Nematicidal Properties of Chitosan Nanoformulation.

Chitosan is the second most abundant bio-polymer available in the world, second only to cellulose. It is found in crustaceous shells, e.g., those of crabs, shrimps, prawns, and fungi, as well as insect exoskeletons. The use of nanoformulations for the management of pests and diseases is receiving increased interest with the advancement of nanotechnology. Here, chitosan nanospheres were obtained from chitosan using the ionic gelation technique. The nanoformulations obtained were characterized using a particle size analyzer, Fourier transform infrared spectroscopy, and a transmission electron microscope. The efficacy of chitosan nanospheres in suppressing the root-knot nematode Meloidogyne incognita was studied. The particle size of nanospheres formulated for this study was 380.2 nm, with a polydispersity index (PI) of 0.4 and Zeta potential of 45.7 or 50.9 mV at pH 5.2. The chitosan nanospheres were spherical and the particles did not agglomerate. FTIR spectra of the chitosan nanospheres peaked at 3334 cm-1, thereby indicating the stretching of the OH and NH group. In In-vitro studies, chitosan nanospheres showed significant nematicidal activity against M. incognita. Under pot culture conditions, chitosan nanospheres (1%- active compound chitosan) at 2ml/plant decreased the nematode population in roots or soil. Compared to the control, the number of galls was reduced by 83.68%, the number of egg masses by 83.85%, the number of adult females by 66.56%, and the number of second-stage juveniles by 73.20%. In a field experiment, application of chitosan nanospheres (1%) was followed by a 18.75% increase in fruit yield compared to the non-treated control.

A Multilevel Transfer Learning Technique and LSTM Framework for Generating Medical Captions for Limited CT and DBT Images.

Medical image captioning has been recently attracting the attention of the medical community. Also, generating captions for images involving multiple organs is an even more challenging task. Therefore, any attempt toward such medical image captioning becomes the need of the hour. In recent years, the rapid developments in deep learning approaches have made them an effective option for the analysis of medical images and automatic report generation. But analyzing medical images that are scarce and limited is hard, and it is difficult even with machine learning approaches. The concept of transfer learning can be employed in such applications that suffer from insufficient training data. This paper presents an approach to develop a medical image captioning model based on a deep recurrent architecture that combines Multi Level Transfer Learning (MLTL) framework with a Long Short-Term-Memory (LSTM) model. A basic MLTL framework with three models is designed to detect and classify very limited datasets, using the knowledge acquired from easily available datasets. The first model for the source domain uses the abundantly available non-medical images and learns the generalized features. The acquired knowledge is then transferred to the second model for the intermediate and auxiliary domain, which is related to the target domain. This information is then used for the final target domain, which consists of medical datasets that are very limited in nature. Therefore, the knowledge learned from a non-medical source domain is transferred to improve the learning in the target domain that deals with medical images. Then, a novel LSTM model, which is used for sequence generation and machine translation, is proposed to generate captions for the given medical image from the MLTL framework. To improve the captioning of the target sentence further, an enhanced multi-input Convolutional Neural Network (CNN) model along with feature extraction techniques is proposed. This enhanced multi-input CNN model extracts the most important features of an image that help in generating a more precise and detailed caption of the medical image. Experimental results show that the proposed model performs well with an accuracy of 96.90%, with BLEU score of 76.9%, even with very limited datasets, when compared to the work reported in literature.

Metabolic syndrome, but not non-alcoholic fatty liver disease, increases 10-year mortality: A prospective, community-cohort study.

BACKGROUND: Data on outcomes of non-alcoholic fatty liver disease (NAFLD) from South Asia are lacking. We compared mortality, among those with- and without-NAFLD, after 10-years follow-up among urban, adult Sri Lankans. METHOD: Participants (aged 35-64 years), selected by age-stratified random sampling, were screened by structured-interview in 2007. Anthropometric measurements, liver ultrasonography and biochemical/serological tests were done. NAFLD was diagnosed on ultrasound criteria, safe-alcohol consumption (Asian-standards) and absence of hepatitis B/C. Subjects without NAFLD were those without any ultrasound criteria of fatty liver, safe-alcohol consumption and absence of hepatitis B/C. The cohort was re-evaluated to assess mortality in 2017. Participants or their households were contacted by telephone/post, and deaths confirmed by home-visits and death certificate review. Cox-regression was used to determine predictors of all-cause mortality (ACM) and cardiovascular mortality (CVM) in those with- and without-NAFLD. RESULTS: 2724 (91.2%) of 2985 original participants were contacted (851-with NAFLD and 1072-without NAFLD). Overall there were 169 (6.2%) deaths [41-deaths among NAFLD (17-cardiovascular; 9-cancer-related; 4-liver-specific; 11-other) and 79-deaths among no-NAFLD (28-cardiovascular; 17-cancer-related; 1-liver-specific; 33-other)]. Metabolic syndrome (MetS), low-education level, higher age and male-gender independently predicted ACM. MetS, increasing age and male-gender independently predicted CVM. NAFLD did not predict either ACM or CVM. In those with NAFLD, MetS and age >55-years were independently associated with ACM, while MetS and male-gender were associated with CVM. CONCLUSION: In this community-based study, increasing age, male-gender and MetS, but not NAFLD, predicted 10-year ACM and CVM. Among those with NAFLD, only those metabolically abnormal were at a higher risk for mortality.

Development and evaluation of loop-mediated isothermal amplification assay for rapid and sensitive detection of potato cyst nematode, Globodera pallida from soil.

Potato cyst nematodes, Globodera pallida and G. rostochiensis, are economically important and difficult to manage pests of the potato crop. The cyst of both the species looks similar and it is difficult to differentiate once it turns brown upon maturity. Early detection of the PCN at the species level is crucial to avoid its further spread and for adopting the appropriate management strategies. Therefore, in the present study, highly specific and sensitive loop-mediated isothermal amplification (LAMP) assay was developed to amplify mitochondrial-Sequence Characterized Amplified Region (SCAR) sequence of potato cyst nematode, G. pallida. The LAMP assay was completed within a shorter incubation period of 60 min at 60 °C followed by the reaction termination at 80 °C for 5 min. The developed LAMP assay exhibited high specificity for G. pallida and did not detect any other species including its sibling species, G. rostochiensis. In sensitivity tests, the assay detected G. pallida at 1000 times less DNA concentration (10 fg/µl) as compared to conventional PCR (10 pg/µl). In addition to this, the developed LAMP assay was tested for the detection of G. pallida directly from the soil samples, and even a single cyst mixed with soil was successfully detected by the developed assay. Moreover, the utility of low-cost instruments like hot water bath was also demonstrated for the detection of G. pallida from the soil. The developed LAMP is a rapid, highly specific, sensitive, and cost-effective technique for the species-specific detection of G. pallida. The developed assay will facilitate the rapid detection of G. pallida at quarantine stations as well as from the fields which will help to stop its further spread in new areas and also to devise effective management strategies for sustainable potato production. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-023-03542-x.

General practitioner referral patterns for women with gynaecological symptoms: a randomised incomplete block study design.

OBJECTIVE: To describe why, when and to whom general practitioners refer women with symptoms possibly attributable to cervical, endometrial or ovarian cancers, and to identify patient and GP factors that predict referral to either a gynaecologist or a gynaecological oncologist. DESIGN AND SETTING: A national survey of GPs between 1 April and 31 August 2009 using a randomised incomplete block design based on case vignettes, and using a self-completed postal or online questionnaire. PARTICIPANTS: A sample of GPs, stratified by location and randomly selected from a database of GPs maintained by the Australasian Medical Publishing Company. MAIN OUTCOME MEASURES: Proportion of vignettes that were deemed to reflect a high probability of cancer being referred; and the patient and clinician factors that were the strongest predictors of referral. RESULTS: Of the 3082 GPs who were selected for participation, 1402 responded, giving a response rate of 45.5%. Overall, for vignettes identified as describing women with a high probability of cancer, 75% were referred by metropolitan GPs and 73% by rural practitioners. Metropolitan GPs were significantly more likely to refer women in scenarios indicative of endometrial cancer than rural GPs. For all three cancers, GPs were significantly more likely to refer a patient to a gynaecologist (between 70.8% and 95.4%) than a gynaecological oncologist. Metropolitan GPs had significantly greater access to both private and public gynaecological oncologists than their rural counterparts. Referral rates were higher for ovarian and cervical cancer (83% and 80%, respectively) and lower for endometrial cancer (68%). For all three cancers, patient factors were stronger predictors of referral than the demographic factors of participating GPs. CONCLUSION: There appears to be significant variation in referral practices among GPs and this variation is greater for endometrial cancer, for which there are currently no evidence-based clinical practice guidelines in Australia. There is a need for further research into understanding the basis of these differences, including a review of the existing guidelines for ovarian and cervical cancer and the development of guidelines for endometrial cancer.

A mixed-methods study to explore opinions of research translation held by researchers working in a Centre of Research Excellence in Australia.

OBJECTIVE: There is a growing need for researchers to demonstrate impact, which is reliant on successful research translation. The Australian National Health and Medical Research Council funded a Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery (CRE-Stroke) to enhance collaborations between researchers conducting different types of stroke rehabilitation research. The purpose of this study was to explore opinions about research translation held by CRE-Stroke researchers conducting preclinical and clinical research, in terms of scope, importance, responsibility and perceived skills and knowledge. DESIGN: Mixed-methods study, comprising a paper-based survey and semistructured interviews. Interview data were inductively coded and thematically analysed. Survey and interview data were compared and synthesised. PARTICIPANTS: 55 (7 preclinical, 48 clinical) researchers attending a CRE-Stroke research forum completed a paper-based survey. Semistructured interviews with 22 CRE-Stroke (5 preclinical, 17 clinical) researchers were conducted. RESULTS: Research translation was described as translating to other research and translating to clinical practice and policy. Most researchers (n=54, 98%) reported that research translation was important, particularly in terms of generating research impact, but the most common sign of project completion reported by researchers (n=7, 100% preclinical; n=37, 77% clinical) was publication. Most researchers (preclinical n=4, 57%; clinical n=37, 77%) reported having responsibility for translating research, but less than half reported having the necessary skills (n=1, 14% preclinical; n=17, 35% clinical) and knowledge (n=3, 43% preclinical; n=19, 40% clinical). Differing opinions about who should be responsible for translating findings to clinical practice were expressed. CONCLUSIONS: Stroke rehabilitation researchers appear confident to translate their research via the traditional mechanism of publications. To optimise impact, clarity is needed regarding who is best placed to translate research findings to clinical practice and policy. Education and skills development to apply broader translation processes are needed to maximise the use of research at all stages.

CareTrack: Toward Appropriate Care for Low Back Pain.

STUDY DESIGN: Retrospective medical record review to assess compliance with low back pain (LBP) care indicators. OBJECTIVE: To establish baseline estimates of the appropriateness of LBP care in the general Australian population provided by a range of healthcare providers in various real-world settings. SUMMARY OF BACKGROUND DATA: LBP is a costly condition and accounts for the greatest burden of disease worldwide, yet the care provided is often at variance with guidelines. No baseline estimates of performance are currently available in Australia across various aspects of LBP care, practitioners, and settings. METHODS: A population-based sample of patients with 22 common conditions was recruited by telephone; consents were obtained to review their medical records against indicators ("CareTrack"). Care for LBP was reviewed against 10 indicators used in a previous study and ratified by experts as representing appropriate LBP care in Australia during 2009 and 2010. RESULTS: Of the 22 CareTrack conditions, LBP had the highest number of eligible healthcare encounters (6588 of 35,573, 19%), 125 to 884 per indicator among 164 LBP patients. Overall compliance with LBP indicators was 72% (range 42%-98%). Allied health practitioners and hospitals were the most compliant (82%-83% respectively), followed by general practitioners (54%). Some aspects of care were poor, such as documenting a thorough neurological examination, screening for serious diseases such as infection and inappropriate use of drugs such as steroids and treatments such as traction. CONCLUSION: Over a quarter of LBP care was not appropriate despite the availability of guidelines. There is a need for national and, potentially, international agreement on clinical standards, indicators and tools to guide, document and monitor the appropriateness of care for LBP, and for measures to increase their uptake, particularly where deficiencies have been identified. LEVEL OF EVIDENCE: N /A.

Assessing the appropriateness of prevention and management of venous thromboembolism in Australia: a cross-sectional study.

OBJECTIVES: The prevention and management of venous thromboembolism (VTE) is often at variance with guidelines. The CareTrack Australia (CTA) study reported that appropriate care (in line with evidence-based or consensus-based guidelines) is being provided for VTE at just over half of eligible encounters. The aim of this paper is to present and discuss the detailed CTA findings for VTE as a baseline for compliance with guidelines at a population level. SETTING: The setting was 27 hospitals in 2 states of Australia. PARTICIPANTS: A sample of participants designed to be representative of the Australian population was recruited. Participants who had been admitted overnight during 2009 and/or 2010 were eligible. Of the 1154 CTA participants, 481(42%) were admitted overnight to hospital at least once, comprising 751 admissions. There were 279 females (58%), and the mean age was 64 years. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary measure was compliance with indicators of appropriate care for VTE. The indicators were extracted from Australian VTE clinical practice guidelines and ratified by experts. Participants' medical records from 2009 to 2010 were analysed for compliance with 38 VTE indicators. RESULTS: Of the 35,145 CTA encounters, 1078 (3%) were eligible for scoring against VTE indicators. There were 2-84 eligible encounters per indicator at 27 hospitals. Overall compliance with indicators for VTE was 51%, and ranged from 34% to 64% for aggregated sets of indicators. CONCLUSIONS: The prevention and management of VTE was appropriate for only half of the at-risk patients in our sample; this provides a baseline for tracking progress nationally. There is a need for national and, ideally, international agreement on clinical standards, indicators and tools to guide, document and monitor care for VTE, and for measures to increase their uptake, particularly where deficiencies have been identified.

Primary pulmonary lymphoma. Report of a case diagnosed by fine needle aspiration cytology.

A case of primary pulmonary lymphoma, small lymphocytic type, with plasmacytoid differentiation (lymphoplasmacytic lymphoma) and IgM gammopathy, was diagnosed by fine needle aspiration of the lung. It was further substantiated by pleural fluid cytology, biochemical and immunologic parameters, and the clinical picture. This case is documented for its rarity along with a review of literature on the diagnosis of low grade small lymphocytic lymphomas.

Multidrug resistance 1 gene expression in Indian patients with gastric carcinoma.

BACKGROUND: Gastric carcinoma is frequently refractory to chemotherapy. The multidrug resistance 1 gene (MDR1) encodes for a protein (p-glycoprotein) that functions as a drug efflux pump and thus contributes to resistance to chemotherapeutic agents. METHODS: We studied gastric tissues from 28 patients with gastric cancer for MDR1 expression, using immunohistochemistry. RESULTS: Sixteen (57%) of 28 cases showed MDR1 expression. Sections of normal mucosa away from the tumor showed perinuclear staining for MDR1 in surface epithelial cells, whereas tumor cells showed diffuse cytoplasmic positivity. CONCLUSIONS: Over one half of gastric carcinoma specimens at our center show MDR1 gene expression.

Growth and characterization of a single crystal of Urea Adipic acid (UAA)--a third order nonlinear optical material.

An organic single crystal of Urea Adipic acid (UAA) was successfully grown in methanol solvent by slow solvent evaporation technique at room temperature (30 °C). The structure of grown crystal was elucidated from the X-ray diffraction study and it belongs to monoclinic system with centrosymmetric space group P21/c. The optical transmission spectrum of UAA has been recorded and its theoretical calculations were carried out to determine the linear optical constants such as linear absorption coefficient, extinction coefficient, refractive index and reflectance etc. The third-order nonlinearities of UAA crystal have been investigated by Z-scan method. The values of nonlinear refractive index (n2), the absorption coefficient (ß) and third-order nonlinear susceptibility (χ((3))) are found to be the order of 0.96×10(-10) cm(2)/W, 1.248×10(-4) cm/W and 6.44×10(-8) esu respectively. Fourier Transform Infra Red and Raman spectroscopy studies reveal the intermolecular interactions present in the UAA sample. The dielectric and mechanical measurements of the title compound are also reported.

ICMR's ethical guidelines for biomedical research on human participants: need for clarification.

The "Ethical guidelines for biomedical research on human participants" prepared by the Indian Council of Medical Research in 2006 came as a welcome step in the process of regulation of research on human subjects, since clear cut Indian guidelines were absent earlier. The guidelines have been accepted as the standard operating manual by Institutional Ethics Committees (IEC) in India. However, over a period of time, it has become obvious that the guidelines lack clarity in certain areas and require to be revised in the light of experiences of members in the IECs. Some of these problems with the ICMR guidelines have been highlighted in this paper to press for revision of the manual in the light of these experiences.

CareTrack Australia: assessing the appropriateness of adult healthcare: protocol for a retrospective medical record review.

Introduction In recent years in keeping with international best practice, clinical guidelines for common conditions have been developed, endorsed and disseminated by peak national and professional bodies. Yet evidence suggests that there remain considerable gaps between the care that is regarded as appropriate by such guidelines and the care received by patients. With an ageing population and increasing treatment options and expectations, healthcare is likely to become unaffordable unless more appropriate care is provided. This paper describes a study protocol that seeks to determine the percentage of healthcare encounters in which patients receive appropriate care for 22 common clinical conditions and the reasons why variations exist from the perspectives of both patients and providers. Methods/design A random stratified sample of at least 1000 eligible participants will be recruited from a representative cross section of the adult Australian population. Participants' medical records from the years 2009 and 2010 will be audited to assess the appropriateness of the care received for 22 common clinical conditions by determining the percentage of healthcare encounters at which the care provided was concordant with a set of 522 indicators of care, developed for these conditions by a panel of 43 disease experts. The knowledge, attitudes and beliefs of participants and healthcare providers will be examined through interviews and questionnaires to understand the factors influencing variations in care. Ethics and dissemination Primary ethics approvals were sought and obtained from the Hunter New England Local Health Network. The authors will submit the results of the study to a relevant journal as well as undertaking oral presentations to researchers, clinicians and policymakers.

Intramuscular injection practices among infants.

Administration of unnecessary Intramuscular (i.m.) Injections to infants for trivial illness is a common problem. This descriptive study included 120 infants who received at least one i.m. injection for their current illness. Data were collected using semi structured questionnaire to their mothers. 91% of infants received unnecessary i.m. injections for minor problems like upper respiratory tract infection. I.m. injections were administered at the wrong site in 97% of the infants. Information regarding i.m. injections was inadequate in mothers. Intensive health education regarding safe injection practices for the public and health care providers is essential.