Neck circumference in polycystic ovary syndrome: a systematic review and bootstrapped meta-analysis with GRADE approach.

INTRODUCTION: Our aim was to perform a systematic review and meta-analysis for the association of neck circumference (NC) in polycystic ovary syndrome (PCOS) patients as compared to non-PCOS controls. METHODS: Primarily the PubMed/MEDLINE database, and others such as SCOPUS, Google Scholar, Cochrane Library, up to November 15, 2023 for observational studies comparing NC in PCOS versus non-PCOS women. The mean and SD values of NC and other covariates in PCOS and control groups were extracted by two independent reviewers, and the quality and risk of bias assessment was done using Newcastle-Ottawa Scale of the studies. The meta-analysis employed combined standardized mean differences (SMD) with 95% confidence intervals (CI) to compare NC between PCOS patients and controls. The heterogeneity and validity were addressed by sub-group, meta-regression, and sensitivity analyses. We conducted a Bootstrapped meta-analysis using 1000 and 10000 simulations to test the accuracy of the obtained results. The certainty of evidence was assessed by GRADE approach. RESULTS: Our meta-analysis included 9 observational studies. The PCOS patients showed a significantly higher NC values than the non-PCOS controls (SMD 0.66, 95% CI 0.41-0.91, p<0.0001). In the bootstrap meta-analysis, the accuracy of the observed findings was proved (SMD=0.66, CI=0.42 to 0.91) for the NC outcome. No publication bias was detected in the funnel plot analysis using Begg's and Egger's tests. The 95% prediction interval of 0.036 to 1.28, suggest that the true outcomes of the studies are generally in the same direction as the estimated average outcome. The sensitivity analysis provided the robustness of the outcome, and no single study was overly influential on the pooled estimate. CONCLUSION: This meta-analysis provides accurate evidence for significantly higher NC in PCOS as compared to non-PCOS controls. There is no sufficient evidence on the diagnostic accuracy measures for NC in PCOS. Hence, further research on its diagnostic utility in PCOS is needed.

Relationship of emotional intelligence and capability of answering higher-order knowledge questions in physiology among first-year medical students.

Emotional intelligence (EI) has a positive correlation with the academic performance of medical students. However, why there is a positive correlation needs further exploration. We hypothesized that the capability of answering higher-order knowledge questions (HOQs) is higher in students with higher EI. Hence, we assessed the correlation between EI and the capability of medical students to answer HOQs in physiology. First-year undergraduate medical students (n = 124) from an Indian medical college were recruited as a convenient sample. EI was assessed by the Schutte Self-Report Emotional Intelligence Test (SSEIT), a 33-item self-administered validated questionnaire. A specially designed objective examination with 15 lower-order and 15 higher-order multiple-choice questions was conducted. The correlation between the examination score and the EI score was tested by Pearson's correlation coefficient. Data from 92 students (33 females and 59 males) with a mean age of 20.14 ± 1.87 yr were analyzed. Overall, students got a percentage of 53.37 ± 14.07 in the examination, with 24.46 ± 9.1 in HOQs and 28.91 ± 6.58 in lower-order knowledge questions (LOQs). They had a mean score of 109.58 ± 46.2 in SSEIT. The correlation coefficient of SSEIT score with total marks was r = 0.29 (P = 0.0037), with HOQs was r = 0.41 (P < 0.0001), and with LOQs was r = 0.14 (P = 0.19). Hence, there is a positive correlation between EI and the capability of medical students to answer HOQs in physiology. This study may be the foundation for further exploration of the capability of answering HOQs in other subjects.NEW & NOTEWORTHY This study assessed the correlation between emotional intelligence (EI) and the capability of medical students to answer higher-order knowledge questions (HOQs) in the specific context of physiology. The finding reveals one of the multifaceted dimensions of the relationship between EI and academic performance. This novel perspective opens the door to further investigations to explore the relationship in other subjects and other dimensions to understand why students with higher EI have higher academic performance.

Multifaceted role of chemokines in solid tumors: From biology to therapy.

Chemokines are small secretory chemotactic cytokines that control the directed migration of immune cells. Chemokines are involved in both anti-and pro-tumorigenic immune responses. Accumulating evidence suggests that the balance between these responses is influenced by several factors such as the stage of tumorigenesis, immune cell activation, recruitment of immune activating or immunosuppressive cells in the tumor microenvironment (TME), and chemokine receptor expression on effector and regulatory target cells. Cancer cells engage in a complex network with their TME components via several factors including growth factors, cytokines and chemokines that are critical for the growth of primary tumor and metastasis. However, chemokines show a multifaceted role in tumor progression including maintenance of stem-like properties, tumor cell proliferation/survival/senescence, angiogenesis, and metastasis. The heterogeneity of solid tumors in primary and metastatic cancers presents a challenge to the development of successful cancer therapy. Despite extensive research on how solid tumors escape immune cell-mediated anti-tumor response, finding an effective therapy for metastatic cancer still remains a challenge. This review discusses the multifarious roles of chemokines in solid tumors including various chemokine signaling pathways such as CXCL8-CXCR1/2, CXCL9, 10, 11-CXCR3, CXCR4-CXCL12, CCL(X)-CCR(X) in primary and metastatic cancers. We further discuss the novel therapeutic approaches that have been developed by major breakthroughs in chemokine research to treat cancer patients by the strategic blockade/activation of these signaling axes alone or in combination with immunotherapies.

Exploring the Oxidative Effects of the Microbial Electro-Fenton Process on the Depolymerization of Lignin Extracted from Rice Straw in a Bio-Electrochemical System Coupled with Wastewater Treatment.

Lignin is a potential renewable feedstock to produce value-added compounds, but the overwhelming bulk of it is either burned for energy or discarded as waste. This paper addressed two critical issues: waste-to-value generation and management by demonstrating the in situ depolymerization of lignin extracted from waste rice straw utilizing the microbial electro-Fenton process in a microbial peroxide-producing cell (MPPC), a type of bio-electrochemical cell, for value addition while synchronously treating wastewater. The MPPC electrochemical voltage yields of 0.171 ± 0.05-0.497 ± 0.2 V produced 9 ± 0.43-34 ± 0.11 mM of H2O2, which was utilized to depolymerize lignin at various concentrations. Interestingly, a direct correlation was observed between lignin depolymerization and H2O2 concentration, while Fourier-transform infrared spectroscopy data revealed a constant disruption of the lignin structure accurately in the wavenumber region of 1000-1750 cm-1 irrespective of the H2O2 concentration. Carboxylic acid derivatives, benzopyran, hexanoic acid, and other valuable compounds were detected in the LC QTOF MS data from the depolymerized lignin mixture. Remarkably, SEM analysis demonstrated morphological changes in depolymerized lignin induced by the oxidative effects of hydroxyl radicals. Biochemical oxygen demand and chemical oxygen demand removal was 60 ± 3-85 ± 1% in anodic wastewater treatment. This research provides a sustainable and efficient technique for lignin valorization and wastewater treatment.

COVID-19-associated 2020 lockdown: a study on atmospheric black carbon fall impact on human health.

The mean mass concentrations of black carbon (BC), biomass burning (BC)bb, and fossil fuel combustion (BC)ff have been estimated during March-May 2020 (during the COVID-19 outbreak) and March-May 2019 at a semiarid region of Agra over the Indo-Gangetic basin region. The daily mean mass concentration of BC in 2020 and 2019 was 3.9 and 6.9 µg m-3, respectively. The high monthly mean mass concentration of BC was found to be 4.7, 3.4 and 3.3 µg m-3 in Mar-2020, Apr-2020, and May-2020, respectively, whereas in Mar-2019, Apr-2019, and May-2019 was 7.7, 7.5 and 5.4 µg m-3, respectively. The absorption coefficient (babs) and absorption angstrom exponent (AAE) of black carbon were calculated. The highest mean AAE was 1.6 in the year 2020 (Mar-May 2020) indicating the dominance of biomass burning. The mean mass concentration of fossil fuel (BC)ff and biomass burning (BC)bb is 3.4 and 0.51 µg m-3, respectively, in 2020 whereas 6.4 and 0.73 µg m-3, respectively, in 2019. The mean fraction contribution of BC with fossil fuel (BC)ff was 82.1 ± 13.5% and biomass burning (BC)bb was 17.9 ± 4.3% in 2020, while in 2019, fossil fuel (BC)ff was 86.7 ± 13.5% and biomass burning (BC)bb was 13.3 ± 6.7%. The population-weighted mean concentration of BC, fossil fuel (BC)ff, and biomass burning (BC)bb has been calculated. The health risk assessment of BC has been analyzed in the form of attributable relative risk factors and attributed relative risk during the COVID-19 outbreak using AirQ + v.2.0 model. The attributable relative risk factors of BC were 20.6% in 2020 and 29.4% in 2019. The mean attributed relative risk per 10,000,000 populations at 95% confidence interval (CI) due to BC was 184.06 (142.6-225.2) in 2020 and 609.06 (418.3-714.6) in 2019. The low attributed factor and attributed relative risk in 2020 may be attributed to improvements in air quality and a fall in the emission of BC. In 2020, due to the COVID-19 pandemic, the whole country faced the biggest lockdown, ban of the transportation of private vehicles, trains, aircraft, and construction activities, and shut down of the industry leading to a fall in the impact of BC on human health. Overall, this was like a blessing in disguise. This study will help in future planning of mitigation and emission control of air pollutants in large and BC in particular. It only needs a multipronged approach. This study may be like torch bearing to set path for mitigation of impacts of air pollution and improvement of air quality.

Effect of Psychosocial Interventions on Cancer's Caregiver Quality of Life: Meta-analysis.

Background: People living with cancer benefit greatly from informal caregivers. No previous meta-analysis was done to check the effect of psychological intervention on cancer caregiver's quality of life. Objectives: The goal of this meta-analysis was to check the effect of psychosocial interventions on Cancer's Caregiver quality of life and check the impact of various psychological intervention programs. Methods: A comprehensive literature search was conducted from January 2006 to April 2021 using PubMed, PubMed Central, Clinical Key, CINAHL Database, EBSCO, Google Scholar and Cochrane database. Results: The effect of psychological intervention programs on caregiver's quality of life was evaluated using a mean difference between experimental and control groups. A random-effects model was used to measure the mean difference (MD) for calculating the cancer caregiver's quality of life. The final report comprised eight trials with a total of 1142 participants. The caregiver intervention programme was found to improve cancer caregivers' quality of life, but not statistically significantly (mean difference=0.10; p<0.00001). Conclusion: According to this meta-analysis, The psychological intervention program positively affected cancer caregiver's quality of life. Further randomised controlled trials are required to prove that psychological interventional programs are successful strategies for improving cancer caregiver's quality of life.

Levothyroxine in Women with Thyroid Peroxidase Antibodies before Conception.

BACKGROUND: Thyroid peroxidase antibodies are associated with an increased risk of miscarriage and preterm birth, even when thyroid function is normal. Small trials indicate that the use of levothyroxine could reduce the incidence of such adverse outcomes. METHODS: We conducted a double-blind, placebo-controlled trial to investigate whether levothyroxine treatment would increase live-birth rates among euthyroid women who had thyroid peroxidase antibodies and a history of miscarriage or infertility. A total of 19,585 women from 49 hospitals in the United Kingdom underwent testing for thyroid peroxidase antibodies and thyroid function. We randomly assigned 952 women to receive either 50 µg once daily of levothyroxine (476 women) or placebo (476 women) before conception through the end of pregnancy. The primary outcome was live birth after at least 34 weeks of gestation. RESULTS: The follow-up rate for the primary outcome was 98.7% (940 of 952 women). A total of 266 of 470 women in the levothyroxine group (56.6%) and 274 of 470 women in the placebo group (58.3%) became pregnant. The live-birth rate was 37.4% (176 of 470 women) in the levothyroxine group and 37.9% (178 of 470 women) in the placebo group (relative risk, 0.97; 95% confidence interval [CI], 0.83 to 1.14, P = 0.74; absolute difference, -0.4 percentage points; 95% CI, -6.6 to 5.8). There were no significant between-group differences in other pregnancy outcomes, including pregnancy loss or preterm birth, or in neonatal outcomes. Serious adverse events occurred in 5.9% of women in the levothyroxine group and 3.8% in the placebo group (P = 0.14). CONCLUSIONS: The use of levothyroxine in euthyroid women with thyroid peroxidase antibodies did not result in a higher rate of live births than placebo. (Funded by the United Kingdom National Institute for Health Research; TABLET Current Controlled Trials number, ISRCTN15948785.).

Mifepristone and misoprostol versus misoprostol alone for the management of missed miscarriage (MifeMiso): a randomised, double-blind, placebo-controlled trial.

BACKGROUND: The anti-progesterone drug mifepristone and the prostaglandin misoprostol can be used to treat missed miscarriage. However, it is unclear whether a combination of mifepristone and misoprostol is more effective than administering misoprostol alone. We investigated whether treatment with mifepristone plus misoprostol would result in a higher rate of completion of missed miscarriage compared with misoprostol alone. METHODS: MifeMiso was a multicentre, double-blind, placebo-controlled, randomised trial in 28 UK hospitals. Women were eligible for enrolment if they were aged 16 years and older, diagnosed with a missed miscarriage by pelvic ultrasound scan in the first 14 weeks of pregnancy, chose to have medical management of miscarriage, and were willing and able to give informed consent. Participants were randomly assigned (1:1) to a single dose of oral mifepristone 200 mg or an oral placebo tablet, both followed by a single dose of vaginal, oral, or sublingual misoprostol 800 µg 2 days later. Randomisation was managed via a secure web-based randomisation program, with minimisation to balance study group assignments according to maternal age (<30 years vs ≥30 years), body-mass index (<35 kg/m2vs ≥35 kg/m2), previous parity (nulliparous women vs parous women), gestational age (<70 days vs ≥70 days), amount of bleeding (Pictorial Blood Assessment Chart score; ≤2 vs ≥3), and randomising centre. Participants, clinicians, pharmacists, trial nurses, and midwives were masked to study group assignment throughout the trial. The primary outcome was failure to spontaneously pass the gestational sac within 7 days after random assignment. Primary analyses were done according to intention-to-treat principles. The trial is registered with the ISRCTN registry, ISRCTN17405024. FINDINGS: Between Oct 3, 2017, and July 22, 2019, 2595 women were identified as being eligible for the MifeMiso trial. 711 women were randomly assigned to receive either mifepristone and misoprostol (357 women) or placebo and misoprostol (354 women). 696 (98%) of 711 women had available data for the primary outcome. 59 (17%) of 348 women in the mifepristone plus misoprostol group did not pass the gestational sac spontaneously within 7 days versus 82 (24%) of 348 women in the placebo plus misoprostol group (risk ratio [RR] 0·73, 95% CI 0·54-0·99; p=0·043). 62 (17%) of 355 women in the mifepristone plus misoprostol group required surgical intervention to complete the miscarriage versus 87 (25%) of 353 women in the placebo plus misoprostol group (0·71, 0·53-0·95; p=0·021). We found no difference in incidence of adverse events between the study groups. INTERPRETATION: Treatment with mifepristone plus misoprostol was more effective than misoprostol alone in the management of missed miscarriage. Women with missed miscarriage should be offered mifepristone pretreatment before misoprostol to increase the chance of successful miscarriage management, while reducing the need for miscarriage surgery. FUNDING: UK National Institute for Health Research Health Technology Assessment Programme.

Prevalence and hazardous impact of pharmaceutical and personal care products and antibiotics in environment: A review on emerging contaminants.

Antibiotic resistance is a global health emergency linked to unrestrained use of pharmaceutical and personal care products (PPCPs) as prophylactic agent and therapeutic purposes across various industries. Occurrence of pharmaceuticals are identified in ground water, surface water, soils, and wastewater treatment plants (WWTPs) in ng/L to µg/L concentration range. The prevalence of organic compounds including antimicrobial agents, hormones, antibiotics, preservatives, disinfectants, synthetic musks etc. in environment have posed serious health concerns. The aim of this review is to elucidate the major sources accountable for emergence of antibiotic resistance. For this purpose, variety of introductory sources and fate of PPCPs in aquatic environment including human and veterinary wastes, aquaculture and agriculture related wastes, and other anthropogenic activities have been discussed. Furthermore, genetic and enzymatic factors responsible for transfer and appearance of antibiotic resistance genes are presented. Ecotoxicity of PPCPs has been studied in environment in order to present risk imposed to human and ecological health. As per published literature reports, the removal of antibiotics and related traces being difficult, couples the possibility of emergence of antibiotic resistance and hence sustainability in global water resources. Therefore, research on environmental behavior and control strategies should be conducted along with assessing their chronic toxicity to identify potential human and ecological risks.

A Deuteromycete Isolate Geotrichum candidum as Oleaginous Cell Factory for Medium-Chain Fatty Acid-Rich Oils.

Single cell oils (SCO) are oils derived from microorganisms which have potential to hyperaccumulate intracellular lipids (called oleaginous) under some essential nutrient (nitrogen, phosphorous or sometimes sulphur) starvation and an excess of carbon. The present work investigates the influence of these key parameters (for triggering oleaginicity), i.e. carbon (C) and nitrogen (N) on oleaginous behaviour of an oleaginous isolate, with the objective of improving the lipid content and obtaining oils of applicative interest. Eleven yeasts were isolated from rotten fruits and a unique yeast from rotten apple was screened on the basis of its ~ 20% (of dry mass) lipid content (LC), trademark of oleaginicity under nitrogen-stressed culture conditions. Subsequent investigation on influence of C, N and w/w ratio of carbon source concentration (Cs) to nitrogen source concentration (Ns) was conducted on this isolate. The isolate was identified as a Deuteromycete-Geotrichum candidum. 4.8 g/l was found to be minimum N concentration and glucose as suitable C source for optimum balance between biomass and lipid content. The highest LC of 73.6% (172.5% higher compared to 27% LC at Cs/Ns 80/4.8) was obtained at Cs/Ns 150/4.8 with a lipid coefficient of 8.7 (g lipid/100 g substrate). While remarkably higher production economy (lipid coefficient of 28.45) was noted at Cs/Ns 100/4.8 with significant LC of 54.4% (~ 100% higher than at Cs/Ns 80/4.8). The derived oils were predominantly rich in medium-chain fatty acids (MCFA)-caprylic acid, rare in plant oils. G. candidum is a previously referred oleaginous species; however, for the first time this study illustrates its detailed oleaginous behaviour and lipid compositional characteristics with varying nutritional parameters. The work is a progressive contribution towards current and upcoming researches in field of SCOs. Compositional characteristics of derived oils, make it an important candidate for potential medical and nutritional applications in future.

Artificial neural network and response surface methodology: a comparative analysis for optimizing rice straw pretreatment and saccharification.

The present study demonstrates a comparative analysis between the artificial neural network (ANN) and response surface methodology (RSM) as optimization tools for pretreatment and enzymatic hydrolysis of lignocellulosic rice straw. The efficacy for both the processes, that is, pretreatment and enzymatic hydrolysis was evaluated using correlation coefficient (R2) & mean squared error (MSE). The values of R2 obtained by ANN after training, validation, and testing were 1, 0.9005, and 0.997 for pretreatment and 0.962, 0.923, and 0.9941 for enzymatic saccharification, respectively. On the other hand, the R2 values obtained with RSM were 0.9965 for cellulose recovery and 0.9994 for saccharification efficiency. Thus, ANN and RSM together successfully identify the substantial process conditions for rice straw pretreatment and enzymatic saccharification. The percentage of error for ANN and RSM were 0.009 and 0.01 for cellulose recovery and for 0.004 and 0.005 for saccharification efficiency, respectively, which showed the authority of ANN in exemplifying the non-linear behavior of the system.

Exposure to respirable and fine dust particle over North-Central India: chemical characterization, source interpretation, and health risk analysis.

This study enhances the understanding of the particulate matters (PM2.5 and PM10) and their physical and chemical behavior over the Taj Mahal, Agra, in North-Central India. The mass concentration was determined, and the shape and size of the particles and chemical characterizations have been carried out using SEM-EDX. The high level and significant variation of PM10 (162.2 µg m-3) and PM2.5 (83.9 µg m-3) were observed. The exceedance factor of the present study region is in critical and moderate condition. Morphological characterization reveals the particles of different shapes and sizes, while elemental analysis shows the presence of Si, Al, Fe, Ca, K, Cl, Mg, Na, Cu, and Zn. The dominance of Si indicated the contribution of natural sources, i.e., soil over this region. Three significant sources, viz. soil/road paved dust/vegetative emissions, vehicular/industrial emissions, and intermingling of dust and combustion particles, have been identified using principal component analysis over North-Central India. Health risk analysis of particulate matter identified carcinogenic and non-carcinogenic metals in the present study, which comes in contact with human beings during inhalation. The non-carcinogenic risk was much higher than the acceptable level. The high carcinogenic risks were found in Zn in PM10 and Cu in PM2.5 for both children and adults.

3-Methyl-3-buten-1-ol (isoprenol) confers longevity and stress tolerance in Caenorhabditis elegans.

The present investigation demonstrates the longevity-promoting effects of 3-methyl-3-buten-1-ol (isoprenol) in the animal model Caenorhabditis elegans that might be served as a lead nutraceutical in geriatric research. Our results showed that 0.5 mM isoprenol extended the mean lifespan of worms by 25% in comparison to control worms. Isoprenol also significantly enhanced survival of the worms under various stress conditions. It was found that the longevity-promoting effects of isoprenol were associated with improved age-associated physiological behaviour and reduced intracellular reactive oxygen species (ROS) accumulation. Finally, studies with gene-specific mutants revealed the involvement of pro-longevity transcription factors (TFs) DAF-16 and SKN-1 with simultaneous over-expression of GST-4 and SOD-3 in isoprenol treated worms. In silico analysis revealed the binding affinity of isoprenol with DAF-16 and SKN-1 TFs. Together, the findings suggest that isoprenol is able to enhance the lifespan of C. elegans and embarks its potential in the developments of formulations for age-related ailments.

A Randomized Trial of Progesterone in Women with Recurrent Miscarriages.

BACKGROUND: Progesterone is essential for the maintenance of pregnancy. However, whether progesterone supplementation in the first trimester of pregnancy would increase the rate of live births among women with a history of unexplained recurrent miscarriages is uncertain. METHODS: We conducted a multicenter, double-blind, placebo-controlled, randomized trial to investigate whether treatment with progesterone would increase the rates of live births and newborn survival among women with unexplained recurrent miscarriage. We randomly assigned women with recurrent miscarriages to receive twice-daily vaginal suppositories containing either 400 mg of micronized progesterone or matched placebo from a time soon after a positive urinary pregnancy test (and no later than 6 weeks of gestation) through 12 weeks of gestation. The primary outcome was live birth after 24 weeks of gestation. RESULTS: A total of 1568 women were assessed for eligibility, and 836 of these women who conceived naturally within 1 year and remained willing to participate in the trial were randomly assigned to receive either progesterone (404 women) or placebo (432 women). The follow-up rate for the primary outcome was 98.8% (826 of 836 women). In an intention-to-treat analysis, the rate of live births was 65.8% (262 of 398 women) in the progesterone group and 63.3% (271 of 428 women) in the placebo group (relative rate, 1.04; 95% confidence interval [CI], 0.94 to 1.15; rate difference, 2.5 percentage points; 95% CI, -4.0 to 9.0). There were no significant between-group differences in the rate of adverse events. CONCLUSIONS: Progesterone therapy in the first trimester of pregnancy did not result in a significantly higher rate of live births among women with a history of unexplained recurrent miscarriages. (Funded by the United Kingdom National Institute of Health Research; PROMISE Current Controlled Trials number, ISRCTN92644181.).

Evaluation of Candida Scoring Systems to Predict Early Candidemia: A Prospective and Observational Study at a Tertiary Care Hospital, Uttarakhand.

BACKGROUND: Candidemia in critically ill patients is usually a severe and life-threatening condition. Furthermore, due to its nonspecific presentation, it is difficult to diagnose leading to delayed treatment, prolonged hospitalization, and increased health-care costs with increase in morbidity and mortality. OBJECTIVES: In view of lack of data on "Candida scoring systems," this study was designed to evaluate the effectiveness of these scoring systems in predicting the development of candidemia among the Intensive Care Unit patients. MATERIALS AND METHODS: The "Candida score" was calculated at the onset of systemic inflammatory response syndrome, sepsis, or shock. Various scoring systems were compared using the area under the receiver operating characteristic curve. RESULTS: Among all three bedside risk scoring systems to predict candidemia both Leon score and Wenzel score offered significant discrimination between candidemic and noncandidemic patients with P = 0.000 and 0.001, respectively. The area under the curve for the scoring systems was 0.946 (95% confidence interval [CI] = 0.89-1) and 0.818 (95% CI = 0.687-0.949). CONCLUSION: Leon scoring system was found to have highest specificity, diagnostic accuracy, and positive likelihood ratio among all. Thus, we might conclude that a Leon score of ≥2.5 was most suitable for diagnosis of candidemia with significant accuracy and shortening of turnaround time when compared to the gold standard of blood culture. To the best of our knowledge, this is the first report on the subject.

Isoprenoid-Based Biofuels: Homologous Expression and Heterologous Expression in Prokaryotes.

Enthusiasm for mining advanced biofuels from microbial hosts has increased remarkably in recent years. Isoprenoids are one of the highly diverse groups of secondary metabolites and are foreseen as an alternative to petroleum-based fuels. Most of the prokaryotes synthesize their isoprenoid backbone via the deoxyxylulose-5-phosphate pathway from glyceraldehyde-3-phosphate and pyruvate, whereas eukaryotes synthesize isoprenoids via the mevalonate pathway from acetyl coenzyme A (acetyl-CoA). Microorganisms do not accumulate isoprenoids in large quantities naturally, which restricts their application for fuel purposes. Various metabolic engineering efforts have been utilized to overcome the limitations associated with their natural and nonnatural production. The introduction of heterologous pathways/genes and overexpression of endogenous/homologous genes have shown a remarkable increase in isoprenoid yield and substrate utilization in microbial hosts. Such modifications in the hosts' genomes have enabled researchers to develop commercially competent microbial strains for isoprenoid-based biofuel production utilizing a vast array of substrates. The present minireview briefly discusses the recent advancement in metabolic engineering efforts in prokaryotic hosts for the production of isoprenoid-based biofuels, with an emphasis on endogenous, homologous, and heterologous expression strategies.

Programmatic experience of post-partum IUD use in Zambia: an observational study on continuation and satisfaction.

OBJECTIVES: The aim of the study was to assess continuation rates and satisfaction among post-partum intrauterine device (PPIUD) accepters. METHODS: This prospective observational study comprised 591 Zambian women who underwent PPIUD insertion at sites of the Society for Family Health, Lusaka, Zambia. The women were contacted 6-12 months after PPIUD insertion and asked to return to the clinic for interview and examination. If the IUD strings were not visible, an ultrasound was performed. Participants were asked about their satisfaction with the PPIUD. Main outcome measures were short-term PPIUD continuation and reported complications according to time of insertion. RESULTS: Of 591 women enrolled, 305 women attended the follow-up appointment for interview and examination, giving a power of 80% to estimate an expulsion rate of 10 ± 5%. The IUD was inserted within 10 min of placental delivery (post-placental insertion) in 24.3% of participants (n = 74) and within 48 h (immediate post-partum insertion) in 71.1% of participants (n = 217). The total expulsion rate was 5.6%. Expulsion rates for post-placental and immediate post-partum insertions were 10.8% and 4.1%, respectively. No significant difference in expulsion rates was found (p = 0.10). Of those with an expulsion, 76.5% (n = 13) recognised that it had occurred. There were no reported complications, and 94.1% of women reported being satisfied or very satisfied with their PPIUD (n = 287). CONCLUSIONS: Overall, expulsion rates were lower than previously reported, particularly for immediate post-partum insertions. Attention to high fundal placement at insertion is a likely explanation for the low expulsion rates. Contrary to conventional wisdom, these low expulsion rates indicate that previous notions regarding insertion timing may not be accurate. Satisfaction levels were also favourable. PPIUD can be safe, acceptable and feasible in an African setting.

Design of a single chambered microbial electrolytic cell reactor for production of biohydrogen from rice straw hydrolysate.

Rice straw was pretreated using a microwave-assisted alkali pretreatment method. Cellulose recovery was approximately 82 %. This material was hydrolysed in an optimized enzymatic saccharification reaction using cellulase from Lysinibacillus sphaericus. This resulted in saccharification of 49 % of cellulosic biomass into glucose. A single chambered microbial electrolytic cell reactor of volume 2l was built using acrylic plastic sheets with graphite sheet as anode and a stainless-steel mesh as cathode. Shewanella putrefaciens was used as exoelectrogen to oxidize rice straw hydrolysate in the reactor for electrohydrogenesis. The maximum H2 yield obtained was 801 ml H2 g(-1) COD removal. Coulombic efficiency of 88 %, cathodic H2 recovery of 58 % and total H2 recovery of 51 % with an energy efficiency of 74 % were recorded.

Catalytic valorization of Kraft lignin into feedstock chemicals with methyltrioxorhenium (MTO) catalyst in microbial electrochemical cell.

In this study, the authors investigate a novel approach to valorize Kraft lignin using the catalyst Methyltrioxorhenium (MTO) in tandem with in-situ produced H2O2 in a Microbial Electrochemical Cell (MEC). This study demonstrates the in-situ oxidation of Kraft lignin using different concentrations of MTO catalyst (2 mM to 8 mM) and H2O2 (5.24 ± 0.40 mM to 8.91 ± 0.70 mM) in three MECs. The depolymerized Kraft lignin samples were characterized using FTIR, CHNS/O, and 1H NMR analysis. The MTO/H2O2 combination showed high selectivity towards the oxidation of Kraft lignin, resulting in both aromatic ring and side chain cleavage reactions and the production of valuable feedstock chemicals. The oxidation also led to a reduction of 68.42 % to 78.18 % in Chemical Oxygen Demand (COD) of lignin. The selective oxidation favored the recovery of Guaiacyl (G) unit-derived feedstock chemicals, with Guaiacol being the most abundant compound (45.04 mg/mL) among the quantified products by HPLC. Additionally, the system demonstrated high efficiency in anodic wastewater treatment, achieving BOD and COD removal rates ranging from 67.68 % to 72.55 %. This method showcases the use of a sustainable system in combination with a selective catalyst to produce valuable products from usually discarded Kraft lignin while simultaneously treating wastewater.