Investigation of the influence of Candida tropicalis on bioethanol production using sugarcane bagasse: stochastic and in silico analysis.

This study investigated the impact of Candida tropicalis NITCSK13 on sugarcane bagasse (SCB) consolidated bioprocessing (CSB) using various parameters, such as pH, steam explosion (STEX) pretreatment, and temperature (at two different temperatures, cellulose hydrolysis and ethanol fermentation). The backpropagation neural network (BPNN) method simulated the optimal CSB conditions, achieving a maximum ethanol yield of 44 ± 0.32 g/L (0.443 g of ethanol/g of SCB) from STEX pretreated SCB within 48 h at 55 °C for cellulose hydrolysis and 33 °C for ethanol fermentation and pH 3.5. The simulated conditions were experimentally validated and showed an R2 value of 0.998 and absolute average deviation (AAD) of 1.23%. The strain NITCSK13 also exhibited a high ethanol tolerance of 16% (v/v). The interactions between the inhibitors, cellobiose, furfural, and thermocellulase were assessed through molecular docking. The results revealed a maximum inhibitory constant of 3.7 mM for furfural against the endoglucanase (EnG) of Humicola insolens (2ENG) at 50 °C. Acremonium chrysogenum endoglucanase (5M2D) exhibited a maximum of 88.7 µM for cellobiose at 50 °C. The SWISS homology model of EnG from Candida viswanathii exhibited inhibitory effects similar to those of EnG from Thermoascus and Thermotoga, indicating that the moderately thermophilic yeast Candida sp. cellulase may be capable of efficiently tolerating inhibitors and could be a promising candidate for consolidated bioprocessing of cellulosic ethanol.

Can Pretreatment MRI and Planning CT Radiomics Improve Prediction of Complete Pathological Response in Locally Advanced Rectal Cancer Following Neoadjuvant Treatment?

OBJECTIVE(S): The treatment response to neoadjuvant chemoradiation (nCRT) differs largely in individuals treated for rectal cancer. In this study, we investigated the role of radiomics to predict the pathological response in locally advanced rectal cancers at different treatment time points: (1) before the start of any treatment using baseline T2-weighted MRI (T2W-MR) and (2) at the start of radiation treatment using planning CT. METHODS: Patients on nCRT followed by surgery between June 2017 to December 2019 were included in the study. Histopathological tumour response grading (TRG) was used for classification, and gross tumour volume was defined by the radiation oncologists. Following resampling, 100 and 103 pyradiomic features were extracted from T2W-MR and planning CT images, respectively. Synthetic minority oversampling technique (SMOTE) was used to address class imbalance. Four machine learning classifiers built clinical, radiomic, and merged models. Model performances were evaluated on a held-out test dataset following 3-fold cross-validation using area under the receiver operator characteristic curves (AUC) with bootstrap 95% confidence intervals. RESULTS: One hundred and fifty patients were included; 58/150 with TRG 1 were classified as complete responders, and rest were incomplete responders (IR). Clinical models performed better (AUC = 0.68) compared to radiomics models (AUC = 0.62). Overall, the clinical + T2W-MR model showed best performance (AUC = 0.72) in predicting the pathological response prior to therapy. Clinical + Planning CT-merged models could only achieve the highest AUC of 0.66. CONCLUSION: Merging clinical and baseline T2W-MR radiomics enhances predicting pathological response in rectal cancer. Validation in larger cohorts is warranted, especially for watch and wait strategies.

Process intensification of biopolymer polyhydroxybutyrate production by pseudomonas putida SS9: A statistical approach.

There are numerous elements of daily life where plastic is employed, yet it is uncertain exactly when it will deteriorate. Poly-(3-hydroxybutyrate) (PHB), a biodegradable polymer, is viewed as a possible substitute for synthetic plastics made from petroleum. With Pseudomonas putida SS9, the current study sought to enhance operational conditions and nutritional factors to enhance PHB production. To maximize the impacts of operational factors, a combination of response surface modeling (RSM) and artificial neural networks (ANN) has been applied. PHB content was used as the response while the interaction effects of the factors were examined. The optimal parameters for PHB synthesis were further tested in a lab scale fermentor. Under optimal conditions, 13.83 g/L of C, 0.57 g/L of N, 0.59 g/L of P, the maximal productivity of PHB obtained with Pseudomonas putida SS9 is 12.89 g/L after 84 h. A mean square value of 15.7 with P < 0.0001 were obtained from the ANOVA results of quadratic polynomial model using RSM. The same construct was employed in MATLAB software to train a feed-forward ANN using the back-propagation approach, generating 12.88 g/L. The data indicated that a properly trained ANN model outperforms the RSM model in prediction. Furthermore, employing dairy waste (cheese whey) as a low-cost feedstock resulted in an equally proportionate PHB yield of 12.02 g/L. Therefore, cheese whey appeared to be a viable alternative carbon source over optimized synthetic media.

Thrombotic Thrombocytopenic Purpura After Live Liver Donation: Villain or Scapegoat?

Living donor liver transplantation is a complex surgery, where the donor's safety is of paramount importance. Despite all precautions, donor morbidity may be inevitable, and long-term follow-up data attest to this fact. However, being a "past donor" all ailments are intuitively attributed to the donation process, which may not always be the case. We present the case of a 47-year-old lady, who developed thrombotic thrombocytopenic purpura secondary to systemic lupus erythematosus 18 months following her liver donation, when she detected to be anti-nuclear antibody (ANA) positive. She developed neurological signs and was managed successfully with therapeutic plasma exchange and steroids. She was discharged home on immunosuppression and remains well on follow-up. We present the medical and social issues that were addressed in the case and highlight the need for a more stringent follow-up protocol in those who are ANA positive. This would also help detect morbidities that may be unrelated to the donation process.

Acute hemorrhagic leukoencephalitis in a COVID-19 patient-a case report with literature review.

PURPOSE: Acute hemorrhagic leukoencephalitis (AHLE) is a rare and severe form of acute disseminated encephalomyelitis (ADEM). Only a few reports of AHLE in coronavirus disease 2019 (COVID-19) patients have been described to date. We report a case of COVID-19-related AHLE along with a literature review describing salient clinical and imaging characteristics. METHODS: A literature search was performed on Medline (2020-present), PubMed, Cochrane Library, CINAHL, and Google scholar on 28 January 2021 for all articles published using MeSH terms "COVID-19" or "SARS-CoV-2" with "Acute hemorrhagic leukoencephalitis" or "Acute hemorrhagic encephalitis." Relevant case reports and case series describing clinical and imaging features of AHLE associated with SARS-CoV-2 infection were included, data compiled, and critically reviewed. RESULTS: Acute onset encephalopathy and rapidly deteriorating neurological status is the common clinical presentation in AHLE. CSF analysis reveals elevated proteins and lymphocytic pleocytosis. Typical neuroimaging features include multifocal, variable-sized, poorly defined cerebral white matter lesions with cortical sparing. Involvement of the brainstem, cerebellar peduncles, and deep grey matter can also occur, although rarely. Lesions are hyperintense on T2-weighted (T2W) and fluid-attenuated inversion recovery (FLAIR) images, hypointense on T1W images, and show microhemorrhages, variable diffusion restriction, and post-contrast enhancement. Extensive microhemorrhages, brainstem involvement, and gross hemorrhage often portend a poor prognosis. CONCLUSION: Heightened awareness about the clinical and imaging presentation of COVID-19-related AHLE can positively alter the outcome in a select few by enabling early diagnosis and aggressive management.

Structural, biological and pharmaceutical importance of antibiotic agent chloramphenicol.

The vibrational, magnetic resonance and electronic spectral techniques are used to evaluate structural activity associated physico-chemical properties. The biological affinity and drug importance was validated by calculating biological parameters using HyperChem. Mulliken charge assignment for restoring chemical potential for generating drug potential in the molecular site was mapped and analyzed. The vibrational spectral pattern was estimated by identifying active and inactive bands and hindrance of vibrational activity of Acetamide group was monitored and thereby drug malfunction was tested. The chemical reaction pathway around the core carbons of chain and ring was keenly noted and the cause of chemical potential for the inducement of drug mechanism was reported. The stimulation of chemical mechanism for antibiotic activity was addressed by suitable evidence and further improvement for enhancing activity was made. The electronic HOMO and LUMO interaction over different molecular entities are discussed to expose accompany of drug mechanical transitions. The CT complex was recognized to be C=N and C=C bonds and operating drug mechanism was monitored. The unwanted drug property induced by perplexes of charge depletion on α-hydroxyl group was assessed from MEP map. The hyperactive polarization energy of 266.18 X10-33 esu and 327 X10-33 esu of present compound is causing biological activity in good order. The uncontrolled breathing region of Acetamide group was clarified in VCD profile and this is main cause to produce toxicity in drug process.

Estimating chronic hepatitis C prognosis using transient elastography-based liver stiffness: A systematic review and meta-analysis.

Chronic hepatitis C (CHC) is a leading cause of hepatic fibrosis and cirrhosis. The level of fibrosis is traditionally established by histology, and prognosis is estimated using fibrosis progression rates (FPRs; annual probability of progressing across histological stages). However, newer noninvasive alternatives are quickly replacing biopsy. One alternative, transient elastography (TE), quantifies fibrosis by measuring liver stiffness (LSM). Given these developments, the purpose of this study was (i) to estimate prognosis in treatment-naïve CHC patients using TE-based liver stiffness progression rates (LSPR) as an alternative to FPRs and (ii) to compare consistency between LSPRs and FPRs. A systematic literature search was performed using multiple databases (January 1990 to February 2016). LSPRs were calculated using either a direct method (given the difference in serial LSMs and time elapsed) or an indirect method given a single LSM and the estimated duration of infection and pooled using random-effects meta-analyses. For validation purposes, FPRs were also estimated. Heterogeneity was explored by random-effects meta-regression. Twenty-seven studies reporting on 39 groups of patients (N = 5874) were identified with 35 groups allowing for indirect and 8 for direct estimation of LSPR. The majority (~58%) of patients were HIV/HCV-coinfected. The estimated time-to-cirrhosis based on TE vs biopsy was 39 and 38 years, respectively. In univariate meta-regressions, male sex and HIV were positively and age at assessment, negatively associated with LSPRs. Noninvasive prognosis of HCV is consistent with FPRs in predicting time-to-cirrhosis, but more longitudinal studies of liver stiffness are needed to obtain refined estimates.

Novel application of high-density polyethylene mesh as self-forming dynamic membrane integrated into a bioreactor for wastewater treatment.

In the present study, self-forming dynamic membrane (SFDM) on rigid high-density polyethylene (HDPE) mesh with a large pore size of 2 mm is reported for the first time. The system was investigated for utilisation in simulated wastewater treatment by integrating the mesh with an aerobic bioreactor. The SFDM was analysed using Fourier transform infra-red (FT-IR) spectroscopy and visualised by scanning electron microscopy (SEM). The effect of the operating parameter on the change in composition of SFDM was also investigated. The system was used as a single unit for treatment of wastewater and showed stability over long-term treatment. The system could achieve a chemical oxygen demand (COD) reduction of 82.16 ± 6.47% at an influent COD concentration of 613.93 ± 72.13 mg/l and ammonia removal efficiency of 97.21 ± 0.62% at an influent ammonia concentration of 55.54 ± 2.23 mg/l. The reactor generated high-quality effluent and the turbidity recorded was less than 2NTU. In addition, the operational parameters, namely hydraulic retention time and organic loading rate, were optimised.

Unraveling viscosity effects on the hysteresis losses of magnetic nanocubes.

Hysteresis losses in magnetic nanoparticles constitute the basis of magnetic hyperthermia for delivering a local thermal stress. Nevertheless, this therapeutic modality is only to be realised through a careful appraisal of the best possible intrinsic and extrinsic conditions to the nanoparticles for which they maximise and preserve their heating capabilities. Low frequency (100 kHz) hysteresis loops accurately probe the dynamical magnetic response of magnetic nanoparticles in a more reliable manner than calorimetry measurements, providing conclusive quantitative data under different experimental conditions. We consider here a set of iron oxide or cobalt ferrite nanocubes of different sizes, through which we experimentally and theoretically study the influence of the viscosity of the medium on the low frequency hysteresis loops of magnetic colloids, and hence their ability to produce and dissipate heat to the surroundings. We analyse the role of nanoparticle size, size distribution, chemical composition, and field intensity in making the magnetisation dynamics sensitive to viscosity. Numerical simulations using the stochastic Landau-Lifshitz-Gilbert equation model the experimental observations in excellent agreement. These results represent an important contribution towards predicting viscosity effects and hence to maximise heat dissipation from magnetic nanoparticles regardless of the environment.

Synthesis of magnetic biocomposite for efficient adsorption of azo dye from aqueous solution.

A novel magnetic biocomposite was synthesized using metal chlorides and aquatic macrophytes by co-precipitation method. The resulting product, magnetic biocomposite was characterized by Fourier transform infrared spectra (FTIR), X-ray diffraction (XRD), Energy-dispersive X-ray spectroscopy (EDX) and Scanning electron microscope (SEM). The adsorption performance of the magnetic biocomposite was tested with removal of Metanil Yellow dye from aqueous solution. The effect of influencing parameters such as initial dye concentration, solution pH and agitation were investigated. The equilibrium isotherm was well described by the Langmuir model with the with maximum adsorption capacity of 90.91mg/g. Adsorption kinetics experiments were carried out and the data were well fitted by a pseudo-second-order equation. The results revealed that the magnetic biocomposite could efficiently adsorb the azo dyes from aqueous solution, and the spent adsorbents could be recovered completely by magnetic separation process. Therefore, the prepared magnetic biocomposite could thus be used as promising adsorbent for the removal of azo dyes from polluted water.

Multidisciplinary assessment of fitness to drive in brain tumour patients in southwestern Ontario: a grey matter.

BACKGROUND: Neurocognitive impairments from brain tumours may interfere with the ability to drive safely. In 9 of 13 Canadian provinces and territories, physicians have a legal obligation to report patients who may be medically unfit to drive. To complicate matters, brain tumour patients are managed by a multidisciplinary team; the physician most responsible to make the report of unfitness is often not apparent. The objective of the present study was to determine the attitudes and reporting practices of physicians caring for these patients. METHODS: A 17-question survey distributed to physicians managing brain tumour patients elicited Respondent demographicsKnowledge about legislative requirementsExperience of reportingBarriers and attitudes to reporting Fisher exact tests were performed to assess differences in responses between family physicians (fps) and specialists. RESULTS: Of 467 physicians sent surveys, 194 responded (42%), among whom 81 (42%) were specialists and 113 (58%) were fps. Compared with the specialists, the fps were significantly less comfortable with reporting, less likely to consider reporting, less likely to have patients inquire about driving, and less likely to discuss driving implications. A lack of tools, concern for the patient-physician relationship, and a desire to preserve patient quality of life were the most commonly cited barriers in determining medical fitness of patients to drive. CONCLUSIONS: Legal requirements to report medically unfit drivers put physicians in the difficult position of balancing patient autonomy and public safety. More comprehensive and definitive guidelines would be helpful in assisting physicians with this public health issue.

Improved fuzzy clustering algorithms in segmentation of DC-enhanced breast MRI.

Segmentation of medical images is a difficult and challenging problem due to poor image contrast and artifacts that result in missing or diffuse organ/tissue boundaries. Many researchers have applied various techniques however fuzzy c-means (FCM) based algorithms is more effective compared to other methods. The objective of this work is to develop some robust fuzzy clustering segmentation systems for effective segmentation of DCE - breast MRI. This paper obtains the robust fuzzy clustering algorithms by incorporating kernel methods, penalty terms, tolerance of the neighborhood attraction, additional entropy term and fuzzy parameters. The initial centers are obtained using initialization algorithm to reduce the computation complexity and running time of proposed algorithms. Experimental works on breast images show that the proposed algorithms are effective to improve the similarity measurement, to handle large amount of noise, to have better results in dealing the data corrupted by noise, and other artifacts. The clustering results of proposed methods are validated using Silhouette Method.

Effective fuzzy c-means based kernel function in segmenting medical images.

The objective of this paper is to develop an effective robust fuzzy c-means for a segmentation of breast and brain magnetic resonance images. The widely used conventional fuzzy c-means for medical image segmentations has limitations because of its squared-norm distance measure to measure the similarity between centers and data objects of medical images which are corrupted by heavy noise, outliers, and other imaging artifacts. To overcome the limitations this paper develops a novel objective function based standard objective function of fuzzy c-means that incorporates the robust kernel-induced distance for clustering the corrupted dataset of breast and brain medical images. By minimizing the novel objective function this paper obtains effective equation for optimal cluster centers and equation to achieve optimal membership grades for partitioning the given dataset. In order to solve the problems of clustering performance affected by initial centers of clusters, this paper introduces a specialized center initialization method for executing the proposed algorithm in segmenting medical images. Experiments are performed with synthetic, real breast and brain images to assess the performance of the proposed method. Further the validity of clustering results is obtained using silhouette method and this paper compares the results with the results of other recent reported fuzzy c-means methods. The experimental results show the superiority of the proposed clustering results.

Mania as a presentation of primary hypothyroidism.

Hypothyroidism is a common problem in clinical practice, with diverse manifestations. Neuropsychiatric problems include affective disorders, disturbances in cognition and psychosis. Mania is commonly associated with hyperthyroidism. Only a few selected case reports mention mania as a presenting feature of hypothyroidism. We report a case of mania with psychotic symptoms in a 47-year-old woman who had no previous history of psychiatric disorder. She had signs of florid hypothyroidism. She required both antipsychotic drugs and thyroxine replacement for the amelioration of her symptoms. The report is followed by a brief review of the literature on mania as a clinical presentation of hypothyroidism and its probable pathogenesis. One has to have a high index of suspicion of underlying organic causes in patients presenting with depression, psychosis or cognitive disorders.

A tale of three diseases of the bone.

Paget's disease is a relatively rare disorder of the bone with only a few reports and case series observations from India. Hypocalcaemia is rare in Paget's disease, usually occurring as a consequence of therapy with bisphosphonates. We report a 65-year-old woman with Paget's disease who had hypocalcaemia secondary to vitamin D deficiency. On further evaluation, she also had severe osteoporosis. How vitamin D deficiency affects the diagnosis and monitoring of Paget's disease and the relationship between the three diseases are discussed. This case illustrates an interesting situation with abnormal bone turnover, remodelling and mineralisation in the form of Paget's disease with osteomalacia and osteoporosis.

Vitamin E and selenium supplementation reduces plasma cortisol and oxidative stress in dystocia-affected buffaloes.

The aim of the study was to evaluate oxidative stress around parturition in normally calved and dystocia-affected buffaloes and the clinical efficacy of vitamin E and selenium (Se) in reducing the effects in buffaloes suffering from dystocia. Plasma cortisol concentration, erythrocytic malondialdehyde (MDA) level and superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities were evaluated in dystocia-affected (supplemented (n = 8) and unsupplemented (n = 5) with vitamin E and Se) and normally calved (unsupplemented; n = 6) buffaloes. The decline in plasma cortisol concentration, MDA level and SOD activity was greater in the group of dystocia-affected buffaloes supplemented with vitamin E and Se (78.62 +/- 2.7%, 13.38 +/- 9.75% and 28.83 +/- 7.72%, respectively) than in the unsupplemented group (54.33 +/- 12.62%, 3.48 +/- 4.16% and 17.69 +/- 12.93%, respectively). These results suggests that supplementation with antioxidants like vitamin E and Se may be beneficial in reducing oxidative stress in dystocia-affected buffaloes in the immediate postpartum period.