Ultrasound-facilitated, catheter-directed thrombolysis vs anticoagulation alone for acute intermediate-high-risk pulmonary embolism: Rationale and design of the HI-PEITHO study.

BACKGROUND: Due to the bleeding risk of full-dose systemic thrombolysis and the lack of major trials focusing on the clinical benefits of catheter-directed treatment, heparin antiocoagulation remains the standard of care for patients with intermediate-high-risk pulmonary embolism (PE). METHODS AND RESULTS: The Higher-Risk Pulmonary Embolism Thrombolysis (HI-PEITHO) study (ClinicalTrials.gov Identifier: NCT04790370) is a multinational multicenter randomized controlled parallel-group comparison trial. Patients with: (1) confirmed acute PE; (2) evidence of right ventricular (RV) dysfunction on imaging; (3) a positive cardiac troponin test; and (4) clinical criteria indicating an elevated risk of early death or imminent hemodynamic collapse, will be randomized 1:1 to treatment with a standardized protocol of ultrasound-facilitated catheter-directed thrombolysis plus anticoagulation, vs anticoagulation alone. The primary outcome is a composite of PE-related mortality, cardiorespiratory decompensation or collapse, or non-fatal symptomatic and objectively confirmed PE recurrence, within 7 days of randomization. Further assessments cover, apart from bleeding complications, a broad spectrum of functional and patient-reported outcomes including quality of life indicators, functional status and the utilization of health care resources over a 12-month follow-up period. The trial plans to include 406 patients, but the adaptive design permits a sample size increase depending on the results of the predefined interim analysis. As of May 11, 2022, 27 subjects have been enrolled. The trial is funded by Boston Scientific Corporation and through collaborative research agreements with University of Mainz and The PERT Consortium. CONCLUSIONS: Regardless of the outcome, HI-PEITHO will establish the first-line treatment in intermediate-high risk PE patients with imminent hemodynamic collapse. The trial is expected to inform international guidelines and set the standard for evaluation of catheter-directed reperfusion options in the future.

Comparison of serology and molecular detection of common red cell antigens in multitransfused thalassemia major and sickle cell disease patients.

BACKGROUND: Serological testing for extended RHCcEe, Kell, Kidd and Duffy blood grouping from multitransfused patients may not give correct blood grouping of the recipient. Hence molecular testing for these blood groups was compared with serological groups in a cohort of multitransfused thalassemia mjor and sickle cell anaemia patients. OBJECTIVE: Molecular genotyping of antigens of Rh (D, C, c, E, e), Kell (K, k), Duffy (Fya, Fyb) and Kidd (Jka, Jkb) blood group antigens by PCR and PCR-RFLP methods and comparison of predicted genotypes with their serological phenotypes. MATERIALS AND METHODS: A cohort of multitransfused thalassemia and sickle cell anemia patient were serologically and molecularly tested for RHCc, RHEe, K, k Fya, Fyb, Jka and Jkb antigens and compared. Serological testing was done by tube agglutination and molecular testing was done either by allele specific PCR or by RFLP technique just before next transfusion. RESULTS: In more than 80% of the cases recipient's molecular testing blood groups were at variance with serologically tested blood groups (p < 0.0001). Mixed field reactions in serological typing were common. In sickle cell anemia patients no discrepancy was found. Molecular technique results were checked by Sanger's sequencing. DISCUSSION: Extended phenotyping in multitransfused thalassemia patients by serological technique often donot detect the exact red cell phenotype of the recipient and molecular techniques for such grouping is preferable, especially in multitransfused thalassemia patients where red cells from previous transfusions continues to be present in significant numbers whenever the testing is done.

Current approaches toward the removal of methylene blue dye from synthetic textile effluent using bacterial treated agricultural waste absorbent through statistical design.

Massive amounts of wastewater are produced by the textile industry, and this waste needs to be appropriately managed. Agricultural waste wheat straw (WS), a biosorbent that is both economically available and environmentally acceptable, was used in this work to treat textile effluent. Microbial treated modification approaches were utilized for WS to study the dye removal from textile wastewater. Total 15 different isolates were screened for the dye degradation ability from Surat textile industrial effluent. The most significant deterioration was seen in PPSUHB3 when compared to other isolates. The amount of methylene blue dye removal was examined using the isolate PPSUHB3 due to its high efficiency. Based on 16s rDNA sequencing, it was predicted that the isolate PPSUHB3 was Bacillus licheniformis, having great capacity to degrade dye & wheat straw by producing efficient enzyme. The isolate showed the highest decolorization % of MB dye during optimization with WS absorbent which was verified using FTIR and SEM. The dye removal process parameters were statistically optimized using a central composite design (CCD). Wheat straw with particle sizes of 180-250 mm was discovered to be a possible adsorbent for the removal of colour. The maximum removal of MB (55.89%) was obtained using a statistical experimental design at pH 6.36, Temperature 44.6 °C, and Bacteria Concentration 3.04%. The created model is highly significant, according to the ANOVA, which found an R2 value of 0.9812 for it. The validation experiment revealed that the experimental and projected results were strikingly similar. The study found that using bacterial treated wheat straw as an adsorbent may remove wastewater that contains colours at a low cost.

A detailed methodology for the long-term in vitro culture and analysis of three-dimensional, self-structuring bone models generated from cell lines or primary osteoblastic cell populations.

Background: There are insufficient in vitro bone models that accommodate long-term culture of osteoblasts and support their differentiation to osteocytes. The increased demand for effective therapies for bone diseases, and the ethical requirement to replace animals in research, warrants the development of such models.Here we present an in-depth protocol to prepare, create and maintain three-dimensional, in vitro, self-structuring bone models that support osteocytogenesis and long-term osteoblast survival (>1 year). Methods: Osteoblastic cells are seeded on a fibrin hydrogel, cast between two beta-tricalcium phosphate anchors. Analytical methods optimised for these self-structuring bone model (SSBM) constructs, including RT-qPCR, immunofluorescence staining and XRF, are described in detail. Results: Over time, the cells restructure and replace the initial matrix with a collagen-rich, mineralising one; and demonstrate differentiation towards osteocytes within 12 weeks of culture. Conclusions: Whilst optimised using a secondary human cell line (hFOB 1.19), this protocol readily accommodates osteoblasts from other species (rat and mouse) and origins (primary and secondary). This simple, straightforward method creates reproducible in vitro bone models that are responsive to exogenous stimuli, offering a versatile platform for conducting preclinical translatable research studies.

Retting of banana pseudostem fibre using Bacillus strains to get excellent mechanical properties as biomaterial in textile & fiber industry.

Banana pseduostem (BP) fibre, sometimes known as banana fibre, is a new natural fibre with potential commercial applications in the textile and fibre industries. Softening these fibres might enhance their mechanical qualities, allowing them to be used in more textile applications. The current research looks at the softening of banana fibres (Musa paradisiaca L) utilising a variety of chemical (NaOH & HCl) and bacterial treatments. Physical (Hygroscopicity, Density, Linear density), chemical (cellulose, Hemi-cellulose and Lignin) and mechanical parameters (Peak load, Breaking Elongation, Tenacity) of the treated fibres were measured as per normal technique with raw banana fibres. The tenacity (g/tex) of microbial treated (Bacillus licheniformis) (7 days) fibre was found to be greater, at 6.33, but the average peak elongation (%) of (Bacillus Subtilis) was found to be higher, at 8.2. The lignin % of untreated Banana fibres (15.98%) was reduced in fibres treated with 5N of NaOH (10.75%), 5N HCl (8.73%), Bacillus aryabhattai (11.4%), Bacillus licheniformis (12.54%) and Bacillus Subtilis (13.56%). In contrast to raw banana fibre, the mechanical qualities of treated fibres showed incremental results. Finally, the study found that treating banana fibre with NaOH, HCl and Bacillus sp. had a substantial impact on the physiochemical parameters. SEM and FTIR methods were used to validate the efficiency of the bacterial treatment.

Evaluating the Effectiveness of Yttrium-90 Glass Microspheres in the Treatment of Hepatocellular Carcinoma, Intrahepatic Cholangiocarcinoma, and Metastatic Colorectal Cancer in Practice: Protocol for the Prospective PROACTIF Phase IV Registry Study in France.

PRIMARY OBJECTIVE: Recently, selective internal radiation therapy using yttrium-90 (Y90) glass microspheres (TheraSphere™) was approved for reimbursement by health authorities in France. The PROACTIF study aims to gather data on effectiveness, patient quality of life, and safety with use of Y90 glass microspheres in real-world clinical settings in France. INCLUSION CRITERIA: Patient with a diagnosis of hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (iCC), and/or metastatic colorectal cancer (mCRC) who was treated with a dose of Y90 glass microspheres that has been reimbursed in France and who do not oppose use of their personal medical data. EXCLUSION CRITERIA: If data collection is opposed, treatment is reimbursed but not administered, or treatment is administered but not reimbursed. OUTCOME MEASURES: Primary outcome measures include overall survival from time of Y90 glass microsphere treatment and quality of life, as assessed using the Functional Assessment of Cancer Therapy- Hepatobiliary questionnaire. ESTIMATED NUMBER OF PATIENTS TO BE INCLUDED: This is an open study and there is no set number of patients; 115 have already been enrolled. PLANNED SUBGROUP ANALYSES: Analyses will be stratified by disease state (HCC, iCC, or mCRC). Subgroups to be analyzed include age group, unilobar/bilobar disease at baseline, Eastern Cooperative Oncology Group (ECOG) status at baseline, liver tumor burden at baseline, target lesion size, and standard versus multi-compartment personalized dosimetry treatment. PLANNED RECRUITMENT AND OBSERVATION PERIOD: Recruitment includes patients who are prescribed and treated with a commercial vial of Y90 glass microspheres between 01 January 2019 and 31 December 2024. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04069468.

Breast Cancer in the Elderly: An Observational Study Investigating Compliance of Screening Mammography in an Underserved Community.

BACKGROUND: The incidence of breast cancer increases with age. Individuals living in higher socioeconomic communities also have higher incidence secondary to early detection of breast cancer from increased accessibility to mammograms. This retrospective study studied the percentage of new breast cancer cases in the elderly between 2010 and 2019, and investigated the compliance of screening mammography in some of the medically underserved suburbs of southern Chicago. METHODS: The parameters used to power this study include "age greater than 70" and "2010 to present" at the time the study was first initiated. The final data set contained 381 electronic health records (EMRs) that met the parameters of interest. We specifically looked at method of diagnosis, stage at diagnosis, date of last normal screening mammogram, hormone status, histology, race, and smoking history. RESULTS: Thirty percent of the breast cancer patients diagnosed at our institution were over 70 years of age between 2010 and 2019. Of the 381 patients included in the overall sample, 45% were diagnosed with breast cancer by screening mammogram, and 52% of individuals in the 70 - 75 age group were diagnosed with breast cancer by screening mammography. Only 40% of individuals in the 75+ age group were diagnosed with breast cancer by screening mammogram (P = 0.0234). Furthermore, in the overall sample, 63% had a normal screening mammogram at some time prior to their breast cancer diagnosis. In the 70 - 75 age group, 76% had a normal screening mammogram at some time prior to their breast cancer diagnosis. In the 75+ age group, only 54% had a normal screening mammogram at some time prior to their breast cancer diagnosis (P < 0.0001). Individuals in both age groups were more likely to have early-stage breast cancers and luminal A hormone expression. CONCLUSIONS: Decreased compliance to screening mammography is observed in the elderly living in underserved communities. Since the elderly are underrepresented in research, organizations do not have sufficient information to recommend screening mammography in the elderly. With increasing life expectancy, observational studies have demonstrated a mortality benefit with screening mammography by early detection of breast cancer, favorable breast cancer characteristics and potentially higher cure rates. Socioeconomic factors also affect screening compliance and likely influenced the results of our study. Future studies should investigate how individual factors influence screening mammography compliance in the elderly in underserved communities.

Idiopathic Intracranial Hypertension in Pregnancy.

Treatment for a patient who presented with severe headaches and decreased vision caused by idiopathic intracranial hypertension was complicated by nonadherence and pregnancy, but the patient's symptoms resolved after a successful delivery.