Severe Disease Burden and the Mitigation Strategy in the Arsenic-Exposed Population of Kaliprasad Village in Bhagalpur District of Bihar, India

The present study was carried out in the village Kaliprasad of Bhagalpur district of Bihar to know the arsenic exposure effect in the exposed population. A total of n = 102 households were studied, and their water and biological samples such as urine and hair were collected and analyzed in a graphite furnace atomic absorption spectrophotometer (GF-AAS). The assessment of arsenic-exposed village population reveals that the villagers were suffering from serious health-related problems such as skin manifestations (hyperkeratosis and melanosis in their palm and soles), breathlessness, general body weakness, mental disorders, diabetes, hypertension (raised blood pressure), hormonal imbalance, neurological disorders, and few cancer cases. About 77% of household hand pump water had arsenic level more than the WHO recommended level of 10 µg/L, with highest level of 523 µg/L. Moreover, in 60% individual's urine samples, arsenic concentration was very high with maximum 374 µg/L while in hair 64% individuals had arsenic concentration above the permissible limit with maximum arsenic concentration of 11,398 µg/kg. The hazard quotient (HQ) was also calculated to know the arsenic risk percentage in children as 87.11%, in females as 83.15%, and in males as 82.27% by groundwater. This has surpassed the threshold value of 1 × 10 - 6 for carcinogenic risk (CR) in children, female, and male population group in the village. Hence, the exposed population of Kaliprasad village are at very high risk of the disease burden.

Compare the Combined Diagnostic Accuracy of Transient Elastography and Visual Liver Score in Assessing Non-Alcoholic Fatty Liver Disease (NAFLD) and Compare it with Liver Biopsy in Morbidly Obese Patients Undergoing Bariatric Surgery: An Observational Study

INTRODUCTION

A liver biopsy is the gold standard for the diagnosis of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). Here, we combine preoperative transient elastography (TE) and intraoperative standardized visual liver score (VLS) which is compared with intraoperative liver biopsy for prediction of NAFLD and NASH in patients undergoing bariatric surgery.

AIM

Evaluate the combined diagnostic accuracy of TE and VLS in assessing NAFLD or NASH and compare it with liver biopsy in patients undergoing bariatric surgery.

METHODS

In a prospective cohort of 70 morbidly obese undergoing bariatric surgery, preoperative TE and intraoperative VLS were calculated. Findings of TE and VLS were compared with histology from intraoperative liver biopsy.

RESULTS

Histologically, 44 (62.85%) had NAFLD (≥ S1). Significant steatosis was seen in 20 (28.57%) while significant fibrosis was visible in 18 (25.71%). Area Under the Receiver Operating Characteristics (AUROC) TE for diagnosis of NAFLD was excellent (0.844, p = 0.001). At the optimal cutoff of 8.1, the positive predictive value (PPV) was 92.9%, and diagnostic accuracy was 90.6%. VLS had a sensitivity of 90.9% for NAFLD. The combined sensitivity of TE + VLS was 95.5% for ruling out NAFLD. Fourteen (20%) had NASH. VLS had a diagnostic accuracy of 97% in identifying NASH in comparison to TE. AUROC-VLS was 0.987, p ≤ 0.001, and a sensitivity of 100%. The overall sensitivity of combined TE and VLS was 100% with a negative predictive value (NPV) of 100%.

CONCLUSION

TE when combined with intraoperative VLS is comparable to liver biopsy and can be used for the diagnosis of NAFLD and NASH in patients undergoing bariatric surgery.

A Multicentric, Retrospective, Real-world Study on Immune-related Adverse Events in Patients with Advanced Non-small Cell Lung Cancers Treated with Pembrolizumab Monotherapy

AIMS

We present 7 years of clinical experience with single-agent pembrolizumab immune checkpoint inhibitor immunotherapy in non-small cell lung cancers (NSCLC) from four UK cancer centres.

MATERIALS AND METHODS

This multi-institutional retrospective cohort study included 226 metastatic NSCLC patients. Outcomes were number and severity of immune-related adverse events (irAEs), median progression-free survival (mPFS) and median overall survival (mOS).

RESULTS

Within our cohort, 119/226 (53%) patients developed irAEs. Of these, 54/119 (45%) experienced irAEs affecting two or more organ systems. The most common irAEs were diarrhoea and rash. The development of an irAE was associated with better mOS (20.7 versus 8.0 months; P < 0.001) and mPFS (12.0 versus 3.9 months; P < 0.001). The development of grade 3/4 toxicities was associated with worse outcomes compared with the development of grade 1/2 toxicities (mOS 6.1 months versus 25.2 months, P < 0.01; mPFS 5.6 months versus 19.3 months, P = 0.01, respectively). Females had a higher proportion of reported grade 3/4 toxicities (13/44 [29.5%] versus 10/74 [13.5%], P = 0.03). Using a multiple Cox regression model, the presence of irAEs was associated with a better overall survival (hazard ratio = 0.42, 95% confidence interval 0.29-0.61; P < 0.01) and better PFS (hazard ratio 0.38, 95% confidence interval 0.27-0.53; P < 0.001).

CONCLUSION

In this multicentre retrospective cohort study, the development of at least one irAE was associated with significantly longer mPFS and mOS; however, more severe grade 3 and 4 irAEs were associated with worse outcomes. Delayed-onset irAEs, after the 3-month timepoint, were associated with better clinical outcomes.

Wearable Technology for Monitoring Electrocardiograms (ECGs) in Adults: A Scoping Review

In the rapidly evolving landscape of continuous electrocardiogram (ECG) monitoring systems, there is a heightened demand for non-invasive sensors capable of measuring ECGs and detecting heart rate variability (HRV) in diverse populations, ranging from cardiovascular patients to sports enthusiasts. Challenges like device accuracy, patient privacy, signal noise, and long-term safety impede the use of wearable devices in clinical practice. This scoping review aims to assess the performance and safety of novel multi-channel, sensor-based biopotential wearable devices in adults. A comprehensive search strategy was employed on four databases, resulting in 143 records and the inclusion of 12 relevant studies. Most studies focused on healthy adult subjects (n = 6), with some examining controlled groups with atrial fibrillation (AF) (n = 3), long QT syndrome (n = 1), and sleep apnea (n = 1). The investigated bio-sensor devices included chest-worn belts (n = 2), wrist bands (n = 2), adhesive chest strips (n = 2), and wearable textile smart clothes (n = 4). The primary objective of the included studies was to evaluate device performance in terms of accuracy, signal quality, comparability, and visual assessment of ECGs. Safety findings, reported in five articles, indicated no major side effects for long-term/continuous monitoring, with only minor instances of skin irritation. Looking forward, there are ample opportunities to enhance and test these technologies across various physical activity intensities and clinical conditions.

TOR coordinates cytokinin and gibberellin signals mediating development and defense

Plants constantly perceive and process environmental signals and balance between the energetic demands of growth and defense. Growth arrest upon pathogen attack was previously suggested to result from a redirection of the plants' metabolic resources towards the activation of plant defense. The energy sensor Target of Rapamycin (TOR) kinase is a conserved master coordinator of growth and development in all eukaryotes. Although TOR is positioned at the interface between development and defense, little is known about the mechanisms by which TOR may potentially regulate the relationship between these two modalities. The plant hormones cytokinin (CK) and gibberellin (GA) execute various aspects of plant development and defense. The ratio between CK and GA was reported to determine the outcome of developmental programmes. Here, investigating the interplay between TOR-mediated development and TOR-mediated defense in tomato, we found that TOR silencing resulted in rescue of several different aberrant developmental phenotypes, demonstrating that TOR is required for the execution of developmental cues. In parallel, TOR inhibition enhanced immunity in genotypes with a low CK/GA ratio but not in genotypes with a high CK/GA ratio. TOR-inhibition mediated disease resistance was found to depend on developmental status, and was abolished in strongly morphogenetic leaves, while being strongest in mature, differentiated leaves. CK repressed TOR activity, suggesting that CK-mediated immunity may rely on TOR downregulation. At the same time, TOR activity was promoted by GA, and TOR silencing reduced GA sensitivity, indicating that GA signalling requires normal TOR activity. Our results demonstrate that TOR likely acts in concert with CK and GA signalling, executing signalling cues in both defense and development. Thus, differential regulation of TOR or TOR-mediated processes could regulate the required outcome of development-defense prioritisation.

Aromatic amino acid metabolites alter interferon signaling and influenza pathogenesis

The ability of gut microbial metabolites to influence the host is increasingly recognized. The microbiota extensively metabolizes the three aromatic amino acids, tryptophan, tyrosine, and phenylalanine. Previously we have found that a metabolite of tyrosine, 4-OH-phenylpropionic acid, can enhance type I interferon (IFN) signaling and protect from influenza pathogenesis in a murine model. Herein we screened 17 related aromatic amino acid metabolites for effects on IFN signaling in human lung epithelial cells and monocytes alone and in the presence of IFN-β, influenza, and LPS. While the tryptophan family metabolites reduced IFN signaling in both cell types, the tyrosine and phenylalanine metabolites had varied effects, which were cell-type dependent. Pooled treatment of all these metabolites reduced IFN signaling in both cell types and suggested a tryptophan metabolite effect dominance. Strikingly, when all the metabolites were pooled together, we found reduced influenza recovery in both cell types. RNA sequencing further validated reduced viral loads and decreased IFN signaling. Single gene silencing of significantly upregulated genes identified by RNA sequencing (EGR2, ATP6VD02, SPOCK1, and IL31RA) did not completely abrogate the metabolite induced decrease in IFN signaling. However, these upregulated targets suggested a mechanistic link to TGF-beta signaling. Treatment with a TGF-beta inhibitor and combined targeted gene silencing led to a significant reversal of metabolite induced IFN signaling suppression. Finally, we demonstrated that intranasal administration of these metabolites prior to influenza infection led to reduced animal morbidity, viral titers, and inflammation. Our work implies that microbial metabolites can alter IFN signaling mechanistically through TGF-beta and promote beneficial outcomes during influenza infection.

The Investigation of Bio-impedance Analysis at a Wrist Phantom with Two Pulsatile Arteries

PURPOSE

Bio-impedance analysis (BIA) has been widely investigated for hemodynamic monitoring. However, previous works rarely modelled two synchronously pulsatile arteries (representing the radial and ulnar arteries) in the wrist/forearm model. This work aims to clarify and quantify the influences of two pulsatile arteries on BIA.

METHODS

First, two blood-filled arteries were structured in a 3D wrist segment using the finite element method (FEM). Afterwards, an easy-to-produce two-arteries artificial wrist was fabricated with two components: gelatine-based surrounding tissue phantom and saline blood phantom. A syringe driver was utilised to constrict the arteries, and the impedance signals were measured using a Multi-frequency Impedance Analyser (MFIA).

RESULTS

Both simulation and experimental results demonstrated the non-negligible influences of the ulnar artery on the overall BIA, inducing unwanted resistance changes to the acquired signals from the radial artery. The phantom experiments revealed the summation of the individual resistance changes caused by a single pulsatile artery was approximately equal to the measured resistance change caused by two synchronously pulsatile arteries, confirming the measured impedance signal at the wrist contains the pulsatile information from both arteries.

CONCLUSION

This work is the first simulation and phantom investigation into two synchronously pulsatile arteries under BIA in the distal forearm, providing a better insight and understanding in the morphology of measured impedance signals. Future research can accordingly select either a small spacing 4-spot electrode configuration for a single artery sensing or a band electrode configuration for overall pulsatile arteries sensing. A more accurate estimation of blood volume change and pulse wave analysis (PWA) could help to develop cuffless blood pressure measurement (BPM).

Omentum Mimicking as a Vaginal Prolapse in a Delayed Vaginal Cuff Dehiscence

A rare consequence of hysterectomy is vaginal vault dehiscence, which commonly occurs five to seven weeks after the procedure. Its frequency ranges from 0% to 7.5%. The incidence of delayed dehiscence is rare. The small bowel is the organ that prolapses most frequently, but other organs and multi-organ prolapses have also been documented. Due to potential catastrophes such as intestinal ischemia, blockage, and perforation, transvaginal protrusion of abdominal viscera is an emergency. A laparoscopic approach facilitates a thorough evaluation of the abdominal contents and provides assistance in challenging circumstances where the contents are not reducible.

A Pilot Study Examining the Dielectric Response of Human Forearm Tissues

This work aims to describe the dielectric behaviors of four main tissues in the human forearm using mathematical modelling, including fat, muscle, blood and bone. Multi-frequency bioimpedance analysis (MF-BIA) was initially performed using the finite element method (FEM) with a 3D forearm model to estimate impedance spectra from 10 kHz to 1 MHz, followed by a pilot study involving two healthy subjects to characterize the response of actual forearm tissues from 1 kHz to 349 kHz. Both the simulation and experimental results were fitted to a single-dispersion Cole model (SDCM) and a multi-dispersion Cole model (MDCM) to determine the Cole parameters for each tissue. Cole-type responses of both simulated and actual human forearms were observed. A paired t-test based on the root mean squared error (RMSE) values indicated that both Cole models performed comparably in fitting both simulated and measured bioimpedance data. However, MDCM exhibited higher accuracy, with a correlation coefficient (R2) of 0.99 and 0.89, RMSE of 0.22 Ω and 0.56 Ω, mean difference (mean ± standard deviation) of 0.00 ± 0.23 Ω and -0.28 ± 0.23 Ω, and mean absolute error (MAE) of 0.0007 Ω and 0.2789 Ω for the real part and imaginary part of impedance, respectively. Determining the electrical response of multi-tissues can be helpful in developing physiological monitoring of an organ or a section of the human body through MF-BIA and hemodynamic monitoring by filtering out the impedance contributions from the surrounding tissues to blood-flow-induced impedance variations.

Randomized single blind trial to compare the short term post-operative outcome and cost analysis of laparoscopic versus ultrasound guided transversus abdominis plane block in patients undergoing bariatric surgery

INTRODUCTION

Laparoscopic Bariatric surgery despite being minimally invasive can cause moderate to severe pain in the immediate postoperative period. Adequate pain management remains a major challenge. Transversus Abdominis Plane (TAP) block is a regional anesthesia technique which blocks the sensory nerve supply of anterior-lateral abdominal wall.

AIMS AND OBJECTIVES

Primary: evaluate Laparoscopic versus ultrasound (USG)-guided TAP block on immediate post-operative analgesia after undergoing laparoscopic bariatric surgery. Secondary: compare cost effectiveness of Laparoscopic versus ultrasound-guided TAP block after undergoing bariatric surgery.

MATERIALS AND METHODS

Randomized Single blind study undertaken after sample size was calculated by (N) = 2(Zα + Z1-β)2σ2/δ2 which proposed 60 patients in each group. Block randomization was done after excluding redo/revision surgeries and patients were alloted Group I: Laparoscopic-guided TAP block & Group II: USG-guided TAP block. In both groups, Bilaterally, 20 ml (0.25%) bupivacaine was injected immediately after completion of bariatric surgery. SPSS v23 (IBM Corp.) was used for analysis.

RESULTS

Group I (N = 61 53F/8 M) & Group II (N = 60 42F/18 M) were demographically comparable. Group I (3.58 ± 0.67) had significantly lower procedure time compared to Group II (12.47 ± 1.61) (p-Value < 0.001). First rescue analgesia was administered at 7.07 ± 2.61 h in Group I vs 7.21 ± 2.39 h in Group II (p-Value 0.659). In first 24 h rescue analgesic dose requirement in Group I was 1.29 ± 0.53 vs 1.39 ± 0.50 in Group II (p-Value 0.487). VAS scores during rest and movement till 24 h post-operative were statistically similar. Procedural cost was more in group II.

CONCLUSION

Laparoscopic-guided TAP block is a safe and cost-effective approach for postoperative pain management after bariatric surgery and provides similar comparable analgesic effect as the USG-TAP block. Laparoscopic TAP is a surgeon delivered, easy to administer and significantly less time-consuming procedure which is feasible even when an ultrasound machine is not available.

The effects of tissue proportions on blood volume change-induced variations using bio-impedance analysis: a simulation study. Annu Int Conf IEEE Eng Med Biol Soc 2023;2023:1-4. [PMID: 38082597 DOI: 10.1109/embc40787.2023.10340562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Bioimpedance Analysis (BIA) along the radial artery has been widely investigated for hemodynamic monitoring. However, its applicability to different body type populations still lacks sufficient research. The Finite Element Method (FEM) was performed on three different wrist models using ANSYS HFSS, aiming to reveal the influences of different fat and muscle proportions on the sensitivity of blood volume change-induced bioimpedance change. The simulation results confirmed that the current density in each tissue mainly depended on the conductivity of tissues. The higher conductivity of the tissue, the higher current density inside said tissue. The amounts of flowing current were decided by both volume and conductivity of tissues. Moreover, increasing the fat layer thickness from 4 mm to 6 mm raised simulated impedance from 86.82 Ω to 100.39 Ω and impedance change from 0.63 Ω to 1.55 Ω. However, a higher muscle proportion occupied more injected current from the blood and resulted in lower impedance change. Therefore, for the overweight population, the placement of BIA is recommended to avoid the muscular body parts for the acquirement of better-quality pulse waves.Clinical Relevance-This establishes the bio-impedance analysis should avoid the muscular body parts for a better blood pulse wave quality for overweight populations.

Esophagogastrectomy for Long-Segment Recurrent Esophageal Stricture Following Hyperemesis Gravidarum

An esophageal stricture is an abnormal tightening of the esophageal lumen. Benign strictures are often caused by gastroesophageal reflux disease (GERD) and are more common in patients over 40 years. When caused by GERD, these strictures develop when acid from the stomach regurgitates into the esophagus, leading to inflammation, fibrosis, and eventual narrowing of the lumen. This case report aims to highlight the importance of obtaining a detailed history in discovering the underlying cause of these strictures. We present a unique case of a young female presenting with dysphagia several months after experiencing Hyperemesis gravidarum. She was found to have a long esophageal stricture that would eventually recur within a few weeks of therapeutic intervention. The pathological report confirmed benign disease, but she ultimately would require surgical intervention for her condition.

Fungal Planet description sheets: 1478-1549

Novel species of fungi described in this study include those from various countries as follows: Australia, Aschersonia mackerrasiae on whitefly, Cladosporium corticola on bark of Melaleuca quinquenervia, Penicillium nudgee from soil under Melaleuca quinquenervia, Pseudocercospora blackwoodiae on leaf spot of Persoonia falcata, and Pseudocercospora dalyelliae on leaf spot of Senna alata. Bolivia, Aspicilia lutzoniana on fully submersed siliceous schist in high-mountain streams, and Niesslia parviseta on the lower part and apothecial discs of Erioderma barbellatum on a twig. Brazil, Cyathus bonsai on decaying wood, Geastrum albofibrosum from moist soil with leaf litter, Laetiporus pratigiensis on a trunk of a living unknown hardwood tree species, and Scytalidium synnematicum on dead twigs of unidentified plant. Bulgaria, Amanita abscondita on sandy soil in a plantation of Quercus suber. Canada, Penicillium acericola on dead bark of Acer saccharum, and Penicillium corticola on dead bark of Acer saccharum. China, Colletotrichum qingyuanense on fruit lesion of Capsicum annuum. Denmark, Helminthosphaeria leptospora on corticioid Neohypochnicium cremicolor. Ecuador (Galapagos), Phaeosphaeria scalesiae on Scalesia sp. Finland, Inocybe jacobssonii on calcareous soils in dry forests and park habitats. France, Cortinarius rufomyrrheus on sandy soil under Pinus pinaster, and Periconia neominutissima on leaves of Poaceae. India, Coprinopsis fragilis on decaying bark of logs, Filoboletus keralensis on unidentified woody substrate, Penicillium sankaranii from soil, Physisporinus tamilnaduensis on the trunk of Azadirachta indica, and Poronia nagaraholensis on elephant dung. Iran, Neosetophoma fici on infected leaves of Ficus elastica. Israel, Cnidariophoma eilatica (incl. Cnidariophoma gen. nov.) from Stylophora pistillata. Italy, Lyophyllum obscurum on acidic soil. Namibia, Aureobasidium faidherbiae on dead leaf of Faidherbia albida, and Aureobasidium welwitschiae on dead leaves of Welwitschia mirabilis. Netherlands, Gaeumannomycella caricigena on dead culms of Carex elongata, Houtenomyces caricicola (incl. Houtenomyces gen. nov.) on culms of Carex disticha, Neodacampia ulmea (incl. Neodacampia gen. nov.) on branch of Ulmus laevis, Niesslia phragmiticola on dead standing culms of Phragmites australis, Pseudopyricularia caricicola on culms of Carex disticha, and Rhodoveronaea nieuwwulvenica on dead bamboo sticks. Norway, Arrhenia similis half-buried and moss-covered pieces of rotting wood in grass-grown path. Pakistan, Mallocybe ahmadii on soil. Poland, Beskidomyces laricis (incl. Beskidomyces gen. nov.) from resin of Larix decidua ssp. polonica, Lapidomyces epipinicola from sooty mould community on Pinus nigra, and Leptographium granulatum from a gallery of Dendroctonus micans on Picea abies. Portugal, Geoglossum azoricum on mossy areas of laurel forest areas planted with Cryptomeria japonica, and Lunasporangiospora lusitanica from a biofilm covering a biodeteriorated limestone wall. Qatar, Alternaria halotolerans from hypersaline sea water, and Alternaria qatarensis from water sample collected from hypersaline lagoon. South Africa, Alfaria thamnochorti on culm of Thamnochortus fraternus, Knufia aloeicola on Aloe gariepensis, Muriseptatomyces restionacearum (incl. Muriseptatomyces gen. nov.) on culms of Restionaceae, Neocladosporium arctotis on nest of cases of bag worm moths (Lepidoptera, Psychidae) on Arctotis auriculata, Neodevriesia scadoxi on leaves of Scadoxus puniceus, Paraloratospora schoenoplecti on stems of Schoenoplectus lacustris, Tulasnella epidendrea from the roots of Epidendrum × obrienianum, and Xenoidriella cinnamomi (incl. Xenoidriella gen. nov.) on leaf of Cinnamomum camphora. South Korea, Lemonniera fraxinea on decaying leaves of Fraxinus sp. from pond. Spain, Atheniella lauri on the bark of fallen trees of Laurus nobilis, Halocryptovalsa endophytica from surface-sterilised, asymptomatic roots of Salicornia patula, Inocybe amygdaliolens on soil in mixed forest, Inocybe pityusarum on calcareous soil in mixed forest, Inocybe roseobulbipes on acidic soils, Neonectria borealis from roots of Vitis berlandieri × Vitis rupestris, Sympoventuria eucalyptorum on leaves of Eucalyptus sp., and Tuber conchae from soil. Sweden, Inocybe bidumensis on calcareous soil. Thailand, Cordyceps sandindaengensis on Lepidoptera pupa, buried in soil, Ophiocordyceps kuchinaraiensis on Coleoptera larva, buried in soil, and Samsoniella winandae on Lepidoptera pupa, buried in soil. Taiwan region (China), Neophaeosphaeria livistonae on dead leaf of Livistona rotundifolia. Türkiye, Melanogaster anatolicus on clay loamy soils. UK, Basingstokeomyces allii (incl. Basingstokeomyces gen. nov.) on leaves of Allium schoenoprasum. Ukraine, Xenosphaeropsis corni on recently dead stem of Cornus alba. USA, Nothotrichosporon aquaticum (incl. Nothotrichosporon gen. nov.) from water, and Periconia philadelphiana from swab of coil surface. Morphological and culture characteristics for these new taxa are supported by DNA barcodes. Citation: Crous PW, Osieck ER, Shivas RG, et al. 2023. Fungal Planet description sheets: 1478-1549. Persoonia 50: 158- 310. https://doi.org/10.3767/persoonia.2023.50.05.

Antifungal Metabolites of Streptomyces chrestomyceticus STR-2 Inhibits Magnaporthe oryzae, the Incitant of Rice Blast

Rice, a staple food crop worldwide, suffers devastating yield losses as a result of blast disease caused by Magnaporthe oryzae Cav. The adverse effects of chemicals on the environment are rising concerns for sustainable and eco-friendly approaches. The use of antagonistic microbes for the management of rice blast appears to be a sustainable solution to this challenge. Herein, we isolated 20 Streptomyces strains from rice rhizosphere, among which the isolate STR-2 exhibited maximum inhibition of mycelial growth of M. oryzae accounting for 50% reduction over control. The isolate STR-2 was identified as S. chrestomyceticus through 16S rRNA gene sequencing. In vitro tests demonstrated its ability to produce antifungal and bioactive compounds and also synthesize siderophore, IAA, and phosphate-solubilizing agents, thereby promoting plant growth upon inoculation on rice seeds. GC-MS analysis showed the presence of volatiles, antifungal, antimicrobial, and antioxidant compounds with different retention times. The crude antibiotic extract of 0.5% of S. chrestomyceticus STR-2 reduced the mycelial growth of M. oryzae over the control. Application of talc-based formulation of Streptomyces chrestomyceticus STR-2 resulted in the least disease incidence (15.89%) with the highest disease reduction of 65.26% over untreated control under field condition. These findings indicate the potential of S. chrestomyceticus as a potential bio-inoculant against rice blast disease.

Resection of Accessory Parotid Gland Tumors: A Multidisciplinary Feat and Review of Literature

Accessory parotid lobe tumors are very rare. For any mass occupying the mid-cheek, tumors of the accessory parotid gland should be strongly suspected. These tumors are properly evaluated using ultrasonography, computed tomography, and fine needle aspiration cytology. Different surgical approaches are mentioned in the literature for the resection of these parotid lesions. These surgical approaches are often accompanied by the extracapsular dissection of the tumor. The extracapsular dissection of the tumor is an adequate technique to resect tumors of the accessory lobe of the parotid.

A Hydrogel-Based Electronic Skin for Touch Detection Using Electrical Impedance Tomography

Recent advancement in wearable and robot-assisted healthcare technology gives rise to the demand for smart interfaces that allow more efficient human-machine interaction. In this paper, a hydrogel-based soft sensor for subtle touch detection is proposed. Adopting the working principle of a biomedical imaging technology known as electrical impedance tomography (EIT), the sensor produces images that display the electrical conductivity distribution of its sensitive region to enable touch detection. The sensor was made from a natural gelatin hydrogel whose electrical conductivity is considerably less than that of human skin. The low conductivity of the sensor enabled a touch-detection mechanism based on a novel short-circuiting approach, which resulted in the reconstructed images being predominantly affected by the electrical contact between the sensor and fingertips, rather than the conventionally used piezoresistive response of the sensing material. The experimental results indicated that the proposed sensor was promising for detecting subtle contacts without the necessity of exerting a noticeable force on the sensor.

Comprehensive Understanding of Foot Development in Children Using Capacitive Textile Sensors

Knowledge of foot growth can provide information on the occurrence of children's growth spurts and an indication of the time to buy new shoes. Podiatrists still do not have enough evidence as to whether footwear influences the structural development of the feet and associated locomotor behaviours. Parents are only willing to buy an inexpensive brand, because children's shoes are deemed expendable due to their rapid foot growth. Consumers are not fully aware of footwear literacy; thus, views of consumers on children's shoes are left unchallenged. This study aims to embed knitted smart textile sensors in children's shoes to sense the growth and development of a child's feet-specifically foot length. Two prototype configurations were evaluated on 30 children, who each inserted their feet for ten seconds inside the instrumented shoes. Capacitance readings were related to the proximity of their toes to the sensor and validated against foot length and shoe size. A linear regression model of capacitance readings and foot length was developed. This regression model was found to be statistically significant (p-value = 0.01, standard error = 0.08). Results of this study indicate that knitted textile sensors can be implemented inside shoes to get a comprehensive understanding of foot development in children.

Nutrient Elements Promote Disease Resistance in Tomato by Differentially Activating Immune Pathways

Nutrient elements play essential roles in plant growth, development, and reproduction. Balanced nutrition is critical for plant health and the ability to withstand biotic stress. Treatment with essential elements has been shown to induce disease resistance in certain cases. Understanding the functional mechanisms underlying plant immune responses to nutritional elements has the potential to provide new insights into crop improvement. In the present study, we investigated the effect of various elements-potassium (K), calcium (Ca), magnesium (Mg), and sodium (Na)-in promoting resistance against the necrotrophic fungus Botrytis cinerea and the hemibiotrophic bacterium Xanthomonas euvesicatoria in tomato. We demonstrate that spray treatment of essential elements was sufficient to activate immune responses, inducing defense gene expression, cellular leakage, reactive oxygen species, and ethylene production. We report that different defense signaling pathways are required for induction of immunity in response to different elements. Our results suggest that genetic mechanisms that are modulated by nutrient elements can be exploited in agricultural practices to promote disease resistance.

The Development of a Built-In Shoe Plantar Pressure Measurement System for Children

There is a rapid increase in plantar pressure from the infant to toddler stage, yet little is known about the reasons for this change. More information about plantar pressure distribution can help clinicians identify early-stage foot-related diseases that may occur during transitions from childhood to adulthood. This information also helps designers create shoes that adapt to different needs. This research describes the development of a low-cost, built-in shoe plantar pressure measurement system that determines foot pressure distribution in toddlers. The study aimed to improve and provide data on pressure distribution during foot growth. This was accomplished by implementing a plantar pressure capacitive measurement system within shoes. The capacitive sensors were laminated using a copper tape sheet on plastic backing with adhesive, elastomer layers, and a combination of conductive and non-conductive fabrics. Constructed sensors were characterized using compression tests with repeated loads. Results demonstrated that the sensors exhibited rate-independent hysteresis in the estimation of pressure. This enabled a calibration model to be developed. The system can mimic more expensive plantar pressure measurement systems at lower fidelity. This emerging technology could be utilized to aid clinicians, researchers, and footwear designers interested in how pressure distribution changes from infants to toddlers.

Resection of a large Solid Pseudopapillary Neoplasm of the Pancreas: A multidisciplinary feat and review of literature

Solid pseudopapillary neoplasm (SPN) is an extremely rare tumor with low malignant potential which is generally located in the tail of the pancreas. The prevalence of SPN has increased with the recent advancement in radiological imaging. CECT abdomen and Endoscopic ultrasound-FNA are excellent modalities in preoperative diagnosis. Surgery is the main treatment modality of choice and a successful R0 resection is curative. We present a case of solid pseudopapillary neoplasm and included a summary of the current literature to provide a reference for the management of this rare clinical entity.

Towards Estimating Arterial Diameter Using Bioimpedance Spectroscopy: A Computational Simulation and Tissue Phantom Analysis

This paper improves the accuracy of quantification in the arterial diameter-dependent impedance variance by altering the electrode configuration. The finite element analysis was implemented with a 3D human wrist fragment using ANSYS Electronics Desktop, containing fat, muscle, and a blood-filled radial artery. Then, the skin layer and bones were stepwise added, helping to understand the dielectric response of multi-tissues and blood flow from 1 kHz to 1 MHz, the current distribution throughout the wrist, and the optimisation of electrode configurations for arterial pulse sensing. Moreover, a low-cost wrist phantom was fabricated, containing two components: the surrounding tissue simulant (20 wt % gelatine power and 0.017 M sodium chloride (NaCl) solution) and the blood simulant (0.08 M NaCl solution). The blood-filled artery was constricted using a desktop injection pump, and the impedance change was measured by the Multi-frequency Impedance Analyser (MFIA). The simulation revealed the promising capabilities of band electrodes to generate a more uniform current distribution than the traditional spot electrodes. Both simulation and phantom experimental results indicated that a longer spacing between current-carrying (CC) electrodes with shorter spacing between pick-up (PU) electrodes in the middle could sense a more uniform electric field, engendering a more accurate arterial diameter estimation. This work provided an improved electrode configuration for more accurate arterial diameter estimation from the numerical simulation and tissue phantom perspectives.

AB1250 TOFACITINIB IS A SAFE AND EFFECTIVE TREATMENT OPTION FOR JUVENILE IDIOPATHIC ARTHRITIS

Background

The management of juvenile idiopathic arthritis(JIA) is often constrained by the limited number of oral drugs available. Whether JAK inhibitors would add a much needed therapeutic armamentarium in this regard needs to be explored.

Objectives

To assess the safety and efficacy of tofacitinib in juvenile idiopathic arthritis (JIA) patient who were prescribed during the period January 2021 to December 2021.

Methods

It’s a retrospective study of JIA patients who were prescribed tofacitinib during the period Jan 21 to Dec 21 with minimum of 3 months’ follow-up after prescribing tofacitinib. The demographics,details of medications,investigations parameters and any adverse events were noted.

Results

There were a total of 35 patients who were given tofacitinib during this period. Male is to female ratio is 25:10, mean age of 12.91(4.81) yrs., the mean disease duration was 58.6 months. Enthesitis related arthritis(ERA) was the commonest seen in 12, followed by oligo articular in 10, polyarticular in 7 and systemic onset in 6. In the ERA group 10 were HLA B27 +VE, of the oligo articular 6 were ANA +VE, in the polyarticular one was RF +ve. Out of the 35,14 were already on biologicals (tocilizumab and anti TNFs). Tofacitinib was stopped in 8 patients during this period, 5 as they achieved remission, 2 with no response and one because of itching and abdominal pain. There were no documented infections. There was significant reduction in the inflammatory markers (ESR, CRP), leucocyte count and platelet count.

Before tofaAfter tofap valueMethotrexate in mg (week) mean(stdev)9.64(1.94)8.88(3.34)0.66Steroid in mg mean (stdev)3(2.35)2.8(1.8)0.91Leucocyte count mean(stdev)11242(1858)7884(1471)0.005Platelet count in lakhsMean(stdev)4.51(0.48)3.37(0.82)0.017ESR mm/1hr57.75(17.25)30.83(11.48)0.009CRP mg/L25.36(10.9)12.36(7.97)0.05

Conclusion

Tofacitinib seems to be a promising drug in the management of JIA with good safety profile and efficacy.

References

[1] Brunner HI, Schanberg LE, Kimura Y et al. New medications are needed for children with juvenile idiopathic arthritis. Arthritis Rheumatol. 2020; 72: 1945-1951.

Disclosure of Interests

None declared

Cell specific peripheral immune responses predict survival in critical COVID-19 patients

SARS-CoV-2 triggers a complex systemic immune response in circulating blood mononuclear cells. The relationship between immune cell activation of the peripheral compartment and survival in critical COVID-19 remains to be established. Here we use single-cell RNA sequencing and Cellular Indexing of Transcriptomes and Epitomes by sequence mapping to elucidate cell type specific transcriptional signatures that associate with and predict survival in critical COVID-19. Patients who survive infection display activation of antibody processing, early activation response, and cell cycle regulation pathways most prominent within B-, T-, and NK-cell subsets. We further leverage cell specific differential gene expression and machine learning to predict mortality using single cell transcriptomes. We identify interferon signaling and antigen presentation pathways within cDC2 cells, CD14 monocytes, and CD16 monocytes as predictors of mortality with 90% accuracy. Finally, we validate our findings in an independent transcriptomics dataset and provide a framework to elucidate mechanisms that promote survival in critically ill COVID-19 patients. Identifying prognostic indicators among critical COVID-19 patients holds tremendous value in risk stratification and clinical management.

Molecular Cloning and Structural Insights into Pectin Lyase Proteins from Different Strains of Fusarium

Aim:

Molecular cloning and analysis of Pectin Iyase (PNL) genes from different strains of Fusarium for structural predictions and docking studies.

Background:

PNLs cleave pectin by β-elimination resulting in the formation of 4,5-unsaturated oligogalacturonates, without affecting the ester content of the polymer chain and hence maintaining the specific aroma of fruits. Several PNL lyase genes from Aspergillus and Penicillium have been cloned, but the molecular biology of that from Fusarium has not been explored.

Objective:

To obtain an insight into the three-dimensional structure of PNL of Fusarium.

Methods:

PCR amplification-based molecular cloning of PNL genes from Fusarium strains, sequencing, and sequence analysis using bioinformatics tools for homology search, multiple sequence alignment, motif search, physiochemical characterization, phylogenetic tree construction, 3D structure prediction, and molecular docking were conducted.

Results:

Five PNL genes were cloned from F. oxysporum MTCC1755, F. monoliforme var. subglutinans MTCC2015, F. avenaceum MTCC10572, and F. solani MTCC3004 using the PCR approach. Many conserved amino acids were found at several positions in all the PNL proteins. Phylogenetic analysis of these proteins with other pectinases revealed two major clusters representing members of lyases and hydrolases. In-silico characterization revealed stable PNL proteins. PNL proteins from different Fusarium strains were similar in structural features and biochemical properties owing to their similar primary sequence. Docking studies revealed that electrostatic forces and van der Waal and hydrogen bonds effectuate the interaction between the ligand and the enzyme. Aspartate, tyrosine, and tryptophan residues in the active site of the enzyme are responsible for ligand binding.

Conclusion:

PNL from different Fusarium species show similarity at structural as well as biochemical level. PNL protein from F. moniliforme and F. solani was similar in properties except for the variation of single amino acid. Docking studies on the enzyme and different ligands provided an insight into the interacting residues and forces as well as the suitability of the substrate for catalysis.

Assessment of arsenic exposure in the population of Sabalpur village of Saran District of Bihar with mitigation approach

Arsenic poisoning through groundwater is the world's greatest normal groundwater catastrophe which got an immense effect on worldwide general wellbeing. India is confronting the outcomes of arsenic poisoning in the zone of Ganga Brahmaputra alluvial plains. In Bihar, out of 38 districts, 18 districts are exceptionally influenced with groundwater arsenic defilement. In the present study, we have assessed the current situation of arsenic exposure in Sabalpur village of Saran district of Bihar after reporting of breast, renal, skin and thyroid cancer cases from this village along with typical symptoms of arsenicosis. Such cancer patients were identified at our institute and were taken for the study. The present investigation deals with the quantification of arsenic in groundwater, hair and nail samples of subjects as well as the survey of entire village to know the overall health status of the village people. A total of n=128 household handpump water samples as well as n=128 human hair and nail samples were collected from over n=520 households. Using the graphite furnace atomic absorption spectrophotometer (GF-AAS), all the samples were analysed. The investigation resulted that the 61% of the analysed samples particularly the groundwater had the arsenic levels more than the permissible limit of WHO (> 10 μg/L) with 244.20 μg/L as the highest arsenic contamination in one of the handpump water sample. The exposure effect of hair sample was worst as 88% of all the collected samples were having high arsenic levels more than the permissible limit (> 0.2 mg/Kg). In case of nail samples, 92% of the samples were having high arsenic concentration more than the permissible limit (> 0.5 mg/Kg). The health survey study revealed high magnitude of disease burden in the exposed population with symptoms such as asthma, anaemia, hepatomegaly, diabetes, cardiac problem, skin fungal infections, breathlessness and mental disability. Few cancer cases of renal, skin, breast and cervix were also found among the exposed population of this village. The percentage of cancer cases in this village was 0.94% that was low, but it would be an aggravated situation in the near future if people will continue drinking arsenic-contaminated water. Therefore, a mitigation intervention was carried out in March 2020 by installing an arsenic filter plant. The health situation in the village in the present scenario is hope to improve in the coming years. However, motivation and awareness among the village population are still required.

ACC deaminase positive Enterobacter-mediated mitigation of salinity stress, and plant growth promotion of Cajanus cajan: a lab to field study

Salinity is a major abiotic stress that negatively impacts plant health and soil microbiota. ACC (1-aminocyclopropane carboxylic acid) deaminase producing microorganisms act as natural stress busters that protect plants from different kinds of stresses. The study focused on the isolation of potent, indigenous, multi-trait ACC deaminase producers. The shortlisted ACC deaminase producers were checked for their ability to promote growth of Cajanus cajan, and mitigate stress under laboratory conditions followed by validation of their potency in naturally saline field conditions. Physiological stress markers were assessed to evaluate the impact of salinity in plants treated with ACC deaminase producer, compared to controls. Further, the contribution of ACC deaminase in stress mitigation was demonstrated by using a chemical inhibitor for ethylene biosynthesis. This study presents a polyphasic approach, transitioning from the rhizospheric soil to the laboratory to validation in the field, and puts forth a promising eco-friendly alternative for sustainable agriculture.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12298-021-01031-0.

Cytokinin Modulates Cellular Trafficking and the Cytoskeleton, Enhancing Defense Responses

The plant hormone cytokinin (CK) plays central roles in plant development and throughout plant life. The perception of CKs initiating their signaling cascade is mediated by histidine kinase receptors (AHKs). Traditionally thought to be perceived mostly at the endoplasmic reticulum (ER) due to receptor localization, CK was recently reported to be perceived at the plasma membrane (PM), with CK and its AHK receptors being trafficked between the PM and the ER. Some of the downstream mechanisms CK employs to regulate developmental processes are unknown. A seminal report in this field demonstrated that CK regulates auxin-mediated lateral root organogenesis by regulating the endocytic recycling of the auxin carrier PIN1, but since then, few works have addressed this issue. Modulation of the cellular cytoskeleton and trafficking could potentially be a mechanism executing responses downstream of CK signaling. We recently reported that CK affects the trafficking of the pattern recognition receptor LeEIX2, influencing the resultant defense output. We have also recently found that CK affects cellular trafficking and the actin cytoskeleton in fungi. In this work, we take an in-depth look at the effects of CK on cellular trafficking and on the actin cytoskeleton in plant cells. We find that CK influences the actin cytoskeleton and endomembrane compartments, both in the context of defense signaling-where CK acts to amplify the signal-as well as in steady state. We show that CK affects the distribution of FLS2, increasing its presence in the plasma membrane. Furthermore, CK enhances the cellular response to flg22, and flg22 sensing activates the CK response. Our results are in agreement with what we previously reported for fungi, suggesting a fundamental role for CK in regulating cellular integrity and trafficking as a mechanism for controlling and executing CK-mediated processes.

Phylogenetic placement and reassessment of Asperisporium pongamiae as Pedrocrousiella pongamiae gen. et comb. nov. (Mycosphaerellaceae)

The leaf spot disease of Pongamia pinnata caused by an asperisporium-like asexual morph, which is usually referred to as Asperisporium pongamiae, is quite common during monsoon seasons in India. Phylogenetic analyses, based on LSU and rpb2 sequence data, and blast searches using ITS sequence data, revealed that this ascomycete forms a lineage within Mycosphaerellaceae distant from all other generic lineages. Pedrocrousiella gen. nov., with P. pongamiae comb. nov., based on Fusicladium pongamiae (≡ A. pongamiae), as type species is introduced for this lineage. This species has been considered the asexual morph of Mycosphaerella pongamiae (≡ Stigmatea pongamiae). However, this connection is unproven and was just based on the occasional association of the two taxa in some collections. Several attempts to induce the formation of a sexual morph in culture failed, therefore the putative connection between these morphs could not be confirmed. Asperisporium pongamiae-pinnatae is reduced to synonymy with P. pongamiae. Asperisporium pongamiae-pinnatae was introduced because of the wrong assumption that F. pongamiae had been described on another host, Pongamia globosa. But Fusicladium pongamiae was actually described in India on Pongamia glabra, which is a synonym of P. pinnata, and hence on the same host as Asperisporium pongamiae-pinnatae. Pedrocrousiella pongamiae clusters in a clade containing Distocercospora, Clypeosphaerella, and “Pseudocercospora” nephrolepidicola, a species which is not congeneric with Pseudocercospora. Phylogenetically, Pedrocrousiella is distant from the Asperisporium s. str. clade (type species A. caricae), which is more closely related to Amycosphaerella, Pseudocercosporella, Distomycovellosiella and Nothopassalora.

Citation: Rajeshkumar KC, Braun U, Groenewald JZ, Lad SS, Ashtekar N, Fatima S, Anand G (2021). Phylogenetic placement and reassessment of Asperisporium pongamiae as Pedrocrousiella pongamiae gen. et comb. nov. (Mycosphaerellaceae). Fungal Systematics and Evolution7: 165–176. doi: 10.3114/fuse.2021.07.08

Surface Proteins of SARS-CoV-2 Drive Airway Epithelial Cells to Induce IFN-Dependent Inflammation

SARS-CoV-2, the virus that has caused the COVID-19 pandemic, robustly activates the host immune system in critically ill patients. Understanding how the virus engages the immune system will facilitate the development of needed therapeutic strategies. In this study, we demonstrate both in vitro and in vivo that the SARS-CoV-2 surface proteins spike (S) and envelope (E) activate the key immune signaling IFN pathway in both human and mouse immune and epithelial cells independent of viral infection and replication. These proteins induce reactive oxidative species generation and increases in human- and murine-specific, IFN-responsive cytokines and chemokines, similar to their upregulation in critically ill COVID-19 patients. Induction of IFN signaling is dependent on canonical but discrepant inflammatory signaling mediators, as the activation induced by S is dependent on IRF3, TBK1, and MyD88, whereas that of E is largely MyD88 independent. Furthermore, these viral surface proteins, specifically E, induced peribronchial inflammation and pulmonary vasculitis in a mouse model. Finally, we show that the organized inflammatory infiltrates are dependent on type I IFN signaling, specifically in lung epithelial cells. These findings underscore the role of SARS-CoV-2 surface proteins, particularly the understudied E protein, in driving cell specific inflammation and their potential for therapeutic intervention.

AB0268 LOW DOSE TACROLIMUS IS AN EFFECTIVE ADD ON THERAPY FOR PATIENTS WITH ACTIVE RHEUMATOID ARTHRITIS – A SINGLE CENTRE EXPERIENCE

Background:

Rheumatoid arthritis (RA) a chronic inflammatory arthritis requiring tight control of disease activity. While traditional DMARDS have been used effectively, there always remains a need for add on drugs in good number of patients. Tacrolimus since its first approval in 2004 had been used widely as monotherapy and in combination with conventional and biological DMARDS. The primary concern was safety followed by the efficacy for patients with active disease.

Objectives:

The main objective was to ascertain the safety and tolerability of patients who were treated with tacrolimus as an add on therapy over and above the standard care in RA.

Methods:

A retrospective analysis of patients who were prescribed Tacrolimus from January 2019 to August 2020 was done. Details of patients along with the change in Blood pressure(BP), Serum creatinine, Blood sugar and Clinical disease activity index(CDAI) before and after tacrolimus were analyzed.

Results:

A total of 245 patients with active Rheumatoid arthritis received the drug. The mean age was 48.58(1.49) years and the disease duration was 5.9(0.56) years. Of 245 patients, 24 patients were lost to follow up,103 patients stopped the drug for various reasons and 118 patients are still continuing the drug. The mean tacrolimus dose was 1.24 + 0.46 mg in the patients who are continuing. The commonest reason for stopping the drug was adverse events (57%) followed by lack of efficacy(29%), low disease activity (8%)and others(7%). There was no significant change in the mean blood pressure, Blood sugars and Creatinine levels in both the stopped and continuing group. However the CDAI and the steroid dosages reduced significantly in the patients who are still on tacrolimus.The lost to follow up group had high disease activity at baseline and also were on higher doses of steroids.

PARAMETERSRA – CONTINUING(118)RA STOPPED(103)LOST TO FOLLOWUP(24)BEFORE TACAFTER TACp valueBEFORE TACAFTER TACP valueBEFORE TACSBP mm of hg100.44(9.54)101.06(9.80)0.67103(9.77)104(9.92)0.44127.35(10.05)DBP mm of hg66.30(6.26)67.22(6.37)0.3068.44(6.4)70.43(6.65)0.0782.83(5.05)SUGAR mg76.43(13.73)76.67(11.24)0.9571.86(10.79)76.74(14.1)0.0889.12(9.7)S.CR mg0.55(0.06)0.56(0.09)0.800.66(0.16)0.57(0.06)0.210.74(0.06)STEROID USE mg2.82(0.41)1.65(0.54)<0.0012.12(0.43)2.43(0.54)0.362.86(1.42)CDAI12.28(1.84)7.42(1.49)<0.00112.23(2.03)10.49(2.69)0.0716.62(3.88)

Conclusion:

Low dose Tacrolimus is an effective add on therapy for patients with high disease activity and did not lead to change in serum creatinine, blood pressure or change in blood sugars in the study subjects.

References:

[1]Yocum D et al. Safety of tacrolimus in patients with rheumatoid arthritis: long-term experience. Rheumatology 2004; 43:992–999.

[2]Shouma Dutta,Yasmeen Ahmad. The efficacy and safety of tacrolimus in rheumatoid arthritis.Therapeutic Advances in Musculoskeletal Disease Ther Adv Musculoskel Dis. 2011; 3(6) 283–291.

Disclosure of Interests:

None declared

Method for the Production and Purification of Plant Immuno-Active Xylanase from Trichoderma

Plants lack a circulating adaptive immune system to protect themselves against pathogens. Therefore, they have evolved an innate immune system based upon complicated and efficient defense mechanisms, either constitutive or inducible. Plant defense responses are triggered by elicitors such as microbe-associated molecular patterns (MAMPs). These components are recognized by pattern recognition receptors (PRRs) which include plant cell surface receptors. Upon recognition, PRRs trigger pattern-triggered immunity (PTI). Ethylene Inducing Xylanase (EIX) is a fungal MAMP protein from the plant-growth-promoting fungi (PGPF)-Trichoderma. It elicits plant defense responses in tobacco (Nicotiana tabacum) and tomato (Solanum lycopersicum), making it an excellent tool in the studies of plant immunity. Xylanases such as EIX are hydrolytic enzymes that act on xylan in hemicellulose. There are two types of xylanases: the endo-1, 4-β-xylanases that hydrolyze within the xylan structure, and the β-d-xylosidases that hydrolyze the ends of the xylan chain. Xylanases are mainly synthesized by fungi and bacteria. Filamentous fungi produce xylanases in high amounts and secrete them in liquid cultures, making them an ideal system for xylanase purification. Here, we describe a method for cost- and yield-effective xylanase production from Trichoderma using wheat bran as a growth substrate. Xylanase produced by this method possessed xylanase activity and immunogenic activity, effectively inducing a hypersensitive response, ethylene biosynthesis, and ROS burst.

Bioimpedance analysis as a tool for hemodynamic monitoring: overview, methods and challenges

Recent advances in hemodynamic monitoring have seen the advent of non-invasive methods which offer ease of application and improve patient comfort. Bioimpedance Analysis or BIA is one of the currently employed non-invasive techniques for hemodynamic monitoring. Impedance Cardiography (ICG), one of the implementations of BIA, is widely used as a non-invasive procedure for estimating hemodynamic parameters such as stroke volume (SV) and cardiac output (CO). Even though BIA is not a new diagnostic technique, it has failed to gain consensus as a reliable measure of hemodynamic parameters. Several devices have emerged for estimating CO using ICG which are based on evolving methodologies and techniques to calculate SV. However, the calculations are generally dependent on the electrode configurations (whole body, segmental or localised) as well as the accuracy of different techniques in tracking blood flow changes. Blood volume changes, concentration of red blood cells, pulsatile velocity profile and ambient temperature contribute to the overall conductivity of blood and hence its impedance response during flow. There is a growing interest in investigating limbs for localised BIA to estimate hemodynamic parameters such as pulse wave velocity. As such, this paper summarises the current state of hemodynamic monitoring through BIA in terms of different configurations and devices in the market. The conductivity of blood flow has been emphasized with contributions from both volume and velocity changes during flow. Recommendations for using BIA in hemodynamic monitoring have been mentioned highlighting the suitable range of frequencies (1 kHz-1 MHz) as well as safety considerations for a BIA setup. Finally, current challenges in using BIA such as geometry assumption and inaccuracies have been discussed while mentioning potential advantages of a multi-frequency analysis to cover all the major contributors to blood's impedance response during flow.

Arsenic exposure in Indo Gangetic plains of Bihar causing increased cancer risk

Reportedly, 300 million people worldwide are affected by the consumption of arsenic contaminated groundwater. India prominently figures amongst them and the state of Bihar has shown an upsurge in cases affected by arsenic poisoning. Escalated arsenic content in blood, leaves 1 in every 100 human being highly vulnerable to being affected by the disease. Uncontrolled intake may lead to skin, kidney, liver, bladder, or lung related cancer but even indirect forms of cancer are showing up on a regular basis with abnormal arsenic levels as the probable cause. But despite the apparent relation, the etiology has not been understood clearly. Blood samples of 2000 confirmed cancer patients were collected from pathology department of our institute. For cross-sectional design, 200 blood samples of subjects free from cancer from arsenic free pockets of Patna urban agglomeration, were collected. Blood arsenic levels in carcinoma patients as compared to sarcomas, lymphomas and leukemia were found to be higher. The geospatial map correlates the blood arsenic with cancer types and the demographic area of Gangetic plains. Most of the cancer patients with high blood arsenic concentration were from the districts near the river Ganges. The raised blood arsenic concentration in the 2000 cancer patients strongly correlates the relationship of arsenic with cancer especially the carcinoma type which is more vulnerable. The average arsenic concentration in blood of the cancer patients in the Gangetic plains denotes the significant role of arsenic which is present in endemic proportions. Thus, the study significantly correlates and advocates a strong relation of the deleterious element with the disease. It also underlines the need to address the problem by deciphering the root cause of the elevated cancer incidences in the Gangetic basin of Bihar and its association with arsenic poisoning.

Plant-microbiome interactions for sustainable agriculture: a review

Plant-microbiome interactions are significant determinant for plant growth, fitness and productivity. Depending upon the specific habitat, plants' microbial communities are classified as the rhizo-, phyllo-, and endospheric regions. Understanding the plant microbiome interactions could provide an opportunity to develop strategies for sustainable agricultural practices. There is a necessity to decipher the complex structural and functional diversity within plant microbiomes to reveal its immense potential in agriculture. The plant microbiota harbors enormous microbial communities that defy analytical methodologies to study dynamics underlying plant microbiome interactions. Findings based on conventional approaches have ignored many beneficial microbial strains, which creates a serious gap in understanding the microbial communications along with the genetic adaptations, which favors their association with host plant. The new era of next generation sequencing techniques and modern cost-effective high-throughput molecular approaches can decipher microbial community composition and function. In this review, we have presented the overview of the various compartments of plants, approaches to allow the access to microbiome and factors that influence microbial community composition and function. Next, we summarize how plant microbiome interactions modulate host beneficial properties particularly nutrient acquisition and defense, along with future agricultural applications.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at. 10.1007/s12298-021-00927-1.

Investigating Electrical Impedance Spectroscopy for Estimating Blood Flow-Induced Variations in Human Forearm

This work aims to investigate the feasibility of employing multi-frequency bioimpedance analysis for hemodynamic assessment. Towards this, we aim to explore one of its implementations, electrical impedance spectroscopy (EIS), for estimating changes in radial artery diameter due to blood flow. Following from our previous investigations, here, we use a commercial device-the Quadra^® Impedance Spectroscopy device-for impedance measurements of the forearm of three subjects under normal conditions and occluding the artery with a cuff. This was performed simultaneously with ultrasound measurements as a reference. The impedance spectra were measured over time, yielding waveforms reflecting changes due to blood flow. Contributions from the fat/muscle domains were accounted for using the occluded impedance response, resulting in arterial impedance. A modified relationship was approximated to calculate the diameter from the arterial impedance, which showed a similarity with ultrasound measurements. Comparison with the ultrasound measurements revealed differences in phase and amplitude, primarily due to the approximated relationship between impedance and diameter and neglecting the impedance phase analysis. This work shows the potential of EIS, with improvements, towards estimating blood flow-induced variation in arteries. Further analysis and improvements could help place this technology in mainstream clinical practice for hemodynamic monitoring.

Risk Factors for Postoperative Hypotension and Hypertension following Carotid Endarterectomy

BACKGROUND

Patients undergoing carotid endarterectomy (CEA) often experience postoperative hemodynamic changes that require intravenous medications for hypo- and hypertension. Prior studies have found these changes to be associated with increased risks of 30-day mortality, stroke, myocardial infarction (MI), and length of stay (LOS). Our aim is to investigate preoperative risk factors associated with the need for postoperative intravenous medications for blood pressure control.

METHODS

A retrospective review of an internally maintained prospective database of patients undergoing carotid interventions between January 2014 and March 2019 was performed. Demographic data, clinical history, and perioperative data were recorded. Carotid artery stents and reinterventions were excluded. Our primary end points were the need to intervene with intravenous medication for either postoperative hypotension [systolic blood pressure (SBP) <100 mm Hg] or postoperative hypertension (SBP >160 mm Hg).

RESULTS

A total of 221 patients were included in the study after excluding those with a prior ipsilateral CEA or carotid artery stent. The mean age was 72.3 (±8.9) years, 157 (71%) patients were male, and 78 (35.3%) were Caucasian. Following CEA, 151 (68.3%) patients were normotensive, while 33 (14.9%) and 37 (16.7%) required medication for hypotension and hypertension, respectively. A univariate logistic regression identified 5 variables as being associated with postoperative blood pressure including race, history of MI, prior percutaneous transluminal coronary angioplasty (PTCA), statin use, and angiotensin-converting enzyme-inhibitor/angiotensin-receptor blocker (ARB) use. A stepwise regression selection found race, prior MI, and statin use to be associated with our primary end points. The hypertensive group was more likely to have a history of MI compared to the hypotensive and normotensive groups (40.5% vs. 27.3% vs. 18.5%, P = 0.02), PTCA (43.2% vs. 39.4% vs. 23.8%, P = 0.03), and statin use (94.6% vs. 93.9% vs. 78.8%, P = 0.01). Mean LOS was also the highest for the hypertensive group, followed by hypotensive and normotensive patients [2.0 (±1.6) vs. 1.8 (±2.4) vs. 1.3 (±0.8), P = 0.002]. Multivariable logistic regression demonstrated that non-Caucasian patients [odds ratio (OR) 2.72, 95% confidence interval (CI) 1.26-5.86, P = 0.01] and those with a history of MI (OR 2.98, 95% CI 1.33-6.67) were more likely to have postoperative hypertension compared to patients who were Caucasian or had no history of MI.

CONCLUSIONS

Postoperative hypertension is associated with non-Caucasian race and a history of MI. Given the potential implications for adverse perioperative outcomes including MI, mortality, and LOS, it is important to continue to elucidate potential risk factors in order to further tailor the perioperative management of patients undergoing CEA.

Patient deprivation and perceived scan burden negatively impact the quality of whole-body MRI

AIM

To evaluate the association between the image quality of cancer staging whole-body magnetic resonance imaging (WB-MRI) and patient demographics, distress, and perceived scan burden.

MATERIALS AND METHODS

A sample of patients recruited prospectively to multicentre trials comparing WB-MRI with standard scans for staging lung and colorectal cancer were invited to complete two questionnaires. The baseline questionnaire, administered at recruitment, collated data on demographics, distress and co-morbidity. The follow-up questionnaire, completed after staging investigations, measured perceived WB-MRI scan burden (scored 1 low to 7 high). WB-MRI anatomical coverage, and technical quality was graded by a radiographic technician and grading combined to categorise the scan as "optimal", "sub-optimal" or "degraded". A radiologist categorised 30 scans to test interobserver agreement. Data were analysed using the chi-square, Fisher's exact, t-tests, and multinomial regression.

RESULTS

One hundred and fourteen patients were included in the study (53 lung, 61 colorectal; average age 65.3 years, SD=11.8; 66 men [57.9%]). Overall, 45.6% (n=52), scans were classified as "optimal" quality, 39.5% (n=45) "sub-optimal", and 14.9% (n=17) as "degraded". In adjusted analyses, greater deprivation level and higher patient-reported scan burden were both associated with a higher likelihood of having a sub-optimal versus an optimal scan (odds ratio [OR]: 4.465, 95% confidence interval [CI]: 1.454 to 13.709, p=0.009; OR: 1.987, CI: 1.153 to 3.425, p=0.013, respectively). None of the variables predicted the likelihood of having a degraded scan.

CONCLUSIONS

Deprivation and patients' perceived experience of the WB-MRI are related to image quality. Tailored protocols and individualised patient management before and during WB-MRI may improve image quality.

Tissue phantom to mimic the dielectric properties of human muscle within 20 Hz and 100 kHz for biopotential sensing applications

Tissue-mimicking materials for phantoms are fabricated for research purposes to simulate the mechanical or electrical properties of real human tissues and promote better understanding of their properties. This research investigated the dielectric properties (from 20 Hz to 100 kHz) of five promising muscle mimicking materials including matrix materials (gelatin powder and agar powder), and fillers (sodium chloride, glycine and aluminum powder) for the development of muscle phantoms. The mechanical behaviors were verified as well. This research determined the effects of electrode polarization (EP) on the dielectric properties of each material and then used a mathematical model to reduce these unwanted effects. Additionally, the results indicated the very low dielectric properties of gels-only samples. Both electrical conductivity and relative permittivity increased with increasing concentrations of fillers. Moreover, all fillers had their own capabilities to alter the levels and trends in the increments of dielectric values, which provide a wider selection to muscle-mimicking materials. Theoretically, it is feasible to achieve desired dielectric properties by mixing these fillers together with certain ratios. In this way, low-cost muscle phantoms can be produced and used as experimental subjects for biopotential sensing application.

Impact of abiotic stressors on native rhizospheric bacterial community of Cajanus cajan

Salinity and drought are the major abiotic stresses that limit agricultural productivity. Application of plant growth promoting rhizobacteria (PGPR) is an attractive technology but with the bottlenecks of reduced efficacy and survivability in the environment. For increased efficiency of PGPR strains, the impact of stresses on the native bacterial community needs to be studied. Experimentally induced stresses would be ideal to assess the immediate perturbances in the structure of soil bacterial community. Hence, the study focused on the effect of experimentally-induced salinity, and drought stress on rhizospheric bacterial community of Cajanus cajan. A plant growth experiment was set up to induce salinity and drought stresses. Shifts in the bacterial community were assessed by a culture-independent technique of denaturing gradient gel electrophoresis using 16S ribosomal RNA gene and transcript as markers, leading to a comparison of the resident with the active bacterial community. The impact on plant was evaluated by measurement of plant biometrics. Further, salinity and drought-stressed conditions led to distinct shifts in native and active rhizospheric bacterial community, corresponding to the higher decline at induction of stresses, and stabilization at later time points. The study encompasses the perturbations in the active and resident rhizospheric bacterial community caused by the induction of two different abiotic stresses along the plant's growth.

A robust method for nucleic acid extraction from fabrics to study bacterial diversity

The importance of studying microbial load on fabrics has been recently realized with reports on fabrics being a source of spread of infection in medical and hospitality sectors. However, methodological limitations have restricted the analysis of microbial diversity on fabrics. Hence, the study aimed to develop a robust method for extraction of DNA from different types of fabrics. Bacterial community profiles could be successfully generated with DNA extracted from real life samples, together with identification of different bacterial genera on fabrics. The study opens up venues to study effect of environmental factors on microbial load on fabrics. Also, such a technique will aid correlation between microbial load and types of fabric so as to come up with recommendation for fabrics bearing minimal microbial load for medical and hospitality sectors.

Endovascular abdominal aortic aneurysm repair in patients with Marfan syndrome

Objectives

Marfan syndrome patients are at risk for aortic degeneration. Repair is traditionally performed with open surgery as this is deemed more durable. Endovascular aneurysm repair remains controversial. We report on the outcomes of Marfan syndrome patients with abdominal aortic aneurysms undergoing endovascular aneurysm repair.

Methods

The Vascular Quality Initiative registry identified 35,889 patients, including 29 with Marfan syndrome, treated with endovascular aneurysm repair from January 2003 to December 2017. Outcomes were analyzed per the Society for Vascular Surgery reporting standards.

Results

Median age was 70.0 years (IQR, 57.0–75.0), and 22 (75.9%) were male. Median aneurysm diameter was 5.3 cm (IQR, 4.9–6.3 cm), with an aortic neck length and diameter of 2.0 cm (IQR, 1.6–2.8 cm) and 2.5 cm (IQR, 2.2–2.8 cm), respectively. Twenty-one (72.4%) patients were asymptomatic, seven (24.1%) symptomatic, and one (3.4%) presented with rupture. Ten (34.5%) patients had prior aortic surgery. Six (20.7%) were unfit for open surgical repair. Length of stay was 2.0 days (IQR, 1.0–3.0 days). Percutaneous femoral access was performed in 15 (51.7%) patients with no complications. A type IA endoleak was present in one (3.4%), type IB in one (3.4%), and type II endoleak in two (6.9%) patients. There were no postoperative pulmonary, cardiac, or neurological complications. In-hospital mortality occurred in one (3.4%) patient who presented with a rupture and had been deemed unfit for open repair. A conversion to open repair was required. The patient expired on post-operative day 0. Early clinical success was achieved in 26 (89.7%) patients. Follow-up was available for 15 (51.7%) patients at a median time of 766 days (IQR, 653–937). There were no reinterventions or mortalities. Change in sac diameter was −0.6 cm (IQR, −1.1 to −0.2 cm), with no type I or III endoleaks.

Discussion

Endovascular aneurysm repair for patients with Marfan syndrome is feasible, and can be performed safely. Mid-term outcomes suggest this technique is durable. More robust long-term follow-up is needed.

The response to the DNA damaging agent methyl methanesulfonate in a fungal plant pathogen

DNA damage can cause mutations that in fungal plant pathogens lead to hypervirulence and resistance to pesticides. Almost nothing is known about the response of these fungi to DNA damage. We performed transcriptomic and phosphoproteomic analyses of Fusarium oxysporum exposed to methyl methanesulfonate (MMS). At the RNA level we observe massive induction of DNA repair pathways including the global genome nucleotide excision. Cul3, Cul4, several Ubiquitin-like ligases and components of the proteasome are significantly induced. In agreement, we observed drug synergism between a proteasome inhibitor and MMS. While our data suggest that Yap1 and Xbp1 networks are similarly activated in response to damage in yeast and F. oxysporum we were able to observe modules that were MMS-responsive in F. oxysporum and not in yeast. These include transcription/splicing modules that are upregulated and respiration that is down-regulated. In agreement, MMS treated cells are much more sensitive to a respiration inhibitor. At the phosphoproteomic level, Adenylate cyclase, which generates cAMP, is phosphorylated in response to MMS and forms a network of phosphorylated proteins that include cell cycle regulators and several MAPKs. Our analysis provides a starting point in understanding how genomic changes in response to DNA damage occur in Fusarium species.

How Does Fusarium oxysporum Sense and Respond to Nicotinaldehyde, an Inhibitor of the NAD+ Salvage Biosynthesis Pathway?

Plant pathogenic fungi are a major threat to food security and impose a severe economic burden, thus there is a continuous need to develop new strategies to manage them. NAD+ is a co-factor in numerous enzymatic activities and determines the metabolic fate of the cell. Therefore, maintenance of NAD+ concentration is important for cellular viability. Consequently, the NAD+ biosynthetic pathway and redox homeostasis was suggested as a target for antifungal development. We aimed to study how Fusarium oxysporum senses and responds to nicotinaldehyde (NA), an inhibitor of Pnc1, a key enzyme in the salvage pathway of NAD+ biosynthesis. We were able to show that NA was inhibitory in high concentrations to several fungal plant pathogens, with much milder effects on tomato growth. Under low nutrient conditions NA reduced the total amounts of NAD+ in the fungal cell, a trend that was also observed in rich media, although without statistical significance. In low and high nutrient availability NA dramatically reduced the NAD+/NADH ratio. After exposure to NA, NADH levels were increased and NAD+ levels and the biomass were greatly reduced. Cells responded to NA by up-regulation of oxidoreductases, with hardly any up-regulation of the classic response to oxidative stress. Direct measurement of oxidative stress response showed that unlike formaldehyde and hydrogen peroxide, NA caused reductive rather than oxidative stress. Surprisingly, alcohol dehydrogenases were significantly up-regulated more than any other dehydrogenases, including aldehyde dehydrogenases. We propose that conidia of F. oxysporum efficiently detoxified the aldehyde group of NA by reducing NAD+ to NADH; the high concentrations of the latter provoked the expression of alcohol dehydrogenases that in yeast can act to reduce NADH and increase NAD+ amounts, respectively. Overall, the results suggest that targeting NAD+ biosynthesis pathway and redox homeostasis can be a potential approach to manage fungal plant pathogens. Many of the natural antifungal compounds produced by bio-control agents or even the natural biome are aldehydes, and thus the results presented here predict the possible response of Fusarium to wide sources of toxicity in the environment.

Life threatening pembrolizumabinduced myositis in a patient treated for advanced adenocarcinoma of the lung

The advent of immunotherapy in oncology has led to the emergence of a new spectrum of adverse effects. A number of these have the potential to contribute to life-threatening outcomes; and therefore require prompt identification and aggressive treatment to optimise management. In this report, we describe a case of pembrolizumab-induced CTCAE (common toxicity criteria for adverse events) grade 4 myositis in a non-small cell lung cancer patient.

Genome-Wide Assessment of Polygalacturonases-Like (PGL) Genes of Medicago truncatula, Sorghum bicolor, Vitis vinifera and Oryza sativa Using Comparative Genomics Approach

The polygalacturonases (PG) is one of the important members of pectin-degrading glycoside hydrolases of the family GH28. In plants, PG represents multigene families associated with diverse processes. In the present study, an attempt has been made to investigate the diversity of PG genes among monocots and dicots with respect to phylogeny, gene duplication and subcellular localization to get an insight into the evolutionary and functional attributes. The genome-wide assessment of Medicago truncatula, Vitis vinifera Sorghum bicolor, and Oryza sativa L. ssp. japonica genomes revealed 53, 49, 38 and 35 PG-like (PGL) genes, respectively. The predominance of glyco_hydro_28 domain, hydrophilic nature and genes with multiple introns were uniformly observed. The subcellular localization showed the presence of signal sequences targeting the secretory pathways. The phylogenetic tree constructed marked uniformity with three distinct clusters for each plant irrespective of the variability in the genome sizes. The site-specific selection pressure analysis based on K _a/K _s values showed predominance of purifying selection pressures among different groups identified in these plants. The functional divergence analysis revealed significant site-specific selective constraints. Results of site-specific selective pressure analysis throw light on the functional diversity of PGs in various plant processes and hence its constitutive nature. These findings are further strengthened by functional divergence analysis which reveals functionally diverse groups in all the four species representing monocots and dicots. The outcome of the present work could be utilized for deciphering the novel functions of PGs in plants.