Charge-ordering breakdown dynamics and ferromagnetic resonance studies ofB-site Cu diluted Pr1‒xSrxMnO3

Here, we report the influence of Jahn-Teller active Cu substitution on the charge-ordering (CO) characteristics of one of the well-known manganite Pr0.45Sr0.55MnO3(S55) with a distorted tetragonal structure. Magnetization studies unveil a complex magnetic phase diagram for S55, showing distinct temperature ranges corresponding to various magnetic phases: a ferromagnetic phase dominated by the Double Exchange interaction withTC∼ 220.5 K, an antiferromagnetic phase belowTN∼ 207.6 K induced by CO with a transition temperature ofTCO∼ 210 K consistent with the specific heatCP(T) data, and a mixed phase in the rangeTNTN(T Collapse

Key Words

• Jahn-Teller effect
• antiferromagnetism
• charge-ordering
• ferromagnetic resonance
• manganites
• perovskites

Collapse

MESH Headings Collapse

Grants Collapse

Affiliation(s)

A Bordoloi Department of Physics, Indian Institute of Technology Guwahati, Guwahati 781039, Assam, India
S K Jena Department of Physics, Indian Institute of Technology Guwahati, Guwahati 781039, Assam, India
P Tiwari Department of Physics, Indian Institute of Technology Guwahati, Guwahati 781039, Assam, India
A Datta Department of Physics, Indian Institute of Technology Guwahati, Guwahati 781039, Assam, India
B Weise Leibniz-IFW Dresden, Institute for Complex Materials, D-01069 Dresden, Germany
R Medwal Department of Physics, Indian Institute of Technology Kanpur, Kanpur 208016, Uttar Pradesh, India
R S Rawat Natural Sciences and Science Education, National Institute of Education, Nanyang Technological University, Singapore 637616, Singapore
S Thota Department of Physics, Indian Institute of Technology Guwahati, Guwahati 781039, Assam, India

Collapse

Reentrant canonical spin-glass dynamics and tunable field-induced transitions in (GeMn)Co2O4Kagomé lattice

We report on the reentrant canonical semi spin-glass characteristics and controllable field-induced transitions in distorted Kagomé symmetry of (GeMn)Co2O4. ThisB-site spinel exhibits complicated, yet interesting magnetic behaviour in which the longitudinal ferrimagnetic (FiM) order sets in below the Néel temperatureTFN∼ 77 K due to uneven moments of divalent Co (↑ 5.33μB) and tetravalent Mn (↓ 3.87μB) which coexists with transverse spin-glass state below 72.85 K. Such complicated magnetic behaviour is suggested to result from the competing anisotropic superexchange interactions (JAB/kB∼ 4.3 K,JAA/kB∼ -6.2 K andJBB/kB∼ -3.3 K) between the cations, which is extracted following the Néel's expression for the two-sublattice model of FiM. Dynamical susceptibility (χac(f, T)) and relaxation of thermoremanent magnetization,MTRM(t) data have been analysed by means of the empirical scaling-laws such as Vogel-Fulcher law and Power law of critical slowing down. Both of which reveal the reentrant spin-glass like character which evolves through a number of intermediate metastable states. The magnitude of Mydosh parameter (Ω ∼ 0.002), critical exponentzυ= (6.7 ± 0.07), spin relaxation timeτ0= (2.33 ± 0.1) × 10-18s, activation energyEa/kB= (69.8 ± 0.95) K and interparticle interaction strength (T0= 71.6 K) provide the experimental evidences for canonical spin-glass state below the spin freezing temperatureTF= 72.85 K. The field dependence ofTFobtained fromχac(T) follows the irreversibility in terms of de Almeida-Thouless mean-field instability in which the magnitude of crossover scaling exponent Φ turns out to be ∼2.9 for the (Ge0.8Mn0.2)Co2O4. Isothermal magnetization plots reveal two field-induced transitions across 9.52 kOe (HSF1) and 45.6 kOe (HSF2) associated with the FiM domains and spin-flip transition, respectively. Analysis of the inverse paramagnetic susceptibilityχp-1χp=χ-χ0after subtracting the temperature independent diamagnetic termχ0(=-3 × 10-3emu mol-1Oe-1) results in the effective magnetic momentμeff= 7.654μB/f.u. This agrees well with the theoretically obtainedμeff= 7.58μB/f.u. resulting the cation distributionMn0.24+↓A[Co22+↑]BO4in support of the Hund's ground state spin configurationS=3/2andS= 1/2of Mn4+and Co2+, respectively. TheH-Tphase diagram has been established by analysing all the parameters (TF(H),TFN(H),HSF1(T) andHSF2(T)) extracted from various magnetization measurements. This diagram enables clear differentiation among the different phases of the (GeMn)Co2O4and also illustrates the demarcation between short-range and long-range ordered regions.

Leveraging Quantitative Imaging and Machine Learning to Differentiate Radionecrosis from Disease Recurrence in Patients with Brain Metastases

PURPOSE/OBJECTIVE(S)

Radiation necrosis can be difficult to non-invasively discern from tumor progression after stereotactic radiosurgery (SRS). In this work, we investigate the utility of radiomics (computerized features) and machine learning to capture per-voxel lesion heterogeneity on routine MRI scans, to differentiate radionecrosis from tumor recurrence in patients with brain metastases treated with SRS.

MATERIALS/METHODS

A retrospective analysis was conducted of patients with brain metastases treated with SRS. Eighty-three lesions (n = 56 intact; n = 27 surgical cavity) from 69 patients were identified with median age 68.8 years (range 40.2 - 91.0), of whom 53.6% were male and 33.3% received prior whole-brain radiotherapy (WBRT). Lesion histology included lung (60.2%), renal cell (15.7%), melanoma (10.8%), breast (9.6%), and other (3.6%). Pathologic confirmation was available in 73.5% of lesions. Both intact and resection cavity lesions were included and individually segmented. Image preprocessing and radiomic feature extraction were done using ANTsPy and open-source software. A total of 210 features were extracted from post-contrast T1-weighted (T1w) and T2/FLAIR MRIs. Highly correlated features were removed. Univariate logistic regression was conducted on the remaining T1w and T2/FLAIR features as well as on clinical variables. Multivariate analysis was implemented with various classifiers (Random Forest, Ridge, Lasso, Support Vector Machine [SVM]) on the top-performing features found on univariate logistic regression. Models were assessed using cross-validation to select the best model by area under ROC curve (AUC). Specificity and sensitivity were calculated.

RESULTS

On univariate analysis, the top 10 radiomics features consisted of 6 T1w features and 4 T2/FLAIR features (4 GLCM, 3 first order, 1 GLSZM, 1 GLRLM, and 1 shape feature). Age, gender, disease site, prior WBRT, prior fractionated SRS, planning tumor volume, brain-GTV V12 Gy, and immunotherapy before or after SRS were not predictive (AUC less than 62.0%) on univariate analysis compared to radiomic features. Multivariate analysis of top performing radiomic features on both intact and surgical cavities yielded an AUC of 72.0% (standard deviation [SD] ±8.8%). Multivariate analysis of top features on intact lesions alone improved the AUC to 80.5% (SD ±10.8%), with sensitivity of 77.8%, specificity of 72.4%, and positive likelihood ratio of 2.82 in differentiating radionecrosis from recurrence.

CONCLUSION

Radiomics and machine learning tools may improve diagnostic ability of distinguishing radiation necrosis from tumor recurrence after SRS. Further work is needed to deploy this in a larger multi-institutional cohort and prospectively evaluate its efficacy as a decision-support tool to personalize care in patients with brain metastases.

How much do we follow birth preparedness? A community-based snapshot study from rural Delhi, India

Introduction

Maternal healthcare remains a challenging public health problem in low and middle-income countries like India. The comprehension and services regarding practices related to birth preparedness and its complications in rural areas of India remain poor and underused. In view of this, we conducted this study to explore the preparedness of the pregnant women in the community residing in rural settlements of Delhi.

Methods

This cross-sectional community-based study was carried out in 165 currently pregnant women selected through proportionate sampling from rural Delhi. A semi-structured questionnaire adapted from Birth Preparedness and Complication Readiness (BPCR) tool kit was used. Binary and multivariate regression analysis was applied to identify the predictors of BPCR.

Results

In our study, BPCR index was found to be 25.78%. Only 17.6% pregnant women were well prepared. Multigravida, literacy, and higher socioeconomic status were found significant predictors for well preparedness for child birth and complication readiness in bivariate analysis. In multivariate logistic regression, multigravida and literacy were found to be predictors for well preparedness.

Conclusion

The skill and knowledge level of the mother-in-laws and other women along with husband in the family needs to be improved in context of pregnancy and child birth. Frontline health workers can assist the to-be mothers and their family members in informed decision-making for better feto-maternal outcomes.

Wide-awake local anesthesia and no tourniquet (WALANT) in upper limb fractures

Wide-awake local anesthesia and no tourniquet (WALANT), first used for hand surgery, has been sparingly described for use in fracture fixation of the upper limb. We present our experience using this technique. 26 patients with upper limb fractures (3 distal radius, 6 radial shaft, 11 ulnar shaft, and 6 olecranon fractures) were operated on using WALANT by three orthopedic surgeons. We used 35-40ml of 2% Lignocaine with 1:80000 Adrenaline(7mg/kg) diluted with normal saline. Numeric Pain Rating (NPR) scoring was done during injection and per-operatively, and the Likert scale was used for the surgeon's satisfaction. The average NPR score was reported as 0.65 (1-3) during injection and 0.15 (0-2) preoperatively. All three surgeons reported excellent satisfaction in all the cases operated on. No complication occurred due to anesthesia. WALANT is a much simpler option and can be safely used in place of general anesthesia or regional blocks for fixation of fractures of the upper limb, with added advantages of no need for a tourniquet and better intraoperative assessment of fracture fixation.

Satisfaction among patients seeking services at an urban health training center during the COVID-19 pandemic in South Delhi, India

Background

The COVID-19 pandemic has posed challenges to the provision of routine health services. As we continue providing non-COVID services, it is essential that the community perceives them to be satisfactory and safe to ensure optimum uptake. The objective of the study was to determine the satisfaction and perceived safety among patients availing services at an urban health training center (UHTC) during the COVID-19 pandemic in South Delhi.

Methods

UHTC, Aliganj caters to a population of over 6000, in an urbanized village of South Delhi. A pre-designed, semi-structured questionnaire incorporating the North Indian OPD Satisfaction Scale along with questions on sociodemographic details and perception of safety was used. Systematic random sampling was used to select the patients from the study population which included those above 18 years attending UHTC from November-December 2020. Exit interviews were done by a trained independent interviewer to reduce bias. Data were analyzed in SPSS using Chi-square and Fisher's Exact tests.

Results

Out of 218 patients, 161 (73.7%) were satisfied, 174 (79.8%) felt safe to visit UHTC during the pandemic and 143 (65.6%) felt both satisfied and safe. Patients were dissatisfied with screening for COVID-19 (29.5%), amenities (47.1%), cleanliness (51.8%), and waiting and registration (62.9%).

Conclusion

The majority of patients were satisfied and found the UHTC services safe. A large proportion of patients found location, doctor-patient interaction, and COVID-appropriate behavior at the center to be satisfactory, but there was scope to improve waiting and registration, cleanliness, and effectiveness of screening for COVID.

Efficacy of Radial Endobronchial Ultrasound (R-EBUS) guided transbronchial cryobiopsy for peripheral pulmonary lesions (PPL...s): A systematic review and meta-analysis

BACKGROUND

Transbronchial lung cryobiopsy (TBLC) is frequently described for the diagnosis of diffuse parenchymal lung diseases (DPLD). A few studies have reported transbronchial cryobiopsy for the diagnosis of peripheral pulmonary lesions (PPL...s). We aimed to study the utility and safety of transbronchial cryobiopsy for the diagnosis of PPL...s.

METHODS

We performed a systematic search of the PubMed and Embase databases to extract the relevant studies. We then performed a meta-analysis to calculate the diagnostic yields of transbronchial cryobiopsy and bronchoscopic forceps biopsy.

RESULTS

Following a systematic search, we identified nine relevant studies (300 patients undergoing cryobiopsy). All used Radial Endobronchial Ultrasound (R-EBUS) for PPL localization. The pooled diagnostic yield of transbronchial cryobiopsy was 77% (95% CI, 71%...84%) (I^2=38.72%, p=0.11). The diagnostic yield of forceps biopsy was 72% (95% CI, 60%...83%) (I^2=78.56%, p<0.01). The diagnostic yield of cryobiopsy and forceps biopsy was similar (RR 1.05, 95% CI 0.96...1.15), with a 5% risk difference for diagnostic yield (95% CI, ...6% to 15%). There was significant heterogeneity (I^2=57.2%, p=0.017), and no significant publication bias. One severe bleeding and three pneumothoraxes requiring intercostal drain (ICD) placement (major complication rate 4/122, 1.8%) were reported with transbronchial cryobiopsy.

CONCLUSIONS

R-EBUS guided transbronchial cryobiopsy is a safe and efficacious modality. The diagnostic yields of TBLC and forceps biopsy are similar. More extensive multicentre randomized trials are required for the further evaluation and standardization of transbronchial cryobiopsy for PPL...s.

A Smartphone-Based Assessment of Hearing Impairment among Students of a Medical College, Delhi, India- A Cross-Sectional Study

Introduction

The burden of hearing impairment in India is substantially high, largely preventable, and avoidable. The present study aimed to estimate the prevalence of hearing impairment using a smartphone-based tool among medical students and to study the factors associated, including personal audio device usage in a medical college hospital in Delhi, India.

Material and Methods

We conducted a cross-sectional study among undergraduate medical students. The study participants were enrolled via. Stratified random sampling. We assessed hearing impairment via-HearWHO application with scores ranging from a minimum of 0 to a maximum of 100 with categorization into i) above 75 ii) 50-75 iii) below 50. A p-value less than 0.05 was considered statistically significant.

Results

A total of 96 study participants were included, with the mean age of study participants as 20.3±1.4 years. On assessment with HearWHO, 36 (37.5%) were in the category of score above 75, 51 (53.1%) in score category 50-75, and 9 (9.4%) in score below 50. The overall mean score of the hearing assessment was 68.9±13.4 (Range: 12 to 94). Among the earphone device users, 27.1% do not comply with volume alerts on user devices.

Conclusion

Among the study population, 9.4% of the study participants were likely to be having hearing loss and 53.1% should be screened regularly for hearing impairment. Addressing hearing loss remains crucial among the young population, especially the medical professionals, which is feasible and imperative in the current scenario.

Stable and Discriminatory Radiomic Features from the Tumor and Its Habitat Associated with Progression-Free Survival in Glioblastoma: A Multi-Institutional Study

BACKGROUND AND PURPOSE

Glioblastoma is an aggressive brain tumor, with no validated prognostic biomarkers for survival before surgical resection. Although recent approaches have demonstrated the prognostic ability of tumor habitat (constituting necrotic core, enhancing lesion, T2/FLAIR hyperintensity subcompartments) derived radiomic features for glioblastoma survival on treatment-naive MR imaging scans, radiomic features are known to be sensitive to MR imaging acquisitions across sites and scanners. In this study, we sought to identify the radiomic features that are both stable across sites and discriminatory of poor and improved progression-free survival in glioblastoma tumors.

MATERIALS AND METHODS

We used 150 treatment-naive glioblastoma MR imaging scans (Gadolinium-T1w, T2w, FLAIR) obtained from 5 sites. For every tumor subcompartment (enhancing tumor, peritumoral FLAIR-hyperintensities, necrosis), a total of 316 three-dimensional radiomic features were extracted. The training cohort constituted studies from 4 sites (n = 93) to select the most stable and discriminatory radiomic features for every tumor subcompartment. These features were used on a hold-out cohort (n = 57) to evaluate their ability to discriminate patients with poor survival from those with improved survival.

RESULTS

Incorporating the most stable and discriminatory features within a linear discriminant analysis classifier yielded areas under the curve of 0.71, 0.73, and 0.76 on the test set for distinguishing poor and improved survival compared with discriminatory features alone (areas under the curve of 0.65, 0.54, 0.62) from the necrotic core, enhancing tumor, and peritumoral T2/FLAIR hyperintensity, respectively.

CONCLUSIONS

Incorporating stable and discriminatory radiomic features extracted from tumors and associated habitats across multisite MR imaging sequences may yield robust prognostic classifiers of patient survival in glioblastoma tumors.

Contraceptive use and its consistency among eligible couples in a peri-urban area of Delhi, India: A secondary data analysis

Background:

Contraceptive use is important to stabilize population growth by reducing the net reproduction rate. The effectiveness of a contraceptive method is decided mainly by its consistent and correct use.

Methods:

A record-based study was undertaken with the aim to study the contraceptive usage and its consistency among eligible couples in a peri-urban area of Delhi, India. Data of 946 eligible couples were analysed. Descriptive analysis was performed and odds ratios were calculated.

Results:

Mean age of females was found to be 30.3 ± 5.5 years and males was 33.5 ± 6.4 years. About 56.2% (532) eligible couples have used contraceptive at least once in the past 6 months and 54.7% (517) used them consistently for 6 months of the study period. There were 12.3 pregnancies per 100 non-users, 2.2 pregnancies per 100 ever users and 1.9 per 100 consistent users (1.7 for condoms and 0.2 for OCPs). Couples having two or more children, having two or more male children and with less than five years of age difference between husband and wife were found to have significantly higher odds of ever and consistent contraceptive use compared to other eligible couples (P < 0.05).

Conclusion:

More than half of the eligible couples were found to be using contraceptives ever in past 6 months, and 54.7% of eligible couples were using them consistently. There is a need to explore social, cultural factors, awareness levels associated with the ever and consistent use of contraceptives for improving overall couple protection rate and enhancing the consistency in usage.

Mortality among adult hospitalized patients during the first wave and second wave of COVID-19 pandemic at a tertiary care center in India

The similarities and differences between the mortality patterns of the two waves in India remain largely unknown. This was a retrospective study of medical records conducted in the COVID data center of our hospital This study analyzed data of patients who died in the month of August, 2020 to October 2020 (one month before and after the peak of first wave i.e., 16th September, 2020) & April 2021 to June 2021 (one month before and after the peak of second wave i.e., 6th May, 2021), corresponding to an equal part of the pandemic during first (2020) and second (2021) wave. Out of 1893 patients in the study, 764 patients were admitted during the first wave and 1129 patients during the second wave of pandemic. In total, 420 patients died during the entire study period. Of those, 147 (35%) deaths occurred during the first wave and 273 (65%) during the second wave, reflecting a case fatality rate (CFR) of 19.2% during the first wave and a CFR of 24.18%. There were no significant differences in the Age Group, Gender, Presenting Complaints, Duration of Stay and Comorbidities. However, the deceased COVID-19 patients had an increase in Case Fatality Rate, average duration of symptoms from onset to Hospital Admission (DOSHA) and a major shift from MODS to ARDS being the Cause of Death during the second wave of Pandemic. This study demonstrates increased CFR, average DOSHA and a paradigm shift to ARDS as cause of mortality during the second peak of the Pandemic. It is necessary to remain vigilant of newer COVID-19 variants of concern, follow COVID-19 appropriate behaviors and keep emphasizing on care of high-risk groups including patients with comorbidities and elderly population to prevent mortality.

Assessing the optimal imaging modality in the diagnosis of jaw osteomyelitis. A meta-analysis

Osteomyelitis is an inflammatory infectious disease that affects bone and bone marrow. Histopathology remains the gold standard method for diagnosis, but imaging modalities also play an important role. We systematically reviewed five articles with comparative studies on plain films, computed tomography (CT) scan, magnetic resonance imaging (MRI), cone beam computed tomography (CBCT), positron emission tomography (PET), single photon-emission computed tomography (SPECT), scintigraphy, and SPECT/CT. Scintigraphy and SPECT/CT has the highest sensitivity of 100%. PET is only to be used in cases of follow up. Orthopantomography (OPG) is the most common initial diagnostic tool despite its low sensitivity. CT provides the necessary specificity needed for radionuclide imaging, which has the highest negative predictive value of 100% and a positive predictive value >95%. SPECT/CT with 100% sensitivity and 85% specificity can be considered as the imaging modality of choice for initial diagnosis and follow up.

An initiative to improve nutritional education among medical students

Background

India faces a double burden of Malnutrition-undernutrition and overnutrition. In the medical institutes of India, there are no practice-based teaching methods to instill a greater understanding of the concepts of nutrition and healthy cooking. Hence, we have focused on an initiative named "Diet Demonstration" (DD) that is being practiced in the Department of Community Medicine at a government medical college in New Delhi.

Methods

Diet Demonstration is conducted in batches of 30-40 students. This specific exercise was conducted in May 2018. A batch of 35 MBBS students was subdivided into five groups, with 7 students/group. Each group was given a scenario/person with certain health conditions. They formulated a 24-h balanced dietary plan for nutrients and devised a food menu according to the scenario provided to them. The groups procured the raw materials from local markets, prepared the food according to their menu in the home/hostel kitchens. The cooked foods, alongside the equivalent raw materials used for cooking the respective foods, were presented and explained by each group in front of the whole batch and the faculty of the department.

Results

majority of the students opined that it had helped them in understanding nutrition in a better way, practice healthy cooking methods, and to learn the associated practical difficulties while planning and cooking a balanced diet.

Conclusion

Diet Demonstration can be an innovative, cost effective way of inculcating nutrition knowledge and healthy cooking practices among the budding doctors, which needs replicability and feasibility studies in other settings.

Determinants of online health information-seeking behavior: A cross-sectional survey among residents of an urban settlement in Delhi

BACKGROUND

In health care, the rapid proliferation of health information on the internet has resulted in more patients turning to the digital media as their first source of health information and acquiring knowledge. The present study was conducted to assess use of the digital medium as a medical information resource in health-related states and to determine their experience and perceptions about the quality and reliability of the information available among the participants.

METHODOLOGY

The study was done in an urban settlement of Delhi among adults who use any digital media. A sample of 321 were selected though convenient sampling. The information was collected through a semi-structured, self-administered, pre-tested questionnaire which contained questions on socio-demographic profile, internet usage and awareness about Digital India. Bivariate analysis was done to determine the association between various socio-demographic variables associated with internet usage for health information.

RESULTS

In the present study, 88.2% (283/321) were using the internet for health information through digital media. This study found out that younger age group (18-30 years), literate and higher socioeconomic group (upper middle and above) population were more likely to access health information via digital media which was found out to be statistically significant.

CONCLUSION

Access to health information through digitization can improve health literacy among the population and help in promoting a preventive aspect to health problems and disease. They can be the building blocks to build "Swasth Bharat (Healthy India)".

Inadequate awareness of cervical cancer and its prevention among young women of Delhi, India: public health policy implications

BACKGROUND

The increasing burden of cancer is a cause of concern worldwide including in India. Cervical cancer is amongst the most common cancers among women associated with high morbidity and mortality. Younger women are at risk of acquiring human papilloma virus (HPV) infection that can lead to cervical cancer later in life. The present study is an attempt to assess awareness about cervical cancer, its prevention and HPV among young women so that future policies can be designed accordingly.

METHODOLOGY

This was a cross-sectional study conducted among college-going women students of Delhi. Data was collected using a pre-designed, pretested semi-structured tool followed by descriptive statistical analysis.

RESULTS

Although 83% women students had heard of cervical cancer, the signs and symptoms were known to less than half (41.9%) of the students. HPV vaccine availability was known to 56.0% of the students, but very few students were vaccinated (15.0%). Similar disparity was also found in screening knowledge and practices.

CONCLUSION

With poor knowledge about risk factors, and preventive strategies among young women, this study highlights the need for health education programmes related to cervical cancer targeting young women. As most of the risk factors of cervical cancer are modifiable, awareness generation at a young age could bring about a paradigm shift in incidence and the mortality associated with it.

Body image perception, eating attitude and influence of media among undergraduate students of medical college in Delhi: a cross sectional study

Background: Body image perception is being shaped by unrealistic ideals portrayed in the media. Body dissatisfaction is one of the most consistent and robust risk factors for eating disorders, low self-esteem, depression, and obesity. Therefore, the objective of the current study is to ascertain the body image perception, abnormal eating attitudes and the role of media among undergraduate students of a medical college in Delhi, India.Methods: Cross-sectional study on 370 undergraduate medical students of Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India selected using stratified random sampling. India. Students completed a self-administered questionnaire which consist of demographic information, perceived body image, Eating Attitudes test (EAT-26) to assess eating attitudes, Socio Cultural Attitude Towards Appearance Questionnaire 3(SATAQ-3) scale for the role of media on body image perception. Data was analyzed using SPSS v21.Results: A total of 370 students (57.6% males and 42.4% females) aged 17-30 years, mean age of 20.30 years±2.02(SD). Abnormal body image perception was seen in 35.4%, 21.1% had abnormal eating attitude (EAT-26≥20), 36.5%, 40.5% agreed to be influenced by models and athletic figures in media respectively, 42.2% accepted that media was their source of information regarding standards of attractiveness, 27.6% felt pressured to be attractive according to SATAQ-3. Males more than females had disordered eating attitudes and felt media pressure to achieve an ideal body image. Significant association was observed between age and perceived body image (p=0.033), gender and EAT-26 score (p=0.039), EAT 26 and perceived body image (p=0.006), general internalization of media and perceived body image (p=0.003), internalization-general, internalization-athlete, media as source of information and EAT-26 score (<0.001, 0.001, 0.003 respectively).Conclusions: The media should take more responsibility to not represent unrealistic ideals of body image concerning both males and females. Educational and preventive efforts at institutional levels should be made to promote a healthy body image and eating behaviours.

Development of a biomarker of efficacy in second-line treatment for lymphangioma of the tongue: a pilot study

Lymphangioma of the tongue is a rare lymphatic malformation, and various authors have reported the successful use of sirolimus for its treatment. However, the safety of sirolimus in children needs further evaluation so that those who do not respond are not necessarily exposed to its potential adverse effects. We hypothesised that assessment of lymphangiogenesis can be used to predict whether the patient will respond to sirolimus, so we organised a prospective study after ethics committee approval had been given. After clinical and histological diagnoses of lymphangioma of the tongue had been confirmed, 16 patients were given sirolimus 0.8mg/day in three divided doses. Clinical response was assessed and compared with lymphatic microvessel density (LMVD), which was calculated immunohistochemically using the monoclonal antibody D2-40 as the lymphatic endothelial marker. Nine patients responded well, five partially, and two failed to respond. Mean (SD) LVD among the good responders was 21.00 (3.74), whereas among non-responders it was 8.00 (4.24). There was a significant difference in mean LVD between good responders, partial responders, and non-responders (p=0.04). Sirolimus is effective in treating children with lymphangioma of the tongue, and lymphangiogenesis is a useful therapeutic predictive marker.

Use of information on pre-packaged foods among residents of an urban village of South Delhi, India

Background

With rapid urbanization and hectic lifestyle, there is a growing demand of pre-packaged food items. 'Food label', present on most packaged food items provides information about the contents, their nutritive value and other information that can help the consumer to make an informed choice. Few studies in India have assessed the consumer's knowledge and practices related to information on a food label.

Methods

We assessed the awareness, perceptions and practices related to the use of information on food labels among residents of an urbanized village of south Delhi. House-to-house visits were made and information gathered using a pre-designed, pre-tested, semi-structured questionnaire. Descriptive analysis was done and logistic regression performed to document the determinants of 'reading food label' by the study participants.

Results

A total of 368 individuals were interviewed. The mean (SD) age of the participants was 29.1 (9.7) years. Around one-fourth (97/368; 26.4%) of all participants reported buying pre-packaged foods daily. A majority (222/ 368; 60%) of participants bought pre-packaged foods because they liked the taste, and also because they were easily available (153/368; 41.7%). A total of 64.1% (236/368) reported that they read food labels, but a majority checked only for the manufacture and expiry dates (203/236; 86%). Educational status, socioeconomic status and body mass index of the study participants were found to be significantly associated with reading of labels.

Conclusions

The intention of promoting healthy food choices through the use of food labels is met inadequately at present. Awareness generation activities would be required to improve this behaviour.

Disorder in Pixel-Level Edge Directions on T1WI Is Associated with the Degree of Radiation Necrosis in Primary and Metastatic Brain Tumors: Preliminary Findings

BACKGROUND AND PURPOSE

Co-occurrence of local anisotropic gradient orientations (COLLAGE) is a recently developed radiomic (computer extracted) feature that captures entropy (measures the degree of disorder) in pixel-level edge directions and was previously shown to distinguish predominant cerebral radiation necrosis from recurrent tumor on gadolinium-contrast T1WI. In this work, we sought to investigate whether COLLAGE measurements from posttreatment gadolinium-contrast T1WI could distinguish varying extents of cerebral radiation necrosis and recurrent tumor classes in a lesion across primary and metastatic brain tumors.

MATERIALS AND METHODS

On a total of 75 gadolinium-contrast T1WI studies obtained from patients with primary and metastatic brain tumors and nasopharyngeal carcinoma, the extent of cerebral radiation necrosis and recurrent tumor in every brain lesion was histopathologically defined by an expert neuropathologist as the following: 1) "pure" cerebral radiation necrosis; 2) "mixed" pathology with coexistence of cerebral radiation necrosis and recurrent tumors; 3) "predominant" (>80%) cerebral radiation necrosis; 4) predominant (>80%) recurrent tumor; and 5) pure tumor. COLLAGE features were extracted from the expert-annotated ROIs on MR imaging. Statistical comparisons of COLLAGE measurements using first-order statistics were performed across pure, mixed, and predominant pathologies of cerebral radiation necrosis and recurrent tumor using the Wilcoxon rank sum test.

RESULTS

COLLAGE features exhibited decreased skewness for patients with pure (0.15 ± 0.12) and predominant cerebral radiation necrosis (0.25 ± 0.09) and were statistically significantly different (P < .05) from those in patients with predominant recurrent tumors, which had highly skewed (0.42 ± 0.21) COLLAGE values. COLLAGE values for the mixed pathology studies were found to lie between predominant cerebral radiation necrosis and recurrent tumor categories.

CONCLUSIONS

With additional independent multisite validation, COLLAGE measurements might enable noninvasive characterization of the degree of recurrent tumor or cerebral radiation necrosis in gadolinium-contrast T1WI of posttreatment lesions.

Shape Features of the Lesion Habitat to Differentiate Brain Tumor Progression from Pseudoprogression on Routine Multiparametric MRI: A Multisite Study

BACKGROUND AND PURPOSE

Differentiating pseudoprogression, a radiation-induced treatment effect, from tumor progression on imaging is a substantial challenge in glioblastoma management. Unfortunately, guidelines set by the Response Assessment in Neuro-Oncology criteria are based solely on bidirectional diametric measurements of enhancement observed on T1WI and T2WI/FLAIR scans. We hypothesized that quantitative 3D shape features of the enhancing lesion on T1WI, and T2WI/FLAIR hyperintensities (together called the lesion habitat) can more comprehensively capture pathophysiologic differences across pseudoprogression and tumor recurrence, not appreciable on diametric measurements alone.

MATERIALS AND METHODS

A total of 105 glioblastoma studies from 2 institutions were analyzed, consisting of a training (n = 59) and an independent test (n = 46) cohort. For every study, expert delineation of the lesion habitat (T1WI enhancing lesion and T2WI/FLAIR hyperintense perilesional region) was obtained, followed by extraction of 30 shape features capturing 14 "global" contour characteristics and 16 "local" curvature measures for every habitat region. Feature selection was used to identify most discriminative features on the training cohort, which were evaluated on the test cohort using a support vector machine classifier.

RESULTS

The top 2 most discriminative features were identified as local features capturing total curvature of the enhancing lesion and curvedness of the T2WI/FLAIR hyperintense perilesional region. Using top features from the training cohort (training accuracy = 91.5%), we obtained an accuracy of 90.2% on the test set in distinguishing pseudoprogression from tumor progression.

CONCLUSIONS

Our preliminary results suggest that 3D shape attributes from the lesion habitat can differentially express across pseudoprogression and tumor progression and could be used to distinguish these radiographically similar pathologies.

How to Proceed with Examination of a Child?

The assessment of a child is quite different from that of adults and requires knowledge of normal variations in anatomy and physiology with growth and development. An important part of initial assessment includes triage and recognizing children with emergency signs so that they can be managed at the earliest to prevent death and referred timely to the specialist. After ruling out emergency signs, the children with priority signs require prompt assessment, management and referral to the specialist. In addition to normal history as in adults, prenatal and birth history, developmental history, immunization history, feeding history and social history are important for complete assessment of the child. The approach to physical examination should consider age and developmental level. It is important to make the child comfortable with pleasant surroundings and playful behavior to yield maximum information from the examination. In addition to diagnosing disease, pediatric assessment should involve identification of malnutrition, immunization status, level of development, screening for 4 Ds (Defects at birth, Deficiencies, Diseases and Developmental Delay including Disability), hearing and visual assessment and detection of child abuse. Tanner staging and psychosocial assessment should be done in adolescents.

Role of intralesional bleomycin and intralesional triamcinolone therapy in residual haemangioma following propranolol

With the emergence of propranolol as the first choice of treatment for problematic infantile haemangioma at many centres, the number of patients with a partial or non-response to propranolol has also been growing. This study investigated the role of intralesional bleomycin and triamcinolone in patients with residual disease following propranolol therapy for infantile haemangioma. Sixty-seven patients with residual haemangioma were assigned randomly to receive either intralesional bleomycin (group A, n=36) or intralesional triamcinolone (group B, n=31). The response to treatment and adverse effects were assessed in both groups. All patients received at least four doses and a maximum of six doses of the assigned drug. In group A (mean follow-up 9.38months), 47.2% had an excellent response and 44.4% a good response. In group B (mean follow-up 7.42months), 25.8% had an excellent response and 48.4% a good response. There was no difference in overall response between the groups (P=0.074). Among patients who were initially non-responders to propranolol, bleomycin showed a better response than triamcinolone (P=0.037). This may be due to an overlap in the mechanism of action of propranolol and triamcinolone. Thus, intralesional bleomycin should be preferred in patients with no initial response to propranolol therapy, while bleomycin or triamcinolone can be used in patients with a partial response to propranolol therapy, as they have equal efficacy.

126 A Comparison of Two Different Follicular Coasting Periods for In Vitro Embryo Production in Indian Nelore Cattle

Ongole, also known as Nelore (Bos indicus) cattle, are indigenous to the Andhra region in the Prakasam District in the State of Andhra Pradesh in India. A better understanding and utilisation of follicular wave dynamics within this breed would ultimately enhance oocyte and potential embryo production. Therefore, the aim of this study was to evaluate the differences between coasting periods of 24 h (S1) and 36 h (S2) on oocyte recovery, the rate of viable oocytes, cleavage, and Day 7 blastocyst rates of Nelore cattle in India. A total of 58 ovum pick-up (OPU) sessions (29 per treatment) were performed on 32 healthy donor cows that were randomly assigned to 1 of 2 coasting treatments (S1 or S2). Donors were stimulated as follows: 2.5 mL of gonadotropin-releasing hormone (GnRH; Receptal, MSD Animal Health, New Zealand) given IM on Day 1 followed by once-daily descending dose of Folltropin® (FSH, Vetoquinol, Canada) on Days 3 to 5 for a total of 180 mg. Cumulus-oocyte complexes were collected following OPU on Day 6 either at 24 (S1) or 36 h (S2) following the last FSH injection (coasting period). Donors were subject to OPU 1 to 3 times with a minimum interval of 15 days between procedures from March to April 2017. All 32 donor cows were non-lactating at the time of aspiration and divided equally between treatment groups. A total of 1492 follicles produced 850 total oocytes with oocyte recovery numbers for treatments S1 and S2 (785, 707; 441, 409; respectively). All data were analysed by ANOVA (P < 0.05). The mean number of follicles aspirated from S1 (27 ± 20.2) was not significantly different from that of S2 (24.4 ± 14.4). For S1, 393/441 (89%) quality oocytes were utilised for culture compared with 323/409 (78.9%) for S2, with no differences between rates. Additionally, there were no differences between mean number of oocytes, cleaved embryos, and blastocysts for S1 (15.2 ± 12.7; 9.9 ± 9.2; 4.3 ± 5.4) and S2 (14.1 ± 10; 7.4 ± 6.0; 3.6 ± 3.3; respectively). In conclusion, there were no differences found between 24- or 36-h coasting periods of Nelore cattle undergoing OPU for follicle counts, oocyte recovery, viable oocyte rates, cleavage, and blastocyst rates. Further research is needed to determine whether different stimulation protocols, the use of lactating cows, or coasting periods could alter outcomes.

Computer-Extracted Texture Features to Distinguish Cerebral Radionecrosis from Recurrent Brain Tumors on Multiparametric MRI: A Feasibility Study

BACKGROUND AND PURPOSE

Despite availability of advanced imaging, distinguishing radiation necrosis from recurrent brain tumors noninvasively is a big challenge in neuro-oncology. Our aim was to determine the feasibility of radiomic (computer-extracted texture) features in differentiating radiation necrosis from recurrent brain tumors on routine MR imaging (gadolinium T1WI, T2WI, FLAIR).

MATERIALS AND METHODS

A retrospective study of brain tumor MR imaging performed 9 months (or later) post-radiochemotherapy was performed from 2 institutions. Fifty-eight patient studies were analyzed, consisting of a training (n = 43) cohort from one institution and an independent test (n = 15) cohort from another, with surgical histologic findings confirmed by an experienced neuropathologist at the respective institutions. Brain lesions on MR imaging were manually annotated by an expert neuroradiologist. A set of radiomic features was extracted for every lesion on each MR imaging sequence: gadolinium T1WI, T2WI, and FLAIR. Feature selection was used to identify the top 5 most discriminating features for every MR imaging sequence on the training cohort. These features were then evaluated on the test cohort by a support vector machine classifier. The classification performance was compared against diagnostic reads by 2 expert neuroradiologists who had access to the same MR imaging sequences (gadolinium T1WI, T2WI, and FLAIR) as the classifier.

RESULTS

On the training cohort, the area under the receiver operating characteristic curve was highest for FLAIR with 0.79; 95% CI, 0.77-0.81 for primary (n = 22); and 0.79, 95% CI, 0.75-0.83 for metastatic subgroups (n = 21). Of the 15 studies in the holdout cohort, the support vector machine classifier identified 12 of 15 studies correctly, while neuroradiologist 1 diagnosed 7 of 15 and neuroradiologist 2 diagnosed 8 of 15 studies correctly, respectively.

CONCLUSIONS

Our preliminary results suggest that radiomic features may provide complementary diagnostic information on routine MR imaging sequences that may improve the distinction of radiation necrosis from recurrence for both primary and metastatic brain tumors.

New distribution record of Sarcopyramis napalensis Wall. (Melastomataceae) from Garhwal Himalaya, Uttarakhand, India

Sarcopyramis napalensis Wall. is reported for the first time from the Garhwal Himalaya, Uttarakhand. A detailed description, phenology, distribution and figures are provided here.

New distribution record of Sarcopyramis napalensis Wall. (Melastomataceae) from Garhwal Himalaya, Uttarakhand, India

Sarcopyramis napalensis Wall. is reported for the first time from the Garhwal Himalaya, Uttarakhand. A detailed description, phenology, distribution and figures are provided here.

The hunt for antimitotic agents: an overview of structure-based design strategies

INTRODUCTION

Structure-based drug discovery offers a rational approach for the design and development of novel anti-mitotic agents which target specific proteins involved in mitosis. This strategy has paved the way for development of a new generation of chemotypes which selectively interfere with the target proteins. The interference of these anti-mitotic targets implicated in diverse stages of mitotic cell cycle progression culminates in cancer cell apoptosis.

AREAS COVERED

This review covers the various mitotic inhibitors developed against validated mitotic checkpoint protein targets using structure-based design and optimization strategies. The protein-ligand interactions and the insights gained from these studies, culminating in the development of more potent and selective inhibitors, have been presented.

EXPERT OPINION

The advent of structure-based drug design coupled with advances in X-ray crystallography has revolutionized the discovery of candidate lead molecules. The structural insights gleaned from the co-complex protein-drug interactions have provided a new dimension in the design of anti-mitotic molecules to develop drugs with a higher selectivity and specificity profile. Targeting non-catalytic domains has provided an alternate approach to address cross-reactivity and broad selectivity among kinase inhibitors. The elucidation of structures of emerging mitotic drug targets has opened avenues for the design of inhibitors that target cancer.

Abstract AS23: Microenvironment mediated downregulation of miR-193b promotes ovarian cancer metastasis

The cross-talk between ovarian cancer cells with the microenvironment of the site of metastasis is an essential determinant of successful metastatic colonization. microRNAs have been well established to play critical roles in various stages of cancer progression, including metastasis. However, the role of the signals from the microenvironment in regulating key microRNAs in metastasizing cancer cells has not been studied. Using a 3D culture model mimicking the human omentum, one of the principal sites of ovarian cancer metastasis, we have identified the microenvironment-induced downregulation of a tumor suppressor microRNA miR-193b in the metastasizing ovarian cancer cells. The direct interaction of the ovarian cancer cells with the mesothelial cells covering the surface of the omentum caused DNA methyltransferase 1 (DNMT1) mediated methylation and decreased expression of miR-193b. The reduction in miR-193b enabled the metastasizing cancer cells to invade and proliferate in the omentum both in vitro and in a mouse xenograft model of ovarian cancer metastasis. The functional effects of miR-193b were mediated at least partly through the concomitant increased expression of its target urokinase-type plasminogen activator (uPA). Our findings link paracrine signals from the microenvironment with the regulation of a key microRNA in cancer cells that is essential for the initial steps of ovarian cancer metastatic colonization. Targeting miR-193b would be a promising approach to treat ovarian cancer metastasis.

Citation Format: AK Mitra, CY Chiang, P Tiwari, ME Peter, E Lengyel. Microenvironment mediated downregulation of miR-193b promotes ovarian cancer metastasis [abstract]. In: Proceedings of the 10th Biennial Ovarian Cancer Research Symposium; Sep 8-9, 2014; Seattle, WA. Philadelphia (PA): AACR; Clin Cancer Res 2015;21(16 Suppl):Abstract nr AS23.

Microenvironment-induced downregulation of miR-193b drives ovarian cancer metastasis

The cross-talk between ovarian cancer (OvCa) cells and the metastatic microenvironment is an essential determinant of successful colonization. Micro(mi)RNAs play several critical roles during metastasis; however, the role of microenvironmental cues in the regulation of miRNAs in metastasizing cancer cells has not been studied. Using a 3D culture model that mimics the human omentum, one of the principal sites of OvCa metastasis, we identified and characterized the microenvironment-induced downregulation of a tumor suppressor miRNA, miR-193b, in metastasizing OvCa cells. The direct interaction of the OvCa cells with mesothelial cells, which cover the surface of the omentum, caused a DNA methyltransferase 1 (DNMT1) mediated decrease in the expression of miR-193b. The reduction in miR-193b enabled the metastasizing cancer cells to invade and proliferate into human omental pieces ex vivo and into the omentum of a mouse xenograft model of OvCa metastasis. The functional effects of miR-193b were mediated, in large part, by the concomitant increased expression of its target, urokinase-type plasminogen activator (uPA), a known tumor-associated protease. These findings link paracrine signals from the microenvironment with the regulation of a key miRNA that is essential for the initial steps of OvCa metastatic colonization. Targeting miR-193b could prove effective in the treatment of OvCa metastasis.