Effects of Diabetes and Hyperlipidemia in Physiological Conditions - A Review

BACKGROUND

Diabetes mellitus (DM) is an autoimmune manifestation defined by persistent hyperglycemia and alterations in protein, fatty substances, and carbohydrate metabolism as an effect of problems with the secretion of insulin action or both. Manifestations include thirst, blurred eyesight, weight loss, and ketoacidosis, which can majorly lead to coma. There are different types of diabetes according to class or by cellular level. They are interrelated with hyperlipidemia as they are involved in the metabolism and regulation of physiological factors. Most parameters are seen at cellular or humoral levels, yet the underlying concern remains the same.

OBJECTIVE

To create a systematic correlation between the disease and locate the exact mechanism and receptors responsible for it. So, this article covers a proper way to resolve the conditions and their manifestation through literacy and diagrammatic.

CONCLUSION

Hence, this will be an insight for many scholars to understand the exact mechanism involved in the process.

Tests of Light-Lepton Universality in Angular Asymmetries of B^{0}→D^{*-}ℓν Decays

We present the first comprehensive tests of the universality of the light leptons in the angular distributions of semileptonic B^{0}-meson decays to charged spin-1 charmed mesons. We measure five angular-asymmetry observables as functions of the decay recoil that are sensitive to lepton-universality-violating contributions. We use events where one neutral B is fully reconstructed in ϒ(4S)→BB[over ¯] decays in data corresponding to 189  fb^{-1} integrated luminosity from electron-positron collisions collected with the Belle II detector. We find no significant deviation from the standard model expectations.

Precise Measurement of the D_{s}^{+} Lifetime at Belle II

We measure the lifetime of the D_{s}^{+} meson using a data sample of 207  fb^{-1} collected by the Belle II experiment running at the SuperKEKB asymmetric-energy e^{+}e^{-} collider. The lifetime is determined by fitting the decay-time distribution of a sample of 116×10^{3} D_{s}^{+}→ϕπ^{+} decays. Our result is τ_{D_{s}^{+}}=(499.5±1.7±0.9)  fs, where the first uncertainty is statistical and the second is systematic. This result is significantly more precise than previous measurements.

Search for a τ^{+}τ^{-} Resonance in e^{+}e^{-}→μ^{+}μ^{-}τ^{+}τ^{-} Events with the Belle II Experiment

We report the first search for a nonstandard-model resonance decaying into τ pairs in e^{+}e^{-}→μ^{+}μ^{-}τ^{+}τ^{-} events in the 3.6-10  GeV/c^{2} mass range. We use a 62.8  fb^{-1} sample of e^{+}e^{-} collisions collected at a center-of-mass energy of 10.58 GeV by the Belle II experiment at the SuperKEKB collider. The analysis probes three different models predicting a spin-1 particle coupling only to the heavier lepton families, a Higgs-like spin-0 particle that couples preferentially to charged leptons (leptophilic scalar), and an axionlike particle, respectively. We observe no evidence for a signal and set exclusion limits at 90% confidence level on the product of cross section and branching fraction into τ pairs, ranging from 0.7 to 24 fb, and on the couplings of these processes. We obtain world-leading constraints on the couplings for the leptophilic scalar model for masses above 6.5  GeV/c^{2} and for the axionlike particle model over the entire mass range.

Measurement of CP Violation in B^{0}→K_{S}^{0}π^{0} Decays at Belle II

We report a measurement of the CP-violating parameters C and S in B^{0}→K_{S}^{0}π^{0} decays at Belle II using a sample of 387×10^{6}  BB[over ¯] events recorded in e^{+}e^{-} collisions at a center-of-mass energy corresponding to the ϒ(4S) resonance. These parameters are determined by fitting the proper decay-time distribution of a sample of 415 signal events. We obtain C=-0.04_{-0.15}^{+0.14}±0.05 and S=0.75_{-0.23}^{+0.20}±0.04, where the first uncertainties are statistical and the second are systematic.

Test of Light-Lepton Universality in the Rates of Inclusive Semileptonic B-Meson Decays at Belle II

We present the first measurement of the ratio of branching fractions of inclusive semileptonic B-meson decays, R(X_{e/μ})=B(B→Xeν)/B(B→Xμν), a precision test of electron-muon universality, using data corresponding to 189  fb^{-1} from electron-positron collisions collected with the Belle II detector. In events where the partner B meson is fully reconstructed, we use fits to the lepton momentum spectra above 1.3  GeV/c to obtain R(X_{e/μ})=1.007±0.009(stat)±0.019(syst), which is the most precise lepton-universality test of its kind and agrees with the standard-model expectation.

Search for an Invisible Z^{'} in a Final State with Two Muons and Missing Energy at Belle II

The L_{μ}-L_{τ} extension of the standard model predicts the existence of a lepton-flavor-universality-violating Z^{'} boson that couples only to the heavier lepton families. We search for such a Z^{'} through its invisible decay in the process e^{+}e^{-}→μ^{+}μ^{-}Z^{'}. We use a sample of electron-positron collisions at a center-of-mass energy of 10.58 GeV collected by the Belle II experiment in 2019-2020, corresponding to an integrated luminosity of 79.7  fb^{-1}. We find no excess over the expected standard-model background. We set 90%-confidence-level upper limits on the cross section for this process as well as on the coupling of the model, which ranges from 3×10^{-3} at low Z^{'} masses to 1 at Z^{'} masses of 8  GeV/c^{2}.

Search for Lepton-Flavor-Violating τ Decays to a Lepton and an Invisible Boson at Belle II

We search for lepton-flavor-violating τ^{-}→e^{-}α and τ^{-}→μ^{-}α decays, where α is an invisible spin-0 boson. The search uses electron-positron collisions at 10.58 GeV center-of-mass energy with an integrated luminosity of 62.8  fb^{-1}, produced by the SuperKEKB collider and collected with the Belle II detector. We search for an excess in the lepton-energy spectrum of the known τ^{-}→e^{-}ν[over ¯]_{e}ν_{τ} and τ^{-}→μ^{-}ν[over ¯]_{μ}ν_{τ} decays. We report 95% confidence-level upper limits on the branching-fraction ratio B(τ^{-}→e^{-}α)/B(τ^{-}→e^{-}ν[over ¯]_{e}ν_{τ}) in the range (1.1-9.7)×10^{-3} and on B(τ^{-}→μ^{-}α)/B(τ^{-}→μ^{-}ν[over ¯]_{μ}ν_{τ}) in the range (0.7-12.2)×10^{-3} for α masses between 0 and 1.6  GeV/c^{2}. These results provide the most stringent bounds on invisible boson production from τ decays.

Observation of e^{+}e^{-}→ωχ_{bJ}(1P) and Search for X_{b}→ωϒ(1S) at sqrt[s] near 10.75 GeV

We study the processes e^{+}e^{-}→ωχ_{bJ}(1P) (J=0, 1, or 2) using samples at center-of-mass energies sqrt[s]=10.701, 10.745, and 10.805 GeV, corresponding to 1.6, 9.8, and 4.7  fb^{-1} of integrated luminosity, respectively. These data were collected with the Belle II detector during special operations of the SuperKEKB collider above the ϒ(4S) resonance. We report the first observation of ωχ_{bJ}(1P) signals at sqrt[s]=10.745  GeV. By combining Belle II data with Belle results at sqrt[s]=10.867  GeV, we find energy dependencies of the Born cross sections for e^{+}e^{-}→ωχ_{b1,b2}(1P) to be consistent with the shape of the ϒ(10753) state. These data indicate that the internal structures of the ϒ(10753) and ϒ(10860) states may differ. Including data at sqrt[s]=10.653  GeV, we also search for the bottomonium equivalent of the X(3872) state decaying into ωϒ(1S). No significant signal is observed for masses between 10.45 and 10.65  GeV/c^{2}.

Measurement of the Λ_{c}^{+} Lifetime

An absolute measurement of the Λ_{c}^{+} lifetime is reported using Λ_{c}^{+}→pK^{-}π^{+} decays in events reconstructed from data collected by the Belle II experiment at the SuperKEKB asymmetric-energy electron-positron collider. The total integrated luminosity of the data sample, which was collected at center-of-mass energies at or near the ϒ(4S) resonance, is 207.2  fb^{-1}. The result, τ(Λ_{c}^{+})=203.20±0.89±0.77  fs, where the first uncertainty is statistical and the second systematic, is the most precise measurement to date and is consistent with previous determinations.

Search for a Dark Photon and an Invisible Dark Higgs Boson in μ^{+}μ^{-} and Missing Energy Final States with the Belle II Experiment

The dark photon A^{'} and the dark Higgs boson h^{'} are hypothetical particles predicted in many dark sector models. We search for the simultaneous production of A^{'} and h^{'} in the dark Higgsstrahlung process e^{+}e^{-}→A^{'}h^{'} with A^{'}→μ^{+}μ^{-} and h^{'} invisible in electron-positron collisions at a center-of-mass energy of 10.58 GeV in data collected by the Belle II experiment in 2019. With an integrated luminosity of 8.34  fb^{-1}, we observe no evidence for signal. We obtain exclusion limits at 90% Bayesian credibility in the range of 1.7-5.0 fb on the cross section and in the range of 1.7×10^{-8}-200×10^{-8} on the effective coupling ϵ^{2}×α_{D} for the A^{'} mass in the range of 4.0  GeV/c^{2}<M_{A^{'}}<9.7  GeV/c^{2} and for the h^{'} mass M_{h^{'}}<M_{A^{'}}, where ϵ is the mixing strength between the standard model and the dark photon and α_{D} is the coupling of the dark photon to the dark Higgs boson. Our limits are the first in this mass range.

P-324 Effectiveness of letrozole in symptomatic women with adenomyosis undergoing IVF: An overview of clinical features, sonographic characteristics, and reproductive outcome

Study question

Is letrozole pre-treatment a cost-effective option in improving symptoms, sonographic features, and reproductive outcomes in women with adenomyosis, undergoing IVF treatment?

Summary answer

Only two months of low dose letrozole pre-treatment is as effective as GnRH-agonist in symptomatic adenomyosis while significantly reducing the cost of treatment.

What is known already

About 20%–25% of women undergoing IVF present with adenomyosis and many of them suffer from dysmenorrhea and menorrhagia. Adenomyosis is often underdiagnosed and neglected uterine pathology which has a major bearing on the quality of life and fertility. Since adenomyosis is an estrogen-dependent disorder, letrozole, an aromatase inhibitor (controls estrogen production) is reported to be effective in improving symptoms of adenomyosis similar to GnRH-agonist but its role as before treatment IVF is unclear. Although GnRH-agonist is an established and effective pre-treatment option, is expensive and comes with the concerns like menopausal symptoms, increased gonadotropin doses, and duration of stimulation.

Study design, size, duration

This longitudinal, randomized cohort study was conducted at a tertiary-care hospital during June-2019 and November-2021. 194 adenomyosis women with symptoms undergoing fresh-cycle IVF, were screened and 147 recruited. These women were resistant to OCPs/progestins for symptomatic relief. 72 patients were treated with letrozole and 75 with GnRH-agonist for 2 months, and changes in their sonographic features and symptoms were evaluated before and after treatment. Reproductive outcomes were also compared between the treatment groups after IVF.

Participants/materials, setting, methods

Adenomyosis was diagnosed on 2D-TVS according to MUSA criteria. Among them, 72 patients were treated with 2.5 mg letrozole (only thrice weekly instead of conventional 2.5mg/daily) and 75 women were treated with GnRH-agonist depot (3.6mg/month) for 2 months. Patients were evaluated before and after 2 months of treatment for improvements in dysmenorrhea (VAS score) and menorrhagia (PBAC score), and quantitative scoring of sonographic features. Reproductive outcomes were also compared after both treatment.

Main results and the role of chance

The majority of women had 3-4 sonographic criteria on TVS (median of 3), such as irregular or interrupted junctional zone (79.49%), asymmetrical thickening of the myometrium (71.15%), globular uterus (43.59%), and myometrial cyst (33.33%). Significant reductions in the sonographic severity scores for diffuse adenomyosis, adenomyoma, and asymmetry in myometrial thickness were observed following both the treatment (p &lt; 0.05). The effects of both the treatments were comparable in terms of severity of sonographic features (p &gt; 0.05). Significant decreases in dysmenorrhea (letrozole: pre-7.76±1.6, post-1.74±0.58; GnRH-agonist: pre-7.92±2.1, post-0) and menorrhagia (letrozole: pre-169±31, post-73±18; GnRH-agonist: pre-171±25, post-12±6) were observed after 2 months in both the treatment (p &lt; 0.05). Since GnRH-agonist treated women experienced cessation of menstruation, the VAS and PBAC scores were not directly comparable between the groups after treatment. All fresh cycle IVF women were included to understand the effect of pre-treatment of these women. Following fresh cycle IVF, clinical pregnancy (23.61%, 25.33%), miscarriage rate (35.29%, 36.84%), and live birth rate (12.5%, 13.33%), respectively for letrozole and GnRH-agonist groups were comparable (p &gt; 0.05). The cost of the treatment was 19 times less with letrozole pre-treatment when compared with GnRH-agonist, while a comparable reduction in symptoms and IVF outcome parameters were observed.

Limitations, reasons for caution

A possible limitation is the lack of a proper blinding due to different routes of administration of the therapies. In the absence of a standardized classification of severity, we have used the TVS based scoring proposed by Lazzeri et al (2018), which is not universally accepted or independently validated.

Wider implications of the findings

Low-dose letrozole pre-treatment for 2 months is an attractive option before IVF for symptoms relief and comparable reproductive outcome to that of GnRH-agonist but with lower cost and without over-suppression of pituitary. This protocol may also be extended to women in general who are suffering from symptomatic adenomyosis.

Trial registration number

CTRI/2019/01/016919 [04/01/2019]

Precise Measurement of the D^{0} and D^{+} Lifetimes at Belle II

We report a measurement of the D^{0} and D^{+} lifetimes using D^{0}→K^{-}π^{+} and D^{+}→K^{-}π^{+}π^{+} decays reconstructed in e^{+}e^{-}→cc[over ¯] data recorded by the Belle II experiment at the SuperKEKB asymmetric-energy e^{+}e^{-} collider. The data, collected at center-of-mass energies at or near the ϒ(4S) resonance, correspond to an integrated luminosity of 72  fb^{-1}. The results, τ(D^{0})=410.5±1.1(stat)±0.8(syst)  fs and τ(D^{+})=1030.4±4.7(stat)±3.1(syst)  fs, are the most precise to date and are consistent with previous determinations.

Search for B^{+}→K^{+}νν[over ¯] Decays Using an Inclusive Tagging Method at Belle II

A search for the flavor-changing neutral-current decay B^{+}→K^{+}νν[over ¯] is performed at the Belle II experiment at the SuperKEKB asymmetric energy electron-positron collider. The data sample corresponds to an integrated luminosity of 63  fb^{-1} collected at the ϒ(4S) resonance and a sample of 9  fb^{-1} collected at an energy 60 MeV below the resonance. Because the measurable decay signature involves only a single charged kaon, a novel measurement approach is used that exploits not only the properties of the B^{+}→K^{+}νν[over ¯] decay, but also the inclusive properties of the other B meson in the ϒ(4S)→BB[over ¯] event, to suppress the background from other B meson decays and light-quark pair production. This inclusive tagging approach offers a higher signal efficiency compared to previous searches. No significant signal is observed. An upper limit on the branching fraction of B^{+}→K^{+}νν[over ¯] of 4.1×10^{-5} is set at the 90% confidence level.

Immunogenicity and safety of two monovalent rotavirus vaccines, ROTAVAC® and ROTAVAC 5D® in Zambian infants

BACKGROUND AND AIMS

ROTAVAC® (frozen formulation stored at -20 °C) and ROTAVAC 5D® (liquid formulation stable at 2-8 °C) are rotavirus vaccines derived from the 116E human neonatal rotavirus strain, developed and licensed in India. This study evaluated and compared the safety and immunogenicity of these vaccines in an infant population in Zambia.

METHODS

We conducted a phase 2b, open-label, randomized, controlled trial wherein 450 infants 6 to 8 weeks of age were randomized equally to receive three doses of ROTAVAC or ROTAVAC 5D, or two doses of ROTARIX®. Study vaccines were administered concomitantly with routine immunizations. Blood samples were collected pre-vaccination and 28 days after the last dose. Serum anti-rotavirus IgA antibodies were measured by ELISA, with WC3 and 89-12 rotavirus strains as viral lysates in the assays. The primary analysis was to assess non-inferiority of ROTAVAC 5D to ROTAVAC in terms of the geometric mean concentration (GMC) of serum IgA (WC3) antibodies. Seroresponse and seropositivity were also determined. Safety was evaluated as occurrence of immediate, solicited, unsolicited, and serious adverse events after each dose.

RESULTS

The study evaluated 388 infants in the per-protocol population. All three vaccines were well tolerated and immunogenic. The post-vaccination GMCs were 14.0 U/mL (95% CI: 10.4, 18.8) and 18.1 U/mL (95% CI: 13.7, 24.0) for the ROTAVAC and ROTAVAC 5D groups, respectively, yielding a ratio of 1.3 (95% CI: 0.9, 1.9), thus meeting the pre-set non-inferiority criteria. Solicited and unsolicited adverse events were similar across all study arms. No death or intussusception case was reported during study period.

CONCLUSIONS

Among Zambian infants, both ROTAVAC and ROTAVAC 5D were well tolerated and the immunogenicity of ROTAVAC 5D was non-inferior to that of ROTAVAC. These results are consistent with those observed in licensure trials in India and support use of these vaccines across wider geographical areas.

Antihyperlipidemic potential of diosmin in Swiss Albino mice with high-fat diet induced hyperlipidemia

The aim of this study was to investigate the antihyperlipidemic potential of Diosmin (DS) in mice fed with a high-fat diet (HFD). Animals were divided in five groups (n = 6). The total duration of the study was 90 days split into two intervals. During the first 45-day interval, mice were administered with HFD, whereas during the second 45-day interval they were co-administered HFD plus DS or the standard drug atorvastatin. DS was administered at the dose of 100 and 200 mg/kg;p.o. DS treatment to HFD-induced hyperlipidemic mice caused significant decrements in the levels of total cholesterol, triglycerides, LDL-C and VLDL-C. Moreover, DS resulted in significant increase in the levels of HDL-C and improvements in total protein levels, whereas it caused remarkable decreases in SGOT, SGPT and ALP enzymatic activities in hyperlipidemic mice. Histopathological examination of hyperlipidemic mice revealed a disorganized hepatic tissue, fatty changes, and mononuclear cell infiltration, which were all ameliorated by DS administration. The results revealed that DS possesses potential ameliorating benefits again.st hyperlipidemia induced by HFD on lipid profile, liver function enzymes and hepatic histoarchitecture. Further investigations are highly recommended and clinical trials are warranted in order to assess the efficacy and to fully dissect the mode-of-action underpinning the observed antihyperlipidemic effect of DS.

Role of CT Nose Paranasal Sinuses and Nasal Endoscopy for Decision Making in a Case of Deviated Nasal Septum

Introduction Deviated nasal septum (DNS) can be asymptomatic in an individual or may cause nasal obstruction. The condition is generally diagnosed clinically and based on clinical diagnosis it is managed Surgically by large without much heed to diagnostic procedure. Thus, often underlying other causes of Obstruction is missed. Thus, it becomes essential to evaluate every patient presenting with history of Nasal obstruction and clinically Deviated septum, with aid of Nasal Endoscopy and CT scan Nose Paranasal Sinuses (PNS) to rule out/diagnose other coexisting conditions. Methods and Methodology 100 patients who presented with nasal obstruction and clinically diagnosed to have Deviated Nasal Septum were then subjected to Nasal Endoscopy and CT scan Nose and PNS and findings were noted for analysis. Results and Analysis Of these 100 patients, 48 patients were found to have coexisting pathological conditions/anatomical variants. Various anatomical and pathological Conditions were found to coexist together. Inferior turbinate hypertrophy in 34% is the most common pathological condition found to be associated with DNS followed by of sinusitis in 25% patients apart from polyp, concha bullosa and paradoxical middle turbinate. Discussion Studies done so far shows there is a definite link of deviated nasal septum to various anatomical and pathological conditions of the nose.  CT Scan Nose PNS and Nasal Endoscopy plays a vital role in diagnosing such anomalies. Conclusion Most of the patients, presenting with nasal obstruction and having Deviated Nasal Septum, undergo management without proper analysis and returns with recurrence of symptoms which could be analyzed properly if Nasal endoscopy and CT scan is employed during diagnosis of the condition, reducing risk of treatment failure.

Endoscopic 3-S Technique Tympanoplasty: Taking the Convention a Step Ahead

Introduction Endoscopic Surgery has immense potential for middle ear surgery and is currently favoured by many surgeons. The 3 (vascular) Strips/ 3 Flap Tympanoplasty with operating microscope is popular but Endoscopic 3-Flap Tympanoplasty remains less explored. Hence this study was conducted to compare advantages and disadvantages of Endoscopic and Microscopic 3-Flap Tympanoplasty. Materials and Methods Forty two patients with large/subtotal perforation of tympanic membrane were divided into two equal groups (Group A & B). Endoscope was used in Group A, whereas, operating microscope in Group B. Temporalis fascia was the graft material in all patients. Patients were followed up for six months. Pre and post-operative audiograms, post-operative pain, graft uptake, time taken for surgery and intra-operative visualization convenience were compared. Results Mean Air-Bone Gap closure at the end of six months was 9.23 dB (SD-0.88 dB) in the endoscope group and 8.95 dB (SD-0.66 dB) in microscope group whereas the graft uptake rate was 95.2% and 90.2% respectively. Post-operative pain, cosmesis, ease of doing surgery and time taken for surgery were better in ‘Endoscope’ as compared to ‘Microscope’ group. Conclusion The three flaps produce adequate exposure in very large or subtotal perforations, very thin anterior rim or with anterior bony overhang. Results in terms of mean hearing gain and graft uptake were comparable. In terms of morbidity (post-op pain), recovery (return to routine activity), mean duration of surgery and cosmesis, endoscopic surgery produced better outcome.

Ossiculoplasty using Autologous Reshaped Incus and Teflon PORP: A Comparative Study

Introduction Autologous reshaped Incus and Teflon partial ossicular replacement prosthesis (PORP) are commonly used for ossicular chain reconstruction. The present study attempts to assess the post-operative outcome with these two prostheses. Materials and Methods  A Randomized prospective study was conducted in Tertiary referral care hospital to determine which material, among autologous reshaped Incus and Teflon partial ossicular replacement prosthesis (PORP) gives better postoperative hearing result in Ossiculoplasty. Patients presenting at outpatients’ department with the clinical diagnosis of chronic otitis media with perforation or retraction. The study population consisted of a total of 50 patients. Ossiculoplasty with reshaped Incus or PORP was performed after Canal Wall Up mastoidectomy. Hearing results were measured by Air-Bone gap in PTA after 6 months of surgery. Results  Selecting the criteria <20 dB ABG as success when Stapes superstructure is present, Incus has 64.29% success rate, whereas PORP has 31.81% success. Extrusion rate of different prosthesis shows PORP has 18.18% extrusion whereas autologous Incus has lower (7.14%) extrusion rate. Conclusion  Among these two ossiculoplasty materials, autologous Incus gives better postoperative hearing gain and lower extrusion rate.

Use of Voice Handicap Index (VHI) as Predictor of Outcome of Non-surgical Treatment in Vocal Nodules

Introduction Vocal Nodule is commonest benign vocal cord lesion which causes varying degree of dysphonia having serious impact on personal and professional well being. Voice Handicap Index (VHI) is a psychometrically validated tool for measuring pshycosocial handicapping effect of voice disorder.   Materials and Methods From data available since last 18 months, patients who had undergone treatment for vocal nodule were selected as study population. In Group A, 50 patients were selected who required surgery and Group B, 50 patients who responded to medical treatment. Patients filled in VHI-30 form at time of diagnosis and subjected to voice therapy and adjunctive medical treatment for 1 month and reassessed using VHI-30. Successful treatment consisted of absence of pathology by laryngoscopy and decrease of VHI total score ≥18.   Results The cut-off score was calculated using Receiver Operating Characteristics (ROC). VHI cut-off of total score was 45 (Sensitivity 94%, Specificity76%). The cut-off score for functional, physical and emotional domains are 14(Sensitivity 94%, Specificity 64%) , 15(Sensitivity 92%, Specificity 60%) and 15(Sensitivity 90%, Specificity 66%) respectively.   Discussion Hard consistency of nodules can explain refractoriness to speech therapy and higher VHI score. The physical subscale of VHI was higher among both groups indicating patients’ perceptions of laryngeal discomfort and voice output affected them more. According to our study patients with higher VHI score should be counselled for MLS at earliest instead of speech therapy for one month which would not have given good outcome.   Conclusion These scores give a good idea about categories of patients who will not benefit by non-surgical treatment and hence early surgical intervention will obviate the duration of handicap and delay in appropriate treatment.

Urinary Ascites and Transient Intestinal Obstruction in a Preterm Infant: An Interesting Case of Posterior Urethral Valve

Posterior urethral valve (PUV) is the most common congenital cause of bladder outflow obstruction in male neonates. We report a preterm neonate with PUV who presented as nonimmune fetal hydrops with intestinal obstruction in the antenatal period. The mother of our patient is a 33-year-old woman who started her prenatal care at our hospital at 30 weeks' gestation. Her sonogram done at 32 weeks in our hospital revealed fetal hydrops. It showed polyhydramnios, mild pyelectasis of right kidney, normal left kidney, and fetal ascites. Amniocentesis revealed bile stained amniotic fluid. Ultrasound during the procedure showed dilated fetal bowel loops with increased echoes. Following delivery at 32 weeks postnatal exam showed ascites with absence of skin edema, pleural, or pericardial effusion. The abdominal sonogram showed distended urinary bladder and bilateral hydroureteronephrosis. Bladder catheterization was done which relieved the bladder outlet obstruction. Voiding cystourethrogram was done later which confirmed PUV and bilateral grade 5 vesicoureteral reflux. The formation of urinary ascites in PUV serves as a pop-off mechanism to relieve the intravesical and intrarenal pressure. When this happens by mechanisms other than bladder rupture, it can lead on to transient intestinal obstruction and hepatic synthetic defects.

Evolution of ligand-capped nanoparticle multilayers toward a near unique thickness

The structural evolution of thiol-capped Au-nanoparticle (AuNP) multilayers on a H-passivated Si substrate, formed through a Langmuir-Schaefer (LS) deposition process, has been investigated using complementary grazing incidence X-ray scattering techniques. The fractional coverage multilayers of AuNPs, formed through a multi-transfer process, are found to be quite unstable under ambient conditions. The thickness of these decreases with time and tends to saturate toward a near unique thickness (NUT ≈ 6 nm). Although initial low coverage and their instability create hindrance in the control and formation of desired 3D-nanostructures in the bottom-up approach, the formation of a NUT-layer, through time-evolution, is quite distinctive, thus interesting. It is clear from the evolution that the thermodynamically driven monolayer structures (of AuNPs) at the air-water interface become thermodynamically unstable when transferred sequentially onto the solid substrate. The thermal energy (kT) and the partial change in the substrate surface energy (Δγ) create the instability and induce diffusion in the AuNPs, which in the presence of a net attractive force towards the substrate (arising from anisotropic interaction of the top AuNPs with the other AuNPs and/or hydrophobic substrate) tries to create a thermodynamically favourable and relatively stable NUT-layer through reorganization for a different duration. This happens if the number of AuNPs is less than or equal to the maximum number that can be accommodated within the NUT. The value of the NUT mainly depends on the particle size and a kT-energy related fluctuation of particles. Furthermore, the formation of the NUT-layer indicates that the hydrophobic-hydrophobic interaction mediated net attraction towards the substrate is long range, while the hydrophilic-hydrophobic interaction mediated repulsion and/or kT-energy induced fluctuations are short range.

Non-inertial lift induced migration for label-free sorting of cells in a co-flowing aqueous two-phase system

We present a novel label-free passive microfluidic technique for isolation of cancer cells (EpCAM+ and CD45−) from peripheral blood mononuclear cells (PBMCs) (CD45+ and EpCAM−) in aqueous two-phase system (ATPS).

Prevalence and genotyping pattern of hepatitis C virus among patients on maintenance hemodialysis at five centers in Pune, India

Background

Worldwide prevalence of Hepatitis C virus (HCV) infection hemodialysis (HD) ranges from 1 to 84.6% with serious complications. Assessment of prevalence, risk factors, and genotyping of HCV infection in patient on HD was carried out at Pune, India.

Methods

A total of 250 patients on HD from five HD centers were recruited and tested for anti-HCV antibody using third-generation enzyme-linked immunosorbent assay (ELISA). Qualitative HCV RNA detection was carried out by nested reverse transcriptase polymerase chain reaction (RT-PCR). Genotyping and sequencing were carried out using the BigDye Terminator cycle sequencing ready reaction kit.

Results

Mean age of patients was 47.3 years. Forty-seven cases out of a total of 250 were reactor for HCV antibody. Overall prevalence rate was 18.8% ranging from 6.7% to 35.6% in the five centers. Of total, 44.1% of females and 13.5% of males were HCV infected. The mean duration of HD in HCV-infected patients was 6.03 years. Prevalence was higher in patients aged > 5 years on HD with higher number of blood transfusions. Thirty-six cases were positive for HCV RNA. Only one HCV RNA was detected among the 203 anti-HCV negative samples. Discordance between antibody and HCV RNA positivity was noted. Seventeen infected cases had changed dialysis centers four times. Thirteen cases were HBsAg positive, of which six cases were coinfected with HCV. Thirty-seven samples were genotyped.

Conclusion

The predominant genotype was 1a (54.1%) followed by 1b (43.2%) and 3a (2.7%). Highest prevalence of HCV (35.6%) and intracenter PNI of 99.3% of genotype 1b (84.6%) in center 3 indicates a possible nosocomial transmission.

Interfacial and thermal energy driven growth and evolution of Langmuir-Schaefer monolayers of Au-nanoparticles

Structures of Langmuir-Schaefer (LS) monolayers of thiol-coated Au-nanoparticles (DT-AuNPs) deposited on H-terminated and OTS self-assembled Si substrates (of different hydrophobic strength and stability) and their evolution with time under ambient conditions, which plays an important role for their practical use as 2D-nanostructures over large areas, were investigated using the X-ray reflectivity technique. The strong effect of substrate surface energy (γ) on the initial structures and the competitive role of room temperature thermal energy (kT) and the change in interfacial energy (Δγ) at ambient conditions on the evolution and final structures of the DT-AuNP LS monolayers are evident. The strong-hydrophobic OTS-Si substrate, during transfer, seems to induce strong attraction towards hydrophobic DT-AuNPs on hydrophilic (repulsive) water to form vertically compact partially covered (with voids) monolayer structures (of perfect monolayer thickness) at low pressure and nearly covered buckled monolayer structures (of enhanced monolayer thickness) at high pressure. After transfer, the small kT-energy (in absence of repulsive water) probably fluctuates the DT-AuNPs to form vertically expanded monolayer structures, through systematic exponential growth with time. The effect is prominent for the film deposited at low pressure, where the initial film-coverage and film-thickness are low. On the other hand, the weak-hydrophobic H-Si substrate, during transfer, appears to induce optimum attraction towards DT-AuNPs to better mimic the Langmuir monolayer structures on it. After transfer, the change in the substrate surface nature, from weak-hydrophobic to weak-hydrophilic with time (i.e. Δγ-energy, apart from the kT-energy), enhances the size of the voids and weakens the monolayer/bilayer structure to form a similar expanded monolayer structure, the thickness of which is probably optimized by the available thermal energy.

Pirfenidone inhibits post-traumatic proliferative vitreoretinopathy

PurposeThe purpose of the study was to evaluate the efficacy and safety of intravitreal pirfenidone for inhibition of proliferative vitreoretinopathy (PVR) in a model of penetrating ocular injury.Patients and methodsPenetrating trauma was induced on the retina of rabbit and treated either with 0.1 ml of phosphate-buffered saline (PBS) or 0.1 ml of 0.5% pirfenidone, and development of PVR was evaluated clinically and graded after 1 month. Histopathology and immunohistochemistry with transforming growth factor beta (TGFβ), alpha smooth muscle actin (αSMA), and collagen-1 were performed to assess the fibrotic changes. Expression of cytokines in the vitro-retinal tissues at different time points following pirfenidone and PBS injection was examined by RT-PCR. Availability of pirfenidone in the vitreous of rabbit at various time points was determined by high-performance liquid chromatography following injection of 0.1 ml of 0.5% pirfenidone. In normal rabbit eye, 0.1 ml of 0.5% pirfenidone was injected to evaluate any toxic effect.ResultsClinical assessment and grading revealed prevention of PVR formation in pirfenidone-treated animals, gross histology, and histopathology confirmed the observation. Immunohistochemistry showed prevention in the expression of collagen-I, αSMA, and TGFβ in the pirfenidone-treated eyes compared to the PBS-treated eyes. Pirfenidone inhibited increased gene expression of cytokines observed in control eyes. Pirfenidone could be detected up to 48 h in the vitreous of rabbit eye following single intravitreal injection. Pirfenidone did not show any adverse effect following intravitreal injection; eyes were devoid of any abnormal clinical sign, intraocular pressure, and electroretinography did not show any significant change and histology of retina remained unchanged.ConclusionThis animal study shows that pirfenidone might be a potential therapy for PVR. Further clinical study will be useful to evaluate the clinical application of pirfenidone.

Structures of spin-coated and annealed monolayer and multilayer poly(3-dodecylthiophene) thin films

The effects of film thickness and post annealing on the edge-on ordering and grain-size of spin-coated P3DDT films, which are of immense importance for their better device performances, were investigated using complementary XR and AFM techniques.

Growth of thiol-coated Au-nanoparticle Langmuir monolayers through a 2D-network of disk-like islands

Formation of 2D-networked structures of disk-like islands for ultrathin Langmuir–Schaefer (LS) films of thiol-coated Au-nanoparticles (DT-AuNPs) on H-passivated Si substrates is evidenced for the first time, by X-ray scattering data and AFM images.

Solvent dependent ordering of poly(3-dodecylthiophene) in thin films

The strong influence of solvents on the ordering of poly(3-dodecylthiophene) (P3DDT) due to edge-on oriented stacking, in the spin-coated thin film on the Si substrate, both near the substrate and away from it, depending upon the substrate surface nature, is observed from the X-ray reflectivity study. The absence of any appreciable amount of coil-like P3DDT chains (i.e. charge localized states) and formation of π-stacked aggregates (i.e. charge delocalized states) in the spin-coated thin films, with slightly better uniformity for the film prepared from toluene (TL) compared to that prepared from chloroform (CF) and chlorobenzene (CB), are well evident from the optical absorption study. No ordering near the weakly hydrophobic H-Si substrate is found in the films prepared from TL, probably due to less diffusion of P3DDT in TL and the appreciable pinning (film-substrate interaction) effect, while appreciable ordering near the film-air interface, overcoming the pinning effect, is likely to be related to the moderate values of the viscosity and the evaporation rate of the solvent. A better ordered Form-I-like relaxed structure near the film-substrate interface and a less ordered interpenetrating Form-II-like structure toward the film-air interface are found in the films prepared from CF, probably related to the low viscosity and high evaporation rate, respectively, of the solvent. Less ordered and mixed but more toward Form-II-like structures are formed throughout the film prepared from CB, probably due to the high viscosity of the solvent, even though its evaporation rate is low. The high evaporation rate of CF and high viscosity of CB probably create hindrance in the formation of continuous films on the weakly hydrophilic O-Si substrate at low speed, while the moderate values of both the parameters for TL, help to form continuous films on the O-Si substrate even at low speed. Such moderate values also help to form less variable (and more toward Form-I-like) structures and better ordering in the latter film. The relative fluctuation between aggregates along the film-thickness is, however, found slightly more in the film prepared from TL compared to that prepared from CF.

Poor solvent and thermal annealing induced ordered crystallites in poly(3-dodecylthiophene) films

The influence of poor solvent and thermal annealing, with their specific roles, in the crystalline ordering of P3DDT films, which is important to their performance as semiconducting materials, were investigated using complementary techniques.

pH-dependent size and structural transition in P123 micelle induced gold nanoparticles

The transition of the structure and size of AuNPs at a pH value around 9.5, from slowly grown, well-faceted, large (≫19 nm), less uniform and near connected to fast grown, near symmetrical, small (<19 nm), more uniform and well-separated, is observed.

A facile low temperature method for the synthesis of CoFe2O4 nanoparticles possessing excellent microwave absorption properties

CoFe₂O₄ nanoparticles, synthesized via a co-precipitation method at 120 °C, exhibited excellent microwave absorption properties, with minimum reflection loss of −55 dB (∼99.99%) at 9.25 GHz.

Preparation of nanoferrites and their applications

Ferrites have a plethora of applications in the myriad fields of technology. Ferrites are widely used in conventional electronic, electrical, and magnetic devices. For the past two decades, since the discovery of the superparamagnetic nature of nanostructured ferrites, their applications in biotechnology and biomedical sciences as well as in advanced electronics and microwave devices have gained immense attention. In this review, the historical development of ferrite science and technology, and the synthesis methods for ferrite nanoparticle preparation and their applications have been discussed. Various synthetic methods with typical examples, their advantages as well as limitations have been discussed in details. Traditional industrial applications of various ferrites have also been discussed citing relevant patents. Recent developments on nanoferrite research in terms of synthetic methods as well as advanced applications have been discussed elaborately.

Long-term type 1 diabetes influences haematopoietic stem cells by reducing vascular repair potential and increasing inflammatory monocyte generation in a murine model

AIMS/HYPOTHESIS

We sought to determine the impact of long-standing type 1 diabetes on haematopoietic stem/progenitor cell (HSC) number and function and to examine the impact of modulating glycoprotein (GP)130 receptor in these cells.

METHODS

Wild-type, gp130(-/-) and GFP chimeric mice were treated with streptozotocin to induce type 1 diabetes. Bone marrow (BM)-derived cells were used for colony-formation assay, quantification of side population (SP) cells, examination of gene expression, nitric oxide measurement and migration studies. Endothelial progenitor cells (EPCs), a population of vascular precursors derived from HSCs, were compared in diabetic and control mice. Cytokines were measured in BM supernatant fractions by ELISA and protein array. Flow cytometry was performed on enzymatically dissociated retina from gfp(+) chimeric mice and used to assess BM cell recruitment to the retina, kidney and blood.

RESULTS

BM cells from the 12-month-diabetic mice showed reduced colony-forming ability, depletion of SP-HSCs with a proportional increase in SP-HSCs residing in hypoxic regions of BM, decreased EPC numbers, and reduced eNos (also known as Nos3) but increased iNos (also known as Nos2) and oxidative stress-related genes. BM supernatant fraction showed increased cytokines, GP130 ligands and monocyte/macrophage stimulating factor. Retina, kidney and peripheral blood showed increased numbers of CD11b(+)/CD45(hi)/ CCR2(+)/Ly6C(hi) inflammatory monocytes. Diabetic gp130(-/-) mice were protected from development of diabetes-induced changes in their HSCs.

CONCLUSIONS/INTERPRETATION

The BM microenvironment of type 1 diabetic mice can lead to changes in haematopoiesis, with generation of more monocytes and fewer EPCs contributing to development of microvascular complications. Inhibition of GP130 activation may serve as a therapeutic strategy to improve the key aspects of this dysfunction.

Abstract S5-7: Combined Blockade of PI3K/AKT and EGFR/HER3 Enhances Anti-Tumor Activity in Triple Negative Breast Cancer

Background: Up to 60% of triple negative breast cancers (TNBCs) express high levels of EGFR (HER1). Moreover, TNBCs are associated with increased frequency of phosphatase and tension homologue (PTEN) loss of function, leading to hyperactivation of the phosphoinositide 3-kinase (PI3K)/AKT pathway. This provides the rationale for using PI3K/AKT inhibitors in this subset of patients. However, compensatory expression of receptor tyrosine kinases (RTKs) such as HER3 may limit efficacy of PI3K/AKT inhibitors. Therefore, we hypothesize that combined targeting of both HER family receptors and the PI3K/AKT pathway will result in superior antitumor activity compared to single agent blockade in TNBC.

Materials and Methods: TNBC cell lines MDA-MB-231, MDA-MB-468, HCC70, HCC1143 and HCC1937 were treated with MEHD7945A, a dual-action antibody that targets both EGFR and HER3, AKT inhibitor GDC0068, and pan-PI3K inhibitor GDC0941. Cell viability was measured by CellTiter-Glo and Crystal Violet. Both cell line- and patient-derived xenograft models of TNBC were grown subcutaneously in Nu/Nu mice and then treated with MEHD7945A, GDC0068, GDC0941, or the combination of MEHD7945A with either GDC0068 or GDC0941. Tumor size and histology were examined. Circulating tumor cells (CTCs) were isolated from murine peripheral blood by Herring Bone CTC chip. Protein expression was measured by Western blot, Reverse Phase Protein Analysis (RPPA), and immunohistochemistry.

Results: GDC0068 and GDC0941 treatment resulted in variable inhibition of cell viability, with IC50s ranging from 170 nM to &gt;1 µM across all TNBC cell lines. Under full-serum (10% FBS) conditions, MEHD7945A led to a very mild decrease in cell viability in vitro. Combination treatments were modestly more effective than monotherapy in vitro. In vivo, MEHD7945, GDC0941 and GDC0068 showed variable delay in tumor growth whereas combination of MEHD7945A with either GDC0068 or GDC0941 was superior to single agent treatment. While untreated tumors increased over 14 fold in size, tumor growth of MEHD7945, GDC0941 and GDC0068 treated xenografts reached 6, 4 and 2.5 fold increase respectively. However, both combination arms prevented tumor growth, with complete responses achieved in 1/9 mice in each of the combination cohorts. Of note, all the treatments (up to 9 weeks of therapeutic exposure) were well tolerated. Analysis of treated tumors reveals potent inhibition of the PI3K/AKT pathway, with decreased levels phospho-PRAS40, and phospho-S6, as well as decreased expression of total EGFR and HER3. Circulating tumor cells are being used as surrogate markers of pathway inhibition.

Conclusions: Combined therapy with MEHD7945A and either GDC0068 or GDC0941 was superior to monotherapy in preclinical models of TNBC. We observed significantly greater effect with the combination treatment in vivo compared to in vitro. We are currently exploring whether expression/activation of the HER receptors following PI3K/Akt blockade are accentuated in vivo. Additionally, this may be the first mouse model enabling CTC collection from subcutaneous xenografts, allowing for real-time pharmacodynamic investigation. These findings provide the rationale for combined targeting of PI3K/AKT and EGFR/HER3 in triple negative breast cancers.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr S5-7.

Role of metal ions in growth and stability of Langmuir-Blodgett films on homogeneous and heterogeneous surfaces

Structure and stability of cadmium arachidate (CdA) Langmuir-Blodgett (LB) films on homogeneous (i.e., OH-, H-passivated Si(001) substrates) and heterogeneous (i.e., Br-passivated Si(001) substrates) surfaces were studied using X-ray reflectivity and atomic force microscopy techniques and compared with those of nickel arachidate (NiA) LB films. While on OH-passivated Si, an asymmetric monolayer (AML) structure starts to grow, on H-passivated Si, a symmetric monolayer (SML) of CdA forms, although for both the films, pinhole-type defects are present as usual. However, on heterogeneous Br-passivated Si substrates, a combination of AML, SML, shifted SML and SML on top of AML (i.e., AML/SML), all types of structures are found to grow in such a way that, due to the variation of heights in the out-of-plane direction, ring-shaped in-plane nanopatterns of CdA molecules are generated. Probably due to stronger head-head interactions and higher metal ion-carboxylic ligand bond strength for CdA molecules compared to NiA, easy flipping of SML on top of another preformed SML, i.e. a SML/SML structure formation was not possible and as a result a wave-like modulation is observed for the CdA film on such heterogeneous substrate. The presence of hydrophilic/hydrophobic interfacial stress on the heterogeneous substrate thus modifies the deposited molecular structure so that the top surface morphology for a CdA film is similar to monolayer buckling while that for NiA film is similar to monolayer collapse.

P3-18-04: Pathway Guided Selection of Targeted Inhibitors for Breast Cancer Treatment

Background: The ability to functionally profile a whole spectrum of pathway proteins in tumor may provide valuable information about the likelihood of drug response and potential mechanisms for drug resistance in breast cancer (BCA) patients. Here we report a comprehensive pathway analysis of membrane associated kinases such as HER1, HER2, HER3, cMET, IGF1R, PI3K and downstream signal transduction proteins including Shc, AKT, ERK, MEK, PDK1, PRAS40, p70S6K and eIF4e in breast cancer cell lines and xenografts as in response to inhibitors targeting the Her1/Her2 and PI3K/AKT and MAPK pathways. For comparison we also analyzed NSCLC lines driven by other receptor tyrosine kinases like EGFR and MET. Methods: Lysates prepared from KPL4 cells and MCF7 cells both harboring PIK3CA mutations (with HER2−amplification and low level HER2 expression, respectively) treated with 6 inhibitors (an allosteric AKT inhibitor, Lapatinib, Regorafenib, MET inhibitor, an allosteric MEK inhibitor or PI3K inhibitor) targeting PI3K/AKT and MAPK pathways were analyzed for modulations of pathway protein phosphorylation using a multiplexed immuno-micorarray.

Tissue lysates prepared from KPL4 xenografts treated with AKT inhibitor were analyzed for pathway modulation in response to the drug treatment. The pathway activation profile shift in response to drug treatments in BCA models are compared to other tumor type models with diverse oncogenic backgrounds.

Results: The level of phosphorylated AKT (pAKT) was reduced when MCF7 cells were treated with AKT inhibitor as well as PI3K inhibitor. However, compensatory AKT activation was observed when these cells were treated with BRAF or MEK inhibitor. KPL4 cells also showed reduction of pAKT when treated with Lapatinib, AKT inhibitor or PI3K inhibitor. Compensatory hyper-phosphorylation of ERK (pERK) was observed in both cell lines and KPL4 xenografts with AKT inhibitor treatment while PI3K inhibition did not induce hyper-ERK phosphorylation. Reduction of pERK level was observed when both cell lines were treated with MEK inhibitor. Downstream analytes like PRAS40 and RPS6 summarize PI3K/AKT pathway activity and correlate well with response to treatment whereas eIF4e is a good final readout for activity in the RAS/RAF/MEK/ERK pathway. Treatment with single agents often even shows adverse profile shift through feedback or pathway cross-talk. The comparative analysis of pathway modulation in BCA models to other tumor types in response to drug treatments revealed several adaptive drug resistance mechanism with different oncogenic backgrounds.

Discussion: Evaluation of drug specific pathway modulations in cancer cells provided comprehensive information on efficacy of specific agents on target protein and pathway inhibition. Multiplexed pathway analysis provides valuable information for drug resistance mechanisms due to either redundant pathway activation, cross-talk or through feedback mechanism and may guide appropriate selection of targeted drug-combinations or drug-sequencing in clinical setting. For example, the observed increase in ERK phosphorylation due to AKT inhibition could be blocked by combination therapy with a MEK inhibitor.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-18-04.

Stability and Nanostrucure of Heterogeneous Amorphous Silicon Thin-Film Synthesized Under High Chamber Pressure (500 To 2200 Mtorr) Regime of Rf Pecvda

We report on improvement in stability of a new type of amorphous silicon films, synthesized (growth rate > 0.1 nm/s) by driving the plasma condition close to the powder regime (or “γ-regime”) of rf PECVD. These films exhibit high mobility-lifetime products [(μτ)annld ∼ 10−4 cm2/V, σph/σd ∼ 5-10×105, Ea ≍ 0.7 - 0.9 eV ], compact network structure [CH ≍ 7 to 8 at%, nanovoid density < 0.01 %, ρ ≍ 2.23 ± 0.01 gm/cm3], new features of optical properties and density-of-state (DOS) above EF is significantly lower than that of state-of-the art films. The kinetics of light-induced (AM 1.5) degradation of μτ is very fast and saturated μτ ∼ 10−6cm2/V, a value similar to that of conventional a-Si:H films at annealed state. The improved stability of “new” a-Si films, henceforth it will be denoted as “quasi-amorphous silicon (qm-Si) thin- film”, will be correlated with its specific nanostructure.