Trastuzumab deruxtecan in human epidermal growth factor receptor 2-positive breast cancer brain metastases: a systematic review and meta-analysis

BACKGROUND

Trastuzumab deruxtecan (T-DXd) has shown promising results in patients with breast cancer brain metastases (BCBMs). We conducted a systematic review and meta-analysis to evaluate the effectiveness and safety of T-DXd in the human epidermal growth factor receptor 2 (HER2)-positive BCBM population.

PATIENTS AND METHODS

We searched PubMed, Embase, and Cochrane Library databases as well as American Society of Clinical Oncology (ASCO), European Society for Medical Oncology (ESMO), and San Antonio Breast Cancer Symposium (SABCS) websites for clinical trials (CTs) and observational studies evaluating T-DXd in patients with HER2-positive BCBM. Heterogeneity was assessed with I2 statistics. Random effects models were used for all statistical analyses, which were carried out using R software (version 4.2.2).

RESULTS

Ten studies were included, six CTs (n = 189) and four observational studies (n = 130), with a total of 319 patients. The median progression-free survival was 15 months [95% confidence interval (CI) 13.9-16.1 months]. The objective response rate (ORR) was 61% (95% CI 52% to 70%), and the intracranial (IC)-ORR was 61% (95% CI 54% to 69%). No significant differences in ORR and IC-ORR were observed between CTs and observational studies (P = 0.31 and 0.58, respectively). The clinical benefit rate (CBR) was 80% (95% CI 52% to 94%), and the IC-CBR was 70% (95% CI 54% to 82%). The ORR was 68% (95% CI 57% to 77%) in the subgroup of patients with stable BMs and 60% (95% CI 48%-72%) in patients with active BM, with no significant difference between groups (P = 0.35).

CONCLUSIONS

Our systematic review and meta-analysis supports the IC activity of T-DXd in patients with stable BM and active BM.

TRIAL REGISTRATION

International Prospective Register of Systematic Reviews (PROSPERO) under the protocol number CRD42023422589.

Nylon fiber waste as a prominent adsorbent for Congo red dye removal

In this research nylon fibers wastes (NF) were fabricated into porous sheet using a phase inversion technique to be utilized as an adsorbent materials for Congo red dye (CR). The fabricated sheet denoted as NS was characterized using FTIR and XRD. The surface studies of the adsorbent materials using SEM and BET analysis reveals a highly pores structure with an average pore volume 0.61 cc/g and BET surface area of 767 m2/g. The adsorption studies of fabricated NS were employed into CR at different parameters as pH, effect of time and dye concentration. The adsorption isotherm and kinetic studies were more fit to Langmuir and pseudo second order models. The maximum adsorption capacity qmax reached 188 mg/g with removal percentage of 95 for CR concentration of 400 mg/L at pH 6 and 0.025 g NS dose for 10 ml CR solution. The regeneration study reveals a prominent adsorption behavior of NS with removal % of 88.6 for CR (300 mg/L) after four adsorption desorption cycles. Effect of incorporation of NaonFil Clay to NS was studied using Response Surface Methodology (RSM) modeling and reveals that 98.4% removal of CR could be achieved by using 19.35% wt. of fiber with 8.2 g/L dose and zero clay, thus at a predetermined parameters studies of NanoFil clay embedded into NS, there are no significant effect for %R for CR.

Morpho-physiological and phytohormonal changes during the induction of adventitious root development stimulated by exogenous IBA application in Magnolia biondii Pamp

Abstract Magnolia biondii Pamp is an important ornamental tree species widely grown and used as a rootstock in the propagation of different Magnolia varieties. In the current studies, anatomical, physiological and endogenous hormones were studied to check the effect of IBA 750 mg/L on the adventitious rooting and to provide theoretical and technical support for the propagation of Magnolia biondii Pamp through stem cuttings. Two thousand stem cuttings were prepared and divided into two groups i.e., IBA treated cuttings and water control. For the evaluation of antioxidant enzyme activities, and endogenous hormones levels, samples were collected on the day of planting and each 5th day and further steps were carried out in the laboratory according to the protocols and proper precautions. For the anatomical observations, samples were collected on the 13th, 15th, and 17th day for IBA treated cuttings while 21st, 23rd, and 25th day for control. Collected samples were preserved in the FAA solution and further observations were carried out in the laboratory. Anatomical observations showed that it took 13 days for the differentiation of root primordia to the appearance of young adventitious roots in IBA treated cuttings, while it took 21 days to develop primordia in the control. Antioxidant enzyme activities involved in ROS were significantly higher in the IBA treated cuttings compared to control. POD showed a peak on the 13th day before the emergence of roots in IBA treated cuttings while it showed a peak on the 21st day in the control. PPO showed a peak on the 21st day in the IBA treated cuttings while it showed a peak on the 29th day in the control. SOD showed a peak on the 17th day in IBA treated cuttings, while it showed a peak on the 25th day in the control. Exogenous application of IBA enhanced the endogenous IAA and GA3 levels compared to CK, while it reduced the levels of ABA continuously at the time of rooting and then increased gradually. Inclusively, our study suggests that IBA 750 mg/L is efficient for the rooting of Magnolia biondii Pamp cuttings, as it enhanced the process of antioxidant enzyme activities, endogenous hormones levels and reduced the time of root formation which is evident from the anatomical observations.

Low delayed bleeding and high complete closure rate of mucosal defects with the novel through-the-scope dual-action tissue clip after endoscopic resection of large nonpedunculated colorectal lesions (with video)

BACKGROUND AND AIMS

Complete closure after endoscopic resection of large nonpedunculated colorectal lesions (LNPCLs) can reduce delayed bleeding but is challenging with conventional through-the-scope (TTS) clips alone. The novel dual-action tissue (DAT) clip has clip arms that open and close independently of each other, facilitating tissue approximation. We aimed to evaluate the rate of complete closure and delayed bleeding with the DAT clip after endoscopic resection of LNPCLs.

METHODS

This was a multicenter prospective cohort study of all patients who underwent defect closure with the DAT clip after EMR or endoscopic submucosal dissection (ESD) of LNPCLs ≥20 mm from July 2022 to May 2023. Delayed bleeding was defined as a bleeding event requiring hospitalization, blood transfusion, or any intervention within 30 days after the procedure. Complete closure was defined as apposition of mucosal defect margins without visible submucosal areas <3 mm along the closure line.

RESULTS

One hundred seven patients (median age, 64 years; 42.5% women) underwent EMR (n = 63) or ESD (n = 44) of LNPCLs (median size, 40 mm; 74.8% right-sided colon) followed by defect closure. Complete closure was achieved in 96.3% (n = 103) with a mean of 1.4 ± .6 DAT clips and 2.9 ± 1.8 TTS clips. Delayed bleeding occurred in 1 patient (.9%) without requiring additional interventions.

CONCLUSIONS

The use of the DAT clip in conjunction with TTS clips achieved high complete defect closure after endoscopic resection of large LNPCLs and was associated with a .9% delayed bleeding rate. Future comparative trials and formal cost-analyses are needed to validate these findings. (Clinical trial registration number: NCT05852457.).

Outcomes of cold snare endoscopic mucosal resection of nonampullary duodenal adenomas ≥1 cm: a multicenter study

BACKGROUND AND AIMS

Endoscopic mucosal resection (EMR) with use of electrocautery (conventional EMR) has historically been used to remove large duodenal adenomas; however, use of electrocautery can predispose to adverse events including delayed bleeding and perforation. Cold snare EMR (cs-EMR) has been shown to be safe and effective for removal of colon polyps, but data regarding its use in the duodenum are limited. The aim of this study was to evaluate the efficacy and safety of cs-EMR for nonampullary duodenal adenomas ≥1 cm.

METHODS

This was a multicenter retrospective study of patients with nonampullary duodenal adenomas ≥1 cm who underwent cs-EMR from October 2014 to May 2023. Patients who received any form of thermal therapy were excluded. Primary outcomes were technical success and rate of recurrent adenoma. Secondary outcomes were adverse events and predictors of recurrence.

RESULTS

A total of 125 patients underwent resection of 127 nonampullary duodenal adenomas with cs-EMR. Follow-up data were available in 89 cases (70.1%). The recurrent adenoma rate was 31.5% (n = 28). Adverse events occurred in 3.9% (n = 5), with 4 cases of immediate bleeding (3.1%) and 1 case of delayed bleeding (.8%). There were no cases of perforation. The presence of high-grade dysplasia was found to be an independent predictor of recurrence (odds ratio, 10.9 [95% confidence interval, 1.1-102.1]; P = .036).

CONCLUSIONS

This retrospective multicenter study demonstrates that cs-EMR for nonampullary duodenal adenomas is safe and technically feasible with an acceptable recurrence rate. Future prospective studies are needed to directly compare outcomes of cs-EMR with conventional and underwater EMR.

Screening of IL-22 first and second introns and FOXP3 second exon for SNPs and mutations with potential role in the susceptibility of SLE in selected population

OBJECTIVE

The main objective of performing this study was the mutational analysis of Forkhead box family member (FoxP3) and Interleukin-22 (IL-22) genes and their associations with systemic lupus erythematosus (SLE).

MATERIALS AND METHODS

A total of sixty blood samples were collected from SLE patients from different hospitals in Lahore. Proforma was based on American College of Rheumatology (ACR) criteria. The total time for this research was one year (2018-2019). DNA was extracted, and FoxP3 and IL-22 genes were polymerized through PCR and further sequenced through the Sanger Sequencing method. Chromas version 2.6.6 was used for the similarity index of sequences. NG_060763 and NG_007392.1 were used as Reference Sequences of IL-22 and FoxP3 genes, respectively.

RESULTS

Three already identified Single Nucleotide Polymorphisms (SNPs) in the IL-22 gene i.e., rs2227491, rs2227485, and rs2227513, were confirmed in the sequencing results of SLE patients. Results showed that there were nine novel mutations (27.27%) in the case of the IL-22 gene in the studied genotyped samples. These SNPs had remarkably increased allele T frequency in rs2227485 and allele C frequency in rs2227491 and rs2227513. On the other hand, in the case of FoxP3 gene exon 2, there was an addition of T at position 10 in the intronic portion, thus not involved in the progression of the disease.

CONCLUSIONS

The importance of cytokine-mediated signaling pathways, such as the IL-22 gene, is thus established. Novel variants in the IL-22 gene likely contributed significantly to the development of this autoimmune disorder. The current study found that the dysregulation of the inflammatory markers in SLE is not related to the FoxP3 gene, even though FoxP3 is implicated in the tolerance process.

A new promising approach to urodynamic stress urinary incontinence care can help menopausal women

Introduction

The goal of this study is to evaluate the effectiveness of single-incision mini-sling in the surgical treatment of postmenopausal urodynamic stress urinary incontinence (SUI) compared to the standard trans-obturator mid-urethral sling.

Material and methods

This prospective study was carried out in two tertiary centres; Al-Azhar University Maternity & Urology Hospitals. A total of 120 postmenopausal women with urodynamic SUI were randomized to undergo either single-incision mini-sling (n = 60) or standard trans-obturator mid-urethral sling procedure (n = 60) from May 2019 until Oct 2021. Main outcome measures: efficacy was evaluated utilizing objective cure rate (cough stress test) and subjective cure rate (Sandvik incontinence severity index and International Consultations on Incontinence Questionnaire - Short Form), intraoperative and postoperative complications, and postoperative pain (using a visual analogue scale).

Results

The single-incision mini-sling (SIMS) and transobturator tape (TOT) groups had no statistically significant difference in subjective and objective cure rates (p > 0.05). Compared with the transvaginal tape O group, patients in the SIMS group had significantly less postoperative pain, shorter operative duration, and less intraoperative blood loss (all p-values < 0.05). No significant difference in perioperative complications was observed between both groups.

Conclusions

Single-incision mini-sling was superior to TOT in postmenopausal as SIMS is of similar effectiveness, more safe and minimally invasive with earlier ambulance.

A Comprehensive Review on Cancer Vaccines and Vaccine Strategies in Hepatocellular Carcinoma

HCC, the most prevalent form of primary liver cancer, presents a substantial global health challenge due to its high mortality and limited therapeutic options. This review delves into the potential of cancer vaccines as a novel therapeutic avenue for HCC. We examine the various categories of cancer vaccines, including peptide-based, dendritic cell-based, viral vector-based, DNA, and mRNA vaccines, and their potential application in HCC management. This review also addresses the inherent challenges in vaccine development, such as tumor heterogeneity and the need for identifying tumor-specific antigens. We underscore the role of cancer vaccines in reshaping the immune environment within HCC, fostering durable immune memory, and their potential in combination therapies. The review also evaluates clinical trials and emphasizes the necessity for more extensive research to optimize vaccine design and patient selection criteria. We conclude with future perspectives, highlighting the significance of personalized therapies, innovative antigen delivery platforms, immune modulatory agents, and predictive biomarkers in revolutionizing HCC treatment. Simple Summary: This review explores the potential of cancer vaccines as a promising therapeutic strategy for hepatocellular carcinoma (HCC), a prevalent and deadly liver cancer. The authors discuss various types of cancer vaccines, their challenges, and their role in modulating the immune response within HCC. They also highlight clinical trials and future perspectives, emphasizing the importance of personalized therapies, novel antigen delivery platforms, and predictive biomarkers. The findings from this research could significantly impact the research community by providing a comprehensive understanding of the current state of cancer vaccines for HCC, thereby guiding future research and potentially transforming HCC treatment strategies.

Potential of a Miniature Spectral Analyzer for District-Scale Monitoring of Multiple Gaseous Air Pollutants

Gas sensors that can measure multiple pollutants simultaneously are highly desirable for on-site air pollution monitoring at various scales, both indoor and outdoor. Herein, we introduce a low-cost multi-parameter gas analyzer capable of monitoring multiple gaseous pollutants simultaneously, thus allowing for true analytical measurement. It is a spectral sensor consisting of a Fourier-transform infrared (FTIR) gas analyzer based on a mid-infrared (MIR) spectrometer. The sensor is as small as 7 × 5 × 2.5 cm³. It was deployed in an open-path configuration within a district-scale climatic chamber (Sense City, Marne-la-Vallée, France) with a volume of 20 × 20 × 8 m³. The setup included a transmitter and a receiver separated by 38 m to enable representative measurements of the entire district domain. We used a car inside the climatic chamber, turning the engine on and off to create time sequences of a pollution source. The results showed that carbon dioxide (CO₂) and water vapor (H₂O) were accurately monitored using the spectral sensor, with agreement with the reference analyzers used to record the pollution levels near the car exhaust. Furthermore, the lower detection limits of CO, NO₂ and NO were assessed, demonstrating the capability of the sensor to detect these pollutants. Additionally, a preliminary evaluation of the potential of the spectral sensor to screen multiple volatile organic compounds (VOCs) was conducted at the laboratory scale. Overall, the results demonstrated the potential of the proposed multi-parameter spectral gas sensor in on-site gaseous pollution monitoring.

A paradigm of higher success rate of intracytoplasmic sperm injection - preovulatory human chorionic gonadotropin-day serum oestradiol

Introduction

The aim of the study is to evaluate the correlation between the level of serum oestradiol (E2) on the day of human chorionic gonadotropin (hCG-day) administration and successful intracytoplasmic sperm injection (ICSI) outcome.

Material and methods

This prospective study was performed during the period from January 2019 to September 2021, at Zagazig Obstetrics and Gynecology Department, and Al-Azhar Obstetrics and Gynecology Department, and private ART centers. One hundred and fifty women attending the infertility clinic for ICSI cycles. All women were divided into 5 groups according to the serum E2 level on the day of hCG administration: Group A - serum E2 < 1000 pg/ml; Group B - serum E2 1000 to < 2000 pg/ml; Group C - serum E2 2000 to < 3000 pg/ml;Group D - serum E2 3000 to < 4000 pg/ml; Group E - serum E2 ≥ 4000 pg/ml.

Results

The highest fertilization rate (58.1%) was among women with E2 ≥ 4000 pg/ml, while the lowest (37%) was in women with E2 1000 to < 2000 pg/ml. Also, the highest pregnancy rate (21.5%) was among women with E2 > 4000 pg/ml, while the lowest (5.3%) was in women with E2 < 1000 pg/ml. In the current study the median serum E2 level on the day of hCG administration was highly significant in women who became pregnant when compared to women who did not. The best cut-off value of serum E2 at hCG administration was ≥ 3682.3 pg/ml.

Conclusions

this study suggests that the optimal range of E2 level for achieving a successful pregnancy is > 4000 pg/ml.

Design and Optimization of a Self-Protected Thin Film c-Si Solar Cell against Reverse Bias

Current mismatch due to solar cell failure or partial shading of solar panels may cause a reverse biasing of solar cells inside a photovoltaic (PV) module. The reverse-biased cells consume power instead of generating it, resulting in hot spots. To protect the solar cell against the reverse current, we introduce a novel design of a self-protected thin-film crystalline silicon (c-Si) solar cell using TCAD simulation. The proposed device achieves two distinct functions where it acts as a regular solar cell at forward bias while it performs as a backward diode upon reverse biasing. The ON-state voltage (V_ON) of the backward equivalent diode is found to be 0.062 V, which is lower than the value for the Schottky diode usually used as a protective element in a string of solar cells. Furthermore, enhancement techniques to improve the electrical and optical characteristics of the self-protected device are investigated. The proposed solar cell is enhanced by optimizing different design parameters, such as the doping concentration and the layers' thicknesses. The enhanced cell structure shows an improvement in the short-circuit current density (J_SC) and the open-circuit voltage (V_OC), and thus an increased power conversion efficiency (PCE) while the V_ON is increased due to an increase of the J_SC. Moreover, the simulation results depict that, by the introduction of an antireflection coating (ARC) layer, the external quantum efficiency (EQE) is enhanced and the PCE is boosted to 22.43%. Although the inclusion of ARC results in increasing V_ON, it is still lower than the value of V_ON for the Schottky diode encountered in current protection technology.

Boosting the Electrostatic MEMS Converter Output Power by Applying Three Effective Performance-Enhancing Techniques

This current study aims to enhance the electrostatic MEMS converter performance mainly by boosting its output power. Three different techniques are applied to accomplish such performance enhancement. Firstly, the power is boosted by scaling up the technology of the converter CMOS accompanied circuit, the power conditioning, and power controlling circuits, from 0.35 µm to 0.6 µm CMOS technology. As the converter area is in the range of mm², there are no restrictions concerning the scaling up of the accompanied converter CMOS circuits. As a result, the maximum voltage of the system for harvesting energy, V_max, which is the most effective system constraint that greatly affects the converter's output power, increases from 8 V to 30 V. The output power of the designed and simulated converter based on the 0.6 µm technology increases from 2.1 mW to 4.5 mW. Secondly, the converter power increases by optimizing its technological parameters, the converter thickness and the converter finger width and length. Such optimization causes the converter output power to increase from 4.5 mW to 11.2 mW. Finally, the converter structure is optimized to maximize its finger length by using its wasted shuttle mass area which does not contribute to its capacitances and output power. The proposed structure increases the converter output power from 11.2 mW to 14.29 mW. Thus, the three applied performance enhancement techniques boosted the converter output power by 12.19 mW, which is a considerable enhancement in the converter performance. All simulations are carried out using COMSOL Multiphysics 5.4.

Full Optoelectronic Simulation of Lead-Free Perovskite/Organic Tandem Solar Cells

Organic and perovskite semiconductor materials are considered an interesting combination thanks to their similar processing technologies and band gap tunability. Here, we present the design and analysis of perovskite/organic tandem solar cells (TSCs) by using a full optoelectronic simulator (SETFOS). A wide band gap lead-free ASnI₂Br perovskite top subcell is utilized in conjunction with a narrow band gap DPPEZnP-TBO:PC61BM heterojunction organic bottom subcell to form the tandem configuration. The top and bottom cells were designed according to previous experimental work keeping the same materials and physical parameters. The calibration of the two cells regarding simulation and experimental data shows very good agreement, implying the validation of the simulation process. Accordingly, the two cells are combined to develop a 2T tandem cell. Further, upon optimizing the thickness of the front and rear subcells, a current matching condition is satisfied for which the proposed perovskite/organic TSC achieves an efficiency of 13.32%, J_sc of 13.74 mA/cm², and V_oc of 1.486 V. On the other hand, when optimizing the tandem by utilizing full optoelectronic simulation, the tandem shows a higher efficiency of about 14%, although it achieves a decreased J_sc of 12.27 mA/cm². The study shows that the efficiency can be further improved when concurrently optimizing the various tandem layers by global optimization routines. Furthermore, the impact of defects is demonstrated to highlight other possible routes to improve efficiency. The current simulation study can provide a physical understanding and potential directions for further efficiency improvement for lead-free perovskite/organic TSC.

Properties and Applications of Geopolymer Composites: A Review Study of Mechanical and Microstructural Properties

Portland cement (PC) is considered the most energy-intensive building material and contributes to around 10% of global warming. It exacerbates global warming and climate change, which have a harmful environmental impact. Efforts are being made to produce sustainable and green concrete as an alternative to PC concrete. As a result, developing a more sustainable strategy and eco-friendly materials to replace ordinary concrete has become critical. Many studies on geopolymer concrete, which has equal or even superior durability and strength compared to traditional concrete, have been conducted for this purpose by many researchers. Geopolymer concrete (GPC) has been developed as a possible new construction material for replacing conventional concrete, offering a clean technological choice for long-term growth. Over the last few decades, geopolymer concrete has been investigated as a feasible green construction material that can reduce CO₂ emissions because it uses industrial wastes as raw materials. GPC has proven effective for structural applications due to its workability and analogical strength compared to standard cement concrete. This review article discusses the engineering properties and microstructure of GPC and shows its merits in construction applications with some guidelines and suggestions recommended for both the academic community and the industrial sector. This literature review also demonstrates that the mechanical properties of GPC are comparable and even sometimes better than those of PC concrete. Moreover, the microstructure of GPC is significantly different from that of PC concrete microstructure and can be affected by many factors.

Severity of oEsophageal Anastomotic Leak in patients after oesophagectomy: the SEAL score

Background

Anastomotic leak (AL) is a common but severe complication after oesophagectomy. It is unknown how to determine the severity of AL objectively at diagnosis. Determining leak severity may guide treatment decisions and improve future research. This study aimed to identify leak-related prognostic factors for mortality, and to develop a Severity of oEsophageal Anastomotic Leak (SEAL) score.

Methods

This international, retrospective cohort study in 71 centres worldwide included patients with AL after oesophagectomy between 2011 and 2019. The primary endpoint was 90-day mortality. Leak-related prognostic factors were identified after adjusting for confounders and were included in multivariable logistic regression to develop the SEAL score. Four classes of leak severity (mild, moderate, severe, and critical) were defined based on the risk of 90-day mortality, and the score was validated internally.

Results

Some 1509 patients with AL were included and the 90-day mortality rate was 11.7 per cent. Twelve leak-related prognostic factors were included in the SEAL score. The score showed good calibration and discrimination (c-index 0.77, 95 per cent c.i. 0.73 to 0.81). Higher classes of leak severity graded by the SEAL score were associated with a significant increase in duration of ICU stay, healing time, Comprehensive Complication Index score, and Esophagectomy Complications Consensus Group classification.

Conclusion

The SEAL score grades leak severity into four classes by combining 12 leak-related predictors and can be used to the assess severity of AL after oesophagectomy.

Effect of Ketamine on Tourniquet Induced Hypertension

Objective: To compare the frequency of tourniquet induced hypertension in patients undergoing limb surgeries under general anesthesia with intravenous infusion of ketamine and placebo (saline infusion). Study Design: Comparative prospective study. Place and Duration of Study: Anaesthesia Department, Combined Military Hospital, Rawalpindi Pakistan, from May to Nov 2018. Methodology: Total 80 patients undergoing upper and lower limb surgeries with tourniquet application under general anesthesia were randomly assigned into two equivalent groups. Group A (n=40) received intravenous ketamine 0.1 mg/kg bolus followed by infusion at a rate of 2ug/kg/min while Group B (n=40) received intravenous bolus of normal saline followed by its infusion via infusion pump. Systolic blood pressures were recorded by non-invasive method 30 seconds prior to tourniquet inflation and at 60 mins interval after its inflation. Results were characterized using the descriptive statistics. Mean and standard deviation (SD) were used for quantitative variables while frequency and percentages for qualitative variables. The p-value <0.05 was considered as significant. Results: Tourniquet induced hypertension was found in 2 (5.0%) group A patients and 11 (27.50%) group B patients with statistically significant p-value of <0.05. Visual analogue scale score was slightly higher in the Saline group, but the result was statistically not significant (p=0.32). Conclusion: Ketamine infusion reduces the occurrence of tourniquet induced hypertension in patients undergoing surgeries with tourniquet application.

Phytochemical screening and evaluation of antioxidant, total phenolic and flavonoid contents in various weed plants associated with wheat crops

This study explores the antioxidant activity, phytochemical screening, total phenolic and flavonoids contents in the extracts of four locally available weeds plants namely Convolvulus arvensis, Chenopodium murale, Avena fatua and Phalaris minor with different solvents. The antioxidant activities of these extracts were determined via various in-vitro methods such as total antioxidant activity (TAA), reducing power (RP), DPPH (2,2-Diphenyl-1-Picrylhydrazyl) free radical scavenging and hydrogen peroxide scavenging assays. Phytochemical screening was performed both qualitatively as well as quantitatively. Total phenolic content (TPC) and total flavonoid content (TFC) were determined through Folin- Ciocalteu reagent and aluminium chloride methods respectively. Methanol-chloroform solvent showed the presence of a high amount of TPC in milligram of gallic acid equivalent per gram of dry weight (mg of GAE/g of DW) in the extracts of all weeds. Their descending sequence was Avena fatua (74.09) ˃ Phalaris minor (65.66) ˃ Chenopodium murale (64.04) ˃ Convolvulus arvensis (61.905), while, chloroform solvent found to be best solvent for the extraction of TFC. Methanol-chloroform solvent was also found to be best solvent for TAA (Total antioxidant activity assay) which showed values in milligram of ascorbic acid equivalent per gram of dry weight (mg of AAE /g of DW), for DPPH scavenging activity, reducing power (antioxidant activity) and hydrogen peroxide scavenging activity. Phytochemical screening indicated the presence of polyphenols, flavonoids, tannins, saponins, alkaloids and glycosides in these weeds.

Sublethal toxicity of carbofuran in cattle egret (Bubulcus ibis coromandus): hematological, biochemical, and histopathological alterations

This study was aimed to investigate Carbofuran (CF)-induced pathological changes in cattle egret. Two hundred cattle egrets were reared and equally divided into four groups and given different CF concentrations (0.03 mg/L, 0.02 mg/L, 0.01 mg/L and 0 mg/L (control group)). Hematology, serum biochemistry, histopathology, and immunological markers were studied. Our results confirm that CF induces anemic conditions, leukocytosis, elevated liver enzymatic activity, and alterations in renal biomarkers. Moreover, specific microscopic lesions such as multifocal necrosis, pyknotic nuclei, hemorrhages, congestion, and inflammatory cell proliferation were observed in the liver, kidney, spleen, and thymus. These findings suggest that CF can induce harmful effects, so the application of this pesticide in the field must be strictly monitored to mitigate the possibility of exposure to non-target species.

Dosimetric impact of tumor position displacements between photon and proton stereotactic body radiation therapy for lung cancer

Purpose

To investigate the impact of tumor position displacements (TPDs) on tumor dose coverage in photon and proton stereotactic body radiation therapy (SBRT) treatments for lung cancer patients.

Methods

From our institutional database of 2877 fractions from 770 lung cancer patients treated with photon SBRT in 2017-2021, 163 fractions from 88 patients with recorded iso-center shifts of >1.5 cm in any direction under kV-cone-beam CT guidance were identified. By double registrations with bony and tumor alignments, the difference between the iso-center shifts of these two alignments was categorized as TPDs. One fraction from each of 15 patients who had TPD magnitudes >3 mm were selected for this study. For each patient, one proton plan using intensity modulated proton therapy (IMPT) with robust optimization was generated retrospectively. All photon plans had V_100%RX>99% of GTVs and V_100%RX>98% of ITVs. Proton plans were evaluated with two worse-case scenario (voxelwise worst and worst scenario) using 5mm and 3.5% uncertainty to achieve the same planning goals as the corresponding photon plans. These two evaluation proton plans were named proton-1st and proton-2nd plans. The dosimetric effect of TPD was simulated by shifting tumor contours with the corresponding shift on patient specific planning CT and by recalculating the dose of the original plan.

Results

The range of magnitude of TPDs was 3.58-28.71 mm. In photon plans, TPDs did not impact tumor dose coverage, still achieving V_100%RX of the GTV≥99% and V_100%RX of the ITV≥98%. In proton plans for patients with TPDs>10 mm, inadequate target dose coverage was observed. More specifically, 8 fractions of proton-1st plans and 4 fractions of proton-2nd had V_100%RX of the GTV<99% and V_100%RX of the ITV<98%.

Conclusions

Adequate tumor dose coverage was achieved in photon SBRT for magnitude of TPDs up to 20 mm. TPDs had greater impact in proton SBRT and adaptive planning was needed when the magnitude of TPDs>10 mm to provide adequate tumor dose coverage.

Prediction of soil seed bank of piedmont and alluvial environments of Dera Ghazi Khan, Punjab, Pakistan

The current focus is on the overall pattern of seed storage present in the fragments of the soil of piedmont and alluvial landscapes of the environment. The present study predicted the seed banks of both soils of alluvial and piedmont zones in different ecological conditions and evaluate the potential of seeds in the restoration of both environments. The composition of the seed bank of soil is mainly affected by the alluvial environment and the structure of cleared area shows that more species of germinating annual grasses and growable seeds with the higher total number. Extant vegetation structures have an important role in the diversity of soil seed reservoirs, whose composition corresponded with the openness of the site. When in situ soil seed bank is recruited, it helps to restore only some components of the plant community in an alluvial environment. In our current research, it was confirmed that seed richness was higher in number at lower elevation (alluvial) than that at high elevation (piedmont). Seed richness showed a significant negative correlation with anions, cations, while significantly positive with altitude that suggests the richness pattern of the overall seed bank of the area is influenced by various environmental factors.

Assessment of anthropogenic-causing-agents act on waterbirds-diversity in the vicinity of Tarbela Dam, Indus River, Pakistan

Birds are among the best bio-indicators, which can guide us to recognize some of the main conservation concerns in ecosystems. Anthropogenic impacts such as deforestation, habitat degradation, modification of landscapes, and decreased quality of habitats are major threats to bird diversity. The present study was designed to detect anthropogenic causative agents that act on waterbird diversity in Tarbella Dam, Indus River, Pakistan. Waterbird censuses were carried out from March 2019 to February 2020 in multiple areas around the dam. A total of 2990 waterbirds representing 63 species were recorded. We detected the highest waterbird richness and diversity at Pehure whereas the highest density was recorded at Kabbal. Human activity impacts seemed to be the main factor determining the waterbird communities as waterbirds were negatively correlated with the greatest anthropogenic impacts. Waterbirds seem to respond rapidly to human disturbance.

Bandwidth Broadening of Piezoelectric Energy Harvesters Using Arrays of a Proposed Piezoelectric Cantilever Structure

One of the most important challenges in the design of the piezoelectric energy harvester is its narrow bandwidth. Most of the input vibration sources are exposed to frequency variation during their operation. The piezoelectric energy harvester’s narrow bandwidth makes it difficult for the harvester to track the variations of the input vibration source frequency. Thus, the harvester’s output power and overall performance is expected to decline from the designed value. This current study aims to solve the problem of the piezoelectric energy harvester’s narrow bandwidth. The main objective is to achieve bandwidth broadening which is carried out by segmenting the piezoelectric material of the energy harvester into n segments; where n could be more than one. Three arrays with two, four, and six beams are shaped with two piezoelectric segments. The effect of changing the length of the piezoelectric material segment on the resonant frequency, output power, and bandwidth, as well as the frequency response is investigated. The proposed piezoelectric energy harvesters were implemented utilizing a finite element method (FEM) simulation in a MATLAB environment. The results show that increasing the number of array beams increases the output power and bandwidth. For the three-beam arrays, at n equals 2, 6 mW output power and a 9 Hz bandwidth were obtained. Moreover, the bandwidth of such arrays covered around 5% deviation from its resonant frequency. All structures were designed to operate as a steel wheel safety sensor which could be used in train tracks.

Graphene Oxide-Doped MgO Nanostructures for Highly Efficient Dye Degradation and Bactericidal Action

Various concentrations (0.01, 0.03 and 0.05 wt ratios) of graphene oxide (GO) nanosheets were doped into magnesium oxide (MgO) nanostructures using chemical precipitation technique. The objective was to study the effect of GO dopant concentrations on the catalytic and antibacterial behavior of fixed amount of MgO. XRD technique revealed cubic phase of MgO, while its crystalline nature was confirmed through SAED profiles. Functional groups presence and Mg-O (443 cm-1) in fingerprint region was evident with FTIR spectroscopy. Optical properties were recorded via UV-visible spectroscopy with redshift pointing to a decrease in band gap energy from 5.0 to 4.8 eV upon doping. Electron-hole recombination behavior was examined through photoluminescence (PL) spectroscopy. Raman spectra exhibited D band (1338 cm-1) and G band (1598 cm-1) evident to GO doping. Formation of nanostructure with cubic and hexagon morphology was confirmed with TEM, whereas interlayer average d-spacing of 0.23 nm was assessed using HR-TEM. Dopants existence and evaluation of elemental constitution Mg, O were corroborated using EDS technique. Catalytic activity against methyl blue ciprofloxacin (MBCF) was significantly reduced (45%) for higher GO dopant concentration (0.05), whereas bactericidal activity of MgO against E. coli was improved significantly (4.85 mm inhibition zone) upon doping with higher concentration (0.05) of GO, owing to the formation of nanorods.

Sex difference in flux of 27-hydroxycholesterol into the brain

Background and Purpose

The cerebrospinal fluid (CSF)/plasma albumin ratio (QAlb) is believed to reflect the integrity of the blood–brain barrier (BBB). Recently, we reported that QAlb is lower in females. This may be important for uptake of neurotoxic 27‐hydroxycholesterol (27OH) by the brain in particular because plasma levels of 27OH are higher in males. We studied sex differences in the relation between CSF and plasma levels of 27OH and its major metabolite 7α‐hydroxy‐3‐oxo‐4‐cholestenoic acid (7HOCA) with QAlb. We tested the possibility of sex differences in the brain metabolism of 27OH and if its flux into the brain disrupted integrity of the BBB.

Experimental Approach

We have examined our earlier studies looking for sex differences in CSF levels of oxysterols and their relation to QAlb. We utilized an in vitro model for the BBB with primary cultured brain endothelial cells to test if 27OH has a disruptive effect on this barrier. We measured mRNA and protein levels of CYP7B1 in autopsy brain samples.

Key Results

The correlation between CSF levels of 27OH and QAlb was higher in males whereas, with 7HOCA, the correlation was higher in females. No significant sex difference in the expression of CYP7B1 mRNA in brain autopsy samples. A correlation was found between plasma levels of 27OH and QAlb. No support was obtained for the hypothesis that plasma levels of 27OH have a disruptive effect on the BBB.

Conclusions and Implications

The sex differences are discussed in relation to negative effects of 27OH on different brain functions.

LINKED ARTICLES

This article is part of a themed issue on Oxysterols, Lifelong Health and Therapeutics. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v178.16/issuetoc

Prognostic indicators and outcomes following surgical management of metastatic cutaneous squamous cell carcinoma of the head and neck

Metastatic cutaneous SCC carries a poor prognosis with five-year survival of 25%-57%. The aim of this study is to examine the outcomes following surgery with adjuvant therapy for management of metastatic cSCC in a UK-based population. This is a retrospective review of patients with metastatic cSCC of the head and neck who underwent primary surgery at a regional center during a six-year period. Overall and disease specific survival were calculated using Kaplan-Meier and log-rank tests. Results were reported as hazard ratios (HR) with 95% confidence intervals. Forty-five patients met the inclusion criteria. The mean time to discovery of metastases was 9.3 months (range, 0-40 months). Only two patients (4%) had discovery of metastases after two years, with none after 3.3 years. The overall five5-year survival was 31% (95% CI 15%to 48%) with two-year survival at 48% (95% CI 31%to 63%). The median OS survival was 722 days (95% CI 607to 1359). Patients aged >80 years had a decreased OS. This is the largest UK based study documenting the overall and disease specific survival associated with metastatic cutaneous SCC of the head and neck. Our overall survival is comparable to similar studies, but remains poor. Total number of involved nodes, and lymph node ratio were not statistically significant.

Immune modulator therapy compared with vitrectomy for management of complicated intermediate uveitis: a prospective, randomized clinical study

PURPOSE

To compare the benefits and side effects of pars plana vitrectomy with those of systemic immune modulator therapy for patients with complicated intermediate uveitis.

METHODS

This prospective clinical trial enrolled patients with recurrent intermediate uveitis who exhibited minimal improvement of visual acuity, despite injections of periocular steroids. Twenty patients were randomized to the pars plana vitrectomy group or oral steroid and cyclosporine-A group (10 eyes of 10 patients per group). Follow-up was performed for 24 months to study changes in visual acuity, binocular indirect ophthalmoscopy score, fluorescein angiography, and optical coherence tomography findings.

RESULTS

Visual acuity (logarithm of the minimal angle of resolution) significantly improved from 0.71 to 0.42 (p=0.001) in the surgical group, whereas it improved from 0.68 to 0.43 (p=0.001) in the immune modulator therapy group. Seven patients (70%) in the surgical group gained ≥2 lines, and six patients (60%) in the immune modulator therapy group gained ≥2 lines (p=0.970). Fluorescein angiography and optical coherence tomography studies showed that six of seven pars plana vitrectomy patients who had cystoid macular edema experienced improvement, whereas two patients with diffuse macular edema did not experience improvement. In the immune modulator therapy group, three of six patients with cystoid macular edema did not experience improvement, whereas two patients with diffuse macular edema experienced improvement.

CONCLUSIONS

Pars plana vitrectomy and immune modulator therapy resulted in significant improvement in visual function in patients with persistent inflammation secondary to chronic intermediate uveitis. Despite this success, there remains a need for the determination of optimal indications for the use of each modality. Immune modulator therapy was successful for the treatment of diffuse macular edema associated with chronic intermediate uveitis, whereas pars plana vitrectomy was not.

Standard cross-linking protocol versus accelerated and transepithelial cross-linking protocols for treatment of paediatric keratoconus: a 2-year comparative study

PURPOSE

To compare the efficacy, safety and stability of standard epithelium-off cross-linking (SCXL) versus accelerated epithelium-off cross-linking (ACXL) and transepithelial epithelium-on cross-linking (TCXL) in the treatment of progressive keratoconus (KC) in children.

METHODS

This prospective multicentre controlled trial included 271 eyes (136 children) with grade 1-3 progressive KC who were randomized to undergo SCXL (n = 91, as a control group), ACXL (n = 92) or TCXL (n = 88). Uncorrected and corrected distance visual acuity, subjective refraction, pachymetry, keratometry and corneal topography measurements were recorded preoperatively and 6, 12 and 24 months postoperatively.

RESULTS

At 1 year, there was no significant difference in uncorrected distance visual acuity, refractive sphere, cylinder, spherical equivalent or Kmax between the ACXL and SCXL groups; however, during year 2, ACXL regressed while SCXL continued to improve. After 2 years, there were significant differences in all visual, refractive and keratometric components between SCXL and both ACXL and TCXL (p < 0.0001) and between ACXL and TCXL (p < 0.0001). KC progressed in 5.4% of patients who had ACXL and 28.4% of those who had TCXL but in none of those who had SCXL. Vernal keratoconjunctivitis was documented in 43.3% of eyes that progressed postoperatively.

CONCLUSION

SCXL was more effective for paediatric KC and achieved greater stability than either ACXL or TCXL, and ACXL was superior to TCXL. SCXL also achieved marked improvement in both myopia and spherical equivalent; however, these refractive outcomes were unpredictable and uncontrollable. TCXL had a 28.4% failure rate within 2 years. SCXL is preferable for management of paediatric KC.

TiO2 Co-doped with Zr and Ag shows highly efficient visible light photocatalytic behavior suitable for treatment of polluted water

The objective of this study is to analyze the effects of zirconium (Zr) and silver (Ag) doping on the photoactivity of titania (TiO₂). Zr–Ag (ZA) co-doped TiO₂ products were fabricated via sol–gel technique and their properties (structural and chemical) were characterized. The weight ratio of TiO₂ was fixed, while weight ratios of Zr and Ag were varied from 2 to 4, 6 and 8 wt% while synthesized samples were calcined at 400 °C for 3 h. The XRD results demonstrated that the incorporation of metal doping agents failed to alter the host material's lattice structure, however, its crystallite size was reduced from 13.54 to 5.05 nm with increasing Zr⁴⁺ and Ag⁺ concentrations. FTIR spectroscopy was used to examine various functional groups. In the attained spectra, an ample absorption peak between 500 and 1000 cm⁻¹ was recorded, which was ascribed to Ti–O–Ti linkage vibration mode present within TiO₂. Surface morphology, microstructure, SAED patterns and elemental composition were examined with FE-SEM, HR-TEM and EDX, which served to confirm the ZA-doped TiO₂ product. Band gap energy of the co-doped material was significantly reduced as indicated by a higher wavelength redshift in the spectra. The photoactivity and kinetics of photo-products were investigated by observing photo-decolorization of methylene blue (MB) under a radiation source. Photodecomposition of MB was dramatically enhanced when titania co-doped with Zr and Ag was employed compared to un-doped or mono-doped TiO₂. The ZA (8 wt%) co-doped TiO₂ photocatalyst depicted the maximum MB removal efficiency (∼93%) within 90 min under a light source.

The objective of this study is to analyze the effects of zirconium (Zr) and silver (Ag) doping on the photoactivity of titania (TiO₂).

Association of Estimated GFR (By MDRD) with the Carotid Intima Media Thickness (CIMT) in Different Stages of CKD among Patients with Type 2 Diabetes Mellitus

Most of the mortalities among Diabetic Nephropathy patients are cardiovascular, if we identify the risk factor, measures can be taken to prevent it. Hence an objective was set to evaluate the association between carotid artery intima media thickness (CIMT) with eGFR in patients of CKD stage III, IV and V among patients with type 2 diabetes mellitus; also, correlation with age, BMI, lipid profile. This cross-sectional, observational study was performed in 70 patients in different stages of CKD in Diabetic Patients selected by Inclusion Criteria (Diabetic nephropathy patients with stages III, IV, V and exclusion Criteria (Acute kidney injury, History of carotid surgery, Patients of MI and stroke). This study was performed in Department of Nephrology, Dhaka Medical College in collaboration with the Department of Radiology and Imaging, laboratory of Department of Biochemistry and Department of Microbiology at Dhaka Medical College Hospital (By standard method in laboratory) from 1st January 2016 to 31st December 2016. eGFR was measured by MDRD formula and the CIMT was measured using an ultrasonographic examination. The mean CIMT was 0.9±0.21mm, and 62.9% of the subjects showed IMT thickening (≥1mm). The carotid IMT elevated significantly with the stage progression of CKD (Overall eGFR mean 28.8±14.5mL/min/1.73m² in CIMT<1mm with range from 6 to 54 and 9.1±9.0mL/min/1.73m² in CIMT ≥1mm with range from 3 to 32 (p=0.001). The eGFR was significantly lower in the patients with CIMT thickening than those without CIMT thickening. eGFR was also significantly associated with CKD stages (p=0.001), serum creatinine (p=0.001), BMI (r = -0.330, p=0.005), and negatively associated with age group, duration of hypertension, smoking. However, the CIMT was not significantly different among the patients at different stages of diabetic nephropathy (r = -0.172, p=156) and age group. It has been concluded that the mean CIMT was markedly high in patients with CKD compared to normal expected value. This study showed a relationship between the CIMT and the renal parameters as eGFR and the stages of diabetic nephropathy with a confirm association between the CIMT and diabetic macroangiopathy.

Formation and metabolism of oxysterols and cholestenoic acids found in the mouse circulation: Lessons learnt from deuterium-enrichment experiments and the CYP46A1 transgenic mouse

While the presence and abundance of the major oxysterols and cholestenoic acids in the circulation is well established, minor cholesterol metabolites may also have biological importance and be of value to investigate. In this study by observing the metabolism of deuterium-labelled cholesterol in the pdgfb^ret/ret mouse, a mouse model with increased vascular permeability in brain, and by studying the sterol content of plasma from the CYP46A1 transgenic mouse overexpressing the human cholesterol 24S-hydroxylase enzyme we have been able to identify a number of minor cholesterol metabolites found in the circulation, make approximate-quantitative measurements and postulate pathways for their formation. These "proof of principle" data may have relevance when using mouse models to mimic human disease and in respect of the increasing possibility of treating human neurodegenerative diseases with pharmaceuticals designed to enhance the activity of CYP46A1 or by adeno-associated virus delivery of CYP46A1.