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Mastectomy serves as the main surgical treatment for both invasive and in situ breast carcinoma and large phyllodes tumors. It is associated with skin necrosis, seroma, and surgical site infection in up to 30% of patients. In the present trial, we compared the complications in patients undergoing skin flap elevation by one of the 4 techniques: thick skin flap raised by scalpel(group1), thin skin flap raised with scalpel (group 2), thick skin flap raised with diathermy (group 3), and thin skin flap raised with diathermy (group 4). A randomized trial with superiority hypothesis and 2 × 2 factorial design was conducted at All India Institute of Medical Sciences New Delhi. Mastectomy skin flap necrosis (MSN) was recorded as the main outcome of interest. MSN was noted in 2.5% in group1, 10% in group 2, 7.5% in group 3, and 30% in group 4. MSN was observed in 5% cases with thick flap compared to 20% cases with a thin skin flap (p = 0.007). Raising the flap with scalpel was associated with MSN in 6.25% compared to 18.75% in the diathermy group (p = 0.029). We conclude that raising a thick flap with scalpel is associated with lowest risk of skin flap necrosis. Trial Registration: Clinical Trial Registry- India CTRI/2014/09/004978 [ABSTRACT FROM AUTHOR]

Objective: To assess the efficacy and safety of fixed-dose combinations (FDC) of triple-drug dapagliflozin, sitagliptin, and metformin (DSM) compared with FDC of two-drug sitagliptin and metformin (SM), in Indian adult patients with type 2 diabetes (T2D). Methods: A multicentric, randomized, double-blind, active-controlled, Phase 3 study (CTRI/2021/10/037461) was conducted on 274 Indian adult patients with T2D. Patients were randomized (1:1) to receive either an FDC of triple-drug (n = 137) dapagliflozin propanediol 10 mg, sitagliptin phosphate 100 mg, and metformin hydrochloride 1000 mg extended-release (DSM) or FDC of two-drug (n = 137) sitagliptin phosphate 100 mg and metformin hydrochloride 1000 mg sustained-release (SM), for 16 weeks. The primary endpoint was a change in HbA1c, while the secondary endpoints were changes in fasting plasma glucose (FPG), postprandial glucose (PPG), body weight, and safety. Results: Both DSM and SM FDCs reduced HbA1c significantly (-1.45% and -1.00%, respectively, both p < 0.0001), however, HbA1c lowering was superior with DSM (∆ -0.45%; p = 0.0005) compared to SM, at week 16. Similarly, both DSM and SM FDCs reduced FPG and PPG significantly, however, FPG (∆ -12.4 mg/dl; p = 0.003) and PPG reduction (∆ -18.45 mg/dl; p = 0.01) were significantly superior to DSM compared to SM, respectively. No significant reduction in body weight was observed between the two arms. Both FDCs were well tolerated. Conclusion: FDC of DSM was superior to SM in reducing HbA1c, FPG, and PPG in Indian adults with T2D. Both triple and dual FDCs had optimal safety profiles. [ABSTRACT FROM AUTHOR]

In the present work we have perform a comparative study of structural and elastic properties of some inorganic and organic molecular crystals viz. Realgar As4S4, As4S3, C14H10 (anthracene), C10H8 (naphthalene). For theoretical prediction, four different EOSs have been used viz. modified Lenard-Jones EOS (M-L Jones EOS), Brennan-Stacey EOS, Hamma—Suito EOS and Thomsen EOS. Further, we have checked the applicability of these EOSs for calculation of Grüneisen parameter at different compressions. Experimental data and theoretical facts give the validity of our work. [ABSTRACT FROM AUTHOR]

Purpose: A locking plate (LP) or non-locking plate (NLP) can be used for distal fibula fracture fixation. However, the advantages of LP over NLP in patients with distal fibula fractures are not clear. In terms of indications, the role of the two plates probably differs; however, to draw comparative conclusions, we conceptualized this systematic review and meta-analysis of studies that directly compared the two plates, wherein both groups' indications and baseline parameters were similar. Methods: An electronic literature search was performed using PubMed/Medline, Embase, Scopus, and Cochrane Library databases for studies comparing the LP versus NLP fixation for the lateral malleolus fracture. A total of 18 studies were included in qualitative and quantitative analysis. A subgroup analysis was performed for patients aged < 55 years and patients aged > 55 years. The statistical analysis was performed by Review Manager Software version 5.4.1. Results: A meta-analysis of 4243 fractures was performed across 18 studies. The rate of fracture union and overall complication rates did not differ between the two fixation groups with an OR of 0.71 (95% CI 0.26, 1.96, p = 0.51 and 1.11 (95% CI 0.84, 1.47, p = 0.47, respectively. There is no difference in the reoperation rate due to minor or major complications between the two groups. There was no difference in functional outcome (MD −0.85, with 95% CI −5.63, 3.93, p = 0.73), but NLP has a shorter surgical duration (MD 3.0, with 95% CI 0.26, 5.75, p = 0.03). A leave-one-out sensitivity analysis performed for overall complications affected the final outcome of the meta-analysis. Conclusion: This meta-analysis demonstrates no clear benefit in selecting LP over NLP for the fixation of lateral malleolus fractures. [ABSTRACT FROM AUTHOR]

Software-Defined Networking (SDN) outperforms conventional networks in terms of programmability, management, flexibility, and efficiency. This is because SDN separates the control and data planes. The centralised control of devices aids in the prevention of Distributed Denial of Service (DDoS) attacks. The controller has a larger network perspective and has the ability to filter network traffic in order to detect harmful flows. The separation of the control and data planes provided benefits, but it is vulnerable to DDoS attacks. DDoS assaults are difficult to detect and resist in real-time. This is only possible if appropriate features for attack detection are chosen. We intend to employ feature selection methods such as BORUTA, IRelief, Random Forest, Information Gain and Chi-Square Test to obtain the most relevant features for DDoS detection. Moreover, we have devised a strategy to detect and mitigate DDoS attack using tracebacking approach through ONOS Flood Defender (OFD) Application. The application effectively detects different DDoS attack traffic using XGBoost and Multilayer Perceptron algorithms with 99% accuracy and least testing times without adding unnecessary load to the system and mitigates the attack in approximately 3.2 s using tracebacking approach. We have performed our experiment on four benchmark datasets CIC-DoS 2017, CIC-DDoS 2019, CIC-IDS 2018 and InSDN. We have evaluated the trade-off between detection accuracy and testing time in order to determine the most effective detection model for addressing DDoS attacks on SDN networks. [ABSTRACT FROM AUTHOR]

Indian population is ageing at a higher pace coupled with the increase in life expectancy, and the prevalence of cognitive impairment, dementia, and comorbidities increase dramatically with age. Such cognitive and physical changes are intimately linked with declines in everyday functioning that include loss of decision-making skills. The present study explored the relationship between socioeconomic and health status of older adults and their role in household decision making. The study used data from the "Building a Knowledge Base of Population Ageing in India" (BKPAI) survey conducted in 2011 (n = 9181). Descriptive statistics along with multivariate negative binomial and binary logistic regression analyses were conducted. A proportion of 29.7% of older adults had no or partial involvement in household decision making and 26.5% of older adults reported that they had witnessed a decline in their role as decision-maker. The involvement of older adults in household decision making was 1.51 times lower among those who did not contribute money in household expenditure (incidence rate tatio (IRR):1.51; 95% confidence interval (CI): 1.24, 1.84) than those who contributed. Respondents who had low cognitive ability (IRR: 1.22; 95% CI: 1.09, 1.37) or had more than one disability (IRR: 1.27; 95%CI: 1.09, 1.47) were significantly 1.22 and 1.27 times less likely to have involvement in household decision making, respecctively. Older adults who reported low self-rated health (adjusted odds rati (aOR): 1.4; 95% CI: 1.21, 1.61), low general health (aOR: 2.85; 95% CI: 2.46, 3.31), low subjective wellbeing (aOR: 2.29; 95% CI: 1.99, 2.64) and low IADL (aOR: 1.49; 95% CI: 1.31, 1.69) were significantly more likely to report a decline in the role as a decision maker compared to their healthy counterparts. Along with the poor socioeconomic characteristics, the negative effects of cognitive and health markers of ageing further diminish the role of older adults in household decision making. Further research in the field of familial role and importance of older adults in different family settings is required in tackling a wide range of issues related to the wellbeing of the aged population. [ABSTRACT FROM AUTHOR]

Cyclical mastalgia of moderate to severe degree requires systemic drug therapy. Tamoxifen is the drug of choice worldwide. A novel molecule, centchroman/Ormeloxifene, developed in India, was found to be equally effective in previous studies. However, its optimal dose regimen is uncertain. We conducted three-arm randomized controlled trial to compare the effectiveness in relieving breast pain. Group 1 received tamoxifen 10 mg daily, and groups 2 and 3 received centchroman 30 mg twice and 30 mg thrice a week, respectively, for 3 months with a follow-up of 3 more months. Breast pain score, nodularity score, sonographic evaluation of the breasts and ovaries, quality of life scores, and adverse events were recorded. The number of patients enrolled was 32, 31, and 30 in group 1, group 2, and group 3, respectively. All three groups had significant improvement in breast pain scores [group 1 (5 → 2), group 2 (5 → 2), group 3 (6 → 2), p < 0.001)], nodularity scores [group1 (1 → 0), group 2 (1 → 0), group 3 (1 → 0), p < 0.001)] and in the quality of life scores over time. However, no significant differences were observed in-between the groups. Transient ovarian cyst formation and menstrual irregularities were more common with a higher dose of centchroman. Centchroman in the dosages of 30 mg twice or thrice a week is as effective as a daily dose of tamoxifen 10 mg in relieving pain, nodularity, and improving quality of life scores. The dose of centchroman 30 mg twice a week for 12 weeks has the least adverse effects and should be accepted as the optimal dosage regimen. There is a need of further study with a greater number of participants and longer follow-up. Trial registration number: CTRI/2018/02/012043 (Registered on: 21/02/2018). [ABSTRACT FROM AUTHOR]

The proportion of older adults are increasing at a much higher rate than ever expected in both developing and developed countries, and India is no exception. High health care expenditure is attributed to deteriorating health condition among older adult following disability in later life stages and also due to the presence of chronic diseases, and multi-morbidity among them as life expectancy has substantially increased in last few decades. Data for the analysis was used from the National Sample Survey Organization conducted during the 71st (2014) and 75th round (2017-18). Descriptive statistics, bivariate analysis, and linear regression were used for the study. It was found that mean OOPE for older adults was high if the household head was an older adult in case of both men and women. Older adults from higher socio-economic status incurred high OOPE. Moreover, older adults who were financially independent incurred high OOPE compared to those who were partially or fully economically dependent. More interestingly, financially independent women incur higher OOPE than financially independent men. In most states, it was observed that mean OOPE was high for men compared to women, which depicts clear gender differentials. The findings of this study are significant and provide new information on discrepancies between older men and women in health-care spending. Older men were found to have slightly higher health care costs relative to women in this nationally representative survey, after adjusting for confounding factors. [ABSTRACT FROM AUTHOR]

A three-dimensional (3D) plane wave incident at a functionally graded triclinic medium (FGTM) under two different types of boundary (viz. stress free (Case I) and rigid (Case II)) has been modelled. The constitutive equations of the functionally graded triclinic medium are used to deduce the Christoffel matrix of order 3. By using Cardano's method, we derive the expressions for the phase velocities of the reflected waves (qP, qSV and qSH waves). The expressions of the reflection coefficients (amplitude ratios) are obtained for the present geometry with the help of the generalized Snell's law and Cramer's rule. The obtained mathematical expressions are perfectly matched with pre-established results. Further, the slowness surface and energy ratios have been also completed to prove the correctness of the presented problem. The effect of anisotropy and functionally graded parameter on the reflection coefficients has been traced out remarkably through a comparative study by numerical modelling. The comparative analysis reveals that the functionally graded parameter and anisotropy have significant impact on the amplitude ratios and both these attributes contribute simultaneously to simulate a realistic elastodynamic model and predict the response of the medium (geo-medium) with better accuracy. [ABSTRACT FROM AUTHOR]

Drawing on institutional theory and resource dependence theory, this study examines whether mandating gender quotas for corporate boards is associated with a greater presence of women on boards, better accounting-based and market-based performance, more innovativeness, and more external female directors. Based on a cross-country comparative sample of companies from 18 countries, our results suggest that organizations in countries where gender quotas are implemented show better market-based performance and better board vigilance through a higher number of external directors than organizations in countries where quotas are not implemented. The direct impact of gender quotas on innovativeness and accounting performance is not observed. Our findings add to the institutional theory literature by suggesting that companies respond strategically and show acquiescence in their strategic response when institutional pressure addresses ethical concerns (gender diversity). The results support institutional theory's contentions that companies from countries mandating gender quotas are valued more highly by the market. Nevertheless, the impacts on accounting performance and innovativeness are not apparent. Additionally, adopting a resource dependence approach, we find that the presence of women on boards is associated with more efficient corporate governance practices. The results of this study demonstrate the positive implications of gender quotas for company boards. The upper echelons of companies and country policymakers may better understand the importance of diversity and the presence of female directors on company boards. [ABSTRACT FROM AUTHOR]

Graves' ophthalmopathy (GO) is an autoimmune disease of the retroocular tissue occurring in patients with Grave's disease leading to exophthalmos. Exophthalmos is usually detected by inspection using Nafziger's method and objectively measured with Hertel's exophthalmometry. Here we have described a novel technique "Pen touch test" to clinically diagnose exophthalmos. This cross-sectional study was conducted on patients with suspicious hyperthyroid ophthalmopathy/Grave's ophthalmopathy (GO) who underwent eye examination by Nafziger's method and our proposed new method "Pen Touch Test (PTT)". In this test, a clean ruler or pen is held straight over the middle of orbital ridge touching the superior orbital margin and ipsilateral malar eminence. In normal persons, the ruler or pen touches both the superior orbital margin and ipsilateral malar eminence with or without touching eyelids. In patients with GO, there is true bulging forward of the eyeball. Hence, the ruler or pen cannot be made to touch both upper orbital margin and malar eminence simultanously. The presence and degree of exophthalmos was measured objectively on Hertel's exophthalmometry, which was considered the "gold standard". Pen touch test was found to have 100% sensitivity, 100% specificity and 100% Positive Predictive value. Whereas Nafziger's method had a sensitivity of only 75% compared to Hertel's exophthalmometry as gold standard test. "Pen touch test" is simple and sensitive method that can be used to screen for exophthalmos in suspected cases of Grave's ophthalmopathy. [ABSTRACT FROM AUTHOR]

A computer views all kinds of visual media as an array of numerical values. As a consequence of this approach, they require image processing algorithms to inspect contents of images. This project compares 3 major image processing algorithms: Single Shot Detection (SSD), Faster Region based Convolutional Neural Networks (Faster R-CNN), and You Only Look Once (YOLO) to find the fastest and most efficient of three. In this comparative analysis, using the Microsoft COCO (Common Object in Context) dataset, the performance of these three algorithms is evaluated and their strengths and limitations are analysed based on parameters such as accuracy, precision and F1 score. From the results of the analysis, it can be concluded that the suitability of any of the algorithms over the other two is dictated to a great extent by the use cases they are applied in. In an identical testing environment, YOLO-v3 outperforms SSD and Faster R-CNN, making it the best of the three algorithms. [ABSTRACT FROM AUTHOR]

Purpose: In the present study, we aimed at assessing the effect of femoral and tibial coronal bowing on varus malalignment and Oxford knee score (OKS) at different grades of knee osteoarthritis (OA). Materials and Methods: This prospective observational study was conducted at a tertiary referral centre in New Delhi, India. Consecutive patients presenting to the "knee OA" outpatient clinics were invited to take part in the study conducted over a 12-month period. All consented patients underwent long-leg standing alignment radiographs using standardised technique and patient reported knee pain and function were recorded using Oxford knee score. The following radiological parameters were measured from weight-bearing long-leg radiographs of 824 varus aligned limbs via a morphometric software (Matlab R2009a) (1) hip–knee–ankle angle (HKAA), (2) femoral bowing, (3) tibial bowing. The knees were graded according to Kellegren and Lawrence grade (K&L) and OKS was recorded. 3 groups of HKAA were made based on the angle, A (0° to − 3°), B (− 3° to − 10°) and C (< − 10°). Both the femoral and tibial bow were also categorized into three groups depending upon the angle; in-range (− 2° to + 2°), varus (< − 2°), valgus (> + 2°). Results: The mean (± SD) of HKAA, femoral bow and tibial bow of the whole cohort was − 6.97° ± 5.64°, − 1.54° ± 4.31° and − 1.96° ± 3.5°, respectively. An increase in the lateral bow of both femur and tibia was seen with an increase in the severity of OA. A consequent increase in the varus malalignment was observed with an increase in the lateral bow of both femur as well as the tibia at all grades of OA, with significant correlation observed between HKAA with Femoral bowing and HKAA with tibial bowing. The mean OKS for femoral bow, in-range, varus and valgus was 30.6 ± 11.5, 21.3 ± 11.5 and 35.3 ± 11.4, respectively, and for tibial bow, in-range, varus and valgus was 27.6 ± 11.5, 26. ± 11.5 and 28 ± 11.4, respectively. The difference in the mean OKS was observed to be significant when the varus bow group was compared to in range as well as valgus group (p < 0.01) for both femur and tibia for all the grades of OA. Conclusion: The present study shows a significant correlation between varus malalignment and the bowing of extremities. Varus coronal bowing of both femur and tibia were seen to have significantly lower mean OKS as compared to valgus bowing or in-range bowing at all grades of knee OA. [ABSTRACT FROM AUTHOR]

Background: Variation in the shape of the femur and tibia has been shown to influence hip–kneeankle-axis angle (HKAA) and bears a role in reconstructive surgeries such as total knee arthroplasty (TKA). However, data on the axial alignment of the lower extremity specific to sex largely remains unavailable. Thus, we conducted a study with an aim to measure alignment and calculate differences in both the sexes in Indian population. Materials and Methods: The following radiological parameters were measured from weight-bearing long leg radiographs of 966 limbs of Indian subjects via a morphometric software (Matlab R2009a) (1) Hip–Knee–Ankle angle (HKAA), (2) femoral bowing, (3) tibial bowing, (4) condylar plateau angle (CPA). The knees were classified according to the Kellegren and Lawrence grading and the differences between both the sexes were calculated with appropriate statistical tests. Results: 56.04% of the subjects were female. An increase in the mean age was observed for both the genders with an increase in the severity of OA. Height did not show any significant association with the alignment of the limb. The mean HKAA observed was − 5.88° ± 0.35° in females and − 4.99° ± 0.41° in males. The overall mean femoral bow and tibial bow was − 1.26° ± 0.24°, − 1.60° ± 0.18° in females and − 1.09 ± 0.28, − 1.47° ± 0.21° in males. The mean condylar plateau angle was higher in females − 2.67 ± 0.34 as compared to males − 2.35° ± 0.39°. A greater lateral bow was seen in males at higher grades of OA for femur and at lower grades of OA for tibia. Conclusion: This study provides gender-based differences in the various axial radio-graphic parameters in a long leg radio-graphs in Indian population which might help in a better understanding of the etiopathogenesis of osteoarthritis and also help planning and execution of reconstructive surgeries such as TKA. [ABSTRACT FROM AUTHOR]

In this paper, a simplified yet efficient architecture of a deep convolutional neural network is presented for lung image classification. The images used for classification are computed tomography (CT) scan images obtained from two scientifically used databases available publicly. Six external shape-based features, viz. solidity, circularity, discrete Fourier transform of radial length (RL) function, histogram of oriented gradient (HOG), moment, and histogram of active contour image, have also been identified and embedded into the proposed convolutional neural network. The performance is measured in terms of average recall and average precision values and compared with six similar methods for biomedical image classification. The average precision obtained for the proposed system is found to be 95.26% and the average recall value is found to be 69.56% in average for the two databases. [ABSTRACT FROM AUTHOR]

This randomized double-blind placebo-controlled trial evaluated the effects of early postnatal oral vitamin A supplementation (VAS) in 196 inborn very-low birth weight (VLBW) infants requiring respiratory support at 24 h of age. Eligible infants were randomized to receive aqueous syrup of vitamin A (10,000 IU of retinol/dose; n = 98) or placebo (n = 98) on alternate days for 28 days. Primary outcome variable was composite incidence of all-cause mortality and/or oxygen requirement for 28 days. Secondary outcome variables were safety/tolerability of VAS, serum retinol concentration at recruitment and day 28, duration of oxygen requirement and respiratory support and incidences of complications. On intention-to-treat analysis, composite incidence of all-cause mortality and oxygen requirement for 28 days was significantly lower in vitamin A group (relative risk (95% confidence interval), 0.440 (0.229-0.844); p < 0.05, number needed to benefit, 7). Requirement and duration of oxygen supplementation and non-invasive respiratory support, incidences of late-onset sepsis, patent ductus arteriosus, and duration of hospital stay were also significantly lower in vitamin A group. Serum retinol concentration improved significantly after VAS. No major adverse effect was observed.Conclusions: Early postnatal oral VAS was associated with better composite outcome of all-cause mortality and oxygen requirement without any major adverse effects.Clinical Trial Registration: Clinical Trials Registry of India (CTRI/2017/03/008131). What is Known: • Postnatal intramuscular vitamin A supplementation improves the survival, respiratory outcome and other morbidities in very low birth weight neonates without major adverse effects. • Limited studies on oral vitamin A supplementation did not document substantial benefits. What is New: • Early postnatal alternate-day oral vitamin A supplementation at the dose of 10,000 IU/dose for 28 days improves the composite outcome of death and oxygen requirement in very low birth weight neonates with respiratory distress • No major adverse effects were documented. [ABSTRACT FROM AUTHOR]

Purpose: This study describes the prevalence and predisposing factors for potentially modifiable unmet emotional, care/support, and information needs among adult survivors of childhood malignancies.Methods: A randomly selected/stratified sample of participants in the Childhood Cancer Survivor Study (CCSS) responded to the CCSS-Needs Assessment Questionnaire (CCSS-NAQ) (n = 1189; mean [SD] current age, 39.7 [7.7], range = 26-61 years; 60.9 % women; mean [SD] years since diagnosis, 31.6 [4.7]). Survivors self-reported demographic information, health concerns, and needs; diagnosis/treatment data were obtained from medical records. Adjusted proportional risk ratios (prevalence ratios, PRs) were used to evaluate 77 separate needs.Results: Fifty-four percent of survivors reported unmet psycho-emotional, 41 % coping, and 35 % care/support needs; 51, 35, and 33 %, respectively, reported unmet information needs related to cancer/treatment, the health care system, and surveillance. Female sex and annual income <$60K were associated with multiple needs; fewer needs were linked to diagnosis/years since/or age at diagnosis. Having moderate/extreme cancer-related anxiety/fear was associated with all needs, including a >6-fold increased prevalence for help dealing with "worry" (PR = 6.06; 95 % confidence interval [CI], 3.79-9.69) and anxiety (PR = 6.10; 95 % CI, 3.82-9.72) and a >5-fold increased prevalence for "needing to move on with life" (PR = 5.56; 95 % CI, 3.34-9.25) and dealing with "uncertainty about the future" (PR = 5.50; 95 % CI, 3.44-8.77). Radiation exposure and perceived health status were related to 42 and 29 needs, respectively.Conclusions: Demographic factors, disease/treatment characteristics, and intrapersonal factors can be used to profile survivors' unmet emotional, care/support, and information needs.Implications For Cancer Survivors: These data can be used to enhance provider-survivor communication, identify at-risk subsamples, and appraise core intervention content. [ABSTRACT FROM AUTHOR]

Mastalgia is defined as pain in the breast for more than 1 week of menstrual cycle. A number of drugs have been recommended for its treatment. However, there is some debate among the experts about the most beneficial agent. In this study, we compared the effectiveness and cost-effectiveness of centchroman and tamoxifen in the treatment of mastalgia. We recruited 106 ladies with mastalgia in a two-arm parallel design open-labelled randomised controlled trial with a non-inferiority hypothesis comparing 3-month therapy with either centchroman or tamoxifen. The response of therapy was assessed by visual analogue scale (VAS) of 0–10, on 1-, 2-, 3-, and 6-month follow-up. Direct and indirect costs were computed for each patient. Baseline mean VAS score was 6.25 in tamoxifen and 6.49 in centchroman group. Women in both groups enjoyed significant pain relief (pain score became < 3). The number of patients who achieved VAS less than 3 were 51 (96.2%) in centchroman and 49 (92.5%) in tamoxifen group at the end of 3 months of treatment. Centchroman was found to be more effective than tamoxifen (p < 0.001). Cost per unit successful relief of mastalgia in the centchroman group was 393 Nepalese Rupees and that in the tamoxifen group was 311.5 Nepalese Rupees. Centchroman is not inferior to Tamoxifen in relieving mastalgia. Tamoxifen proved more cost-effective than centchroman because of lower cost of tamoxifen in Nepal. [ABSTRACT FROM AUTHOR]

Objective: To correlate qualitative and quantitative diffusion weighted imaging (DWI) characteristics of intrahepatic cholangiocarcinoma (ICC) with histopathologic tumour grade and fibrosis content.Methods: Fifty-one patients (21M/30F; mean age 61y) with ICC and MRI including DWI were included in this IRB-approved multicentre retrospective study. Qualitative tumour features were assessed. Tumour apparent diffusion coefficient (ADC) mean, minimum, and normalized (nADCliver) values were computed. Tumour grade [well(G1), moderately(G2), or poorly differentiated(G3)] and tumour fibrosis content [minimal(1), moderate(2), or abundant(3)] were categorized pathologically. Imaging findings and ADC values were compared with pathologic measures. Utility of ADC values for predicting tumour grade was assessed using ROC analysis.Results: 51 ICCs (mean size 6.5±1.1 cm) were assessed. 33/51(64%) of ICCs demonstrated diffuse hyperintensity and 15/51(29%) demonstrated target appearance on DWI. Infiltrative morphology (p=0.02) and tumour size (p=0.04) were associated with G3. ADCmean and nADCmean of G3 (1.32±0.47x10-3 mm2/sec and 0.97±0.95) were lower than G1+G2 (1.57±0.39x10-3 mm2/sec and 1.24±0.49; p=0.03 and p=0.04). ADCmean and nADCmean were inversely correlated with tumour grade (p<0.025). No correlation was found between ADC and tumour fibrosis content. AUROC, sensitivity and specificity of nADCmean for G3 versus G1+G2 were 0.71, 89.5% and 55.5%.Conclusion: ADC quantification has reasonable accuracy for predicting ICC grade.Key Points: • ADC quantification was useful for predicting ICC tumour grade. • Infiltrative tumour morphology and size were associated with poorly differentiated ICCs. • ADC values depended more on ICC tumour grade than fibrosis content. • Ability to predict ICC tumour grade non-invasively could impact patient management. [ABSTRACT FROM AUTHOR]

The present study provides a comparative morphological analysis of spikes in different Indian species of Selaginella. The salient features of spikes including their types and also the shape and margin of sporophylls of the closely related taxa are characteristically useful in taxonomic delineation. We have used the term Leaf-flap, for the first time, and the Sporophyll-pteryx to denote the occurrence of vertical/oblique projection on the dorsal surface of leaf and sporophyll, respectively. The shape and colour of both mega- and micro-sporangia are also helpful in taxonomy; however, their size is not much significant as these are variable within the same spike of the species. A new pattern of sporangial distribution is being reported for the first time in the spike of S. plana (Desv. ex Poir.) Hieron. [ABSTRACT FROM AUTHOR]

Background: Urinary neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-beta-D-glucosaminidase (NAG), and interleukin 18 (IL-18) were found to be useful for early detection of acute kidney injury (AKI). The objective of this study was to determine the predictive ability of biomarkers for mortality and variation in levels in relation to different stages of AKI, need for dialysis, etiologies, and with duration of hospital stay. Methods: Urinary NGAL, NAG, and IL-18 levels were measured in 50 children with AKI and 30 age- and gender-matched healthy controls. AKI was classified as per pediatric Risk, Injury, Failure, Loss, and End-stage (RIFLE) criteria. Results: Median NGAL, NAG, and IL-18 values were significantly increased in AKI patients compared with controls ( p < 0.001), with significant increase among risk, injury, and failure stages. Nonsurvivors had significantly higher median levels of NGAL ( p = 0.008) and NAG ( p = 0.018) than survivors. NGAL had highest area under the curve (AUC) at 0.750 [confidence interval (CI) 0.580-0.920], followed by NAG at 0.724 (CI 0.541-0.907), with sensitivity and specificity of 75 % each; and IL-18 (AUC 0.688, CI 0.511-0.864), with sensitivity 62.5 % and specificity 70.8 %, for predicting mortality. Values were significantly higher in patients who required peritoneal dialysis (PD) than in those in whom it was not indicated. Levels were comparable among different etiologies. Only NGAL level was found to be a significant risk factor associated with longer duration of hospital stay. Conclusions: Urinary NGAL and NAG had modest predictive ability for mortality. Children requiring dialysis had significantly raised levels, and the NGAL level had significant association with duration of hospital stay. [ABSTRACT FROM AUTHOR]

In recent past, many moving object segmentation methods under varying lighting changes have been proposed in literature and each of them has their own benefits and limitations. The various methods available in literature for moving object segmentation may be broadly classified into four categories i.e., moving object segmentation methods based on (i) motion information (ii) motion and spatial information (iii) learning (iv) and change detection. The objective of this paper is two-fold i.e., firstly, this paper presents a comprehensive comparative study of various classical as well as state-of-the art methods for moving object segmentation under varying illumination conditions under each of the above mentioned four categories and secondly this paper presents an improved approximation filter based method in complex wavelet domain and its comparison with other methods under four categories mentioned as above. The proposed approach consist of seven steps applied on given video frames which include: wavelet decomposition of frames using Daubechies complex wavelet transform; use of improved approximate median filter on detail co-efficient (LH, HL, HH); use of background modeling on approximate co-efficient (LL sub-band); soft thresholding for noise removal; strong edge detection; inverse wavelet transformation for reconstruction; and finally using closing morphology operator. The qualitative and quantitative comparative study of the various methods under four categories as well as the proposed method is presented for six different datasets. The merits, demerits, and efficacy of each of the methods under consideration have been examined. The extensive experimental comparative analysis on six different challenging benchmark data sets demonstrate that proposed method is performing better to other state-of-the-art moving object segmentation methods and is well capable of dealing with various limitations of existing methods. [ABSTRACT FROM AUTHOR]

The thermal degradation of graft copolymers of both polysaccharides (guar gum and xanthan gum) showed gradual decrease in mass loss. Pure guar gum degraded about 95% but pure xanthan gum degraded about 76% up to 1173.15 K, while graft copolymers of guar gum and xanthan gum degraded only 65-76% up to 1173.15 K. Acrylic acid grafted guar gum and xanthan gum showing two-step degradation with formation of anhydride and ketonic linkage during heating, same pattern of degradation was found for xanthan gum- g-methacrylic acid. Guar gum- g-acrylamide degraded in single step and xanthan gum- g-acrylamide started to degrade above 448.15 K and it is a two-stage process and imparts thermal stability due to the formation of imide linkage with evolution NH. Guar gum- g-methacrylamide degraded in three steps due to the loss of NH and CO successively. 4-vinyl pyridine grafted both polysaccharides show single step degradation due to loss of pyridine pendent. N-vinyl formamide grafted guar gum and xanthan gum started to degrade at about 427.15 K, showed two-stage degradation process with the evolution of CO and NH molecules while guar gum- g-( N-vinyl-2-pyrrolidone) degraded into two steps by the loss of pyrrolidone nucleus. Gum- g-2-acrylamido-2-methyl-1-propane sulfonic acid (AMPS) showed two-step degradation processes in two successive degradation steps, while xanthan gum- g-AMPS has started degradation at about 427.15 K and completed in five degradation steps. Overall, it was found that the grafted polysaccharides are thermally more stable than pure polysaccharides. [ABSTRACT FROM AUTHOR]

Ocimum basilicum, a member of the family Lamiaceae, is a rich source of polyphenolics that have antioxidant properties. The present study describes the development and application of an online HPLC-coupled acidic potassium permanganate chemiluminescence assay for the qualitative and quantitative assessment of antioxidants in three cultivars of O. basilicum grown under greenhouse conditions. The chemiluminescence based assay was found to be a sensitive and efficient method for assessment of total and individual compound antioxidant potential. Leaves, flowers and roots were found to be rich reserves of the antioxidant compounds which showed intense chemiluminescence signals. The polyphenolics such as rosmarinic, chicoric, caffeic, p-coumaric, m-coumaric and ferulic acids showed antioxidant activity. Further, rosmarinic acid was found to be the major antioxidant component in water-ethanol extracts. The highest levels of rosmarinic acid was found in the leaves and roots of cultivars "holy green" (14.37; 11.52 mM/100 g DW respectively) followed by "red rubin" (10.02; 10.75 mM/100 g DW respectively) and "subja" (6.59; 4.97 mM/100 g DW respectively). The sensitivity, efficiency and ease of use of the chemiluminescence based assay should now be considered for its use as a primary method for the identification and quantification of antioxidants in plant extracts. [ABSTRACT FROM AUTHOR]

Purpose: Transesophageal Doppler (TED)-guided intraoperative fluid therapy has shown to noninvasively optimize intravascular volume and reduce postoperative morbidity. The aim of this study was to compare the effects of Doppler-guided intraoperative fluid administration and central venous pressure (CVP)-guided fluid therapy on renal allograft outcome and postoperative complications. Methods: A prospective nonrandomized active controlled study was conducted on end-stage renal disease patients scheduled for living donor renal transplant surgery. 110 patients received intraoperative fluid guided by corrected flow time (FTc) and variation in stroke volume values obtained by continuous TED monitoring. Data of 104 patients in whom intraoperative fluid administration was guided by CVP values were retrospectively obtained for a control. Results: The amount of intraoperative fluid given in the study group (12.20 ± 4.24 ml/kg/h) was significantly lower than in the controls (22.21 ± 4.67 ml/kg/h). The amount of colloid used was also significantly less and fewer recipients were seen to require colloid (69 vs 85 %). The mean arterial pressures were comparable throughout. CVP reached was 7.18 ± 3.17 mmHg in the study group. It was significantly higher in the controls (13.42 ± 3.12 mmHg). The postoperative graft function and rate of dysfunction were comparable. Side-effects like postoperative dyspnoea (4.8 vs 0 %) and tissue edema (9.6 vs 2.7 %) were higher in the controls. Conclusions: FTc-guided intraoperative fluid therapy achieved the same rate of immediate graft function as CVP-guided fluid therapy but used a significantly less amount of fluid. The incidence of postoperative complications related to fluid overload was also reduced. The use of TED may replace invasive central line insertions in the future. [ABSTRACT FROM AUTHOR]

Many people now use websites as their sole source of news and information, and more and more people use the Web to search for and buy products and services. Loyal users are equally important for all types of websites, but at times the studies have acknowledged that depending on the website characteristics users' loyalty perception differs i.e. relationships between e-loyalty and its antecedents vary across websites. Despite these acknowledgements, very limited study, if any, has done the comparative analysis of the relative importance of e-loyalty antecedents across different website categories. This study aims to examine the e-loyalty and its antecedent's relationship across three different categories of websites, namely product website, service website and social networking website. Website categorisation is done on the basis of users' primary need. The study helps to determine what antecedent should be given closer attention for enhancing loyalty in the respective category. The findings suggest that e-service quality, perceived value, e-trust, e-satisfaction, number of members and number of peers, contributes to generate e-loyalty but with varied significance for different websites. Perceived value, e-service quality and number of peers are the most significant contributor of e-loyalty for product website, service website and social networking website, respectively. Structural equation modelling (SEM) analysis is used for performing empirical analysis using AMOS 20. [ABSTRACT FROM AUTHOR]

Antimalarial drug resistance including artemisinin resistance in Plasmodium falciparum malaria is a major concern in combating malaria throughout the world. Delayed parasite clearance time (PCT) is indicative of emergence of artemisinin resistance. Herein, PCT has been monitored with the help of gold standard technique microscopy accompanied by a more sensitive real-time assay for academic purpose. After the administration of artemisinin based combination therapy, artesunate + sulfadoxine pyrimethamine (AS + SP), all the subjects were followed up to day 42 for monitoring the therapeutic efficacy of AS + SP in Bisra Community Health Centre (CHC), Sundergarh district in the state of Odisha in India. Further, representative samples were analyzed for L263E, E431K, A623E and S769N SNPs in Pfatpase6 gene and copy number polymorphisms in Pfmdr1 gene. Though all the samples were found parasite negative according to microscopy by the end of day 3 and attained adequate clinical and parasitological response (ACPR) at the end of day 42, real-time PCR showed day 3 positivity in 12 of the total analyzed samples ( n = 43). This was further validated by end-point diagnostic PCR and correlated with high initial parasite load. E431K mutation was observed in 2 of the 12 samples (16.7 %) while the controls ( n = 18) were all wild. L263E, A623E and S769N were wild in all the analyzed samples ( n = 30). Pfmdr1 copy number analysis showed no change in the said trait. Conclusively, real-time PCR could support microscopy for better monitoring of PCT and may provide as an additional but useful research tool for artemisinin resistance studies. [ABSTRACT FROM AUTHOR]

A case control study including 175 children aged 0-36 months suffering from diarrhea of > or = 14 days duration was undertaken to determine whether there is an association between Giardia lamblia, Entamoeba histolytica or Cryptosporidium infection and persistent diarrhea (PD). Subjects were identified by ongoing household surveillance and enrolled as cases. For each case two controls were selected by survey of neighbouring households--a child with acute diarrhea and one without diarrhea. Both the controls were matched with the case for age and nutritional status. Two fresh stool samples were collected from all cases and controls at enrollment and examined for trophozoites of Giardia lamblia, Entamoeba histolytica and Cryptosporidium. Giardia lamblia trophozoites were detected in a significantly higher proportion of PD cases (20.0%) than acute diarrheal and non diarrheal controls (4.6% each, p < 0.0001). There were no significant differences in the proportion of cases and controls who passed E. histolytica trophozoites or cryptosporidium in their stools. There was a consistent trend towards poorer weight gain in PD cases who passed Giardia trophozoites in stool; the differences were statistically significant at days 14 and 21, after enrollment. Giardia lamblia infection is more prevalent in PD cases than in acute diarrhea or non-diarrheal controls. This prevalence is not high enough to warrant routine anti-giardia therapy in patients with PD. However, as giardiasis was observed to have adverse growth impact in PD cases, stool microscopy for detection and subsequent treatment of Giardia lamblia seems to be justified. [ABSTRACT FROM AUTHOR]

A simple method for coagulating proteins in aqueous leaf extract, through microbial fermentation, has been reported. The Leaf Protein Concentrate (LPC) obtained through this fermentation has been compared with those obtained through conventional heat coagulation methods to show that the former improves the yield and nutritional quality of LPC. [ABSTRACT FROM AUTHOR]

Seed protein concentrates (SPC) were extracted from 4 leguminous species and the extractabilities of total N (nitrogen), protein N and SPC determined. In addition, composition, calorie value and in vitro enzymatic digestibility of these SPCs was analysed. Results indicate the promising nutritional potential of these SPCs. [ABSTRACT FROM AUTHOR]

Temporal variation in total protein and soluble protein contents and protein yield of Vigna mungo leaves at intervals of every three hours during day and night was studied. The study was done with the view to ascertain the hour of harvesting the leaves for maximum yield of leaf protein concentrate. Observations reveal that the total protein and soluble protein contents in the leaves are minimum during 3.00 to 6.00 hrs, which steadily rise with time to reach the maximum values during 12.00 to 15.00 hrs, after which the same shows a steady decrease with time. [ABSTRACT FROM AUTHOR]

Seed Protein Concentrates (SPC) of 6 species of Crotalaria were extracted and the extractabilities of SPC, total N and protein N determined. SPC of high yielding species (C. Juncea) was analyzed for the contents of amino acids, ash, phosphorus, sugar, starch, fibre and calories, as well as for in vitro digestibility. Results indicate the promising potential of C. juncea for SPC yield. [ABSTRACT FROM AUTHOR]

Background: The aim of this prospective comparative study was to compare outcomes and complications of humeral diaphyseal fracture non-unions managed with humerus interlocking nail (HIL) and locking compression plate (LCP). Materials and methods: 40 patients with non-union of humeral diaphyseal fractures were included in this study and were randomly allocated in two groups; group A had 20 cases treated with HIL and group B had 20 cases treated with LCP. Clinico-radiological assessments were done for each case up to 2-year follow-up period. Primary outcome measures (time to fracture union, union rate) and secondary outcome measures (functional outcome and complication such as infection, malunion, delayed union, implant failure, joint stiffness and iatrogenic radial nerve palsy) were compared between both the groups. Disabilities of the arm, shoulder and hand (DASH) scoring and Steward and Hundley's scoring system were used to assess functional outcome of the fracture fixation. Results: There was no significant difference ( p = 0.12) in terms of mean fracture union time between group A (15.8 ± 4.2 weeks) and group B (17.2 ± 3.8 weeks). Group A had 95 % union rate and group B had 100 % union rate ( p = 0.14). At the 2-year follow-up visit, there was no significant difference found between both the groups regarding range of motion of shoulder and elbow joint. There was no significant difference found in final functional outcomes between both the groups on comparing DASH score ( p = 0.14) and Steward and Hundley's score ( p = 0.08). In terms of complications, there was insignificant difference found between both the groups. Conclusions: This study concludes that both the implants can be used in non-union of humeral shaft fractures with good functional outcomes and acceptable rate of complications. [ABSTRACT FROM AUTHOR]

This research focuses on the study of different electrokinetic parameters of carbon nanotubes (CNTs) and fullerene aggregates in liquid crystal (LC) host medium, which are investigated in the homogeneously aligned nematic LC cells driven by in-plane field. The colloidal CNTs in LC medium are observed to move towards the negative electrodes whereas the fullerenes in LC medium are observed to move towards positive electrode at low frequencies. We propose a model to estimate the charge and zeta potential of colloidal particles by incorporating both the dielectrophoresis and electrophoresis forces in order to probe the reason of moving the colloidal particles in opposite direction. Interestingly, charge and zeta potential values on CNTs and fullerenes estimated from given model were positive and negative, respectively. The CNTs and fullerenes at high frequency and field are found to stretch along the direction of electric field. The CNTs dispersed whereas fullerenes start to move in perpendicular direction to the applied electric field with increasing electric field at high frequency. [ABSTRACT FROM AUTHOR]

Background: Gastric carcinogenesis has been well documented in the step-wise histopathological model, known as Correa pathway. Several biomarkers including CD44, Musashi-1 and CD133 have been reported as putative stem cell (PSC) markers.Methods: We investigated expression of PSC markers CD44, Musashi-1 and CD133 in relation to gastric carcinogenesis and prognosis and chemoresponse. Immunohistochemistry staining was performed in gastric cancer (GC) clinical specimens representing different steps of the Correa pathway. Gastric cancer samples taken before and after neoadjuvant chemotherapy with docetaxel, cisplatin and capecitabine (DCX) were also evaluated for PSC marker expression.Results: We showed that the expression of three PSC markers was significantly elevated in GC relative to normal gastric mucosa (P<0.001 for each marker). Precancerous lesions, including intestinal metaplasia and dysplasia, demonstrated increased expression of CD44 and Musashi-1. CD133 was predominantly expressed along the border between intramucosal carcinoma and connective tissue at later stages. High CD44 and CD133 expression showed prognostic value for worse patient survival (P=0.014 and P=0.019, respectively). A small number of tumours with high expression of CD44 and CD133 showed pathological response to DCX-based neoadjuvant chemotherapy.Conclusion: CD44 and Musashi-1 are frequently expressed in both premalignant gastric lesions and invasive GC, whereas CD133 expression is restricted mainly to neoplastic tissues. [ABSTRACT FROM AUTHOR]

Multi-stage Interconnection Networks (MINs) are designed to achieve fault-tolerance and collision solving by providing a set of disjoint paths. Ching-Wen Chen and Chung-Ping Chung had proposed a fault-tolerant network called Combining Switches Multi-stage Interconnection Network (CSMIN) and an inaccurate algorithm that provided two correct disjoint paths only for some source-destination pairs. This paper provides a more comprehensive and accurate algorithm that always generate correct routing-tags for two disjoint paths for every source-destination pair in the CSMIN. The 1-fault tolerant CSMIN causes the two disjoint paths to have regular distances at each stage. Moreover, our algorithm backtracks a packet to the previous stage and takes the other disjoint path in the event of a fault or a collision in the network. Furthermore, to eliminate the backtracking penalties of CSMIN, we propose a new design called Fault-tolerant Fully-Chained Combining Switches Multi-stage Interconnection Network (FCSMIN). It has similar characteristics of 1-fault tolerance and two disjoint paths between any source-destination pair, but it can tolerate only one link or switch fault at each stage without backtracking. Our simulation and comparative analysis result shows that FCSMIN has added advantages of destination-tag routing, lower hardware costs, strong reroutability, lower preprocessing overhead, and higher fault-tolerance power in comparison to CSMIN. [ABSTRACT FROM AUTHOR]

Sponges are an ancient group of animals that diverged from other metazoans over 600 million years ago. Here we present the draft genome sequence of Amphimedon queenslandica, a demosponge from the Great Barrier Reef, and show that it is remarkably similar to other animal genomes in content, structure and organization. Comparative analysis enabled by the sequencing of the sponge genome reveals genomic events linked to the origin and early evolution of animals, including the appearance, expansion and diversification of pan-metazoan transcription factor, signalling pathway and structural genes. This diverse ‘toolkit’ of genes correlates with critical aspects of all metazoan body plans, and comprises cell cycle control and growth, development, somatic- and germ-cell specification, cell adhesion, innate immunity and allorecognition. Notably, many of the genes associated with the emergence of animals are also implicated in cancer, which arises from defects in basic processes associated with metazoan multicellularity. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the outcomes of three surgical techniques for the closure of urethrocutaneous fistula (UCF) after hypospadias repair.Materials and Methods: Fifty-one patients (mean age 6.5 years) who underwent UCF closure between June 1998 and February 2008 were divided in to three groups depending on fistula size; group I had <2 mm and (n = 17, 33.4%), group II had 2-4 mm (n = 21, 41.2%) and group III had >4 mm or multiple fistulas (n = 13, 25.4%). Group I patients were treated by excision and simple closure. Patients in group II and III were treated with flip flap technique along with the wrapping of repaired area with scrotal dartos flap and tunneled tunica vaginalis flap (TVF), respectively.Results: Mean surgical time was 45 min (range 30-55), 60 min (range 50-75) and 80 min (range 60-100) in three techniques, respectively. The mean follow-up was 3.5 years (range 6 months-10 years). No patient had recurrence of fistula in group III, while 2 (9.5%) and 4 (25.4%) patients in groups II and I, respectively, had recurrent UCF. No postoperative complications were encountered in the testis or the scrotum. No patient had torsion or deviation of penis.Conclusion: Simple fistula closure carries a higher risk of recurrence even in small sized fistulas. The application of scrotal dartos or TVF for wrapping the repaired area gives excellent results and they are easy to harvest with no harmful effects on the scrotum or testis. [ABSTRACT FROM AUTHOR]

Natural killer (NK)-cell malignancies are among the most aggressive lymphoid neoplasms with very poor prognosis. We performed array comparative genomic hybridization analysis on a number of NK cell lines and primary tumors to gain better understanding of the pathogenesis and tumor biology of these malignancies. We also obtained transcriptional profiles of genes residing in these regions and compared them with normal and activated NK cells. Only 30-50% of the genes residing in the gained or deleted regions showed corresponding increased or decreased expression. However, many of the upregulated genes in regions of gain are functionally important for the proliferation and growth of the neoplastic population. Genes downregulated in regions of loss included many transcription factors or repressors, tumor suppressors or negative regulators of the cell cycle. The minimal common region of deletion in 6q21 included three known genes (PRDM1, ATG5 and AIM1) showing generally low expression. Mutations resulting in truncated PRDM1 and changes in conserved amino-acid sequences of AIM1 were detected. Highly methylated CpG islands 5' of PRDM1 and AIM1 correlated with low expression of the transcripts. Reversal of methylation by Decitabine induced expression of PRDM1 and cell death. In conclusion, we have shown a general tumor-promoting effect of genetic alterations and have identified PRDM1 as the most likely target gene in del6q21. ATG5, an essential gene for autophagy and AIM1, a gene implicated in melanoma, may also participate in the functional abnormalities. [ABSTRACT FROM AUTHOR]

Curcumin has been shown to inhibit the growth of various types of cancer cells; however, at concentrations much above the clinically achievable levels in humans. The concentration of curcumin achieved in the plasma after oral administration in humans was estimated to be around 1.8 microM. Here, we report that treatment of BxPC-3 human pancreatic cancer cells with a low and single exposure of 2.5 microM curcumin for 24 h causes significant arrest of cells in the G2/M phase and induces significant apoptosis. Immunoblot studies revealed increased phosphorylation of H2A.X at Ser-139 and Chk1 at Ser-280 and a decrease in DNA polymerase-beta level in curcumin-treated cells. Phosphorylation of H2A.X and Chk1 proteins are an indicator of DNA damage whereas DNA polymerase-beta plays a role in the repair of DNA strand breaks. Normal immortalised human pancreatic ductal epithelial (HPDE-6) cells remained unaffected by curcumin treatment. In addition, we also observed a significant increase in the phosphorylation of Chk1 at Ser-345, Cdc25C at Ser-216 and a subtle increase in ATM phosphorylation at Ser-1981. Concomitant decrease in the expressions of cyclin B1 and Cdk1 were seen in curcumin-treated cells. Further, curcumin treatment caused significant cleavage of caspase-3 and PARP in BxPC-3 but not in HPDE-6 cells. Silencing ATM/Chk1 expression by transfecting BxPC-3 cells with ATM or Chk1-specific SiRNA blocked the phosphorylation of ATM, Chk1 and Cdc25C and protected the cells from curcumin-mediated G2/M arrest and apoptosis. This study reflects the critical role of ATM/Chk1 in curcumin-mediated G2/M cell cycle arrest and apoptosis in pancreatic cancer cells. [ABSTRACT FROM AUTHOR]

Id protein family consists of four members namely Id-1 to Id-4. Different from other basic helix-loop-helix transcription factors, they lack the DNA binding domain. Id proteins have been shown to be dysregulated in many different cancer types and their prognostic value has also been demonstrated. Recently, Id-1 has been shown to be upregulated in oesophageal squamous cell carcinoma (ESCC). However, the prognostic implications of Id proteins in ESCC have not been reported. We examined the expression of the Id proteins in ESCC cell lines and clinical ESCC specimens and found that Id protein expressions were dysregulated in both the ESCC cell lines and specimens. By correlating the expression levels of Id proteins and the clinicopathological data of our patient cohort, we found that M1 stage tumours had significantly higher nuclear Id-1 expression (P=0.012) while high nuclear Id-1 expression could predict development of distant metastasis within 1 year of oesophagectomy (P=0.005). In addition, high levels of Id-2 expression in both cytoplasmic and nuclear regions predicted longer patient survival (P=0.041). Multivariate analysis showed that high-level expression of Id-2 in both cytoplasmic and nuclear regions and lower level of nuclear Id-1 expression were independent favourable predictors of survival in our ESCC patients. Our results suggest that Id-1 may promote distant metastasis in ESCC, and both Id-1 and Id-2 may be used for prognostication for ESCC patients. [ABSTRACT FROM AUTHOR]

Antimicrobial susceptibility of 25 Helicobacter pylori strains isolated from patients with acid peptic diseases were tested for in vitro sensitivity to commonly used antibiotics using disk-diffusion and E-test, methods. All strains tested were susceptible to tetracycline by E-test, with the minimum inhibitory concentration (MIC) values being <0.125 μg/ml for all strains except for 6 (<0.023 μg/ml). However 1 strain was resistant by disk-diffusion method. One strain was resistant to clarithromycin both by disk diffusion and E-test (MIC <48 μg/ml), and 1 strain was resistant only by disk diffusion. Only one strain was resistant to amoxicillin by disk diffusion and E-test (MIC >256 μg/ml). For ciprofloxacin, three strains were resistant by disk diffusion and two by E-test (MIC <32 μg/ml). Sixteen strains were resistant to metronidazole by disk diffusion and E-test (MIC ≥ 8 μg/ml), and 1 was resistant only by E-test (MIC <48 μg/ml). Overall, 64% of the strains were resistant to metronidazole. The MIC for metronidazole was also tested by agar-dilution method, and metronidazole resistant strains had an, MIC >8 μg/ml. The disk-diffusion method showed excellent correlation with E-test results; there was 100% agreement for amoxicillin a other antibiotics showed 90% to 95% accuracy. Disk diffusion is cheaper than E-test (approximately 2.6 cents vs. US$2.60), is easy to perform, and is a reliable method for testing H. pylori susceptibility to antimicrobial agents in the clinical microbiology laboratory. [ABSTRACT FROM AUTHOR]

Bisphosphonates are synthetic analogues of pyrophosphate that inhibit bone resorption by their action on osteoclasts. In recent years, bisphosphonates have been used in children for treatment of a growing number of disorders associated primarily with generalized or localized osteoporosis, metabolic bone diseases, heterotopic calcification in soft tissues, and for resistant hypercalcemia. In the present review we discuss the pharmacological aspects of bisphosphonates and related bone pathophysiology, review the pediatric literature on the role of bisphosphonates in childhood diseases and our experience with these drugs. The theoretical concerns of possible adverse effects of these drugs on the growing skeleton have not materialized in the limited pediatric clinical experience. Bisphosphonates provide the pediatrician with an opportunity to treat mineral and bone disorders of childhood which until recently did not have satisfactory therapy, at the same time, being aware of the theoretical concerns on microdamage accumulation in bone, bone quality and teratogenic potential of these drugs. [ABSTRACT FROM AUTHOR]

The mouse is frequently used as an animal model to study skeletal mechanisms relevant to humans. Biochemical markers of bone formation and resorption provide one of the key parameters for assessing skeletal metabolism. One biochemical marker that has proven to be useful in the studies of mouse skeletal metabolism is osteocalcin. Assay for osteocalcin is available in the mouse. The present study describes development of an osteocalcin radioimmunoassay (RIA) using a synthetic peptide. Intact osteocalcin purified from mouse bone extracts shows parallel displacement with synthetic peptide. Sensitivity of the RIA was 19 ng/ml. The average (n = 9) intra- and interassay coefficient of variation for two controls was less than 10%; the averaged recoveries were 106%. The osteocalcin concentration measured by peptide RIA shows a high correlation (r = 0.88, n = 117, P < 0.0001) with an intact osteocalcin assay. In addition, when the intact assay and peptide assays were applied to evaluate skeletal perturbation, similar results were obtained. Accordingly, osteocalcin levels measured by both intact and peptide-based RIA in 8-week C57BL/6J (n = 8) mice treated with PTH 1-34 were twofold higher compared with the vehicle-treated control group. Further studies of the application of the peptide-based RIA for osteocalcin revealed that osteocalcin levels in 4-week postovariectomized (OVX) C57BL/6N mice (n = 10) were 80% higher than the sham-operated (n = 10) mice receiving vehicle. OVX mice receiving weekly injections of estradiol (400 microg/kg body weight) were 38% lower compared with the OVX group treated with vehicle. In conclusion, the peptide-based RIA has analytical and a discriminative power similar to that of the intact osteocalcin assay but has the advantage that the resources for this assay are much easier to accrue. [ABSTRACT FROM AUTHOR]

Trimidox (3,4,5-trihydroxybenzamidoxime), a newly synthesized analog of didox (N,3,4-trihydroxybenzamide) reduced the activity of ribonucleotide reductase (EC 1.17.4.1) in extracts of L1210 cells by 50% (50% growth-inhibitory concentration, IC50) at 5 microM, whereas hydroxyurea, the only ribonucleotide reductase inhibitor in clinical use, exhibited an IC50 of 500 microM. Ribonucleotide reductase activity was also measured in situ by incubating L1210 cells for 24 h with trimidox at 7.5 microM, a concentration that inhibits cell proliferation by 50% (IC50) or at 100 microM for 2 h; these concentrations resulted in a decrease in enzyme activity to 22% and 50% of the control value, respectively. Trimidox and hydroxyurea were cytotoxic to L1210 cells with IC50 values of 7.5 and 50 microM, respectively. Versus ribonucleotide reductase, trimidox and hydroxyurea yielded IC50 values of 12 and 87 microM, respectively. A dose-dependent increase in life span was observed in mice bearing intraperitoneally transplanted L1210 tumors. Trimidox treatment (200 mg/kg; q1dx9) significantly increased the life span of mice bearing L1210 leukemia (by 82% in male mice and 112% in female mice). The anti-tumor activity appeared more pronounced in female mice than in male mice. Viewed in concert, these findings suggest that trimidox is a new and potent inhibitor of ribonucleotide reductase and that it is a promising candidate for the chemotherapy of cancer in humans. [ABSTRACT FROM AUTHOR]

Background: Retraction in lingual orthodontics has biomechanical differences when compared to labial orthodontics, which is not yet established. Thus, we have intended to compare the biomechanical characteristics of closed helical loop and T-loop on 1 mm activation with 30° of compensatory curvatures during retraction in lingual orthodontics.Methods: STb lingual brackets were indirectly bonded to maxillary typhodont model that was scanned to obtain FEM model. Closed helical loop (2 × 7 mm) and T-loop (6 × 2 × 7 mm) of 0.016″ × 0.016″ TMA wire were modeled without preactivation bends. Preactivation bends at 30° were given in the software. Boundary conditions were set. The force (F) and moment (M) of both the loops were determined on 1 mm activation, using ANSYS software. M/F ratio was also calculated for both the loops.Results: T-loop exerted less force, thus increased M/F ratio as compared to closed helical loop on 1 mm activation.Conclusions: When torque has to be preserved in the anterior segment during retraction in lingual orthodontics, T-loop can be preferred over closed helical loop. [ABSTRACT FROM AUTHOR]