A rare diagnosis of Langerhans cell histiocytosis made on thyroid histology with coexisting papillary thyroid cancer and AVP deficiency

Summary

A 48-year-old Asian male, presented to the hospital for an elective total thyroidectomy in the context of 6.3 cm thyroid nodule. The fine needle aspiration cytology of the nodule confirmed papillary thyroid cancer (PTC) with some atypical histiocytes. He has a history of idiopathic arginine vasopressin deficiency (AVP-D) and has been taking oral DDAVP 100 µg daily, self-adjusting the dose based on thirst and polyuria. Additionally, he also has a history of recurrent spontaneous pneumothorax. His total thyroidectomy was aborted due to significant intraoperative bleeding, and his admission was further complicated by post-operative hyponatraemic seizure. Thyroid histology revealed the diagnosis of Langerhans cell histiocytosis (LCH), and further investigation with contrast CT demonstrated multi-organ involvement of the thyroid, lungs, and bones.

Learning points

Langerhans cell histiocytosis (LCH) is a condition that can affect one or more organ systems, including the pituitary, where it can present as AVP deficiency. Strict monitoring of fluid balance, as well as serial monitoring of serum sodium, is essential in all patients with AVP-D in the perioperative setting. Iatrogenic hyponatraemic seizure is an uncommon but serious complication of DDAVP treatment in hospitalised patients with AVP-D. DDAVP dosing must be carefully monitored. LCH with multisystem involvement is an important mimic for metastatic conditions, and histological diagnosis is essential to guide treatment and prognosis. Although LCH without bone marrow involvement is unlikely to increase the risk of bleeding, its effect on tissue integrity may make surgery more challenging. BRAF-V600E mutation is an important driver mutation and a potential therapeutic target in the treatment of LCH.

Forecasting demand for blood products: Towards inventory management of a perishable product

Forecasting consumption of blood products can reduce their order frequency by 60% and inventory level by 40%. This also prevents shortage by balancing demand and supply. The study aimed to establish a "Simple Average with Mean Annual Increment" (SAMAI) method of time series forecasting and to compare its results with those of ARIMA, ratio to trend, and simple average to forecast demand of blood products. Monthly demand data of blood component from January 2017 to December 2022 (data set I) was used for creating a forecasting model. To avoid the effect of COVID19 pandemic instead of actual data of year 2020 and 2021, average monthly values of previous three years were used (data set II). The data from January to July 2023 were used as testing data set. To assess the fitness of model MAPE (Mean Absolute Percentage Error) was used. By SAMAI method MAPE were 18.82%, 13.392%, 14.516% and 27.637% respectively for of blood donation, blood issue, RDP issue and FFP issue for data set I. By Simple Average method MAPE were 20.05%, 12.09%, 29.06% and 34.85%, respectably. By Ratio-to-Trend method MAPE were 21.08%, 21.65%, 25.62% and 39.95% respectively. By SARIMA method MAPE were 12.99%, 19.59%, 37.15% and 31.94% respectively. The average MAPE was lower in data set II by all tested method and overall MAPE was lower by SAMAI method. The SAMAI method is simple and easy to perform. It can be used in the forecasting of blood components demand in medical institution without knowledge of advanced statistics.

Temperature dependent structural properties of Mn1.90M0.10O3(M = Cr and Fe)

The polycrystalline samples of Mn1.90Cr0.10O3(MCO) and Mn1.90Fe0.10O3(MFO) have been investigated for their temperature dependent magnetic and structural properties. The Cr and Fe substitutions have significant effect on the magnetic and structural properties of Mn2O3. Like pristine Mn2O3, the Cr and Fe substituted samples MCO and MFO also exhibit two antiferromagnetic transitions; one at ∼77 K, ∼80 K, respectively and another at ∼40 K. Our room temperature synchrotron x-ray powder diffraction (SXRD) results confirm that both the MCO and MFO samples crystallize in cubic symmetry. The temperature dependent SXRD results demonstrate the cubic to orthorhombic structural transition for the studied samples. The pristine Mn2O3shows cubic to orthorhombic transition around 310 K, whereas this structural transition shifted towards lower temperature side with these substitutions i.e. around 240 K for MCO and 260 K for MFO. Interestingly, the centrosymmetricPcabto non-centrosymmetricPca21change in symmetry is also resolved at the ferroelectric ordering temperature for MCO.

Prevalence of TTI among Indian blood donors

Transfusion Transmissible Infections (TTIs) such as human immune-deficiency virus (HIV-I/II), hepatitis B virus (HBV), Hepatitis C virus (HCV), Malaria parasite (MP) and syphilis can spread through contaminated blood or blood products. The present study was designed to analyze the prevalence of TTIs and their association with blood group, among the blood donors of Delhi. Blood group was determined by hem-agglutination using Gel card. HIV, HBV, and HCV test was performed by ELISA, syphilis by RPR and MP rapid card method. A total Transfusion Transmissible Infections (TTIs) such as human immune-deficiency virus (HIV-I/II), hepatitis B virus (HBV), Hepatitis C virus (HCV), Malaria parasite (MP) and syphilis can spread through contaminated blood or blood products. The present study was designed to analyze the prevalence of TTIs and their association with blood group, among the blood donors of Delhi. Blood group was determined by hem-agglutination using Gel card. HIV, HBV, and HCV test was performed by ELISA, syphilis by RPR and MP rapid card method. A total of 345(2.038%) blood donors were positive for TTIs. Prevalence of HBV, HCV, HIV-I/II, syphilis and MP were 188(1.111%), 73(0.431%), 34(0.201%), 49(0.29%) and 1(0.006%) respectively. Our result shows a trend of decrease in prevalence of TTIs; 2.267%, 2.111% and 1.614% between the year 2020, 2021 and 2022 respectively. Significant association of syphilis infection (P=0.036) and HCV infection (P=0.012) with ABO blood group antigen was observed. Blood group O donors were 1.81 times more infected with syphilis compared to donor having A and B antigen. Donors having blood group antigen B were 1.80 times more infected with HCV compared to donor not having B antigen. HBV and HIV prevalence found to be not associated with ABO and Rh blood group antigens. A low prevalence of TTIs positivity was observed among blood donors. Public awareness, proper counseling, medical examination and testing can help to minimize TTIs. Our study results shows ABO blood group has an association with HCV and VDRL infection.

Link between human ABO blood groups with diseases influencing blood donors and recipients frequency at RBTC, Delhi, India

Blood groups had associations with many diseases that affect blood transfusion services by increasing or decreasing the blood demand of particular blood group. The present study was designed to compare the frequency of ABO and Rh blood groups among blood donors and blood component recipients. The ABO and Rh(D) blood groups of donors and recipients were determined using Gel card method. The frequency of blood donors and blood component recipients from January 1, 2020, to December 31, 2023, at regional blood transfusion centre of Delhi, were compared using χ² test. The ABO blood group frequencies of blood donors (n=23025) were: A(23.1%), B(37.53%), AB(10.09%), and O(29.29%). The blood issue (n=20255) was significantly (p=0.0000) higher in A(24.96%), B(39.92%), and lower in AB(9.76%) and O(25.37%). The RDP issue (n=7239) was significantly (p=0.0000) higher in A(24.71%), B(39.34%), and AB(11.53%) and lower in O(24.41%). The FFP issue (n=4164) was significantly (p=0.00024) higher in AB (12.3%) and lower in A (22.05%), B(37.32%), and O(28.14%). The difference between the blood donor frequencies of Rh(D)+Ve(95.19%) and Rh(D)-Ve(4.81%) and the blood issued by Rh(D)+Ve(95.06%) and Rh(D)-Ve(4.94%) was statistically not significant(P=0.52).Blood issues were higher in blood group A and B than in O, platelet issues were higher in A, B and AB than in O, and FFP issues were higher in the AB. Non-O blood groups may have a higher frequency of blood transfusions, while O blood groups may have a protective influence against diseases due to their innate immune response.

Alloantibody among Thalassemia patients receiving multiple blood transfusions at a tertiary care hospital in India

Regular blood transfusion is a lifesaving treatment for thalassemia patients; however, it exposes them to multiple alloantigens. The present study was designed to assess the frequency of alloantibodies in thalassemia patients receiving multiple blood transfusions. Blood samples were tested by Gel card method for ABO, Rh, Direct Antiglobulin Test (DAT), Indirect Antiglobulin Test (IAT), Auto Control (AC) and presence of alloantibody. Alloantibody screening and identification were performed using commercial 3-cell and 11-cell identification panels. Of a total of 66 thalassemia patients, 37 were male and 29 were female, with a mean age of 15.63±5.93 years and a range of 4.0 to 29.0 years. The ABO profiles of thalassemia patients were B-33, A-19, O-11, and AB-3, with 63 Rh-D positives and 3 Rh-D negatives. An average of 533.39±284.95 units were transfused an average of 304±119.65 times. Positive cases for DAT were 29(43.93%), AC was 26(39.39%) and IAT was 4(6.06%). Nine (13.636%) patients had developed alloantibodies, in which anti-K was seen in 5(27.77%), anti-Kpa in 4(22.22%), anti-C in 3(16.66%), anti-Cw in 3(16.66%), anti-D in 1(5.55%), anti-Lea in 1(5.55%), anti-Lua in 1 (5.55%). Alloantibodies were single in 4(44.44%) and multiple in 5(55.55%) patients. The rate of alloimmunization and positivity of DAT, AC, ICT, and splenectomy were significantly associated with higher age, the number of units transfused, and also the number of times of transfusion. Every new thalassemia patient needs extended blood group typing prior to the start of a blood transfusion and antigen-matched blood. For patients with alloantibodies, corresponding antigen-negative blood must be selected for cross-matching.

Phenotype, allele and genotype frequency distribution of ABO and Rh(D) blood group among blood donors attending regional blood transfusion centre in Delhi, India

The ABO and Rh blood group phenotypes, alleles, and genotype frequencies have many biological and medical implications. The frequency differs broadly according to races, geographical borders and ethnicity, even within the same region. This study was designed to determine the frequency of ABO and Rh blood groups among blood donors attending the regional blood transfusion centre in Delhi. The gel card method was used to determine the ABO and Rh(D) blood groups of donors who donated blood between January 1, 2020, and June 30, 2022. The assumption of Hardy-Weinberg equilibrium was used to determine allele and genotype frequencies of blood donors. A total of 16,925 blood units were donated during the study period. Donors phenotype frequencies of ABO were as follows: 'A' (23.88%), 'B' (37.38%), 'AB' (9.97%) and 'O '(29.27%). Rh(D)+Ve (D) were (94.9%) and Rh(D)-Ve (d) were (5.01%), which follow an order of B > O > A > AB and Rh-D > d for Rh. Donors ABO and Rh (D) allele frequencies were IA-0.183, IB-0.277, IO-0.541 and ID-0.776, Id-0.224 respectively. Allele frequencies follow an order of IO > IB > IA and Rh- ID > Id. Donors ABO genotype frequencies were AA-0.0333, AO-0.198, BB-0.0768, BO-0.30, AB-0.101, OO-0.293 and Rh(D) genotype frequencies were DD-0.602, Dd-0.347, dd-0.0501. Genotype frequencies follow an order of BO > OO > AO > AB > BB > AA and DD > Dd > dd. Among our donors, which were mostly from northern India, the ABO and Rh(D) blood groups have the highest proportion of ABO-B and Rh(D)+Ve and the lowest proportion of ABO-AB and Rh(D)-Ve, with a stable order of B > O > A > AB and D > d for phenotype, IO > IB > IA and ID > Id for allele and BO > OO > AO > AB > BB > AA and DD > Dd > dd for genotype.

Comparative study of the short-range structure of α-V2O5, α-TeO2 and xV2O5-(100 - x)TeO2 glasses using X-ray diffraction, Rietveld analysis and reverse Monte Carlo simulations

Vanadium-tellurite glasses, tetragonal TeO₂ and orthorhombic V₂O₅ crystalline samples were characterized for their atomic structure properties by synchrotron X-ray diffraction, pair distribution function analysis, reverse Monte Carlo simulations (RMC) and Rietveld analysis. The pair correlation function, G(r), of V₂O₅ shows the first peak at 1.61 Å. G(r) of TeO₂ shows three peaks at 1.57, 2.13 and 2.88 Å due to Te-O linkages of three different lengths, whereas the Te-Te atomic pair correlation shows a peak at 3.85 Å. The average coordination number of V with O in crystalline V₂O₅ is 4.39 while that of Te with O in crystalline TeO₂ is 3.71. G(r) of the vanadium tellurite glass shows the first peak at 1.90 Å due to overlapping Te-O and V-O atomic pair correlations. The RMC analysis on diffraction data of glasses found that the V-O coordination number is in the range 5.27-5.59 and the Te-O coordination number is 5.39-5.67. However, it is found that these coordination numbers cannot be clearly defined due to short-range disorder.

Perceived stigma among diabetic patients and their caregivers: a review

AIMS

Considerable number of studies in the existing literature indicate the existence of stigma related to many diseases, disabilities, and disorders, but less attention has been given to diabetes-related stigma. This narrative review of literature aims to explore the existence of stigma surrounding type 1 diabetes mellitus (T1DM).

METHODS

Literature were searched using search engines, Google Scholar, PubMed, and Scopus electronic databases published from year 2000 to 2020. Both qualitative and quantitative studies focusing on the stigma associated with T1DM were included. A total of 21 articles met the inclusion criteria. Thematic analysis of collected research material was done.

RESULTS

Results provided substantial evidence that stigma associated with T1DM was experienced by T1DM patients and their caregivers at some point in their lives and it had affected their lives in different domains such as difficulty finding a spouse, discrimination at employment opportunities, educational institutions, management of disease, being misjudged as a druggie, poor quality of life of the patient and caregiver, depressive symptoms among parents of patients, constant worrying of their child's disease management, and so on.

CONCLUSION

Stigma related to T1DM is experienced by individuals suffering from it, and it is widespread. It not only affects the sufferers but their loved ones also. To reduce and cope-up with stigma, there is a need to increase public education and awareness at a mass level. Further research and awareness will serve to build our understanding of the experience of diabetes-related stigma.

Angiomatoid Fibrous Histiocytoma with EWSR1 Rearrangement in an Unusual Location

Introduction/Objective

Angiomatoid fibrous histiocytoma (AFH) is a rare mesenchymal neoplasm most often arising in the superficial extremities of children and young adults. AFH can mimic clinical, histologic, and radiologic presentation of several different tumors, therefore diagnosis can be quite challenging.

Methods/Case Report

We report the case of a 32-year-old woman with no significant medical history who presented with three days of right upper quadrant pain. Radiologic studies showed a 2.3 centimeter right lower lobe soft tissue nodule abutting the right lower lobe bronchus.

Results (if a Case Study enter NA)

Subsequent lobectomy with mediastinal lymph node dissection was performed. Histopathologic examination of the right middle and lower lobes revealed a fibrohistiocytic appearing neoplasm with bland nuclear features and brisk associated lymphoplasmacytic and histiocytic infiltrate. Given the suspicion for AFH, fluorescent in situ hybridization for EWSR1 and FUS were performed at an outside facility with detection of EWSR1 gene rearrangement supporting the diagnosis of AFH.

Conclusion

AFH is a rare soft tissue neoplasm that is often indolent but intermediate in potential given the rare possibility of metastasis. While most common in superficial extremities, increasing unusual anatomic sites are being reported. Histologically, the tumor can show a spectrum of morphologic patterns including nodules to sheets of often monomorphic bland, spindle or ovoid cells in an inflammatory background and with associated fibrous pseudocapsule. Three characteristic chromosomal translocations have been identified: EWSR1-CREB1, EWSR1-ATF1 and FUS- ATF1. Treatment is wide surgical excision or radiotherapy if unresectable. The differential diagnosis can be broad with a spectrum from reactive, benign lesions to malignant neoplasms, including a variety of sarcomas.

Sub-nanograin metal based high efficiency multilayer reflective optics for high energies

The present finding illuminates the physics of the formation of interfaces of metal based hetero-structures near layer continuous limit as an approach to develop high-efficiency W/B₄C multilayer (ML) optics with ML periodicity varying d = 1.86–1.23 nm at a fixed number of layer pairs N = 400. The microstructure of metal layers is tailored near the onset of grain growth to control the surface density of grains resulting in small average sizes of grains to sub-nanometers. This generates concurrently desirable atomically sharp interfaces, high optical contrast, and desirable stress properties over a large number of periods, which have evidence through the developed ML optics. We demonstrate significantly high reflectivities of ML optics measured in the energy range 10–20 keV, except for d = 1.23 nm due to quasi-continuous layers. The reflectivities at soft gamma-rays are predicted.

The present finding illuminates the physics of the formation of interfaces of metal based hetero-structures near layer continuous limit as an approach to develop high-efficiency W/B₄C multilayer optics with varying periods at a fixed large layer pairs.

Mechanistic insights into defect generation and tuning of optical properties in Zn1-xFexAl2O4(0.01 ≤ x ≤ 0.40) nanocrystals

The correlation of several defects and optical and magnetic properties with Fe content in Zn_1-xFe_xAl₂O₄ (0.01 ≤ x ≤ 0.40) nanocrystals has been scrutinized through X-ray diffraction, O K-edge X-ray absorption near-edge structure, FT-IR, diffuse reflectance, photoluminescence and electron spin-resonance spectroscopies, and vibrating sample magnetometry. Increasing Fe content causes elongation in the octahedral units of the lattice, accompanied by distortion in the octahedral coordination. Fe introduces non-radiative centres in the forbidden gap, thereby tuning the band gap from 4.37 to 3.88 eV and eliminating emission in the visible region. Zn vacancies are found to tail off, while {\rm Fe}_i^{\bullet \bullet \bullet}, {\rm Al}_{\rm Zn}^\bullet and Fe_Al^× antisite defects increase in concentration with increasing Fe content. Inhomogeneous broadening of spin-resonance signals infers strong spin-lattice interactions of Fe³⁺ ions at distorted octahedral and non-symmetric tetrahedral sites. A transition is observed from paramagnetism to superparamagnetism at higher Fe concentrations. A visual colour change from pearly white to orange-brown is observed in Zn_1-xFe_xAl₂O₄ nanocrystals with increasing Fe content, revealing its potential candidature for pigments in the paint and dye industries.

Unravelling oxygen driven α to β phase transformation in tungsten

Thin films of β-W are the most interesting for manipulating magnetic moments using spin–orbit torques, and a clear understanding of α to β phase transition in W by doping impurity, especially oxygen, is needed. Here we present a combined experimental and theoretical study using grazing incidence X-ray diffraction, photoelectron spectroscopy, electron microscopy, and ab initio calculations to explore atomic structure, bonding, and oxygen content for understanding the formation of β-W. It is found that the W films on SiO₂/Si have 13–22 at.% oxygen in A15 β structure. Ab initio calculations show higher solution energy of oxygen in β-W, and a tendency to transform locally from α to β phase with increasing oxygen concentration. X-ray absorption spectroscopy also revealed local geometry of oxygen in β-W, in agreement with the simulated one. These results offer an opportunity for a fundamental understanding of the structural transition in α-W and further development of β-W phase for device applications.

Structural correlations in the enhancement of ferroelectric property of Sr doped BaTiO3

The effect of Sr doping in BaTiO3 (BTO) with nominal compositions Ba0.80Sr0.20TiO3 (BSTO) have been explored on its structural, lattice vibration, dielectric, ferroelectric and electrocaloric properties. The temperature dependent dielectric results elucidate the enhancement in dielectric constant and exhibit three frequency independent transitions around 335, 250 and 185 K, which are related to different structural transitions. All these transitions occur at lower temperature as compared with pristine BTO, however; remnant electric polarization (P r) of BSTO is much higher than in BTO. The value of P r is ∼5 μC cm-2 at room temperature and the maximum P r ∼ 8 μC cm-2 is observed at tetragonal to orthorhombic and orthorhombic to rhombohedral transitions. The electro-caloric effect shows the maximum adiabatic change in temperature ΔT ∼ 0.24 K at cubic to tetragonal transition. The temperature dependent synchrotron x-ray diffraction and Raman results show correlations between P r, crystal structure and lattice vibrations. Our results demonstrate the enhancement in ferroelectric properties of BTO with Sr doping. The origin of the enhancement in ferroelectric property is also discussed in correlations with the appearance of superlattice peak around room temperature due to TiO6 octahedral distortion. These enhanced properties would be useful to design lead free high quality ferroelectric and piezoelectric materials.

Direct hybridization gap from intersite and onsite electronic interactions in CeAg2Ge2

Electronic and crystal structure studies are presented to describe the role of intersite and onsite interactions for antiferromagnetic ordering in CeAg2Ge2. The crystal structure showed a prominent magnetovolume effect with anomalous negative thermal expansion at low temperature as a consequence of itinerant electron magnetism. The direct hybridization gap with a V-shaped band observed in the angle resolved photoemission data at room temperature, indicates that spin polarized quasiparticle states exist in the gapped region. Valence band broadening and enhanced localization effects at low temperature indicate strong hybridization of the valence orbitals of Ce atoms with the near neighbor Ge atoms. We find that the intersite interaction between the Ce atoms at high temperature stabilizes the onsite interaction at low temperature that leads to the spin density wave type antiferromagnetism in CeAg2Ge2.

High-Temperature Thermal Cycling Effect on the Irreversible Responses of Lattice Structure, Magnetic Properties, and Electrical Conductivity in Co2.75Fe0.25O4+δ Spinel Oxide

We report high-temperature synchrotron X-ray diffraction (SXRD), magnetization, and current-voltage (I-V) characteristics for the samples of Co_2.75Fe_0.25O₄ ferrite. The material was prepared by chemical reaction of the Fe and Co nitrate solutions at pH ∼ 11 and subsequent thermal annealing. Physical properties of the samples were measured by cycling the temperature from 300 K to high temperature (warming mode) and returning back to 300 K (cooling mode). The lattice structure showed sensitivity to high measurement temperatures. Magnetization curves showed a defect-induced ferromagnetic phase at higher temperatures and superparamagnetic blocking of the ferrimagnetic particles near to 300 K or below. Electrical conductivity exhibited a thermal hysteresis loop at higher measurement temperatures. The samples exhibited new form (not studied so far) of surface magnetism in Co rich spinel oxides and irreversibility phenomena in the lattice structure, magnetization, and conductivity on cycling the measurement temperatures.

Combined pathologic-genomic algorithm for early-stage breast cancer improves cost-effective use of the 21-gene recurrence score assay

Background

The 21-gene recurrence score (RS) (Oncotype DX®; Genomic Health, Redwood City, CA) partitions hormone receptor positive, node negative breast cancers into three risk groups for recurrence. The Anne Arundel Medical Center (AAMC) model has previously been shown to accurately predict RS risk categories using standard pathology data. A pathologic-genomic (P-G) algorithm then is presented using the AAMC model and reserving the RS assay only for AAMC intermediate-risk patients.

Patients and methods

A survival analysis was done using a prospectively collected institutional database of newly diagnosed invasive breast cancers that underwent RS assay testing from February 2005 to May 2015. Patients were assigned to risk categories based on the AAMC model. Using Kaplan-Meier methods, 5-year distant recurrence rates (DRR) were evaluated within each risk group and compared between AAMC and RS-defined risk groups. Five-year DRR were calculated for the P-G algorithm and compared with DRR for RS risk groups and the AAMC model's risk groups.

Results

A total of 1268 cases were included. Five-year DRR were similar between the AAMC low-risk group (2.7%, n = 322) and the RS < 18 low-risk group (3.4%, n = 703), as well as between the AAMC high-risk group (22.8%, n = 230) and the RS > 30 high-risk group (23.0%, n = 141). Using the P-G algorithm, more patients were categorized as either low or high risk and the distant metastasis rate was 3.3% for the low-risk group (n = 739) and 24.2% for the high-risk group (n = 272). Using the P-G algorithm, 44% (552/1268) of patients would have avoided RS testing.

Conclusions

AAMC model is capable of predicting 5-year recurrences in high- and low-risk groups similar to RS. Further, using the P-G algorithm, reserving RS for AAMC intermediate cases, results in larger low- and high-risk groups with similar prognostic accuracy. Thus, the P-G algorithm reliably identifies a significant portion of patients unlikely to benefit from RS assay and with improved ability to categorize risk.

Application of XANES in gamma dosimetry

The thermoluminescence material, CaSO₄:Dy, is widely used for the dosimetry of ionizing radiation due to its high sensitivity, low fading and wide dose range from μGy to few tens of gray. However, its application is limited at high doses due to non-linear and saturation effects. In this paper, X-ray Absorption Near Edge Structure (XANES) studies at the Dy L₃-edge have been carried out on CaSO₄:Dy discs exposed to gamma doses in the range 0-1000 Gy. The results show an increase in white line in XANES spectra with gamma dose. Structural change in CaSO₄:Dy also has been studied using X-Ray Diffraction (XRD) and has found no structural change up to 1000 Gy. The study indicates that XANES can be used as an alternative dosimetry technique and is useful in the evaluation of absorbed dose in the case of accidental exposure to high radiation in a radiation facility or during a radiological accident.

Experimental setup to measure thermal waves generated by X-ray absorption using pyroelectric sensor

Pyroelectric detectors are widely used for infrared radiation detection, whereas these can also be used in the X-ray region. They have multiple advantages when used at synchrotron radiation sources, such as (a) can be used with a white beam (high flux), (b) have a flat spectral response, and (c) can be used both as a detector and as a sample. However, when used in the hard X-ray region, absorption in the detector plays an important role depending upon the thickness of the detector. Hence, the estimation of the responsivity of the detector is important. In this paper, we report an improved experimental setup for the measurement of a pyroelectric signal in the hard X-ray region. The responsivity (V/W) of a pyroelectric detector for absorbed radiation in the hard x-ray region is measured. Measurements of the K-edge x-ray absorption fine structure of 10-μm copper and nickel foils are carried out using a LiTaO₃ pyroelectric detector and compared with the measurements carried out using an ionization chamber as a sensor for the same foils. Absorption spectra near the Ta L_III and L_II edges in LiTaO₃, measured using a LiTaO₃ crystal both as a sample and as a sensor, are also reported in this paper.

Free radical scavenging potential of sericin obtained from various ecoraces of tasar cocoons and its cosmeceuticals implication

Tropical tasar silkworm Antheraea mylitta is a wild sericigenous insect which is distributed in different geographical regions and named as different ecoraces. In the present study, we investigated the molecular characterisation and cosmeceutical properties of sericin extracted from different ecoraces of tasar cocoons. The surface morphology and molecular weight of cocoons were determined by scanning electron microscope (SEM) and SDS-PAGE, respectively. Characterisation of sericin was performed by various methods such as FTIR, CHNS, TGA and amino acid analyzer. The anti-tyrosinase, anti-elastase, glutathione-S-transferase inhibition, free radical scavenging potential and inhibition of oxidative damages were measured in tasar ecoraces sericin. SEM images have revealed the removal of sericin from the surface of cocoons. SDS-PAGE of sericin depicted the presence of diverse molecular weight of proteins. Structural determination by FTIR revealed the presence of both α-helical and β-sheet structures. Thermal properties of sericin were studied by TGA which showed a 50% weight loss at temperature 410 °C-430 °C. Additionally, ecoraces sericin contains 17 amino acids in which serine, aspartic acid and glycine are predominantly present (55.68-59.61%). Further, anti-tyrosinase, anti-elastase, inhibition of glutathione-S-transferase activity, free radical scavenging potential and inhibition of lipid peroxidation were also observed in ecoraces sericin. Our findings suggest that the present study appear to be helpful in exploiting sericin as potential biomaterial in cosmeceutical and allied field.

Tasar silk fiber waste sericin: New source for anti-elastase, anti-tyrosinase and anti-oxidant compounds

The present study investigates the properties of sericin extracted from tasar silk fiber waste (TSFW). The surface morphology of TSFW was observed by scanning electron microscope (SEM). SEM images revealed the removal of residual sericin over the surface of TSFW. The molecular weight distribution of sericin was examined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). The results suggested that TSFW sericin represented a family of proteins with wide-ranging molecular weight distribution (11-245 kDa). Structural determination by FTIR revealed the presence of both α-helical and β-sheet structures. The colour was studied by colorimeter indicating less brightness, more red and yellow colour intensities. The carbon: nitrogen ratio (C:N) was studied by CHNS element analyzer and the ratio is 5.15-7.85. Thermal properties of TSFW sericin have been studied by thermogravimetric analysis (TGA) method. TGA curve showed higher thermal stability and variable degradation profiles. Furthermore, TSFW sericin contains 17 amino acids where serine, aspartic acid and glycine are the more significant compounds (54.34-60.49%). In addition, sericin was found to inhibit tyrosinase, elastase and glutathione-S-transferase activity, and had apparent radical scavenging impacts on 2.2‑diphenyl‑1‑picryl‑hydrazil (DPPH), hydrogen peroxide and inhibition of lipid peroxidation. Result suggested that TSFW sericins might be a valuable ingredient for cosmoceutical products.

Long-term survival outcomes of triple-receptor negative breast cancer survivors who are disease free at 5 years and relationship with low hormone receptor positivity

Background:

We counsel our triple-negative breast cancer (TNBC) patients that the risk of recurrence is highest in the first 5 years after diagnosis. However, there are limited data with extended follow-up on the frequency, characteristics, and predictors of late events.

Methods:

We queried the MD Anderson Breast Cancer Management System database to identify patients with stage I–III TNBC who were disease free at 5 years from diagnosis. The Kaplan–Meier method was used to estimate yearly recurrence-free interval (RFI), recurrence-free survival (RFS), and distant relapse-free survival (DRFS), as defined by the STEEP criteria. Cox proportional hazards model was used to compute hazard ratios (HRs) and 95% confidence intervals (CIs).

Results:

We identified 873 patients who were disease free at least 5 years from diagnosis with median follow-up of 8.3 years. The 10-year RFI was 97%, RFS 91%, and DRFS 92% the 15-year RFI was 95%, RFS 83%, and DRFS 84%. On a subset of patients with oestrogen receptor and progesterone receptor percentage recorded, low hormone receptor positivity conferred higher risk of late events on multivariable analysis for RFS only (RFI: HR=1.98, 95% CI=0.70–5.62, P-value=0.200; RFS: HR=1.94, 95% CI=1.05–3.56, P-value=0.034; DRFS: HR=1.72, 95% CI=0.92–3.24, P-value=0.091).

Conclusions:

The TNBC survivors who have been disease free for 5 years have a low probability of experiencing recurrence over the subsequent 10 years. Patients with low hormone receptor-positive cancers may have a higher risk of late events as measured by RFS but not by RFI or DRFS.

Giant Rashba effect at the topological surface of PrGe revealing antiferromagnetic spintronics

Rashba spin-orbit splitting in the magnetic materials opens up a new perspective in the field of spintronics. Here, we report a giant Rashba spin-orbit splitting on the PrGe [010] surface in the paramagnetic phase with Rashba coefficient α R  = 5 eVÅ. We find that α R can be tuned in this system as a function of temperature at different magnetic phases. Rashba type spin polarized surface states originates due to the strong hybridization between Pr 4f states with the conduction electrons. Significant changes observed in the spin polarized surface states across the magnetic transitions are due to the competition between Dzyaloshinsky-Moriya interaction and exchange interaction present in this system. Presence of Dzyaloshinsky-Moriya interaction on the topological surface give rise to Saddle point singularity which leads to electron-like and hole-like Rashba spin split bands in the [Formula: see text] and [Formula: see text] directions, respectively. Supporting evidences of Dzyaloshinsky-Moriya interaction have been obtained as anisotropic magnetoresistance with respect to field direction and first-order type hysteresis in the X-ray diffraction measurements. A giant negative magnetoresistance of 43% in the antiferromagnetic phase and tunable Rashba parameter with temperature makes this material a suitable candidate for application in the antiferromagnetic spintronic devices.

Grading, staging and Nottingham prognostic index scoring of breast carcinoma

Background: Breast carcinoma is the most frequent malignant tumor in women accounting for approximately 15% of female cancer deaths. It is the second most common malignancy among women in Nepal. Our objectives were to study the extent and spread of different histological types breast carcinoma in the eastern region of Nepal, to grade and stage the tumors, score the prognosis.Materials and Methods: A cross-sectional descriptive study of mastectomy specimens with axillary lymph node sampling was done for a period of two years. Diagnosis was done using WHO classification. Modified Bloom Richardson score and TNM system was used to grade and stage the tumors. Nottingham Prognostic index was applied to score the prognosis.Results: Out of 31 total cases, the most common histologic type was Invasive Carcinoma of No Special Type (67.74%). The largest tumor size was of 12cm which had poor NPI score. Most tumors were of grade II and T2. Out of 30 cases with lymph nodes, 13 were negative for metastasis pN0, 10 were pN1 and 7 were pN2. Extranodal spread was observed in 6 out of 17 cases with lymph node metastasis and was associated with higher grades and poor prognosis.Conclusion: Higher grade tumors, lymph node metastasis and extranodal extension are associated with higher Nottingham Prognostic Index score. 

Comparison of semen analysis by manual and automated method

Background: Semen analysis is used to evaluate male fertility. The aim of this study was to compare the results of semen analysis using manual method and automated sperm analyzer.Materials and Methods: This was a comparative study of 50 cases of semen analysis done in the Department of Pathology at the B.P. Koirala Institute of Health Sciences from March 2009 to March 2010. The automated sperm analyzer did not show the WHO parameters of patients who had functional sperm count (FSC) less than five hundred thousand (500,000). Semen analysis of each of the case included in the study was done by manual and automated method (using SQAII-P analyzer).Results: Out of 31 patients, the mean age of the patients was 28.56 years with youngest patient of 20 years and eldest of 45 year. Sensitivity and specificity was 100% in analysis of sperm concentration by both the methods. Sperm motility analysis showed 100% sensitivity and 81.81% specificity. Sperm morphology analysis showed 100% sensitivity and 34.48% specificity.Conclusion: It was observed that the automated method is much quicker and precise than the conventional, manual method for semen analysis.

Externally limited defect generation in multiwalled carbon nanotubes upon thermal annealing, and possible mechanism

Structural defects in multiwalled carbon nanotubes (MWCNTs) are found to increase upon moderate thermal annealing below 1400 K in an argon atmosphere. The defects are estimated using the ID/IG ratio in Raman spectroscopy of MWCNTs and confirmed by a direct observation using high-resolution transmission electron microscopy (HRTEM). HRTEM shows that the structural defects are created due to large damage to the outer walls of the nanotubes, while inner walls do not sustain any damage. The generation of defects on MWCNTs is attibuted to mechanical abrasion between the MWCNTs in contact, augmented by the momentum transfer from the flow of hot gas. A possible mechanism is proposed and experimentally validated by means of modulating the chemical environment of annealing from argon to hydrogen.

Structural analysis of lead magnesium niobate using synchrotron powder X-ray diffraction and the Rietveld method

The room-temperature synchrotron powder X-ray diffraction pattern of the single phase perovskite lead magnesium niobate (PMN) has shown significant broadening in the q range ∼ 5-7 Å(-1) compared with standard LaB6 synchrotron powder X-ray diffraction data, taken under similar conditions. This broadening/asymmetry lies mainly towards the lower 2θ side of the Bragg peaks. Attempts to fit this data with the paraelectric cubic phase (Pm\bar 3m) and the local rhombohedral phase (R3m) corresponding to polar nanoregions (PNRs) are made using the Rietveld method. Rietveld refinements show that neither cubic (Pm\bar 3m) nor rhombohedral (R3m) symmetry can fit this XRD pattern satisfactorily. The two-phase refinement fits the experimental data satisfactorily and suggests that the weight percentage of the PNRs is approximately 12-16% at room temperature. The unit-cell volume of these rhombohedral PNRs is approximately 0.15% larger than that of the unit cell volume of the paraelectric cubic phase.

Mask-less deposition of Au-SnO2 nanocomposites on CMOS MEMS platform for ethanol detection

Here we report on the mask-less deposition of Au-SnO2 nanocomposites with a silicon-on-insulator (SOI) complementary metal oxide semiconductor (CMOS) micro electro mechanical system (MEMS) platform through the use of dip pen nanolithography (DPN) to create a low-cost ethanol sensor. MEMS technology is used in order to achieve low power consumption, by the employment of a membrane structure formed using deep reactive ion etching technique. The device consists of an embedded tungsten micro-heater with gold interdigitated electrodes on top of the SOI membrane. The tungsten micro-heater is used to raise the membrane temperature up to its operating temperature and the electrodes are used to measure the resistance of the nanocomposite sensing layer. The CMOS MEMS devices have high electro-thermal efficiency, with 8.2 °C temperature increase per mW power of consumption. The sensing material (Au-SnO2 nanocomposite) was synthesised starting from SnO nanoplates, then Au nanoparticles were attached chemically to the surface of SnO nanoplates, finally the mixture was heated at 700 °C in an oven in air for 4 h. This composite material was sonicated for 2 h in terpineol to make a viscous homogeneous slurry and then 'written' directly across the electrode area using the DPN technique without any mask. The devices were characterised by exposure to ethanol vapour in humid air in the concentration range of 100-1000 ppm. The sensitivity varied from 1.2 to 0.27 ppm(-1) for 100-1000 ppm of ethanol at 10% relative humid air. Selectivity measurements showed that the sensors were selective towards ethanol when they were exposed to acetone and toluene.

A clinico-histopathological study on skin appendageal tumors

Background: Skin Appendageal tumors are a large and diverse group of tumors that are commonly classified according to their state of appendageal differentiation: follicular, sebaceous, eccrine and apocrine. Objectives of this study were to study the clinic-epidemiological profile of skin appendageal tumors and to correlate the clinico-histopathological diagnosis.Materials and Methods: This was a retrospective and prospective study which included all cases of skin adnexal tumours diagnosed histologically during the period of f

Microvessel density in Prostatic Lesions : Relevance to prognosis

Background:  Angiogenesis is required for growth and metastasis of tumor tissue. Quantization of angiogenesis by calculating the microvessel density can be done in histopathology specimens with the help of immunochemistry. In this study we used anti CD 34 antibody to highlight the endothelial cells and thus calculate microvessel density. Most studies have shown a positive correlation of microvessel density with increasing pathological grade and have also shown microvessel density as an independent predictor of cancer progression and survival. The present study was to find out the microvessel density in benign and malignant lesions of prostate and also to correlate the vascularity with increasing grade of cancer.Materials and methods:  Sixty five prostatic biopsies were evaluated for microvessel density using CD34 monoclonal antibody. Comparison was done between BPH and Carcinoma Prostate. MVD was correlated with Gleason’s score, weight of specimen and increasing age of patient. Effect of prostatitis on Microvessel density was studied.Results: Microvessel density was significantly higher in carcinoma prostate than in Benign Prostatic Hyperplasia. There was positive correlation of Microvessel density with increasing Gleason’s score. Microvessel was significantly increased in patients having symptoms for more than a year and also with biopsies revealing prostatitis. However, there was no significant correlation between Microvessel density and weight of specimen or increasing age.Conclusion: Since Microvessel density was found to be significantly higher in Prostatic Carcinoma and it showed positive correlation with Gleason’s score it can be added as one of the indicators for predicting the disease outcome. 

Co-processing of bio-oil from de-oiled Jatropha curcas seed cake with refinery gas–oil over sulfided CoMoP/Al2O3 catalyst

Schematic representation of Co-processing of bio-oil from de-oiled Jatropha curcas seed cake with refinery gas–oil over sulfided CoMoP/Al₂O₃ catalyst.

Study of the microstructure information of GaAs epilayers grown on silicon substrate using synchrotron radiation

Williamson-Hall (WH) analysis is a well established method for studying the microstructural properties of epilayers grown on foreign substrates. However, the method becomes inapplicable in specific cases where the structure factor considerations and the presence of anti-phase domains forbid the data acquisition for certain reflections in conventional high-resolution X-ray diffraction (HRXRD) measurements. Here, this limitation is overcome by exploiting the large intensity (25 µW mm(-2)) and high photon energy (15.5 keV) of the X-ray beam obtained from a synchrotron radiation source. The lateral coherence length, vertical coherence length, tilt and micro-strain of GaAs epilayers grown on Si substrate have been successfully measured using the conventional WH analysis. The microstructure information obtained from the conventional WH analysis based on the data acquired at the synchrotron radiation source is in reasonable agreement with the results obtained from atomic force microscope and surface profiler measurements. Such information cannot be obtained on a laboratory-based HRXRD system where modification of the WH method by involving a set of parallel asymmetric crystallographic planes is found to be essential. However, the information obtained from the modified WH method is along a different crystallographic orientation.

Tailored Synthesis of Porous TiO₂ Nanocubes and Nanoparallelepipeds with Exposed {111} Facets and Mesoscopic Void Space: A Superior Candidate for Efficient Dye-Sensitized Solar Cells

Anatase TiO2 nanocubes and nanoparallelepipeds, with highly reactive {111} facets exposed, were developed for the first time through a modified one pot hydrothermal method, through the hydrolysis of tetrabutyltitanate in the presence of oleylamine as the morphology-controlling capping-agent and using ammonia/hydrofluoric acid for stabilizing the {111} faceted surfaces. These nanocubes/nanoparallelepipeds were characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), high resolution transmission electron microscopy (HRTEM) and high angle annular dark-field scanning TEM (HAADF-STEM). Accordingly, a possible growth mechanism for the nanostructures is elucidated. The morphology, surface area and the pore size distribution of the TiO2 nanostructures can be tuned simply by altering the HF and ammonia dosage in the precursor solution. More importantly, optimization of the reaction system leads to the assembly of highly crystalline, high surface area, {111} faceted anatase TiO2 nanocubes/nanoparallelepipeds to form uniform mesoscopic void space. We report the development of a novel double layered photoanode for dye sensitized solar cells (DSSCs) made of highly crystalline, self-assembled faceted TiO2 nanocrystals as upper layer and commercial titania nanoparticles paste as under layer. The bilayered DSSC made from TiO2 nanostructures with exposed {111} facets as upper layer shows a much higher power conversion efficiency (9.60%), than DSSCs fabricated with commercial (P25) titania powder (4.67%) or with anatase TiO2 nanostructures having exposed {101} facets (7.59%) as the upper layer. The improved performance in bilayered DSSC made from TiO2 nanostructures with exposed {111} facets as the upper layer is attributed to high dye adsorption and fast electron transport dynamics owing to the unique structural features of the {111} facets in TiO2. Electrochemical impedance spectroscopy (EIS) measurements conducted on the cells supported these conclusions, which showed that the bilayered DSSC made from TiO2 nanostructures with exposed {111} facets as the upper layer possessed lower charge transfer resistance, higher electron recombination resistance, longer electron lifetime and higher collector efficiency characteristics, compared to DSSCs fabricated with commercial (P25) titania powder or with anatase TiO2 nanostructures having exposed {101} facets as the upper layer.

Green synthesis of Pt-doped TiO2 nanocrystals with exposed (001) facets and mesoscopic void space for photo-splitting of water under solar irradiation

We report a non-trivial facile chemical approach using ionic liquid ([bmim][Cl]) as a porogen for the synthesis of (001) faceted TiO2 nanocrystals having mesoscopic void space. This faceted TiO2 nanomaterial has been doped with Pt nanoclusters through chemical impregnation. The resulting Pt-doped TiO2 nanomaterials are thoroughly characterized by powder X-ray diffraction (PXRD), Raman spectroscopy, field emission scanning electron microscopy (FE-SEM), ultra high resolution transmission electron microscopy (UHR-TEM), energy dispersive X-ray spectrometry (EDX), UV-vis diffuse reflection spectroscopy (DRS) and N2 sorption studies. These Pt/TiO2 nanocrystals with (001) exposed facets are employed as efficient and benign catalysts for hydrogen production from pure water and methanol-water systems under one AM 1.5G sunlight illumination. The effect of platinum loading and methanol-water ratio on the photocatalytic activity of the faceted TiO2 nanocrystals are investigated and it is found that hydrogen evolution rates have been enhanced significantly upon Pt loading. Under optimized reaction conditions the highest photocatalytic activity of 11.2 mmol h(-1) g(-1) has been achieved over ca. 1.0 wt% Pt loaded Pt/TiO2 nanocrystals with (001) exposed facets, which is one of the highest hydrogen evolution rates over the noble metal/TiO2 system reported to date in the literature.

Anesthetic management of Wolff-Parkinson-White syndrome in a pregnant patient posted for emergency caesarean section

The most common arrhythmia seen during pregnancy is paroxysmal supraventricular tachycardia and Wolff-Parkinson-White syndrome accounts for majority of this in such population. The presence of pre-disposing factors may facilitate the onset of tachyarrhythmias in previously asymptomatic parturients with the WPW syndrome such as increased hemodynamic, hormonal, autonomic, and emotional changes. Therefore, meticulous monitoring is essential perioperatively. Epidural anesthesia providing added advantage of hemodynamic stability and post-operative analgesia is preferred in such pregnant patients undergoing emergency cesarean section.

Incidental Enterobius Vermicularis infestation in surgically removed appendices with a clinical diagnosis of acute appendicitis: A retrospective analysis

Background: Appendiceal parasites can cause symptoms of appendicitis. Although the symptomatology imitates acute appendicitis clinically, the true nature of disease is diagnosed through histological examination. The aim of this study is to therefore determine the prevalence of E. Vermicularis in appendicectomy specimens to relate this to acute inflammation histologically.Materials & Methods: Histological data on all appendectomy specimens with a clinical diagnosis of acute appendicitis were retrieved from the archives of department of pathology, B.P.K.I.H.S, over the period of  five years (January 2004- December 2008) and was analyzed retrospectively.Results: There were a total of 1528 patients. M:F ratio being 1.2:1.Inflamed appendix constituted for 94.24% of all cases. There were a total of six (0.39%) appendicectomy specimens  which showed presence of oxyuriasis appendix. Though all patients with oxyuriasis presented with appendicial colic only one (1) out of the six cases of oxyuriasis showed histologic evidence of inflammation. Conclusion: We conclude that enterobius does not frequently cause inflammation of appendix though it may clinically mimic acute appendicitis. Since it represents a disease curable without necessitating surgery, symptomatology awareness is stressed upon.Journal of Pathology of Nepal (2015) Vol. 5, 720-722

Transverse wobbling in ^{135}pr

A pair of transverse wobbling bands is observed in the nucleus ^{135}Pr. The wobbling is characterized by ΔI=1, E2 transitions between the bands, and a decrease in the wobbling energy confirms its transverse nature. Additionally, a transition from transverse wobbling to a three-quasiparticle band comprised of strong magnetic dipole transitions is observed. These observations conform well to results from calculations with the tilted axis cranking model and the quasiparticle rotor model.