Reduced sperm number of murrah (Bubalus bubalis) bull semen in french mini-straw affects kinetic and functional competence after cryopreservation.

BACKGROUND: Extensive dilution of cattle semen with tris-based extender compromises certain sperm kinetic and functional traits following cryopreservation. OBJECTIVE: To study sperm functions of buffalo bulls under high dilution rates. MATERIALS AND METHODS: Twenty-four ejaculates were harvested twice a week from four buffalo bulls, and diluted to sperm concentrations of 80, 60, 40 and 20 million/mL. Diluted samples were filled in straws, equilibrated at refrigeration temperature for 4 h, and frozen in liquid nitrogen. Frozen sperm samples were thawed for evaluation of kinetic and functional attributes. RESULTS: Compared to 20 million/mL (million/mL) sperm sample, the total motility, progressive motility and rapid motility were reduced (P < 0.05) in 5 million/mL sample. The proportion of live sperm were significantly (P < 0.05) higher in 10, 15 and 20 million/mL samples than in 5 million/mL sample. The percentage of moribund sperm, dead sperm, and sperm with lipid per oxidation increased significantly (P < 0.05) in 5 million/mL sample. CONCLUSION: The reduction of sperm concentrations to < 10 million/mL affects post-thaw Buffalo sperm kinetic and functional attributes.. https://doi.org/10.54680/fr24110110712.

Negligible radiological impact of Indian nuclear power plants on the environment and the public: Findings from a 20-year study.

Nuclear power plants, recognized for their extended operational life, minimal greenhouse gas emissions, and high-power density, are deemed as reliable energy sources. Nonetheless, concerns persist regarding the radioactive discharges from these plants and their potential impact on health and the environment. To comprehend the radiological implications of such releases, this study presents, for the first time, an analysis of radiological data from 7 Indian nuclear power plants (NPPs), collected by Indian environmental survey laboratories (ESL) over the past two decades (2000-2020). This dataset encompasses radioactivity concentrations in the atmospheric, aquatic, and terrestrial environments within a 30 km radius of each NPP, as well as the annual cumulative external gamma doses recorded by environmental thermoluminescence dosimeters (TLDs). The analysis yielded several key findings: (i) Radioactivity concentrations around the NPPs were low and comparable to values measured at other nuclear power plant sites worldwide; (ii) Tritium concentrations in receiving water bodies were <1 % of the internationally recommended limit of 10,000 Bq/l; (iii) The estimated total radiation doses to the public were at most 10 % of the stipulated regulatory dose limit of 1000 µSv and consistently decreased over the study period and (iv) Variations in doses among the NPP sites were primarily attributed to legacy technology used in specific reactors. These results indicate efficient and secure reactor operations and the minimal contribution of Indian nuclear power plants to anthropogenic doses in the country. The findings hold potential significance for reinforcing India's commitment to advancing its nuclear power program.

Green synthesis of iron nanoparticles: Sources and multifarious biotechnological applications.

Green synthesis of iron nanoparticles is a highly fascinating research area and has gained importance due to reliable, sustainable and ecofriendly protocol for synthesizing nanoparticles, along with the easy availability of plant materials and their pharmacological significance. As an alternate to physical and chemical synthesis, the biological materials, like microorganisms and plants are considered to be less costly and environment-friendly. Iron nanoparticles with diverse morphology and size have been synthesized using biological extracts. Microbial (bacteria, fungi, algae etc.) and plant extracts have been employed in green synthesis of iron nanoparticles due to the presence of various metabolites and biomolecules. Physical and biochemical properties of biologically synthesized iron nanoparticles are superior to that are synthesized using physical and chemical agents. Iron nanoparticles have magnetic property with thermal and electrical conductivity. Iron nanoparticles below a certain size (generally 10-20 nm), can exhibit a unique form of magnetism called superparamagnetism. They are non-toxic and highly dispersible with targeted delivery, which are suitable for efficient drug delivery to the target. Green synthesized iron nanoparticles have been explored for multifarious biotechnological applications. These iron nanoparticles exhibited antimicrobial and anticancerous properties. Iron nanoparticles adversely affect the cell viability, division and metabolic activity. Iron nanoparticles have been used in the purification and immobilization of various enzymes/proteins. Iron nanoparticles have shown potential in bioremediation of various organic and inorganic pollutants. This review describes various biological sources used in the green synthesis of iron nanoparticles and their potential applications in biotechnology, diagnostics and mitigation of environmental pollutants.

Novel deep transfer learning model for COVID-19 patient detection using X-ray chest images.

Around the world, more than 250 countries are affected by the COVID-19 pandemic, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This outbreak can be controlled only by the diagnosis of the COVID-19 infection in early stages. It is found that the radiographic images are ideal for the fastest diagnosis of COVID-19 infection. This paper proposes an ensemble model which detects the COVID-19 infection in the early stage with the use of chest X-ray images. The transfer learning enables to reuse the pretrained models. The ensemble learning integrates various transfer learning models, i.e., EfficientNet, GoogLeNet, and XceptionNet, to design the proposed model. These models can categorize patients as COVID-19 (+), pneumonia (+), tuberculosis (+), or healthy. The proposed model enhances the classifier's generalization ability for both binary and multiclass COVID-19 datasets. Two popular datasets are used to evaluate the performance of the proposed ensemble model. The comparative analysis validates that the proposed model outperforms the state-of-art models in terms of various performance metrics.

Time and dose-dependent effect of preconditioning with sodium nitroprusside (SNP) and 3-morpholinosydnonimine (SIN-1) on post-thaw semen quality of Karan-Fries (KF) bulls.

A novel strategy, focused on the induction of sub-lethal oxidative stress to optimize sperm cryosurvival, has been used before cryopreservation. The present study compared the effect of preconditioning with various concentrations of nitric oxide-donor (sodium nitroprusside, SNP) and peroxynitrite-generator (3-morpholinosydnonimine, SIN-1) on in vitro sperm functions and lipid peroxidation status (LPO) of cryopreserved Karan-Fries (KF) crossbred bull semen. To optimize the concentration of additives, spermatozoa obtained from 36 ejaculates were supplemented with different concentrations of SNP (0.01, 0.05, 0.1 µM) and SIN-1 (80, 160, 200 µM) versus control in the extender. The post-freezing sperm motility and viability were greater (p < 0.05) in 0.1 µM SNP and 80 µM SIN-1 in comparison to other concentrations used. Furthermore, the spermatozoa obtained from 48 ejaculates were supplemented with 0.1 µM SNP and 80 µM SIN-1 in the extender. A significant increase (p < 0.05) was observed in progressive motility, viability and membrane integrity in SNP and SIN-1 treated extender at 24 h, 15 days, and 2-month post-cryopreservation (PC) periods. There was no significant difference in sperm abnormality in the extended groups and the control group. The seminal plasma of SNP-treated extender had less (p < 0.05) lipid peroxidation as compared to SIN-1 treated and control groups. In post-thaw semen, both SNP and SIN-1 showed a higher (p < 0.05) proportion of acrosome intact (FITC-PNA) sperm with a greater decrease (p < 0.05) in membrane scrambling and lipid peroxidation. SNP and SIN-1 improved (p < 0.05) the proportion of sperm with higher mitochondrial membrane potential (Δψm) as compared to the control. In conclusion, it seems that the preconditioning of SNP and SIN-1 at lower doses may have beneficial effects on post-thawed crossbred bull sperm quality.

Generalized rough and fuzzy rough automata for semantic computing.

The classical automata, fuzzy finite automata, and rough finite state automata are some formal models of computing used to perform the task of computation and are considered to be the input device. These computational models are valid only for fixed input alphabets for which they are defined and, therefore, are less user-friendly and have limited applications. The semantic computing techniques provide a way to redefine them to improve their scope and applicability. In this paper, the concept of semantically equivalent concepts and semantically related concepts in information about real-world applications datasets are used to introduce and study two new formal models of computations with semantic computing (SC), namely, a rough finite-state automaton for SC and a fuzzy finite rough automaton for SC as extensions of rough finite-state automaton and fuzzy finite-state automaton, respectively, in two different ways. The traditional rough finite-state automata can not deal with situations when external alphabet or semantically equivalent concepts are given as inputs. The proposed rough finite-state automaton for SC can handle such situations and accept such inputs and is shown to have successful real-world applications. Similarly, a fuzzy finite rough automaton corresponding to a fuzzy automaton is also failed to process input alphabet different from their input alphabet, the proposed fuzzy finite rough automaton for SC corresponding to a given fuzzy finite automaton is capable of processing semantically related input, and external input alphabet information from the dataset obtained by real-world applications and provide better user experience and applicability as compared to classical fuzzy finite rough automaton.

Adaptation of the gut pathobiont Enterococcus faecalis to deoxycholate and taurocholate bile acids.

Enterococcus faecalis is a natural inhabitant of the human gastrointestinal tract. This bacterial species is subdominant in a healthy physiological state of the gut microbiota (eubiosis) in adults, but can become dominant and cause infections when the intestinal homeostasis is disrupted (dysbiosis). The relatively high concentrations of bile acids deoxycholate (DCA) and taurocholate (TCA) hallmark eubiosis and dysbiosis, respectively. This study aimed to better understand how E. faecalis adapts to DCA and TCA. We showed that DCA impairs E. faecalis growth and possibly imposes a continuous adjustment in the expression of many essential genes, including a majority of ribosomal proteins. This may account for slow growth and low levels of E. faecalis in the gut. In contrast, TCA had no detectable growth effect. The evolving transcriptome upon TCA adaptation showed the early activation of an oligopeptide permease system (opp2) followed by the adjustment of amino acid and nucleotide metabolisms. We provide evidence that TCA favors the exploitation of oligopeptide resources to fuel amino acid needs in limiting oligopeptide conditions. Altogether, our data suggest that the combined effects of decreased DCA and increased TCA concentrations can contribute to the rise of E. faecalis population during dysbiosis.

Lightning Characteristics Over Humid Regions and Arid Regions and Their Association With Aerosols Over Northern India.

The association between aerosol and lightning has been investigated with long-term decadal data (2005-2014) for lightning, aerosol optical depth (AOD), relative humidity, and effective cloud droplet size. To understand the complex relationship between aerosol and lightning, two different regions with different climatic and weather conditions, a humid region R1 (22°-29° N, 89°-92° E) and an arid region R2 (23°-28° N, 70°-76° E) of northern India, were chosen for the study domain. The results show that lightning activity was observed to occur more over the humid region R1, i.e., 1141 days (1/3 of total days), than over the arid region R2, i.e., 740 days (1/5 of total days). Also, over the humid region R1, the highest lightning flash density was recorded as nearly 4.6 × 10-4 flashes/km2/day observed for 18 days (1.5%); on the contrary, over the arid region R2, the maximum lightning flash density was observed to be 2.5 × 10-4 flashes/km2/day and occurred for about 22 days (2.9%). The analysis shows that a nonlinear relationship exists between aerosol and lightning with a highly associated influence of relative humidity. A very significant positive and negative co-relation that varies with relative humidity has been observed between AOD and lightning for both humid and arid regions. This shows relative humidity is the key factor in determining the increase or decrease of lightning activity. This study also shows that the larger the cloud droplet size, the higher the relative humidity and vice versa. This study emphasizes that aerosol concentration in the atmosphere influences cloud microphysics by modulating the size of cloud droplets and thereby regulating the lightning frequency. The atmospheric humidity is the driving factor in deciding the positive or negative co-relationship between aerosol and lightning. Supplementary Information: The online version contains supplementary material available at 10.1007/s00024-022-02981-6.

Plantaricin LD1 purified from Lactobacillus plantarum LD1 inhibits biofilm formation of Enterococcus faecalis ATCC 29212 in tooth model.

Plantaricin LD1 was purified to homogeneity using activity-guided chromatography. Enterococcus faecalis ATCC 29212 was found to be sensitive to plantaricin LD1 showing 13 ± 0·21 mm zone of growth inhibition. The minimum inhibitory concentration (MIC) was found to be 50 µg ml-1 against Ent. faecalis ATCC 29212. The in vitro biofilm formation by Ent. faecalis ATCC 29212 was observed, which was completely inhibited in the presence of bacteriocin. Similarly, biofilm formation was also observed on the teeth surface showing purple colour, whereas treated-teeth were clean and indicated no biofilm formation. Further, untreated cells of Ent. faecalis ATCC 29212 were found normal and plantaricin LD1-treated cells were ruptured when seen under light microscope, suggesting killing of target cells. These findings have proven the initial leads for antimicrobial and anti-biofilm activity of plantaricin LD1 against Ent. faecalis and its possible application for the treatment of endodontic diseases.

Comparative evidence support better antioxidant efficacy of mitochondrial-targeted (Mitoquinone) than cytosolic (Resveratrol) antioxidant in improving in-vitro sperm functions of cryopreserved buffalo (Bubalus bubalis) semen.

The present study compared the effect of mitochondria-targeted (Mitoquinone, MitoQ) and untargeted cytosolic antioxidant (Resveratrol, RESV) supplementation on lipid peroxidation (LPO) and in-vitro sperm functions of cryopreserved buffalo bull semen. To optimize additive's concentration, sperm pellet obtained from twenty-four ejaculates was supplemented with different concentrations of MitoQ (20 nM, 100 nM, 200 nM); and RESV (10 µM, 25 µM, 50 µM) against control in the extender. The post-thaw sperm motility, livability, and membrane integrity were higher (P < 0.05) in 200 nM MitoQ and 50 µM RESV than other concentrations used. In another experiment, sperm pellet from thirty-two ejaculates was supplemented with 200 nM MitoQ and 50 µM RESV in the extender. Pre-freeze and post-thaw progressive motility and livability were higher (P < 0.05) in MitoQ (200 nM) than RESV (50 µM) treatment. MitoQ supplementation improved post-thaw membrane integrity (CFDA-PI) higher (P < 0.05) than RESV, however, hypo-osmotic swelling response observed no improvement with RESV treatment. Post-thaw LPO rate was lower (P < 0.05) and Bovine cervical mucus penetration was higher (P < 0.05) in MitoQ than RESV treatment. In post-thaw semen, MitoQ showed higher (P < 0.05) proportion of acrosome intact (FITC-PNA), live non-apoptotic (P < 0.01) sperm with a higher reduction (P < 0.05) in membrane scrambling. MitoQ improved (P < 0.01) proportion of sperm with high Mitochondrial Membrane Potential and low LPO (P < 0.01) than RESV treatment. In conclusion, improvement in post-thaw in-vitro sperm functions and cryo-tolerance was more evident in MitoQ than RESV supplemented buffalo bull semen. Our study provides a better strategy to mitigate oxidative stress by enhancing mitochondrial antioxidant system with targeted antioxidants than cytosolic antioxidant supplementation.

Anti-tuberculosis activity and its structure-activity relationship (SAR) studies of oxadiazole derivatives: A key review.

With the increasing number of cases of inactive and drug-resistance tuberculosis, there is an urgent need to develop new potent molecules set for fighting this brutal disease. Medicinal chemistry concerns the discovery, the development, the identification, and the interpretation of the mode of action of biologically active compounds at the molecular level. Molecules bearing oxadiazoles are one such class that could be considered to satisfy this need. Oxadiazole regioisomers have been investigated in drug discovery programs for their capacity to go about as powerful linkers and as pharmacophoric highlights. Oxadiazoles can go about as bioisosteric substitutions for the hydrazide moiety which can be found in first-line anti-TB drugs, and some have been likewise answered to cooperate with more current anti-TB targets. This present review summarizes the current innovations of oxadiazole-based derivatives with potential antituberculosis activity and bacteria discussing various aspects of structure-activity relationship (SAR).

Identification and characterization of a halocin-producing haloarchaeon isolated from Pachpadra salt lake.

Haloarchaea are known to produce antimicrobial proteins, halocins which are generally stable at extreme conditions suggesting their potential biotechnological applications. Here, we report a halocin-producing haloarchaeon isolated from salt lake and identified as Haloferax larsenii HA4 using partial 16S rDNA sequence and biochemical properties. Whole-cell methanolysate showed ether-linked lipids, which is a characteristic feature of haloarchaea. Strain HA4 was able to grow at pH 6·0-10·0 and 15-30% NaCl. The growth response was normal but antimicrobial activity was detected only during the log-phase. Crude halocin HA4 was active in the pH range of pH 2·0-10·0 with stability up to 100°C. Cell-free supernatant (CFS) was also stable in different organic solvents and detergents tested. However, halocin activity was reduced after treatment with proteinase K suggesting the proteinaceous nature of the active compound. Concentrated CFS showed the presence of several proteins from 6·5-66 kDa but bioassay suggested ~14 kDa protein as halocin. Crude halocin preparation showed cytocidal activity against indicator strain, H. larsenii HA10 and inhibited the growth of other related strains such as H. larsenii HA3, HA8, HA9 and HA10.

A molecular dynamics investigation for predicting the effect of various parameters on the mechanical properties of carbon nanotube-reinforced aluminum nanocomposites.

Carbon nanotube (CNT)-reinforced aluminum (Al) composites are being developed to replace the conventional materials due to the enhanced stiffness for more cost-effective engineering applications. In the present study, a qualitative analysis has been conducted on carbon nanotube aluminum (CNT-Al) composites to predict the effect of CNT volume fraction, diameter, and structure (zigzag, armchair) on elastic modulus, shear modulus, bulk modulus, and ultimate tensile strength (UTS) through molecular dynamics simulation. This study shows that the elastic modulus was improved by 105% compared with pure Al, for the CNT-Al composite reinforced with the (4, 4) armchair SWCNT at a volume fraction of 8.79%. The highest value of Young's modulus of 130.37 GPa occurred at the volume fraction of 11.75% for zigzag SWCNT. The CNT-Al composites showed better UTS for the Al matrix reinforced with larger diameter CNT. An enhancement of 31.65% was observed in the UTS of CNT-Al composite from 4.74 to 6.24 GPa with (6, 6) CNT at 0.51% volume fraction. Elastic and bulk moduli were found to improve with a higher volume fraction of CNTs. The CNT-Al composite reinforced with smaller diameter CNT's have better elastic modulus than those reinforced with larger diameter CNT for the same volume fraction. Graphical abstract Variation of Young's modulus with SWCNT volume fraction for a constant cell size of CNT-Al composite.

Correlation of cochlear nerve cross-sectional area and auditory performance after cochlear implantation in prelingual children with bilateral profound hearing loss.

OBJECTIVE: To assess whether cochlear nerve (CN) cross-sectional area as measured with parasagittal magnetic resonance imaging (MRI) in prelingual pediatric deaf patients correlates with auditory performance after cochlear implantation. STUDY DESIGN: Prospective Cohort study. METHODS: Thirty-two prelingual children with bilateral profound sensorineural hearing loss (SNHL) who received unilateral cochlear implant were included in this study. Diameters of CN at Internal auditory canal (IAC) fundus and mid-point of IAC were retrospectively measured on parasagittal images of FIESTA (Fast Imaging Employing Steady-state Acquisition) sequence MRI by two independent observers. Cross-sectional areas [π (Height/2) (Width/2)] were then correlated with post-operative CAPS (Categories of Auditory Performance) and IT-MAIS (Infant-Toddler Meaningful Auditory Integration Scale) scores regularly assessed at 3 monthly intervals post device activation. RESULTS: The cochlear nerve was identified in all the 32 patients. Mean cross-sectional areas (CSA) of cochlear nerve were 0.71 ± 0.16 mm2 at IAC fundus and 0.73 ± 0.18 mm2 at mid-point of IAC. The correlation value between CSA at mid-point of IAC and CAPS score at 6 months was 0.271 (p-value- 0.140) and correlation value between CSA at mid-point of IAC and IT-MAIS score at 6 months was 0.282 (p-value- 0.124) which were statistically not significant. CONCLUSION: There was no significant correlation between the cross-sectional areas of the cochlear nerve on MRI and postoperative auditory scores as measured by CAPS and IT-MAIS scores at six months from the device activation. Hence, we conclude that above an adequate diameter, which can affect the minimum required neurons, the changes in the diameter do not have significant bearing on auditory outcomes after cochlear implantation.

Tunable Magnetoelastic Effects in Voltage-Controlled Exchange-Coupled Composite Multiferroic Microstructures.

The magnetoelectric properties of exchange-coupled Ni/CoFeB-based composite multiferroic microstructures are investigated. The strength and sign of the magnetoelastic effect are found to be strongly correlated with the ratio between the thicknesses of two magnetostrictive materials. In cases where the thickness ratio deviates significantly from one, the magnetoelastic behavior of the multiferroic microstructures is dominated by the thicker layer, which contributes more strongly to the observed magnetoelastic effect. More symmetric structures with a thickness ratio equal to one show an emergent interfacial behavior which cannot be accounted for simply by summing up the magnetoelastic effects occurring in the two constituent layers. This aspect is clearly visible in the case of ultrathin bilayers, where the exchange coupling drastically affects the magnetic behavior of the Ni layer, making the Ni/CoFeB bilayer a promising next-generation synthetic magnetic system entirely. This study demonstrates the richness and high tunability of composite multiferroic systems based on coupled magnetic bilayers compared to their single magnetic layer counterparts. Furthermore, because of the compatibility of CoFeB with present magnetic tunnel junction-based spintronic technologies, the reported findings are expected to be of great interest for the development of ultralow-power magnetoelectric memory devices.

Development of Comprehensive Satisfaction Index (ComSI) and Its Association with WHOQOL-BREF.

BACKGROUND: Comprehensive satisfaction in life may be considered as a significant contributor to health for everyone, including the aging population (individuals aged 45 years and above). For understanding the comprehensive satisfaction, an assessment measure with various psychometric properties may be useful. During a longitudinal study of aging and geriatric mental health, a 26-item tool was developed in Hindi for the assessment of satisfaction. This article aimed to analyze the items of Comprehensive Satisfaction Index (ComSI) applying Varimax rotation and to find out its association with World Health Organization Quality of Life Brief (WHOQOL-BREF). METHODS: Data of 260 subjects were extracted from the longitudinal study to analyze the psychometric properties of the tool named as Comprehensive Satisfaction Index and its association with various domains of WHOQOL-BREF. Varimax rotation was applied after computing Kaiser-Meyer-Olkin and Bartlett's test of sphericity. Furthermore, the association between various components of ComSI and various domains of WHOQOL-BREF was explored. RESULTS: Of the total 26 items of the tool, item no. 17 was excluded due to its -ve/ <0.31 value. A total of three components were generated with >1 eigenvalues; maximum items were loaded in component 1 (19) followed by components 2 (4) and 3 (2). Each of these factors has been significantly correlated with each other. Furthermore, these components also were compared with various domains of WHOQOL-BREF, and positive correlation was obtained for most of them. CONCLUSION: There is a positive association between ComSI and WHOQOL-BREF. This tool will help in identifying the satisfaction level of the aging subjects promptly and efficiently, which would further help in making strategies for interventions.

Spatial and Temporal Variation of Atmospheric Particulate Matter in Bangalore: A Technology-Intensive Region in India.

All of India's megacities are experiencing acute air pollution problems due to the accelerated urbanization/industrialization and rapid economic growth. Nowadays, environmental pollution due to particulate matter is a major threat to human health and our regional air quality. Long-term air pollution data with the high spatial and temporal resolution are required to understand regional air quality and its effects on environmental degradation and human health. In view of the above, the particulate matter (PM2.5: particles with diameters less than 2.5 µm and PM10: particles with diameters less than 10 µm) were measured from January 2017 to March 2018 at five locations (PM2.5 at 3 sites and PM10: at 2 sites) across the Bangalore city, India. The measured concentrations indicated that PM2.5 and PM10 concentrations in Bangalore exceeded the World Health Organization's air quality standards although the PM2.5 values did meet the Indian National Ambient Air Quality Standards (NAAQS). The PM10 NAAQS was exceeded at one site. Temporal patterns showed a strong evening peak at all sites and morning rush hour peaks of varying strength. Season peaks were observed in the winter or premonsoon seasons again with variations among the five sites. Lower pairwise correlation coefficients among the sites suggest that the PM sources were largely localized. The role of meteorological parameters (MP) was studied, and it was observed that MP play a vital role in the accumulation of PM2.5. During calm wind condition (WS < 0.5 m/s), the concentrations of PM2.5 has increased by 17%, indicating localized sources; however, in the case of PM10, it was opposite. Annually, the highest concentrations of PM2.5 (> 30 µg/ m3) and PM10 (> 75 µg/m3) over receptor side were observed during lower wind speeds (< 2 knots), which indicate that the transportation does not play any crucial role in higher concentrations of PM over Bangalore.

Prospective evaluation of psychological burden in patients with oral cancer.

The high morbidity and mortality that is associated with oral cancer places a huge psychological burden on patients. The purpose of this prospective study was to evaluate levels of depression, anxiety, and stress, at three time points using DASS-21 (Depression, Anxiety and Stress Scale-21). We also compared DASS-21 with HADS (Hospital Anxiety and Depression Scale). A total of 111 patients were enrolled and 75 of them completed the questionnaires at diagnosis, one month after treatment, and three months after discharge. Scores were high for stress at diagnosis, and for depression at the other time points, but were low for anxiety at all three. The results of Friedman's ANOVA showed that mean ranks for depression and stress were significant (p<0.05). Scores for depression and stress rose significantly between diagnosis and three months after operation, but those for anxiety (which had increased between diagnosis and operation p>0.05), were stable three months postoperatively. The DASS-21 was a useful method of evaluating stress. Correlation of the results from the two questionnaires showed a strongly positive association. We therefore recommend psychological intervention to improve overall outcome.