Bevacizumab Combination Therapy Versus Standard Chemotherapy for Ovarian Cancer in Shorter and Longer Follow-Up Duration: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

OBJECTIVE: This systematic review and meta-analysis aims to evaluate the efficacy and safety of bevacizumab in patients with ovarian cancer over a shorter and longer follow-up period. METHODS: We searched Medline, Cochrane CENTRAL, Scopus, and Google Scholar for all phase 3 randomized controlled trials (RCTs) that administered bevacizumab to women with ovarian cancer. Review Manager 5.4 was used to calculate risk ratios (RR) and hazard ratios (HR) with 95% CIs. We assessed the quality of the included studies using version 2 of the Cochrane Risk of Bias tool (RoB 2). RESULTS: After screening the titles, abstracts, and full texts, we included nine RCTs in our systematic review and meta-analysis. Four RCTs had a low risk of bias, while 5 had some concerns. Bevacizumab was associated with a progression free survival benefit for <36 months (HR: 0.59, 95% CI: 0.45-0.76, P<0.0001, I2=90%) and >36 months (HR: 0.66, 95% CI: 0.55-0.80, P<0.0001, I2=80%), and an overall survival benefit for <36 months (HR: 0.87, 95% CI: 0.78-0.98, P=0.02, I2=0%) but not for >36 months (HR: 0.98, 95% CI: 0.89-1.09, P=0.77, I2=30%). There was no difference in deaths between intervention and control groups <36 months (RR: 0.95, 95% CI: 0.86-1.04, P=0.26, I2=10%) or >36 months (RR: 1.02, 95% CI: 0.97-1.06, P=0.50, I2=0%). Bevacizumab reduced disease progression <36 months (RR: 0.82, 95% CI: 0.72-0.92, P=0.0008, I2=82%) but not at >36 months (RR: 0.83, 95% CI: 0.58-1.19, P=0.30, I2=94%). The adverse events reported with Bevacizumab use included thrombocytopenia, neutropenia, leukocytopenia, anemia, hypertension, bleeding or hemorrhage, and gastrointestinal, cardiac, and dermatological adverse events. CONCLUSION: Bevacizumab may improve progression-free survival within and after 36 months, overall survival within 36 months, and reduce disease progression within 36 months.

Robust Federated Learning for Heterogeneous Model and Data.

Data privacy and security is an essential challenge in medical clinical settings, where individual hospital has its own sensitive patients data. Due to recent advances in decentralized machine learning in Federated Learning (FL), each hospital has its own private data and learning models to collaborate with other trusted participating hospitals. Heterogeneous data and models among different hospitals raise major challenges in robust FL, such as gradient leakage, where participants can exploit model weights to infer data. Here, we proposed a robust FL method to efficiently tackle data and model heterogeneity, where we train our model using knowledge distillation and a novel weighted client confidence score on hematological cytomorphology data in clinical settings. In the knowledge distillation, each participant learns from other participants by a weighted confidence score so that knowledge from clean models is distributed other than the noisy clients possessing noisy data. Moreover, we use symmetric loss to reduce the negative impact of data heterogeneity and label diversity by reducing overfitting the model to noisy labels. In comparison to the current approaches, our proposed method performs the best, and this is the first demonstration of addressing both data and model heterogeneity in end-to-end FL that lays the foundation for robust FL in laboratories and clinical applications.

How long to wait after local infiltration anaesthesia: systematic review.

BACKGROUND: Conflicting evidence exists regarding the optimal waiting time for stable analgesic and vasoconstrictive effects after local infiltration of lidocaine with epinephrine. An objective review is needed to dispel surgical dogma. METHODS: This systematic review (PROSPERO ID: CRD42022362414) included RCTs and prospective cohort studies. Primary outcomes were (1) onset of analgesia and (2) onset of stable hypoperfusion, assessed directly, or measured indirectly using perfusion imaging. Other data extracted include waiting strategies, means of outcome assessment, anaesthetic concentrations, volume/endpoint of infiltration, and injection sites. Methodological quality was evaluated using the Cochrane risk-of-bias tool for randomized trials. Articles describing waiting strategies were critically appraised by the Joanna Briggs Institute tools. RESULTS: Twenty-four articles were analysed, comprising 1013 participants. Ten investigated analgesia onset. Their pooled mean was 2.1 min (range 0.4-9.0 min). This varied with anatomic site and targeted nerve diameter. Fourteen articles investigated onset of stable hypoperfusion. Four observed bleeding intraoperatively, finding the minimum time to hypoperfusion at 7.0 min in the eyelid skin and 25.0 min in the upper limb. The ten remaining studies used perfusion imaging, reporting a wide range of results (0.0-30.0 min) due to differences in anatomic sites and depth, resolution and artefacts. Studies using near-infrared reflectance spectroscopy and hyperspectral imaging correlated with clinical observations. Thirteen articles discussed waiting strategies, seven relating to large-volume tumescent local infiltration anaesthesia. Different waiting strategies exist for emergency, arthroscopic and cosmetic surgeries, according to the degree of hypoperfusion required. In tumescent liposuction, waiting 10.0-60.0 min is the norm. CONCLUSION: Current literature suggests that around 2 min are required for most patients to achieve complete analgesia in all sites and with all anaesthesia concentrations. Waiting around 7 min in eyelids and at least 25 min in other regions results in optimal hypoperfusion. The strategies discussed inform decisions of when and how long to wait.

Investigation of CeO2 nanoparticles on the performance enhancement of InsulatingOils.

Integrating nanotechnology in dielectric fluid significantly inhibits losses and boosts overall dielectric fluid performance. There has been research done on the effects of introducing various nanoparticles, such as titania, alumina, silica nanodiamonds, etc. In this paper, a novel nanoparticle, Ceria (CeO2), has been used, and its properties were examined using the FTIR (Fourier Transform Infrared) spectrum, the XRD (X-ray Diffraction) spectrum, the SEM (Scanning Electron Microscopy), and the TEM (Transmission Electron Microscopy). This paper illustrates an efficient dielectric fluid prepared by the successful dispersion of Cerium Oxide (CeO2) nanoparticles in various concentrations into four commercial oils, namely mineral oil, rapeseed oil, synthetic ester oil, and soybean oil, to enhance and improve their dielectric characteristics. The performance investigation emphasises breakdown strength enhancement and other dielectric properties of the colloidal solution comprising different nanoparticle (NP) concentrations. Various commercial oils are used as a base in nano-oil to diversify their applicability as dielectric fluids by measuring the correlation in dielectric parameters and statistically assessing their applicability with normal and Weibull distributions. The obtained experimental data sets were analyzed using the Statistics and Machine Learning Toolbox in MATLAB. The aging measurement has been done only on mineral oil, and results were matched using a predictive model of statistics and the Machine Learning Toolbox in MATLAB. Well-dispersed CeO2 NPs in the insulating oils lead to a significant increase in AC breakdown strength. The effect of ageing on the dielectric properties of nano oils yields better results than conventionally aged oil. It has been observed that the breakdown voltage is enhanced by up to 30% for mineral oil at an optimal concentration of 0.01 g/L, 9% for synthetic ester oil at 0.03 g/L, 18% for rapeseed oil at 0.02 g/L, and 19% for soybean oil at 0.03 g/L nanoparticle concentration. Following the dispersion of CeO2 nanoparticles, the dielectric constant of all insulating oils has also significantly improved. The overall experimental results are promising and show the potential of the CeO2 NPs-based nano oil as an efficient and highly performing dielectric oil for different power applications.

Seed Priming Modulates Physiological and Agronomic Attributes of Maize (Zea mays L.) under Induced Polyethylene Glycol Osmotic Stress.

Drought and osmotic stresses are major threats to agricultural crops as they affect plants during their life cycle. The seeds are more susceptible to these stresses during germination and establishment of seedlings. To cope with these abiotic stresses, various seed priming techniques have broadly been used. The present study aimed to assess seed priming techniques under osmotic stress. Osmo-priming with chitosan (1 and 2%), hydro-priming with distilled water, and thermo-priming at 4 °C were used on the physiology and agronomy of Zea mays L. under polyethylene glycol (PEG-4000)-induced osmotic stress (-0.2 and -0.4 MPa). The vegetative response, osmolyte content, and antioxidant enzymes of two varieties (Pearl and Sargodha 2002 White) were studied under induced osmotic stress. The results showed that seed germination and seedling growth were inhibited under osmotic stress and germination percentage, and the seed vigor index was enhanced in both varieties of Z. mays L. with chitosan osmo-priming. Osmo-priming with chitosan and hydro-priming with distilled water modulated the level of photosynthetic pigments and proline, which were reduced under induced osmotic stress; moreover, the activities of antioxidant enzymes were improved significantly. In conclusion, osmotic stress adversely affects the growth and physiological attributes; on the contrary, seed priming ameliorated the stress tolerance resistance of Z. mays L. cultivars to PEG-induced osmotic stress by activating the natural antioxidation enzymatic system and accumulating osmolytes.

Kinetin Capped Zinc Oxide Nanoparticles Improve Plant Growth and Ameliorate Resistivity to Polyethylene Glycol (PEG)-Induced Drought Stress in Vigna radiata (L.) R. Wilczek (Mung Bean).

Plants are sessile and mostly exposed to various environmental stresses which hamper plant growth, development, and significantly decline its production. Drought stress is considered to be one of the most significant limiting factors for crop plants, notably in arid and semi-arid parts the world. Therefore, the present study aimed to evaluate the potential impact of different concentrations (10, 100, and 200 µg/mL) of kinetin capped zinc oxide nanoparticles (Kn-ZnONPs) on Vigna radiata (L.) R. Wilczek under varying levels (5%, 10%, 15%) of PEG-induced drought stress. ZnONPs were synthesized by a co-precipitation method using Zinc acetate as a precursor at pH-12, incinerated to 500 °C, and kinetin was used as a surface functionalizing agent. The resulting Kn-ZnONPs were characterized by various contemporary analytical techniques, including SEM, SEM-EDS, XRD, DLS, and Zeta potential and IR spectroscopy. Crystalline Kn-ZnONPs, with a zeta potential of 27.8 mV and a size of 67.78 nm, of hexagonal wurtzite structure and vibrational stretches associated with N-H, C-O, C-N, etc., were confirmed. PEG-induced drought stress significantly reduced the growth of V. radiata by declining the chlorophyll and carotenoid contents. Moreover, a significant decrease in the levels of superoxide dismutase (SOD), peroxidase (POD), catalase (CAT), ascorbate peroxidase (APX), soluble sugar contents, proline, protein contents, phenol, and tannin were observed compared to the control. However, the exogenous application of Kn-ZnONPs ameliorated all photosynthetic parameters by up-regulating the antioxidant defense system through the promotion of SOD, POD, CAT, and lipid peroxidation levels. The biochemical parameters, such as proteins, soluble sugars, and proline, were observed to be maximum in plants treated with 200 µg/mL Kn-ZnONPs under 5% drought stress. The application of Kn-ZnONPs also enhanced the total phenol contents, flavonoid, and tannin contents. In conclusion, the findings of this study demonstrate that the exogenous application of Kn-ZnONPs provides beneficial effects to V. radiata by attenuating the damaging effects of drought stress through the up-regulation of the antioxidant defense system and osmolytes. These results suggest that Kn-ZnONPs have potential as a novel approach to improve crop productivity under drought stress conditions.

Swarm-FHE: Fully Homomorphic Encryption-based Swarm Learning for Malicious Clients.

Swarm Learning (SL) is a promising approach to perform the distributed and collaborative model training without any central server. However, data sensitivity is the main concern for privacy when collaborative training requires data sharing. A neural network, especially Generative Adversarial Network (GAN), is able to reproduce the original data from model parameters, i.e. gradient leakage problem. To solve this problem, SL provides a framework for secure aggregation using blockchain methods. In this paper, we consider the scenario of compromised and malicious participants in the SL environment, where a participant can manipulate the privacy of other participant in collaborative training. We propose a method, Swarm-FHE, Swarm Learning with Fully Homomorphic Encryption (FHE), to encrypt the model parameters before sharing with the participants which are registered and authenticated by blockchain technology. Each participant shares the encrypted parameters (i.e. ciphertexts) with other participants in SL training. We evaluate our method with training of the convolutional neural networks on the CIFAR-10 and MNIST datasets. On the basis of a considerable number of experiments and results with different hyperparameter settings, our method performs better as compared to other existing methods.

Telehealth Readiness of Healthcare Providers during COVID-19 Pandemic in Saudi Arabia.

OBJECTIVE: This study aimed to assess and explore the telehealth readiness of healthcare providers in Saudi Arabia. METHODS: This descriptive cross-sectional survey was conducted in a government healthcare facility in Saudi Arabia between August and October 2020. The Telehealth Readiness Assessment (TRA) tool was used. RESULTS: A total of 372 healthcare providers participated in this study. Their mean age was 35.5 years (SD = 10.46). The majority of respondents were female (65.6%), nurses (68.0%), married (60.2%), and non-Saudi nationals (64.2%). The analysis shows that healthcare providers generally had moderate-to-high telehealth readiness. Of the five domains, financial contributions had the lowest rating among nurses and physicians, 63.4% and 66.1%, respectively. Gender (ß = 7.64, p = 0.001), years of experience in the organization (ß = 11.75, p = 0.001), and years of experience in the profession (ß = 10.04, p = 0.023) predicted the telehealth readiness of healthcare providers. CONCLUSION: The telehealth readiness of healthcare providers in Saudi Arabia showed moderate to high levels. The COVID-19 pandemic poses a catastrophic threat to both patients and healthcare providers. Assessing telehealth readiness should include both patients and healthcare provider factors. A better understanding of the factors of organizational readiness, particularly healthcare providers, could help avoid costly implementation errors.

Multiplex Immunofluorescence: A Powerful Tool in Cancer Immunotherapy.

Traditional immunohistochemistry (IHC) has already become an essential method of diagnosis and therapy in cancer management. However, this antibody-based technique is limited to detecting a single marker per tissue section. Since immunotherapy has revolutionized the antineoplastic therapy, developing new immunohistochemistry strategies to detect multiple markers simultaneously to better understand tumor environment and predict or assess response to immunotherapy is necessary and urgent. Multiplex immunohistochemistry (mIHC)/multiplex immunofluorescence (mIF), such as multiplex chromogenic IHC and multiplex fluorescent immunohistochemistry (mfIHC), is a new and emerging technology to label multiple biomarkers in a single pathological section. The mfIHC shows a higher performance in cancer immunotherapy. This review summarizes the technologies, which are applied for mfIHC, and discusses how they are employed for immunotherapy research.

Near Infrared Photoimmunotherapy: A Review of Recent Progress and Their Target Molecules for Cancer Therapy.

Near infrared photoimmunotherapy (NIR-PIT) is a newly developed molecular targeted cancer treatment, which selectively kills cancer cells or immune-regulatory cells and induces therapeutic host immune responses by administrating a cancer targeting moiety conjugated with IRdye700. The local exposure to near-infrared (NIR) light causes a photo-induced ligand release reaction, which causes damage to the target cell, resulting in immunogenic cell death (ICD) with little or no side effect to the surrounding normal cells. Moreover, NIR-PIT can generate an immune response in distant metastases and inhibit further cancer attack by combing cancer cells targeting NIR-PIT and immune regulatory cells targeting NIR-PIT or other cancer treatment modalities. Several recent improvements in NIR-PIT have been explored such as catheter-driven NIR light delivery, real-time monitoring of cancer, and the development of new target molecule, leading to NIR-PIT being considered as a promising cancer therapy. In this review, we discuss the progress of NIR-PIT, their mechanism and design strategies for cancer treatment. Furthermore, the overall possible targeting molecules for NIR-PIT with their application for cancer treatment are briefly summarised.

Budget Impact of Early Introduction of Amino Acid Formula in Managing Infants with Cow Milk Protein Allergy: Arabian Gulf Countries' Experience.

Objective: This study estimates the budgetary impact of the introduction of amino-acid formula (AAF) as first-line management in the elimination diet of infants with suspected cow milk protein allergy (CMPA) in the Kingdom of Saudi Arabia (KSA), Kuwait, and the United Arab Emirates (UAE) from a health-care payer's perspective. Methods: A global decision tree model was adapted to compare estimated costs in current practice (extensively hydrolyzed formula [eHF] or soy formula [SF] with the proposed approach of early introduction of AAF as first-line treatment of CMPA in non-breast-fed infants). Model inputs were derived from explorative literature reviews and medical experts' opinions. All costs were reported in local currency, ie, Saudi Riyal (SAR) for KSA, Kuwaiti Dinar (KWD) for Kuwait, and United Arab Emirates Dirham (AED) for the UAE. Results: Cost savings with the early introduction of AAF were 10% (SAR 15102542) in KSA, 10% (KWD 306565) in Kuwait, 17% (AED 1842018) in the UAE government sector and 13% (AED 4232932) in the UAE private sector. The highest cost reduction was observed in the cost of soy formula (SF), with a 58% reduction both in KSA (SAR 4204540) and UAE public sector (AED 110331). A significant cost reduction in medication costs in Kuwait (37%; KWD 5630) and medical examination costs in the UAE private sector (50%; AED 1508918) was observed. Conclusion: Results indicated that the introduction of AAF as the first line in the management of CMPA is a cost-saving strategy for the Gulf Cooperation Council (GCC) countries-KSA, Kuwait, and UAE- from a health-care payer's perspective.

Influence of Mn Ions' Insertion in Pseudo-Tetragonal Phased CaBi4Ti4O15-Based Ceramics for Highly Efficient Energy Storage Devices and High-Temperature Piezoelectric Applications.

In the present era of advanced technology, the surge for suitable multifunctional materials capable of operating above 300 °C has increased for the utilization of high-temperature piezoelectric devices. For this purpose, a pseudo-tetragonal phased CaBi4Ti3.98 (Nb0.5Fe0.5)0.02O15:xwt%MnO2 (CBTNF:xMn), with x = 0-0.20, ceramic system has been engineered for the investigation of structural, ferroelectric, dielectric and high-temperature-dependent piezoelectric properties. XRD analysis confirms that low-content Mn-ion insertion at the lattice sites of CBTNF does not distort the pseudo-tetragonal phase lattice of CBTNF:xMn ceramics, but enhances the functional behavior of the ceramic system, specifically at x = 0.15 wt%Mn. Compared to pure CBT and CBTNF ceramics, CBTNF:0.15Mn has demonstrated a highly dense relative density (~96%), a saturated polarization (PS) of 15.89 µC/cm2, a storage energy density (WST) of ~1.82 J/cm3, an energy-conversion efficiency (ƞ) of ~51% and an upgraded piezoelectric behavior (d33) of 27.1 pC/N at room temperature. Sharp temperature-dependent dielectric constant (εr) peaks display the solid ferroelectric behavior of the CBTNF:0.15Mn sample with a Curie temperature (TC) of 766 °C. The thermally stable piezoelectric performance of the CBTNF:0.15Mn ceramic was observed at 600 °C, with just a 0.8% d33 loss (25 pC/N). The achieved results signify that multi-valence Mn ions have effectively intercalated at the lattice sites of the pseudo-tetragonal phased CBTNF counterpart and enhanced the multifunctional properties of the ceramic system, proving it to be a durable contender for utilization in energy-storage applications and stable high-temperature piezoelectric applications.

In Situ Nitrogen Functionalization of 2D-Ti3C2Tx-MXenes for High-Performance Zn-Ion Supercapacitor.

Zinc (Zn) ion supercapacitors (ZISCs) have attracted considerable attention as a viable energy storage technology because they are cost-effective, safe, and environmentally friendly. However, cathode materials with suitable properties are rare and need to be explored. In this regard, metal carbides (MXenes) are a good choice for capacitive energy storage, but they exhibit low capacitance. The energy storage performance of MXenes can be bossed using functionalization with heteroatom doping, e.g., nitrogen (N), to simultaneously modify ZISCs' fundamental characteristics and electrochemical properties. Herein, we present an in-situ N-functionalization of Ti3C2Tx-MXene via a hydrothermal reaction with urea (denoted as N-Ti3C2Tx-MXene). N-functionalization into Ti3C2Tx-MXene raised Ti3C2Tx-MXene's interlayer spacing and boosted the Zn-ion storage in 1 M ZnSO4 electrolyte. The N-Ti3C2Tx-MXene electrode delivered an excellent specific capacitance of 582.96 F/g at 1 A/g and retained an outstanding cycle stability of 94.62% after 5000 cycles at 10 A/g, which is 1.8 times higher than pristine Ti3C2Tx-MXene at identical conditions. Moreover, the N-Ti3C2Tx-MXene//Zn device demonstrated a maximum capacitance of 153.55 F/g at 1 A/g, retained 92% of its initial value after 5000 cycles, and its Coulombic efficiency was ~100%. This strategy considerably reduced Ti3C2Tx-MXene nanosheet restacking and aggregation and enhanced electrochemical performance. Further, this research elucidated N-Ti3C2Tx-MXene's charge-storage process and offered a fresh approach to the rational design of novel electrode materials for ZISCs.

An infant with patau syndrome associated with congenital heart defects.

Introduction: and background: Patau syndrome or trisomy 13 is a clinically severe condition; 85 percent of patients die before reaching the age of one year, and the majority of children die before reaching the age of six months. Case presentation: This report discusses a case of a male infant, two days old diagnosed with Patau syndrome. After birth, his APGAR score was satisfactory. The initial clinical examination revealed cleft palate, cleft lip, and congenital clubfoot. A pansystolic murmur was heard at the left sternal border. The patient was managed according and was referred to a surgeon for pulmonary binding, PDA ligation, VSD closure, and repair of ASA with disbanding of the pulmonary artery. Clinical discussion: Studies have reported that patients with Patau syndrome present with cleft lip and palate, congenital heart defects, omphalocele, and holoprosencephaly. we also discovered dysmorphic characteristics such as the cleft palate and cleft lip, as well as serious congenital cardiac abnormalities. In addition, up to 80% of patients have been documented to have cardiac abnormalities, with patent ductus arteriosus, atrial septal defect, and ventricular septal defect. Conclusion: Patau syndrome is the third most common trisomy found in infants. The clinical manifestation of Patau syndrome includes cleft palate, cleft lip, limb impairments, and congenital heart problems. Despite the fact that early diagnosis and management prognosis is poor for patients suffering from Patau syndrome. Genetic counseling may be beneficial not just for increasing awareness of the diagnosis and its implications.

Single- and Multilayered Perovskite Thin Films for Photovoltaic Applications.

Organic-inorganic lead halide perovskites materials have emerged as an innovative candidate in the development of optoelectronic and photovoltaic devices, due to their appealing electrical and optical properties. Herein, mix halide single-layer (~95 nm) and multilayer (average layer ~87 nm) CH3NH3PbIBr2 thinfilms were grown by a one-step spin coating method. In this study, both films maintained their perovskite structure along with the appearance of a pseudo-cubic phase of (200) at 30.16°. Single-layer and multilayer CH3NH3PbIBr2 thinfilms displayed leaky ferroelectric behavior, and multilayered thinfilm showed a leakage current of ~5.06 × 10-6 A and resistivity of ~1.60 × 106 Ω.cm for the applied electric field of 50 kV/cm. However, optical analysis revealed that the absorption peak of multilayered perovskite is sharper than a single layer in the visible region rather than infrared (IR) and near-infrared region (NIR). The band gap of the thinfilms was measured by Tauc plot, giving the values of 2.07 eV and 1.81 eV for single-layer and multilayer thinfilms, respectively. The structural analysis has also been performed by Fourier transform infrared spectroscopy (FTIR). Moreover, the fabricated CH3NH3PbIBr2 as an absorber layer for photoelectric cell demonstrated a power conversion efficiency of 7.87% and fill factor of 72%. Reported electrical, optical and photoelectric efficiency-based results suggest that engineered samples are suitable candidates for utilization in optoelectronic and photovoltaic devices.

EpCAM- and EGFR-Specific Antibody Drug Conjugates for Triple-Negative Breast Cancer Treatment.

Triple-negative breast cancer (TNBC) is a group of heterogeneous and refractory breast cancers with the absence of estrogen receptor (ER), progesterone receptor (PgR) and epidermal growth factor receptor 2 (HER2). Over the past decade, antibody drug conjugates (ADCs) have ushered in a new era of targeting therapy. Since the epidermal growth factor receptor (EGFR) and epithelial cell adhesion molecule (EpCAM) are over expressed on triple-negative breast cancer, we developed novel ADCs by conjugating benzylguanine (BG)-modified monomethyl auristatin E (MMAE) to EpCAM- and EGFR-specific SNAP-tagged single chain antibody fragments (scFvs). Rapid and efficient conjugation was achieved by SNAP-tag technology. The binding and internalization properties of scFv-SNAP fusion proteins were confirmed by flow cytometry and fluorescence microscopy. The dose-dependent cytotoxicity was evaluated in cell lines expressing different levels of EGFR and EpCAM. Both ADCs showed specific cytotoxicity to EGFR or EpCAM positive cell lines via inducing apoptosis at a nanomolar concentration. Our study demonstrated that EGFR specific scFv-425-SNAP-BG-MMAE and EpCAM-specific scFv-EpCAM-SNAP-BG-MMAE could be promising ADCs for the treatment of TNBC.

AMNIOTIC MEMBRANE GRAFT FOR THE TREATMENT OF LARGE REFRACTORY MACULAR HOLE.

PURPOSE: Study off-label human amniotic membrane use outcomes for giant refractory macular hole closure. MATERIALS AND METHODS: The study was performed at Lahore General Hospital, Lahore, over 52 months on patients who had undergone standard macular hole surgical procedures for treatment, but the hole failed to close. Refractory macular hole dimensions ranged from 824 µ m to 1,568 µ m. Before surgery, patients underwent slit-lamp examination, fundus photography, and optical coherence tomography for macular scan. Amniotic membrane graft (AMG) used in surgery was harvested from a human placenta 24 hours before. Before AMG application, enough internal limiting membrane peeling was performed to ensure perfect fitting and recovery. All holes were plugged with AMG and SF6 gas tamponade. RESULTS: Twenty-nine patients, 20 men and nine women, were included in this study. Mean age of patients was 58 ± 6. Patients had refractory holes of average 1,237.48 ± 151.25 µ m. Post-op, 100% macular hole closure was achieved in all patients. Type 1 closure was found in patients (37.93%) who underwent AMG surgery within 3 months after primary surgical failure. Type 2 closure was found in patients (62.07%) who were operated on 3 months after primary surgical failure. CONCLUSION: Refractory macular holes treated by AMG with SF6 gas tamponade achieve anatomical Type 1 closure if performed within 3 months of primary surgical repair.

DAVS-NET: Dense Aggregation Vessel Segmentation Network for retinal vasculature detection in fundus images.

In this era, deep learning-based medical image analysis has become a reliable source in assisting medical practitioners for various retinal disease diagnosis like hypertension, diabetic retinopathy (DR), arteriosclerosis glaucoma, and macular edema etc. Among these retinal diseases, DR can lead to vision detachment in diabetic patients which cause swelling of these retinal blood vessels or even can create new vessels. This creation or the new vessels and swelling can be analyzed as biomarker for screening and analysis of DR. Deep learning-based semantic segmentation of these vessels can be an effective tool to detect changes in retinal vasculature for diagnostic purposes. This segmentation task becomes challenging because of the low-quality retinal images with different image acquisition conditions, and intensity variations. Existing retinal blood vessels segmentation methods require a large number of trainable parameters for training of their networks. This paper introduces a novel Dense Aggregation Vessel Segmentation Network (DAVS-Net), which can achieve high segmentation performance with only a few trainable parameters. For faster convergence, this network uses an encoder-decoder framework in which edge information is transferred from the first layers of the encoder to the last layer of the decoder. Performance of the proposed network is evaluated on publicly available retinal blood vessels datasets of DRIVE, CHASE_DB1, and STARE. Proposed method achieved state-of-the-art segmentation accuracy using a few number of trainable parameters.

Activity of ethanolic extract of Eucalyptus globulus leaves against multi drug resistant poultry pathogens in broiler chicks.

The present study was designed to evaluate the antimicrobial activity of E. globulus leaves in broiler chicks. Total (n=255) day-old chicks were segregated into five groups i.e. Pathogenic E. coli, S. pullorum, S. gallinarum and C. perfringens type A and control negative group. Each bacterial challenged (1x 107 CFU) group was divided into control positive, antibiotic, probiotic and E. globulus group. Experimental birds were exposed to E. coli, S. pullorum, S. gallinarum and C. perfringens type A at different ages. At 35th day of experiment the log reduction for each group was determined. The highest log reduction in E. coli and C. perfringens Type A colonies count were found in E. globulus (3.26) (2.33) treated group followed by antibiotic (2.85) (1.59) and probiotic (2.84) (1.50) respectively. The log reduction in S. pullorum colonies count was highest in E. globulus (2.50) followed by probiotic (2.24) and antibiotic (2.16). The S. gallinarum colonies count log reduction was found highest for antibiotic (2.84) followed by probiotic (2.48) and E. globulus group. The results of in-vivo experiment revealed that ethanolic extract of E. globulus has antibacterial activity and it can be used as a replacement to low level of antibiotics added in poultry feed.