral bone, meniscus, infrapatellar fat pad, anterior cruciate ligament, synovium, and vastus medialis oblique muscle. RNA extraction protocols were tested for each tissue type. The most significant modification involved the method of disintegration used for low-cell, high-matrix, hard tissues (considered as cartilage, bone, and meniscus) versus relatively high-cell, low-matrix, soft tissues (considered as fat pad, ligament, synovium, and muscle). It was found that pulverization was appropriate for hard tissues, and homogenization was appropriate for soft tissues. A proclivity for some subjects to yield higher RNA integrity number (RIN) values than other subjects consistently across multiple tissues was observed, suggesting that underlying factors such as disease severity may impact RNA quality. The ability to isolate high-quality RNA from primary human OA tissues provides a physiologically relevant model for sophisticated gene expression experiments, including sequencing, that can lead to clinical insights that are more readily translated to patients.

Chiral Hypervalent Iodine Catalysis Enables an Unusual Regiodivergent Intermolecular Olefin Aminooxygenation

A novel iodide-catalyzed intermolecular aminooxygenation strategy is described here. Amide is used as the O- and N- source to probe for regiocontrol strategies. Notably, simple additives can be selectively introduced to achieve regiodivergent oxyamination processes for electronically activated alkenes while being regio-complementary for unactivated alkenes. Our preliminary data demonstrates that this regiocontrol strategy based on nucleophile can also be applied in asymmetric processes using chiral hypervalent iodine catalysis.

Cavernous sinus thrombosis with central retinal artey occlusion in COVID-19: A case report and review of literature

Coronavirus disease-2019 (COVID-19) is showing a wide spectrum of ocular manifestations. They are creeping from vision sparing to irreversible visual loss as a result of its thromboembolic events. Hypercoagulability associated with COVID-19 is also called “sepsis-induced coagulopathy” and may predispose to thromboembolic phenomenon that decides the morbidity and mortality of this pandemic. A 37-year-old man presented with no perception of light in the left eye with optic atrophy and macular pucker on fundus examination. Visual evoked potential showed extinguished P 100 wave. His past medical history revealed severe pneumonia secondary to severe acute respiratory syndrome-coronavirus-2 (SARS-CoV 2) infection about 3 months back.

Technology-Based Psychological Interventions for Young Adults With Early Psychosis and Cannabis Use Disorder: Qualitative Study of Patient and Clinician Perspectives

Background

The persistence of cannabis use disorder (CUD) in young adults with first-episode psychosis (FEP) is associated with poor clinical and functional outcomes. Face-to-face psychological interventions are effective in treating CUD. However, their use in early intervention services (EISs) for psychosis is inconsistent because of barriers, including high workload and heterogeneity in training of clinicians and lack of motivation for treatment among patients. Tailoring new technology-based psychological interventions (TBPIs) to overcome these barriers is necessary to ensure their optimal acceptability.

Objective

The aim of this study is twofold: to explore psychological intervention practices and intervention targets that are relevant for treating CUD in individuals with early psychosis and to explore factors related to the development and implementation of a technology-assisted psychological intervention.

Methods

A total of 10 patients undergoing treatment for FEP and CUD in EISs participated in a focus group in June 2019. Semistructured individual interviews were conducted with 10 clinicians working in first-episode clinics in the province of Québec, Canada. A hybrid inductive-deductive approach was used to analyze data. For the deductive analysis, we used categories of promoting strategies found in the literature shown to increase adherence to web-based interventions for substance use (ie, tailoring, reminders, delivery strategies, social support, and incentives). For the inductive analysis, we identified new themes through an iterative process of reviewing the data multiple times by two independent reviewers.

Results

Data were synthesized into five categories of factors that emerged from data collection, and a narrative synthesis of commonalities and differences between patient and clinician perspectives was produced. The categories included attitudes and beliefs related to psychological interventions (eg, behavioral stage of change), strategies for psychological interventions (eg, motivational interviewing, cognitive behavioral therapy, psychoeducation, stress management), incentives (eg, contingency management), general interest in TBPIs (eg, facilitators and barriers of TBPIs), and tailoring of TBPIs (eg, application needs and preferences, outcome measures of interest for clinicians).

Conclusions

This study provides a comprehensive portrait of the multifaceted needs and preferences of patients and clinicians related to TBPIs. Our results can inform the development of smartphone- or web-based psychological interventions for CUD in young adults with early psychosis.

Association of Erythropoietin Gene Polymorphisms With Type 2 Diabetic Retinopathy in Adult Patients From Northern India

OBJECTIVES

Our aim in this study was to determine the association of erythropoietin (EPO) gene polymorphisms with diabetic retinopathy in type 2 diabetes patients from northern India.

METHODS

In this case-control study, we recruited 614 participants, consisting of 302 diabetic retinopathy cases and 312 individuals with confirmed type 2 diabetes without retinopathy as controls. EPO polymorphism analysis was performed in all participants using polymerase chain reaction and direct DNA sequence analysis.

RESULTS

The genotype distribution and allele frequency of the c.246+265G>A (rs507392) polymorphism in differed significantly (p<0.05) between the retinopathy and control groups. For the -1306C>A (rs1617640) polymorphism, genotype distribution among the 2 groups analyzed differed significantly (p=0.047), but the distribution of allele frequency was not found to be statistically significant (p=0.07). For the c.∗772G>T (rs551238) variant, genotype distribution did not differ significantly when comparing the 2 groups (p=0.062), but allele frequency distribution did differ significantly (p=0.045). For the polymorphisms analyzed, namely rs507392 and rs1617640, a statistically significant association with retinopathy was observed (dominant model: adjusted odds ratio [OR], 2.23; 95% confidence interval [CI], 1.36 to 3.35; p<0.01; codominant model: adjusted OR, 1.45; 95% CI, 1.00 to 2.09; p=0.048). However, no significant association between c.∗772G>T (rs551238) polymorphism and diabetic retinopathy was found.

CONCLUSIONS

Our findings show 2 polymorphisms (c.246+265G>A [rs507392] and -1306C>A [rs1617640]) in EPO to be risk factors for type 2 diabetic retinopathy in a northern Indian cohort. To our knowledge, this is the first report from India to demonstrate an association between EPO gene polymorphisms and retinopathy.

Effect of fibronectin, FGF-2, and BMP4 in the stemness maintenance of BMSCs and the metabolic and proteomic cues involved

Background

Growing evidence suggests that the pluripotent state of mesenchymal stem cells (MSCs) relies on specific local microenvironmental cues such as adhesion molecules and growth factors. Fibronectin (FN), fibroblast growth factor 2 (FGF2), and bone morphogenetic protein 4 (BMP4) are the key players in the regulation of stemness and lineage commitment of MSCs. Therefore, this study was designed to investigate the pluripotency and multilineage differentiation of bone marrow-derived MSCs (BMSCs) with the introduction of FN, FGF-2, and BMP4 and to identify the metabolic and proteomic cues involved in stemness maintenance.

Methods

To elucidate the stemness of BMSCs when treated with FN, FGF-2, and BMP4, the pluripotency markers of OCT4, SOX2, and c-MYC in BMSCs were monitored by real-time PCR and/or western blot. The nuclear translocation of OCT4, SOX2, and c-MYC was investigated by immunofluorescence staining. Multilineage differentiation of the treated BMSCs was determined by relevant differentiation markers. To identify the molecular signatures of BMSC stemness, gas chromatography-mass spectrometry (GC-MS), liquid chromatography-tandem mass spectrometry (LC-MS/MS), and bioinformatics analysis were utilized to determine the metabolite and protein profiles associated with stem cell maintenance.

Results

Our results demonstrated that the expression of stemness markers decreased with BMSC passaging, and the manipulation of the microenvironment with fibronectin and growth factors (FGF2 and BMP4) can significantly improve BMSC stemness. Of note, we revealed 7 differentially expressed metabolites, the target genes of these metabolites may have important implications in the maintenance of BMSCs through their effects on metabolic activity, energy production, and potentially protein production. We also identified 21 differentially abundant proteins, which involved in multiple pathways, including metabolic, autophagy-related, and signaling pathways regulating the pluripotency of stem cells. Additionally, bioinformatics analysis comfirned the correlation between metabolic and proteomic profiling, suggesting that the importance of metabolism and proteome networks and their reciprocal communication in the preservation of stemness.

Conclusions

These results indicate that the culture environment supplemented with the culture cocktail (FN, FGF2, and BMP4) plays an essential role in shaping the pluripotent state of BMSCs. Both the metabolism and proteome networks are involved in this process and the modulation of cell-fate decision making. All these findings may contribute to the application of MSCs for regenerative medicine.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13287-021-02227-7.

CAP rigidification of MS-275 and chidamide leads to enhanced antiproliferative effects mediated through HDAC1, 2 and tubulin polymerization inhibition

The study focuses on the prudent design and synthesis of anilide type class I HDAC inhibitors employing a functionalized pyrrolo[2,3-d]pyrimidine skeleton as the surface recognition part. Utilization of the bicyclic aromatic ring to fabricate the target compounds was envisioned to confer rigidity to the chemical architecture of MS-275 and chidamide. In-vitro enzymatic and cellular assays led to the identification of compound 7 as a potent inhibitor of HDAC1 and 2 isoform that exerted substantial cell growth inhibitory effects against human breast MDA-MB-231, cervical HeLa, breast MDA-MB-468, colorectal DLD1, and colorectal HCT116 cell lines with an IC₅₀ values of 0.05-0.47 μM, better than MS-275 and chidamide. In addition, the anilide 7 was also endowed with a superior antiproliferative profile than MS275 and chidamide towards the human cutaneous T cell lymphoma (HH and HuT78), leukemia (HL60 and KG-1), and HDACi sensitive/resistant gastric cell lines (YCC11 and YCC3/7). Exhaustive exploration of the construct 7 confirmed it to be a microtubule-targeting agent that could trigger the cell-cycle arrest in mitosis. In pursuit of extracting the benefits of evidenced microtubule-destabilizing activity of the anilide 7, it was further evaluated against non-small-cell lung cancer cell lines as well as the multiple-drug resistant uterine cancer cell line (MES-SA/Dx5) and overwhelmingly positive results in context of inhibitory effects were attained. Furthermore, molecular modelling studies were performed and some key interactions of the anilide 7 with the amino acid residues of the active site of HDAC1 isoform and tubulin were figured out.

Development and pilot testing of an oral hygiene self-care photonovel for Punjabi immigrants: a qualitative study

INTRODUCTION

The purpose of this research study was to develop and pilot test a culturally and linguistically appropriate oral hygiene self-care photonovel for Punjabi immigrants.

METHODS

Purposeful sampling technique was used to recruit 5 members of a Punjabi community organization (the Sikh Women's Association of Montreal) for participation in 3 focus group sessions in August 2015. A thematic content analysis approach was used to sort the data, enabling identification of the storyline and photonovel contents from the themes that emerged. Comic Life 3 version 3.1.1 software was used to create a "Safeguard Your Smile" (SYS) photonovel, which was printed for pilot testing. Ten additional participants were recruited for this pilot testing, enabling further revision of the photonovel based on their suggestions.

RESULTS

Four major themes emerged from the focus group discussions: 1) lack of understanding of oral hygiene self-care and risk factors; 2) lack of oral hygiene self-care-related awareness and routine; 3) lack of emphasis on prevention by oral health care providers; and 4) perceived barriers to accessing dental health care. Thematic content analysis revealed a lack of knowledge of oral hygiene self-care skills and routine. Guided by these overarching themes, a final version of the photonovel script was created including photographs of key characters. The photonovel was subsequently printed for pilot testing. Pilot test results revealed close to 80% of participants agreed that the SYS photonovel was culturally and linguistically appropriate and easy to understand.

CONCLUSIONS

A culturally and linguistically appropriate photonovel may be a useful tool for enhancing oral hygiene self-care knowledge among ethnic communities. Further studies are required to test the effectiveness of such a tool.

Cardiac tamponade and its medicolegal aspects: A case report

Cardiac tamponade is a life-threatening emergency having both acute and a delayed presentation. In the latter there is a potential for medical practitioners to miss the diagnosis as happened in our case resulting in allegations of medical negligence. Before starting the autopsy in such cases, the forensic pathologist should try to obtain the complete treatment record and be ready to request ancillary investigations as required. We report a case of death due to cardiac tamponade caused by a penetrating injury to the heart. A feature of this case was the failure of our medical system to diagnose the condition and the legal system due to failure of the police to register the first information report under appropriate legal sections.

Cost-effective diagnostic kits for selective detection of gaseous H2S

Unsymmetrical tri-functionalized perylene diimide dyes were explored for making solution- and solid-state-based colorimetric kits for the detection of gaseous and aqueous H2S.

The Study of Postoperative Recall in Patients under Total Intravenous Anesthesia

BACKGROUND

The incidence of postoperative recall under total intravenous anesthesia (TIVA) is not yet fully established. Avoidance of inhalational agent is a known risk factor for awareness. In addition, lack of reliable technique to monitor drug concentration needed for adequate depth of anesthesia makes TIVA challenging. Hence, we intend to evaluate our standard anesthesia practice for postoperative recall.

METHODOLOGY

This questionnaire-based observational study was done over the period of 2 years. We enrolled 1080 adult (American Society of Anesthesiologists physical status Class I or II) patients undergoing TIVA for Endoscopic retrograde cholangiopancreatography (ERCP). All patients received fentanyl, midazolam and propofol-based anesthesia. Manual boluses of propofol were given to achieve adequate sedation. (Ramsay sedation scale of 5) in accordance with clinical signs as judged by the primary anesthesiologist. Postoperatively within 12-24 h, patients were assessed for recall using Brice questionnaire. Primary outcome was number of patients reporting postoperative recall in the Brice interview. Secondary outcome was the incidence of dreaming.

RESULTS

On postoperative interview, none of the patients reported awareness. 12.5% of patients had dreams which were pleasant. None of the dreams was unpleasant. The worst thing about surgery was pain.

CONCLUSION

Our study suggests that if adequate doses of propofol are adhered to and necessary action is taken against responses indicating wakefulness, postoperative recall under TIVA is an uncommon occurrence.

A Network Biology Approach to Understanding the Tissue-Specific Roles of Non-Coding RNAs in Arthritis

Discovery of non-coding RNAs continues to provide new insights into some of the key molecular drivers of musculoskeletal diseases. Among these, microRNAs have received widespread attention for their roles in osteoarthritis and rheumatoid arthritis. With evidence to suggest that long non-coding RNAs and circular RNAs function as competing endogenous RNAs to sponge microRNAs, the net effect on gene expression in specific disease contexts can be elusive. Studies to date have focused on elucidating individual long non-coding-microRNA-gene target axes and circular RNA-microRNA-gene target axes, with a paucity of data integrating experimentally validated effects of non-coding RNAs. To address this gap, we curated recent studies reporting non-coding RNA axes in chondrocytes from human osteoarthritis and in fibroblast-like synoviocytes from human rheumatoid arthritis. Using an integrative computational biology approach, we then combined the findings into cell- and disease-specific networks for in-depth interpretation. We highlight some challenges to data integration, including non-existent naming conventions and out-of-date databases for non-coding RNAs, and some successes exemplified by the International Molecular Exchange Consortium for protein interactions. In this perspective article, we suggest that data integration is a useful in silico approach for creating non-coding RNA networks in arthritis and prioritizing interactions for further in vitro and in vivo experimentation in translational research.

Prospecting the antimicrobial and antibiofilm potential of Chaetomium globosum an endophytic fungus from Moringa oleifera

The current study prospects the antimicrobial potential of an endophytic fungus Chaetomium globosum which showed a wide spectrum antimicrobial activity against the tested pathogenic microorganisms. This is apparently the first report where Chaetomium globosum as an endophyte from Moringa oleifera showed antimicrobial potential and is optimized for physiochemical parameters to enhance the antimicrobial metabolites production. In the classical optimization yeast peptone dextrose medium, inoculum size of two discs, incubation period of 6 days, production temperature of 25 ºC and pH 7 was best supportive for optimal growth and antimicrobial activity whereas maltose and ammonium nitrate were the best carbon and nitrogen sources, respectively. The statistical optimization resulted in up to 1.33 fold increase in antimicrobial activity. Chloroform was found to be the best extractant. The chloroformic extract showed minimum inhibitory concentration ranging from 0.05 to 5 mg/ml and its microbicidal nature was established by viable cell count studies. The efficacy of the extract was also established in terms of post antibiotic effect which ranged from 2 to 20 h. The chloroformic extract exhibited the good antibiofilm potential and was also found to be biosafe. The clinical relevance of the study was justified as it showed good antimicrobial efficacy against some resistant clinical isolates, too.

Bioactive potential of endophytic fungus Chaetomium globosum and GC-MS analysis of its responsible components

The recent exploration of various medicinal plants for bioactive potential has led to the growing interest to explore their endophytes for such bioactive potential which may turn out to be better option than the plants. In the present study, Chaetomium globosum, an endophytic fungus isolated from Moringa oleifera Lam has been explored for its various biological activities. The chloroformic extract of C. globosum showed good antimutagenicity against the reactive carcinogenic mutagen, 2-aminofluorene (2-AF) in Ames test. The antiproliferative activity against various cell lines such as HCT-15, HeLa and U87-MG was found to be dose dependent and the viability reduced to 9.26%, 15.7% and 16.3%, respectively. Further, the chloroformic fungal extract was investigated for free radical scavenging activity using 2, 2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azino-bis(3-ethyl-benzthiazolin-6-sulfonic acid) assay which showed the IC₅₀ value of 45.16 µg/ml and 50.55 µg/ml, respectively. The fungal extract also showed good ferric reducing power. Total phenolic and flavonoid content was found to be in linear relationship with the antioxidant potential of the fungal extract. High performance liquid chromatography showed the presence of phenolics which may help to combat the free radicals. The presence of various bioactive compounds was analysed by GC–MS which endorsed Chaetomium globosum to be a promising candidate for drug development.

Perylene diimides: will they flourish as reaction-based probes?

Perylene diimides (PDI) are a well-studied class of functional organic dyes, and in recent years, they have been accepted as promising scaffolds for the design of small molecule/polymer-based chromogenic and fluorogenic reaction-based-probes because of their strong absorption combined with high fluorescence quantum yield in organic solvents, low reduction potential, good electron-acceptor properties, and broad color range properties. Undoubtedly, the intrinsically poor solubility of PDI-based derivatives in water greatly hampers their exploitation as reaction-based probes; however, a vast array of functionalizations now offer design strategies that have resulted in >50% solubility of PDI derivatives in water. A chemodosimeter, wherein chemical transformation is achieved by specific reactions, affords naked-eye visibility, fast response time, sensitivity, ratiometric response, and low cost. The present review focuses on the progress of PDI-based chemodosimeters achieved so far since the inception of this member in the rylene diimide family. This comprehensive review may facilitate the development of more powerful chemodosimeters based on PDI for broad and exciting applications in the future.

Self-inflicted injuries: Three case reports

The means by which people self-harm are diverse and so are the motives that drive them. They are intended for personal gain which may be psychological, legal or material. Fabricated injuries may be self-inflicted or permitted by others. We present three cases of fabricated injuries over the shoulder and upper limbs both alleging assault with a firearm. In all the cases meticulous examination elicited suspicion on how these were caused. Meticulous examination is essential to differentiate true from false accusations so that no innocent person is punished.