Analyzing mastectomy and reconstruction weight in immediate autologous breast reconstruction: A preliminary study.

BACKGROUND: This study aims to explore the ideal breast size by assessing the relationship between mastectomy to free flap weight ratio and complications as well as patient-reported outcomes in autologous breast reconstruction (ABR). METHOD: A retrospective review of patients undergoing bilateral immediate ABR with mastectomy and flap weights available was completed. Patients were divided into three groups based on the ratio of mastectomy to flap weights. The patients were grouped as "maintained" if the flap weight was within 10% of the mastectomy weight. Patients with a weight difference greater than 10% were used to declare "downsized" or "upsized." Outcomes included complications and four domains of the BREAST-Q at 1-year postoperatively. RESULTS: Three hundred and fifty-nine patients were included in the analysis, of which 112 were downsized, 91 maintained, and 156 upsized, respectively. Presence of complications did not significantly differ among the groups. At 1-year postoperatively, Sexual Well-being significantly differed (p = 0.033). Between preoperative and 1 year, patients who upsized experienced an improvement in Satisfaction with Breasts by 16 points (p < 0.001), while patients who downsized experienced a decline in Physical Well-being of the Chest by 7 points (p = 0.016). Multivariable linear regression model showed that Sexual Well-being was 13 points lower in the downsized cohort than in the maintained cohort (ß = -13, 95% confidence interval: -21 to -5.4; p = 0.001). CONCLUSION: Although complication rates do not significantly differ between the three cohorts, patients who downsize may have lower Sexual Well-being postoperatively. Surgeons should consider our preliminary findings to counsel patients preoperatively about the predicted breast size and the impact of downsizing on sexual health.

Clinical, functional, and patient-reported outcomes of radial forearm versus anterolateral thigh free tissue transfer for reconstruction of glossectomy defects.

BACKGROUND: There is a lack of literature of health-related quality of life endpoints for radial forearm (RF) versus anterolateral thigh (ALT) free flap reconstruction for glossectomy defects. Our goal was to perform a comprehensive evaluation of clinical, functional, and quality of life outcomes after glossectomy reconstruction using a RF or ALT flap. METHODS: A retrospective review was performed on patients who underwent glossectomy and immediate reconstruction with RF or ALT flaps between 2016 and 2021. Outcomes of interest included readmission and reoperation rates, functional assessments, tracheostomy and gastrostomy tube status, and FACE-Q Head and Neck Cancer scores. RESULTS: Seventy-eight patients consisting of 54 RF and 24 ALT free flaps were included. ALT patients had a larger median flap size (72 vs. 48 cm2 , p = 0.021) and underwent mandibulotomy (50% vs. 7.4%, p < 0.0001) and base of tongue resection (58.3% vs. 24.1%, p = 0.005) at higher rates. No significant differences were found with respect to other outcomes. CONCLUSION: The RF and ALT flaps are suitable for glossectomy reconstruction, with minimal differences seen in postoperative outcomes. Our study suggests that ALT can be used in patients with base of tongue and larger defect sizes, while providing similar functional and clinical outcomes to RF reconstruction.

High prevalence of antibiotic-resistant and metal-tolerant cultivable bacteria in remote glacier environment.

Studies of antibiotic-resistant bacteria (ARB) have mainly originated from anthropic-influenced environments, with limited information from pristine environments. Remote cold environments are major reservoirs of ARB and have been determined in polar regions; however, their abundance in non-polar cold habitats is underexplored. This study evaluated antibiotics and metals resistance profiles, prevalence of antibiotic resistance genes (ARGs) and metals tolerance genes (MTGs) in 38 ARB isolated from the glacier debris and meltwater from Baishui Glacier No 1, China. Molecular identification displayed Proteobacteria (39.3%) predominant in debris, while meltwater was dominated by Actinobacteria (30%) and Proteobacteria (30%). Bacterial isolates exhibited multiple antibiotic resistance index values > 0.2. Gram-negative bacteria displayed higher resistance to antibiotics and metals than Gram-positive. PCR amplification exhibited distinct ARGs in bacteria dominated by ß-lactam genes blaCTX-M (21.1-71.1%), blaACC (21.1-60.5%), tetracycline-resistant gene tetA (21.1-60.5%), and sulfonamide-resistant gene sulI (18.4-52.6%). Moreover, different MTGs were reported in bacterial isolates, including mercury-resistant merA (21.1-63.2%), copper-resistant copB (18.4-57.9%), chromium-resistant chrA (15.8-44.7%) and arsenic-resistant arsB (10.5-44.7%). This highlights the co-selection and co-occurrence of MTGs and ARGs in remote glacier environments. Different bacteria shared same ARGs, signifying horizontal gene transfer between species. Strong positive correlation among ARGs and MTGs was reported. Metals tolerance range exhibited that Gram-negative and Gram-positive bacteria clustered distinctly. Gram-negative bacteria were significantly tolerant to metals. Amino acid sequences of blaACC,blaCTX-M,blaSHV,blaampC,qnrA, sulI, tetA and blaTEM revealed variations. This study presents promising ARB, harboring ARGs with variations in amino acid sequences, highlighting the need to assess the transcriptome study of glacier bacteria conferring ARGs and MTGs.

Soot biodegradation by psychrotolerant bacterial consortia.

To probe the bioavailability of soot released into the atmosphere is pivotal to understanding their environmental impacts. Soot aerosol absorbs organic matter, creating a hot spot for biogeochemical transformation and the global carbon cycle. Soot primarily contains condensed aromatics chemically recalcitrant; however, oligotrophic microorganisms might use it as a nutritional source. This study investigated the influence of psychrotolerant bacterial consortia on soot. Significant increase in the bacterial biomass, reduction in water-insoluble organic carbon (OC) and elemental carbon (EC) in soot residues and increase in water-soluble OC in the filtrate signifies the use of soot as a carbon and nutritional source. The influence on morphology and composition of soot was reported using Fourier Transform Infrared Spectroscopy (FTIR), Scanning Electron Microscopy, and Energy Dispersive X-Ray analysis (EDX). The FTIR analysis showed significant variations in the pattern of soot spectra, suggesting degradation. Elemental analysis and EDX showed a reduction in carbon percentage. Besides, the reduction of optical density with incubation time signifies the OC and EC consumption. This study shows that soot can be a substrate and pivotal factor in the microbial food web. Nowadays, soot emission to the environment is growing; therefore, soot involvement in microbe-mediated processes should be closely focused.

Phytotoxic effects on chloroplast and UHPLC-HRMS based untargeted metabolomic responses in Allium tuberosum Rottler ex Sprengel (Chinese leek) exposed to antibiotics.

Introduction of antibiotics into agricultural fields poses serious health risks to humans. This study investigated the uptake of antibiotics, their effects on metabolic pathways, and chloroplast structure changes of Allium tuberosum exposed to norfloxacin (NFL), oxytetracycline (OTC), and tetracycline (TC). Among all the antibiotic treatments, the highest accumulation of antibiotics in roots (4.15 mg/kg) and leaves (0.29 mg/kg) was TC, while in bulbs it was NFL (5.94 mg/kg). OTC was with the lowest accumulation in roots: 0.19 mg/kg, bulbs: 0.18 mg/kg, and leaves: 0.11 mg/kg. The number of mitochondira and the number of plastoglobulli increased. The chloroplast structure was disturbed under the stress of NFL, OTC, and TC. Disturbance in the chloroplast ultrastructure leads to altered chlorophyll fluorescence variables. Simultaneously, metabolomic profiling of leaves demonstrated that NFL stress regulated more of metabolic pathways than OTC and TC. Differences in metabolic pathways among the antibiotic treatments showed that each antibiotic has different impact even under the same experimental conditions. TC and NFL have more toxic effects than OTC antibiotic. Metabolic variations induced by antibiotics stress highlighted pools of metabolites that affect the metabolic activities, chlorophyll fluorescence, ultrastructural adjustments, and stimulate defensive impact in A. tubersoum. These findings provide an insight of metabolic destabilization as well as metabolic changes in defensive mechanism and stress response of A. tuberosum to different antibiotics.

Unplanned reoperations after microsurgical breast reconstruction: Findings from the American College of Surgeons National Surgical Quality Improvement Program.

BACKGROUND: While microsurgical breast reconstruction may require multiple planned operations, unplanned reoperations has not been studied. We sought to investigate unplanned reoperations after microsurgical breast reconstruction. METHODS: We queried the American College of Surgeons' National Surgical Quality Improvement Program between 2005 and 2018. Current Procedural Terminology code 19364 was used to identify all patients with microsurgical breast reconstruction. Patient demographics, medical comorbidities, preoperative laboratory results, and operative data were analyzed. The primary outcome measure was 30-day unplanned reoperation. RESULTS: Of 8449 patients meeting inclusion criteria, 1021 required an unplanned reoperation (12.1%). These patients were more likely to be obese, smokers, hypertensive, on steroids preoperatively, needing concomitant mastectomy, and with prolonged operating room time >9 h (p < .05). Multivariable regression model revealed preoperative steroids intake (OR = 1.92, CI 1.09-3.38, p = .03), concomitant mastectomy (OR = 1.45, CI 1.23-1.71, p < .01), and operating room time >9 h (OR = 1.37, CI 1.16-1.62, p < .01) as independent risk factors. Mastectomy was found to be an independent risk factor for early reoperation, that is, ≤2 days (OR = 1.44, CI 1.14-1.82, p < .01), whereas obesity was an independent risk factor for three reoperations (OR = 3.92, CI 1.14-13.46, p = .03). CONCLUSION: Unplanned reoperations within 30-days after microsurgical breast reconstruction are a significant problem. Mastectomy is an independent risk factor for early reoperation whereas obesity is an independent risk factor for multiple reoperations. Identification of such patients preoperatively may help microsurgeons improve patient safety and quality of care.

Phytochemical Profiling, In Vitro Biological Activities, and In Silico Molecular Docking Studies of Dracaena reflexa.

Dracaena reflexa, a traditionally significant medicinal plant, has not been extensively explored before for its phytochemical and biological potential. The present study was conducted to evaluate the bioactive phytochemicals and in vitro biological activities of D. reflexa, and perform in silico molecular docking validation of D. reflexa. The bioactive phytochemicals were assessed by preliminary phytochemical testing, total bioactive contents, and GC-MS analysis. For biological evaluation, the antioxidant (DPPH, ABTS, CUPRAC, and ABTS), antibacterial, thrombolytic, and enzyme inhibition (tyrosinase and cholinesterase enzymes) potential were determined. The highest level of total phenolic contents (92.72 ± 0.79 mg GAE/g extract) was found in the n-butanol fraction while the maximum total flavonoid content (110 ± 0.83 mg QE/g extract) was observed in methanolic extract. The results showed that n-butanol fraction exhibited very significant tyrosinase inhibition activity (73.46 ± 0.80) and acetylcholinesterase inhibition activity (64.06 ± 2.65%) as compared to other fractions and comparable to the standard compounds (kojic acid and galantamine). The methanolic extract was considered to have moderate butyrylcholinesterase inhibition activity (50.97 ± 063) as compared to the standard compound galantamine (53.671 ± 0.97%). The GC-MS analysis of the n-hexane fraction resulted in the tentative identification of 120 bioactive phytochemicals. Furthermore, the major compounds as identified by GC-MS were analyzed using in silico molecular docking studies to determine the binding affinity between the ligands and the enzymes (tyrosinase, acetylcholinesterase, and butyrylcholinesterase enzymes). The results of this study suggest that Dracaena reflexa has unquestionable pharmaceutical importance and it should be further explored for the isolation of secondary metabolites that can be employed for the treatment of different diseases.

Bacterial Diversity and Communities Structural Dynamics in Soil and Meltwater Runoff at the Frontier of Baishui Glacier No.1, China.

Comprehensive knowledge of bacterial ecology mainly in supraglacial habitats is pivotal particularly at the frontier of accelerated glacier retreat. In this study, bacterial diversity and community composition in glacial soil and meltwater runoff at the frontier of Baishui Glacier No.1 were evaluated using high throughput sequencing. Significant variations in the physiochemical parameters formed an ecological gradient between soil and meltwater runoff. Based on the richness and evenness indexes, the bacterial diversity was relatively higher in soil compared with meltwater runoff. Hierarchical clustering and bi-plot ordination revealed that the taxonomic composition of soil samples was highly similar and significantly influenced by the ecological parameters than the meltwater runoff. The overall relative abundance trend of bacterial phyla and genera were greatly varied in soil and water samples. The relative abundance of Proteobacteria was higher in water runoff samples (40.5-87%) compared with soil samples (32-52.7%). Proteobacteria, Firmicutes, and a little part of Cyanobacteria occupied a major portion of water runoff while the soil was dominated by Acidobacteria (6-16.2%), Actinobacteria (5-16%), Bacteroidetes (0.5-8.8%), and Cyanobacteria (0.1-8.3%) besides Proteobacteria and Firmicutes. Higher numbers of biomarkers were found in soil group compared with the water group. The study area is diverse in terms of richness, while community structures are not evenly distributed. This study provides a preliminary understanding of the bacterial diversity and shifts in community structure in soil and meltwater runoff at the frontier of the glacial. The findings revealed that the environmental factors are a significantly strong determinant of bacterial community structures in such a closely linked ecosystem.

Perioperative Safety of Combined Augmentation-Mastopexy: An Evaluation of National Database.

INTRODUCTION: The safety of combined augmentation-mastopexy is controversial. This study evaluates a national database to analyze the perioperative safety of combined augmentation-mastopexy to either augmentation or mastopexy alone. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried to identify patients undergoing augmentation mammaplasty and mastopexy from 2005 to 2018. The patients were divided into the following groups: group I, augmentation; group II, mastopexy; group III, combined augmentation-mastopexy. Baseline characteristics and outcomes were compared. Outcomes were 30-day complications, reoperation, and readmission. RESULTS: We found 5868 (74.2%) augmentation only, 1508 (19.1%) mastopexy only and 534 (6.6%) combined augmentation-mastopexy cases. Mean operative time was highest among the combined group at 129 minutes compared with 127 minutes for mastopexy alone and 66 minutes for augmentation alone (P < 0.01). Rates of any complications and readmission were different among groups (0.8% vs 2.5% vs 1.5% respectively, P < 0.01 and 0.7% vs 1.5% vs 1.5% respectively, P = 0.049), whereas reoperation was not statistically different (1.2% vs 1.4% vs 1.5%, P = 0.75). The incidence of dehiscence (0.6%; P < 0.01) was highest in the combined group. Multivariable logistic regression analysis did not reveal an increased odds of complications, reoperation, or readmission with combined augmentation-mastopexy. CONCLUSIONS: An evaluation of the nationwide cohort suggests that combined augmentation-mastopexy is a safe procedure in the perioperative period.

Inpatient Versus Outpatient Operative Management of Isolated Facial Fractures.

BACKGROUND: Patients with isolated facial fractures requiring operative fixation can be managed on an inpatient or outpatient basis. The goal of this study was to compare the safety of each approach using a large multi-institutional database. METHODS: The American College of Surgeons' National Surgical Quality Improvement Project was reviewed for facial fractures between 2005 and 2018. Groups were identified using inpatient and outpatient status as designated in the database. Patients who required additional procedures, concurrent procedures, or other emergency procedures were excluded. Descriptive statistics were used for group comparisons and logistic regression models were used to identify risk factors for complications. RESULTS: We identified 4240 patients who underwent operative fixation of isolated facial fractures. The majority of these cases (67.9%) were done on an outpatient basis. Compared to those in the outpatient group, patients in the inpatient group were older, had more medical comorbidities, had higher wound class, and had higher American Society of Anesthesiologists class. Complication (5.9% versus 2.3%), reoperation (4.3% versus 1.7%), and readmission (5.7% versus 2.5%) rates were all higher in the inpatient group (P < 0.01). By logistic regression analysis, the odds ratios for complications, reoperation, and readmission were higher in the inpatient group. After adjusting for imbalanced preoperative patient characteristics, the increased risk of complications [odds ratio (OR) = 1.728, confidence interval (CI) 1.146-2.606, P = 0.01] and the increased risk of reoperation (OR = 2.302, CI 1.435-3.692, P = 0.01) in the inpatient group persisted, while the risk of readmission (OR = 1.684, CI 0.981-2.891, P = 0.06) no longer showed statistical significance between the inpatient and outpatient groups. CONCLUSIONS: Inpatient operative management of isolated facial fractures is associated with an increased risk of complications and a 2-fold increased risk of reoperation, though no increased risk of readmission.

Morbidity Associated With Structural Graft Use in Paramedian Forehead Flap.

INTRODUCTION: Paramedian forehead flap for nasal reconstruction may involve the use of a structural graft. The authors hypothesized that the use of structural grafts with paramedian forehead flap is associated with an increased risk of 30-day complications. METHODS: This is a retrospective study of the American College of Surgeon (ACS) National Surgical Quality Improvement Program (NSQIP). We identified all patients undergoing paramedian forehead flap reconstruction from 2007 through 2018 using Current Procedural Terminology code 15731. Patients who had structural graft harvested at the time of paramedian forehead flap were identified using Current Procedural Terminology codes. Groups were defined based on the use of structural grafts. Propensity score matching was performed using preoperative and intraoperative characteristics to produce matched cohorts. The authors further stratified individual graft types to identify differential risks associated with each. Logistic regression was then used to determine whether the use of structural grafts was associated with increased risk for 30-day complications. RESULTS: The authors identified 1198 patients with paramedian forehead flap reconstruction, of whom 325 (27.1%) required structural grafts. Propensity score matching 1:1 yielded 247 patients in each of the matched cohorts. Overall 30-day complications (4.5% versus 5.3%), wound related complications (3.2% versus 4.1%), systemic complications (1.2% versus 2%), unplanned reoperation (6.5% versus 3.2%), and unplanned readmission (6.6% versus 10.2%) were similar between the 2 groups (P > 0.05). Subgroup analysis of different graft types showed that costochondral graft was associated with increased wound related complications (0.9% versus 8.3%, P = 0.03). The odds of having wound related complications with the use of costochondral graft was OR = 5.3, CI = 1.5-18.8, P = 0.02. CONCLUSIONS: Although the use of structural grafts does not increase risk of overall 30-day complications, there is an increased risk of wound related complications associated with the use of costochondral and rib grafts.

Pigment production by cold-adapted bacteria and fungi: colorful tale of cryosphere with wide range applications.

Pigments are an essential part of everyday life on Earth with rapidly growing industrial and biomedical applications. Synthetic pigments account for a major portion of these pigments that in turn have deleterious effects on public health and environment. Such drawbacks of synthetic pigments have shifted the trend to use natural pigments that are considered as the best alternative to synthetic pigments due to their significant properties. Natural pigments from microorganisms are of great interest due to their broader applications in the pharmaceutical, food, and textile industry with increasing demand among the consumers opting for natural pigments. To fulfill the market demand of natural pigments new sources should be explored. Cold-adapted bacteria and fungi in the cryosphere produce a variety of pigments as a protective strategy against ecological stresses such as low temperature, oxidative stresses, and ultraviolet radiation making them a potential source for natural pigment production. This review highlights the protective strategies and pigment production by cold-adapted bacteria and fungi, their industrial and biomedical applications, condition optimization for maximum pigment extraction as well as the challenges facing in the exploitation of cryospheric microorganisms for pigment extraction that hopefully will provide valuable information, direction, and progress in forthcoming studies.

Study amino acid contents, plant growth variables and cell ultrastructural changes induced by cadmium stress between two contrasting cadmium accumulating cultivars of Brassica rapa ssp. chinensis L. (pak choi).

Cadmium (Cd) is an inauspicious abiotic traction that not only influences crop productivity and its growth parameters, but also has adverse effects on human health if these crops are consumed. Among crops, leafy vegetables which are the good source of mineral and vitamins accumulate more Cd than other vegetables. It is thus important to study photosynthetic variables, amino acid composition, and ultrastructural localization of Cd differences in response to Cd accumulation between two low and high Cd accumulating Brassica rapa ssp. chinensis L. (pak choi) cultivars, differing in Cd accumulation ability. Elevated Cd concentrations significantly lowered plant growth rate, biomass, leaf gas exchange and concentrations of amino acids collated to respective controls of both cultivars. Electron microscopy indicated that the impact of high Cd level on ultrastructure of leaf cells was associated to affecting cell functionalities, i.e. irregular cell wall, withdrawal of cell membrane, and chloroplast structure which has negative impact on photosynthetic activities, thus causing considerable plant growth suppression. Damage in root cells were observed in the form of enlargement of vacuole. The energy dispersive micro X-ray spectroscopy of both cultivars leaves indicated that cellular structure exhibited exudates of Cd-dense material. Ultrastructural damages and phytotoxicity were more pronounced in high accumulator cultivar as compared to the low accumulator cultivar. These findings are useful in determining the mechanisms of differential Cd-tolerance among cultivars with different Cd tolerance abilities at cellular level.

Culture-dependent diversity of bacteria from Laohugou glacier, Qilian Mts., China and their resistance against metals.

In the current study, psychrophilic, endolithic, and epilithic bacterial strains were isolated and characterized from the nonpolar Laohugou glacier (LHG) no. 12, the largest valley glacier in the western Qilian Mts. located on the northeastern edge of the Tibetan Plateau. Five different types of samples, rocks, soil, glacial water, ice/snow, and cryoconite, were collected. A total of 48 bacterial strains were isolated by using the R2A bacterial cultural medium. The findings revealed that the Gram-positive bacteria 41 (85.4%) dominated the Gram-negative bacteria 7 (14.6%) in this extremely harsh environment. Molecular characterization based on 16S ribosomal RNA gene sequencing exhibited that the obtained isolates belong to four phyla, among which the diversity of Firmicutes (58.33%) was higher followed by Actinobacteria (23.0%), Proteobacteria (14.6%), and least diversity was reported in Euryarchaeota (4.2%). The bacterial communities were most dominant in soil samples followed by cryoconite sample and least dominant in the ice and snow samples. Moreover, the obtained bacterial isolates were found resistant to high concentrations of heavy metals (Cr3+ , Cd2+ , Hg2+ , and Ar3+ ) and sodium chloride, and, therefore, exhibited polyextremophilic characteristics. LHG no. 12 is rich in bacterial and archaeal diversities and provides a potentially curious site for further in-depth exploration of microbial diversity and their biotechnological applications.

Culture-dependent hunt and characterization of iron-oxidizing bacteria in Baiyin Copper Mine, China, and their application in metals extraction.

The exploration of microbial diversity in extremely acidic habitats has provided a vital base for the progression of minerals biotechnology. Three indigenous iron-oxidizing acidophilic bacterial strains were isolated through serial dilution of enriched bacterial culture from Baiyin Copper Mine Stope, China. The morphological, biochemical, physiological, and phylogenetic characteristics of isolates were investigated. These isolates were motile, Gram-negative, and curved shape with pleomorphism except isolate WG101 that was a straight rod. The optimum growth pH and temperature for all isolates were 1.5 and 30 °C, respectively, and showed extreme acidophilic nature. All the isolates showed obligate chemoautotrophic nature and used ferrous iron and pyrite as an energy source, however, isolates WG102 and WG103 were unable to use sulfur, while isolate WG101 could use elemental sulfur and reduced inorganic sodium thiosulfate as an energy source. The phylogenetic analyses based on 16S rRNA sequences revealed that the isolates WG101, WG102, and WG103 were homologous with Acidithiobacillus ferrooxidans strain AS2 (99%), Leptospirillum ferriphilum strain YSK (98%), and Leptospirillum ferrooxidans strain L15 (98%), respectively. These bacterial isolates showed efficient copper and zinc dissolution from the ore. The metals dissolution rate of At. ferrooxidans strain WG101 was 54.5 ± 4.33% (copper) and 49.6 ± 5% (zinc). The metals recovery rate of L. ferriphilum strain WG102 was 45.7 ± 3.5% (copper) and 40.5 ± 2.5% (zinc). The recovery rate of copper and zinc was 49.6 ± 4% and 46.5 ± 3% respectively in the case of L. ferrooxidans strain WG103. The findings of this study are consistent with the notion that the indigenous bacteria are more efficient in minerals dissolution.

Fungal Systematics and Evolution: FUSE 5.

Thirteen new species are formally described: Cortinarius brunneocarpus from Pakistan, C. lilacinoarmillatus from India, Curvularia khuzestanica on Atriplex lentiformis from Iran, Gloeocantharellus neoechinosporus from China, Laboulbenia bernaliana on species of Apenes, Apristus, and Philophuga (Coleoptera, Carabidae) from Nicaragua and Panama, L. oioveliicola on Oiovelia machadoi (Hemiptera, Veliidae) from Brazil, L. termiticola on Macrotermes subhyalinus (Blattodea, Termitidae) from the DR Congo, Pluteus cutefractus from Slovenia, Rhizoglomus variabile from Peru, Russula phloginea from China, Stagonosporopsis flacciduvarum on Vitis vinifera from Italy, Strobilomyces huangshanensis from China, Uromyces klotzschianus on Rumex dentatus subsp. klotzschianus from Pakistan. The following new records are reported: Alternaria calendulae on Calendula officinalis from India; A. tenuissima on apple and quince fruits from Iran; Candelariella oleaginescens from Turkey; Didymella americana and D. calidophila on Vitis vinifera from Italy; Lasiodiplodia theobromae causing tip blight of Dianella tasmanica 'variegata' from India; Marasmiellus subpruinosus from Madeira, Portugal, new for Macaronesia and Africa; Mycena albidolilacea, M. tenuispinosa, and M. xantholeuca from Russia; Neonectria neomacrospora on Madhuca longifolia from India; Nothophoma quercina on Vitis vinifera from Italy; Plagiosphaera immersa on Urtica dioica from Austria; Rinodina sicula from Turkey; Sphaerosporium lignatile from Wisconsin, USA; and Verrucaria murina from Turkey. Multi-locus analysis of ITS, LSU, rpb1, tef1 sequences revealed that P. immersa, commonly classified within Gnomoniaceae (Diaporthales) or as Sordariomycetes incertae sedis, belongs to Magnaporthaceae (Magnaporthales). Analysis of a six-locus Ascomycota-wide dataset including SSU and LSU sequences of S. lignatile revealed that this species, currently in Ascomycota incertae sedis, belongs to Pyronemataceae (Pezizomycetes, Pezizales).

Production of ingredient type flavoured white enzyme modified cheese.

Enzyme modified white cheese (EMWC) was produced to use as flavouring ingredient. White cheese curd coupled with low fat was hydrolysed using combination of proteinases/peptidase to produce a range of proteolysed products followed by lipolysis. The results revealed that lowering pH 5.6 known to impart flavour strength of cheese. The inclusion of enzyme preparations significantly elevated free amino acids and free fatty acids. Developed EMWC had relatively higher levels of volatiles and improved sensory characteristics including less negative attributes such as, astringent, bitter, pungent, rancid, smoky, and more positive attributes, such as the strength of buttery, sweaty, caramel and nutty notes. Spray-dried EMWC powders had low moisture content and water activity values whereas, scanning electron micrographs showed spherical with a uniform distribution and large microparticles size. Because consumers like low fat products with cheese flavour, EMWCs are important products. Thus, process demonstrates the potential to be a cost-effective to produce EMWC flavour as ingredient and may suited to the products in which added.

Nanomedicines for developing cancer nanotherapeutics: from benchtop to bedside and beyond.

Cancer is a devastating disease and remains a significant cause of mortality and morbidity in both developed and developing countries. Although there are large number of drugs that can be used for the treatment of cancer, the problem is selective and specific killing of cancerous cells without harming the normal cells. There are some biological barriers to potential drug delivery in cancer cells like hepatic, renal, abnormal vasculature, dense extracellular matrix, and high interstitial fluid pressure. The physicochemical characteristics of nanoparticles (NPs) such as size, shape, and surface charge may also have significant effects on tumor penetration. NPs coated with drug can be used to overcome these biological barriers to enhance targeted delivery. This literature survey encompasses the biological barriers to potential drug delivery in cancer cells, elaborate on designing strategies to enhance NPs penetration and distribution inside the tumor interstitium. Scientists are now doing great efforts to design next-generation of nanomedicines (NMs) that need to be better targeted with high specificity and efficacy to kill cancer cells. These challenges need to be overcome through collaborations among academia, pharmaceutical industries, and regulatory agencies to eradicate this global menace. Furthermore, this review article has critically discussed the recent developments, controversies, challenges, emerging concepts, and future perspectives in cancer NMs.

Hybrid Repair of Complex Left Subclavian Artery Injury with Partial Transection and Complete Thrombosis in an Unstable Patient following Blunt Trauma.

Blunt subclavian artery injuries are rare and are associated with high morbidity and mortality. Several case reports have suggested that endovascular repair is safe with short operative times and minimal blood loss. We report a case of a 20-year-old male patient involved in a high-speed motor vehicle collision that resulted in partial transection of left subclavian artery with complete luminal thrombosis. Patient also had a left main-stem bronchus avulsion along with major intra-abdominal injuries and multiple spine and long bone fractures. He underwent emergent abdominal exploration due to multisystem trauma and hemodynamic instability. Following laparotomy and resuscitation, the subclavian artery injury was repaired using a hybrid technique geared at protecting the patent vertebral and axillary arteries from embolization. We used supraclavicular dissection and arterial control with endovascular stent-graft placement in retrograde fashion to repair the left subclavian artery injury. At 6-month follow-up, computed tomography scan confirmed patency of the left subclavian artery stent and there was no evidence of vertebrobasilar insufficiency or left upper extremity ischemia. In conclusion, stent-graft repair of blunt subclavian artery injuries is expedient and safe. Supraclavicular vascular dissection and control are effective in preventing distal embolization in rare cases complicated with luminal thrombosis.

Impact of different feedstocks derived biochar amendment with cadmium low uptake affinity cultivar of pak choi (Brassica rapa ssb. chinensis L.) on phytoavoidation of Cd to reduce potential dietary toxicity.

Biochar has become eco-friendly amendment used for phytoavoidation with low cadmium (Cd) accumulating cultivars of crops to ensure food safety in Cd contaminated soils. In this study, biochar with different waste feedstock material were evaluated for their effectiveness on essential trace metals mobility, Cd bioavailability and its accumulation in two contrasting Cd accumulating cultivars of pak choi (Brassica rapa ssp. chinensis L.) grown in Cd contaminated Mollisol soil. A greenhouse experiment was conducted with plants grown in Cd contaminated soil that had been amended with biochar derived from barley straw, tomato green waste, chicken manure, duck manure and swine manure at application rate of 0%, 2.5% and 5.0% (w/w). The results showed that soil pH was significantly increased by all treatments. Biochar increased plant dry biomass, micronutrients bioavailability with significant differences in the Cd sorption capacity, with the effectiveness higher with increasing biochar application rate. However, tomato green waste (TGW) and chicken manure (CM) derived biochar were more effective than the other biochar in reducing Cd mobilization in soil by 35-54% and 26-43% and reduced its accumulation in shoots of pak choi cultivars by 34-76% and 33-72% in low Cd accumulator cultivar and 64-85% and 55-80% in high Cd accumulator cultivar than the control. Overall, results indicate that TGW and CM biochar can efficiently immobilize Cd, thereby reducing bioavailability in Cd contaminated Mollisol soil to ensure food safety.