Reduced expression of SOX11 in colorectal adenocarcinoma is associated with mucinous and signet ring cell types, poor survival, and lower ALK expression.

BACKGROUND: Mucinous and signet ring cell colorectal carcinoma (m/srCRC) are challenging colorectal adenocarcinoma (CRC) types with poor prognosis. This study aimed to investigate SOX11 and ALK immunohistochemical expression in the m/srCRC group, comparing the results to those of nonmucinous CRC (nmCRC) and studying their association with different clinicopathological CRC features to better understand their significance and role. Besides, the study assesses which marker has a better predictive value for clinical practice. METHODS: Tissue microarrays were prepared from 150 CRC blocks distributed equally between the m/srCRC and nmCRC groups. SOX11 and ALK immunohistochemical expressions were compared between both groups. In addition, their association with CRC clinicopathological data and survival was investigated. The Receiver Operating Characteristic (ROC) Curve analysis examined the predictive ability of SOX11 and ALK IHC expression for CRC mortality. RESULTS: Both SOX11 and ALK expression were significantly reduced in m/srCRC compared to nmCRC. SOX11 is significantly associated with other prognostic clinicopathological factors (tumor size, lymph node status, overall TNM stage, grade, lymphovascular and perineural invasion) and overall survival. SOX11 significantly positively correlates with ALK expression. Using the ROC analysis, SOX11 is superior to ALK in survival prediction. CONCLUSION: SOX11 can be used as a prognostic marker and is a suggested therapeutic target in mucinous and signet ring cell colorectal carcinoma through upregulation modulation.

A transfer learning enabled approach for ocular disease detection and classification.

Ocular diseases pose significant challenges in timely diagnosis and effective treatment. Deep learning has emerged as a promising technique in medical image analysis, offering potential solutions for accurately detecting and classifying ocular diseases. In this research, we propose Ocular Net, a novel deep learning model for detecting and classifying ocular diseases, including Cataracts, Diabetic, Uveitis, and Glaucoma, using a large dataset of ocular images. The study utilized an image dataset comprising 6200 images of both eyes of patients. Specifically, 70% of these images (4000 images) were allocated for model training, while the remaining 30% (2200 images) were designated for testing purposes. The dataset contains images of five categories that include four diseases, and one normal category. The proposed model uses transfer learning, average pooling layers, Clipped Relu, Leaky Relu and various other layers to accurately detect the ocular diseases from images. Our approach involves training a novel Ocular Net model on diverse ocular images and evaluating its accuracy and performance metrics for disease detection. We also employ data augmentation techniques to improve model performance and mitigate overfitting. The proposed model is tested on different training and testing ratios with varied parameters. Additionally, we compare the performance of the Ocular Net with previous methods based on various evaluation parameters, assessing its potential for enhancing the accuracy and efficiency of ocular disease diagnosis. The results demonstrate that Ocular Net achieves 98.89% accuracy and 0.12% loss value in detecting and classifying ocular diseases by outperforming existing methods.

Anthropometry of Proximal Tibia in Patients Undergoing Total Knee Replacement at a Tertiary Care Hospital.

Introduction Total knee arthroplasty is the standard of care treatment for advanced knee osteoarthritis. However, patients frequently continue to have pain and disability after surgery, with one of the most common reasons being a bone-implant mismatch. Notably, there is a significant difference reported in proximal tibia morphometry between Asian and Caucasian populations, and the currently available implants do not account for the anthropometric variations observed across ethnicities. We aimed to evaluate the proximal tibia anthropometry in a Pakistani population. Materials and methods A study was conducted at The Indus Hospital, Karachi Campus, from August 2019 to July 2020. All consecutive patients fulfilling the eligibility criteria and undergoing knee replacement surgery were included in the study. Baseline characteristics and anthropometry of proximal tibia were recorded on a pre-designed proforma. Statistical analysis was done using SPSS version 24. Results  A total of 30 patients were enrolled in this study, which included 17 females (56.7%) and 13 males (43.3%). The mean age was 61.6± 7.9 years and the BMI was 33±5.7 kg/m2. There was a significant difference found in the anteroposterior and mediolateral dimensions in both genders. A significant association was noted with body mass index (p-value 0.01) and occupation (p-value=0.02). Conclusion The results indicated that the anatomical profile of the proximal tibia in the Pakistani population is distinct, thus stressing the fact that it requires developing prostheses specifically tailored to this population's sizing requirements.

GATA3 Positively Correlates with BCL2 Expression in Indolent and Aggressive Histological Types of Cutaneous Basal Cell Carcinoma.

OBJECTIVE: Some histological basal cell carcinoma (BCC) types demonstrate more aggressive behavior than others. They are known as high-risk BCC and are more challenging in therapy, contrary to indolent (low-risk) BCC types. Identifying novel protein markers to predict aggressiveness and potential therapeutic targets in challenging cases is recommended. GATA3 is a transcription factor critical for epithelial and lymphocytic differentiation. This study investigated the immunohistochemical expression of GATA3 in indolent and aggressive BCC and its association with BCL2 expression. MATERIAL AND METHODS: Retrospectively collected indolent and aggressive BCC groups (24 cases each) were immunohistochemically stained with anti-GATA3 and BCL2 antibodies. The mean expression score (by area percentage) and TIL counts were determined and compared using ImageJ analysis. Stromal tumor-infiltrating lymphocytes (TIL) were counted per high-power field (HPF) on hematoxylin and eosin (H&E) staining. RESULTS: GATA3 and BCL2 expressions were significantly higher in the indolent group than in the aggressive group. GATA3 expression significantly correlated with BCL2 score and TIL counts. Higher GATA3 expression was significantly associated with a more indolent BCC histological type, higher BCL2 expression, and higher TIL count. CONCLUSION: GATA3 is a possible target for immunomodulation experiments to improve BCC immunotherapy outcomes.

Synthesis and Characterization of Short α and ß-Mixed Peptides with Excellent Anti-Lipase Activities.

Obesity is a source of significant pathologies and deadly diseases, including heart disease, diabetes, and cancer. One of the most intriguing strategies in the hunt for new anti-obesity medications is the inhibition of pancreatic lipase (PL). This study presents a novel application of short α and ß-mixed peptides as pancreatic lipase inhibitors. These peptides were synthesized in the solution phase and characterized using FTIR and 1H-NMR. L-proline is present in a high percentage of natural anti-lipase peptides and was used as a ß-amino acid in this study to enhance anti-lipase activity and proteolytic stability. Moreover, L-α-proline was converted to ß-amino acid derivatives using the Arndt-Eistert method with the advantage of stereo control at the α-carbon. The synthesized peptides with anti-lipase activity are N-Boc-ß-Pro-Gly-OBz (93%), N-Boc-O-Bz-Tyr-ß-Pro-ß-Pro-Gly-OBz (92%), N-Boc-O-Bz-Tyr-ß-Pro-COOH (91%), N-Boc-Phe-ß-Pro-OCH3 (90%), and N-Boc-O-Bz-Tyr-ß-Pro-OCH3 (89%). These peptides may function as lead molecules for further modification to more significant molecules, which can help control obesity.

The patient with a painful knee.

Knee pain encompasses a wide array of differential diagnoses and can often pose a diagnostic challenge, as it can have traumatic or non-traumatic causes. A good clinical history, assessment and anatomical knowledge gives a strong foundation to narrow down the diagnosis, and understanding the correct imaging modality and findings further informs correct and timely management. This article reviews various disease processes including fractures, inflammatory, infective and neoplastic causes, and discusses the assessment and various imaging modalities to aid diagnosis in both primary and secondary care.

The patient with an acute painful wrist.

Patients with wrist pain commonly present to primary care and emergency departments. A detailed history and examination, alongside relevant imaging, will help find the correct diagnosis and ensure that patients receive the correct treatment in a timely manner. This article summarises the key points in history and examination and the role of imaging, including suggestions of which modality should be requested. Finally, important acute pathologies are highlighted, including fractures, soft tissue injuries and infection, with examples of their relevant imaging.

The adult with low back pain: causes, diagnosis, imaging features and management.

Low back pain is the leading cause of disability worldwide. This article highlights the importance of succinct history taking and a thorough clinical examination when managing a patient with lower back pain in hospital. Furthermore, it encourages the clinician to consider the pertinent causes of low back pain such as age-related degeneration, malignancy, trauma, infection and seronegative inflammatory spondyloarthropathies, and looks at the diagnosis, imaging features and key management options which are available in secondary care.

Erratum: Zircon-Type CaCrO4 Chromite Nanoparticles: Synthesis, Characterization, and Photocatalytic Application for Sunlight-Induced Degradation of Rhodamine B.

[This corrects the article DOI: 10.1021/acsomega.3c02457.].

Zircon-Type CaCrO4 Chromite Nanoparticles: Synthesis, Characterization, and Photocatalytic Application for Sunlight-Induced Degradation of Rhodamine B.

The degradation of organic dye pollutants is a critical environmental issue that has garnered significant attention in recent years. To address this problem, we investigated the potential of CaCrO4 chromite (CCO) as a photocatalyst for the degradation of cationic and anionic dye solutions under sunlight irradiation. CaCrO4 was synthesized via a sol-gel auto-combustion route and sintered at 900 °C. The Rietveld refined XRD profile confirmed the zircon-type structure of CaCrO4 crystallized in the tetragonal unit cell with I41/amd space group symmetry. The surface morphology of the sample was investigated by field emission scanning electron microscopy (FESEM), which revealed the polyhedral texture of the grains. Energy-dispersive X-ray spectroscopy (EDX) and X-ray photoelectron spectroscopy (XPS) studies were carried out to analyze the elemental composition and chemical states of the ions present in the compound. Fourier transform infrared (FT-IR) spectroscopy analysis revealed the vibrational modes corresponding to the tetrahedral and dodecahedral metal oxide bonds. The optical band gap was approximated to be in the range of 1.928 eV by using the Tauc relation. The CaCrO4 catalyst with different contents (5, 20, 35, and 50 mg) was investigated for its photocatalytic performance for the degradation of RhB dye solution under sunlight irradiation using a UV-Vis spectrometer over the experimental wavelength range of 450-600 nm. The degradation efficacy increased from 70.630 to 93.550% for 5-35 mg and then decreased to 68.720% for 50 mg in 140 min under visible light illumination. The comparative study demonstrates that a higher degradation rate was achieved for cationic than anionic dyes in the order RhB > MB > MO. The highest deterioration (93.80%) was achieved for the RhB dye in 140 min. Equilibrium and kinetic studies showed that the adsorption process followed the Langmuir isotherm and pseudo-second-order models, respectively. The maximum adsorption capacity of 21.125 mg/g was observed for the catalyst concentration of 35 mg. From the cyclic test, it has been observed that the synthesized photocatalyst is structurally and morphologically stable and reusable. The radical trapping experiment demonstrated that superoxide and hydroxyl radicals were the primary species engaged in the photodegradation process. A possible mechanism for the degradation of RhB has been proposed. Hence, we conclude that CaCrO4 can be used as an efficient photocatalyst for the remediation of organic dye pollutants from the environment.

Evaluation of paediatric hip pain.

Hip pain in a child can pose a diagnostic conundrum. In most cases, the cause of a painful hip is often attributed to trauma, but a number of these cases will be atraumatic. The main entities to consider are inflammatory, infective and neoplastic causes. Pathologies such as avascular necrosis and slipped upper femoral epiphysis can also present in a similar manner. A detailed history and clinical examination are crucial in narrowing down the differential diagnosis. In addition, understanding the most appropriate imaging modalities and the characteristic radiological findings is key in ensuring timely treatment and management. This article reviews the various disease processes in children who present with hip pain and outlines the most appropriate assessment and imaging modalities that will aid diagnosis.

Imaging for patients presenting with a painful shoulder.

Shoulder pain is a common cause of musculoskeletal presentation in primary care, where both traumatic and atraumatic pathologies can also lead to emergency department attendances. This article discusses common acute and chronic presentations of a painful shoulder, looking at the typical history of patients presenting with a painful shoulder, examination findings and the most appropriate imaging modalities to consider. Strengths and weaknesses of each imaging modality are discussed along with their role in aiding diagnosis, as well as management of the various pathologies encountered in primary and secondary care.

Examining the role of ICT, transportation energy consumption, and urbanization in CO2 emissions in Asia: a threshold analysis.

ICT is viewed in earlier research as a double-edged sword that may either help or hurt the environment. Asian nations' ICT penetration has significantly expanded in recent years, and they are eager to bring about a digital revolution by building up their ICT infrastructure while consuming less energy for transportation and urban growth. Therefore, the purpose of this article is to investigate how ICT might reduce CO2 emissions through the use of transport energy and urban development. Empirical and theoretical debates have been remaining ambiguous and contentious topic of whether energy consumed by the transport sector and urbanization causes CO2 emanation in Asia, and what role ICT played in determining the level of CO2 remains unanswered. This study adds to the ongoing discussion for sustainable transportation in ten Asian nations for 30 years that concentrate on the relationship between the energy consumption of transport, urbanization, ICT, and carbon emanation (1990-2020) and checked the validity of EKC. The STIRPAT and panel threshold models having two regimes are used to explore the stochastic impacts of the dependent and explanatory variables. We have divided explanatory into two categories, that is, the threshold variable ICT and the regime-dependent variables urbanization and transport energy consumption. Our results confirm that the EKC hypothesis holds in these Asian economies. Thus, our findings indicate that the environmental quality improves in terms of reduction in CO2 emissions when ICT passes the threshold level due to the technological advancement in ICT dominating the scale effect induced by ICT. Furthermore, the possible policy recommendations are discussed according to the findings.

A modified trans-anconeus approach to facilitate fixation of a posterior radial head fracture: a cadaveric feasibility study.

Fixation of radial head fracture with minimally invasive posterior approach remains a significant challenge. The aim of this study was to determine the feasibility of trans-anconeus posterior elbow approach and to observe lateral ulnar collateral ligament (LUCL) in extended elbows. This cadaveric study was performed in twenty upper limbs of fresh fixed adult male cadavers. An oblique incision was made in the middle segment of anconeus until the lateral ligament complex and the joint capsule had been revealed. A deep dissection was explored to observe the anatomical relationship of the LUCL to the anconeus. Measurements of the LUCL were recorded while the elbow was fully extended. The mean distance between the edge of the radial head and the proximal insertion of the LUCL was 13.3 mm (11.5-16.2 mm); the mean distance between the edge of the radial head and the distal insertion of the LUCL was 20.9 mm (19.2-23.4 mm); the distance between the edge of the radial head and the distal edge of the annular ligament was 11.2 mm (8.22-11.7 mm). By estimate correlation of the previous measurements, the direct and accessible way to expose the posterolateral articular capsule of the elbow joint was through a window in medial 2/3 of the middle segment of anconeus muscle. These trans-anconeus approach is useful. It provides good visualization, facilitates applying the implants, and lessens the risk of radial nerve injury. Awareness of the anatomy is mandatory to avoid injury of LUCL.

Outcome Of The Distal Radius Fractures Managed With Across Wrist External Fixator Vs Buttress Plates.

BACKGROUND: Distal radius fracture is one of the most common injuries presented to emergency department and can be presented in any age group. In young patients the most common cause is Road Traffic Accident (RTA), while old patient history of fall is the most common cause. Different surgical options are available to treat this injury. This study aims to compare the outcome of volar buttress plate vs across wrist external fixator for Arbeitsgemeinschaft für Osteosynthesefragen (AO) type C2/C3 fracture of the distal radius. METHODS: A retrospective comparative study between July 2020 to June 2021 at Ghurki Trust Teaching Hospital was done and a total of 50 patients who underwent surgical intervention for AO C2/C3 fracture of the distal Radius, were included. The follow-up period was 12 weeks. QuickDASH score was used to find out patient's functional outcomes. Functional outcome was analyzed between the two groups using Mann-Whitney U test, using SPSS version 21. RESULTS: There was no significant statistical difference between the functional outcome of patients with distal radius fracture treated with across wrist external fixator vs volar buttress plate, in term of QuickDASH score. Furthermore, age and gender also were having no effect on functional outcome in our population. CONCLUSIONS: Across wrist external fixator is a reasonable option for AO C2/C3 type fractures of the distal radius with comparable results with volar buttress plate. It is the procedure of choice in high volume tertiary care hospitals like Gurki Trust Teaching hospital as it saves time, have similar functional outcome score, no need to re-open for removal of implant, less chances of tendon rupture as compared to volar buttress plate for distal radius fracture.

Modified Graner's Technique with\without Vascularized Capitate Lengthening for Kienböck Disease Stage IIIb-A Pilot Study.

Background Intercarpal fusions are used to treat stage IIIb Kienböck disease. They increase force transfer across the radioscaphoid articulation with predisposition to arthritis. Description of Technique This technique is excision of lunate followed by proximal transfer of capitate, with scaphocapitate and triquetrocapitate fusion to increase area of load transfer mimicking wrist hemiarthroplasty. Our purpose is to evaluate mid-term results of this technique. Patients and Methods A prospective case series study was conducted on 11 patients with stage IIIb and IIIc. In seven cases, transfer of the capitate was performed by osteotomizing the capitate just distal to its waist, proximal migration to replace the excised lunate then bone grafting. In four cases, proximal transfer of vascularized pedicled capitate was done. Clinical outcome measures included pain (visual analog scale), grip strength, range of motion, and functional evaluation by modified Mayo wrist score and scoring system of Evans. Radiological outcome measures included healing of fusion mass, progression of the disease, and occurrence of avascular necrosis to the capitate. Results Follow-up period averaged 54 months. Scaphocapitate fusion healing averaged 11 weeks. Union of the lengthened capitate occurred in 10 patients only. There was postoperative improvement in pain scores, grip, Evans, and modified Mayo wrist score. There was postoperative decrease in wrist flexion and extension. One patient showed resorption of the capitate head with progressive radioscaphoid arthritis-necessitated wrist fusion. Conclusion The mid-term results of this technique may be satisfactory due to low incidence of degenerative arthritis in the radioscaphoid joint. However, longer follow-up with recruiting larger number of patients is needed.

Climate change adaption strategies in urban communities: new evidence from Islamabad, Pakistan.

Pakistan is urbanizing at the fastest pace in South Asia, and if left unplanned, it will not only reduce adaptive capacity of its residents rather it will be a chaos for its residents. The aim of this study is to answer the question on how urbanites of Pakistan are coping with climate change and which part of the society required support to cope with changing climate? To answer this questions, this study conducted survey through a structured questionnaire, from the urban residents of Islamabad, to explore their coping mechanisms towards climate change. Survey collected information on demographic, social, economic, and physical aspects, using Hackman's Treatment effect model. The sample selection equation is conditional on the adaptations to climate change in the outcome equation. Main independent variables are income, age, education, and occupation. Selection equation is based on perceptions of individuals about climate change which contains dependent variables of changes in temperature of summers and winters, changes in rain fall pattern, fog, hailstorm, and information received from social media and peer groups. With the result of 57.55, the Wald test shows that overall, there exists goodness of fit at the 99 percent confidence level. The value of rho in the Heckman model is 0.40 which implies the Heckman model provides more consistent and more efficient estimates. The results are suggesting that increasing age enhances the likelihood of adaptations as the positive and significant coefficient of age implies that age has probability to adapt to climate change. The positive and significant coefficient of income, education, and occupation implies that urbanites have higher probability to adapt to climate change. Perception is the essential foundation of adaptation, and differences in perception can be transferred to the adapted strategies. Households that experience a greater variation in annual mean temperature are more likely to adopt any adaptation strategy to cope with climate change. Essentially, poverty encompasses the majority of the characteristics that reduce respondents' adaptation capacity and increase their susceptibility to climate change. The major contextual disparities were discovered across union councils in the form of financial, personal, social, physical, and natural capitals of families. Therefore, obligation is on government to offer greater support for individuals who are less affluent in terms of these assets. For this city, officials must offer subsidy schemes to less privileged and marginalized people of urban dwellers to enhance their adaptive capacity.

Atmospheric Pressure Plasma Polymerisation of D-Limonene and Its Antimicrobial Activity.

Antibacterial coating is necessary to prevent biofilm-forming bacteria from colonising medical tools causing infection and sepsis in patients. The recent coating strategies such as immobilisation of antimicrobial materials and low-pressure plasma polymerisation may require multiple processing steps involving a high-vacuum system and time-consuming process. Some of those have limited efficacy and durability. Here, we report a rapid and one-step atmospheric pressure plasma polymerisation (APPP) of D-limonene to produce nano-thin films with hydrophobic-like properties for antibacterial applications. The influence of plasma polymerisation time on the thickness, surface characteristic, and chemical composition of the plasma-polymerised films was systematically investigated. Results showed that the nano-thin films deposited at 1 min on glass substrate are optically transparent and homogenous, with a thickness of 44.3 ± 4.8 nm, a smooth surface with an average roughness of 0.23 ± 0.02 nm. For its antimicrobial activity, the biofilm assay evaluation revealed a significant 94% decrease in the number of Escherichia coli (E. coli) compared to the control sample. More importantly, the resultant nano-thin films exhibited a potent bactericidal effect that can distort and rupture the membrane of the treated bacteria. These findings provide important insights into the development of bacteria-resistant and biocompatible coatings on the arbitrary substrate in a straightforward and cost-effective route at atmospheric pressure.

A study to examine the ageing behaviour of cold plasma-treated agricultural seeds.

Cold plasma (low pressure) technology has been effectively used to boost the germination and growth of various crops in recent decades. The durability of these plasma-treated seeds is essential because of the need to store and distribute the seeds at different locations. However, these ageing effects are often not ascertained and reported because germination and related tests are carried out within a short time after the plasma-treatment. This research aims to fill that knowledge gap by subjecting three different types of seeds (and precursors): Bambara groundnuts (water), chilli (oxygen), and papaya (oxygen) to cold plasma-treatment. Common mechanisms found for these diverse seed types and treatment conditions were the physical and chemical changes induced by the physical etching and the cold plasma on the seeds and subsequent oxidation, which promoted germination and growth. The high glass transition temperature of the lignin-cellulose prevented any physical restructuring of the surfaces while maintaining the chemical changes to continue to promote the seeds germination and growth. These changes were monitored over 60 days of ageing using water contact angle (WCA), water uptake, electrical conductivity, field emission scanning electron microscopy (FE-SEM) and X-ray photoelectron spectroscopy (XPS). The vacuum effect was also investigated to separate its effect from cold plasma (low pressure). This finding offers a framework for determining how long agricultural seeds that have received plasma treatment can be used. Additionally, there is a need to transfer this research from the lab to the field. Once the impact of plasma treatment on seeds has been estimated, it will be simple to do so.

Styloid Ulna Window Approach for Repair of Avulsed Foveal Attachment of Triangular Fibrocartilage Complex.

PURPOSE: To describe a surgical approach for open repair of the triangular fibrocartilage complex foveal avulsion via ulnar styloid osteotomy, and to assess its clinical results. METHODS: We reviewed 12 patients with distal radioulnar joint (DRUJ) instability due to isolated foveal avulsion of DRUJ ligaments. Wrist arthroscopy was conducted for all patients to exclude the presence of concomitant tear of the superficial part of the triangular fibrocartilage complex and to corroborate the diagnosis with a positive hook test. Through an ulnar approach between flexor and extensor carpi ulnaris, an ulnar styloid osteotomy was performed under image intensifier control just ulnar to the fovea of the head of the ulna. The avulsed foveal attachment was anchored through transosseous sutures passing from the fovea to the neck of the ulna. The ulnar styloid was fixed by means of screws or tension band wires. Outcome measures included clinical assessment of pain (visual analog scale), grip strength, DRUJ instability, range of motion of the wrist, and modified Mayo wrist score. Radiographic assessment was done to determine union of the ulnar styloid osteotomy, DRUJ subluxation, and any hardware-related problems. RESULTS: Outcome measures were evaluated after a mean follow-up of 21 months. Healing of the osteotomy was obtained in all cases by 11 weeks. The DRUJ laxity, visual analog scale, and modified Mayo wrist score improved, while grip strength and range of motion remained unchanged. One patient had prominent hardware necessitating removal after union of the osteotomy. There were no reported cases of injury or neuropraxia of the dorsal cutaneous branch of the ulnar nerve. CONCLUSIONS: Open repair of an avulsed foveal attachment of the triangular fibrocartilage complex using an ulnar styloid osteotomy is an alternative to either open or arthroscopic repair approaches. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.