Hormonal and inflammatory modulatory effects of hesperidin in hyperthyroidism-modeled rats

The goal of the current study was to investigate the hormonal modulatory efficiency of hesperidin, through its regulatory potential of immunological, inflammatory, and/or antioxidant changes in on hyperthyroidism modeled adult female albino rats. Both normal and hyperthyroidism modeled rats (140-160g) were randomly divided into four groups (10 animals each) as follows: 1) healthy animals were daily ingested with saline for six weeks, and served as control group, 2) healthy animals were intraperitoneally injected with hesperidin (50 mg/kg/day) for a similar period, 3) hyperthyroidism-modeled animals without any treatment acted as positive control, and 4) hyperthyroidism-modeled animals were treated intraperitoneally with hesperidin for a similar period. The findings showed that hesperidin significantly modulated hyperthyroidism deteriorations, this was evidenced by a remarkable decline in serum T4, FT4, T3, FT3, TNF-α, IL1β-, IL4-, IL-6, and IL-10 levels, with a minor increase in TSH and significant raise in CD4+ level. Similarly, valuable improvement was observed in the oxidative status; serum SOD, GPx, CAT, and GSH levels were dramatically enhanced, associated with remarkable drop in MDA and NO levels. Also, hesperidin demonstrated nephro-hepatoprotective and anti-atherogenic potential, this was achieved from the notable reduction in ALAT and ASAT activities as well as urea, creatinine, cholesterol, and triglyceride close to the corresponding values of healthy group. These findings were supported by histological and immunohistochemical ones that showed a notable decrease in the expression of the calcitonin antibody. In conclusion, hesperidin possesses anti-hyperthyroidism, immunoinflammatory regulatory, and antioxidant activities that evidenced from the improvement of physio-architecture of the thyroid gland, reduction of inflammation and restoration of the impaired oxidative stress. This effect might be mechanized through immunological, inflammatory, apoptotic, and/or antioxidant modulatory pathways.

P14.71 An assessment of the reporting and methodological quality of meningioma systematic reviews and meta-analyses

BACKGROUND

Systematic reviews and meta-analyses constitute the highest level of research evidence and for a disease with limited clinical trial activity, are often relied upon to help inform clinical practice. This review of reviews evaluates both the reporting & methodological quality of meningioma evidence syntheses.

MATERIAL AND METHODS

Potentially eligible meningioma reviews published between 1st January 1990 and 31st December 2020 were identified from eight electronic databases. Inclusion required the study to meet the Cochrane guideline definition of a systematic review or meta-analysis. Reviews concerning neurofibromatosis type 2, spinal and pediatric meningiomas were excluded. The reporting and methodological quality of articles were assessed against the following modified guidelines: Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), A MeaSurement Tool to Assess Systematic Reviews (AMSTAR2) and the Risk of Bias in Systematic Reviews (ROBIS) guidelines.

RESULTS

117 systematic reviews were identified, 57 of which included meta-analysis (48.7%). The number of meningioma systematic reviews published each year has increased with 63 studies (53.9%) published between 01/2018 and 12/2020. A median of 17 studies (IQR 9–29) were included per review. Impact factor of journals publishing a systematic review with or without a meta-analysis was similar (median 2.3 vs 1.8, P=0.397). The mean PRISMA scores for systematic reviews with a meta-analysis was 21.11 (SD 4.1, 78% adherence) and without was 13.89 (SD 3.4, 63% adherence). Twenty-nine systematic reviews with meta-analysis (51%) and 11 without meta-analysis (18%) achieved greater than 80% adherence to PRISMA recommendations. Methodological quality assessment using AMSTAR2 revealed one study (0.9%) as high quality whilst 111 (94.8%) studies were graded as critically low. One hundred and two articles (87.2%) did not utilize a comprehensive search strategy as defined by the AMSTAR2 tool. Ninety-nine studies (84.6%) obtained a high level of concern for potential bias as per the ROBIS assessment. One hundred and eight articles (92.3%) failed to present information that a protocol had been established prior to study commencement and 76 articles (65.0%) did not conduct a risk of bias assessment. Across the three tools, domains relating to the establishment of a protocol prior to review commencement and conducting appropriate risk of bias assessments were frequently low scoring.

CONCLUSION

Overall reporting and methodological quality of meningioma systematic reviews was sub-optimal. Established critical appraisal tools and reporting guidelines should be utilized a priori to assist in producing high-quality systematic reviews.

OS09.7.A Quality of life outcomes in patients with incidental and operated meningiomas: the QUALMS study

BACKGROUND

Long-term Health-Related Quality of Life (HRQoL) is an important measure of patient wellbeing. There is a paucity of studies evaluating HRQoL in meningioma patients.

MATERIAL AND METHODS

Cross-sectional study of adult patients with an incidental or symptomatic intracranial meningioma. Patients with less than 5 years of follow-up, a history of craniospinal radiation or neurofibromatosis type 2 were excluded. HRQoL was evaluated with SF-36, EORTC QLQ-C30 and EORTC QLQ-BN20 questionnaires. Outcome determinants were evaluated using a multi-variable linear regression analysis, adjusted for patient, tumour and treatment characteristics, and duration of follow-up.

RESULTS

699 patients were invited to participate and 246 responded: 118 (48%) had an incidental meningioma. Mean age at diagnosis was 56.8 years (SD=13) and 81% were female. Median time from diagnosis to completion of questionnaire was 8.5 years (IQR 6.8–11.5). During follow-up, 158 patients (64.2%) had at least one operation for their meningioma and 47 patients (19.1%) had radiotherapy. Of those operated, 126 (79.7%) had WHO grade 1 and 24 (15.2%) had grade 2 meningiomas. Compared to normative population values, meningioma patients reported a worse SF-36 general health score (mean 61.9 vs 56.5, P=0.003) but a similar QLQ-C30 global health score (mean 62.3 vs 65.8, P=0.039), worse SF-36 and QLQ-C30 physical functioning scores (mean 74.1 vs 64.6, P<0.001 and mean 81.8 vs 76.5, P=0.007) and similar SF-36 and QLQ-C30 emotional health scores (mean 72.2 vs 70.9, P=0.367 and mean 71.0 vs 71.9, P=0.960). QLQ-C30 cognitive functioning was worse (mean 80.5 vs 71.4, P<0.001). Compared to the meningioma literature, QLQ-BN20 seizure burden was similar (mean 2.0 vs 1.6, P=0.760). A worse performance status at diagnosis was associated with an inferior QLQ-C30 global health score (β-coefficient=-4.9 [95% CI -9.1-(-)0.6] P=0.024). Number of surgeries was significantly associated with a worse QLQ-C30 cognitive functioning score (β-coefficient=-7.0 [95% CI -13.2-(-)0.9], P=0.025). Anti-epileptic drug use was associated with a significantly worse QLQ-C30 emotional health score (β-coefficient=-10.9 [95% CI -21.7-(-)0.01], P=0.050).

CONCLUSION

Meningioma patients have long-term HRQoL impairments affecting their physical and cognitive functions. An understanding that multiple surgeries affects cognitive function, and the need for anti-epileptic drugs equate to poorer emotional health, could help target appropriate therapies and support in the future.

P14.66 Re-operation for recurrent meningioma - are we helping patients?

BACKGROUND

Meningioma is the commonest primary brain tumour. Despite surgery, meningiomas can recur. Surgery is usually the first line treatment for recurrent meningioma. The aim was to determine the risk factors associated with clinical outcomes (performance status, morbidity, mortality, recurrence) following re-operation for recurrence of intracranial meningioma.

MATERIAL AND METHODS

Retrospective cohort study (1998–2018). Eligible patients had reoperation for local recurrence of a previously operated meningioma. Collected data included baseline clinical and imaging characteristic. Primary outcome measure was performance status after each reoperation. Secondary outcome measures were medical and surgical morbidity, recurrence-free survival (RFS) and overall survival (OS).

RESULTS

Fifty-eight patients were eligible (37 female, mean age at 1st re-operation 56.1 years (SD=11.6)). Eleven patients (19.6%) had 2 re-operations and 3 patients (5.4%) had 3 re-operations. Median follow up was 128.5 months (IQR=73–194.5). Median time to 1st recurrence and 1st re-operation were 36.5 (IQR=24.3–81.0) and 43.8 months (IQR=20.3–103.4), respectively. Fifteen patients (26.8%) had worse performance status after 1st reoperation, compared to 5.4% (n=3) after the primary operation. Complication rate was 32.1% (n=18) after the primary operation compared to 48.2% (n=27) after 1st reoperation. At primary operation, there were 29 (51.8%) grade 1, 24 (42.9%) grade 2, and 1 (1.8%) grade 3 tumours. Median RFS after first re-operation was 36.5 months (95% CI 29.3–43.9). Median OS was 312 months (95 % CI 257.8–366.2). Increased number of post-operative complications were a risk factor for worsened performance status following reoperation (OR 2.2 [95% CI 1.1–4.6], P=0.029).

CONCLUSION

Re-operation is associated with a worse performance status and increased risk of complications. Re-operating meningiomas for radiological recurrence without symptoms increases patient morbidity. Shared-care management decision should be made with patients when considering operating for radiological recurrence only.

P14.02 The Natural History of a Residual Intracranial Meningioma- Volumetric Growth and Predictors of Progression

BACKGROUND

Resection of meningioma leaves residual solid tumour in ~25% of patients. Selection for further treatment and follow-up strategy may benefit from knowledge of volumetric growth and associated prognostic factors.

MATERIAL AND METHODS

Growth rates were assessed using a linear mixed effects model, in a retrospective adult cohort that underwent subtotal resection of meningioma (2004–2018). Endpoints were re-treatment, end of follow-up or death. Cox regression analysis was used to identify prognostic factors for progression, defined using the Response Assessment in Neuro-Oncology (RANO) volumetric criteria.

RESULTS

236 patients were included. Mean age at surgery was 56.3 years (SD=13.7) and 73.7% were female. WHO grades were 1 (n=195, 82.6%), 2 (n=40, 16.9%) and 3 (n=1, 0.5%). Adjuvant fractionated radiotherapy (fRT) was administered to 34 patients (14.4%), with no propensity towards higher WHO grade or residual volume. Median pre-operative meningioma and post-operative residual volumes were 34.0cm3 (IQR 16.0–63.0) and 2.0cm3 (IQR 0.8–5.2), respectively. Median follow-up was 64 months (IQR 42–104). Median absolute growth rate (AGR) and relative growth rate (RGR) were 0.1cm3/year and 4.3%/year, respectively. According to RANO criteria, 132 (55.9%) patients progressed, of which 13 (9.8%) developed symptoms. Median progression-free survival was 56 months (95% CI 43.1–69.0). Multivariable analysis identified adjuvant fRT (HR 1.7, [95% CI 1.0–2.8], P=0.046), skull base location (HR 1.5, [95% CI 1.0–2.4], P=0.047) and Ki-67 index (HR 3.7 [95% CI 1.3–10.8], P=0.017) as prognostic factors for volumetric progression. WHO grade was not significant (HR 1.0, [95% CI 0.5–1.7], P=0.905). Forty-nine patients who progressed (37.1%) underwent further treatment: fRT (n=19), re-operation (n=15), Stereotactic radiosurgery (SRS) (n=10) and surgery+adjuvant fRT (n=5). Of those, 8 (16.3%) progressed further (after re-operation [n=6] and SRS [n=2]). Seven were treated with a 2nd re-operation (n=3), fRT (n=3), and SRS (n=1). One patient progressed after a 2nd reoperation and was treated with SRS, after which they remained stable. Median survival was not reached. 5- and 10-year overall survival (OS) was 96% and 86% respectively.

CONCLUSION

Growth rates of a residual meningioma vary with a dichotomy observed in progression rates. Half of patients with a residual meningioma showed radiological progression requiring multiple treatment to control the tumour. The other half demonstrate a more indolent course. Skull base location and higher Ki67 are important prognostic factors for progression and therefore, should be considered to stratify patients for adjuvant radiotherapy.

Nephroprotective Effect of Costus (Saussurea costus) Ethanolic Extract on Oxaliplatin®-induced Nephrotoxicity in Adult Male Wistar Rats

<b>Background and Objective:</b> Oxaliplatin<sup>®</sup> is an antineoplastic platinum-based compound; nephrotoxicity is one of its most serious side effects. This study aimed to explore the nephroprotective potential of Costus Ethanolic Extract (CEE) against Oxaliplatin<sup>®</sup>-induced nephrotoxicity. <b>Materials and Methods:</b> Adult male Wistar rats, weighting 140-160 g, were randomly divided into four groups: (1) Normal rats, (2) Rats ingested with CEE (67.08 mg kg<sup>1</sup> day<sup>1</sup>), (3) Rats injected (ip) with Oxaliplatin<sup>®</sup> (10 mg kg<sup>1</sup> week<sup>1</sup>) and (4) rats treated with CEE in combination Oxaliplatin<sup>®</sup> injection. <b>Results:</b> After six weeks of treatments, the results revealed that CEE ingestion along with Oxaliplatin<sup>®</sup> injection markedly minimized the Oxaliplatin<sup>®</sup>-induced renal deterioration; this was evidenced by the significant reduction in serum urea, creatinine, uric acid, Tumor Necrosis Factor Alpha (TNF-α), Interleukin 1Beta (IL<sup>1</sup>β) and Sodium ion (Na<sup>+</sup>) levels as well as kidney Malondialdehyde (MDA), Nitric Oxide (NO) and DNA fragmentation values. Controversially, a marked rise in serum Calcium, Potassium Ion (K<sup>+</sup>) and Cluster of Differentiation 4 (CD4) levels besides renal Glutathione (GSH), Catalase (CAT) and Superoxide Dismutase (SOD) values. Similarly, the histopathological findings confirmed the biochemical ones as the CEE restored the Oxaliplatin<sup>®</sup>-induced histological degenerations. <b>Conclusion:</b> In conclusion, CEE exhibited nephron-protection efficiency against Oxaliplatin<sup>®</sup>-induced nephrotoxicity; this promising effect may be achieved through the antioxidant and radical scavenging activities of its constituents.

The Role of Serum Procalcitonin Level as an Early Marker of Ascitic Fluid Infection in Post Hepatitic Cirrhotic Patients

AIMS & BACKGROUND

The early diagnosis of spontaneous bacterial peritonitis (SBP) has been considered important in the overall patient's survival. Ascitic fluid culture examination performance, in the emergency setting, is time-consuming and not always available, so there is a need for easy to apply, rapid and reliable markers for diagnosis of patients with ascites. The present prospective study aimed to determine the early diagnostic value of serum procalcitonin (PCT) levels in decompensated cirrhotic patients (DCPs) with SBP.

METHODS

47 HCV cirrhotic patients with ascites were enrolled for this prospective study. The severity of cirrhosis was classified based on the Child-Pugh criteria. All patients were subjected to paracentesis and ascitic fluid (AF) culture. Serum PCT levels were measured using enzyme-linked fluorescence analysis (ELFA).

RESULTS

The diagnostic value of serum PCT levels and WBC/PLT ratios for detecting infections were serum PCT levels (3.63 ± 3.47 ng/mL) in DCPs with infections which were significantly higher than in DCPs without infections (0.505 ± 0.230 ng/mL); p < 0.05. The cut-off value for serum PCT levels was 0.7 ng/mL for the diagnosis of infections in DCPs, for which the sensitivity and specificity were 93.1% and 73.2%, respectively. The AUC was 0.91 (95% CI: 0.83-0.99).

CONCLUSION

Serum procalcitonin seems to provide satisfactory diagnostic biomarkers in SBP.

Data Mining and Fusion of Unobtrusive Sensing Solutions for Indoor Activity Recognition

This paper proposes the fusion of data from unobtrusive sensing solutions for the recognition and classification of activities in home environments. The ability to recognize and classify activities can help in the objective monitoring of health and wellness trends in ageing adults. While the use of video and stereo cameras for monitoring activities provides an adequate insight, the privacy of users is not fully protected (i.e., users can easily be recognized from the images). Another concern is that widely used wearable sensors, such as accelerometers, have some disadvantages, such as limited battery life, adoption issues and wearability. This study investigates the use of low-cost thermal sensing solutions capable of generating distinct thermal blobs with timestamps to recognize the activities of study participants. More than 11,000 thermal blobs were recorded from 10 healthy participants with two thermal sensors placed in a laboratory kitchen: (i) one mounted on the ceiling, and (ii) the other positioned on a mini tripod stand in the corner of the room. Furthermore, data from the ceiling thermal sensor were fused with data gleaned from the lateral thermal sensor. Contact sensors were used at each stage as the gold standard for timestamp approximation during data acquisition, which allowed the attainment of: (i) the time at which each activity took place, (ii) the type of activity performed, and (iii) the location of each participant. Experimental results demonstrated successful cluster-based activity recognition and classification with an average regression co-efficient of 0.95 for tested clusters and features. Also, an average accuracy of 95% was obtained for data mining models such as k-nearest neighbor, logistic regression, neural network and random forest on Evaluation Test.Clinical Relevance-This study presents an unobtrusive (i.e., privacy-friendly) solution for activity recognition and classification, for the purposes of profiling trends in health and wellbeing.

Simplified read schemes for krypton tagging velocimetry in N2 and air

The background and results for two simplified read schemes for krypton tagging velocimetry (KTV) are presented. The first scheme utilizes the excitation/re-excitation approach found in the literature but replaces the pulsed dye laser used for the re-excitation step with a continuous wave, narrowband laser diode. The second scheme is a single-laser setup with no read laser where the fluorescence of the tagged Kr is imaged at successive times. Results are presented and compared to historical data for experiments performed in 99%N₂/1% Kr and 95% air/5% Kr underexpanded jets. The approach with the laser diode has a higher signal, while the single-laser approach yields more consistent results. Both schemes maintain an SNR comparable to that in the literature, but with a simpler setup that enables future high-repetition rate KTV experiments.

Application of lemongrass oil in vapour phase for the effective control of anthracnose of 'Sekaki' papaya

AIMS

To evaluate the potential use of lemongrass essential oil vapour as an alternative for synthetic fungicides in controlling anthracnose of papaya.

METHODS AND RESULTS

Lemongrass oil used in the study was characterized using gas chromatography-flame ionization detection (GC-FID) before it was tested against anthracnose of papaya in vitro and in vivo. The GC-FID analysis showed that geranial (45·6%) and neral (34·3%) were the major components in lemongrass oil. In vitro study revealed that lemongrass oil vapour at all concentrations tested (33, 66, 132, 264 and 528 μl l(-1) ) suppressed the mycelial growth and conidial germination of Colletotrichum gloeosporioides. For the in vivo study, 'Sekaki' papaya were exposed to lemongrass oil fumigation (0, 7, 14, 28 μl l(-1) ) for 18 h and at room temperature for 9 days. Lemongrass oil vapour at the concentration of 28 μl l(-1) was most effective against anthracnose of artificially inoculated papaya fruit while quality parameters of papaya were not significantly altered.

CONCLUSIONS

This suggests that lemongrass oil vapour can control anthracnose disease development on papaya without affecting its natural ripening process.

SIGNIFICANCE AND IMPACT OF THE STUDY

The potential practical application of this technology can reduce reliance on synthetic fungicides for the control of postharvest diseases in papaya.

Prophylactic efficacy of recombinant IL-12, clindamycin alone or in combination against experimental reactivated toxoplasmosis

Reactivation of experimental chronic toxoplasmosis was induced by daily i.m. injection of 0.1 ml hydrocortisone acetate (25 mg/ml) per mouse. Administration of clindamycin (5 mg/kg orally), rIL-12 (0.25 microg i.p.) or combination of both was done once weekly for 3 months course starting 2 days post suppression. The prophylactic effect was assessed by determination of both survival rate and brain cyst counts with histopathological examination of brain sections at different time points post suppression besides the influence of these drug regimens on interferon gamma (IFN-delta) production. All immunocompromised untreated mice exhibited increased brain cyst burdens and reduced IFN-delta production and died due to toxoplasmic encephalitis. Neither clindamycin nor rIL-12 prevented reactivation of chronic infection, however, the slight prolongation of survival was observed. Simultaneous administration of clindamycin and rIL-12 resulted in prevention of reactivation in 73.3% of the mice till the end of the experiment. The combination regimen produced significant higher levels of IFN-delta than either drug alone suggesting that both rIL-12 and clindamycin can act additively or synergistically to prevent reactivation of chronic infection with T. gondii most probably through enhancement of IFN-delta production.

PAH-DNA adducts in a petrol refinery in Egypt

Epidemiological surveys in occupationally exposed populations postulate that long-term exposure to polycyclic aromatic hydrocarbons (PAHs) is carcinogenic. We studied the ability of PAHs to induce the formation of adducts in the DNA of white blood cells of petrol refinery workers exposed at the workplace. Our study included a random sample of 56 workers exposed to PAHs and 37 non-exposed workers. In the univariate analysis, the DNA adduct level of PAH-exposed workers (42.22 +/- 45.11) was significantly increased (P < 0.05) compared with that in the non-exposed group (20.90 +/- 22.56). However, we could not identify either current smoking or absence of glutathione S-transferase class Mu as possible risk factors for DNA adducts. Linear regression analysis identified degree of exposure to PAHs as the only DNA adducts risk factor. Further research with a larger sample size is under investigation to identify the DNA adduct levels and relationship between the different types of PAHs.

Responses of larval Chrysomyia albiceps (Wiedemann) to light

Investigations into the phototactic behaviour of Chyrsomyia albiceps led to the following results: (a) The phototactic behaviour of the third instar fresh larvae had moved away from the light within 50 sec. (96%). (b) Fatigued larvae moved across the division line several times and took more time to travel away from light.

Supercontinuum generated by six-photon mixing

We obtain the shape, phase, and spectral distribution of an ultrafast pulse propagating in a chi((5)) medium (six-photon mixing). The calculation is performed in the plane-wave approximation for a dispersionless medium but with self-steepening present.

Interference pattern of the supercontinuum generated by self-phase modulation

We compute the interference pattern generated by a plane-wave self-phase-modulated ultrafast pulse. For high intensities, the presence of the amplitude-phase time shift in this signal generates fringe position shifts. We also compute the Fourier transform of the interferometric intensity distribution and relate its range to the functions that determine the supercontinuum spectral extents and frequency shift.

Male attitudes towards family planning in Khartoum, Sudan

In a 1982 survey of 250 men living in Khartoum, knowledge of, attitudes towards and use of contraception among Sudanese men were explored. Particular attention was given to attitudes towards male and female sterilization. Although most of the men expressed a desire to have large families, several findings suggest that they felt that they may have to be satisfied with a lower number for economic reasons. Three-fifths of the men with wives of reproductive age wished to use family planning services now but only about one-fifth were currently using an effective method. Almost 60% of the men were interested in learning more about female sterilization and about 50%, more about male sterilization. In general, attitudes towards family planning were more favourable than previously believed by providers of these services. Only 2·8% of these men had obtained services from a family planning clinic, suggesting that the demand currently exceeds the supply.