Production and characterization of protease enzyme from Acinetobacter pittii using peanut meal as substrate

A significantly high protease enzyme yield of 617 U/ml was achieved with Acinetobacter pittii as the microorganism and peanut oil meal as the substrate. Peanut oil meal, which consists of proteins (40-60%) and carbohydrates (22-30%), serves as a sufficient source of nitrogen and carbon necessary for microbial growth and production of enzymes. Moreover, peanut meal offers the advantages of being affordable and available in large quantities, making the meal suitable for cost-effective enzyme production. In the present study, two bacterial strains and one fungal strain were selected to produce proteases utilizing peanut oil meal as the substrate. The experimental conditions during the enzyme production, including pH and temperature, were optimized. In addition, the substrate was enriched with various carbon and nitrogen sources. The microbial strains were streaked on nutritional agar (for bacteria) and potato dextrose agar (for fungus). Following an incubation period, the plates were stored at 4°C for further studies. The molecular weight of partially purified proteases of Acinetobacter pittii was found to be ≅ 95.5 kDa. Potassium nitrate was the most ideal nitrogen source (up to 411% increase in activity) and fructose was the best carbon source (425% increase). These enzymes exhibited excellent temperature tolerance and were capable of functioning over a wide pH range. Furthermore, the obtained proteases demonstrated ability to coagulate milk effectively, indicating their potential for various food-related applications.

Review of Gold Nanoparticles in Surface Plasmon-Coupled Emission Technology: Effect of Shape, Hollow Nanostructures, Nano-Assembly, Metal-Dielectric and Heterometallic Nanohybrids

Point-of-care (POC) diagnostic platforms are globally employed in modern smart technologies to detect events or changes in the analyte concentration and provide qualitative and quantitative information in biosensing. Surface plasmon-coupled emission (SPCE) technology has emerged as an effective POC diagnostic tool for developing robust biosensing frameworks. The simplicity, robustness and relevance of the technology has attracted researchers in physical, chemical and biological milieu on account of its unique attributes such as high specificity, sensitivity, low background noise, highly polarized, sharply directional, excellent spectral resolution capabilities. In the past decade, numerous nano-fabrication methods have been developed for augmenting the performance of the conventional SPCE technology. Among them the utility of plasmonic gold nanoparticles (AuNPs) has enabled the demonstration of plethora of reliable biosensing platforms. Here, we review the nano-engineering and biosensing applications of AuNPs based on the shape, hollow morphology, metal-dielectric, nano-assembly and heterometallic nanohybrids under optical as well as biosensing competencies. The current review emphasizes the recent past and evaluates the latest advancements in the field to comprehend the futuristic scope and perspectives of exploiting Au nano-antennas for plasmonic hotspot generation in SPCE technology.

Epidermis of Cereus hildmannianus as a biomimetic scaffold for tissue engineering

A thin plastic-like film separated from the epidermis of Cereus hildmannianus has excellent tensile strength, resistance to water and high antimicrobial activity and supports the growth of mouse fibroblast cells. Cactuses are one of the most under explored plant species with high potential for food, materials, pharmaceutical and other applications. Although studies have shown the ability of cactuses to be used for food, as a source for fibers, as reinforcement for composites and other applications, the role of individual layers and their properties has been studied to a limited extent. In this paper, a thin translucent layer was separated from the epidermis of C. hildmannianus and studied for its composition, structure and properties. The layer is composed of about 73% cellulose and 2% lignin and morphologically, shows surface with uneven and serrated edges. Films with length of up to 36 cm, strength of 6.8 MPa and elongation of 2.5% could be peeled from the cactus suggesting their suitability for food packaging and other applications. X-ray diffraction patterns and FTIR spectrums indicated that the films are similar to that of cellulose and major thermal degradation occurred above 280°C. Compared to standards, the cactus films showed about 41% and 44% inhibition against gram positive and gram negative bacteria and 67% inhibition of the common fungal strain (A. niger). Films showed high stability in water and to common chemicals. When used as substrates for mouse fibroblast cell growth, no cytotoxicity was observed and the cactus peel supported the attachment and proliferation of cells demonstrating potential to be used as a biomaterial for tissue engineering applications.

Transgenic modifications of silkworms as a means to obtain therapeutic biomolecules and protein fibers with exceptional properties

Transgenic modification of Bombyx mori silkworms is a benign approach for the production of silk fibers with extraordinary properties and also to generate therapeutic proteins and other biomolecules for various applications. Silk fibers with fluorescence lasting more than a year, natural protein fibers with strength and toughness exceeding that of spider silk, proteins and therapeutic biomolecules with exceptional properties have been developed using transgenic technology. The transgenic modifications have been done primarily by modifying the silk sericin and fibroin genes and also the silk producing glands. Although the genetic modifications were typically performed using the sericin 1 and other genes, newer techniques such as CRISPR/Cas9 have enabled successful modifications of both the fibroin H-chain and L-chain. Such modifications have led to the production of therapeutic proteins and other biomolecules in reasonable quantities at affordable costs for tissue engineering and other medical applications. Transgenically modified silkworms also have distinct and long-lasting fluorescence useful for bioimaging applications. This review presents an overview of the transgenic techniques for modifications of B. mori silkworms and the properties obtained due to such modifications with particular focus on production of growth factors, fluorescent proteins, and high performance protein fibers.

Natural sub-bituminous coal as filler enhances mechanical, insulation and flame retardant properties of coir-polypropylene bio-composites

Additives provide substantial improvement in the properties of composites. Although bio-based composites are preferred over synthetic polymer and metal-based composites, they do not have the requisite properties to meet specific needs. Hence, organic, inorganic and metallic additives are included to improve the properties of bio-based composites. Coal is a readily available resource with high thermal insulation, flame resistance and other properties. This work demonstrates the addition of 20-30% natural sub-bituminous coal as filler for coir-reinforced polypropylene (PP) composites and exhibits an increased tensile strength by 66% and flexural strength by 55% compared to the composites without any filler. Such composites are intended for insulation applications and as a replacement for gypsum-based false ceiling tiles. Various ratios of coal samples were included in the composites and their effect on mechanical, acoustic, thermal insulation, flame and water resistance have been determined. A substantial improvement in both flexural and tensile properties has been observed due to the addition of coal. However, a marginal improvement has been observed in both thermal conductivity (0.65 W/mK) and flame resistance values due to the presence of coal. Adding coal increases the intensity of noise absorption, particularly at a higher frequency, whereas water sorption of the composites tends to decrease with an increase in the coal content. The addition of coal improves and adds unique properties to composites, allowing coir-coal-PP composites to outperform commercially available gypsum-based insulation panels.

Natural history of non-functioning pituitary microadenomas - results from the UK NFPA consortium

OBJECTIVE

The optimal approach to the surveillance of non-functioning pituitary microadenomas (micro-NFPAs) is not clearly established. Our aim was to generate evidence on the natural history of micro-NFPAs to support patient care.

DESIGN

Multi-centre, retrospective, cohort study involving 23 endocrine departments (UK NFPA consortium).

METHODS

Clinical, imaging, and hormonal data of micro-NFPA cases between 1/1/2008 and 21/12/2021 were analysed.

RESULTS

Data for 459 patients were retrieved [median age at detection 44 years [interquartile range (IQR) 31-57) - 152 males/307 females]. 419 patients had more than two MRIs [median imaging monitoring 3.5 years (IQR 1.71-6.1)]. One case developed apoplexy. Cumulative probability of micro-NFPA growth was 7.8% (95%CI 4.9%-8.1%) and 14.5% (95%CI 10.2%-18.8%) at 3 and 5 years, respectively, and of reduction 14.1% (95%CI 10.4-17.8%) and 21.3% (95%CI 16.4-26.2%) at 3 and 5 years, respectively. Median tumour enlargement was 2 mm (IQR 1-3) and 49% of micro-NFPAs that grew became macroadenomas (nearly all >5 mm at detection). Eight (1.9%) patients received surgery (only one had visual compromise with surgery required >3 years after micro-NFPA detection). Sex, age, size at baseline were not predictors of enlargement/reduction. At time of detection, 7.2%, 1.7% and 1.5% patients had secondary hypogonadism, hypothyroidism and hypoadrenalism, respectively. Two (0.6%) developed hypopituitarism during follow-up (after progression to macroadenoma).

CONCLUSIONS

Probability of micro-NFPA growth is low and development of new hypopituitarism is rare. Delaying first follow-up MRI to three years and avoiding hormonal re-evaluation in absence of tumour growth or clinical manifestations is a safe approach for micro-NFPA surveillance.

MAPP Compatibilized Recycled Woodchips Reinforced Polypropylene Composites with Exceptionally High Strength and Stability

Wood chips were used in their original form without any physical or chemical treatment as reinforcement for polypropylene to develop composites as potential replacement for medium density fiber (MDF) boards, gypsum based false ceiling and other building materials. Wood chips are generated as byproducts and have limited and low value applications. Composites with up to 90% wood chips were developed through compression molding and the mechanical, acoustic and thermal properties were studied. Further, maleated polypropylene (MAPP) was used (1-5% w/w based on woodchips used) as compatibilizer and changes in properties were recorded. Up to 300% increase in tensile properties were observed when 5% compatibilizer was present. Tensile properties of the composites containing MAPP were higher than that of commercially available medium density plywood boards and also gypsum based ceiling tiles. Addition of MAPP did not change thermal conductivity but decreased sound absorption. Wood chips reinforced PP composites containing MAPP show exceedingly high properties and could replace particle, fiber boards and other building materials in current use. Utilizing the wood waste also results in environmentally friendly, sustainable and low cost building materials.

Graphical Abstract

Highly Elastic and Strain Sensing Corn Protein Electrospun Fibers for Monitoring of Wound Healing

Due to the lack of sufficient elasticity and strain sensing capability, protein-based ultrafine fibrous tissue engineering scaffolds, though favorable for skin repair, can hardly fulfill on-spot wound monitoring during healing. Herein, we designed highly elastic corn protein ultrafine fibrous smart scaffolds with a three-layer structure for motion tracking at an unpackaged state. The densely cross-linked protein networks were efficiently established by introducing a highly reactive epoxy and provided the fiber substrates with wide-range stretchability (360% stretching range) and ultrahigh elasticity (99.91% recovery rate) at a wet state. With the assistance of the polydopamine bonding layer, a silver conductive sensing layer was built on the protein fibers and endowed the scaffolds with wide strain sensing range (264%), high sensitivity (gauge factor up to 210.55), short response time (<70 ms), reliable cycling stability, and long-lasting duration (up to 30 days). The unpackaged smart scaffolds could not only support cell growth and accelerate wound closure but also track motions on skin and in vivo and trigger alarms once excessive wound deformations occurred. These features not only confirmed the great potential of these smart scaffolds for applications in tissue reconstruction and wound monitoring but also proved the possibility of employing various plant protein ultrafine fibers as flexible bioelectronics.

Prevalence of depression and anxiety in older people in low- and middle- income countries in Africa, Asia and South America: A systematic review and meta-analysis

BACKGROUND

There is rapid growth of older people in Low- and Middle- Income Countries (LMICs). The aim of this review was to assess the literature on prevalence of anxiety and depression in this demographic, which to our knowledge, has not yet been conducted.

METHODS

Databases including Medline, PsychInfo, Embase, Scielo and African Journals Online were searched for terms including "mental disorders", "neurotic disorders", "mood disorders" and "anxiety disorders". Studies published between 1990 and 2020 providing data on older people (≥50 years) in LMICs (defined by World Bank Criteria) were included and quality-assessed. Meta-analysis was conducted on a subset of higher-quality studies to derive pooled prevalence estimates of depression.

RESULTS

One hundred and forty relevant studies were identified, of which thirty-two were included in meta-analysis. One hundred and fifteen studies reported depression prevalence only, 19 reported both depression and anxiety, and six reported anxiety only. In all studies identified, depression prevalence ranged from 0.5 % to 62.7 %, and Generalised Anxiety Disorder prevalence ranged from 0.2 % to 32.2 %. The pooled prevalence of depression on meta-analysis was 10.5 % (95 % CI, 8.9 % - 11.2 %). Reported prevalence rates of depression were significantly different in studies using ICD-10 compared with DSM criteria, and between community and clinical settings.

LIMITATIONS

The search strategy contained bias towards English language papers and high income country (HIC) publications. There is significant heterogeneity within the meta-analysis.

DISCUSSION

A wide range of methodologies and clinical criteria are used in prevalence studies of depression and anxiety in older people. Studies using screening tools found higher prevalence rates; clinicians and researchers should ensure diagnosis is made with gold-standard clinical criteria. Meta-analysis data suggest that rates of depression are similar in older people in LMICs compared to HICs but mental healthcare resources are limited, suggesting a large potential treatment gap.

MOFFeCo/B-CN composites achieve efficient degradation of antibiotics in a non-homogeneous concurrent photocatalytic-persulfate activation system

We synthesized an M_FeCoB_0.4CN_x% (MOF-Fe/Co nanosheets/boron-doped g-C₃N₄) composite catalyst for enhancing the concurrent photocatalytic-persulfate activation (CPPA) system and achieved efficient degradation of antibiotics. The role of MOF-Fe/Co is to activate persulfate, while boron-doped g-C₃N₄ can generate photogenerated electrons for the reduction of Co³⁺/Fe³⁺ to enhance the regeneration of the active center. The rate constant for Tetracycline degradation by the CPPA system was 4.74 and 7.54 times higher than the photocatalytic and persulfate-activated systems, respectively. This composite was shown to be practical and economically viable for antibiotic degradation. The degradation behavior was explored based on experiments, and molecular orbitals and Fukui functions were obtained by density functional theory calculations. Mechanisms were investigated using reactive oxygen species trapping studies and electron spin resonance, and the process was explained in terms of the charge population and electron density difference of MOF-Fe/Co nanosheets. The CPPA system is an ecologically benign technology for removing antibiotic-related risks to the environment and human health.

RF19 | PSUN353 Liquid Biopsies - Detecting and Tracking Circulating Cell Free Tumor Derived DNA in Patients with Neuroendocrine Neoplasms

Introduction

There is a clinical need to develop novel and better biomarkers to monitor patients with neuroendocrine neoplasms (NENs). Circulating cell free tumor derived DNA (ctDNA), a form of liquid biopsy, is finding clinical utility in an ever increasing number of malignancies however has not been widely tested in patients with NENs.

Aims

Our aim was to identify and track plasma ctDNA in a cohort of patients with NENs using a personalized, patient specific approach.

Materials and methods

A total of 35 serial plasma samples were collected from 9 patients with metastatic, well differentiated NENs (6 small intestinal and 1 lung, 1 ovarian and 1 pelvic; range 2-5 plasma samples per patient) over the space of 2-25 months. For each patient, NEN specific somatic mutations (single nucleotide variants and insertions/deletions) were identified through whole exome sequencing of paired tumor-leucocyte DNA and were used to design a bespoke multi-variant Ampliseq™ HD ctDNA panel (5-20 variants per patient) for targeted next generation sequencing. Imaging and treatment were provided as per usual clinical care.

Results

ctDNA was detectable in 6/9 patients and in 19/35 plasma samples. A rise in the number of ctDNA target variants and/or variant allele frequency was seen in 4/6 patients who experienced disease progression. Two of these patients received peptide receptor radionuclide therapy after which ctDNA disappeared in one patient and substantially reduced in the other, which correlated with treatment response. The 3 patients who did not have detectable ctDNA at any time point all had grade 1 small intestinal NENs with stable disease during the observation period.

Discussion

Our data provide exciting evidence for the feasibility of using ctDNA as a biomarker in NENs. By targeting multiple individualized variants using next generation sequencing, we have demonstrated that ctDNA can track changes in disease burden and can monitor response to treatment in patients. Of equal importance, ctDNA was not detectable in patients with quiescent disease. This could help identify patients who do not need intensive monitoring. Targeting bespoke, multiple variants per patient is a novel and powerful approach for NENs, especially given their heterogenous genetic landscape. This study provides important early evidence that ctDNA may be a clinically useful biomarker for detection and surveillance of NENs.

Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m., Sunday, June 12, 2022 1:06 p.m. - 1:11 p.m.

Audit of long-term treatment outcomes of thyrotoxicosis in a single-centre virtual clinic: The utility of long-term antithyroid drugs

OBJECTIVE

To investigate the long-term outcomes and prognosis of thyrotoxicosis in a large number of patients in a single UK county (Leicestershire).

DESIGN

Retrospective cohort analysis of 56,741 thyroid function test (TFT) results, treatment modalities and outcomes in a well-established virtual thyrotoxicosis clinic database.

PATIENTS

One thousand four hundred and eighty-nine patients were included with a median length of follow-up of 10.9 years. The aetiology of thyrotoxicosis was autoimmune (85.9%), nodular (9.1%) and mixed (5.0%). Treatment modalities included antithyroid drugs (ATDs), radioiodine (RAI; 555 MBq fixed dose) and thyroidectomy.

METHODS

We analysed both individual TFTs and groups of sequential TFTs on or after the same thyroid treatment(s), which we describe as 'phase of thyroid care' (POTC). Patients studied entered the virtual clinic between 1 January 1995 and 1 January 2010; we exported data on every TFT sample up to April 2020.

RESULTS

ATD had been used in 99.2% (median 2, maximum seven courses) with long-term ATD (&gt;2 years) in 48%. RAI and thyroidectomy were used more commonly with nodular and mixed aetiology. Overall, T4 was more often controlled than thyroid-stimulating hormone (TSH), and at the latest follow-up, T4 was normal in &gt;96%, TSH in &gt;79% and both in &gt;76% of different aetiologies. The mean percentage control of T4 was 85% and TSH 50%; in long-term ATD courses, this improved to 89% and 62%, respectively. In the latest POTC, control of T4 and TSH was best in cases off treatment (95%/87%) and on T4 without ablative therapy (94%/72%), but was broadly similar in patients on long-term ATD (90%/68%), after RAI (92%/60%) or after thyroidectomy (91%/58%). After the first course of ATD, remission or hypothyroidism was seen in 47.3% autoimmune, 20.9% nodular and 32.5% mixed, with 90% relapses seen within 4 years. Relapse was more common in patients with ophthalmopathy, but there was no difference between the sexes.

CONCLUSIONS

Thyrotoxicosis can be well controlled with minimal specialist clinic attendance using a software-supported virtual shared-care scheme. Long-term ATD appears to be a valid patient choice achieving TFT control comparable to that seen after RAI or surgery. In patients with autoimmune disease, relapse is more common in patients with ophthalmopathy, and hypothyroidism is common after RAI. In nodular disease, we found that spontaneous remission may occur.

Sericin-Based Bio-Inspired Nano-Engineering of Heterometallic AgAu Nanocubes for Attomolar Mefenamic Acid Sensing in the Mobile Phone-Based Surface Plasmon-Coupled Interface

Engineering photo-plasmonic platforms with heterometallic nanohybrids are of paramount significance for realizing augmented sensitivity in fluorescence-based analytical detection. Although myriad nanomaterials with versatile functionalities have been explored in this regard in the surface plasmon-coupled emission (SPCE) interface, light harvesting using nano-antennas synthesized via sustainable bio-inspired routes still remains a high priority in current research. Our study provides a rational design for in situ fabrication of nanoparticles of silver, gold, and their plasmonic hybrids using biocompatible, non-hazardous sericin protein (obtained Bombyx mori) as the reducing and capping agent. The one-pot, user-eco-friendly technology demonstrated here utilizes UV irradiation to promote the photo-induced electron transfer mechanism, thereby yielding nanomaterials of tunable optoelectronic functionalities. The resulting homometallic and heterometallic nanohybrids with robust localized surface plasmon resonances (LSPR) showed strong light-confining attributes when interfaced with the propagating surface plasmon polaritons (SPPs) of the SPCE platform, thereby yielding tunable, highly directional, polarized, and amplified fluorescence emission. The experimentally obtained emission profiles displayed an excellent correlation with the theoretically obtained dispersion diagrams validating the spectro-plasmonic results. The abundant hotspots from AgAu nanocubes presented in excess of 1300-fold dequenched fluorescence enhancement and were utilized for cost-effective and real-time mobile phone-based sensing of biologically relevant mefenamic acid at an attomolar limit of detection. We believe that this superior biosensing performance accomplished using the frugal bioinspired nano-engineering at hybrid interfaces would open new doors for developing nanofabrication protocols with the quintessential awareness of the principles of green nanotechnology, consequently eliminating hazardous chemicals and solvents in the development of point-of-care diagnostic tools.

Sagittal Angle of the Trigeminal Nerve at the Porus Trigeminus: A Novel Measurement to Distinguish Different Causes of Classic Trigeminal Neuralgia

BACKGROUND AND PURPOSE

Classic trigeminal neuralgia is a clinical syndrome of facial pain, most often attributable to vascular compression of the proximal cisternal segment of the trigeminal nerve and treatable with microvascular decompression of the nerve. Some patients, however, meet all clinical criteria for classic trigeminal neuralgia yet do not respond to microvascular decompression. Because the reasons for surgical failure are not well understood, the aim of this study was to determine if a subset of patients with classic trigeminal neuralgia could be distinguished by measuring the angle of the trigeminal nerve in the sagittal plane as the nerve traverses the porus trigeminus.

MATERIALS AND METHODS

We retrospectively identified patients with either classic trigeminal neuralgia (n = 300) or hemifacial spasm (n = 300) who had undergone MR imaging, including 3-plane steady-state free precession imaging. Patients with hemifacial spasm served as controls. On sagittal steady-state free precession images, we measured the angle of each trigeminal nerve as it crosses through the porus trigeminus into the Meckel cave (SATNaPT). In patients with classic trigeminal neuralgia, we separated the nerves into symptomatic and asymptomatic sides. We compared these 3 groups using the Student t test.

RESULTS

Control patients had a mean SATNaPT of 170° (SD, 11°) with a normal distribution. The contralateral asymptomatic nerve in patients with classic trigeminal neuralgia had the same distribution of angles. The symptomatic nerves in patients with classic trigeminal neuralgia had a bimodal distribution; 83% of patients fell into the same distribution as the asymptomatic nerves, but the other 15% had an average angle of 143° (SD, 7°). This difference was statistically significant (P < .0001).

CONCLUSIONS

Patients with the clinical syndrome of classic trigeminal neuralgia fell into 2 categories based on the radiologic measurement of the SATNaPT. Most patients had an anatomically normal nerve that was affected by vascular compression, but 17% of these patients had aberrant anatomy that may cause or contribute to their clinical presentation. Further study is needed to determine whether this subset of patients should receive a different surgery to better address their underlying anatomic abnormality. The SATNaPT measurement should be included in every MR imaging interpretation performed on patients with classic trigeminal neuralgia.

Risk of second brain tumour after radiotherapy for pituitary adenoma or craniopharyngioma: a retrospective, multicentre, cohort study of 3679 patients with long-term imaging surveillance

BACKGROUND

Radiotherapy is a valuable treatment in the management algorithm of pituitary adenomas and craniopharyngiomas. However, the risk of second brain tumour following radiotherapy is a major concern. We assessed this risk using non-irradiated patients with the same primary pathology and imaging surveillance as controls.

METHODS

In this multicentre, retrospective cohort study, 4292 patients with pituitary adenoma or craniopharyngioma were identified from departmental registries at six adult endocrine centres (Birmingham, Oxford, Leeds, Leicester, and Bristol, UK and Ferrara, Italy). Patients with insufficient clinical data, known genetic predisposition to or history of brain tumour before study entry (n=532), and recipients of proton beam or stereotactic radiotherapy (n=81) were excluded. Data were analysed for 996 patients exposed to 2-dimensional radiotherapy, 3-dimensional conformal radiotherapy, or intensity-modulated radiotherapy, and compared with 2683 controls.

FINDINGS

Over 45 246 patient-years, second brain tumours were reported in 61 patients (seven malignant [five radiotherapy, two controls], 54 benign [25 radiotherapy, 29 controls]). Radiotherapy exposure and older age at pituitary tumour detection were associated with increased risk of second brain tumour. Rate ratio for irradiated patients was 2·18 (95% CI 1·31-3·62, p<0·0001). Cumulative probability of second brain tumour was 4% for the irradiated and 2·1% for the controls at 20 years.

INTERPRETATION

Irradiated adults with pituitary adenoma or craniopharyngioma are at increased risk of second brain tumours, although this risk is considerably lower than previously reported in studies using general population controls with no imaging surveillance. Our data clarify an important clinical question and guide clinicians when counselling patients with pituitary adenoma or craniopharyngioma on the risks and benefits of radiotherapy.

FUNDING

Pfizer.

Using polyvinyl alcohol-ionic hydrogels containing a wound healing agent to manage wounds in different environments

OBJECTIVE

To explore the effects of pH on properties of polyvinyl alcohol (PVA)-ionic hydrogels containing wound healing promoters.

METHOD

PVA was combined with a natural wound healing promoter (silk sericin (SS)), and an anionic agent (eosin (ES)) or cationic agent (methylene blue (MB)), and made into hydrogels. Properties of the hydrogels and behaviour at different pHs were investigated.

RESULTS

The density and gel fraction of PVA/SS-ES hydrogel and PVA/SS-MB hydrogel were considerably lower compared with hydrogel without SS. The swelling ratio and degradation of the hydrogels increased with increasing SS concentration in all pH solutions. The influence of SS in interrupting long-chain PVA molecules was confirmed based on changes in Fourier-transform infrared spectroscopy (FTIR). The SS released from the gels was found to interact with the ionic agent and influenced the release profile of the ionic agent. Surprisingly, the anionic agent in PVA/SS-ES hydrogel showed 70% release in high pH solution whereas the cationic agent in PVA/SS-MB hydrogel showed 86% release in low pH solution. Moreover, the active agent could accumulate on the skin layer and had a positive effect on a specific wound area.

CONCLUSION

Based on the results obtained in this study, it is suggested to use anionic hydrogels containing wound healing promoter for wounds at high pH and cationic hydrogels containing wound healing promoter for wounds with low pH. Ability to improve wound healing using a natural healing agent combined with ionic agents and controlling the pH of hydrogels will help in developing quick and low-cost treatment for wounds.

A review on the synthesis and properties of hydroxyapatite for biomedical applications

Hydroxyapatite (HA or HAp) is one of the most preferred biomaterials, specifically for bone tissue engineering. HAp is available naturally and is also chemically synthesized. The properties, shape, size and crystalline structure and applications of HAp vary widely depending on the source and extraction methods used. In addition to conventional chemical approaches such as precipitation or sol-gel techniques, newer methods such as microwave synthesis and atomic-layer deposition provide an opportunity to generate HAp with desirable structure and properties. Various methods used for the synthesis of HAp have their own pros and cons. Hence, it is essential to understand the role of specific methods and conditions on the properties and structure of HAps in order to obtain HAp with properties suitable for specific applications. In addition to pure HAp, substantial efforts have been made to dope HAp with various minerals or bioentities to enhance their suitability for medical, environmental remediation and other approaches. In this review, we provide an overview of the various chemical methods used to produce HAp, properties of the HAp produced and its potential applications. Particular focus of this paper is on the co-relation between properties and processes used to synthesis HAp. This review will enable readers to quickly understand the importance of synthesis methods and conditions on the properties of HAp and choose appropriate means to generate HAp with desired properties for specific applications.

Extraction and characterisation of bioactive proteins from Pongamia pinnata and their conversion into bioproducts for food packaging applications

In this research, proteins were obtained from Pongamia pinnata oil meal and subsequently converted into films and compression molded into various packaging products. Films with a maximum tensile strength of 1.9 MPa were obtained when 15% citric acid was used as the crosslinker. Minimum swelling of 120% was seen in 20% citric acid crosslinked film whereas the uncrosslinked films readily disintegrated in water. The protein films had excellent antioxidant properties with an IC50 value of 14.6 µg/ml compared to 26.9 µg/ml for the standard ascorbic acid. The pongamia protein-based bioproducts showed good activity against Bacillus cereus and Aspergillus niger. Unique properties, low cost, and large availability make pongamia proteins an ideal biopolymer for the development of green and sustainable materials and bioproducts.

Vegetation Type Does not Affect Nitrous Oxide Emissions from Riparian Zones in Agricultural Landscapes

Riparian zones provide multiple benefits in agricultural landscapes, but nitrogen (N) loading can cause N₂O emissions. There is a knowledge gap on how different types of riparian vegetation influence N₂O emissions. This study quantified N₂O emissions from a rehabilitated riparian zone with deciduous trees (RH), a herbaceous (grassed) riparian zone (GRS), a natural forested riparian zone with deciduous trees (UNF-D), a natural forested riparian zone with coniferous trees (UNF-C), and an agricultural field (AGR). N₂O fluxes were not significantly different (p > 0.05) among riparian zones (11-17 µg N₂O-N m^-2 h^-1) and were not significantly different (p > 0.05) when comparing riparian zones to the AGR field (34 µg N₂O-N m^-2 h^-1). Despite high N-loading, cumulative N₂O emissions (1989 µg N₂O-N m^-2) in the riparian zones was significantly lower (p > 0.05) than AGR (13,278 µg N₂O-N m^-2). The main predictors of N₂O fluxes were soil temperature and soil NO₃^--N for the riparian zones and the AGR field. We found that environmental conditions played a greater role than the type of riparian vegetation or age in predicting N₂O emissions. We suggest that soil environmental factors created an anaerobic environment that favored N₂O consumption via complete denitrification.

Litter to Leaf: The Unexplored Potential of Silk Byproducts

Silk has remained the most preferred protein fiber since its discovery in 3000 BC. However, the cost, availability, and resources required to rear the silkworms and process silk are imposing considerable constraints on the future of silk. It is often unrealized that apart from the fibers, production and processing of silk are a source for a diverse range of sustainable, biodegradable, and biocompatible polymers. Hence, delineating itself from being the primary source of protein fibers for millenniums, the silk industry worldwide is transitioning into a biobased industry and as a source for pharmaceuticals, biomaterials, cosmetics, food, and energy. Toward this, byproducts (BPs) and co-products (CPs) that are inevitably generated are now being considered to be of immense economic value and could be up to 10 times more valuable than the silk fibers. Here, we elucidate the properties and potential applications of silk BPs and CPs to present the true potential of silkworms and to promote the establishment of silkworm-based bioeconomy and biorefineries.

Three-dimensional rope-like and cloud-like nanofibrous scaffolds facilitating in-depth cell infiltration developed using a highly conductive electrospinning system

Three-dimensional (3D) nanofibrous scaffolds are at the forefront of tissue engineering research. However, owing to the compact geometries or unstable reserved pores, the scaffolds produced by the current techniques provide limited in-depth cell infiltration, leaving the regeneration of 3D tissues a major challenge. Herein, we have developed a novel single-step 3D electrospinning technique to create 3D rope-like or cloud-like nanofibrous scaffolds by introducing 0 to 0.9 wt% of silver nanoparticles (Ag NPs) into a spinning system and provided an insight into the mechanism. The incorporation of Ag NPs caused intense jet whipping and elevated fiber conductivity, allowing reverse charge transfer and segmented charge storage to provoke vertical collection of waved spirals. The resultant scaffolds exhibited ultrahigh specific pore volumes, facilitating in-depth cell attachment, migration, and proliferation. This work demonstrated a feasible approach to establish versatile 3D culture nanofibrous platforms for a variety of biomedical applications.

Hybrid robotic transversus abdominis release versus open: propensity-matched analysis of 30-day outcomes

PURPOSE

To examine the hospital length of stay (LOS) and 30 day outcomes of hybrid robotic transversus abdominis release (hrTAR) compared with open transversus abdominis release (oTAR).

METHODS

Patients receiving hrTAR were selected from the AHSQC database and propensity matched with a contemporary cohort of oTAR patients.

RESULTS

The cohort included 95 hrTAR and 285 oTAR patients. There was a significantly shorter median LOS in the hrTAR cohort (3 vs. 5 days, p < 0.001). The rate of surgical site occurrences in the hrTAR cohort was also lower than for oTAR (5% vs. 15%, p = 0.015). Readmission rates were not different between hrTAR and oTAR (6% vs. 8%, p = 0.65).

CONCLUSION

hrTAR demonstrates improved LOS compared to oTAR as well as fewer surgical site related occurrences. Further studies are needed to investigate the etiology behind the improved LOS and to confirm appropriate long-term outcomes from hybrid robotic TAR.

AB0953 CANNABINOIDS: FRIEND OR FOE OR A BYSTANDER?

Background:

Cannabinoids has recently gained popularity for use in chronic pain. There is a lot of inquisitiveness among our patients wherein health care professionals are asked about its efficacy, side effects and sometimes even ask for a prescription! As there is paucity of data and research about its use in rheumatology, patient reported outcome(PROM) can guide ahead in expanding our knowledge and experience.

Objectives:

To study usage of cannabinoids by rheumatology patients

To study awareness among primary physicians regarding Cannabinoid usage in rheumatology.

Methods:

Cross sectional survey with two arms. Arm 1 Information from patients attending tertiary rheumatology clinic,including perception regarding the use of Cannabinoids.

Arm 2 consisted of collecting data via web-based survey with20-question from 100 GPs of Leicestershire. Questions on demographics, perspectives on and knowledge of cannabinoid use. Statistical analysis SPSS software.

Results:

Arm1 Total 102 rheumatology patients with 60%were females and 45% secondary education. 48% were unemployed. 75% Caucasians, 18% Asians. RA most common diagnosis followed by OA and FMS. 40 % depression and anxiety in addition to Rheumatic disease. 94% reported ongoing pain with 6-8 on a VAS scale. 79% were satisfied with their current therapy. 65% had heard about complementary medicine and 15% reported using cannabinoids.

Most common form Cannabinoids oil 60% followed by smoking 20%. 56% reported using >3 months and majority 72% use daily. Median age 55 years. 88% users Caucasians. Mean disease duration 6.25 years among users indicates chronicity of disease has a direct proportion in usage. All users had ongoing pain of 7 on VAS. 87% believed it helps them managing pain effectively with a pain free state. On an average spends between 50-100 pounds per week. More than half believe cannabinoids should be available as a prescription drug in NHS and 30% interested to know more about it.

In Arm 2 consisting of Primary care physicians, response rate 50%. Average clinical experience 5 years. Only 20% heard about usage of complementary medicine by rheumatology patient. Most replied that 10% of their patients use Cannabinoids for pain management. Most did not believe use of cannabinoids benefited the patients. Only 4% recommend its usage. 25% think it should be available as prescription. 40% experienced patients asking about cannabinoids during appointment. 88% of respondents did not know much about cannabinoid usage in rheumatology and have never prescribed it in their practice.

Conclusion:

Cannabinoids widely used by the rheumatology patients with PROM favouring its efficacy for control of chronic pain. Preclinical data suggest that cannabinoids might have a therapeutic potential RA1, OA, FMS2. Clinical data regarding cannabinoid treatment for rheumatic diseases are scarce, therefore, recommendations concerning cannabinoid treatment cannot be made. All patients who reported using it suffered from moderate to severe chronic pain. Thus main indication of usage was pain rather than recreational purpose. Although a small survey it clearly highlights lack of knowledge among primary physicians. These results emphasise the need for further research regarding the benefits and risks of cannabinoids in rheumatology.

References:

[1]RichardsonD. etal Characterisation ofthe cannabinoid receptor system in synovial tissue andfluid in patients with OA and RA Arthritis Res.Ther. 10, R43 (2008).

[2]Walitt, B etal Cannabinoids for fibromyalgia. Cochrane DatabaseSyst. Rev. 7, CD011694 (2016).

Disclosure of Interests:

Nibha Jain: None declared, Neelima Reddy: None declared, Arumugam Moorthy Speakers bureau: Abbvie, Novartis,UCB,MSD

Outcomes of Patients with Nelson's Syndrome after Primary Treatment: A Multicenter Study from 13 UK Pituitary Centers

CONTEXT

Long-term outcomes of patients with Nelson's syndrome (NS) have been poorly explored, especially in the modern era.

OBJECTIVE

To elucidate tumor control rates, effectiveness of various treatments, and markers of prognostic relevance in patients with NS.

PATIENTS, DESIGN, AND SETTING

Retrospective cohort study of 68 patients from 13 UK pituitary centers with median imaging follow-up of 13 years (range 1-45) since NS diagnosis.

RESULTS

Management of Cushing's disease (CD) prior to NS diagnosis included surgery+adrenalectomy (n = 30; eight patients had 2 and one had 3 pituitary operations), surgery+radiotherapy+adrenalectomy (n = 17; two received >1 courses of irradiation, two had ≥2 pituitary surgeries), radiotherapy+adrenalectomy (n = 2), and adrenalectomy (n = 19). Primary management of NS mainly included surgery, radiotherapy, surgery+radiotherapy, and observation; 10-year tumor progression-free survival was 62% (surgery 80%, radiotherapy 52%, surgery+radiotherapy 81%, observation 51%). Sex, age at CD or NS diagnosis, size of adenoma (micro-/macroadenoma) at CD diagnosis, presence of pituitary tumor on imaging prior adrenalectomy, and mode of NS primary management were not predictors of tumor progression. Mode of management of CD before NS diagnosis was a significant factor predicting progression, with the group treated by surgery+radiotherapy+adrenalectomy for their CD showing the highest risk (hazard ratio 4.6; 95% confidence interval, 1.6-13.5). During follow-up, 3% of patients had malignant transformation with spinal metastases and 4% died of aggressively enlarging tumor.

CONCLUSIONS

At 10 years follow-up, 38% of the patients diagnosed with NS showed progression of their corticotroph tumor. Complexity of treatments for the CD prior to NS diagnosis, possibly reflecting corticotroph adenoma aggressiveness, predicts long-term tumor prognosis.

Increased Infection Risk in Addison's Disease and Congenital Adrenal Hyperplasia

CONTEXT

Mortality and infection-related hospital admissions are increased in patients with primary adrenal insufficiency (PAI). However, the risk of primary care-managed infections in patients with PAI is unknown.

OBJECTIVE

To estimate infection risk in PAI due to Addison's disease (AD) and congenital adrenal hyperplasia (CAH) in a primary care setting.

DESIGN

Retrospective cohort study using UK data collected from 1995 to 2018.

MAIN OUTCOME MEASURES

Incidence of lower respiratory tract infections (LRTIs), urinary tract infections (UTIs), gastrointestinal infections (GIIs), and prescription counts of antimicrobials in adult PAI patients compared to unexposed controls.

RESULTS

A diagnosis of PAI was established in 1580 AD patients (mean age 51.7 years) and 602 CAH patients (mean age 35.4 years). All AD patients and 42% of CAH patients were prescribed glucocorticoids, most frequently hydrocortisone in AD (82%) and prednisolone in CAH (50%). AD and CAH patients exposed to glucocorticoids, but not CAH patients without glucocorticoid treatment, had a significantly increased risk of LRTIs (adjusted incidence rate ratio AD 2.11 [95% confidence interval (CI) 1.64-2.69], CAH 3.23 [95% CI 1.21-8.61]), UTIs (AD 1.51 [95% CI 1.29-1.77], CAH 2.20 [95% CI 1.43-3.34]), and GIIs (AD 3.80 [95% CI 2.99-4.84], CAH 1.93 [95% CI 1.06-3.52]). This was mirrored by increased prescription of antibiotics (AD 1.73 [95% CI 1.69-1.77], CAH 1.77 [95% CI 1.66-1.89]) and antifungals (AD 1.89 [95% CI 1.74-2.05], CAH 1.91 [95% CI 1.50-2.43]).

CONCLUSIONS

There is an increased risk of infections and antimicrobial use in PAI in the primary care setting at least partially linked to glucocorticoid treatment. Future studies will need to address whether more physiological glucocorticoid replacement modes could reduce this risk.

Sustained Local Delivery of Diclofenac from Three-Dimensional Ultrafine Fibrous Protein Scaffolds with Ultrahigh Drug Loading Capacity

The three-dimensional (3D) ultrafine fibrous scaffolds loaded with functional components can not only provide support to 3D tissue repair, but also deliver the components in-situ with small dosage and low fusion frequency. However, the conventional loading methods possess drawbacks such as low loading capacity or high burst release. In this research, an ultralow concentration phase separation (ULCPS) technique was developed to form 3D ultrafine gelatin fibers and, meanwhile, load an anti-inflammatory drug, diclofenac, with high capacities for the long-term delivery. The developed scaffolds could achieve a maximum drug loading capacity of 12 wt.% and a highest drug loading efficiency of 84% while maintaining their 3D ultrafine fibrous structure with high specific pore volumes from 227.9 to 237.19 cm3/mg. The initial release at the first hour could be reduced from 34.7% to 42.2%, and a sustained linear release profile was observed with a rate of about 1% per day in the following 30 days. The diclofenac loaded in and released from the ULCPS scaffolds could keep its therapeutic molecular structure. The cell viability has not been affected by the release of drug when the loading was less than 12 wt.%. The results proved the possibility to develop various 3D ultrafine fibrous scaffolds, which can supply functional components in-situ with a long-term.

Biofibers and biocomposites from sabai grass: A unique renewable resource

Natural cellulose fibers were extracted from a fast growing perennial grass Eulaliopsis binata (commonly known as Sabai) and characterized for their structure and properties. The untreated sabai grass has been used as reinforcement for polypropylene composites and properties of the composites have been investigated. Although the composition of the sabai grass is typical to other lignocellulosic sources, there is a high content of flavonoids (630 mg/g) and phenols (510 mg/g) which provides high antibacterial, and antifungal properties to the fibers and composites developed. Fiber bundles extracted from the grass had tensile strength of 493 MPa and tensile modulus of 21 GPa, similar to common natural cellulose fibers. Both tensile and flexural properties of polypropylene composites increased with increasing ratio of sabai grass. Polypropylene composites reinforced with sabai grass show high noise insulation and thermal resistance properties suggesting their suitability for automotive and building applications.