Bacteriology of endotracheal tube biofilms and antibiotic resistance: a systematic review

Bacteria commonly adhere to surfaces and produce polymeric material to encase the attached cells to form communities called biofilms. Within these biofilms, bacteria can appear to be many times more resistant to antibiotics or disinfectants. This systematic review explores the prevalence and microbial profile associated with biofilm production of bacteria isolated from endotracheal tubes and its associations with antimicrobial resistance. A comprehensive search was performed on databases PubMed, Embase, and Google Scholar for relevant articles published between 1st January 2000 and 31st December 2022. The relevant articles were exported to Mendeley Desktop 1.19.8 and screened by title and abstract, followed by full text screening based on the eligibility criteria of the study. Quality assessment of the studies was performed using the Newcastle-Ottawa Scale (NOS) customized for cross-sectional studies. Furthermore, the prevalence of antimicrobial resistance in biofilm-producers isolated from endotracheal tube specimens was investigated. Twenty studies encompassing 981 endotracheal tubes met the eligibility criteria. Pseudomonas spp. and Acinetobacter spp. were predominant isolates among the biofilm producers. These biofilms provided strong resistance against commonly used antibiotics. The highest resistance rate observed in Pseudomonas spp. was against fluoroquinolones whereas the least resistance was seen against piperacillin-tazobactam. A similar trend of susceptibility was observed in Acinetobacter spp. with a very high resistance rate against fluoroquinolones, third-generation cephalosporins and carbapenems. In conclusion, endotracheal tubes were associated with colonization by biofilm forming bacteria with varying levels of antimicrobial resistance. Biofilms may promote the occurrence of recalcitrant infections in endotracheal tubes which need to be managed with appropriate protocols and antimicrobial stewardship. Research focus should shift towards meticulous exploration of biofilm-associated infections to improve detection and management.

Clinico-pathologic profile and outcomes of pediatric endocrine patients managed by endocrine surgeons: Experience over three decades in a tertiary center in India

BACKGROUND

Pediatric endocrine disorders requiring surgical intervention are rare and so are experienced surgeons dealing with these. The aim of the current study was to investigate disease profile and perioperative outcome of pediatric patients with surgical endocrine disorders in an endocrine surgery unit.

METHODS

This retrospective study (Sep 1989-Aug 2019) consisted of pediatric endocrine surgery patients (<18 years) who were managed by a team of pediatric endocrinologists and endocrine surgeons at our center. Patients were divided into three cohorts consisting of a decade each. Clinico-pathologic variables, perioperative events operative and follow-up details were recorded.

RESULTS

A total of 332 children were included and their mean age was 14.6 ± 3.9 years (M:F = 1:1.6). Thyroid disorders were most prevalent (59.8%), followed by adrenal (28.2%), parathyroid (10.4%), and pancreas (1.5%). Incidence of benign, malignant, and congenital/developmental disorders were 65.4, 28.1 and 8.3, respectively. Familial association was observed in 8.9% children, which is highest among pheochromocytoma patients. Overall, 201 thyroidectomies + associated procedures, 35 parathyroidectomies, 96 adrenal and paraganglioma resections, and 5 pancreatic procedures were performed. Median hospital stay was 5.6 ± 4.1 days. The number of cases increased significantly over 3 decades. Clinical profile and outcome did not vary except for significant decrease in incidence of malignant pathology (p = 0.04) and increase in VHL cases (p = 0.04) in the last decade though overall increase in familial cases was nonsignificant (p = 0.11). No perioperative mortality was observed except for 3% after adrenalectomy.

CONCLUSION

A team of dedicated endocrine surgeons and pediatric endocrinologists is effective in management of pediatric endocrine surgery.

Artificial intelligence predicts normal summer monsoon rainfall for India in 2023

Inaccuracy in the All Indian Summer Monsoon Rainfall (AISMR) forecast has major repercussions for India's economy and people's daily lives. Improving the accuracy of AISMR forecasts remains a challenge. An attempt is made here to address this problem by taking advantage of recent advances in machine learning techniques. The data-driven models trained with historical AISMR data, the Niño3.4 index, and categorical Indian Ocean Dipole values outperform the traditional physical models, and the best-performing model predicts that the 2023 AISMR will be roughly 790 mm, which is typical of a normal monsoon year.

Sediment modeling using laboratory-scale rainfall simulator and laser precipitation monitor

The characterization of a rainfall simulator provides an excellent opportunity to study the potential of soil erosivity without waiting for natural rain. But, precise instrumentation is required to estimate the parameters, which is seldom available. To overcome this problem, the empirical and conceptual relationships obtained through physically-based modeling help to correlate the rain parameters contributing to soil erosion. The present laboratory study used five pressurized nozzles of different capacities and a Laser Precipitation Monitor (LPM) to generate different rain intensities (21.0-79.0 mm h-1) and to register drop size distribution, respectively. The sediment transportation induced by rain and runoff was measured with an erosion flume of 2.50 × 1.25 × 0.56 m with an adjustable longitudinal slope. The spatial uniformity, drop size distribution, drop velocity, and kinetic energy were used to evaluate the simulator's performance. The different rain erosivity parameters were correlated and tested statistically using linear and non-linear regression analysis. The rain simulation experiments of different intensities at different pressure ranges were performed on flat, 5, 10, and 15% slopes of the erosion flume to evaluate rain characteristics and record the surface runoff and sediment yield. The median drop sizes produced during the simulator ranged from 0.38 to 2.11 mm, coinciding with natural rain. The empirical relationships were developed to correlate surface discharge and sediment yield with rain intensity by optimizing the parameters for further study of experimental field plots of different slopes. The observed and estimated rain erosivity parameters showed a significant relationship (R2 = 0.75 to 0.93; P < 0.001) in multiple regression analysis, and the metrics used to test the developed regression equations showed lower MAE, MSE, and RMSE errors indicating the adequacy of the relationships. The results indicated that the simulator helps to understand the complex task of soil erosion with hydrologic and geomorphic processes in laboratory experimentation with sufficient accuracy in measuring sediment transport events.

Supplementation of nano-selenium (SeNPs) improved growth, immunity, antioxidant enzyme activity, and selenium retention in broiler chicken during summer season

The present experiment was aimed at finding the optimal supplemental dose of nano-selenium in broiler chicken during the summer season for better performance in terms of growth, blood metabolites, immune response, antioxidant status, and selenium concentration in vital organs. Three-hundred-day-old Vencobb broiler chicks were randomly distributed into five dietary treatment groups with six replicates of 10 chicks each. The dietary treatments were as follows: T1 (control group), basal diet; T2, basal diet with 0.0375 ppm of nano-Se; T3, basal diet with 0.075 ppm of nano-Se; T4, basal diet with 0.15 ppm of nano-Se; T5, basal diet with 0.3 ppm of nano-Se. The experiment was carried out for 35 days. The average gain and feed conversion ratio were best observed in T4 and T5. The antibody titres were significantly higher (P < 0.05) in the treated birds. At the 5th week, erythrocytic glutathione peroxidase, catalase, and superoxide dismutase activities were significantly (P < 0.05) higher and lipid peroxidation values were significantly (P < 0.05) lower in all the nano-Se-treated groups. The Se levels in the liver, breast muscle, kidney, brain, and gizzard were significantly (P < 0.05) increased with increased dietary nano-Se. Histological studies of the liver and kidney in the highest nano-Se-treated groups (T4 and T5) did not show any abnormal changes. It is concluded that supplementation of nano-selenium at 0.15 ppm over and above the basal level improved the performance and protect the birds from summer stress without any adverse effect on the vital organs of chicken.

Total vs less than total thyroidectomy for benign multinodular non-toxic goiter: an updated systematic review and meta-analysis

BACKGROUND

We have performed an updated meta-analysis of randomized controlled trials (RCT) comparing total thyroidectomy (TT) with less than total thyroidectomy (LTT) for benign multinodular non-toxic goiter (BMNG).

OBJECTIVES

The objective was to evaluate the effects and outcomes of TT as compared to LTT.

METHODS

Eligibility criteria: RCTs comparing TT vs LTT.

INFORMATION SOURCES

PubMed, Embase, Cochrane Library and online registers were searched for articles comparing TT with LTT. Risk of bias: Articles were assessed for risk of bias using the Cochrane's revised tool to assess risk of bias in randomized trials (RoB 2 tool).

SYNTHESIS OF RESULTS

The main summary measures were risk difference using a random effects model.

RESULTS

Five randomized controlled trials were included in the meta-analysis. Recurrence rate was lower for TT compared to LTT. Adverse events like temporary or permanent recurrent laryngeal nerve (RLN) palsy and permanent hypoparathyroidism were similar in both groups except for the rate of temporary hypoparathyroidism which was lower in the LTT group.

DISCUSSION

All studies had unclear risk of bias for blinding of the participants and personnel and high risk of bias for certain selective reporting. This meta-analysis did not show any clear benefit or harm of either procedure (TT vs LTT) for goiter recurrence and re-operation rates (for both recurrence and incidental thyroid cancer). However, re-operation for goiter recurrence was significantly higher in the LTT group based on a single RCT. Evidence suggests increased rates of temporary hypoparathyroidism with TT but there was no difference in the rate of RLN palsy and permanent hypoparathyroidism between the two methods. The overall quality of evidence was low to moderate.

Seasonal dependent suitability of physical parameterizations to simulate precipitation over the Himalayan headwater

The Himalayan ecosystem is fragile and needs robust management strategies for sustainability of natural resources such as water and vegetation. Therefore, reliable precipitation estimation becomes quite important from operational and regulation standpoints. It is crucial for numerous activities including policy/planning, agriculture, reservoir operations, disaster management, and others. In addition, reliable information on temporal variability of precipitation is also crucial for various applications such as agricultural and hydrological. The western Himalaya receives two distinct weather systems during summer and winter. Summer is responsible (largely) for rainfall and winter is for snowfall. Therefore, we hypothesize that there may not be a single set of parameterization schemes that can represent well both the weather systems. To investigate, we set up the WRF modeling system and performed six experiments with a combination of three microphysics (MP3, MP3, and WSM6) and two cumulus schemes (KF, and BMJ). It was found that the precipitation along the Himalayan foothills (near to basin terminal) is underestimated in four out of six experiments. Only experiments with BMJ cumulus scheme along with WSM6 and MP8 microphysics were able to show a considerable amount of precipitation along these foothills. It was noted that all six experiments showed high precipitation in the upstream region and over the mountain peaks and ridges in North-Western Himalaya. For DJF, each experiment was found to have large biases and none of them represented the observation with high confidence. However, the selection of observation reference data itself is a challenging task because of data paucity in this region. Therefore, the closest experiment to the most appropriate observation was selected as the reliable configuration (MP8_KF: MP8 microphysics and KF cumulus scheme) for DJF precipitation simulation. In this study we have, for the first time, reported the role of seasonal sensitivity for the climate scale simulations as we found that different schemes were suitable for different weather systems.

Mapping and visualizing the research contribution of India on telemedicine: A scientometric study

Background

The term "Telemedicine" is being used in the medical and health sector to treat patients and to provide medical guidance remotely. The intellectual output from India in terms of publications was harvested from Scopus^® with the keyword "Telemedicine" and analyzed by using bibliometric techniques.

Methods

The source data was downloaded from the Scopus^® database. All the publications on telemedicine and indexed in the database up to the year 2021 were considered for scientometric analysis. The software tools VOSviewer^® version 1.6.18 to visualize bibliometric networks, statistical software R Studio^® version 3.6.1 with the Bibliometrix package Biblioshiny^® were used for analysis and data visualization, and EdrawMind^® was used for mind mapping.

Result

India contributed 2,391 (4.32%) publications on telemedicine to a total of 55,304 publications worldwide until 2021. There were 886 (37.05%) papers that appeared in open access mode. The analysis revealed that the first paper was published in the year 1995 from India. Steep growth in the number of publications was observed in 2020 with 458 publications. The highest, 54 research publications, appeared in the "Journal of Medical Systems." The All India Institute of Medical Sciences (AIIMS), New Delhi, contributed the highest number of publications (n = 134). A considerable overseas collaboration was observed (USA: 11%; UK: 5.85%).

Conclusions

This is the first such attempt to address the intellectual output of India in the emerging medical discipline of telemedicine and has yielded useful information such as leading authors, institutions, their impact, and year-wise topic trends.

Identification of novel allelic patterns and evolutionary lineage of BoLA MHC class II DQA locus in indicine and taurine cattle

Among different cattle types, Bos indicus are known for their ability to better resist the tropical microbial infections comparatively, wherein MHC molecules play a significant role. In this study allelic diversity at MHC locus, DQA of Bos indicus, Bos taurus and crossbred of taurine-indicus has been explored to understand the possible role of MHC region in differential immune response. Thirty nine different DQA alleles were identified, out of which 14 were novel, along with documentation of duplication of DQA alleles. Indicus cattle population presented diverse types of DQA alleles compared to crossbred and exotic. Translated amino acid sequence analysis indicated, codon 64 and 50 of peptide binding sites being highly polymorphic and most of the indicus cattle presented alanine and arginine amino acid at position 64 and 50. Within breed genetic variation found to be higher than between breeds. Because of their ability to bind and subsequently respond to a wide array of antigens, the newly identified DQA alleles with high diversity present in the form of duplicated haplotypes in different combinations in cattle populations provided significant insights into probable role of this MHC locus in better tropical disease combating ability and genetic fitness of indicus cattle.

Circumferential Laryngotracheal Resection in Thyroid Cancer: Experience and Outcome in a Single Center

There is limited experience of laryngotracheal resection in patients with differentiated thyroid carcinoma (DTC). The aim of this study was to report our experience of circumferential laryngotracheal resection in DTC and its long-term outcome. In this retrospective study, 10 patients of locally invasive DTC who underwent circumferential laryngotracheal resection between January 2000 and December 2015 were included. Clinicopathologic profile and follow up was noted. Mean age of the cohort was 50.1 ± 7.8 years (M:F = 1: 2.3). Papillary carcinoma was the commonest pathology (60%) followed by follicular carcinoma (20%), 10% each had Hurthle cell and poorly differentiated thyroid carcinoma. Sixty percent patients presented with recurrent or persistent disease and 20% with distant metastases. Vocal cord palsy was observed in 30%. Fifty percent patients underwent tracheal resection with end to end anastomosis and remaining laryngotracheal resection. Carotid artery resection and anastomosis was performed in one patient. Shin stage IV invasion was observed in 80% and stage III in remaining. There was no perioperative mortality. All patients received adjuvant radioiodine therapy and 40% external beam radiotherapy. Median follow up was 48 months. One patient who earlier had tracheal resection underwent total laryngectomy due to recurrent disease after 24 months. Forty percent patients developed distant metastases during follow-up. Mean survival was 77.8 months (CI = 63.0-92.5). Five-year overall survival was 60% and was significantly high in those without distant metastases (p = 0.006). The outcome of circumferential larygotracheal resections for DTC is excellent in terms of local disease control and long term survival.

Truncal Ligation of Inferior Thyroid Artery Does Not Affect the Incidence of Hypocalcaemia After Central Compartment Lymph Node Dissection

Preserving all parathyroids with intact blood supply in situ is a desirable goal while performing total thyroidectomy (TT) and central compartment dissection (CCLND), but the same is not feasible in presence of bulky and/or matted lymph nodes in the central compartment. The aim of this study was to investigate the difference in incidence of postoperative hypocalcemia between the groups of papillary thyroid carcinoma (PTC) patients who had truncal ligation (TL) versus ligation of peripheral branches (PL) of inferior thyroid artery (ITA) during TT and CCLND. Retrospective review of prospectively kept data of PTC patients undergoing TT and CCLND. Patients were divided in two groups: Group 1-(n = 57) patients who had to undergo TL and Group 2-(n = 99) patients having PL. Clinico-pathologic profile, operative details and follow-up events were noted. Clinico-pathologic profile of both groups was comparable except for higher incidences of tumor multicentricity (p = 0.014) in Group 1. There was no significant difference in the number of parathyroids identified between the Groups (p = 0.556) but more parathyroids were auto-transplanted in Group 1 (p = 0.001). The incidence of temporary (77.2% vs 83.8, p = 0.304) and permanent hypocalcemia (7% vs 8.1%, p = 0.810) was not significantly different between the groups and neither was need for intravenous calcium. At discharge, Group 1 patients received lower dose of calcium (p = 0.001) but not of vitamin D (p = 0.769). TL of ITA during CCLND does not result in increased temporary or permanent hypocalcemia rate.

Feasibility and impact of a one-stop thyroid clinic in a low- and middle-income country

BACKGROUND

The study was done to evaluate the feasibility, safety and outcomes of a one-stop thyroid clinic (OSTC) in a low- and middle-income country (LMIC) setting.

METHODS

This was a prospective non-randomised case control study consisting of patients with thyroid nodules evaluated and managed at a tertiary referral centre in an LMIC between February 2019 and January 2020. Patients were divided into two groups based on the kind of preoperative evaluation protocol: OSTC group (n = 118) - OSTC protocol, and control group (CG, n = 108) - routine protocol.

RESULTS

Baseline clinical characteristics of the two groups including median age (p = 0.13) and gender distribution (p = 0.76) were comparable. The majority of patients in both groups belonged to a low-income group (46.6% vs 47.3%; p = 0.91), followed by a middle-income group (35.6% vs 30.5%; p = 0.41). The median number of outpatient department visits (1 vs 3 days; p = < 0.001), waiting time for neck ultrasonography (1 vs 3 days; p = < 0.0001), fine needle aspiration cytology (1 vs 2 days; p = < 0.0001), and out of pocket expenditure (INR 3 965 vs 6 624; p = < 0.001) was significantly less in the OSTC group compared to the CG. Patients in the OSTC group reported better satisfaction levels (p = < 0.0001). Accuracy of diagnosis did not differ between the two groups (p = 0.14).

CONCLUSION

OSTC practice is feasible, provides comparative clinical outcomes and seems cost effective in an LMIC. This protocol can be adopted as a routine practice in any health system.

Potential future malaria transmission in Odisha due to climate change

Future projections of malaria transmission is made for Odisha, a highly endemic region of India, through numerical simulations using the VECTRI dynamical model. The model is forced with bias-corrected temperature and rainfall from a global climate model (CCSM4) for the baseline period 1975–2005 and for the projection periods 2020s, 2050s, and 2080s under RCP8.5 emission scenario. The temperature, rainfall, mosquito density and entomological inoculation rate (EIR), generated from the VECTRI model are evaluated with the observation and analyzed further to estimate the future malaria transmission over Odisha on a spatio-temporal scale owing to climate change. Our results reveal that the malaria transmission in Odisha as a whole during summer and winter monsoon seasons may decrease in future due to the climate change except in few districts with the high elevations and dense forest regions such as Kandhamal, Koraput, Raygada and Mayurbhanj districts where an increase in malaria transmission is found. Compared to the baseline period, mosquito density shows decrease in most districts of the south, southwest, central, north and northwest regions of Odisha in 2030s, 2050s and 2080s. An overall decrease in malaria transmission of 20–40% (reduction in EIR) is seen during the monsoon season (June-Sept) over Odisha with the increased surface temperature of 3.5–4 °C and with the increased rainfall of 20–35% by the end of the century with respect to the baseline period. Furthermore, malaria transmission is likely to reduce in future over most of the Odisha regions with the increase in future warm and cold nights temperatures.

Safe and Standard Thyroid Cancer Surgery, or Lack Thereof: Patterns and Correlates of Patient Referral to Tertiary Care Centre for Revision Thyroid Surgery in a LMIC

Background A surgeon's characteristics such as volume and practice setup are essential elements in outcome of thyroid cancer. However, little information is available from the developing world regarding qualities of primary surgeon, such as level of knowledge, skill, and proper documentation while referring to higher center.

Methods Records of 164 patients of differentiated thyroid cancer (DTC) from January 1990 to December 2018 undergoing revision thyroid surgery following primary surgery elsewhere were retrospectively analyzed.

Results Out of 164 patients with postoperative diagnosis of DTC, referral patterns were as follows: low volume (LV) to high volume (HV) (n = 120, 73.2%), followed by HV to HV (n = 44, 26.8%). The primary surgery assessed by the extent of residual disease was in agreement with the documentation in only 55%. The type of thyroidectomy performed was not mentioned in 9.8%. The status of the parathyroid glands was mentioned only in 15.8% and recurrent laryngeal nerve in 12.2%. Less than recommended surgery was performed in 52.5% patients. Despite less than recommended surgery, 44.5% patients were directly referred for radioactive iodine ablation (RAIA). Thirty two percent patients were referred for RAIA after hemithyroidectomy. Central or lateral compartment lymphadenectomy, even after indication, was less likely at LV centers (risk ratio [RR], 0.71; 95% confidence interval [CI], 0.64–0.77). Similarly, for DTC patients, the relationship between LV center surgery and subsequent referral for RAIA was RR, 0.71 (95% CI, 0.48–1.02).

Conclusions Most patients referred from LV surgeons are less likely to have proper thyroidectomy, have inadequate documentation of the primary surgery, and are referred for RAIA after less than total thyroidectomy. Our study highlights the lacunae in the approach to and understanding of thyroid cancer surgery by secondary care physicians in our country. We believe that there is an urgent necessity of educational reform and training to rectify this problem.

Medial Approach for Identification of Recurrent Laryngeal Nerve in Locally Advanced Differentiated Thyroid Carcinoma: Revisited

Recurrent laryngeal nerve injury is a well-recognized and potentially catastrophic complication of thyroidectomy. In literature, four approaches have been described for identification of RLN, the superior, lateral, medial, and inferior approaches. But medial approach is lesser known amongst surgeons. Locally infiltrative thyroid cancer with extensive lymph nodal metastasis in central and lateral compartment sometimes makes it difficult to identify RLN by any of these standard approaches described above. A medial approach was described where RLN is identified as it extends up to interdigitate with the trunk or the branches of the inferior thyroid artery. We present here a new alternative technique for identification of recurrent laryngeal nerve through modified medial approach that was used in difficult thyroidectomies.

Outcome of 18f-Fluorodeoxyglucose Positron Emission Tomography (PET)-Directed Resections in Differentiated Thyroid Carcinoma (DTC): Experience in a Developing Country

The aim of this study was to assess the accuracy of 18F-fluorodeoxyglucose positron emission tomography (18-FDG-PET scan) in localizing the disease in differentiated thyroid carcinoma patients undergoing re-operations. This is a retrospective analysis of a prospectively maintained data (December 2007 to December 2016). The patients included had elevated serum thyroglobulin (Tg) levels and negative iodine uptake (TENIS) and planned for re-operation with one or more accessible site of metastasis detected on FDG-PET scan. Clinical details, FDG-PET/CT findings, operative findings, histology, pre-, and post-operative Tg levels were recorded. Thirty-two patients were included. The mean age of the patients was 46.8 ± 15.8 years (M:F = 1:1.6) and mean pre-operative Tg value was 247.6 ± 92.3 ng/ml. FDG-PET disclosed a total of 77 hot spots in these 32 patients, 56 of which were surgically explored and resections performed. Patient- and lesion-based positive predictive value (PPV) of FDG-PET in detecting recurrent/metastatic DTC lesions was 87.5 and 71%, respectively. Remaining cases had granulomatous or nonspecific inflammatory lesions. A total of 12.5% of recurrent DTC patients explored could achieve biochemical cure. All these had disease confined to neck. Remaining patients continued to have high serum Tg level, though it fell substantially in majority of patients. False positive scans are frequent in regions with high prevalence of inflammatory diseases. Hence, FDG-PET directed re-operations should be taken up judiciously.

Particle composition and morphology over urban environment (New Delhi): Plausible effects on wheat leaves

Particulate matter (PM) deposition on leaves adversely affects physical, chemical and biological nature of agricultural crops resulting in their loss of productivity and yield. Wheat being a staple food in major parts of Northern India and around the World, has been selected for research purpose by designing a study to explore the probable effects of PM deposition on wheat leaves and wheat crops to ensure the food security. PM₅ (Particulate matter with aerodynamic diameter <5 μm) and Dry Deposited Particulate Matter (DDPM) on wheat leaves (Leaf_DDPM) were collected from the wheat crop field in Indian Agriculture Research Institute (IARI), New Delhi for growing and harvesting season of wheat crops (i.e. December 2014 to April 2015). The EDS (Energy Dispersive Spectroscopy) analysis was used for this study and the individual particle analysis revealed the presence of both acidic and alkaline components like C, Al, Si, Fe, Ca, K, S and Mg. The offline characterization tool i.e. SEM (Scanning Electron Microscope) was utilized for obtaining the micrographs which clearly showed the presence of some angular, sharp-edged and spherical particles consisting of both smooth and rough texture. Apart from that, prevalence of slightly non-spherical particles with aspect ratio of range (>1.20-1.40) and CIR (>0.70-0.80) for both PM₅ and leaf_DDPM were observed. The size distribution of individual particles for both PM₅(#194 particles) and Leaf_DDPM(#657 particles) revealed that Surface Equivalent Radius (SER) and Volume Equivalent Radius (VER) of particles observed to be 0.40-0.80 μm while surface area to be 0-1 μm². These particles may easily block stomatal openings (with typical diameter range: 42-51 μm) of wheat leaves and damage internal leaf tissues while particle VER determines the interaction of incoming solar radiation with leaf surfaces. Average PM₅ concentrations ± Standard deviations (μg/m³) were reported to be 231.05 ± 113.03. The XRF (X-Ray Fluorescence) spectrometer analysis of bulk PM₅ revealed the concentrations of non-carbonaceous elements (μg/m³) as N (67.34 ± 16.09), Si (27.44 ± 11.01), Al (7.79 ± 3.37), S (3.88 ± 2.24), Na (2.29 ± 0.94), Mg (1.65 ± 0.62), K (0.51 ± 0.26), Ca (0.60 ± 0.26), Fe (0.54 ± 0.26), Cr (1.10 ± 0.70), Zn (0.05 ± 0.03), P (0.10 ± 0.03), Cu (0.07 ± 0.06). The dominant elemental oxides were calculated as SiO₂, Al₂O₃, SO₄^2-, Na₂O, MgO, K₂O, CaO, Fe₂O₃, Cr₂O₃, ZnO, P₂O₅, Cu₂O with variable concentrations. In high humid conditions, with relative humidity (~85%) during the vegetative and flowering growth stages of wheat crops, presence of C and S rich acidic and hygroscopic particles may cause the corrosion of wheat leaves that ultimately affect the wheat crops.

Role of postoperative intact serum PTH as an early predictor of severe post-thyroidectomy hypocalcemia: a prospective study

BACKGROUND

Post thyroidectomy hypocalcemia is a major sequel of thyroidectomy and continues to trouble the endocrinologists and the endocrine surgeons as there is no ideal predictive marker of hypocalcemia which has the potential to develop into a life-threatening complication. The role of early serum intact parathormone (iPTH) to predict post thyroidectomy hypocalcemia is becoming useful but the literature is still unclear regarding the optimal time of testing and the optimal cut-off value of serum iPTH.

PATIENTS AND METHODS

This is a prospective cohort study of 111 patients who underwent total thyroidectomy in a tertiary care endocrine surgery referral unit. Serum iPTH was measured after 20 min and 4 h of surgery. Receiver-Operator characteristic Curve (ROC) was used to find out of the best cut-off value of S. iPTH 20 min and 4 h after surgery in predicting hypocalcemia.

RESULTS

Hypocalcemia was noted in 60 (54%) out of 111 subjects who underwent total thyroidectomy. The best cut-off values of Serum iPTH to predict hypocalcemia was found to be 4.28 pmol/l at 20 min post total thyroidectomy with a sensitivity and specificity of 81.7% and 51%, respectively. In addition, patients with malignancy or central lymph nodal dissection were significantly over-represented in the hypocalcemia group with serum iPTH above the threshold level of 4.28 pmol/l. Below the cut off level, parenteral calcium supplementation was required in 23% (17/74) subjects while the rate was only 5.4% (2/37) patients when serum iPTH was above the cut-off level.

CONCLUSIONS

The decline of serum iPTH below a specific level after surgery has predictive value together with other factors strictly related to patient, the thyroid disease itself and surgery. The risk of development of hypocalcemia and consequent need for calcium supplementation should be evaluated by clinical assessment along with serum PTH measurement.

Spin-up conversion, exchange-interactions, and tailored magnetic properties in core-shell La2NiMnO6of small crystallites

La₂NiMnO₆-a ferromagnetic (FM) insulator offers tunable charge carriers and spins useful to devise its multiple properties and applications. In this view, we studied a core-shell La₂NiMnO₆(2-3 nm shell on 65 - 80 nm core) of a Ni²⁺/Ni³⁺(d⁷) to Mn⁴⁺/Mn³⁺(d⁴) spin-up conversion- revived a new FM phase-2, raising a spin-densityσ_s = 0.7 s a^-1over the Ni^2+/Mn⁴⁺species (phase-1),σ_s = 0.5 s a^-1, i.e. 2.12μ_B/f.u. larger spin moment. HRTEM images studied with x-ray diffraction characterizing core-shell structure that plays a crucial role in tuning the high spin FM phase-2 of profound properties. Below 110 K, the dc magnetization and ac magnetic susceptibilityχ(ω,T) reveal a metastable magnetic behavior on an antiferromagnetic canting of a spin-glass nature. The results follow a Vogel-Fulcher type relaxation with a relaxation timeτ₀∼ 10^-13s, confirming a spin-glass freezing behavior. Uniquely, FM field of phase-1 controls magnetics of phase 2 of a coupled magnet, modulating joint features with small thermal magnetic hysteresis on heating-cooling cycles.

Thyroid dysfunctions and autoimmunity in breast cancer patients: a prospective case-control study

OBJECTIVE

The relationship of thyroid dysfunction and autoimmunity with breast cancer (BC) continues to be contentious. The primary aim of this study was to estimate the prevalence of thyroid dysfunctions and autoimmunity in BC patients, and the secondary aims were to investigate the relationship of thyroid dysfunction with the clinicopathological profile of and therapy received by BC patients.

METHODS

This was a single-center prospective case-control study (March 2015-May 2017). Women with BC (n = 191), age-matched healthy controls (n = 166) and malignant controls (patients with cervical cancer, n = 87) were enrolled. Basal serum free thyroxin (fT4), thyrotropin (TSH) and anti-thyroid peroxidase (TPO) antibody levels were measured in all three groups; fT4, TSH and TPO measures were repeated after chemotherapy and at the 1-year follow-up (one year after diagnosis) in the BC patients.

RESULTS

The prevalence of overall hypothyroidism and autoimmunity (p = 0.106) did not differ significantly between the three groups, but the rate of clinical hypothyroidism was significantly higher in the BC group than in the healthy control group and the malignant control group (12.2% vs. 3.0% vs. 4.6%, respectively; p = 0.001). BC patients had significantly lower mean basal TSH concentrations than the healthy controls (p = 0.017). The postchemotherapy TSH concentrations were significantly lower (p = 0.001), and the fT4 concentrations were higher, albeit not significantly (p = 1.00), than the respective basal concentrations. The reverse was true for the follow-up values, in which the TSH (p = 1.00) values were higher and the fT4 (p = 0.03) concentrations were lower than the respective basal concentrations. An additional 6% of the BC patients developed clinical hypothyroidism during follow-up. Hypothyroid (p = 0.02) and TPO-positive (p = 0.004) patients had significantly smaller tumors, but their other clinicopathological features were comparable to those without thyroid dysfunction.

CONCLUSION

The prevalence of clinical hypothyroidism requiring thyroxine replacement was significantly high in BC patients and increased further during follow-up. Hence, BC patients should be considered a high-risk group that should receive routine screening for hypothyroidism.

Spin reorientation behaviour and dielectric properties of Fe-dopedh-HoMnO3

We have studied the magnetic structure, spin reorientation behaviour and dielectric properties of polycrystalline HoMn_1-xFe_xO₃(0.0 ⩽x⩽ 0.25) compounds using magnetization, neutron diffraction and dielectric measurements. These compounds crystallize predominantly in the hexagonal phase (P6₃cm) with a small phase fraction of the orthorhombic phase (Pnma) which increases with increase in dopant concentration and a total suppression of the hexagonal phase is observed atx= 0.25. Doping Fe at the Mn site leads to an increase in the spin reorientation temperature (T_SR) from 33 K (x= 0) to 55 K (x= 0.1) while theT_Nremains nearly constant at 72 K. The magnetic structure of the hexagonal phase was found to be Γ₄(P6₃'c'm) belowT_Nand Γ₃(P6₃'cm') belowT_SR. The magnetic ordering temperature of Ho³⁺ions at 2(a) site appears to coincide with theT_SRonly in the case ofx= 0 sample. The Ho ions at 4(b) site are found to magnetically order below 8 K. TheT_Nof the Ho ions at both 4(b) and 2(a) sites do not appear to be affected by doping at the Mn site. The temperature variation of the Mn and Ho moments follow the Brillioun function dependence albeit with differing values of the molecular field constantλ₀andλ₁. Short range magnetic order alone was found for the completely orthorhombic sample (x= 0.25). An anomalous suppression of the dielectric constant (ε) atT_Nis observed in the case of hexagonal samples. Further, a linear correlation between Δε(=ε(T) -ε(0)) and the square of the antiferromagnetic momentM, is observed in these compounds.

Hereditary Medullary Thyroid Carcinoma: Genotype, Phenotype and Outcomes in a North Indian Cohort

BACKGROUND

Aggressiveness of hereditary medullary thyroid carcinoma (hMTC) has been conventionally described to correlate with American Thyroid Association (ATA) risk groups based on RET mutations. Recent evidence increasingly contradicts this notion. We studied the RET genotype and its correlation with disease phenotype and survival outcomes in a cohort of hMTC patients.

METHODS

In a retrospective cohort of 55 hMTC patients from 23 families treated at a north Indian tertiary care institute over 15-years, RET genotype was correlated with disease phenotype (clinical, biochemical, and pathological attributes) and outcomes in terms of biochemical cure (normalization of serum calcitonin), structural cure, overall survival (OS) and disease specific survival (DSS).

RESULTS

Forty-nine patients had Multiple Endocrine Neoplasia (MEN)-type 2A syndrome, 02 had MEN-2B, and 4 had familial MTC. Two patients belonged to highest ATA risk, 41 to high-risk, and 12 to moderate risk categories. Age of the patients or stage of disease at presentation did not differ significantly between the ATA risk groups. Though the baseline serum calcitonin was significantly higher in highest risk category, the biochemical cure rates were not significantly different. At a median follow up of 48 months (Inter-quartile range 18-84, range 12-192) structural cure rates in ATA moderate and high risk groups were significantly higher than highest risk group (p = 0.04). No significant difference in OS between the three ATA groups of hMTC among the patients who underwent surgical treatment was observed (p = 0.098).

CONCLUSIONS

The ATA moderate and high risk groups have better structural cure rates compared to ATA highest risk group. The biochemical cure and overall survival rates did not significantly differ between ATA risk-groups, and were impacted by the disease stage at presentation. The current ATA risk-groups do not reliably predict the outcomes in terms of biochemical cure and survival in hMTC patients.

Comparative retrospective analysis of locoregional recurrence in unselected breast cancer patients treated with conventional versus hypofractionated radiotherapy at a tertiary cancer center?

Background

Role of hypofractionated radiotherapy (HFRT) in early breast cancer is established; comparatively, there are limited data for HFRT in locally advanced breast cancer (LABC). We report the impact of HFRT in unselected breast cancer patients in comparison with historically treated patients with conventional fractionated radiotherapy (CFRT).

Patients and Methods

Records of 463 breast cancer patients treated between January 09 and July 13 with CFRT (50 Gy/25 fr) or HFRT (42.4 Gy in 16 fractions or 40 Gy in 15 fractions) in two sequential periods were retrospectively reviewed. The analysis was done in August 2018. The primary endpoint was to compare the differences in locoregional recurrence rate.

Results

Of the 463 patients, 209 received CFRT and 254 received HFRT. The median age was 48 years (interquartile range: 40-56), premenopausal (CFRT: 23% vs. HFRT 39%, P = 0.005). The most common pathology was infiltrating ductal carcinoma (81%) with Grade III tumors (45%), estrogen receptor (+) was seen in 44%, triple-negative breast cancer in 34%, and Her2Neu (3+) were seen in 27%. Two hundred and fifty-four patients (54.5%) had undergone breast-conserving surgery (BCS) and 209 patients (45%) modified radical mastectomy (MRM). Nodal radiotherapy was delivered in 76% versus 64% in patients receiving CFRT versus HFRT, respectively (P = 0.005). With a median follow-up of 46 months in CFRT and 57 months in HFRT, 9/209 (4.3%) patients in CFRT and 7/254 (2.7%) in HFRT had locoregional relapse (LRR). The 4 years#39; actuarial local recurrence-free survival (LRFS) in CFRT versus HFRT was 95% versus 97% (P = 0.37). The mean estimated LRFS (local relapse-free survival) for CFRT is 113.4 months and for HFRT 94.2 months (P = 0.3).

Conclusions

The risk of local recurrence among patients of breast cancer treated with HFRT after BCS or MRM was not worse when compared to CFRT.

Smartphone-Based Application for Tele-follow-up of Patients with Endocrine Disorders in Context of a LMIC: A Compliance, Satisfaction, Clinical Safety and Outcome Assessment

BACKGROUND

Remote video consultations are increasingly used in clinical practice, and a lot of data are emerging on its feasibility and acceptability. This study aims to bring out qualitative and quantitative data which will enhance our understanding of strengths and limitations of this media in the setting of a low- and middle-income country (LMIC).

MATERIALS AND METHODS

This was a prospective study conducted from January 2017 to May 2018, at the Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, India. A total of 107 patients were selected who chose remote follow-up care through social media (WhatsApp). Data were analyzed on feasibility, clinical safety, satisfaction and economic burden.

RESULTS

A total of 107 postoperative patients were followed up using a social media tool. A total of 396 tele-sessions were held. The average number of tele-consultations per patient was 3.7 (range 2-6). Reasons for tele-follow-up included: confirmation of histology report (n = 92), medication dosage adjustments (n = 148), wound evaluation (n = 102), reporting of serum TSH and serum calcium levels (n = 296) and medical fitness certificate (n = 13). Wound evaluation through tele-follow-up was on par with the outpatient department (OPD) follow-up as no patient had to report to OPD for wound infection. Satisfaction level was excellent in 55% of patients and very good in 25%. 20% of the patients reported an average satisfaction level. If all of these 107 patients would have come to our OPD follow-up, they would have traveled 613.2 miles (908 km) per patient on an average, apart from losing work hours. Average cost and workdays saved per visit were $78 and 5.4 days, respectively.

CONCLUSION

Video consultation using social media tools is clinically safe and cost effective. Economic benefits far outweigh the risk of missing an adverse event, especially in the setting of low- and middle-income countries.

Low-dose ACTH test for evaluation of hypothalamus-pituitary-adrenal axis preoperatively and 3-month follow-up in non-functioning pituitary adenomas

BACKGROUND

Peri-operative glucocorticoids are routinely administered to patients undergoing trans-sphenoidal surgery for non-functional pituitary adenomas (NFPA) irrespective of hypothalamus-pituitary-adrenal (HPA) axis status.

PURPOSE

Evaluation of HPA axis before and 12 weeks after endoscopic trans-sphenoidal adenomectomy (E-TSA) utilizing low-dose (1 μg) ACTH stimulation test (LDACTH) to determine the need for glucocorticoid administration in patients with NFPA. We also determined the factors that can predict occurrence of hypocortisolism at 12 weeks after surgery.

METHODS

Sixty-three consecutive patients with NFPA requiring surgical excision were enrolled in this study. Glucocorticoids were administered to patients with demonstrable hypocortisolism [preoperative peak cortisol < 16 μg/dL during LDACTH test, postoperative day 3 (POD-3) 0800 hrs Cortisol < 8 μg/dL or stimulated cortisol (LDACTH) < 16 μg/dL at 12 weeks].

RESULTS

Hypocortisolism was present in 43 patients (68.2%) pre-operatively and persisted in 33 patients (52.4%) on POD-3. Thirty-three patients (52.4%) had hypocortisolism at 12 weeks after surgery. Eleven patients (17.4%) did not require glucocorticoids during the entire study period and 30 patients (47.6%) did not require glucocorticoids after 3 months. None of the patients developed adrenal crisis during the study. Hypocortisolism on the third post-operative day was the single significant predictor of hypocortisolism at 12 weeks after the surgery. There was a significant correlation between POD-3 0800 hrs cortisol ≥ 8μg/dL and stimulated cortisol (LDACTH) ≥16μg/dL at 12 weeks (r = 0.62, p < 0.0001). POD-3 0800 hrs cortisol ≥ 8 μg/dL had 73% sensitivity and 79% specificity in predicting eucortisolism at 12 weeks.

CONCLUSIONS

HPA function is preserved in significant proportion of NFPA patients undergoing E-TSA. Perioperative glucocorticoids should be given only in patients with demonstrable preoperative hypocortisolism on 1 μg ACTH test. Postoperative day 3 0800 hrs cortisol is a reasonable predictor of HPA axis status at 12 weeks after surgery.

Whole-genome resequencing of Dulong Chicken reveal signatures of selection

1. Dulong Chickens (DLCs) live at high altitude (~3000 m) and humidity (~90%), are endemic to the Yunnan province, and have gradually developed unique physiological characteristics, but their genetic basis is still unclear. Using the fixation index (F_ST ) approach, based on whole-genome resequencing, DLCs were analysed to uncover the genomic architecture of the population and candidate genes involved in selection during domestication. 2. A total of 469 candidate genes were obtained to be putatively under selection in DLCs. Further investigations revealed the genic footprint for local adaptation (high-altitude and high-humidity) as the genic signatures that are involved in economic traits (related to egg production). 3. Candidate genes were identified that may be associated with disease resistance, aggressiveness, small body size and positive selection of vision in DLCs. 4. These data revealed loci of selective signals that operate during selection for production at high altitude and humidity.

Ethics committee meeting by video-conferencing during Covid-19

The Covid-19 pandemic has created a situation demanding rapid ethical review of research on various aspects of the pandemic, while maintaining social distancing norms. Research during an outbreak is important for understanding the disease and its management and allows scientists to study the disease in situ.

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Mitochondrial sequence-based evolutionary analysis of riverine-swamp hybrid buffaloes of India indicates novel maternal differentiation and domestication patterns

In this study, mitochondrial D-loop sequence data on riverine, swamp and hybrid buffaloes from India have been generated and compared with other reported Indian riverine, Chinese and Bangladeshi swamp buffalo populations. Sequence analysis revealed the presence of 132 haplotypes, with a haplotype diversity of 0.9611 ± 0.0045 and a nucleotide diversity of 0.04801 ± 0.00126. For the first time, the existence of riverine-swamp hybrids among the Indian Chilika buffalo population has been recorded, having 49 chromosomes, which was also confirmed by mitochondrial haplotype sharing between Chilika and Indian swamp as well as Chinese swamp buffalo populations in the network analysis. Phylogenetic analysis documents the sharing of reported pre-domestication haplogroups 'SA1', 'SA2', 'SA3' and 'SB1' between the Chilika and swamp buffalo populations of India, China and Bangladesh, an indication of the migration of swamp buffaloes towards Bangladesh and adjoining lower parts of India and north towards Chinese domestication sites. The results have also been supplemented by multidimension scaling, grouping Indian and Chinese swamp buffaloes more closely together with Bangladeshi buffaloes, but into a separate quadrant, whereas Chilika grouped away from other riverine as well as swamp buffaloes. These findings thus confirm the previous reports that the northeast region of India, close to the Indo-China border, is the point of evolution of swamp buffaloes with multiple sites of domestication.

Primary hyperparathyroidism in developing world: a systematic review on the changing clinical profile of the disease

While the developed world is focusing on laying guidelines for selecting out cases of Asymptomatic primary hyperparathyroidism (PHPT) for surgical intervention and promoting minimal access surgery, the developing world is observing a change in disease spectrum from advanced symptomatic to lesser degree of symptomatic disease and not many with associated Vitamin D deficiency. Few studies from the developing countries of the world have focused on the changing clinical spectrum of PHPT. Objective of this study is to review the changing profile of PHPT in developing world. A systematic literature search was done in December 2017 focussing on publications from the developing world. All studies pertaining to the epidemiology of PHPT published after 1st January 2000 and published in English language were included for analysis. Most of the studies published from developing countries report a predominance of symptomatic disease (79.6% of all included patients) with musculoskeletal disease present in the majority of patients (52.9%). The combined mean serum total calcium (11.9 ± 1.4 mg/dL), serum PTH (668.6 ± 539 pg/mL), serum alkaline phoshpatase (619 ± 826.9 IU/L) and weight of excised parathyroid glands (4.4 ± 3.8 grams) are much higher than those reported from the western studies. Despite this, we found that there is a distinct trend towards a milder form of disease presentation and biochemical profile noticeable in more recent times. Although there is a striking difference in all aspects of PHPT disease epidemiology, clinical presentation and biochemical profile of developing and developed countries, there is a distinct trend towards a milder form of disease presentation and biochemical profile in more recent times.

Longitudinal trial of smart-phone based social media applications for remote monitoring of cancer patients in the context of a LMIC: compliance, satisfaction, and cost-benefit analysis

The cancer burden is expected to reach 20 million new cases annually in low and middle-income countries (LMICs) by 2025. Few estimates suggest that thyroid cancer could become the third most common cancer diagnosed in women by 2019. Health care services need to gear up to provide close clinical follow-up care for patients especially in LMICs where there is already a shortage of healthcare personnel. We conducted this study to assess the effect of remote monitoring using tele-follow up on compliance, satisfaction and economic benefit. Participants were recruited to traditional hospital follow-up (consultation, clinical examination, and investigations as per hospital policy) or tele-follow up based on social media. Outcomes included information needs, participants’ compliance, and satisfaction, post-op complications, clinical investigations ordered. A total of 64 patients with thyroid cancer were recruited- 24 in hospital follow up group and 40 in the remote monitoring group. There were no significant differences between groups regarding satisfaction with information received. Responses were significantly more positive in the social media group, with a higher percentage reporting “very satisfied”. Wound evaluation through tele-follow up was on par with OPD follow up. If all of these 40 patients would have come to our OPD follow-up, they would have travelled on an average of 930 kms per patient. This study shows that social media is a practical tool in follow-up of cancer patients in LMICs where traditional telemedicine tools are restricted and conventional follow-up is economically challenging to patients. It also ensures compliance which is a major issue with conventional follow-up due to poor infrastructure.

Patient, thyroid, and surgeon related factors that make thyroidectomy difficult-cohort study

Introduction

When thyroidectomy is performed under optimal conditions within a milieu of sound anatomical and physiological knowledge combined with meticulous surgical skills, complications are minimal. However, thyroidectomy can be difficult, and its complications can be life-threatening. The factors that predict difficult thyroidectomy can be patient-, thyroid-, or surgeon-related, and we aimed to study these three factors. .

Materials and methods

This prospective study was performed in a tertiary care center between September 2016 and March 2017. We developed and validated modified thyroidectomy difficulty scale (TDS), with 11 items. Preoperatively, height, weight, neck length, and other parameters were recorded. Postoperatively, the modified TDS form was filled out by the surgeon and assistant, blinded to each other's responses. The minimum score was 19 and maximum was 54. The surgeon's baseline pulse rate was monitored throughout the procedure using a pulse oximeter probe that was On-The-Go (OTG) compatible. The probe was placed over the ear lobule/pinna of the surgeon and connected to an Android phone that was comfortably placed in the surgeon's pocket inside the gown. An application USB SPO₂, was used in recording the pulse rate.

Results

A total of 52 patients undergoing hemi- or total thyroidectomy were included in this study. All had benign cytology on fine needle aspiration cytology (colloid, 71.42%). A total of 104 modified TDS questionnaires filled by the operating surgeon and assistant were analyzed. The pulse rate of the operating surgeon, as measured by the novel pulse oximeter, was recorded in 52 surgeries. The minimum score was 20, maximum score was 35.50, and mean score was 26.85 ± 2.80. There was an interobserver agreement in most domains of the modified TDS except mobility. The surgeon was found to have the maximum heart rate when performing recurrent laryngeal nerve (RLN) dissection in 38 patients (73.07%).

Discussion

We found that majority of the trainees found thyroidectomy to be a vigorously intense activity. Thyroidectomy is a demanding surgery, which requires meticulous identification and dissection of the RLN and parathyroid glands for optimum outcome.

Comparative modeling and mutual docking of structurally uncharacterized heat shock protein 70 and heat shock factor-1 proteins in water buffalo

Aim:

In this study, a wide range of in silico investigation of Bubalus bubalis (BB) heat shock protein 70 (HSP70) and heat shock factor-1 (HSF1) has been performed, ranging from sequence evaluation among species to homology modeling along with their docking studies to decipher the interacting residues of both molecules.

Materials and Methods:

Protein sequences of BB HSP70 and HSF1 were retrieved from NCBI database in FASTA format. Primary and secondary structure prediction were computed using Expasy ProtParam server and Phyre2 server, respectively. TMHMM server was used to identify the transmembrane regions in HSP70. Multiple sequence alignment and comparative analysis of the protein was carried out using MAFFT and visualization was created using ESPript 3.0. Phylogenetic analysis was accomplished by COBALT. Interactions of HSP70 with other proteins were studied using STRING database. Modeller 9.18, RaptorX, Swiss-Modeller, Phyre2, and I-TASSER were utilized to design the three-dimensional structure of these proteins followed by refinement; energy minimization was accomplished using ModRefiner and SPDBV program. Stereochemical quality along with the accuracy of the predicted models and their visualization was observed by PROCHECK program of PDBsum and UCSF Chimera, respectively. ClusPro 2.0 server was accessed for the docking of the receptor protein with the ligand.

Results:

The lower value of Grand Average of Hydropathy indicates the more hydrophilic nature of HSP70 protein. Value of the instability index (II) classified the protein as stable. No transmembrane region was reported for HSP70 by TMHMM server. Phylogenetic analysis based on multiple sequence alignments (MSAs) by COBALT indicated more evolutionarily closeness of Bos indicus (BI) with Bos taurus as compared to BI and BB. STRING database clearly indicates the HSF1 as one of the interacting molecules among 10 interacting partners with HSP 70. The best hit of 3D model of HSP70 protein and HSF1 was retrieved from I-TASSER and Phyre2, respectively. Interacting residues and type of bonding between both the molecules which were docked by ClusPro 2.0 were decoded by PIC server. Hydrophobic interactions, protein-protein main-chain-side-chain hydrogen bonds, and protein-protein side-chain-side-chain hydrogen bonds were delineated in this study.

Conclusion:

This is the first-ever study on in silico interaction of HSP70 and HSF1 proteins in BB. Several bioinformatics web tools were utilized to study secondary structure along with comparative modeling, physicochemical properties, and protein-protein interaction. The various interacting amino acid residues of both proteins have been indicated in this study.

Performance evaluation of light weight gas sensor system suitable for airborne applications against co-location gas analysers over Delhi

In the present work, we discuss the light-weight gas sensor system (LWGSS) [350 g, 7″ ∗ 3″] originally developed at CSIR-National Physical Laboratory. This instrument is equipped with low-cost electrolytic gas sensors for quantifying major gaseous pollutants present in the atmosphere. Alphasense electrochemical gas sensors were used to measure gas pollutant species such as CO, SO₂, NO₂, O₃ and H₂S. In our experiment, we focus on the observation of CO, SO₂, NO₂, O₃ using this system. LWGSS has been designed for vertical observations using balloons or unmanned aerial vehicles (UAVs) to study the gaseous concentration in the atmospheric boundary layer (ABL). But, before using such instruments in field campaigns, there is a strong need for the inter-comparison of these instruments with that of the collocated high-end gas analysers. Thus, the inter-comparisons were performed between LWGSS and other high-end analysers during 6-7, March 2017 and 26-27, April 2017. The LWGSS system comprising all the sensors was compared against high-end analyser present at CSIR-NPL for ozone and other gas analysers present at IMD, New Delhi. The ozone sensor deployed in LWGSS showed good correlation (i.e. R² = 0.83, slope = 0.93) against the high-end ozone gas analyser, which was calibrated with primary ozone facility (SRP43) available at CSIR-NPL. Inter-comparisons performed for NO₂, SO₂ and CO showed different results. While the NO₂ gas sensor showed medium correlation (R² = 0.75; slope = 0.49), the SO₂ and CO gas sensor showed a poor correlation (and R² = 0.44; slope = 0.98; R² = 0.28, slope = 0.79) respectively, when compared with co-location gas analysers present at IMD, New Delhi. Comparisons were performed for LWGSS data during 1-28 February 2018 with data collected at CPCB station (Shadipur, Delhi) and IMD station (Pusa, Delhi). The comparison results showed variations in LWGSS CO and SO₂ data whereas LWGSS O₃ and NO₂ results were in accordance with data collected at aforementioned monitoring stations.

Superior Photo-thermionic electron Emission from Illuminated Phosphorene Surface

This work demonstrates that black phosphorene, a two dimensional allotrope of phosphorus, has the potential to be an efficient photo-thermionic emitter. To investigate and understand the novel aspects we use a combined approach in which ab initio quantum simulation tools are utilized along with semiclassical description for the emission process. First by using density functional theory based formalism, we study the band structure of phosphorene. From the locations of electronic bands, and band edges, we estimate the Fermi level and work function. This leads us to define a valid material specific parameter space and establish a formalism for estimating thermionic electron emission current from phosphorene. Finally we demonstrate how the emission current can be enhanced substantially under the effect of photon irradiation. We observe that photoemission flux to strongly dominate over its coexisting counterpart thermionic emission flux. Anisotropy in phosphorene structure plays important role in enhancing the flux. The approach which is valid over a much wider range of parameters is successfully tested against recently performed experiments in a different context. The results open up a new possibility for application of phosphorene based thermionic and photo-thermionic energy converters.

Genetic Profile of Indian Pheochromocytoma and Paraganglioma Patients - A Single Institutional Study

BACKGROUND AND AIMS

Pheochromocytomas (PCCs) and Paragangliomas (PGL) are rare catecholamine producing tumors that may present in sporadic or familial settings. Despite vast strides in understanding of PCC/PGL genetics in the last two decades, there is a dearth of information from India. The aim here is to study the prevalence of genetic mutations in Indian PCC/PGL patients.

SETTINGS AND DESIGN

Tertiary care academic hospital; prospective study.

METHODS

50 histopathologically diagnosed PCC/PGL patients formed the study group. Clinical, biochemical, pathological attributes and outcomes were documented and the phenotype was compared to the genotype. Succinyl dehydrogenase (SDH), Re-Arranged during Transfection (RET), Von-Hippel-Lindau (VHL) and NeuroFibromatosis-1 (NF1) mutations were studied. Additionally, immunohistochemisty for SDHB was also done, and the results compared to mutational analysis of SDH by MLPA (Multiplex Ligation-dependent Probe Activation).

STATISTICAL ANALYSIS

Independent samples t-test and Fisher's exact test were used as appropriate. P values ≤0.05 were considered statistically significant.

RESULTS

The mean age was 34.3 years. Of the 50 patients, 27 were males and 23 females. 10 patients (20%) in all were detected to have a genetic mutation. 6 patients possessed a RET mutation, while two had VHL mutations. No patient presented with a NF1 mutation. 2 patients had a SDH mutation, and Immunohistochemistry for SDHB correlated with mutational analysis for these patients.

CONCLUSIONS

The proportion of patients with a familial variant of PCC/PGL is more than what the historic "Rule of Ten" suggests. Our study found that one in five patients have a genetic mutation. PCC/PGL patients with genetic mutations not only require more stringent follow-up, but also screening of family members.

Genetic Alterations in Anaplastic Thyroid Carcinoma

INTRODUCTION

Anaplastic thyroid cancer (ATC) is rare but fatal thyroid cancer responsible for majority of thyroid cancer related mortality. ATC may originate de novo or from preexisting differentiated thyroid cancer. Complex interaction between different gene mutation has been suggested to be the main causative factor for origin of ATC in both pathways. Mostly affected pathways are MAP kinase and PI3CA kinase. Hence, we decided to study the frequent alterations in both the pathways in ATC patients.

METHODOLOGY

Clinico-pathological data of 34 ATC patients were collected retrospectively and Formalin Fixed Paraffin Embedded (FFPE) blocks were taken out for genetic analysis. DNA and RANA were isolated from FFPE tissues. BRAF V600E mutations were screened by RFLP PCR method and confirmed by sequencing. RAS, PI3CA and p53 mutations were checked by sequencing. RET/PTC translocations were screened by Real Time PCR.

RESULTS

A total of 34 patients were studied: Mean age 58.6+ 11.6 years with F:M- 1.8:1, 60% had history of goiter. Most common presenting symptom was rapidly growing thyroid mass followed by dyspnea, dysphasia and hoarseness of voice. Extent of disease was local, locoregional and metastatic in 32%, 35% and 33% respectively. 57.6% were euthyroid, 20.5 % were hyperthyroid while functional status were not available in 11.7%. FNAC was suggestive of ATC only in 52.9% cases. 15 (44%) were operated. BRAF V600E mutations were observed in 10/34 (29.4%). Interestingly, all three ATC patients with DTC components had previous history of goiter with rapid increase in size and BRAF V600E mutation, while BRAF was positive only in 7/31 (22.5%) of patients with no DTC component. Mean survival of 3.5 months in BRAF positive cases in comparison to 5.5 months in BRAF negative ATC. RAS mutations were found to be positive in 5.8%, and none had RET-PTC/PI3CA mutations. P53 mutation was positive in 7 patients. 3 patients presented with history of rapid increase in size of previous goiter while rest 4 patients presented with rapidly increasing thyroid swelling of 1 to 3 months. At presentation 2 patients has disease localized to thyroid, 4 has loco-regional disease and one patient presented with metastasis. 5 out of these 7 patients were operated (Total thyroidectomy:3, thyroidectomy with neck dissection:2). Mean survival was 4 months (1-6 months).

CONCLUSION

BRAF V600E was the commonest mutation followed by p53 of the 5 genes tested and BRAF was more common in patients with previous history of longstanding goiter or differentiated thyroid cancer. This provides an indirect evidence of neoplastic transformation of PTC to ATC.

Identification of novel polymorphism in buffalo stanniocalcin-1 gene and its expression analysis in mammary gland under different stages of lactation

Stanniocalcin-1 (STC1) is secreted by the variety of tissues having a major role in the regulation of calcium ions in the involuting mammary gland. The present work aims to sequence and structural characterization as well as expression profiling of STC1 gene in buffalo. Polymorphism identified in the 3-untranslated region (UTR) was analysed by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) genotyping in riverine and swamp buffaloes. Expression profiling of STC1 was performed in different lactation stages of mammary gland and peripheral blood mononuclear cells to study the impact of 3'-UTR polymorphism on its expression. Different polymorphic sites were detected in the entire coding and noncoding regions of riverine and swamp buffaloes, including two INDELs. An identified polymorphic nucleotide locus A324G, having target sites for two miRNAs, namely bta-miR-2382 and bta-miR-1343, reported in cattle, was genotyped by PCR-RFLP to reveal variable allelic distribution among swamp and riverine buffaloes. Gene expression profiling across buffalo mammary tissues representing different lactation stages showed maximum expression of the STC1 gene in the involuting mammary gland. Ruminants' specific genetic variation has been observed in STC1 and its implication in buffalo mammary gland involution as well as coregulation of gene expression through miRNA binding in the 3'-UTR is suggested.

TRPV4 activation in rat carotid artery in DOCA hypertension involves eNOS and endothelium-derived contractile factor (EDCF)

Aim: Role of TRPV4 channel in regulation of endothelial function in the carotid artery in deoxycorticosterone acetate (DOCA) model of hypertension in rat was studied. Methods: 8-10 weeks old albino Wistar rats divided into three groups namely Control, UNX and hypertensive animals. Vascular smooth muscle response was studied in isolated carotid artery of rat with acetylcholine, sodium nitroprusside, GSK1016790A (GSK) in presence and absence of L-NAME and indomethacin. Results: At the end of the 6th week, the mean systolic blood pressure was increased in DOCA-treated hypertensive rats (166 ± 8 mm Hg) compared to Control and UNX (125 ± 5 mm Hg). ACh (10-9 to 10-5 M) produced almost 100% relaxation in Control (Emax = 97.48 ± 1.06 %) and UNX animals (Emax = 93.16 ± 2.33 %) which was attenuated in DOCA-treated hypertensive animals (Emax = 70.85 ± 1.65 %). No significant changes seen in SNP (10-12 to 10-5 M) induced relaxation. GSK1016790A (10-12 to 10-7 M)-mediated relaxation was significantly attenuated in DOCA-treated hypertensive animals (Emax = 25.58 ± 13.60%) compared to the control (Emax = 80.59 ± 6.86%) and UNX (Emax = 87.32 ± 2.01%) animals. L-NAME (10-4 M) potently blocked GSK-induced relaxation, and a contractile response to GSK was observed in presence of L-NAME in all the three groups of animals which was sensitive to indomethacin (10-5 M). Conclusion: TRPV4 may regulate the vascular tone of rat carotid artery through an attenuated NO pathway and stimulation of the release of contractile prostanoids in the DOCA hypertensive rats.

Concentration of rare earth elements during high temperature pyrolysis of waste printed circuit boards

An in-depth investigation was carried out on the recovery of rare earth elements (REEs) from a variety of waste printed circuit boards (PCBs). High temperature pyrolysis was carried out at 850 °C for 15 min using horizontal resistance and thermal plasma furnaces with different levels of turbulence. The concentration of REEs in key pyrolysis residues, namely, copper rich red metallic fraction, lead/tin rich white metallic fraction and slag rich carbonaceous residues, were determined using ICP analysis. Most of the REEs were found concentrated in the carbonaceous residue with negligible levels of REEs recovered in the two metallic fractions. Most of the recovered REEs showed a high affinity towards to refractory oxides silica and alumina, and little affinity towards metals Cu, Pb and Sn. The yield of REEs was significantly higher from the plasma furnace indicating the important role of turbulence in the dissociation & subsequent diffusion of REEs during pyrolysis. While La, Pr, Sm and Y required turbulent conditions for their recovery, Nd, Gd, Ce and Dy were relatively easy to dissociate and extract from the waste. Significant amounts of REEs could thus be recovered from waste PCBs as concentrated recyclates for further processing and extraction of individual rare earths. This study has shown that PCBs could prove to be a valuable urban mining resource of REEs. The recovery of REEs, in addition to precious and other metals, could play an important role towards enhancing the economic and environmental sustainability of e-waste recycling.

Teaching learning based optimization-functional link artificial neural network filter for mixed noise reduction from magnetic resonance image

BACKGROUND

The clinical magnetic resonance imaging (MRI) images may get corrupted due to the presence of the mixture of different types of noises such as Rician, Gaussian, impulse, etc. Most of the available filtering algorithms are noise specific, linear, and non-adaptive.

OBJECTIVE

There is a need to develop a nonlinear adaptive filter that adapts itself according to the requirement and effectively applied for suppression of mixed noise from different MRI images.

METHODS

In view of this, a novel nonlinear neural network based adaptive filter i.e. functional link artificial neural network (FLANN) whose weights are trained by a recently developed derivative free meta-heuristic technique i.e. teaching learning based optimization (TLBO) is proposed and implemented.

RESULTS

The performance of the proposed filter is compared with five other adaptive filters and analyzed by considering quantitative metrics and evaluating the nonparametric statistical test. The convergence curve and computational time are also included for investigating the efficiency of the proposed as well as competitive filters.

CONCLUSION

The simulation outcomes of proposed filter outperform the other adaptive filters. The proposed filter can be hybridized with other evolutionary technique and utilized for removing different noise and artifacts from others medical images more competently.

Importance of Number of Foci of Capsular Invasion in Follicular Thyroid Carcinoma

The importance of capsular invasion in follicular thyroid carcinoma (FTC) has not been extensively studied. The aim of the present study was to correlate the clinical features and outcome of FTC with histology features particularly emphasizing on the importance of the number of foci of capsular invasion. This was a retrospective study. Histology of 123 FTC patients was reviewed. Patients were divided in three groups based on the number of foci of vascular and capsular invasion noted in primary tumor: group 1-capsular invasion at <6 and vascular invasion at <4 foci, group 2-either capsular invasion ≥6 or vascular invasion at ≥4 foci, and group 3-capsular invasion ≥6 and vascular invasion at ≥4 foci. Different prognostic factors and overall survival (OS) were compared among the groups. The incidences of distant metastases (p = 0.008) and OS (p = <0.001) were significantly different among the groups. On univariate analysis, age (p = 0.001), tumor size (p = <0.0001), distant metastases (p = <0.0001), vascular invasion (p = 0.018), and capsular invasion (p = 0.003) were significantly associated with OS. On multivariate analysis, age (p = 0.020), distant metastases (p = 0.045), and foci of capsular invasion (p = 0.005) were significant. The number of foci of capsular invasion seems to have significant prognostic value in widely invasive FTC.