Bacillus tequilensis influences metabolite production in tomato and restores soil microbial diversity during Fusarium oxysporum infection

This study evaluates cellular damage, metabolite profiling, and defence-related gene expression in tomato plants and soil microflora during Fusarium wilt disease after treatment with B. tequilensis PBE-1. Histochemical analysis showed that PBE-1 was the primary line of defence through lignin deposition and reduced cell damage. GC-MS revealed that PBE-1 treatment ameliorated stress caused by F. oxysporum infection. PBE-1 also improved transpiration, photosynthesis, and stomatal conductance in tomato. qRT-PCR suggested that the defence-related genes FLS2, SERK, NOS, WRKYT, NHO, SAUR, and MYC2, which spread infection, were highly upregulated during F. oxysporum infection, but either downregulated or expressed normally in PBE-1 + P treated plants. This indicates that the plant not only perceives the bio-control agent as a non-pathogen entity but its presence in normal metabolism and gene expression within the host plant is maintained. The study further corroborated findings that application of PBE-1 does not cause ecological disturbances in the rhizosphere. Activity of soil microflora across four treatments, measured by Average Well Colour Development (AWCD), showed continuous increases from weeks 1 to 4 post-pathogen infection, with distinct substrate usage patterns like tannic and fumaric acids impacting microbial energy source utilization and diversity. Principal Component Analysis (PCA) and diversity indices like McIntosh, Shannon, and Simpson further illustrated significant microbial community shifts over the study period. In conclusion, our findings demonstrate that B. tequilensis PBE-1 is an ideal bio-agent for field application during Fusarium wilt disease management in tomato.

Clinicopathological Profile and Survival Outcomes in Patients with Localised Extremity Synovial Sarcomas

AIMS

Synovial sarcoma is a rare but aggressive variant of soft-tissue sarcoma. Literature is sparse and reported mostly from the West. We analysed the clinical profiles and prognostic factors of extremity synovial sarcoma patients in order to study their clinical journey.

MATERIALS AND METHODS

This was a retrospective analysis. All patients with extremity synovial sarcoma treated between 1992 and 2020 were included. Patients with metastases at presentation were excluded. A descriptive analysis of demographic and clinicopathological features of patients undergoing limb salvage surgery (LSS) or amputation was carried out. Overall survival and disease-free survival were calculated for the entire cohort as well as for the LSS and amputation groups. Factors prognostic for survival were identified.

RESULTS

In total, 157 patients had localised extremity synovial sarcoma. Predominantly, young adults (median 31 years) and males (61%) were affected. Over 70% of patients presented after recurrence or unplanned surgeries. Sixty-seven per cent of tumours were >5 cm, 69% were deep and 23% involved bone. The limb salvage rate was 64%. In the LSS group, adjuvant radiotherapy and chemotherapy were given to 72% and 68% of patients, respectively. In the amputation group, 72% of patients received adjuvant chemotherapy. In a median follow-up of 59 months, 39.4% of patients had recurrences, the majority (61.2%) were systemic. Five-year overall survival and disease-free survival were 53.4% and 49.8%, respectively. Overall survival was 63.9% and 29.7% in the LSS and amputation groups, respectively. On multivariate analysis, tumour size, depth, omission of radiotherapy and bone invasion were found to be the adverse prognostic factors.

CONCLUSION

This is one of the largest studies on extremity synovial sarcoma. Mostly males and young adults were affected. The limb salvage rate was 64%, despite most being referred after unplanned surgery. Almost 70% of patients received radiotherapy and chemotherapy. Overall survival was inferior in the amputation group. Tumour size >5 cm, depth and bone invasion were negative, whereas adjuvant radiotherapy was a positive prognostic factor for survival. Chemotherapy had no impact on survival.

Vasoactive Intestinal Peptide Receptor, CRTH2, Antagonist Treatment Improves Eosinophil and Mast Cell-Mediated Esophageal Remodeling and Motility Dysfunction in Eosinophilic Esophagitis

BACKGROUND AND AIMS

Ultrasonography has shown that eosinophils accumulate in each segment of the esophageal mucosa in human EoE, ultimately promoting esophageal motility dysfunction; however, no mechanistic evidence explains how or why this accumulation occurs.

METHODS

Quantitative PCR, ELISA, flow cytometry, immunostaining, and immunofluorescence analyses were performed using antibodies specific to the related antigens and receptors.

RESULTS

In deep esophageal biopsies of EoE patients, eosinophils and mast cells accumulate adjacent to nerve cell-derived VIP in each esophageal segment. qRT-PCR analysis revealed five- to sixfold increases in expression levels of VIP, CRTH2, and VAPC2 receptors and proteins in human blood- and tissue-accumulated eosinophils and mast cells. We also observed a significant correlation between mRNA CRTH2 levels and eosinophil- and nerve cell-derived VIPs in human EoE (p < 0.05). We provide evidence that eosinophil and mast cell deficiency following CRTH2 antagonist treatment improves motility dysfunction in a chronic DOX-inducible CC10-IL-13 murine model of experimental EoE.

CONCLUSIONS

CRTH2 antagonist treatment is a novel therapeutic strategy for inflammatory cell-induced esophageal motility dysfunction in IL-13-induced chronic experimental EoE.

Making bioinformatics training FAIR: the EMBL-EBI training portal

EMBL-EBI provides a broad range of training in data-driven life sciences. To improve awareness and access to training course listings and to make digital learning materials findable and simple to use, the EMBL-EBI Training website, www.ebi.ac.uk/training, was redesigned and restructured. To provide a framework for the redesign of the website, the FAIR (findable, accessible, interoperable, reusable) principles were applied to both the listings of live training courses and the presentation of on-demand training content. Each of the FAIR principles guided decisions on the choice of technology used to develop the website, including the details provided about training and the way in which training was presented. Since its release the openly accessible website has been accessed by an average of 58,492 users a month. There have also been over 12,000 unique users creating accounts since the functionality was added in March 2022, allowing these users to track their learning and record completion of training. Development of the website was completed using the Agile Scrum project management methodology and a focus on user experience. This framework continues to be used now that the website is live for the maintenance and improvement of the website, as feedback continues to be collected and further ways to make training FAIR are identified. Here, we describe the process of making EMBL-EBI's training FAIR through the development of a new website and our experience of implementing Agile Scrum.

Comparative assessment of immunogenicity of recombinant insulin Aspart from BioGenomics and its originator NovoRapid® in adult patients with type 2 diabetes mellitus

OBJECTIVES

To assess and compare the immunogenicity of recombinant Insulin Aspart [manufactured by BioGenomics Limited (BGL-ASP)] with its originator NovoRapid® (manufactured by Novo Nordisk) in adult patients with type 2 diabetes mellitus.

RESEARCH DESIGN AND METHODS

BGL-IA-CTP301 study was a randomized, open label, parallel group, multicenter phase-III clinical study to compare the efficacy and safety of recombinant Insulin Aspart 100 U/mL [manufactured by BioGenomics Limited (BGL-ASP)] with its reference medicinal product (RMP); NovoRapid® [manufactured by Novo Nordisk], in adult patients with Type 2 diabetes mellitus (T2DM). The primary objective of the study was to compare the immunogenicity of BGL-ASP and RMP; NovoRapid® in patient serum samples collected from phase-III clinical study. Immunogenicity was studied as the incidence of patients positive for anti-insulin Aspart (AIA) antibodies, developed against BGL-ASP/RMP at baseline, end of 12 week and end of 24 week of the treatment period. The changes in incidence of patients positive for AIA antibodies post-baseline were also studied to assess and compare the treatment-emergent antibody response (TEAR) between the treatment groups (BGL-ASP and RMP). Statistical evaluation was done by Fisher's exact test to compare the overall incidence of patients positive for AIA antibodies and the TEAR positives observed post-baseline in both the treated groups. An in-vitro neutralizing antibody assay (Nab assay) was also performed to study the effect of AIA antibodies in neutralizing the biological activity/metabolic function of the insulin. The neutralizing potential of AIA was studied by its effect on %glucose uptake. We also evaluated the association between AIA antibody levels and its impact on biological activity by studying the correlation between them.

RESULTS

Analysis of immunogenicity data suggested that the percentage of patients positive for AIA antibodies until week 24 was similar and comparable in both the treatment groups, BGL-ASP and RMP; NovoRapid®. The changes in incidence of patients positive for AIA post-baseline in terms of TEAR positives were also similar and comparable between the treatment groups. The results of the Nab assay with confirmed positive AIA samples from BGL-ASP- and RMP-treated groups did not have any negative impact on %glucose uptake by the cells in Nab assay, confirming the absence of neutralizing antibodies in both the treatment groups. The correlation studies also showed absence of association between AIA antibody levels and percentage glucose uptake in both BGL-ASP and RMP-NovoRapid® treatment groups. CONCLUSIONS: The immunogenicity assessment based on the overall incidence of patients positive for AIA, changes in incidence of patients positive for AIA post-baseline, TEAR rates and absence of neutralizing antibodies, were found to be apparently similar and comparable in both the treatment groups (BGL-ASP and RMP). We conclude from our studies that the immunogenicity of BGL-ASP is similar and comparable to RMP and the observed immunogenicity in terms of anti-insulin Aspart antibody levels had no impact on the biological activity of insulin.

Gasless laparoscopy in rural India-registry outcomes and evaluation of the learning curve

BACKGROUND

A program of gasless laparoscopy (GL) has been implemented in rural North-East India. To facilitate safe adoption, participating rural surgeons underwent rigorous training prior to independent clinical practice. An online registry was established to capture clinical data on safety and efficacy and to evaluate initial learning curves for gasless laparoscopy.

METHODS

Surgeons who had completed the GL training program participated in the online RedCap Registry. Patients included in the registry provided informed consent for the use of their data. Data on operative times, conversion rates, perioperative complications, length of stay, and hospital costs were collected. Fixed reference cumulative sum (CUSUM) model was used to evaluate the learning curve based on operative times and conversion rates published in the literature.

RESULTS

Four surgeons from three rural hospitals in North-East India participated in the registry. The data were collected over 12 months, from September 2019 to August 2020. One hundred and twenty-three participants underwent GL procedures, including 109 females (88.6%) and 14 males. GL procedures included cholecystectomy, appendicectomy, tubal ligation, ovarian cystectomy, diagnostic laparoscopy, and adhesiolysis. The mean operative time was 75.3 (42.05) minutes for all the surgeries. Conversion from GL to open surgery occurred in 11.4% of participants, with 8.9% converted to conventional laparoscopy. The main reasons for conversion were the inability to secure an operative view, lack of operating space, and adhesions. The mean length of stay was 3 (2.1) days. The complication rate was 5.7%, with one postoperative death. The CUSUM analysis for GL cholecystectomy showed a longer learning curve for operative time and few conversions. The learning curve for GL tubal ligation was relatively shorter.

CONCLUSION

Gasless laparoscopy can be safely implemented in the rural settings of Northeast India with appropriate training programs. Careful case selection is essential during the early stages of the surgical learning curve.

A systematic review and meta-analysis of the sources of Campylobacter in poultry production (preharvest) and their relative contributions to the microbial risk of poultry meat

A systematic review and meta-analysis were conducted to idetnify the relative contributions of the sources of Campylobacter in poultry live production to Campylobacter prevalence of broiler meat. The keywords of Campylobacter, prevalence, live production, and broiler were used in Google Scholar to address the research interest. A total of 16,800 citations were identified, and 63 relevant citations were included in the meta-analysis after applying predetermined inclusion and exclusion criteria. A generalized linear mixed model approach combined with logit transformation was used in the current meta-analysis to stabilize the variance. The analysis revealed that Campylobacter is ubiquitous in the poultry house exterior environment including surroundings, wildlife, domestic animals, and farm vehicle, with a predicted prevalence of 14%. The recovery of Campylobacter in the interior environment of the poultry house is far less abundant than in the exterior, with a prevalence of 2%, including litter, water, insects, mice, feed, and air. A lack of evidence was observed for vertical transmission due to the day-old chicks being free of Campylobacter from 4 studies identified. Live birds are the predominant carrier of Campylobacter, with a predicted prevalence of 41%. Transportation equipment used for live haul had an overall prevalence of 39%, with vehicles showing a predicted prevalence of 44% and crates with a predicted prevalence of 22%. The results of this meta-analysis highlight the need to implement effective biosecurity measures to minimize the risk of Campylobacter in poultry meat, as human activity appears to be the primary factor for Campylobacter introduction.

Synthesis and in silico studies of some new pyrrolidine derivatives and their biological evaluation for analgesic and anti-inflammatory activity

BACKGROUND

An array of commercially viable intermediate molecules necessary for the synthesis of a variety of bioactive molecules are chemically synthesized by pyrrolidine and its derivatives, which play a significant role in drug design and development process.

AIM

The aim of the present research work was to explore the synthesis of some new pyrrolidine derivatives and to perform their in silico studies and finally evaluation of analgesic and anti-inflammatory activity.

OBJECTIVE

The purpose of this study was to synthesis new pyrrolidine derivatives, examine how they affected the COX-1 and COX-2 enzymes computationally, and to screen their in vivo analgesic and anti-inflammatory activity on laboratory animals.

METHOD

The new pyrrolidine derivatives were synthesized by condensing N-(3-acetylphenyl)-2-(pyrrolidin-1-yl)acetamide with substituted aniline in ethanol in the presence of catalytic amounts of glacial acetic acid. The structures of novel pyrrolidine derivatives were characterised using IR, NMR, and mass spectroscopy. Several molecular properties of the newly synthesized derivatives were calculated in order to evaluate the nature of the drug-like candidate. A specific reference cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzyme was used to dock the newly synthesized pyrrolidine derivatives.

RESULTS

From the observed data, it was noted that amongst all newly synthesized compounds, A-1 and A-4 exhibited the highest anti-inflammatory and analgesic effects, respectively.

CONCLUSION

On the basis of findings of present research, it was concluded that A-1 and A-4 might be utilized as a promising new lead compound for Non-Steroidal Anti-Inflammatory Drug (NSAIDs) development.

Allergen-induced NLRP3/caspase1/IL-18 signaling initiate eosinophilic esophagitis and respective inhibitors protect disease pathogenesis

The current report describes a stepwise mechanistic pathway of NLRP3/caspase1/IL-18-regulated immune responses operational in eosinophilic esophagitis (EoE). We show that esophageal epithelial cells and macrophage-derived NLRP3 regulated IL-18 initiate the disease and induced IL-5 facilitates eosinophil growth and survival. We also found that A. fumigatus-exposed IL-18^-/- mice or IL-18-neutralized mice are protected from EoE induction. Most importantly, we present that intravascular rIL-18 delivery to ΔdblGATA mice and CD2-IL-5 mice show the development of EoE characteristics feature like degranulated and intraepithelial eosinophils, basal cell hyperplasia, remodeling and fibrosis. Similarly, we show an induced NLRP3-caspase1-regulated IL-18 pathway is also operational in human EoE. Lastly, we present the evidence that inhibitors of NLRP3 and caspase-1 (MCC950, BHB, and VX-765) protect A. fumigatus- and corn-extract-induced EoE pathogenesis. In conclusion, the current study provides a new understanding by implicating NLRP3/caspase1-regulated IL-18 pathway in EoE pathogenesis. The study has the clinical significance and novel therapeutic strategy, which depletes only IL-18-responsive pathogenic eosinophils, not naïve IL-5-generated eosinophils critical for maintaining innate immunity.

A rare case of syphilitic Charcot joint involving left elbow

Charcot arthropathy is characterized by joint dislocations, pathologic fractures, and debilitating deformities. Syphilis was believed to be the most common cause of Charcot arthropathy a century back, but now, it is one of the rare causes which get missed in the routine evaluation. We present a rare case of syphilitic Charcot joint in a middle aged, paraplegic, wheel-chaired bound male, who presented with a history of recurrent painless joint swelling. He underwent multiple surgeries on the left elbow to deal with his soft tissues and bony infections along with multiple courses of systemic high end antibiotics including anti-tubercular drugs without much benefit. He was even planned for midarm amputation. Timely opinion of dermatologist and correct interpretation of serological tests clinched the diagnosis. This case highlights a high index of suspicion and correct interpretation of serological test of syphilis is essential to diagnose tertiary syphilis. Timely management with injection benzathine penicllin resulted in life time gratifying outcome.

A systematic review and meta-analysis of the sources of Salmonella in poultry production (pre-harvest) and their relative contributions to the microbial risk of poultry meat

Salmonella is a major foodborne pathogen associated with poultry and poultry products and a leading cause for human salmonellosis. Salmonella is known to transmit in poultry flocks both vertically and horizontally. However, there is a lack of knowledge on relative contribution of the factors on Salmonella prevalence in poultry live production system including hatchery, feed, water, environment-interior, and -exterior. Therefore, a systematic review and meta-analysis was conducted to quantify the potential sources of Salmonella during preharvest and their relative contributions to the microbial risk of poultry meat. A total of 16,800 studies identified from Google Scholar and 37 relevant studies were included in the meta-analysis for relative contributions to Salmonella positivity on broilers after applying exclusion criteria. A generalized linear mixed model approach combined with logit transformation was used in the current study to stabilize the variance. The analysis revealed that the hatchery is the most significant contributor of Salmonella with a prevalence of 48.5%. Litter, feces, and poultry house internal environment were the other 3 major contributing factors with a prevalence of 25.4, 16.3, and 7.9%, respectively. Moreover, poultry house external environment (4.7%), feed (4.8%), chicks (4.7%), and drinker water also contributed to the Salmonella positivity. Results from this meta-analysis informed the urgent need for controls in live production to further reduce Salmonella in fresh, processed poultry. The control strategies can include eliminating the sources of Salmonella and incorporating interventions in live production to reduce Salmonella concentrations in broilers.

An analysis of the dynamic role of lipids in the progression and development of cardiovascular disease

The main cause of mortality around the globe is cardiovascular disease (CVD). There are several indications followed by experimental validation that dysfunctional lipotoxicity is one of the primary causes of cardiovascular illnesses such as atherosclerosis, “coronary heart disease”, (CHD), and hypertension. Obesity and diabetes raise the number of circulating lipids, which may enhance the production of harmful intermediates and cause issues related to cardiovascular disorders. Effective and affordable medicines to lower cardiovascular risk are desperately required. Lipids or lipoprotein particles play a critical role in atherosclerosis, the pathophysiology behind CVD. They also have an effect on inflammatory processes, vascular or cardiac cell function, leukocyte activity, and ultimately the health of the heart and blood arteries. In this paper, an attempt was made to identify the cause of lipid buildup that led to the pathophysiology of cardiovascular disorders as well as the processes behind lipotoxicity. A summary of current and developing treatment approaches to decrease the incidence of lipid-induced cardiovascular disease is also compiled through previous studies.

IL-18-mediated neutrophil recruitment promotes acute lung injury in inflammation-mediated chronic pancreatitis

Lung injury is the most common secondary complication of pancreatitis and pancreatic malignancy. Around 60-70% of pancreatitis-related deaths are caused by lung injury; however, there is no animal model of the inflammation-mediated progressive pulmonary pathological events that contribute to acute lung injury in chronic pancreatitis (CP). Hence, we developed an inflammation-mediated mouse model and studied the pathological events that have a critical role in promoting the pathogenesis of lung injury. Our proteomic analysis of lung tissue revealed neutrophil-associated induction of neutrophil gelatinase-associated lipocalin (NGAL) and myeloperoxidase enzyme, further supporting a role for neutrophils in promoting IL-18-associated lung injury. We show that neutrophils released IL-18-induced p-NF-κB along with profibrotic and oncogenic proteins like TTF1, PDX1, and SOX9 in lung tissues of a mouse model of chronic pancreatitis. We also show that neutrophil infiltration induces TGF-β and SMAD4 and activates epithelial cells to produce other profibrotic proteins like ZO-1 and MUC2, along with the fibroblast markers FGF-1 and αSMA, that cause mesenchymal transition and accumulation of extracellular matrix collagen. Most importantly, we present evidence that IL-18 inhibition significantly alleviates CP-induced lung injury. This was further established by the finding that IL-18 gene-deficient mice showed improved lung injury by inhibition of TGF-β and fibroblast to mesenchymal transition and reduced collagen accumulation. The present study suggests that inhibition of IL-18 may be a novel treatment for CP-associated induced acute lung injury.

Potential protective effects of isoflavones in effective management of cardiovascular diseases

For human life, health, and biological growth, nutrition is crucial. A prominent example of a food that is nutrient rich at the moment is "Soybean”. In Asian nations, it is thought to be a significant source of proteins and may be used in place of dairy products and meat. When compared to other food legumes, soybeans offer several nutritional benefits in terms of their composition in macro- and micronutrients. As more information on negative effects of chemical treatments is being available to people, they are now is search of potential phytocompounds. The aim of the present review is to provide potential evidence of isoflavones in management of cardiovascular diseases like heart failure, myocardial infarction, hypertension and coronary artery disease. Nevertheless, soy isoflavones can have certain adverse consequences since they are endocrine disruptors. Thyroid function abnormalities have sparked concerns. In light of the aforementioned findings, an effort has been undertaken to examine the literature on the beneficial and harmful roles of isoflavones, soy-derived bioactive compounds.

Development and Characterization of Novel Chronic Eosinophilic Inflammation- Mediated Murine Model of Malignant Pancreatitis

AIMS

Develop a novel murine models of malignant pancreatitis.

BACKGROUND

Although patients with chronic pancreatitis are at a greater risk of developing pancreatic cancer, there is no definitive mouse model that currently develops chronic pancreatitis-induced pancreatic cancer.

OBJECTIVE

Characterization of eosinophilic inflammation-mediated malignant pancreatitis in novel murine model.

METHODS

We developed a murine model of chronic eosinophilic inflammation associated with pancreatitis that also shows characteristic features of pancreatic malignancy. The mouse received cerulein and azoxymethane via intraperitoneal administration developed pathological malignant phenotype, as well as concomitant lung inflammation.

RESULTS

We discovered pathological alterations in the pancreas that were associated with chronic pancreatitis, including a buildup of eosinophilic inflammation. Eosinophil degranulation was reported nearby in the pancreas tissue sections that show acinar-to-ductal metaplasia and acinar cell atrophy, both of which are characteristic of pancreatic malignancies. Additionally, we also observed the formation of PanIN lesions after three initial doses of AOM and eight weeks of cerulein with the AOM treatment regimen. We discovered that persistent pancreatic eosinophilic inflammation linked with a pancreatic malignant phenotype contributes to pulmonary damage. The RNA seq analysis also confirmed the induction of fibro-inflammatory and oncogenic proteins in pancreas and lung tissues. Further, in the current manuscript, we now report the stepwise kinetically time-dependent cellular inflammation, genes and proteins involved in the development of pancreatitis malignancy and associated acute lung injury by analyzing the mice of 3 AOM with 3, 8, and 12 weeks of the cerulein challenged protocol regime.

CONCLUSION

We first show that sustained long-term eosinophilic inflammation induces time-dependent proinflammatory, profibrotic and malignancy-associated genes that promote pancreatic malignancy and acute lung injury in mice.

Primary synovial chondromatosis of the hip joint (PrSC of the hip): A retrospective cohort analysis and review of the literature

Introduction

Primary synovial osteochondromatosis (SOCM) or Synovial chondromatosis (SC) of the hip is a benign metaplastic condition of the synovium that is rare and may present with a spectrum of clinical features and radiological findings.

Patients and methods

A retrospective search using the keyword 'Synovial chondromatosis' (SC) of the hip was performed at a tertiary care orthopaedic referral centre in the UK and a hospital in India. The radiology images were collected from our Picture Archiving and Communication System (PACS) and Radiology Information System (RIS), over 15 years. The patient's data was collated with Electronic Patient Records (EPR), RIS, and correlated with histo-pathology laboratory records where available. The demographic details of the patients, their clinical symptoms, imaging details, and management outcomes were collected.

Results

We found 15 cases, with a mean age of 36.53 years (range: 14-50 years). There were 9 male and 6 female patients. The follow-up ranged from 1 year to 6 years. Predominantly unilateral presentation with insidious onset of symptoms was found. A spectrum of radiological Imaging was undertaken. Management strategies included supervised observation, arthroscopic or open synovectomy, and hip arthroplasty. No malignant transformation was found in the analysed cohort.

Conclusion

Primary 'Synovial chondromatosis' of the hip had a male preponderance in our cohort, presenting with a range of clinical features. Radiologically, Magnetic Resonance Imaging (MRI) was the commonest modality of cross-sectional imaging utilised and crucial for the diagnosis, evaluating underlying articular involvement including guiding appropriate patient management presenting with Primary 'Synovial chondromatosis' of the hip.

Non-destructive insights into photosynthetic and photoprotective mechanisms in Arabidopsis thaliana grown under two light regimes

Probing insights into understanding photosynthetic processes via non-invasive means has an added advantage when used in phenotyping or precision agriculture. We employed Raman spectroscopy and fluorescence-based methods to investigate both the changes in the photosynthetic processes and the underlying protective mechanisms on Arabidopsis thaliana wild-type (WT), and ros1, which is a mutant of a repressor of transcriptional gene silencing, both grown under low light (LL: 100 μmol m^-2s^-1) and high light (HL: 400 μmol m^-2s^-1) regimes. Raman imaging detected a lower carotenoid intensity after two weeks in those plants grown under HL, compared to those grown under the LL regime; we interpret this as the result of oxidative damage of β-carotene molecules. Further, the data revealed a significant depletion in carotenoids with enhanced phenolics around the midrib and tip of the WT leaves, but not in the ros1. On the contrary, small necrotic zones appeared after two weeks of HL in the ros1 mutant, pointing to the starting oxidative damage. The lower maximum quantum yield of the photochemistry (F_v/F_m) in the WT as well as in the ros1 mutant grown in HL (compared to those in the LL two weeks post-exposure), indicates the HL partially inactivated photosystems. Chlorophyll a fluorescence imaging further showed high non-photochemical quenching (NPQ) in the plants grown under the HL regime for both the WT and the ros1 mutant, but the spatial heterogeneity of NPQ images was much higher in the HL-grown ros1 mutant. Fluorescence screening methods revealed significantly high values of chlorophyll proxies in the WT as well as in the ros1 mutant two weeks after in the HL compared to those under LL. The data generally revealed an increased accumulation of phenolics under HL in both the WT and ros1 mutant plants, but the proxies of anthocyanin and flavonols were significantly lower in the ros1 mutant than in the WT. The comparatively low accumulation of anthocyanin in the ros1 mutant compared to the WT supports the Raman data. We conclude that integrated use of these techniques can be efficiently applied for a better understanding of insights into photosynthetic mechanisms.

Diversity in American Society of Transplant Surgeons Governance: Equitable but Unequal

OBJECTIVES

The diversity in the governance of the American Society of Transplant Surgeons has not been described. We aimed to quantify the present state of its leadership as a baseline to inform future research.

MATERIALS AND METHODS

Lists of leaders on the American Society of Transplant Surgeons Council, the COVID-19 Strike Force, and 20 different American Society of Transplant Surgeons committees were obtained from the Society's website. Demographic and training information for the members were compiled through internet searches and analyzed.

RESULTS

The American Society of Transplant Surgeons Council included 15 members, with 20% women. It was 93.3% non-Hispanic White. The COVID-19 Strike Force included 12 surgeons, 16.7% of whom were female, with 75% non-Hispanic White. Of the 198 committee members, 23.7% were women, 68.7% were nonHispanic White, 16.6% were Asian, 8.1% were Hispanic, and 6.6% were Black. Among female committee members, underrepresented minorities comprised 23.6%. Committee chairs included 23% women, 23% underrepresented minorities, and 2.3% minority women. International medical graduates were more likely men (P = .02).

CONCLUSIONS

Representation of women in the American Society of Transplant Surgeons leadership has kept pace with their membership in the transplant surgery workforce. There is a deficiency of female under - represented minorities in leadership positions at the Society. Further interventions are required to recruit underrepresented minorities to transplant surgery, catalog their footprint in the workforce, and champion their role as leaders within the American Society of Transplant Surgeons.

Kinetic and Computational Study of Degradation of Two Azo Dyes, Metanil Yellow and Orange II, by Iron Oxide Nanoparticles Synthesized Using Hylocereus undatus

Wastewater treatment is an unavoidable necessity and requires immediate action with the aim of saving future generations from water crises and ensuring the sustainability of clean and drinkable water. In the present work, green synthesis of iron oxide nanoparticles (IONPs) was carried out from fruit extract of Hylocereus undatus to observe its photocatalytic activity towards two azo dyes, namely, Metanil yellow and Orange II dye. IONPs served as an efficient photocatalyst for the degradation of Metanil yellow dye, and the reaction followed pseudo-first-order kinetics. The effect of the initial dye concentration, amount of photocatalyst added, and effect of pH on photocatalytic degradation of Metanil yellow and Orange II dye using IONPs was studied. The results were compiled to reveal the most effective conditions for degradation to occur. A computational study of two dyes using DFT (Density Functional Theory) calculations were also performed to calculate thermodynamic properties such as the free energy, dipole moment, HOMO-LUMO energy gap, chemical potential, global hardness, softness, global electrophilicity index, ionization potential, electron affinity, etc. These parameters were used to describe the reactivity of dye toward the active photocatalytic species responsible for the degradation of dye. Natural population analysis was also performed, and Fukui indices were also calculated to explain the possible attacking sites of dyes by active photocatalytic species.

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.

Long term Th2 cytokines immunotherapy beneficial for EoE pediatric patients?

Eosinohilic esophagitis (EoE) and gastroesophageal reflux diseases (GERD) are closely related esophageal disorders, and both accumulate eosinophils in the esophagus. However, origin of both these diseases are very different. The evidence indicates that acid reflux is the main cause of GERD; whereas EoE is induced in response to food or environment allergens exposed accumulation of inflammatory cells like eosinophils, mast cells and T cell subsets. EoE is a global problem, and effect even 1 year old children to adult population. Currently, mepolizumab (anti-IL-5) neutralization therapy sdata showed reduced epithelial layer eosinophilia in EoE,^{1, 2} and most recently FDA approved FDA has also approved Dupixent (anti-IL4R and anti-IL-13) for EoE following Phase 3 randomized, double-blind, placebo-controlled trial. The efficacy and safety of Dupixent 300 mg weekly patients 12 year or older on limited patient number, 69% and 64% reduction in EoE symptoms from baseline compared to 32% and 41% for placebo (FDA, 2022). In this commentary, we raised few concerns to be considered on these therapies based on the significance of IL-5, IL-4 in maintaining the innate immunity of the young children are mostly effected by EoE that require long term immunotherapy of mepolizumab (anti-IL-5) or Dupixent (anti-IL4R and anti-IL-13).

Molecules involved in the development of Barrett's esophagus phenotype in chronic eosinophilic esophagitis

This paper aims to investigate the molecules involved in development of Barrett's esophagus (BE) in human eosinophilic esophagitis (EoE). Histopathological, immunohistochemical, real-time PCR Immuno blot, and ELISA analyses are performed to identify the signature genes and proteins involved in the progression of BE in EoE. We detected characteristic features of BE like intermediate columnar-type epithelial cells, induced BE signature genes like ErbB3, CDX1, ErbB2IP in the esophageal mucosa of patients with EoE. In addition, we had observed several BE-associated proteins such as TFF3, p53 and the progression markers like EGFR, p16, MICA, MICB, and MHC molecules in esophageal biopsies of patients with chronic EoE. Interestingly, we also detected mucin-producing columnar cells and MUC-2, MUC-4, and MUC5AC genes and proteins along with induced IL-9 in patients with chronic EoE. A strong correlation of IL-9 with mucin genes is observed that implicated a possible role for IL-9 in the transformation of esophageal squamous epithelial cells to columnar epithelial cells in patients with EoE. These findings indicate that IL-9 may have an important role in BE development in patients with chronic EoE. We also discovered that IL-9 stimulates mucin-producing and barrier cell transcripts and proteins such CK8/18, GATA4, SOX9, TFF1, MUC5AC, and tight junction proteins in primary esophageal epithelial cells when exposed to IL-9. Taken together, these findings provide evidence that indeed IL-9 has a role in the initiation and progression of BE characteristics like development of mucin-producing columnar epithelial cells in patients with chronic EoE.NEW & NOTEWORTHY Intermediate columnar-type epithelial cells are observed in biopsies of patients with EoE. Induced BE signature genes (CK8/18, CDX1 GATA4, SOX9, and Occludin) were observed in patients with chronic EoE. Induction of IL-9 and its correlation with eosinophils mucin-producing genes and proteins was observed in patients with EoE. Induced IL-9 may be responsible for the development of BE in patients with chronic EoE.

Enteric viruses replicate in salivary glands and infect through saliva

Enteric viruses like norovirus, rotavirus and astrovirus have long been accepted as spreading in the population through fecal-oral transmission: viruses are shed into feces from one host and enter the oral cavity of another, bypassing salivary glands (SGs) and reaching the intestines to replicate, be shed in feces and repeat the transmission cycle1. Yet there are viruses (for example, rabies) that infect the SGs2,3, making the oral cavity one site of replication and saliva one conduit of transmission. Here we report that enteric viruses productively and persistently infect SGs, reaching titres comparable to those in the intestines. We demonstrate that enteric viruses get released into the saliva, identifying a second route of viral transmission. This is particularly significant for infected infants, whose saliva directly transmits enteric viruses to their mothers' mammary glands through backflow during suckling. This sidesteps the conventional gut-mammary axis route4 and leads to a rapid surge in maternal milk secretory IgA antibodies5,6. Lastly, we show that SG-derived spheroids7 and cell lines8 can replicate and propagate enteric viruses, generating a scalable and manageable system of production. Collectively, our research uncovers a new transmission route for enteric viruses with implications for therapeutics, diagnostics and importantly sanitation measures to prevent spread through saliva.

Role of Macrophage accumulation activates NLRP3 inflammasome induced IL-18 pathway in EoE pathogenesis

Objective

Most studies implicated eosinophilic esophagitis (EoE) to the induced esophageal eosinophilia mediated inflammation and fibrosis. However, yet the initial mechanism of allergen-induced eosinophils generation is yet not understood. Our current study provides stepwise pathway operating following the interaction of allergen and antigen presenting cells to induce EoE pathogenesis.

Methods

We performed immunostaining, RT-PCR measure transcript levels and Masson trichrome staining for collagen accumulation.

Results

We show that allergen-challenge promotes induced macrophage accumulation and epithelial cells hyperplasia in esophagus. Further, we observed that NLRP3 is induced in both macrophage and epithelial cells. The NLRP3 is the source of IL-18 and we show induced levels of IL-18 in allergen challenge mice that generate tissue eosinophilia in experimental model of EoE. Further, we observed a similar induced NLRP3 in the accumulated macrophage and epithelial cells along with induced IL-18 in the esophageal biopsies of human EoE. Mechanistically, to substantiate the role of macrophages, epithelial cells, and IL-18 role in EoE pathogenesis, we experimentally induced EoE in wild type, GM-CSF−/−, IL-18−/− mice. We show a similar NLRP3 expression with no IL-18 induction in IL-18−/− mice compare to induced NLRP3 and IL-18 in wild-type and significantly reduced NLRP3 and IL-18 in GM-CSF−/− mice. The NLRP3 regulated IL-18 induction or reduction is consistent with the tissue accumulated eosinophila and promoting esophageal remodeling and fibrosis in murine model of EoE.

Conclusions

The findings show that epithelial cells and macrophage derived NLRP3 regulated IL-18 is critical in promoting EoE pathogenesis.

Supported by NIH grant R01 AI080581 

IL-9 has an important role in promoting Barrett’s esophagus (BE) phenotype in eosinophilic esophagitis (EoE)

Objectives

Establish the role of IL-9 in development of Barrett’s esophagus (BE) in human EoE.

Methods

Histopathological, immunohistochemical, RT-PCR and ELISA analyses are performed to identify the signature genes and proteins involved in the progression of BE in EoE.

Results

We detected characteristic feature of BE like intermediate columnar type epithelial cells, induced BE signature genes like ErbB3, CDX1, ErbB2IP in the esophageal mucosa of EoE patients. Further, we observed BE associated diagnostic proteins (TFF3, p53) and the progression markers (EGFR, p16), MHC molecules (MICA, MICB) in esophageal biopsies of chronic EoE patients. Furthermore, we also detected mucin-producing columnar cells and MUC-2, MUC-4 and MUC5AC genes and proteins along with induced IL-9 in chronic EoE patients. Interestingly, a strong correlation of IL-9 with mucin genes were observed that indicate IL-9 may have an important role in BE development in chronic EoE patients. Herein, we present in vitro data of IL-9 exposure to primary esophageal epithelial cells provide evidence that IL-9 is involved in the induction of mucins producing and epithelial barrier cells transcripts and proteins like CK8/18, GATA4, SOX9, TFF1, MUC5AC, including tight junction proteins that are the markers of BE.

Conclusions

Taken together, we provide evidence that IL-9 has a role in the initiation and progression of BE characteristics like development of mucin producing columnar epithelial cells in chronic EoE patients.

Supported by grants from NIH (R01 AI080581-Anil Mishra)

Role of IL-18-transformed CD274-expressing eosinophils in promoting airway obstruction in experimental asthma

BACKGROUND

IL-5-dependent residential and IL-18-transformed pathogenic eosinophils have been reported; however, the role of IL-18-transformed CD274-expressing pathogenic eosinophils compared to IL-5-generated eosinophils in promoting airway obstruction in asthma has not yet been examined.

METHODS

Eosinophils are detected by tissue anti-MBP and anti-EPX immunostaining, CD274 expression by flow cytometry, and airway resistance using the Buxco FinePointe RC system.

RESULTS

We show that A. fumigatus-challenged wild-type mice, and different gene-deficient mice including naïve CC10-IL-18-transgenic mice, accumulate mostly peribronchial and perivascular CD274-expressing eosinophils except naïve CD2-IL-5-transgenic mice. Additionally, we show that CD2-IL-5 transgenic mice following rIL-18 treatment accumulate high number of CD274-expressing perivascular and peribronchial eosinophils with induced collagen, goblet cell hyperplasia and airway resistance compared to saline-challenged CD2-IL5 transgenic mice. Furthermore, we also show that even A. fumigatus-challenged IL-5 ^-/- mice and rIL-18 given ΔdblGATA mice accumulate CD274-expressing eosinophil-associated asthma pathogenesis including airway obstruction. Most importantly, we provide evidence that neutralization of CD274 and IL-18 in A. fumigatus-challenged mice ameliorate experimental asthma. Taken together, the data presented are clinically significant in establishing that anti-IL-18 neutralization is a novel immunotherapy to restrict asthma pathogenesis.

CONCLUSIONS

We demonstrate that IL-18 is critical for inducing asthma pathogenesis, and neutralization of CD274 is a potential immunotherapeutic strategy for asthma.

IL-5 overexpression induced blood eosinophilia associated progression of cardiac abnormalities

Eosinophilia may be responsible for cardiac injuries of widely varying severity, from acute myocarditis to endomyocardial fibrosis. In this manuscript, we present both the molecular and physiological evidence that promotes eosinophils accumulation in mice heart epicardium and myocardium region of allergen or transgene-insertion of overexpressed IL-15, eotaxin-deficient CD2 promoter driven IL-5 transgenic mice shows abnormal physiological function. Numerous etiologies can lead to severe eosinophilia, but these are mainly represented by hypersensitivity reactions, rheumatological diseases and hypereosinophilic syndrome. Because cardiac involvement may be extremely severe; therefore, we even present echocardiography analysis that indicates IL-15 overexpressed mice showed induced blood eosinophilia associated progression of cardiac abnormalities.

The RAIS Device for Global Surgery: Using a Participatory Design Approach to Navigate the Translational Pathway to Clinical Use

Background: Over 5 billion people worldwide have no access to surgery worldwide, typically in low-resource settings, despite it being a primary life-saving treatment. Gas Insufflation-Less Laparoscopic Surgery (GILLS) can address this inequity, by improving current GILLS instrumentation to modern surgical standards. Objective: to develop and translate a new Retractor for Abdominal Insufflation-less Surgery (RAIS) into clinical use and thus provide a context-appropriate system to advance GILLS surgery. Methods: A collaborative multidisciplinary team from the UK and India was formed, embedding local clinical stakeholders and an industry partner in defining user and contextual needs. System development was based on a phased roadmap for ‘surgical device design in low resource settings’ and embedded participatory and frugal design principles in an iterative process supported by traditional medical device design methodologies. Each phase of development was evaluated by the stakeholder team through interactive workshops using cadaveric surgical simulations. A Commercialisation phase undertook Design to Manufacture and regulatory approval activities. Clinical validation was then conducted with rural surgeons performing GILLS procedures using the RAIS system. Semi-structured questionnaires and interviews were used to evaluate device performance. Results: A set of user needs and contextual requirements were defined and formalised. System development occurred across five iterations. Stakeholder participation was instrumental in converging on a design which met user requirements. A commercial RAIS system was then produced by an industry partner under Indian regulatory approval. This was successfully used in clinical validation to conduct 12 surgical procedures at two locations in rural India. Surgical feedback showed that the RAIS system provided a valuable and usable surgical instrument which was appropriate for use in low-resource contexts. Conclusions: Using a context-specific development approach with close engagement of stakeholders was crucial to develop the RAIS system for low-resource regions. The outcome is translation from global health need into a fully realized commercial instrument which can be used by surgeons in low-resource regions across India.

Synthesis, molecular docking, and biological evaluation of Schiff base hybrids of 1,2,4-triazole-pyridine as dihydrofolate reductase inhibitors

In this study novel derivatives of 1,2,4-triazole pyridine coupled with Schiff base were obtained in altered aromatic aldehyde and 4-((5-(pyridin-3-yl)-4H-1,2,4-triazol-3-ylthio)methyl)benzenamine reactions. Thin layer chromatography and melting point determination were employed to verify the purity of hybrid derivatives. The structures of the hybrid derivatives were interpreted using methods comprising infrared, nuclear magnetic resonance, and mass spectroscopy. The in vitro anti-microbial properties and minimum inhibitory concentration were determined with Gram-positive and Gram-negative bacteria. Among the derivatives produced, two derivatives comprising (Z)-2-((4-((5-(pyridine-3-yl)-4H-1,2,4-triazol-3-ylthio)methyl)phenylimino)methyl)phenoland (Z)-2-methoxy-5-((4-((5-(pyridine-3-yl)-4H-1,2,4-triazol-3- ylthio)methyl)phenylimino)methyl)phenol obtained promising results as antibacterial agents. After synthesizing different derivatives, docking studies were performed and the scores range from −10.3154 to −12.962 ​kcal/mol.

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Synthesis and evaluation of Schiff Base Hybrids of 1, 2, 4-Triazole-Pyridine as DHFR Inhibitors.

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Schiff Base Hybrids shown promising antibacterial results.

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Docking studies reveals a good binding affinity in range of -10.3154 to -12.962 kcal/mol with DHFR.

The importance of small samples in medical research

Almost all bio-statisticians and medical researchers believe that a large sample is always helpful in providing more reliable results. Whereas this is true for some specific cases, a large sample may not be helpful in more situations than we contemplate because of the higher possibility of errors and reduced validity. Many medical breakthroughs have occurred with self-experimentation and single experiments. Studies, particularly analytical studies, may provide more truthful results with a small sample because intensive efforts can be made to control all the confounders, wherever they operate, and sophisticated equipment can be used to obtain more accurate data. A large sample may be required only for the studies with highly variable outcomes, where an estimate of the effect size with high precision is required, or when the effect size to be detected is small. This communication underscores the importance of small samples in reaching a valid conclusion in certain situations and describes the situations where a large sample is not only unnecessary but may even compromise the validity by not being able to exercise full care in the assessments. What sample size is small depends on the context.

Transplant surgery departmental leaders do not represent workforce demographics especially among women and underrepresented minorities - A retrospective analysis

INTRODUCTION

The diversity among surgical directors for liver, kidney, and pancreas transplant departments has not been previously evaluated. We aim to quantify the sex and racial demographics of transplant department leaders and assess the impact on patient outcomes.

METHODS

Demographics were collected for 116 liver, 192 kidney, and 113 pancreas transplant directors using Organ Procurement and Transplantation Network (OPTN) directory and program websites. Scientific Registry of Transplant Recipients (SRTR) 5-tier program outcomes rankings were obtained for each program and matched to leader demographics. A retrospective analysis of transplant recipients from 2010 to 2019 was performed using the United Network for Organ Sharing (UNOS) database.

RESULTS

91.5% of transplant surgical directors were male. 55% of departments had a Non-Hispanic White leader. Asian, Hispanic and Black transplant chiefs were at the helm of 23.3%, 9%, and 5% of divisions respectively. Multivariate cox regression analysis did not identify any differences in patient outcomes by transplant director demographics.

CONCLUSION

There is a paucity of female and URM leaders in transplant surgery. Initiatives to promote research, mentorship, and career advancement opportunities for women and URM are necessary to address the current leadership disparity.