Separation of lead from aqueous phase by cucumber peel in column bioreactor: A phenomenon of interaction between biological and chemical system and its ecological importance

This research work represents a holistic approach of separation of aqueous lead through dynamic adsorption on cucumber peel in fixed bed column bioreactor and highlights the biological perspective of mode of interaction between adsorbent and adsorbate. Additionally attempt has been made to elucidate the importance of this process in preservation of aquatic ecosystem. The study illustrates influence of design parameters, periodic surveillance of generated effluents, statistical and mathematical model analyses of results and desorption. The findings exhibited a direct association between quality of treated effluent and speed of the feed solution, feed concentration and height of the fixed bed. Lead removal percentage was at its best (99.25%) at 8 cm bed height, 20 mL min^-1 (0.9 L h^-1) flow rate and 50 mg L^-1 feed concentration whereas adsorption capacity reached its peak (300.26 mg g^-1) when feed concentration was doubled up to 100 mg L^-1. Time bound monitoring confirmed concentration of lead in treated effluents remained within satisfactory level. Adsorbed lead was recovered up to ∼95%. Experimentation with actual industrial effluents demonstrated that lead removal percentage remained in the range of 99.97-99.46% and 99.96-99.17% up to the entire phase of bioreactor operation. In summation proper combination of design parameters of column bioreactor played important role in generating superior quality effluent, multiple reuse of the bioreactor bed was dependent on proper eluant treatment and practicability of the study was ascertained by its ability to maintain concentration of lead in actual industrial effluents within permissible limit for prolonged duration.

CD24-Fc suppression of immune related adverse events in a therapeutic cancer vaccine model of murine neuroblastoma

Introduction

The combination of Myc-suppressed whole tumor cells with checkpoint inhibitors targeting CTLA-4 and PD-L1 generates a potent therapeutic cancer vaccine in a mouse neuroblastoma model. As immunotherapies translate from pre-clinical to clinical trials, the potential immune-related adverse events (irAEs) associated with induction of potent immunity must be addressed. The CD24-Siglec 10/G interaction is an innate checkpoint that abrogates inflammatory responses to molecules released by damaged cells, but its role in cancer immunology is not well defined. We investigate irAEs of an effective whole cell neuroblastoma vaccine and subsequently the effect of CD24-Fc, a CD24 and Fc fusion protein, on both the vaccine efficacy and induced irAEs in a mouse neuroblastoma model.

Methods

To test whether the whole tumor cell vaccination leads to autoimmune responses in other organ systems we harvested lung, heart, kidney and colon from naïve mice (n=3), unvaccinated tumor only mice (n=3), and vaccinated mice with CD24 Fc (n=12) or human IgG-Fc control (n=12) after tumor inoculation and vaccination therapy at day 30. The Immune cell infiltrates and immunogenic pathway signatures in different organ systems were investigated using NanoString Autoimmune Profiling arrays. Nanostring RNA transcript results were validated with immunohistochemistry staining.

Results

The whole tumor cell vaccine combined with immune checkpoint therapy triggers occult organ specific immune cell infiltrates, primarily in cardiac tissue and to a lesser extent in the renal and lung tissue, but not in the colon. CD24-Fc administration with vaccination partially impedes anti-tumor immunity but delaying CD24-Fc administration after initial vaccination reverses this effect. CD24-Fc treatment also ameliorates the autoimmune response induced by effective tumor vaccination in the heart.

Discussion

This study illustrates that the combination of Myc suppressed whole tumor cell vaccination with checkpoint inhibitors is an effective therapy, but occult immune infiltrates are induced in several organ systems in a mouse neuroblastoma model. The systemic administration of CD24-Fc suppresses autoimmune tissue responses, but appropriate timing of administration is critical for maintaining efficacy of the therapeutic vaccine.

Designing a single-mode anomalous dispersion silicon core fiber for temporal multiplet formation

A highly nonlinear single-mode anomalous dispersion silicon core fiber (SCF) is suitably designed and optimized to generate a high repetition rate pulse train in the temporal domain from a single input pulse at a sufficiently shorter optimum length in comparison to silica-based standard fibers used for the same purpose. The large amount of Kerr-induced nonlinearity of a SCF is effectively utilized here such that input Gaussian pulses or pulse trains transform into a highly repetitive temporal multiplet. The effects of free-carrier generation-induced change in absorption and dispersion are included while studying the nonlinear pulse propagation through the SCF. To declare the generated pulse as a superior-graded triplet, a Q parameter, as a function of relative pulse parameters of the individual pulses of a triplet, is defined for the first time, to the best of our knowledge. Different pulse parameters are thoroughly optimized as well as the effect of external gain is examined from the perspective of requirement of shorter fiber length and development of quality triplets. Finally, the work is further extended for the formation of quadruplet pulses by the same type of SCF. It is to be mentioned here that such a methodical study for the generation of a temporal multiplet using a semiconductor core fiber has not been reported earlier.

Tumor Apolipoprotein E is a key checkpoint blocking anti-tumor immunity in mouse melanoma

Immunotherapy is a key modality in the treatment of cancer, but many tumors remain immune resistant. The classic mouse model of B16-F10 melanoma is immune resistant even in the face of checkpoint inhibition. Apolipoprotein E (apoE), a known immune suppressant is strikingly elevated in many human tumors, but its role in cancer immunology is not defined. We investigated the role of apoE in the immune micro-environment using a mouse melanoma model. We demonstrate that ApoE is -highly expressed in wild-type B16-F10 melanoma and serum levels progressively increase as tumors grow. The conditioned media from wild type ApoE secreting melanoma cells suppress T-cell activation in vitro while this suppressive effect is absent in conditioned media from ApoE knock out tumor cells. Mechanistically, apoE induces IL-10 secreting dendritic cells and stimulates T-cell apoptosis and arrest partially via the lrp8 receptor. Ablating ApoE in mice inoculated with tumor cells enabled tumor cell rejection and was associated with induction of immune pathway activation and immune cell infiltration. Tumor secreted apoE appears to be a potent immune cell checkpoint and targeting apoE is associated with enhanced tumor immunity in the mouse melanoma model.

Modernising physician resource planning: a national interactive web platform for Canadian medical trainees

Background

Healthcare systems rely heavily upon human resources to ensure high-quality access to care for the general population. With significant health worker shortages predicted worldwide in the coming decades, maximizing the current workforce by means of a physician resource planning (PRP) strategy that ensures the right number, mix, and distribution of physicians to meet population needs is warranted. In Canada, there is an insufficient number of primary care providers, and disproportionately low numbers of specialist physicians in rural compared to urban regions. Currently, Canadian medical students are not effectively included in PRP strategy and lack the required information for career orientation to help rebalance the population’s workforce needs. This paper present the Health Human Resource (HHR) Platform, a comprehensive web tool that includes relevant workforce data to empower medical students in choosing a discipline based on both personal interests and social accountability.

Results

Physician workforce data, comments from Canadian residency program directors, and career planning resources were collected by the Canadian Federation of Medical Student’s (CFMS) HHR Task Force. This information was consolidated to create a national interactive platform that uses a map, comparison table, and trend graphs to illustrate over 500,000 unique data points from 37 datasets, including specific information and resources spanning 62 medical specialties from 2015 onwards. There was a 24.6% response rate for program director comments. During the first 4 months of the HHR Platform launch, there were 2434 different users, of which 985 were returning, with an average of 20.0 users per day spending on average 3 min on the platform.

Conclusions

The HHR Platform constitutes a national approach to PRP informing medical students on the mix and distribution of physicians needed to meet the future healthcare demands of the Canadian population.

Time-transformation technique for generation of optical pulse multiplets in a single mode anomalous dispersion optical fiber

We present the generation of optical pulse multiplets in the temporal domain from a single pulse using the time-transformation technique for the first time, to the best of our knowledge. The generation of a pair of compressed, well-spaced, and identical Gaussian pulses from a third-order super-Gaussian input pulse when propagated through an anomalous dispersion fiber is reported. Detailed analysis on the effect of variation of input energy, pulse parameters, and optical gain in view of doublet formation leading to the possibility of high effective repetition rate (ERR) at smaller propagating length is reported. The formation of triplets and quadruplets from different input pulse shapes is investigated.

Unusual Growth and Hydration Characteristics of Oil Solubilized Micelles in Aqueous Pluronic Systems

Lipophile induced modulations of self-assembly characteristics in aqueous Pluronic systems merit attention because of wide-ranging uses of Pluronics as solubilizing agents of lipophilic substances. In this paper, we report unusual evolutions of structural and hydration properties in lavender essential oil (LO) solubilized Pluronic P85 aqueous micellar systems as a function of micellar volume fraction and temperature. Our DLS, SANS, and viscometry studies show that the spherical-to-wormlike micellar structural transition observed in 1% P85 solutions upon solubilization of LO quite unexpectedly gets suppressed with increased P85 concentration to ≥5%. Detailed SANS studies reveal that the core sizes of the oil solubilized micelles cannot attain the threshold value required for the onset of structural transition at higher copolymer concentrations due to their progressive shrinking with an increase in P85 concentration. Oil solubilized P85 solutions show two cloud points and very interestingly exhibit micellar growth upon cooling to their lower cloud points. Steady state fluorescence studies explain this based on increasing dehydration of micellar corona with a decrease in temperature, very much opposite to what is observed in pure aqueous Pluronic systems. The results give new insight into viscous flow properties and low temperature storage possibilities of oil solubilized aqueous Pluronic systems.

Multi-Objective Economic Environmental Dispatch of Variable Hydro-Wind-Thermal Power System

This article presents a multi-objective economic environmental/emission dispatch (EED) of variable head hydro-wind-thermal power system. The combination of NOx emission, SO2 emission, and fuel cost are minimized for non-smooth hydrothermal plants while satisfying various operational constraints like non-smooth fuel cost, penalty coefficient, and wind power uncertainty. The objectives—cost, NOx emission, and SO2 emission—are optimized at the same time. In this research, the non-dominated sorting genetic algorithm-II (NSGA-II) has been employed for solving the given problem where the total cost, NOx emission level, and SO2 emission level are optimized at the same time while satisfying all the operational constraints. The simulation results that are obtained by applying the two test systems on the proposed scheme have been evaluated against strength pareto evolutionary algorithm 2 (SPEA 2).

MYC oncogene is associated with suppression of tumor immunity and targeting Myc induces tumor cell immunogenicity for therapeutic whole cell vaccination

Background

MYC oncogene is deregulated in 70% of all human cancers and is associated with multiple oncogenic functions including immunosuppression in the tumor microenvironment. The role of MYC in the immune microenvironment of neuroblastoma and melanoma is investigated and the effect of targeting Myc on immunogenicity of cancer cells is evaluated.

Methods

Immune cell infiltrates and immunogenic pathway signatures in the context of MYCN amplification were analyzed in human neuroblastoma tumors and in metastatic melanoma. Dose response and cell susceptibility to MYC inhibitors (I-BET726 and JQ1) were determined in mouse cell lines. The influence of downregulating Myc in tumor cells was characterized by immunogenic pathway signatures and functional assays. Myc-suppressed tumor cells were used as whole cell vaccines in preclinical neuroblastoma and melanoma models.

Results

Analysis of immune phenotype in human neuroblastoma and melanoma tumors revealed that MYCN or c-MYC amplified tumors respectively are associated with suppressed immune cell infiltrates and functional pathways. Targeting Myc in cancer cells with I-BET726 and JQ1 results in cell cycle arrest and induces cell immunogenicity. Combining vaccination of Myc-inhibited tumor cells with checkpoint inhibition induced robust antitumor immunity and resulted in therapeutic cancer vaccine therapy in mouse neuroblastoma tumors. Despite vigorous antitumor immunity in the mouse melanoma model, upregulation of immunosuppressive pathways enabled tumor escape.

Conclusions

This study demonstrates that the Myc oncogene is an appropriate target for inducing tumor cell immunogenicity and suggests that Myc-suppressed whole tumor cells combined with checkpoint therapy could be used for formulating a personalized therapeutic tumor vaccine.

Efficient generation of triangular optical pulses in an erbium-doped chalcogenide fiber amplifier by exploiting the time transformation technique

The time transformation (TT) technique is used to study the nonlinear pulse reshaping towards triangular pulse (TP) generation by efficiently optimizing the pulse parameters in an erbium-doped chalcogenide fiber amplifier (EDCFA), for the first time, to the best of our knowledge. The effects of input chirp parameter, optical gain, and dipole relaxation time are also depicted in the context of TP generation. The results obtained from the TT approach when compared with that from the nonlinear Schrodinger equation show excellent agreement. The study also reveals that spectral pulse doubling can be achieved at a shorter length when a pre-chirped Gaussian pulse is propagated through the proposed EDCFA.

Altering the X-ray Scattering Contrast of Triton X-100 Micelles and Its Trapping in a Supercooled Solvent

The structure of core-shell micelles formed by nonionic surfactant Triton X-100 (TX-100) in a supercooled glucose-urea melt is investigated by contrast variation small-angle X-ray scattering (SAXS), small angle neutron scattering (SANS), and HR-TEM. Cooling a molten mixture of glucose-urea (weight ratio of 3:2) to room temperature yields a supercooled solvent without crystallization that can be used for trapping micelles of TX-100. By use of a combination of water and glucose-urea mixture at different proportions as solvent for micellization, the scattering length density (SLD) of the solvent can be tuned to match the shell contrast of the micelles. A systematic analysis of SAXS and SANS data with different SLD of solvent permits a quantitative evaluation of electron density profile of micelles in different matrices. The core of TX-100 micelles shows significant swelling in glucose-urea melt, as compared to that in water. The dimension and morphology of micelles were evaluated by scattering techniques and HR-TEM. Dynamic light scattering (DLS) studies suggest that, unlike micelles in water, the diffusion of micelles in supercooled glucose-urea melt decreased by several orders of magnitude.

Sprayable and biodegradable, intrinsically adhesive wound dressing with antimicrobial properties

Conventional wound dressings are difficult to apply to large total body surface area (TBSA) wounds, as they typically are prefabricated, require a layer of adhesive coating for fixation, and need frequent replacement for entrapped exudate. Large TBSA wounds as well as orthopedic trauma and low-resource surgery also have a high risk of infection. In this report, a sprayable and intrinsically adhesive wound dressing loaded with antimicrobial silver is investigated that provides personalized fabrication with minimal patient contact. The dressing is composed of adhesive and biodegradable poly(lactic-co-glycolic acid) and poly(ethylene glycol) (PLGA/PEG) blend fibers with or without silver salt (AgNO3). in vitro studies demonstrate that the PLGA/PEG/Ag dressing has antimicrobial properties and low cytotoxicity, with antimicrobial silver controllably released over 7-14 days. In a porcine partial-thickness wound model, the wounds treated with both antimicrobial and nonantimicrobial PLGA/PEG dressings heal at rates similar to those of the clinical, thin film polyurethane wound dressing, with similar scarring. However, PLGA/PEG adds a number of features beneficial for wound healing: greater exudate absorption, integration into the wound, a 25% reduction in dressing changes, and tissue regeneration with greater vascularization. There is also modest improvement in epidermis thickness compared to the control wound dressing.

Third-order optical nonlinearity of the CuCo0.5Ti0.5O2 nanostructure under 120 fs laser irradiation

Recently, titanium-based nanostructures with high nonlinear optical properties have found use in ultrafast photonic system applications. Here, we report a study of the third-order nonlinear optical property of the ${{\rm CuCo}_{0.5}}{{\rm Ti}_{0.5}}{{\rm O}_2}$CuCo_0.5Ti_0.5O₂ (CCoTO) nanostructure synthesized via a simple chemical route. The 40-70 nm CCoTO nanoparticles with centrosymmetric crystalline structure show strong absorption in the 325-850 nm wavelength range due to the presence of different crystalline phases and surface vacancies. A Z-scan technique is used to study the electronic third-order nonlinearity of the synthesized nanoparticles, where a low-repetition-rate 120 fs laser source is employed to minimize thermal agitation-related nonlinearity. The CCoTO nanoparticles possess high surface defects due to oxygen- and copper-related vacancies, which are able to enhance the exciton oscillator strength resulting from the high value of third-order optical nonlinearity. The estimated values of nonlinear refractive index (${n_2}$n₂) and nonlinear absorption coefficient ($\beta $β) of the CCoTO are $ - {1.24}\; \times \;{{10}^{ - 15}}$-1.24×10^-15 and ${3.79} \times {{10}^{ - 11}}$3.79×10^-11, respectively, under ${188}\,\,{{\rm GW/cm}^2}$188GW/cm² incident intensity. The intensity-dependent nonlinear optical property of the synthesized nanoparticles is also studied under different incident laser irradiation (62.7, 93, and ${188}\,\,{{\rm GW/cm}^2}$188GW/cm²). In the two-photon absorption (TPA)-dominated third-order nonlinear optical process, the values of ${n_2}$n₂ and $\beta $β of CCoTO are increased with intensifying the incident laser irradiation. The obtained high value of third-order optical nonlinearity of the synthesized nanostructure can be exploited in optical power limiters, pulse power reshaping, and optical switching applications.

Adsorption of Lead on Lentil Husk in Fixed Bed Column Bioreactor

This study depicts successful employment of fixed bed column bioreactor for adsorption of lead in continuous mode using lentil husk as sorbent. Design parameters considerably controlled the reactor performance, amongst which height of the fixed bed and flow rate were crucial in generating cleaner effluent. Adsorption capacity was found to shoot up to the level of 205.87 mg g^-1 at 10 cm bed height, 100 mg L^-1 feed concentration and 20 mL min^-1 flow rate. Kinetic study done at regular intervals of time revealed high percentage removal of lead (99-96%) throughout entire span of reactor operation. Experimental data were well interpreted by Thomas model and Yoon-Nelson model. The reactor bed was regenerated after each adsorption and loaded metal was recovered up to the extent of ∼96%. The column reactor was efficient enough to treat lead containing actual industrial effluents.

Prospective use of a normally dispersive step-index chalcogenide fiber in nonlinear pulse reshaping

In this work, several normally dispersive highly nonlinear chalcogenide optical fibers (NDHNCFs) with a step-index profile have been designed and optimized in view of efficient parabolic pulse (PP) generation. A typical NDHNCF is selected such that the group velocity dispersion is highest among them and the corresponding nonlinearity is also very high. The input pulse parameters are optimized to find the lowest possible optimum length (L_opt) of the fiber where the linearly chirped PP is obtained. Further, it is found that for a shorter input pulse width, PP can be generated at a sufficiently smaller length of the NDHNCF with a slight compromise for its misfit parameter. A detailed analysis of the effect of pre-chirping helps to identify the suitable amount of initial chirp for different chalcogenide fibers with a choice of input pulse parameters. Although no improvement in PP generation is found for normal and initially chirped hyperbolic secant pulses, a highly efficient triangular pulse is achieved for a particular value of input pulse energy and the initial chirp parameter. Finally, the comparative study substantiates that our optimized NDHNCF is capable enough to generate quality PP at a length almost 70% shorter than a standard silica-based fiber.

PD-L1 checkpoint inhibition and anti-CTLA-4 whole tumor cell vaccination counter adaptive immune resistance: A mouse neuroblastoma model that mimics human disease

BACKGROUND

Adaptive immune resistance induces an immunosuppressive tumor environment that enables immune evasion. This phenomenon results in tumor escape with progression and metastasis. Programmed cell death-ligand 1 (PD-L1) expressed on tumors is thought to inhibit tumor-infiltrating lymphocytes (TILs) through programmed cell death 1 (PD1), enabling adaptive immune resistance. This study investigates the role of PD-L1 in both mouse and human neuroblastoma immunity. The consequence of PD-L1 inhibition is characterized in the context of an established whole tumor cell vaccine.

METHODS AND FINDINGS

A mouse model of neuroblastoma was investigated using an Id2 knockdown whole cell vaccine in combination with checkpoint inhibition. We show that immunogenic mouse neuroblastoma acquires adaptive immune resistance by up-regulating PD-L1 expression, whereas PD-L1 is of lesser consequence in nonimmunogenic neuroblastoma tumors. Combining PD-L1 checkpoint inhibition with whole tumor cell/anti-CTLA-4 vaccination enhanced tumor cell killing, cured mice with established tumors, and induced long-term immune memory (6 months). From an evaluation of patient neuroblastoma tumors, we found that the inflammatory environment of the mouse neuroblastoma mimicked human disease in which PD-L1 expression was associated directly with TILs and lower-risk tumors. High-risk patient tumors were lacking both TILs and PD-L1 expression. Although a correlation in immunity seems to exist between the mouse model and human findings, the mouse tumor model is induced and not spontaneously occurring, and furthermore, the number of both mouse and human correlates is limited.

CONCLUSIONS

This study demonstrates the role PD-L1 plays in neuroblastoma's resistance to immunity and defines the nonredundant effect of combination checkpoint inhibition with vaccine therapy in a mouse model. High-risk, nonimmunogenic human tumors display both diminished PD-L1 expression and adaptive immune resistance. Paradoxically, high-risk tumors may be more responsive to effective vaccine therapy because of their apparent lack of adaptive immune resistance.

Insight of solvent extraction process: Reassessment of trace level determinations

Solvent extraction is hoary yet modern technique with great scope of research due to the various intriguing phenomena in the system. Tri-n-butyl phosphate (TBP) is a well known extractant which has been extensively used for separation of uranium matrix prior to elemental profiling. In this paper, one of the impurities namely Fe is being considered as it posed a challenge to the separation due to its co-extraction with TBP along with uranium. In these studies, for the first time, the existence of cation-cation inner sphere complexes between the UO2(2+)and Fe(3+) ions in both aqueous and organic phases have been establisted in addition to the selective separation of iron from uranium sample matrix using only TBP. The data from both spectrophotometric and thermophysical studies corroborated one another confirming the presence of cation-cation interactions (CCIs). The developed solvent extraction with only TBP showed almost no interferences on the iron extraction from matrix uranium and other co-ions like aluminum and copper. This has been the first time application of pure TBP for selective removal of iron from uranium samples. The procedure possessed excellent reproducibility and robustness.

A Case of Hereditary Pancreatitis Presenting as Recurrent Abdominal Pain in a 11 Year Old Girl

Recurrent abdominal pain is a common problem among children. Since its first description by John Apley in 1958, the condition has remained poorly understood with a multitude of factors being implicated in causation. The symptoms tend to be vague and investigations seldom show organic disease. But the importance to evaluate each child with recurrent abdominal pain should be considered important nevertheless, particularly, in protracted cases. Here, we present a case who presented with history of recurrent abdominal pain for several years before being diagnosed as a case of hereditary pancreatitis. This stresses the importance of evaluating each case with a detailed and complete history, physical examination and selected investigations.J Nepal Paediatr Soc 2015;35(1):57-58

Salivary biochemical markers as potential acute toxicity parameters for acute radiation injury: A study on small experimental animals

Researchers have been evaluating several biodosimetric/screening approaches to assess acute radiation injury, related to mass causality. Keeping in mind this background, we hypothesized that effect of whole-body irradiation in single fraction in graded doses can affect the secretion of various salivary components that could be used as acute radiation injury/toxicity marker, which can be used in screening of large population at the time of nuclear accidents/disaster. Thirty Sprague Dawley rats treated with whole-body cobalt-60 gamma irradiation of dose 1-5 Gy (dose rate: 0.95 Gy/min) were included in this study. Whole mixed saliva was collected from all animals before and after radiation up to 72 h postradiation. Saliva was analyzed for electrolytes, total protein, urea, and amylase. Intragroup comparison of salivary parameters at different radiation doses showed significant differences. Potassium was significantly increased as the dose increased from 1 Gy to 5 Gy (p < 0.01) with effect size of difference (r > 0.5). Sodium was significantly altered after 3-5 Gy (p < 0.01, r > 0.5), except 1 and 2 Gy, whereas changes in sodium level were nonsignificant (p > 0.5). Urea, total protein, and amylase levels were also significantly increased as the radiation dose increased (p < 0.01) with large effect size of difference (r > 0.5). This study suggests that salivary parameters were sensitive toward radiation even at low radiation dose which can be used as a predictor of radiation injury.

The effect of age on pressure flow parameters in women with lower urinary tract symptoms

This study aimed to evaluate changes in voiding with age in women with different urodynamic diagnoses. Correlation was used to analyse the association between age and voiding parameters (maximum flow rate, voided volume, flow rate centile and maximum detrusor pressure - PdetMax) in 896 datasets. Multivariate analysis was used to analyse the data further by age group and diagnosis - urodynamic stress incontinence (USI); detrusor overactivity (DO); mixed USI and DO; no urodynamic abnormality. Results showed that diagnosis accounts for a significant amount of variation in all four of the dependent variables Age group shows a significant effect on voiding volume but does not show significant effects on any other variable studied. There is no significant interaction term in any of the analyses, meaning that age and diagnosis do not appear to function together, e.g. age does not relate to flow rate centile, maximum flow rate or PdetQMax. It was concluded that the data suggest that there is no significant change in voiding function related to age. In the elderly, the main alteration in voiding is due to a higher prevalence of DO.

Pattern and Determinants of Overweight and Obesity Among Future Physicians

Background   Overweight including obesity is a leading cause of present day morbidity and kills more people than underweight. Keeping this background in mind this study had been conducted to establish the pattern of overweight and obesity in the midst of undergraduate medical group and to find out the association of overweight (plump) and obesity with probable hazardous factors. Materials and Methods This descriptive observational study had been conducted among undergraduate medical group for the duration of May to June 2011. Simple random sampling was adopted to select the students under study. A pretested, predesigned self-administered questionnaire was utilized for data collection. Body Mass Index (BMI) was assessed through weight and height and acted as forecaster of heavy figure and or obesity. Overweight and or obesity were analyzed to see the association with certain socio-demographic variables, dietary habits, family history of overweight and or obesity, life style issues, computer use etc. After collection of data, these were analyzed using tabulation, proportion and Chi square through Epi-Info software. Results The study subjects were young adults. The general pattern of overweight (plump) and obesity was 18.0 percent and 4.0 percent respectively. Overweight and or obesity was found significantly high among male students, fast food and soft drinks takers, low takers of fruits and vegetables, alcohol consumers, students with lack of exercise and family history of obesity. Overweight and obesity were not found associated with type of diet (vegetarian or non-vegetarian) and smoking. Conclusion Presence of probable associated factors with regard to overweight (plump) and obesity exists amid medical undergraduate pupils.DOI: http://dx.doi.org/10.3126/nje.v4i1.10134 Nepal Journal of Epidemiology 2014;4 (1): 323-329

Observational assessment and correlates to blood pressure of future physicians of Bengal

INTRODUCTION

Hypertension is a modern day epidemic and growing public health problem. A sizable proportion of world populations suffer from prehypertension or hypertension.

OBJECTIVES

The present study was carried out to detect the prevalence of undiagnosed hypertension among undergraduate medical students and to identify the associated risk factors.

MATERIALS AND METHODS

The study was observational in nature and was done in medical colleges of Bengal. Study tool was a predesigned, pretested, validated, and semi-structured questionnaire containing both open-ended and close-ended questions. Data were collected through self-administration, clinical, and anthropometric examination. The data were then tabulated, analyzed and interpretation was done by using percentage and Chi-square test.

RESULTS

Most of the students (63%) were young adults, predominantly males (67%) and day scholars (71%). Almost one-third of them either suffered from hypertension or at risk of hypertension. Hypertension was found higher among male students. Family history of hypertension or diabetes mellitus was not associated with hypertension. Vegetarian or nonvegetarian diet or extra-salt consumption was also not associated with hypertension. Smoking was shown positively associated with hypertension but alcohol consumption was not. Higher per capita monthly income and overweight or obesity were shown positively associated with hypertension.

CONCLUSION

The overall prevalence of hypertension in this study was 13% and there were positive association of hypertension with multiple socio-demographic factors like age, sex, type of family, per capita monthly income, residence, BMI, smoking, etc.

Perineal trauma in women undergoing vaginal delivery following intra-uterine fetal demise: a case-control analysis

INTRODUCTION AND HYPOTHESIS

This study aimed to evaluate any differences in the incidence of perineal trauma in women undergoing vaginal delivery following intrauterine fetal death (IUFD) versus live-births. This information would be of interest in evaluating the possible effect of fetal demise on the mechanism of labour in the second stage and thus may provide invaluable insights to contribute to our understanding of the impact of fetal tone on the mechanics of labour and delivery.

METHODS

323 women who delivered vaginally following IUFD were matched with 1,000 women with a live-birth for age, parity, gestation and birth weight. Women undergoing assisted vaginal delivery and/or episiotomy were excluded.

RESULTS

Women with an IUFD had a significantly lower risk of perineal trauma overall (relative risk 0.16) as well as a lower risk of obstetric anal sphincter injury specifically (RR 0.12).

CONCLUSIONS

Women delivering vaginally after IUFD have a lower incidence of perineal trauma compared with women delivering a live infant. This may be due to differences in biomechanics following an IUFD.

Metal accumulation in cell wall: a possible mechanism of cadmium resistance by Pseudomonas stutzeri

A heavy metal resistant strain, Pseudomonas stutzeri (MTCC 101) has been investigated for its cadmium tolerance properties along with its antibiotic resistance. The organism could tolerate cadmium up to 1,200 μg/mL with LD50 value 700 μg/mL. The gene(s) involved in such high resistance appear(s) to be induced in the presence of the metal. Increasing concentrations of cadmium successively prolonged the lag phase of growth with delayed attainment of the stationary phase. Transmission electron microscope and scanning electron microscope-energy dispersive analysis of X-ray spectroscope analysis showed cadmium adsorption on the bacterial surface with morphological distortion. Atomic absorption spectrometric study corroborated this data, showing highest cadmium accumulation in the cell wall fraction of the bacteria. Additionally, the cell wall fraction showed synthesis of new proteins when grown under metal stress.

Organochlorine pesticide levels and risk of Alzheimer’s disease in north Indian population

Alzheimer’s disease (AD) could result from a multifactorial process involving both genetic predisposition and exposure to environmental factors like pesticides. A case control study of 70 patients of AD and 75 controls was done to examine the association between organochlorine pesticides (OCPs) and risk of AD. OCPs (hexachlorocyclohexane (HCH), aldrin, dieldrin, endosulfan, pp′-dichlorodiphenyldichloroethylene ( pp′-DDE), op′-DDE, pp′-dichlorodiphenyltrichloroethane ( pp′-DDT), op′-DDT, pp′-dichlorodiphenyldichloroethane ( pp′ -DDD) and op′-DDD) were extracted from blood and quantitatively estimated using gas chromatography. A Mann–Whitney U test revealed significant difference in β-HCH levels ( U = 1237.00, W = 4087.00, z = −6.296, p = 0.000, r = −0.71), dieldrin levels ( U = 1449.00, W = 4299.00, z = −5.809, p = 0.000, r = −0.68) and pp′-DDE levels ( U = 2062.00, W = 4912.00, z = −2.698, p = 0.007, r = −0.59) between AD patients and controls. In conclusion, this study supports epidemiological studies that associate exposure to pesticides with increased risk of AD, and we identified the specific pesticides β-HCH, dieldrin and pp′-DDE that are associated with the risk of AD in the north Indian population. However, further research is needed to establish the potential role of these OCPs as an etiologic agent for AD case.

Prevalence and Covariates of Undiagnosed Hypertension in the Adult Population of Puducherry, South India

Background Globally the prevalence of both hypertension and pre-hypertension are increasing and pre-hypertension has been associated with higher cardiovascular risk. The objective of this study was to find out the prevalence of undiagnosed hypertension and pre-hypertension and associated covariates among adults of rural and urban area of Puducherry. Material and Methods A population based cross-sectional study was carried out in the field practices area of Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute without intervention. Results Among 856 participants, 27.6 percent were hypertensive and 57 percent pre-hypertensive; the magnitude of both stage 1 and stage 2 hypertension increased with the age. Of the hypertensives, 26.3 and 28.7 percent were from rural and urban area respectively, whereas in pre-hypertension the corresponding figures were 61 and 53.4 percent.  Significantly increased risk of hypertension was noted among adults with increasing age, having less than six members in the family, suffering from obesity (general and abdominal obesity) and living sedentary life. On the other hand, the probability of having increased risk of pre-hypertension was significantly higher among adults living in the rural areas, having non-vegetarian dietary habit, suffering from obesity (general and abdominal obesity), living sedentary life and having family history of hypertension. Multivariate logistic regression however showed significant correlation of hypertension with increasing age, sedentary lifestyle, tobacco addiction and obesity (general and central). Significant correlates of pre-hypertensive were rural residence, sedentary living habits, family history of hypertension, tobacco addiction and obesity (general and central). Conclusion The present findings show high prevalence of hypertension and pre-hypertension among population of Puducherry in South India.DOI: http://dx.doi.org/10.3126/nje.v2i2.6576 Nepal Journal of Epidemiology 2012;2(2):191-199

Protein kinase Cα and Src kinase support human prostate-distributed dihydrotestosterone-metabolizing UDP-glucuronosyltransferase 2B15 activity

Because human prostate-distributed UDP-glucuronosyltransferase (UGT) 2B15 metabolizes 5α-dihydrotestosterone (DHT) and 3α-androstane-5α,17β-diol metabolite, we sought to determine whether 2B15 requires regulated phosphorylation similar to UGTs already analyzed. Reversible down-regulation of 2B15-transfected COS-1 cells following curcumin treatment and irreversible inhibition by calphostin C, bisindolylmaleimide, or röttlerin treatment versus activation by phorbol 12-myristate 13-acetate indicated that 2B15 undergoes PKC phosphorylation. Mutation of three predicted PKC and two tyrosine kinase sites in 2B15 caused 70-100 and 80-90% inactivation, respectively. Anti-UGT-1168 antibody trapped 2B15-His-containing co-immunoprecipitates of PKCα in 130-140- and >150-kDa complexes by gradient SDS-PAGE analysis. Complexes bound to WT 2B15-His remained intact during electrophoresis, whereas 2B15-His mutants at phosphorylation sites differentially dissociated. PKCα siRNA treatment inactivated >50% of COS-1 cell-expressed 2B15. In contrast, treatment of 2B15-transfected COS-1 cells with the Src-specific activator 1,25-dihydroxyvitamin D(3) enhanced activity; treatment with the Src-specific PP2 inhibitor or Src siRNA inhibited >50% of the activity. Solubilized 2B15-His-transfected Src-free fibroblasts subjected to in vitro [γ-(33)P]ATP-dependent phosphorylation by PKCα and/or Src, affinity purification, and SDS gel analysis revealed 2-fold more radiolabeling of 55-58-kDa 2B15-His by PKCα than by Src; labeling was additive for combined kinases. Collectively, the evidence indicates that 2B15 requires regulated phosphorylation by both PKCα and Src, which is consistent with the complexity of synthesis and metabolism of its major substrate, DHT. Whether basal cells import or synthesize testosterone for transport to luminal cells for reduction to DHT by 5α-steroid reductase 2, comparatively low-activity luminal cell 2B15 undergoes a complex pattern of regulated phosphorylation necessary to maintain homeostatic DHT levels to support occupation of the androgen receptor for prostate-specific functions.

Molecular characterization of nucleotide binding and oligomerization domain (NOD)-2, analysis of its inductive expression and down-stream signaling following ligands exposure and bacterial infection in rohu (Labeo rohita)

Nucleotide-binding and oligomerization domain (NOD)-2 is a cytoplasmic pattern recognition receptor (PRR) and is a member of NOD like receptor (NLR) family. It senses a wide range of bacteria and viruses or their products and is involved in innate immune responses. In this report, NOD-2 gene was cloned and characterized from rohu (Labeo rohita) which is highly commercially important fish species in the Indian subcontinent. The full length rohu NOD-2 (rNOD-2) cDNA comprised of 3176 bp with a single open reading frame (ORF) of 2949 bp encoding a polypeptide of 982 amino acids (aa) with an estimated molecular mass of 109.65 kDa. The rNOD-2 comprised two N-terminal CARD domains (at 4-91 aa and 111-200 aa), one NACHT domain (at 271-441 aa) and seven C-terminal leucine rich repeat (LRR) regions. Phylogenetically, rNOD-2 was closely related to grass carp NOD-2 (gcNOD2) and exhibited significant similarity (94.2%) and identity (88.6%) in their amino acids. Ontogeny analysis of rNOD-2 showed its constitutive expression across the developmental stages, and highlighted the embryonic innate defense system in fish. Tissue specific analysis of rNOD-2 by quantitative real-time PCR (qRT-PCR) revealed its wide distribution; highest expression was in liver followed by blood. In response to PGN and LTA stimulation, Aeromonas hydrophila and Edwardsiella tarda infection, and poly I:C treatment, expression of rNOD-2 and its associated downstream molecules RICK and IFN-γ were significantly enhanced in the treated fish compared to control. These findings suggested the key role of NOD-2 in augmenting innate immunity in fish in response to bacterial and viral infection. This study may be helpful for the development of preventive measures against infectious diseases in fish.

Inductive expression of toll-like receptor 5 (TLR5) and associated downstream signaling molecules following ligand exposure and bacterial infection in the Indian major carp, mrigal (Cirrhinus mrigala)

Toll-like receptors (TLRs) are one of the key components of innate immunity. Among various types of TLRs, TLR5 is involved in recognizing bacterial flagellin and after binding, it triggers myeloid differentiation primary response gene 88 (MyD88)-dependent signaling pathway to induce pro-inflammatory cytokines. In this report, we analyzed the expression profile of TLR5 and its associated downstream signaling molecules like MyD88 and tumor necrosis factor (TNF) receptor-associated factor (TRAF) 6 in the Indian major carp (IMC), mrigal (Cirrhinus mrigala) which is highly commercially important fish species in the Indian subcontinent. Ontogeny analysis of TLR5, MyD88 and TRAF6 revealed constitutive expression of these genes in all embryonic developmental stages, and highlighted the importance of embryonic innate immune defense system in fish. Tissue specific expression analysis of these genes by quantitative real-time PCR (qRT-PCR) revealed their wide distribution in various organs and tissues; highest expression of TLR5 and MyD88 was in liver and TRAF6 was in kidney. Modulation of TLR5, MyD88 and TRAF6 gene expression, and the induction of interleukin (IL)-8 and TNF-α were analyzed in various organs by qRT-PCR following flagellin stimulation, and Aeromonas hydrophila and Edwardsiella tarda infection. In the treated fish, majority of the tested tissues exhibited significant induction of these genes, although with varied intensity among the tissues and with the types of treatments. Among the examined tissues, a significant relationship of TLR5 induction, MyD88 and TRAF6 up-regulation, and enhanced expression of IL-8 and TNF-α gene transcripts was observed in the blood and intestine of both flagellin stimulated and bacteria infected fish. These findings may indicate the involvement of TLR5 in inducing IL-8 and TNF-α, and suggest the important role of TLR5 in augmenting innate immunity in fish in response to pathogenic invasion. This study will enrich the information in understanding the innate immune mechanism in fish and may be helpful in developing preventive measures against infectious diseases in fish.

Time interval as a quality measure: What is our baseline prior to nurse navigator implementation?

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Background: There are various outcome measures to evaluate the quality of multidisciplinary care for breast cancer patients. The National Consortium of Breast Centers defines quality of breast cancer care as accurate evaluation and appropriate services in a timely manner. In a tertiary academic center a diverse referral pattern possibly influences time to treatment. We choose to examine two outcome measures before the start of a nurse navigator: Time from initial diagnosis to first consultation and if the pretreatment consultation for those receiving neoadjuvant chemotherapy or hormonal therapy included all subspecialists.

Methods: Electronic medical records of female patients with breast cancer seen during January-June 2010 were reviewed. Patients with stage IV breast cancer were excluded.

Results: 150 patients were divided into 4 categories: external pathology consult (B1), internally diagnosed with a primary care physician (PCP) at our institution (B2), evaluated by a surgical oncologist before the biopsy (B3), and internally diagnosed with PCP outside of the institution (B4). For B2, B3 and B4 we examined the time intervals to first surgical oncology appointment after diagnosis as shown in the table. For all patients (n=10) who received neoadjuvant therapy, 1 patient saw a surgical oncologist, medical oncologist and radiation oncologist, 9 patients saw 2 subspecialties prior to initiation of first treatment.

Conclusions: Patients are seen within an average of 2 weeks whether they are diagnosed internally (B2, B3) or externally (B4). The group seen by a surgical oncologist prior to biopsy (B3) were seen sooner. For the patients receiving neoadjuvant therapy, 10% saw all 3 specialties prior to initiation of therapy. In July 2010 a nurse navigator was added to the care team. With this new position, our goal is to decrease the time from biopsy to visit by 33% and have 100% of patients receiving neoadjuvant therapy evaluated by all 3 specialists prior to treatment. Our intent is to quantify the effect of a nurse navigator in a large academic center as a quality metric in improving care.

[Table: see text]

A qualitative study of women's preferences for treatment of pelvic floor disorders

OBJECTIVE

to explore women's perceptions of new and established treatments for stress urinary incontinence (SUI) and prolapse, and to identify factors important to women in decision-making about treatments.

DESIGN

qualitative interview study.

SETTING

urogynaecology unit in a large UK district general hospital.

POPULATION

women referred from their general practitioner with SUI and/or prolapse symptoms.

METHODS

each woman was given a questionnaire detailing nonsurgical and surgical treatments for SUI and/or prolapse. This briefly detailed the treatment, together with published success and complication rates. Participants were taken through a semi-structured interview based on their perceptions of each treatment, and the factors that lead them to find treatments acceptable or not acceptable. Interviews were conducted by a member of the research team before the initial appointment with the clinical team. Interviews were transcribed and subjected to thematic analysis using constant comparison derived from grounded theory.

MAIN OUTCOME MEASURE

themes identified from analysis of interview transcripts.

RESULTS

a total of 16 women were interviewed. Their median age was 54 years (range 48-70 years). Women with SUI were keen to have the treatment with the highest chance of long-term success, even if this was more invasive. Women with prolapse were more unsure about this, and less willing to risk potential complications for a higher chance of long-term success.

CONCLUSIONS

many factors affect women's decision-making with regards to treatment choices. This analysis highlights the need for careful exploration of women's hopes and expectations before embarking on treatment.

Regulated phosphorylation of a major UDP-glucuronosyltransferase isozyme by tyrosine kinases dictates endogenous substrate selection for detoxification

Whereas UDP-glucuronosyltransferase-2B7 is widely distributed in different tissues, it preferentially detoxifies genotoxic 4-OH-estradiol and 4-OH-estrone (4-OHE(1)) with barely detectable 17β-estradiol (E(2)) conversion following expression in COS-1 cells. Consistent with the UDP-glucuronosyltransferase requirement for regulated phosphorylation, we discovered that 2B7 requires Src-dependent tyrosine phosphorylation. Y236F-2B7 and Y438F-2B7 mutants were null and 90% inactive, respectively, when expressed in COS-1. We demonstrated that 2B7 incorporated immunoprecipitable [(33)P]orthophosphate and that 2B7His, previously expressed in SYF-(Src,Yes,Fyn)(-/-) cells, was Src-supported or phosphorylated under in vitro conditions. Unexpectedly, 2B7 expressed in SYF(-/-) and SYF(+/-) cells metabolized 4-OHE(1) at 10- and 3-fold higher rates, respectively, than that expressed in COS-1, and similar analysis showed that E(2) metabolism was 16- and 9-fold higher than in COS-1. Because anti-Tyr(P)-438-2B7 detected Tyr(P)-438-2B7 in each cell line, results indicated that unidentified tyrosine kinase(s) (TKs) phosphorylated 2B7 in SYF(-/-). 2B7-transfected COS-1 treated with increasing concentrations of the Src-specific inhibitor PP2 down-regulated 4-OHE(1) glucuronidation reaching 60% maximum while simultaneously increasing E(2) metabolism linearly. This finding indicated that increasing PP2 inhibition of Src allows increasing E(2) metabolism caused by 2B7 phosphorylation by unidentified TK(s). Importantly, 2B7 expressed in SYF(-/-) is more competent at metabolizing E(2) in cellulo than 2B7 expressed in COS-1. To confirm Src-controlled 2B7 prevents toxicity, we showed that 2B7-transfected COS-1 efficiently protected against 4-OH-E(1)-mediated depurination. Finally, our results indicate that Src-dependent phosphorylation of 2B7 allows metabolism of 4-OHE(1), but not E(2), in COS-1, whereas non-Src-phosphorylated 2B7 metabolizes both chemicals. Importantly, we determined that 2B7 substrate selection is not fixed but varies depending upon the TK(s) that carry out its required phosphorylation.

Transperineal ultrasound to assess the effect of tension-free vaginal tape position on flow rates

OBJECTIVE

To determine whether the position of the tension-free vaginal tape (TVT) has an effect on postoperative flow rates and voiding function in women successfully cured of urodynamic stress incontinence.

METHODS

Postoperatively 72 women who had undergone TVT surgery had a transperineal ultrasound examination to assess the position of the TVT on the urethra. The tape was categorized as proximal, mid or distal urethral. The effect on voiding was assessed using the maximum flow rate (MFR) centiles corrected for voided volume and detrusor pressure at maximum flow.

RESULTS

Forty-six women had distal tapes and 26 mid-urethral tapes. A tape lying on the mid urethra was associated with a fall in MFR centile (P = 0.04) while a tape lying on the distal urethra did not cause a fall in the MFR centile (P = 0.52). There was no significant change in the detrusor pressure at maximum flow between mid and distally placed tapes.

CONCLUSIONS

Distally placed tapes cause less alteration in flow rates than do mid-urethrally placed tapes. This may be beneficial in certain patient groups.