Potential in-vitro antioxidant and anti-inflammatory activity of Martynia annua extract mediated Phytosynthesis of MnO2 nanoparticles.

The present research work describes the phyto-synthesis of Manganese dioxide nanoparticles (MnO2NPs) from the reduction of potassium permanganate using Martynia annua (M.annua) plant extract. From the literature review, we clearly understood the M.annua plant has anti-inflammatory activity. Manganese dioxides are important materials due to their wide range of applications. Their increased surface area gives them distinct capabilities, as it increases their mechanical, magnetic, optical, and catalytic qualities, allowing them to be used in more pharmaceutical applications. A detailed review of literature highlighting the issues related to this present work and its knowledge gap that none of the inflammatory activities had been done by MnO2 NPs synthesized from M.annua plant extract. So we selected this study. The product MnO2 NPs showed the wavelength centre at 370 nm and was monitored by UV-Vis spectra. The wave number around 600 cm-1 has to the occurrence of O-Mn-O bonds of pure MnO2 confirmed by FTIR spectroscopy. Transmission electron microscopy images showed the morphology of MnO2 NPs as spherical-shaped particles with average sizes at 7.5 nm. The selected area electron diffraction analysis exhibits the crystalline nature of MnO2 NPs. The obtained MnO2 NPs showed potential antioxidant and anti-inflammatory activity was compared to the plant extract. The synthesized MnO2 NPs have a large number of potential applications in the field of pharmaceutical industries. In the future, we isolate the phytocompounds present in the M.annua plant extract and conduct a study against corona virus. MnO2 produces manganese (III) oxide and oxygen, which increases fire hazard. But further research is required to understand their environmental behaviour and safety.

Multi-layered genome defences in bacteria.

Bacteria have evolved a variety of defence mechanisms to protect against mobile genetic elements, including restriction-modification systems and CRISPR-Cas. In recent years, dozens of previously unknown defence systems (DSs) have been discovered. Notably, diverse DSs often coexist within the same genome, and some co-occur at frequencies significantly higher than would be expected by chance, implying potential synergistic interactions. Recent studies have provided evidence of defence mechanisms that enhance or complement one another. Here, we review the interactions between DSs at the mechanistic, regulatory, ecological and evolutionary levels.

Raced and risky subjects: The interplay of racial and managerial ideologies as an expression of "colorblind" racism.

Contemporary manifestations of race are dynamic and elusive in the forms and shapes they take. "Colourblind" racism is effective at drawing on seemingly objective and race-neutral discourses to obfuscate racialized forms of structural exclusion. Framed by Critical Race Theory and Critical Narrative Analysis this paper presents an example from the Australian context that examines the relationships between a grassroots initiative developed by creatives from the African diaspora and two not-for-profit human services organizations, to illustrate how ideologies of race are enacted and obscured by managerialist ideologies and discourses of risk. Specifically, it shows how harmful dominant cultural narratives of deficit and danger transforms racialized Africans in Australia into "risky subjects." In a managerialist organization, risk must be controlled, and thus risk becomes the rationality for the control of racialized and risky subjects. Resistance to control by those subjects produces forms of organizational defensiveness that are mobilized through managerialist discourses and practices that work to structurally exclude. These findings illustrate the ways ideologies of race work alongside and through other ideological discourses and practices which render racialized dynamics of oppression race-neutral.

Evolutionary barriers to horizontal gene transfer in macrophage-associated Salmonella.

Horizontal gene transfer (HGT) is a powerful evolutionary force facilitating bacterial adaptation and emergence of novel phenotypes. Several factors, including environmental ones, are predicted to restrict HGT, but we lack systematic and experimental data supporting these predictions. Here, we address this gap by measuring the relative fitness of 44 genes horizontally transferred from Escherichia coli to Salmonella enterica in infection-relevant environments. We estimated the distribution of fitness effects in each environment and identified that dosage-dependent effects across different environments are a significant barrier to HGT. The majority of genes were found to be deleterious. We also found longer genes had stronger negative fitness consequences than shorter ones, showing that gene length was negatively associated with HGT. Furthermore, fitness effects of transferred genes were found to be environmentally dependent. In summary, a substantial fraction of transferred genes had a significant fitness cost on the recipient, with both gene characteristics and the environment acting as evolutionary barriers to HGT.

Eco-friendly green synthesis of silver nanoparticles from Aegle marmelos leaf extract and their antimicrobial, antioxidant, anticancer and photocatalytic degradation activity.

The present research work, green synthesis of silver nanoparticles (Ag NPs) was synthesized from silver ions using the reducing and capping agents of Aegle marmelos leaf extract. Initially, UV-vis spectrophotometry absorption of the Surface Plasmon Resonance centre at 450 nm was confirmed the formation of Ag NPs. Preliminary phytochemical and FT-IR analysis indicate the identification of secondary metabolised flavonoids that act as the reducing and capping agent of the synthesized Ag NPs. Transmission electron microscope analysis, morphology of Ag NPs shown by transmission electron microscopy is spherical with a size range of ∼30-50 nm. The synthesized Ag NPs were investigate the in-vitro anticancer, antimicrobial and antioxidant activity, results shows the potential activity against the standard drugs. The Ag NPs also revealed the cytotoxicity against MDA-MB-231 human breast cancer cells. The MTT assay shows the IC50 values at 125 ± 4.26 µg/mL of Ag NPs compared to the untreated cells of negative control. The Ag NPs was excellent photocatalyst act as degradation of environmentally polluted Basic Fuchsin dye within 18 min.

The role of artificial intelligence based systems for cost optimization in colorectal cancer prevention programs.

Colorectal Cancer (CRC) has seen a dramatic increase in incidence globally. In 2019, colorectal cancer accounted for 1.15 million deaths and 24.28 million disability-adjusted life-years (DALYs) worldwide. In India, the annual incidence rates (AARs) for colon cancer was 4.4 per 100,000. There has been a steady rise in the prevalence of CRC in India which may be attributed to urbanization, mass migration of population, westernization of diet and lifestyle practices and a rise of obesity and metabolic risk factors that place the population at a higher risk of CRC. Moreoever, CRC in India differs from that described in the Western countries, with a higher proportion of young patients and more patients presenting with an advanced stage. This may be due to poor access to specialized healthcare and socio-economic factors. Early identification of adenomatous colonic polyps, which are well-recognized pre-cancerous lesions, at the time of screening colonoscopy has been shown to be the most effective measure used for CRC prevention. However, colonic polyps are frequently missed during colonoscopy and moreover, these screening programs necessitate man-power, time and resources for processing resected polyps, that may hamper penetration and efficacy in mid- to low-income countries. In the last decade, there has been significant progress made in the automatic detection of colonic polyps by multiple AI-based systems. With the advent of better AI methodology, the focus has shifted from mere detection to accurate discrimination and diagnosis of colonic polyps. These systems, once validated, could usher in a new era in Colorectal Cancer (CRC) prevention programs which would center around "Leave in-situ" and "Resect and discard" strategies. These new strategies hinge around the specificity and accuracy of AI based systems in correctly identifying the pathological diagnosis of the polyps, thereby providing the endoscopist with real-time information in order to make a clinical decision of either leaving the lesion in-situ (mucosal polyps) or resecting and discarding the polyp (hyperplastic polyps). The major advantage of employing these strategies would be in cost optimization of CRC prevention programs while ensuring good clinical outcomes. The adoption of these AI-based systems in the national cancer prevention program of India in accordance with the mandate to increase technology integration could prove to be cost-effective and enable implementation of CRC prevention programs at the population level. This level of penetration could potentially reduce the incidence of CRC and improve patient survival by enabling early diagnosis and treatment. In this review, we will highlight key advancements made in the field of AI in the identification of polyps during colonoscopy and explore the role of AI based systems in cost optimization during the universal implementation of CRC prevention programs in the context of mid-income countries like India.

Preventive effect of tacrolimus on patients with post-endoscopic retrograde cholangiopancreatography pancreatitis.

BACKGROUND/AIMS: In patients undergoing endoscopic retrograde cholangiopancreatography (ERCP), calcineurin activates zymogen, which results in pancreatitis. In this study, we aimed to determine the efficacy of tacrolimus, a calcineurin inhibitor, in preventing post-ERCP pancreatitis (PEP). METHODS: This was a prospective pilot study in which patients who underwent ERCP received tacrolimus (4 mg in two divided doses); this was the Tac group. A contemporaneous cohort of patients was included as a control group. All patients were followed-up for PEP. PEP was characterized by worsening abdominal pain with an acute onset, elevated pancreatic enzymes, and a duration of hospital stay of more than 48 hours. Serum tacrolimus levels were measured immediately before the procedure in the Tac group. RESULTS: There were no differences in the baseline characteristics between the Tac group (n=48) and the control group (n=51). Only four out of 48 patients (8.3%) had PEP in the Tac group compared to eight out of 51 patients (15.7%) who had PEP in the control group. The mean trough tacrolimus level in patients who developed PEP was significantly lower (p<0.05). CONCLUSION: Oral tacrolimus at a cumulative dose of 4 mg safely prevents PEP. Further randomized controlled studies are warranted to establish the role of tacrolimus in this context.

Mechanical Characterization of Graphene-Hexagonal Boron Nitride-Based Kevlar-Carbon Hybrid Fabric Nanocomposites.

Polymer nanocomposites have been gaining attention in recent years. The addition of a low content of nanomaterials into the matrix improves mechanical, wear, thermal, electrical, and flame-retardant properties. The present work aimed to investigate the effect of graphene and hexagonal boron nitride nanoparticles on Kevlar and hybrid fiber-reinforced composites (FRP). Composites are fabricated with different filler concentrations of 0, 0.1, 0.3, and 0.5 wt.% by using a hand layup process. Characterizations like tensile, flexural, hardness, and impact strength were evaluated separately, heat deflection and viscosity properties of the epoxy composites. The dynamic viscosity findings indicated that a higher concentration of filler material resulted in nano-particle agglomeration. Graphene filler showed superior properties when compared to hexagonal boron nitride filler. Graphene showed optimum mechanical properties at 0.3 wt.%, whereas the hBN filler showed optimum properties at 0.5 wt.%. As compared to Kevlar composites, hybrid (carbon-Kevlar) composites significantly improved properties. As compared to graphene-filled composites, hexagonal boron nitride-filled composites increased scratch resistance. Digimat simulations were performed to validate experimental results, and it was observed that hybrid fabric composites exhibited better results when compared to Kevlar composites. The error percentage of all composites are within 10%, and it was concluded that hybrid-graphene fiber composites exhibited superior properties compared to Kevlar composites.

Transcriptomic profiling of Escherichia coli K-12 in response to a compendium of stressors.

Environmental perturbations impact multiple cellular traits, including gene expression. Bacteria respond to these stressful situations through complex gene interaction networks, thereby inducing stress tolerance and survival of cells. In this paper, we study the response mechanisms of E. coli when exposed to different environmental stressors via differential expression and co-expression analysis. Gene co-expression networks were generated and analyzed via Weighted Gene Co-expression Network Analysis (WGCNA). Based on the gene co-expression networks, genes with similar expression profiles were clustered into modules. The modules were analysed for identification of hub genes, enrichment of biological processes and transcription factors. In addition, we also studied the link between transcription factors and their differentially regulated targets to understand the regulatory mechanisms involved. These networks validate known gene interactions and provide new insights into genes mediating transcriptional regulation in specific stress environments, thus allowing for in silico hypothesis generation.

An outcome-based composite approach for the diagnosis of intestinal tuberculosis: a pilot study from a tertiary care centre in South India.

BACKGROUND: The diagnosis of intestinal TB (ITB) is challenging because of its overlapping features with Crohn's disease. This outcome-based study evaluated the combination of colonoscopy, histopathology, Xpert MTB/RIF and TB culture for best sensitivity and specificity. METHOD: This was a four-year retrospective, observational study of 426 clinically suspected patients who underwent colonoscopy with biopsies for histopathology, Xpert MTB/RIF and TB culture. ITB was diagnosed using the composite reference standard (CRS), which comprised either histological features or culture or Xpert MTB/RIF positivity, and positive response to anti-tuberculous treatment on follow up. RESULTS: 35 (8.2%) patients were diagnosed with ITB. Histopathology had the highest sensitivity (91.4%) and negative predictive value (99.2%), MTB/RIF had the highest specificity (100%) and positive predictive value (100%). A combinatorial approach with Xpert MTB/RIF and histopathology had optimal diagnostic value (97%), approaching 100% sensitivity with culture. 40% of cases were diagnosed within 12 hours with Xpert MTB/RIF and 97% cases within three days. CONCLUSION: This combinatorial diagnostic model provides rapid and reliable diagnosis of ITB which may be useful in endemic areas.

Endoscopic management of high-grade biliary strictures complicating living donor liver transplantation using soehendra stent retrievers.

BACKGROUND: Biliary strictures following living donor liver transplantation (LDLT) are usually managed by endoscopic retrograde cholangiography (ERC) with stricture dilation and stent placement. While current endoscopic techniques are successful in most cases, high-grade biliary strictures (HGBS) pose a challenge using currently employed techniques which have a low rate of technical success. AIMS: In this study, we have explored the safety and efficacy of Soehendra stent retrievers (SSR) for the dilation of HGBS complicating LDLT. METHODS: This was a prospective cohort study where all patients with anastomotic biliary strictures following LDLT from January 2016 till February 2018 were included. Patients with HGBS defined as the exclusive passage of 0.018-inch guidewire, were included in Group 1. In these patients, 5 Fr Soehendra stent retrievers were used to dilate HGBS over guidewire, using torsional movements. Technical success, safety and clinical response was compared with patients who required Per-cutaneous transhepatic cholangiography (PTC) with rendezvous procedure due to a failed ERC, before the commencement of the study (Group 2). RESULTS: Ten patients with HGBS were included into Group 1. Technical success defined as successful placement of a biliary stent across the stricture was achieved in all the patients in group 1. Favorable response to endotherapy was higher in group 1(8/10 patients (80%)) as compared to group 2(6/14 patients (42.8%)). There were no post procedure complications in patients of group 1, while 3 patients developed cholangitis in group 2. CONCLUSIONS: HGBS can be successfully treated with SSR for stricture dilation. It is safe with no significant complications and requires fewer procedures.

Role of endoscopic ultrasound guided fine needle aspiration/biopsy in the evaluation of intra-abdominal lymphadenopathy due to tuberculosis.

BACKGROUND: Intra-abdominal lymphadenopathy due to tuberculosis (TB) poses a diagnostic challenge due to difficulty in tissue acquisition. Although endoscopic ultrasound guided fine needle aspiration/biopsy (EUS-FNA/B) has shown promise in the evaluation of mediastinal lymph nodes, its role in the evaluation of intra-abdominal lymphadenopathy is not clear. AIM: To assess the role of EUS-FNA/B in the evaluation of intra-abdominal lymphadenopathy due to TB. METHODS: This was a retrospective study where patients with intra-abdominal lymphadenopathy who underwent evaluation with EUS-FNA/B were included. TB was diagnosed if the patient had any one of the following: (1) Positive acid fast bacilli (AFB) stain/TB GeneXpert/TB-polymerase chain reaction/AFB culture of tissue sample; and (2) Positive Mantoux test and response to anti-tubercular therapy. EUS-FNA reports, clinical reports and imaging characteristics of patients were recorded for a detailed analysis of patients with TB. RESULTS: A total of 149 patients underwent an EUS-FNA/B from lymph nodes (mean age 51 ± 17 years, M:F = 1.2). Benign inflammatory reactive changes were seen in 45 patients (30.2%), while 54 patients (36.2%) showed granulomatous inflammation with/without caseation. Among these, 51 patients (94.4%) were confirmed to have TB as per pre-defined criteria. Patients with TB were more likely to have hypoechoic and matted nodes [40 patients (67.7%)]. EUS-FNA/B was found to have a sensitivity and specificity of 86% and 93% respectively, with a diagnostic accuracy of 88% in the evaluation of intra-abdominal lymphadenopathy due to TB. CONCLUSION: EUS-FNA/B has a high diagnostic yield with a good sensitivity and specificity in the evaluation of intra-abdominal lymphadenopathy due to TB. However, the validity of these findings in populations with low prevalence of TB needs further evaluation.

Role of High-Density Lipoprotein Cholesterol (HDL-C) as a Clinical Predictor of Decompensation in Patients with Chronic Liver Disease (CLD).

INTRODUCTION: Systemic inflammation triggered by bacterial products like lipopolysaccharides (LPS) in the circulation is an important factor leading to decompensation in patients with chronic liver disease (CLD). High-density lipoprotein cholesterol (HDL-C) has a significant role in innate immune response to LPS in the circulation and could therefore increase the risk for decompensation in patients with CLD. In this study, we have explored the role of HDL-C as a prognostic marker for decompensation. METHODS: This was a prospective, observational, cohort study where consecutive patients with CLD were included. Patients with cholestatic liver disease and hepatocellular carcinoma were excluded. Fasting lipids were measured in all patients at the time of recruitment. Each patient was carefully followed up for development of decompensation events such as new-onset/worsening ascites, hepatic encephalopathy, or variceal bleed during follow-up. RESULTS: A total of 170 patients were included (mean age 60 ± 11.5 years, M : F = 6 : 1). At the end of follow-up, 97/170 patients (57%) had decompensation events. Mean HDL-C levels were significantly lower among patients with decompensation (27.5 ± 15 mg/dL vs. 43.5 ± 13.9 mg/dL; p value 0.004). Using ROC analysis, cut-off for HDL-C of 36.4 mg/dL was identified. On multivariate analysis, HDL-C (OR = 6.072; 95% CI 2.39-15.39) was found to have an independent association with risk of decompensation. CONCLUSIONS: HDL-C level (<36.4 mg/dL) is a reliable marker for risk of decompensation and can be a useful addition to existing prognostic scoring systems in CLD. It can be a valuable tool to streamline treatment protocols and prioritise liver transplantation.

Critically ill COVID-19 patients attended by anesthesiologists in northwestern Spain: a multicenter prospective observational study. / Pacientes críticos COVID-19 atendidos por anestesiólogos en el Noroeste de España: estudio multicéntrico, prospectivo, observacional.

BACKGROUND AND OBJECTIVES: There are limited information on outcome, complications and treatments of critically ill COVID-19 patients requiring admission to an intensive care unit (ICU). The aim of this study is to describe the clinical ICU course, treatments used, complications and outcomes, of critically ill COVID-19 patients admitted in seven ICU in Galicia region during the 2020 March-April pandemic peak. METHODS: Between March 21 and April 19, 2020, we evaluated critically ill COVID-19 patients admitted to the ICU of Anesthesia of seven hospitals in Galicia, northwestern Spain. Outcome, complications, and treatments were monitored until May 6, 2020, the final date of follow-up. RESULTS: A total of 97 critically ill COVID-19 patients were included. During ICU stay, mechanical ventilation became necessary in 80 (82.5%) patients, and tracheostomy in 22 (22.7%) patients. Prone position was used frequently in both intubated (67.5%) and awake (27.8%) patients. Medications consisted of antivirals agents (92.7%), corticosteroids (93.8%), tocilizumab (57.7%), and intermediate or high doses of anticoagulants (83.5%). The most frequent complications were ICU-acquired infection (52.6%), thrombosis events (16.5%), and reintubation (9.3%). After a median follow-up of 42 (34-45) days, 15 patients (15.5%) deceased, 73 patients (75.2%) had been discharged from ICU, and nine patients (9.3%) were still in the ICU. CONCLUSIONS: A high proportion of our critically ill COVID-19 patients required mechanical ventilation, prone positioning, antiviral medication, corticosteroids, and anticoagulants. ICU complications were frequent, mainly infections and thrombotic events. We had a relatively low mortality of 15,5%.