The Salutary Effects of Diminazene, Lisinopril or Valsartan on Cisplatin - Induced Acute Kidney Injury in Rats: A Comparative Study

Nephrotoxicity as a cause of acute kidney injury (AKI) induced by cisplatin (CP), limits its usefulness as an anticancer agent. Diminazene, an angiotensin converting enzyme 2 activator, exhibited renoprotective properties on rat models of kidney diseases. This research aims to investigate the salutary effect of diminazene in comparison with lisinopril or valsartan in CP-induced AKI. The first and second groups of rats received oral vehicle (distilled water) for 9 days, and saline injection or intraperitoneal CP (6 mg/kg) on day 6, respectively. Third, fourth, and fifth groups received intraperitoneal injections of CP on day 6 and diminazene (15 mg/kg/day, orally), lisinopril (10 mg/kg/day, orally), or valsartan (30 mg/kg/day, orally), for 9 days, respectively. 24h after the last day of treatment, blood and kidneys were removed under anesthesia for biochemical and histopathological examination. Urine during the last 24 h before sacrificing the rats was also collected. CP significantly increased plasma urea, creatinine, neutrophil gelatinase-associated lipocalin, calcium, phosphorus, and uric acid. It also increased urinary albumin/creatinine ratio, N-Acetyl-beta-D-Glucosaminidase/creatinine ratio, and reduced creatinine clearance, as well the plasma concentrations of inflammatory cytokines [plasma tumor necrosis factor-alpha, and interleukin-1beta], and significantly reduced antioxidant indices [catalase, glutathione reductase , and superoxide dismutase]. Histopathologically, CP treatment caused necrosis of renal tubules, tubular casts, shrunken glomeruli, and increased renal fibrosis. Diminazine, lisinopril, and valsartan ameliorated CP-induced biochemical and histopathological changes to a similar extent. The salutary effect of the three drugs used is, at least partially, due to their anti-inflammatory and antioxidant effects. Keywords: Cisplatin, Diminazene, ACE2 activator, Lisinopril, Valsartan, Acute kidney injury.

The Impact of Age, Comorbidities, and Discharge Timing on Clinical Outcomes Following Elective Percutaneous Coronary Intervention

Background The adoption of same-day discharge (SDD) in elective percutaneous coronary intervention (PCI) procedures offers potential benefits in terms of patient satisfaction and reduced healthcare costs. Despite these advantages, the safety and efficacy of SDD, especially among patients with diverse health profiles, are not fully understood. This study investigates the effects of patient-specific factors, including age, comorbidities, and discharge timing, on the clinical outcomes of elective PCI, focusing on the viability of SDD. Methods A prospective study was carried out at Lady Reading Hospital, Peshawar, Pakistan, involving 220 patients undergoing elective PCI from January to June 2023. This research compared the clinical outcomes of patients discharged on the same day with those who had extended hospital stays, examining the impact of age, comorbidities, and PCI success. Main outcome measures included post-procedure complications and hospital readmissions within 30 days. Results The study enrolled participants with an average age of 62 years, the majority (88%, n=194/220) of whom had comorbidities. Interestingly, 16% (n=35/220) of the participants were discharged on the same day, while the rest stayed longer in the hospital. Notably, those in the SDD group experienced significantly more complications and readmissions, with 95.14% (n=33/36) compared to only 16.22% (n=30/184) in their counterparts. Factors such as age, comorbidities, success of PCI, timing of discharge, and patient satisfaction emerged as significant predictors of the observed outcomes. Conclusion This study highlights the essential role of personalized care in discharge planning following elective PCI, advocating for a cautious approach towards SDD, especially for older patients and those with multiple health issues.

Evaluating the Differential Risk of Contrast-Induced Nephropathy Among Diabetic and Non-diabetic Patients Following Percutaneous Coronary Intervention

Background Contrast-induced nephropathy (CIN) significantly complicates percutaneous coronary intervention (PCI), with a higher prevalence in diabetic patients. This study compares the incidence of CIN in diabetic and non-diabetic patients undergoing PCI. Material and methods Conducted at Lady Reading Hospital, Peshawar, PAK, from January to December 2023, this observational study involved 450 adult patients with coronary artery disease (CAD) undergoing PCI. The cohort was categorized based on diabetes status, excluding patients with chronic kidney disease and those on renal replacement therapy. Baseline characteristics documented included age, gender, blood pressure, creatinine levels, and the presence of acute coronary syndrome (ACS). CIN was defined as a ≥25% increase in serum creatinine from baseline within 48-72 hours post-PCI. Data analysis was performed using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 25.0, Armonk, NY), incorporating descriptive statistics, Chi-square tests, and independent t-tests, with a significance level of p<0.05. Results The median age of the study population was 55 years. The cohort comprised 52% male (n=234) and 48% female (n=216). Notably, 33% (n=149) had ACS. Diabetic patients exhibited a significantly higher incidence of CIN post-PCI compared to non-diabetics. The highest incidence of CIN (17%, n=77) occurred in the 70+ age group. The findings highlight the criticality of renal function monitoring and procedural adjustments for diabetic patients. Conclusion Diabetic patients demonstrate an increased risk of CIN following PCI. This necessitates the development of tailored prevention strategies for this high-risk subgroup.

Phytotoxicity of radionuclides: A review of sources, impacts and remediation strategies

Various anthropogenic activities and natural sources contribute to the presence of radioactive materials in the environment, posing a serious threat to phytotoxicity. Contamination of soil and water by radioactive isotopes degrades the environmental quality and biodiversity. They persist in soils for a considerable amount of time and disturb the fauna and flora of any affected area. Hence, their removal from the contaminated medium is inevitable to prevent their entry into the food chain and the organisms at higher levels of the food chain. Physicochemical methods for radioactive element remediation are effective; however, they are not eco-friendly, can be expensive and impractical for large-scale remediation. Contrastingly, different bioremediation approaches, such as phytoremediation using appropriate plant species for removing the radionuclides from the polluted sites, and microbe-based remediation, represent promising alternatives for cleanup. In this review, sources of radionuclides in soil as well as their hazardous impacts on plants are discussed. Moreover, various conventional physicochemical approaches used for remediation discussed in detail. Similarly, the effectiveness and superiority of various bioremediation approaches, such as phytoremediation and microbe-based remediation, over traditional approaches have been explained in detail. In the end, future perspectives related to enhancing the efficiency of the phytoremediation process have been elaborated.

Cadmium (Cd) influences calcium (Ca) levels in the skeleton of a freshwater fish Channa gachua

Abstract Environmental contamination with heavy metals is a threat to the organisms due to their toxicity, persistence and bioaccumulation in food chains. The study was aimed to assess cadmium (Cd) effect on calcium (Ca) level in bones of a freshwater fish Channa gachua. 42 fish individuals were kept into six (6) aquaria; labelled aq.0, 1, 2, 3,4 and 5 in the laboratory for treatment. Aq.0 was control group and aq.1, 2,3,4,5 were experimental with treatment solution of Cd 0, 0.1ppm, 0.5ppm, 1ppm, 2.5ppm and 5ppm respectively for three months. After exposure, bones tissue were examined for Cd accumulation and Ca concentration. Highest accumulation of Cd were recorded in aq.5 mean 46.86 ± 0.46 mgkg-1 .and lowest in the control group with mean 0.61 ± 0.06 mgkg-1. The order of Cd bioaccumulation in bones were aq.5 > aq.4 >aq.3 > aq.2 > aq.1 > aq.0. Highest concentration of Ca were noted in aq.0 (Control group) mean 7888.06 ± 4827.22 mgkg-1 and lowest were 1132.36 ± 203.73 mgkg-1 in aq.5 (at 5.0 ppm). Generally a pattern of decreasing Ca level were observed with each rise of Cd bioaccumulation aq.0 > aq.1 > aq.2 > aq.3 > aq.4 > aq.5. Current study indicated that Cd accumulation have substantial effect on Ca level in bones and hence on skeleton system. Strict rules must be implemented by government to control metals pollution and exploitations of biota.

Anticancer Properties of Ru and Os Half-Sandwich Complexes of N,S Bidentate Schiff Base Ligands Derived from Phenylthiocarbamide

The versatile coordinating nature of N,S bidentate ligands is of great importance in medicinal chemistry imparting stability and enhancing biological properties of the metal complexes. Phenylthiocarbamide-based N,S donor Schiff bases converted into RuII /OsII (cymene) complexes and characterized by spectroscopic techniques and elemental analysis. The hydrolytic stability of metal complexes to undergo metal-halide ligand exchange reaction was confirmed both by the DFT and NMR experimentation. The ONIOM (QM/MM) study confirmed the histone protein targeting nature of aqua/hydroxido complex 2 aH with an excellent binding energy of -103.19 kcal/mol. The antiproliferative activity against a panel of cancer cells A549, MCF-7, PC-3, and HepG2 revealed that ruthenium complexes 1 a-3 a were more cytotoxic than osmium complexes and their respective ligands 1-3 as well. Among these ruthenium cymene complex bearing sulfonamide moiety 2 a proved a strong cytotoxic agent and showed excellent correlation of cellular accumulation, lipophilicity, and drug-likeness to the anticancer activity. Moreover, the favorable physiochemical properties such as bioavailability and gastrointestinal absorption of ligand 2 also supported the development of Ru complex 2 a as an orally active anticancer metallodrug.

Heavy metal toxicity arising from the industrial effluents repercussions on oxidative stress, liver enzymes and antioxidant activity in brain homogenates of Oreochromis niloticus

Industrial effluents reaching to the aquatic ecosystem is one of the major causes of environmental pollution and exposure to industrial effluents containing harmful substances may be a serious threat to human health. Therefore, the present study aimed to determine the sub-lethal (1/5th of predetermined LC50) impact of industrial effluents from Sundar Industrial Estate on Oreochromis niloticus with proper negative control. The physicochemical analysis of industrial effluents showed enormous loads of inorganic pollutants and exhibited high mean levels of heavy metals, Mn, Fe, Pb, Ni, Cr, Hg, As, Zn and Fe with statistically significant differences at p < 0.05. Highest level of Mn and Fe was detected in effluent's samples as 147.36 ± 80.91 mg/L and 90.52 ± 32.08 mg/L, respectively. Exposure led to increase in serum biochemical parameters alanine aminotransferase + 25%, aspartate aminotransferase + 20% and alkaline phosphatase + 7% over control although superoxide dismutase, catalase, glutathione peroxidase and reduced glutathione significantly increased as 3.42, 2.44, 4.8 and 8 folds, respectively in metabolically active tissue brain which indicated stress caused by industrial effluents. The results concluded that industrial effluent has potent oxidative stress inducers on one hand whereas histoarchitectural and physiological toxicity causing contaminants on the other. This condition may adversely affect the health of aquatic organisms, the fish and ultimately the human beings.

Cerebral small vessel disease modifies outcomes after minimally invasive surgery for intracerebral haemorrhage

BACKGROUND

Minimally invasive surgery (MIS) for spontaneous supratentorial intracerebral haemorrhage (ICH) is controversial but may be beneficial if end-of-treatment (EOT) haematoma volume is reduced to ≤15 mL. We explored whether MRI findings of cerebral small vessel disease (CSVD) modify the effect of MIS on long-term outcomes.

METHODS

Prespecified blinded subgroup analysis of 288 subjects with qualified imaging sequences from the phase 3 Minimally Invasive Surgery Plus Alteplase for Intracerebral Haemorrhage Evacuation (MISTIE) trial. We tested for heterogeneity in the effects of MIS and MIS+EOT volume ≤15 mL on the trial's primary outcome of good versus poor function at 1 year by the presence of single CSVD features and CSVD scores using multivariable models.

RESULTS

Of 499 patients enrolled in MISTIE III, 288 patients had MRI, 149 (51.7%) randomised to MIS and 139 (48.3%) to standard medical care (SMC). Median (IQR) ICH volume was 42 (30-53) mL. In the full MRI cohort, there was no statistically significant heterogeneity in the effects of MIS versus SMC on 1-year outcomes by any specific CSVD feature or by CSVD scores (all Pinteraction >0.05). In 94 MIS patients with EOT ICH volume ≤15 mL, significant reduction in odds of poor outcome was found with cerebral amyloid angiopathy score <2 (OR, 0.14 (0.05-0.42); Pinteraction=0.006), absence of lacunes (OR, 0.37 (0.18-0.80); Pinteraction=0.02) and absence of severe white matter hyperintensities (WMHs) (OR, 0.22 (0.08-0.58); Pinteraction=0.03).

CONCLUSIONS

Following successful haematoma reduction by MIS, we found significantly lower odds of poor functional outcome with lower total burden of CSVD in addition to absence of lacunes and severe WMHs. CSVD features may have utility for prognostication and patient selection in clinical trials of MIS.

Organoleptic characteristics and compositional profile of meat of growing Japanese quail fed different levels of poultry byproducts compost

The poultry industry generates a lot of waste, including dead birds, manure, and poultry litter. Poultry waste should never be disposed of improperly because it can seriously harm the environment. The waste can be recycled as a feedstock for use in poultry feed by composting the litter and deceased birds. The compositional profile and organoleptic properties of the meat of growing Japanese quail were examined over the course of a 4-week trial to ascertain the effect of adding compost to the diet. In a completely randomized design (CRD), 1200 newly hatched quail chicks (Coturnix coturnix japonica) were divided into five treatment groups (diets with 0, 2.5, 5, 7.5, and 10% compost), each consisting of 40 birds with six replicates. The addition of compost to the diet had no noticeable effects on the organoleptic qualities of appearance, color, aroma, taste, texture, juiciness, tenderness, and acceptability (P>0.05). The compositional profile characteristics for chicks given compost at any level compared to chicks fed the control diet showed no differences (P>0.05). These findings suggest that the sensory characteristics and compositional profile of growing meat quails can be maintained when fed diets including up to 10% compost.

Demaghi, a polyherbal formulation, mitigates aluminum chloride-induced neurological impairment in mice: Insights from phytochemical analysis and behavioral assessment

Herbal products have been very popular in Pakistan for their curative significance against various disorders. Demaghi (DEMG) is a widely used herbal product claimed to own natural substances having neuroprotective potential. The current study aims to scientifically validate the chemical composition as well as its neuroprotective claims of this widely used herbal tonic. The commercially available Demaghi product was chemically characterized for its phytocomposition. The mice were treated with two doses of Demaghi (DEMG 50 mg and 100 mg/kg/day), and the effects of its prolonged exposure on animal anxiety, memory, and depression were noted through a series of behavioral tests in the AlCl3-induced memory deficient mice model. Besides that, dissected brains were biochemically analyzed for oxidative stress markers and acetylcholinesterase activity, as well as histopathological changes. The study outcomes showed that DEMG (100 mg/kg/day) has prominent anti-anxiety effects, memory-enhancing properties, and anti-depressants effects observed in the AlCl3-induced memory-deficient mice model. Biochemical assays also showed a greater decrease in oxidative stress of tested animals treated with 100 mg/kg/day of DEMG. The histopathological analysis also revealed that administration of DEMG reduced the AlCl3-induced toxicity. UPLC-MS results revealed the presence of many phytoconstituents, which showed to support cholinergic signaling in in-silico studies. The current research validates the neurological benefits of Demaghi for memory-boosting properties. The phytocompounds present in Demaghi exert neuroprotective effects, possibly by enhancing the cholinergic neurotransmission and combating the neurotoxin-induced oxidative stress.

Association between oxidative stress, antioxidant enzymes, and homocysteine in patients with polycystic ovary syndrome

OBJECTIVE

Polycystic ovary syndrome (PCOS) is a prevalent health condition that commonly affects adolescent girls and young women. The purpose of this study was to evaluate the correlation between levels of total glutathione (TG), reduced glutathione (GSH), superoxide dismutase (SOD), lipid peroxidation, and homocysteine with PCOS.

PATIENTS AND METHODS

This study employed a cross-sectional case-control design, involving a target population of 305 Sudanese females. Among them, 205 individuals were categorized as cases, and 100 served as controls. The TG, GSH, SOD, lipid peroxidation, and homocysteine levels were measured in the serum of study participants through enzyme-linked immunosorbent essay.

RESULTS

Total glutathione (1,174.5 ± 271.4 vs. 986.1 ± 191.5, p = 0.01), GSH (801.3 ± 132.2 vs. 748.6 ± 103.1, p = 0.007), SOD (225.2 ± 57.8 vs. 195.5 ± 49.6, p = 0.009), lipid peroxidation (3.4 ± 1.1 vs. 2.4 ± 0.7, p = 0.03), and homocysteine (14.9 ± 2.1 vs. 13.5 ± 1.6, p = 0.04), showed significant differences between the two groups (cases vs. controls). A moderate positive correlation between TG, GSH, SOD, lipid peroxidation, homocysteine, BMI, age, and duration of PCOS was observed. Furthermore, a strong positive correlation between BMI, age, and duration of PCOS was noted within the patient group.

CONCLUSIONS

In conclusion, this study demonstrates that patients with PCOS have elevated levels of TG, GSH, SOD, lipid peroxidation, and homocysteine compared to the control group. These findings suggest a potential association between PCOS and oxidative stress, lipid metabolism, and homocysteine pathways. Moreover, the observed positive correlation with BMI, age, and duration of PCOS indicates the importance of these factors in disease progression.

Treatment Tolerance and Toxicity in Elderly Oropharyngeal Cancer Patients and Implication on Outcomes

PURPOSE/OBJECTIVE(S)

To investigate the tolerance level and toxicity for standard of care treatment for oropharyngeal cancer (OP) in elderly patients and their impact on outcomes.

MATERIALS/METHODS

Using our in-house head and neck cancer database, we looked for non-metastatic OP cases that received definitive treatment between 1/2009-6/2020. All patients received either definitive radiation therapy (RT) +/- concomitant systemic therapy (ST), or surgery followed by adjuvant RT or RT-ST. For the elderly (age at diagnosis ≥65 years) and young (<65 years) patients, we compared treatment package time (TPT) (time from surgery to RT conclusion) for adjuvant RT, total RT duration and unplanned RT interruptions. ST details and dose/protocol modifications were also compared. We evaluated worst grade of pain and mucositis, hospitalization for non-hydration causes and febrile neutropenia (FN) during RT. Feeding tube (FT) use and weight loss were compared. The independent effect of these indicators on locoregional (LRFS), distant (DRFS) recurrence free and overall (OS) survival was assessed using multivariate analyses (MVA).

RESULTS

A cohort of 326 patients was included: 36% elderly (n = 118) and 64% young (n = 208), with no differences in AJCC stage distribution (8th), treatment received and HPV status (HPV+ve: 73% vs 74.6%; p = 0.86). In 23.6 % who received adjuvant RT, median TPT was 86 (range 72-128) and 81 (65-137) days for elderly vs young (p = 0.27); whereas in the definitive RT cases 76.4%, total RT duration was 49 days for both age groups. Overall, prescribed RT course was not completed in 4% and unplanned RT interruptions occurred in 22.8% and both were non-significant between age groups. Among the 261 patients that received ST, elderly utilized more cetuximab (26 vs 12%; p = 0.007). For those who received cisplatin, 20% of elderly had cumulative dose <200 mg/m2 compared to 6% among the younger age group (p = 0.006); and cisplatin was changed to carboplatin or cetuximab in 18% vs 8% (p = 0.019). Delayed/cancelled cycles and dose reductions were similar. There were more hospitalizations (47% vs 27%; p<0.001) and a trend for more FN (9% vs 3%; p = 0.09) with older age, while worst pain and mucositis was similar. FTs were used more in elderly patients (64% vs 50%; p = 0.02), for a median of 97 vs 64 days (p = 0.31); of which 19.5% vs 11% (p = 0.28) were inserted before RT start. However, % weight loss was non-significant. On MVA, longer RT duration, FT use and hospitalizations predicted worse LRFS and DRFS; and they were prognostic for OS in addition to TPT >90 days (p<0.05 for all). Nevertheless, elderly vs young had non-significant 3-year LRFS (91% vs 90% and 67% vs 69%), DRFS (86% vs 90% and 79% vs 81%) & OS (85% vs 81% and 39% vs 52%) for HPV+ve and HPV-ve respectively (p>0.05).

CONCLUSION

Elderly patients with OP need more multi-disciplinary supportive care when receiving RT and concurrent ST. However, survival outcomes are equivalent to younger patients. Ongoing studies should enroll more elderly candidates and stratify endpoints with age.

First-in-Human Phase I Trial Combining Biologically Guided Radioimmunotherapy (RIT) Using a 90Y-Anti-CD25 Monoclonal Antibody (Mab) with CT-guided Total Marrow and Lymphoid Irradiation (TMLI) in Relapsed and Refractory (R/R) Acute Leukemia

PURPOSE/OBJECTIVE(S)

Patients with R/R acute leukemia after allogeneic hematopoietic cell transplant (alloHCT) have a dismal prognosis with 3-year survival rates of < 20%. To improve outcomes, innovative targeted forms of organ sparing radiotherapy, such as tumor-specific RIT and TMLI, are needed to dose escalate with acceptable toxicities, especially in patients ≥ age 60 years who cannot tolerate total body irradiation (TBI) / myeloablative regimens and who have a poor prognosis. CD25 is an ideal RIT target given its expression in acute leukemias, association with poor prognosis, and expression by leukemia stem cells. In this phase I trial (NCT05139004) we hypothesized that combining dose escalated 90Y-anti-CD25 RIT with fixed dose TMLI 12 Gy, fludarabine (flu), and melphalan (mel) in patients with R/R disease is safe and associated with acceptable toxicities.

MATERIALS/METHODS

The primary objective of this trial is to determine the maximum tolerated dose and recommended phase 2 dose of 90Y-anti-CD25 Mab (Day -15) with 12 Gy TMLI (1.5 Gy twice a day, days -8 to -5), flu (30 mg/m2/d days -5 to -2), and mel (100 mg/m2, day -2) in patients ≥ 60 years old or with a HCT-comorbidity index ≥ 2 and with R/R AML, ALL or myelodysplastic syndrome (MDS) scheduled to undergo alloHCT from a matched donor. TMLI mean organ dose constraints for kidney, lung and liver were 4 Gy. Planned dose levels of 90Y-anti-CD25 were 0.3, 0.4, and 0.5 mCi/kg. 111In-anti-CD25 (5 mCi) was co-infused followed by serial nuclear scans to assess dosimetry and biodistribution.

RESULTS

To date 5 patients (ages 31-74) with R/R AML have been treated. Marrow and circulating blasts ranged from 10-36% and 9-44%, respectively. For the 3 patients at 0.3 mCi/kg, follow-up ranged from 89-191+ days. 90Y/111In-anti-CD25 nuclear scans demonstrated persistent uptake in bone out to 144 hours, which was associated with a decline in circulating blasts. After combined RIT and TMLI, mean doses (Gy) to lungs ranged from 5.7-6.5, to kidneys from 7.5-8.2 and to liver from 7.2-11.6. No dose-limiting toxicities (DLT) were observed. All 3 patients achieved CR on day +30 bone marrow biopsies and 2 remained in CR on day +90 biopsies. Two patients have recently been treated at the 0.4 mCi/kg dose level. The results of patients treated at the higher dose levels will be provided.

CONCLUSION

Dose escalation by adding 90Y-anti-CD25 RIT at 0.3 mCi/kg to 12 Gy TMLI was safe, including in older patients, with no dose-limiting toxicities, mean critical organ doses lower than conventional myeloablative TBI, and encouraging response rates. The toxicity profile and dose estimates at 0.3 mCi/kg predict that the planned higher dose levels will also be feasible with acceptable toxicities. RIT and TMLI are complementary and when combined address the limitations of each modality. Combining these targeted therapies may be a superior strategy to intensify dose to leukemia compared to dose escalation of either modality alone.

Nickel (Ni) phytotoxicity and detoxification mechanisms: A review

Scientists studying the environment, physiology, and biology have been particularly interested in nickel (Ni) because of its dual effects (essentiality and toxicity) on terrestrial biota. It has been reported in some studies that without an adequate supply of Ni, plants are unable to finish their life cycle. The safest Ni limit for plants is 1.5 μg g^-1, while the limit for soil is between 75 and 150 μg g^-1. Ni at lethal levels harms plants by interfering with a variety of physiological functions, including enzyme activity, root development, photosynthesis, and mineral uptake. This review focuses on the occurrence and phytotoxicity of Ni with respect to growth, physiological and biochemical aspects. It also delves into advanced Ni detoxification mechanisms such as cellular modifications, organic acids, and chelation of Ni by plant roots, and emphasizes the role of genes involved in Ni detoxification. The discussion has been carried out on the current state of using soil amendments and plant-microbe interactions to successfully remediate Ni from contaminated sites. This review has identified potential drawbacks and difficulties of various strategies for Ni remediation, discussed the importance of these findings for environmental authorities and decision-makers, and concluded by noting the sustainability concerns and future research needs regarding Ni remediation.

All-Microwave Leakage Reduction Units for Quantum Error Correction with Superconducting Transmon Qubits

Minimizing leakage from computational states is a challenge when using many-level systems like superconducting quantum circuits as qubits. We realize and extend the quantum-hardware-efficient, all-microwave leakage reduction unit (LRU) for transmons in a circuit QED architecture proposed by Battistel et al. This LRU effectively reduces leakage in the second- and third-excited transmon states with up to 99% efficacy in 220 ns, with minimum impact on the qubit subspace. As a first application in the context of quantum error correction, we show how multiple simultaneous LRUs can reduce the error detection rate and suppress leakage buildup within 1% in data and ancilla qubits over 50 cycles of a weight-2 stabilizer measurement.

Beta-propeller protein-associated neurodegeneration: A clinical update with a case report

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Hemolytic uremic syndrome with central nervous system manifestations, a case report and literature review

Hemolytic uremic syndrome (HUS) is a multisystem disorder generally seen in children and young adults, manifesting with the symptomatic triad of thrombocytopenia, hemolytic anemia, and acute kidney injury. These symptoms are often preceded by a prodrome of bloody diarrhea, vomiting, fever, and weakness. HUS is an exceedingly rare entity, with less than 1.5 per 100,000 people affected annually. HUS with central nervous system (CNS) manifestations constitutes approximately 20%-50% of cases and often presents with seizures, altered level of consciousness, and brainstem symptoms. CNS involvement in HUS is a major cause of acute morbidity and mortality; therefore, timely diagnosis and treatment are crucial in the management of these cases. Neuroimaging plays a critical role in the diagnosis; however, it might be very challenging in a large number of cases because studies that report the typical neuroradiologic features of brain injury in cases with HUS are not commonly available. Herein, we demonstrate in a case-based approach, the importance of combining clinical suspicion with different radiologic modalities to better characterize HUS cases with CNS involvement, as well as demonstrate how the early start of meticulous supportive therapy can lead to a favorable outcome even when severe brain involvement is evident on acute imaging studies. Furthermore, we provide an illustrated overview of the current theories that explain the neurologic involvement in HUS, as well as the commonly affected brain areas and how this entity can be radiologically differentiated from other potential diagnoses.

Pronounced effect of yttrium oxide on the activity of Pd/rGO electrocatalyst for formic acid oxidation reaction

A highly efficient and stable electrocatalyst comprised of yttrium oxide (Y₂O₃) and palladium nanoparticles has been synthesized via a sodium borohydride reduction approach. The molar ratio of Pd and Y was varied to fabricate various electrocatalysts and the oxidation reaction of formic acid was checked. X-ray photoelectron spectroscopy (XPS), transmission electron microscopy (TEM), and X-ray powder diffraction (XRD) are used to characterize the synthesized catalysts. Among the synthesized catalysts (Pd_yY_x/rGO), the optimized catalyst i.e., Pd₆Y₄/rGO exhibits the highest current density (106 mA cm^-2) and lowest onset potential compared to Pd/rGO (28.1 mA cm^-2) and benchmark Pd/C (21.7 mA cm^-2). The addition of Y₂O₃ to the rGO surface results in electrochemically active sites due to the improved geometric structure and bifunctional components. The electrochemically active surface area 119.4 m² g^-1 is calculated for Pd₆Y₄/rGO, which is ∼1.108, ∼1.24, ∼1.47 and 1.55 times larger than Pd₄Y₆/rGO, Pd₂Y₈/rGO, Pd/C and Pd/rGO, respectively. The redesigned Pd structures on Y₂O₃-promoted rGO give exceptional stability and enhanced resistance to CO poisoning. The outstanding electrocatalytic performance of the Pd₆Y₄/rGO electrocatalyst is ascribed to uniform dispersion of small size palladium nanoparticles which is possibly due to the presence of yttrium oxide.

Synergistic Effect of Pd Co-Catalyst and rGO–TiO2 Hybrid Support for Enhanced Photoreforming of Oxygenates

Photoreforming biomass-derived waste such as glycerol into hydrogen fuel is a renewable hydrogen generation technology that has the potential to become important due to unavoidable CO2 production during methane steam reforming. Despite tremendous efforts, the challenge of developing highly active photocatalysts at a low cost still remains elusive. Here, we developed a novel photocatalyst with a hybrid support comprising reduced graphene oxide (rGO) and TiO2 nanorods (TNR). rGO in the hybrid support not only performed as an excellent scavenger of electrons from the semiconductor conduction band due to its suitable electrochemical potential, but also acted as an electron transport highway to the metal co-catalyst, which otherwise is not possible by simply increasing metal loading due to the shadowing effect. A series of hybrid supports with different TNR and rGO ratios were prepared by the deposition method. Pd nanoparticles were deposited over hybrid support through the chemical reduction method. Pd/rGO-TNRs photocatalyst containing 4 wt.% rGO contents in the support and 1 wt.% nominal Pd loading demonstrated hydrogen production activity ~41 mmols h−1g−1, which is 4 and 40 times greater than benchmark Au/TiO2 and pristine P25. The findings of this works provide a new strategy in optimizing charge extraction from TiO2, which otherwise has remained impossible due to a fixed tradeoff between metal loading and the detrimental shadowing effect.

A bibliometric study on blockchain-based supply chain: a theme analysis, adopted methodologies, and future research agenda

The emergence of the underlying blockchain technology of bitcoin has gained extensive attention from researchers and practitioners. As distributed ledger technology, blockchain widely finds its applications in the supply chain to mitigate issues related to transparency, information sharing, process efficiency, and traceability. This study employed a knowledge-based visualization technique to create a vision beyond other review studies on the blockchain-based supply chain. We used bibliometric and network analysis to synthesize the previous literature. In total, 431 articles in the timespan of 2017 to April 2022 from Scopus and Web of Science (WOS) databases were analyzed after applying search string, inclusion, and exclusion criteria. Basic information was extracted from initial data screening; then, data was analyzed on the grounds of co-occurrence, bibliographic coupling, citation, co-authorship, and co-citation analysis. In addition, thematic analysis was performed to analyze the content of the previous studies, adopted research methods, and dynamic industries in the literature. Besides all these, we identified various research gaps and proposed research directions for future study. We believe that this study provides adequate knowledge to academic scholars and supply chain practitioners to fast-track the current research in the supply chain domain using blockchain technology.

Abstract B053: Targeting SMURF1 with low-dose proteasome inhibitors in pancreatic cancer organoids

Global initiatives focused on whole genome and transcriptome analysis (WGTA) of metastatic pancreatic ductal adenocarcinoma (PDAC) tumor cohorts are driving progress in understanding the clinical impact of PDAC heterogeneity. This knowledge is key to continue the discovery of subsets of patients who could benefit from biomarker-informed targeted therapy and expand the currently limited PDAC treatment options. To identify clinically actionable subtypes in metastatic PDAC (mPDAC), our team analyzes prospectively collected WGTA data from patients enrolled in the PanGen trial (NCT02869802), in parallel with analysis of a set of patient-derived organoids (PDOs). In a cohort of 69 sequenced tumors, four cases (5.8%) had an amplification of chromosome 7q22, which included copy gains of transcriptional co-factor TRRAP, drug metabolizing cytochrome P450 genes CYP3A4 and CYP3A5, and SMURF1. SMURF1 is a ubiquitin-protein ligase that regulates TGFβ receptor signaling, in part via its interaction with SMAD7, and has been implicated in the epithelial-to-mesenchymal program and tumor invasiveness in PDAC. The proteasome inhibitor (PI) bortezomib has been shown to attenuate SMURF1 levels. We investigated whether SMURF1 signaling axis is associated with sensitivity to PIs in mPDAC, by analyzing the cytotoxic effects of the PIs bortezomib, carfilzomib and ixazomib in PDOs. Eight PDOs were treated with PIs at concentrations between 0.1pM-1mM. The presence of live and dead cells was quantified using the IN Cell Analyzer, and cell toxicity was analyzed using GRtoxic metrics (grcalculator.org). The PIs bind catalytic subunits of the 26S proteasome, primarily proteasome subunit beta-5, encoded by PSMB5. The cytotoxic activity of all three PIs negatively correlated with tumor biopsy PSMB5 expression (p&lt;0.05), suggesting that PDOs established from tumors with low expression of PSMB5 are more sensitive to PI-induced cell death. There was a positive correlation between ixazomib cytotoxicity and SMURF1 expression (p&lt;0.05). PanGen patients with high (&gt;75th percentile) tumor SMURF1 expression showed shorter overall survival (OS) compared to the rest of the cohort (median OS 9 vs. 14 months, respectively; p=0.004). Immunohistochemistry analysis of a tumor tissue microarray comprising 175 resected PDAC cases detected an association of concomitant low SMURF1 and high SMAD7 protein levels with adjuvant therapy response (median OS: 40 vs. 12 months with no adjuvant treatment, p=0.002), suggesting that attenuation of SMURF1 in the presence of SMAD7 may improve chemotherapy response in early disease stages. In summary, we present data indicating increased sensitivity to PIs in a subset of tumors with low PSMB5 and high SMURF1 expression, and highlight the translational utility of the investigation of genomic and clinically annotated pre-clinical models in PDAC predictive biomarker discovery.

Citation Format: Andrew Metcalfe, Joanna M. Karasinska, James T. Topham, Steve E. Kalloger, Hassan Ali, Dawn Ashforth, Marco A. Marra, Janessa Laskin, Patricia A. Tang, Rachel Goodwin, Oliver F. Bathe, Daniel J. Renouf, David F. Schaeffer. Targeting SMURF1 with low-dose proteasome inhibitors in pancreatic cancer organoids [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer; 2022 Sep 13-16; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2022;82(22 Suppl):Abstract nr B053.

Abstract B066: Elucidating the role of insulin receptor isoform expression in metastatic pancreatic ductal adenocarcinoma

Introduction: While type 2 diabetes mellitus (T2DM) has been shown to be both a risk factor and consequence of pancreatic ductal adenocarcinoma (PDAC), the bidirectional relationship between T2DM and PDAC remains to be fully understood. Due to spatial proximity of insulin-producing beta cells, PDAC tumor cells are presumably exposed to a highly concentrated insulin microenvironment, which may contribute to the dysregulation of the insulin receptor gene INSR. There are two isoforms of insulin receptor: IR-A and IR-B. IR-A activity has been associated with oncogenic function and is upregulated in several cancer types. This leads to questions regarding the role of INSR and more specifically, how the ratio of the two isoforms may potentiate tumor aggressiveness in PDAC. Results: Using data from whole-genome and RNA sequencing of metastatic PDAC (mPDAC) from both the PanGen (n=70; NCT01855477) and Personalized Oncogenomics (n=22; NCT02155621) trials, we identified somatic copy loss of INSR in 39/92 (42%) patient tumors, with the majority of such cases (35/39; 90%) showing heterozygous copy loss. There was no statistical association between INSR copy status and PDAC transcriptomic subtypes. INSR expression was lower in basal-like versus classical subtype tumors (p=1.1e-4), and INSR expression was further attenuated in basal-like tumors with heterozygous copy loss of INSR (p=0.0041). The ratio of IR-A:IR-B expression was heterogenous across samples, and heightened IR-A:IR-B ratio was significantly (p&lt;0.05) associated with expression of genes linked to the PI3K-Akt signaling axis (CCDC88A, THEM4) and glucose metabolism (HK1, G6PC, PKLR) in basal-like tumors. Interestingly,HK1 and IGF1R were significantly upregulated, independent of IR-A:IR-B ratio, among basal-like (p 9.1e-9 and p=1.4e-5, respectively) compared to classical subtype tumors. Conclusion: These data indicate that heightened IR-A:IR-B ratio is associated with the expression of key pathways converging on PI3K signalling and glucose metabolism in mPDAC, while highlighting that several IR-A:IR-B-associated gene correlations are unique to basal-like tumors. Such findings warrant further investigation of relative INSR isoform expression in mPDAC and pre-clinical models to elucidate the role of the oncogenic isoform, IR-A, in driving tumor aggressiveness in basal-like subtype tumors.

Citation Format: Lan V. Tao, James T. Topham, Joanna M. Karasinska, Erica S. Tsang, Andrew Metcalfe, Hassan Ali, Dawn Ashforth, Rachel Goodwin, Patricia A. Tang, Oliver F. Bathe, Janessa Laskin, Marco Marra, Daniel J. Renouf, David F. Schaeffer. Elucidating the role of insulin receptor isoform expression in metastatic pancreatic ductal adenocarcinoma [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer; 2022 Sep 13-16; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2022;82(22 Suppl):Abstract nr B066.

A novel approach for the quantification of paclitaxel loaded in ethyl cellulose/kollicoat and ethylcellulose/eudragit colloidal particles by UPLC-PDA

An optimized rapid reversed phase ultra-performance liquid chromatography (UPLC-PDA) method has been developed and validated for precise and accurate quantification of paclitaxel in drug delivery systems. The chromatographic separation was attained on L1 (USP) column (2.1 ×50 mm, 1.7µm) with an isocratic mobile phase comprised of acetonitrile and water (1:1; flow rate 0.6 mL/min) and detection was executed at 227 nm by PDA detector. The proposed UPLC-PDA method is found to be rapid with retention time of 1.37 min, selective with homogenous peaks and sensitive with Limit of Detection (LOD) of 0.08µg/mL and Limit of Quantification (LOQ) of 2.6µg/mL. The method showed excellent linearity (R²>0.998) over the range of 0.1 to 0.4mg/mL and applied for the paclitaxel quantification in different formulations with no inference of excipients. Thus, the proposed approach has potential for rapid estimation of drug purity, assay and release profile from pharmaceutical preparations.

Electrocatalytic water oxidation on CuO-Cu2O modulated cobalt-manganese layered double hydroxide

Layered double hydroxides (LDH) are potential electrocatalysts to address the sluggish oxygen evolution reaction (OER) of water splitting. In this work, copper oxide (CuO/Cu₂O) nanoparticles are integrated with cobalt-manganese layered double hydroxide (CoMn-LDH) to enhance their performance towards OER. The catalyst is synthesized by growing CoMn-LDH nanosheets in the presence of CuO/Cu₂O nanoparticles that were obtained by the calcination of the copper containing metal-organic framework (HKUST-1). The synthesized CoMn-LDH@CuO/Cu₂O electrocatalyst shows excellent activity towards OER with an overpotential of 297 mV at a catalytic current density of 10 mA cm^-2 and have a Tafel slope value of 89 mV dec^-1. Moreover, a slight decrease in the performance parameters is observed until the 15 h of continuous operation. We propose that the conductive strength of CuO/Cu₂O and its synergistic effect with the CoMn-LDH are responsible for the improved OER performance of the desired electrocatalyst.

Integrative analysis of KRAS wildtype metastatic pancreatic ductal adenocarcinoma reveals mutation and expression-based similarities to cholangiocarcinoma

Oncogenic KRAS mutations are absent in approximately 10% of patients with metastatic pancreatic ductal adenocarcinoma (mPDAC) and may represent a subgroup of mPDAC with therapeutic options beyond standard-of-care cytotoxic chemotherapy. While distinct gene fusions have been implicated in KRAS wildtype mPDAC, information regarding other types of mutations remain limited, and gene expression patterns associated with KRAS wildtype mPDAC have not been reported. Here, we leverage sequencing data from the PanGen trial to perform comprehensive characterization of the molecular landscape of KRAS wildtype mPDAC and reveal increased frequency of chr1q amplification encompassing transcription factors PROX1 and NR5A2. By leveraging data from colorectal adenocarcinoma and cholangiocarcinoma samples, we highlight similarities between cholangiocarcinoma and KRAS wildtype mPDAC involving both mutation and expression-based signatures and validate these findings using an independent dataset. These data further establish KRAS wildtype mPDAC as a unique molecular entity, with therapeutic opportunities extending beyond gene fusion events.

KRAS wildtype metastatic pancreatic ductal adenocarcinoma (mPDAC) could represent a distinct molecular entity from other PDACs. Here, the authors analyse KRAS wildtype mPDAC tumours using genomics and transcriptomics and find molecular similarities with cholangiocarcinomas.

Pharmacological effects (gastrointestinal, respiratory and vascular) of Calligonum polygonoides: Animal model based studies

The aim of this study was to analyze gastrointestinal, respiratory and vascular pharmacological effects of 70% hydro-alcoholic extract of Calligonum polygonoides (Cp. Cr) in animal models. All the procedures were carried-out as per previous literature with slight modification where necessary. It was found that Cp. Cr affected significant relaxation of spontaneous and K+ (80 mM) induced contractions. The results showed a corresponding shift of calcium concentration response curves. Similarly Cp. Cr showed relaxant effect on trachea in carbachol (Cch) induced tracheal contractions. Moreover, contractions induced by phenylephrine (1μM) in quarantine rabbit aortic preparations causes Cp. Cr induced relaxation of aortal contractions. Verapamil was used as a standard calcium channel blocker. The findings of this study suggested vasodilator, bronchodilator and spasmolytic effects of Cp. Cr.

A novel approach for the quantification of paclitaxel loaded in ethyl cellulose/kollicoat and ethylcellulose/eudragit colloidal particles by UPLC-PDA

An optimized rapid reversed phase ultra-performance liquid chromatography (UPLC-PDA) method has been developed and validated for precise and accurate quantification of paclitaxel in drug delivery systems. The chromatographic separation was attained on L1 (USP) column (2.1 ×50 mm, 1.7µm) with an isocratic mobile phase comprised of acetonitrile and water (1:1; flow rate 0.6 mL/min) and detection was executed at 227 nm by PDA detector. The proposed UPLC-PDA method is found to be rapid with retention time of 1.37 min, selective with homogenous peaks and sensitive with Limit of Detection (LOD) of 0.08µg/mL and Limit of Quantification (LOQ) of 2.6µg/mL. The method showed excellent linearity (R²>0.998) over the range of 0.1 to 0.4mg/mL and applied for the paclitaxel quantification in different formulations with no inference of excipients. Thus, the proposed approach has potential for rapid estimation of drug purity, assay and release profile from pharmaceutical preparations.

P-572 Hormonal Monitoring and Progesterone Adjustment in Frozen Embryo Transfer Cycles

Study question

We investigated the effect of monitoring and follow-up of serum progesterone, estradiol & luteinizing hormone levels and progesterone supplement adjustments on pregnancy outcomes for FET in programmed HRT cycles.

Summary answer

Monitoring and follow-up of different hormones in patient’s serum in programmed frozen embryo transfer cycles didn’t have an impact on overall pregnancy rate.

What is known already

Frozen Embryo transfer treatment rapidly expanded in recent years. FET can effectively prevent IVF associated complications, such as ovarian hyperstimulation syndrome and multiple pregnancy. In addition, FET serves as a safe & cost-effective way to increase cumulative pregnancy rate.

Though progesterone levels on the day of transfer have not yet been studied extensively in humans, tailoring the time of transferring a frozen embryo based on serial P4 values rather than cycle day number alone results in higher pregnancy rates.The value of measuring the serum E2 levels on the day of embryo transfer as an indicator for clinical pregnancy is still doubtful.

Study design, size, duration

Six Hundred FETs were performed in a randomized prospective manner in an infertility center in Alexandria starting from 2019 till 2021.These were further subdivided based on computer randomization into Group I (Non-intervention) including300 patients with only ultrasound monitoring & Group II (intervention) including 300 patients with monitoring of serum level of progesterone, estrogen & luteinizing hormone as well as progesterone supplement adjustments.

Participants/materials, setting, methods

Group I (Non-intervention) including300 patients with only ultrasound monitoring & Group II (intervention) including 300 patients with monitoring of serum level of progesterone, estrogen & luteinizing hormone as well as progesterone supplement adjustments which are further subdivided into three groups depending on progesterone level in patient’s serum early in the morning prior to embryo transfer. Group II A: P4 levels &lt; 5ng/dl, Group II B: P4 levels 5-10ng/dl, Group II C: P4 levels &gt;10ng

Main results and the role of chance

Live birth and overall pregnancy rate showed no significant difference among group monitored with ultrasound only compared to the hormonal monitored group. However, on the day of embryo transfer, serum P4 &gt; 11.83 ng/ml represented a cut-off value above which there is marked increase in OPR/LBR and a sensitivity of 53.7% & specificity of 51.2% in predicting pregnancy. Also, serum E2 value more than 292 pg/ml at day 18 demonstrated an increase in OPR/LBR.In our study, the cut off value of LH level less than of 10.8 IU/L at day13 had a sensitivity of 58.3% & specificity of 50.4% in predicting pregnancy. Regarding pregnancy outcome, monitoring of LH levels didn’t generate useful data with no added prognostic value.Conclusion: Monitoring and follow-up of different hormones in patient’s serum in programmed frozen embryo transfer cycles didn’t have an impact on live birth, overall pregnancy & abortion rate when compared to ultrasound only in non-intervention group.

Limitations, reasons for caution

Patients in non-intervention group didn’t have a hormonal pre-transfer assessment so it’s not possible to determine if the progesterone levels are suboptimal or not when compared to intervention group.

Also, we didn’t have a post transfer hormonal assessment in case group to determine whether the progesterone dose reached desired levels.

Wider implications of the findings

Kofinas et al. proposed in his study that in order to optimize pregnancy and rate, P4 levels in FET cycles should be sustained between 10 and 20 ng/ml.

This was in accordance to our study where the cut off value of P4 on day of 11.83 ng/ml optimized pregnancy rates.

Trial registration number

NCT05189145

Drought stress enhances the efficiency of floral dip method of Agrobacterium-mediated transformation in Arabidopsis thaliana

The Agrobacterium-mediated floral dip protocol is the most extensively used transformation method for a model plant Arabidopsis thaliana. Several useful methods for Agrobacterium tumefaciens-mediated transformations of Arabidopsis are existing, but they are time consuming and with low transformation efficiency. Here, we developed a transgenic Arabidopsis lines TET12p::TET12-RFP in a short period of time and enhanced transformation efficiency by using a modified transformation method by applying drought stress after floral dip. In this protocol, Agrobacterium cells carrying TET12p::TET12-RFP recombinant vectors were resuspended in a solution of 5% sucrose, 0.05% (v/v) silwet L-77 to transform female gametes of developing Arabidopsis inflorescences. Treated Arabidopsis were then applied with different levels of drought stresses to stimulate plants for the utilization of maximum plant energy in seed maturation process. The applied stresses achieved the fast maturation of already treated inflorescences while stopped the growing of newly arising untreated inflorescence, thus decreased the chances of wrong collection of untransformed seeds. Consequently, the collected seeds were mostly transgenic with a transformation frequency of at least 10%, thus the screening for positive transformants selection was more advantageous on a selective medium as compared to a classical floral dip method. Within 2-3 months, two hundred of individual transgenic plants were produced from just 10 infiltrated plants. This study concludes that application of drought stresses in a specific stage of plant is a beneficial strategy for achieving the transgenic Arabidopsis in a short period of time with high transformation efficiency.

Abstract LB129: Analysis of KRAS wildtype pancreatic ductal adenocarcinoma reveals mutation and expression-based similarities to cholangiocarcinoma

Introduction

Oncogenic KRAS mutations are absent in 10% of patients with pancreatic ductal adenocarcinoma (PDAC) and may represent a subgroup of PDAC with therapy options beyond standard-of-care chemotherapy. While distinct gene fusions have been implicated in KRAS wildtype (wt) PDAC, other traits unique to KRAS wt PDAC remain unexplored.

Methods

Patients with treatment-naive metastatic PDAC (n=63) received matched tumor/normal whole-genome and RNA sequencing and clinical follow-up as part of the PanGen trial (NCT02869802). Clinical data and mutation, gene fusion and copy alteration frequency was compared between KRAS wt (n=9) and mutant (n=54) groups. Metastatic colorectal adenocarcinoma and cholangiocarcinoma samples from the POG trial (NCT02155621) were incorporated for sequencing-based comparison.

Results

KRAS wt tumors showed lower frequency of TP53 SNV/indels (p=0.01) and distinct amplifications affecting chr1q genes NR5A2 (p=9.0e-4), MPC2 (p=0.002) and MCL1 (p=0.02) and chr8q gene SQLE (p=0.02). Oncogenic fusions involving NRG1, FGFR2, NTRK2 or BRAF were unique to KRAS wt tumors (67% of samples; p=1e-6). KRAS wt tumors showed expression patterns indicative of cholangiocytes and, when clustered alongside other tumor types, formed a distinct cluster with cholangiocarcinoma samples.

Conclusion

These data provide the first identification of distinct chr1q/chr8q amplification events unique to KRAS wt PDAC while highlighting novel and striking molecular similarities to cholangiocarcinoma. Taken together, results of the PanGen trial generate new hypotheses relevant to therapeutic targeting of KRAS wt PDAC and rationale towards incorporating KRAS mutation status as part of routine clinical testing in PDAC.

Citation Format: James Topham, Erica Tsang, Joanna Karasinska, Andrew Metcalfe, Hassan Ali, Steve Kalloger, Veronika Csizmok, Laura Williamson, Emma Titmuss, Hui-Li Wong, Richard Moore, Andrew Mungall, Jonathan Loree, Oliver Bathe, Patricia Tang, Rachel Goodwin, Janessa Laskin, Marco Marra, Steven Jones, David Schaeffer, Daniel Renouf. Analysis of KRAS wildtype pancreatic ductal adenocarcinoma reveals mutation and expression-based similarities to cholangiocarcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr LB129.

Erector Spinae Plane Block for Children Undergoing Cardiac Surgeries via Sternotomy: A Randomized Controlled Trial

Background

Ineffective management of postoperative pain following pediatric cardiac surgeries adversely affects a patient’s postoperative course. The erector spinae plane (ESP) block has been described in the literature regarding perioperative pain management. We hypothesized that bilateral ESP blocks in pediatric patients would decrease intraoperative fentanyl consumption, reduce the need for postoperative morphine consumption, and improve pain scores.

Objectives

The aim of this double-blinded randomized controlled trial was to assess the efficacy and safety of bilateral ESP blocks in pediatric patients undergoing cardiac surgeries through a median sternotomy.

Methods

The study involved 98 children aged 6 months to 7 years who were American Society of Anesthesiologists (ASA) II and III and scheduled for cardiac surgery through a median sternotomy. Patients were divided randomly into 2 groups: the ES group (n = 50) who received bilateral ultrasound-guided ESP blocks, and the N group (n = 48) who received no block. The primary outcome was the total dose of administered fentanyl intraoperatively. Secondary outcomes included morphine consumption in the first 24 hours postoperatively; the length of time before the first need for postoperative analgesia; and FLACC (face, legs, activity, consolability, and cry) scores at the first and second hours postoperatively and every 4 hours, with readings taken for a period of 24 hours.

Results

There were statistically significantly higher levels of administered fentanyl intraoperatively (6.7 ± 3 vs 4.3 ± 1.9 µg.kg^-1) and postoperative morphine consumption (0.5 ± 0.2 vs 0.4 ± 0.2 mg.kg^-1) in the N group compared with the ES group (P < 0.001). Moreover, the timing of the first rescue analgesia was significantly delayed in the ES group compared with the N group (231.6 ± 104.5 vs 108.8 ± 47.8 minutes).

Conclusions

Bilateral ultrasound-guided ESP blocks can be used to reduce perioperative opioid consumption in pediatric patients undergoing cardiac surgery through a sternotomy. It also can be used to decrease postoperative pain scores.

Dual-mode independent detection of pressure and refractive index by miniature grating-coupled surface plasmon sensor

Multiple parameters need to be monitored to analyze the kinetics of biological progresses. Surface plasmon polariton resonance sensors offer a non-invasive approach to continuously detect the local change of refractive index of molecules with high sensitivity. However, the fabrication of miniaturized, compact, and low-cost sensors is still challenging. In this paper, we propose and demonstrate a grating-coupled SPR sensor platform featuring dual mode operation for simultaneous sensing of pressure and refractive index, which can be fabricated using a highly-efficient low-cost method, allowing large-scale production. Both sensing functionalities are realized by optical means via monitoring the spectral positions of a surface plasmon polariton mode (for refractive index sensing) and Fabry-Perot or metal-insulator-metal modes (for pressure sensing), which are supported by the structure. Simultaneous measurement of refractive index with the sensitivity of 494 nm/RIU and pressure was demonstrated experimentally. The proposed platform is promising for biomonitoring that requires both high refractive index sensitivity and local pressure detection.

Heterojunction-based photocatalytic nitrogen fixation: principles and current progress

Nitrogen fixation is considered one of the grand challenges of the 21st century for achieving the ultimate vision of a green and sustainable future. It is crucial to develop and design sustainable nitrogen fixation techniques with minimal environmental impact as an alternative to the energy-cost intensive Haber-Bosch process. Heterojunction-based photocatalysis has recently emerged as a viable solution for the various environmental and energy issues, including nitrogen fixation. The primary advantages of heterojunction photocatalysts are spatially separated photogenerated charge carriers while retaining high oxidation and reduction potentials of the individual components, enabling visible light-harvesting. This review summarises the fundamental principles of photocatalytic heterostructures, the reaction mechanism of the nitrogen reduction reaction, ammonia detection methods, and the current progress of heterostructured photocatalysts for nitrogen fixation. Finally, future challenges and prospects are briefly discussed for the emerging field of heterostructured photocatalytic nitrogen fixation.