Substratifying the risk of covert malignancy in significant rectal polyps: Outcomes from a specialist multidisciplinary team (MDT).

AIM: A treatment strategy for patients with a significant polyp or early colon cancer (SPECC) of the rectum presents a challenge due to the significant rate of covert malignancy and lack of standardized assessment. For this reason, NICE recommends multidisciplinary meetings to improve outcomes. The primary aim of the present study was to report the performance of our specialist early rectal cancer (SERC) multidisciplinary team (MDT) in correctly substratifying the risk of cancer and to discuss the limitations of staging investigations in those patients with "poor outcomes". METHOD: This was a retrospective review of patients referred to our SERC MDT from 2014 to 2019. Lesions were assigned by the MDT to three pre-resection categories (low, intermediate, high) according to the risk of covert malignancy. Resection method and final histology were compared to the pre-resection categories. RESULTS: Of 350 SPECC lesions, 174 were assessed as low-risk, 108 intermediate-risk and 68 high-risk. The cancer incidence was 4.8%, 8.3% and 53%, respectively (15.5% overall). Eight lesions were categorized as low-risk but following piecemeal resection were found to be malignant. Five lesions, three of which were categorized as high-risk, were ultimately benign following conventional surgery. One pT1sm1 cancer, removed by anterior resection, may have been treated by local excision. CONCLUSION: A total of 83% of malignant polyps were triaged to an en bloc resection technique and surgical resection avoided for nearly all benign lesions. However, 12 patients from this cohort were deemed to have a poor outcome because of miscategorization. Further comparative research is needed to establish the optimum strategy for rectal SPECC lesion assessment. ORIGINALITY STATEMENT: There is currently no consensus for staging significant polyps of the rectum. This paper reports the effectiveness of a specialist early rectal cancer MDT to correctly risk-stratify significant rectal polyps. It underscores the importance of accurate categorization for treatment decision-making, while acknowledging the limitations of current staging modalities.

Integrated machine learning-based virtual screening and biological evaluation for identification of potential inhibitors against cathepsin K.

Cathepsin K is a type of cysteine proteinase that is primarily expressed in osteoclasts and has a key role in the breakdown of bone matrix protein during bone resorption. Many studies suggest that the deficiency of cathepsin K is concomitant with a suppression of osteoclast functioning, therefore rendering the resorptive properties of cathepsin K the most prominent target for osteoporosis. This innovative work has identified a novel anti-osteoporotic agent against Cathepsin K by using a comparison of machine learning and deep learning-based virtual screening followed by their biological evaluation. Out of ten shortlisted compounds, five of the compounds (JFD02945, JFD02944, RJC01981, KM08968 and SB01934) exhibit more than 50% inhibition of the Cathepsin K activity at 0.1 µM concentration and are considered to have a promising inhibitory effect against Cathepsin K. The comprehensive docking, MD simulation, and MM/PBSA investigations affirm the stable and effective interaction of these compounds with Cathepsin K to inhibit its function. Furthermore, the compounds RJC01981, KM08968 and SB01934 are represented to have promising anti-osteoporotic properties for the management of osteoporosis owing to their significantly well predicted ADMET properties.

Plant mediated fabrication of silver nanoparticles, process optimization, and impact on tomato plant.

Nanotechnology is one of the fastest-growing markets, but developing eco-friendly products, their maximum production, stability, and higher yield is a challenge. In this study, silver nanoparticles were synthesized using an easily available resource, leaves extract of the Neem (Azadirachta indica) plant, as a reducing and capping agent, determined their effect on germination and growth of tomato plants. The maximum production of silver nanoparticles was noted at 70 °C after 3 h of reaction time while treating the 10 ml leaf extract of Neem plant with 10 ml of 1 mM silver nitrate. The impact of the extract preparation method and solvent type on the plant mediated fabrication of silver nanoparticles was also investigated. The UV-spectrophotometric analysis confirmed the synthesis of silver nanoparticles and showed an absorption spectrum within Δ420-440 nm range. The size of the fabricated silver nanoparticles was 22-30 nm. The functional groups such as ethylene, amide, carbonyl, methoxy, alcohol, and phenol attached to stabilize the nanoparticles were observed using the FTIR technique. SEM, EDX, and XRD analyses were performed to study the physiochemical characteristics of synthesized nanoparticles. Silver nanoparticles increased the germination rate of tomato seeds up to 70% while decreasing the mean germination time compared to the control. Silver nanoparticles applied at varying concentrations significantly increased the shoot length (25 to 80%), root length (10 to 60%), and fresh biomass (10 to 80%) biomass of the tomato plant. The production of total chlorophyll, carotenoid, flavonoids, soluble sugar, and protein was significantly increased in tomato plants treated with 5 and 10 ppm silver nanoparticles compared to the control. Green synthesized silver nanoparticles are cost-effective and nontoxic and can be applied in agriculture, biomedical, and other fields.

What is the optimal timing of surgery after short-course radiotherapy for rectal cancer?

BACKGROUND: Short-course neoadjuvant radiotherapy is a valuable tool in managing rectal cancers and has improved local recurrence rates. However, limited and conflicting data has resulted in variable usage and a lack of consensus on the optimal timing of surgery following short-course radiotherapy. This review aims to provide a contemporary summation of the available evidence regarding the optimal time interval between short-course neoadjuvant radiotherapy and surgery. METHODS: A focused literature search was undertaken using the PubMed and Embase databases from January 1980 until January 2023. Randomised control trials, large observational studies and systematic reviews focusing on the use of short-course preoperative radiotherapy for localised rectal cancers, with a focus on the timing of surgery, were included. Primary outcomes were overall survival, disease-free survival and perioperative complications. RESULTS: Five randomised control trials, two meta-analyses, and two large, population-based studies were included for their eligibility and relevance. Increased downstaging and fewer postoperative complications are demonstrated in patients receiving delayed surgery (> four weeks), but more recent data raise concerns regarding increased rates of local recurrence in this cohort. Studies directly comparing different time intervals to surgery following short-course radiotherapy have failed to demonstrate an effect on overall survival. CONCLUSIONS: This review highlights the complexities and relative shortcomings of the available data with few high-quality studies and randomised control trials directly comparing different time intervals to surgery following short-course radiotherapy. Continuing research is needed to confirm existing findings and explore gaps in the current literature.

Glutathione primed seed improved lead-stress tolerance in Brassica rapa L. through modulation of physio-biochemical attributes and nutrient uptake.

Heavy metal toxicity is a major environmental issue that affects all life forms, including plants. The accumulation of lead (Pb) in agricultural soils is a significant contributor to reduced crop yields, and it poses serious health risks to people who consume lead-contaminated agricultural products. The current study was undertaken to investigate the beneficial effects of glutathione (GSH) on the amelioration of stress induced by Pb (300 mg kg-1 Pb) in Brassica rapa L. (turnip). For this purpose, B. rapa seeds primed with 25, 50, and 75 µmol L-1. The root and shoot length, seedling biomass, and leaf area, was reduced under Pb stress. Lead toxicity inhibited the net photosynthetic rate (31.36%), total chlorophyll content (74.54%) of B. rapa plants in comparison to control. Lead-stressed plants additionally exhibited changes in proline levels, as well as lower levels of total soluble protein and phenolic content. Nevertheless, seed priming with GSH resulted in higher concentrations of the nutritional content (Mg+2, Zn+2, Na+, K+) that increased Pb stress tolerance. The GSH2 treated seed enhanced the photosynthetic rate (46.34%), stomatal conductance (80.55%), and transpiration rate (53.125%) over Pb stress. Furthermore, GSH2 enhanced total soluble proteins (37.75%), phenolic content (58.38%), and DPPH (1.5fold) of turnip plant over control seedlings. According to our research, GSH2 primed B. rapa seed demonstrated a reduction in Pb toxicity, which could be used to help seedling establishment in soils contaminated with Pb.

Numerous studies highlight the advantages of plant growth regulators for agricultural crop development and productivity. Nevertheless, we know remarkably little about the role of glutathione as a seed-priming agent in vegetable crops. Additionally, little is known about how glutathione affects the physiological traits, nutrient content, and growth of B. rapa L. (turnip) under lead stress. Therefore, the goal of this work was to evaluate how exogenously applied glutathione improved the agronomic traits, physiochemical characteristics, and nutrient content of B. rapa L. under lead stress.

The role of iron in the pathogenesis of endometriosis: a systematic review.

STUDY QUESTION: What is the role of iron in the pathophysiology of endometriosis? SUMMARY ANSWER: Iron excess is demonstrated wherever endometriotic tissues are found and is associated with oxidative stress, an inflammatory micro-environment, and cell damage; the iron-mediated oxidative stress is independently linked to subfertility, symptom severity, and malignant transformation. WHAT IS KNOWN ALREADY: Iron is found in excess in endometriotic tissues, and multiple mechanisms have been studied and posited to explain this. It is clear that iron excess plays a vital role in promoting oxidative stress and cell damage. The evidence base is large, but no comprehensive reviews exist to summarize our understanding and highlight the overarching themes to further our understanding and suggest future directions of study for the field. STUDY DESIGN SIZE DURATION: This systematic review with a thematic analysis retrieved studies from the PubMed, Embase, Web of Science, and Cochrane Library databases and searches were conducted from inception through to August 2022. Human and animal studies published in the English language were included and identified using a combination of exploded MeSH terms ('Iron' and 'Endometriosis') and free-text search terms ('Iron', 'Ferric', 'Ferrous', 'Endometriosis', 'Endometrioma'). PARTICIPANTS/MATERIALS SETTING METHODS: This review was reported in accordance with the PRISMA guidelines. All studies reporting original data concerning the role of iron or iron complexes in the pathophysiology of endometriosis were included. Studies that did not report original data or provided a review of the field were excluded. Bias analysis was completed for each included study by using the Newcastle-Ottawa scoring system. MAIN RESULTS AND THE ROLE OF CHANCE: There were 776 records identified and these were screened down to 53 studies which met the eligibility criteria, including 6 animal and 47 human studies, with 3556 individual participants. Iron excess is demonstrated in various tissues and fluids, including ovarian endometriomas, ovarian follicles, ectopic endometriotic lesions, and peritoneal fluid. Markers of oxidative stress are strongly associated with high iron levels, and aberrant expression of iron-transport proteins has been demonstrated. Abnormal resistance to ferroptosis is likely. Iron-mediated oxidative stress is responsible for a pro-inflammatory micro-environment and is linked to subfertility, symptom severity, and, possibly, malignant transformation. LIMITATIONS REASONS FOR CAUTION: A minority of the included studies were of objectively low quality with a high risk of bias and may lead to misleading conclusions. Additionally, multiple studies failed to appropriately characterize the included patients by known confounding variables, such as menstrual cycle phase, which may introduce bias to the findings. WIDER IMPLICATIONS OF THE FINDINGS: Current literature depicts a central role of aberrant iron mechanics and subsequent oxidative stress in endometriosis. It is likely that iron excess is at least partly responsible for the persistence and proliferation of ectopic endometriotic lesions. As such, iron mechanics represent an attractive target for novel therapeutics, including iron chelators or effectors of the iron-oxidative stress pathway. There are significant gaps in our current understanding, and this review highlights and recommends several topics for further research. These include the role of iron chelation, resistance to ferroptosis, the relationship between iron excess and localized hypoxia, systemic iron pathophysiology in endometriosis, and the role of oxidative stress in malignant transformation. STUDY FUNDING/COMPETING INTERESTS: J.W. and S.G.P. are supported by clinical fellowships at Liverpool University Hospital NHS Foundation trust. No additional funding was requested or required for the completion of this work. C.J.H. is supported by a Wellbeing of Women project grant (RG2137). D.K.H. is supported by a Wellbeing of Women project grant (RG2137) and an MRC clinical research training fellowship (MR/V007238/1). The authors have no conflicts of interest to declare. REGISTRATION NUMBER: A protocol was prospectively registered with the PROSPERO database in August 2021 (CRD42021272818).

Inguinal lymph node metastases from rectal adenocarcinoma: a systematic review.

PURPOSE: Inguinal lymph nodes are a rare but recognised site of metastasis in rectal adenocarcinoma. No guideline or consensus exists for the management of such cases. This review aims to provide a contemporary and comprehensive analysis of the published literature to aid clinical decision-making. METHODS: Systematic searches were performed using the PubMed, Embase, MEDLINE and Scopus and Cochrane CENTRAL Library databases from inception till December 2022. All studies reporting on the presentation, prognosis or management of patients with inguinal lymph node metastases (ILNM) were included. Pooled proportion meta-analyses were completed when possible and descriptive synthesis was utilised for the remaining outcomes. The Joanna Briggs Institute tool for case series was used to assess the risk of bias. RESULTS: Nineteen studies were eligible for inclusion, encompassing 18 case series and one population-based study using national registry data. A total of 487 patients were included in the primary studies. The prevalence of ILNM in rectal cancer is 0.36%. ILNM are associated with very low rectal tumours with a mean distance from the anal verge of 1.1 cm (95% CI 0.92-1.27). Invasion of the dentate line was found in 76% of cases (95% CI 59-93). In patients with isolated inguinal lymph node metastases, modern chemoradiotherapy regimens in combination with surgical excision of inguinal nodes are associated with 5-year overall survival rates of 53-78%. CONCLUSION: In specific subsets of patients with ILNM, curative-intent treatment regimens are feasible, with oncological outcomes akin to those demonstrated in locally advanced rectal cancers.

Vascularisation in Deep Endometriosis: A Systematic Review with Narrative Outcomes.

Deep endometriosis (DE) is the most severe subtype of endometriosis, with the hallmark of lesions infiltrating adjacent tissue. Abnormal vascularisation has been implicated in contributing to endometriosis lesion development in general, and how vascularisation influences the pathogenesis of DE, in particular, is of interest. This systematic review followed the PRISMA guidelines to elucidate and examine the evidence for DE-specific vascularisation. A literature search was performed using MEDLINE, Embase, PubMed, Scopus, Cochrane CENTRAL Library and Europe PubMed Central databases. The databases were searched from inception to the 13 March 2023. A total of 15 studies with 1125 patients were included in the review. The DE lesions were highly vascularised, with a higher microvessel density (MVD) than other types of endometriotic lesions, eutopic endometrium from women with endometriosis and control tissue. Vascular endothelial growth factor, its major subtype (VEGF-A) and associated receptor (VEGFR-2) were significantly increased in the DE lesions compared to superficial endometriosis, eutopic endometrium and control tissue. Progestin therapy was associated with a significant decrease in the MVD of the DE lesions, explaining their therapeutic effect. This review comprehensively summarises the available literature, reporting abnormal vascularisation to be intimately related to the pathogenesis of DE and presents potentially preferential therapeutic targets for the medical management of DE.

Potassium silicate and zinc oxide nanoparticles modulate antioxidant system, membranous H+-ATPase and nitric oxide content in faba bean (Vicia faba) seedlings exposed to arsenic toxicity.

Current research focused on the potential role of zinc oxide nanoparticles (ZnONPs) and potassium (K+ ) in mitigation of arsenic (As) toxicity in Vicia faba L. seedlings. Faba bean seedlings were grown for 30days in potted soil. As stress curtailed root and shoot length, chlorophyll (Chl) content and net photosynthetic rate in V. faba seedlings. However, ZnONPs and K+ curtailed As stress in faba bean seedling through enhanced activity of superoxide dismutase (SOD), ascorbate peroxidase (APX), catalase (CAT) and peroxidase (POD) enzyme. Furthermore, ZnONPs and K+ significantly enhanced cysteine (Cys) content and serine acetyletransferase (SAT) activity in faba bean seedling exposed to As-toxificated soil. Application of ZnONPs and K+ curtailed superoxide ionic content and hydrogen peroxide (H2 O2 ) accumulation in V. faba seedlings exposed to As-polluted soil. Nitric oxide (NO) content also increased in faba bean seedlings treated with ZnONPs and K+ in normal and As-polluted soil. As stress alleviation was credited to reduce As uptake in faba bean seedlings treated with synergistic application of ZnONPs and K+ . It is proposed that K+ interaction with nanoparticles can be exploited at molecular level to understand the mechanisms involved in abiotic stress tolerance.

Ligand-based in silico identification and biological evaluation of potential inhibitors of nicotinamide N-methyltransferase.

Nicotinamide N-methyltransferase (NNMT) is a protein coding gene, which methylates the nicotinamide (NA) (vitamin B3) to produce 1-methylnicotinamide (MNA). Several studies have suggested that the overexpression of NNMT is associated with different metabolic disorders like obesity and type-2 diabetes thereby making it an important therapeutic target for development of anti-diabetic agents. Here we describe a workflow for identification of new inhibitors of NNMT from a library of small molecules. In this study, we have hypothesized a four-point pharmacophore model based on the pharmacophoric features of reported NNMT inhibitors in the literature. The statistically significant pharmacophore hypothesis was used to explore the Maybridge compound library that resulted in mapping of 1330 hit compounds on the proposed hypothesis. Subsequently, a total of eight high scoring compounds, showing good protein-ligand interactions in the molecular docking study, were selected for biological evaluation of NNMT activity. Eventually, four compounds were found to show significant inhibitory activity for NNMT and can be further explored to design new derivatives around the identified scaffolds with improved activities as NNMT inhibitors.

Impact of soaking and cooking treatments on the physicochemical and antioxidant properties of parboiled and non-parboiled rice (Oryza sativa L.).

The effects of soaking and cooking on the physicochemical properties and bioactive compounds of two parboiled and non-parboiled rice cultivars (BRRI-28 and Katari bhog) were investigated in this study. Total phenolic content (TPC) increased significantly (p ≤ 0.5) after soaking, while total flavonoid content (TFC) and proanthocyanidin content (PC) decreased significantly (p ≤ 0.5) compared to untreated rice samples. TPC increased by around 23% and 20% in parboiled BRRI 28 and Katari bhog rice extracts, respectively, due to the cooking process, while TFC and PC decreased significantly. DPPH radical scavenging increased whereas reducing power activity decreased after soaking and cooking in parboiled BRRI 28. After processing, the protein, starch, and amylose content of all samples decreased in the majority of cases. After being soaked, all samples L * and b * values increased as compared to raw rice samples. As a result, it can be concluded that the treatment of soaking and cooking of parboiled rice (BRRI-28) was suitable to improve the antioxidant properties as compared to non-parboiled rice.

Impression of foliar-applied folic acid on coriander (Coriandrum sativum L.) to regulate aerial growth, biochemical activity, and essential oil profiling under drought stress.

Drought is one of the major environmental limitations in the crop production sector that has a great impact on food security worldwide. Coriander (Coriandrum sativum L.) is an herbaceous angiosperm of culinary significance and highly susceptible to rootzone dryness. Elucidating the drought-induced physio-chemical changes and the foliar-applied folic acid (FA; vitamin B9)-mediated stress tolerance mechanism of coriander has been found as a research hotspot under the progressing water scarcity challenges for agriculture. The significance of folic acid in ameliorating biochemical activities for the improved vegetative growth and performance of coriander under the mild stress (MS75), severe stress (SS50), and unstressed (US100) conditions was examined in this study during two consecutive seasons. The results revealed that the plants treated with 50 mM FA showed the highest plant fresh biomass, leaf fresh biomass, and shoot fresh biomass from bolting stage to seed filling stage under mild drought stress. In addition, total soluble sugars, total flavonoids content, and chlorophyll content showed significant results by the foliar application of FA, while total phenolic content showed non-significant results under MS75 and SS50. It was found that 50 mM of FA upregulated the activity of catalase, superoxide dismutase, and ascorbate peroxidase enzymes in MS75 and SS50 plants compared with untreated FA plants. Thus, FA treatment improved the overall biological yield and economic yield regardless of water deficit conditions. FA-accompanied plants showed a decline in drought susceptibility index, while it improved the drought tolerance efficiency, indicating this variety to become stress tolerant. The optimum harvest index, essential oil (EO) percentage, and oil yield were found in MS75 followed by SS50 in FA-supplemented plants. The gas chromatography-mass spectrometry analysis revealed a higher abundance of linalool as the major chemical constituent of EO, followed by α-terpeniol, terpinene, and p-Cymene in FA-treated SS50 plants. FA can be chosen as a shotgun tactic to improve drought tolerance in coriander by delimiting the drastic changes due to drought stress.

Insight into the first multi-epitope-based peptide subunit vaccine against avian influenza A virus (H5N6): An immunoinformatics approach.

The rampant spread of highly pathogenic avian influenza A (H5N6) virus has drawn additional concerns along with ongoing Covid-19 pandemic. Due to its migration-related diffusion, the situation is deteriorating. Without an existing effective therapy and vaccines, it will be baffling to take control measures. In this regard, we propose a revers vaccinology approach for prediction and design of a multi-epitope peptide based vaccine. The induction of humoral and cell-mediated immunity seems to be the paramount concern for a peptide vaccine candidate; thus, antigenic B and T cell epitopes were screened from the surface, membrane and envelope proteins of the avian influenza A (H5N6) virus, and passed through several immunological filters to determine the best possible one. Following that, the selected antigenic with immunogenic epitopes and adjuvant were linked to finalize the multi-epitope-based peptide vaccine by appropriate linkers. For the prediction of an effective binding, molecular docking was carried out between the vaccine and immunological receptors (TLR8). Strong binding affinity and good docking scores clarified the stringency of the vaccines. Furthermore, molecular dynamics simulation was performed within the highest binding affinity complex to observe the stability, and minimize the designed vaccine's high mobility region to order to increase its stability. Then, Codon optimization and other physicochemical properties were performed to reveal that the vaccine would be suitable for a higher expression at cloning level and satisfactory thermostability condition. In conclusion, predicting the overall in silico assessment, we anticipated that our designed vaccine would be a plausible prevention against avian influenza A (H5N6) virus.

Iron oxide nanoparticles and selenium supplementation improve growth and photosynthesis by modulating antioxidant system and gene expression of chlorophyll synthase (CHLG) and protochlorophyllide oxidoreductase (POR) in arsenic-stressed Cucumis melo.

Current research reveals the positive role of iron oxide nanoparticles (IONPs) and selenium (Se) in extenuation of arsenic (As) induced toxicity in Cucumis melo. C. melo plants grown in As spiked soil (20 mg kg-1 As) showed reduced growth, chlorophyll (Chl) content, photosynthetic rate, stomatal conductivity and transpiration. On the other hand, the alone applications of IONPs or Se improved growth and physiochemical parameters of C. melo plants. Additionally, exogenous application IONPs and Se synergistically improved the activity of antioxidative enzymes and glyoxalase system in C. melo plants. In addition, the collective treatment of IONPs and Se reduced As uptake, enhanced rate of photosynthesis and increased gas exchange attributes of C. melo plants under As stress. Interactive effect of IONPs and Se regulated reduced glutathione (GSH), oxidized glutathione (GSSG) and ascorbate (AsA) content in C. melo plants exposed to As-contaminated Soil. IONPs and Se treatment also regulated expression of respiratory burst oxidase homologue D (RBOHD) gene, chlorophyll synthase (CHLG) and protochlorophyllide oxidoreductase (POR). Therefore, the combined treatment of IONPs and Se may enhance the growth of crop plants by alleviating As stress.

Alleviation of cadmium phytotoxicity in triacontanol treated Coriandrum sativum L. by modulation of physiochemical attributes, oxidative stress biomarkers and antioxidative system.

Cadmium (Cd) is a hazardous metal that has a significant risk of transfer from soil to edible parts of food crops including shoots and seeds. Reduction of Cd accumulation is required to lower the risk of Cd exposure in humans and animals feeding on metal contaminated parts of such plants. Coriandrum sativum L. (coriander) exposed to Cd showed stress symptoms such as stunted growth, reduced photosynthetic activity and synthesis of chlorophyll pigments. Growth inhibition in Cd-treated plants was attributed to induction of oxidative stress as demonstrated by higher level of stress biomarkers such as electrolyte leakage, lipid peroxidation and hydrogen peroxide. Primary objective of the current study was to observe the ameliorative role of triacontanol (Tria) in Cd-stressed coriander seedlings. For this purpose, coriander seeds were primed with Tria concentrations of 5, 10, and 20 µmol L-1. Seedlings developed from Tria treated seeds exhibited reduced loss of photosynthetic pigments; mitigated oxidative stress caused by Cd, through improved efficacy of antioxidant machinery comprising superoxide dismutase (SOD), peroxidase (POX), and catalase (CAT) enzymes besides non-enzymatic antioxidants including proline, phenolics and flavonoids. Triacontanol treated seedlings showed enhanced yield attributes suggesting that exogenous Tria could be employed to improve plant tolerance to Cd stress.

Completion Total Mesorectal Excision After Transanal Local Excision of Early Rectal Cancer: A Systematic Review and Meta-analysis.

BACKGROUND: Completion total mesorectal excision is recommended when local excision of early rectal cancers demonstrates high-risk histopathological features. Concerns regarding the quality of completion resections and the impact on oncological safety remain unanswered. OBJECTIVE: This study aims to summarize and analyze the outcomes associated with completion surgery and undertake a comparative analysis with primary rectal resections. DATA SOURCES: Data sources included PubMed, Cochrane library, MEDLINE, and Embase databases up to April 2021. STUDY SELECTION: All studies reporting any outcome of completion surgery after transanal local excision of an early rectal cancer were selected. Case reports, studies of benign lesions, and studies using flexible endoscopic techniques were not included. INTERVENTION: The intervention was completion total mesorectal excision after transanal local excision of early rectal cancers. MAIN OUTCOME MEASURES: Primary outcome measures included histopathological and long-term oncological outcomes of completion total mesorectal excision. Secondary outcome measures included short-term perioperative outcomes. RESULTS: Twenty-three studies including 646 patients met the eligibility criteria, and 8 studies were included in the meta-analyses. Patients undergoing completion surgery have longer operative times (standardized mean difference, 0.49; 95% CI, 0.23-0.75; p = 0.0002) and higher intraoperative blood loss (standardized mean difference, 0.25; 95% CI, 0.01-0.5; p = 0.04) compared with primary resections, but perioperative morbidity is comparable (risk ratio, 1.26; 95% CI, 0.98-1.62; p = 0.08). Completion surgery is associated with higher rates of incomplete mesorectal specimens (risk ratio, 3.06; 95% CI, 1.41-6.62; p = 0.005) and lower lymph node yields (standardized mean difference, -0.26; 95% CI, -0.47 to 0.06; p = 0.01). Comparative analysis on long-term outcomes is limited, but no evidence of inferior recurrence or survival rates is found. LIMITATIONS: Only small retrospective cohort and case-control studies are published on this topic, with considerable heterogeneity limiting the effectiveness of meta-analysis. CONCLUSIONS: This review provides the strongest evidence to date that completion surgery is associated with an inferior histopathological grade of the mesorectum and finds insufficient long-term results to satisfy concerns regarding oncological safety. International collaborative research is required to demonstrate noninferiority. REGISTRATION NO: CRD42021245101.

Role of exogenously applied putrescine in amelioration of cadmium stress in Coriandrum sativum by modulating antioxidant system.

Abiotic stress reduces the plant growth and biomass production. Putrescine (Put) may be applied to alleviate numerous types of abiotic stresses in plants. The present research was intended to evaluate the role of exogenously applied Put in extenuation of cadmium (Cd) stress in coriander plants. Coriander seeds primed with 0.25, 0.5, and1 mM Put were allowed to grow in 50 mg kg-1 Cd contaminated soil for one month. Put treatment improved seed germination, gas exchange attributes, root growth and shoot growth of coriander. The improved activity of stress-responsive enzymes such as superoxide dismutase, catalase and peroxidase, besides amplification of proline was observed in Put treated seedlings under Cd stress. In addition, a reduced amount of total soluble protein and sugars content were noticed in Cd stressed seedlings. Nevertheless, Put reduced MDA level in treated plants. Our results demonstrated that Put mitigated Cd induced stress by modulating antioxidants and photosynthetic activity of coriander plants.Novelty statement Most of the researchers have studied the role of endogenous putrescine in alleviation of plant stress. However, during current study, we primed coriander seeds with putrescine. Our results elucidated very promising role of exogenously applied putrescine in stress mitigation and growth improvement of coriander seedlings under Cd stress. The findings of current study advocate the application of putrescine for stress alleviation in crop plants.

Selenium nanoparticles reduced cadmium uptake, regulated nutritional homeostasis and antioxidative system in Coriandrum sativum grown in cadmium toxic conditions.

Nanotechnology has become a valuable novel approach to manage several environmental challenges through providing innovative and effective solutions. Heavy metal stress is an important abiotic limiting factor. Seed priming with selenium (Se) alleviates various kinds of environmental stresses; yet, the potential of seed priming with selenium nanoparticles (SeNPs) under cadmium (Cd) stress for coriander crop has never been evaluated. This research work was designed to explore the effects of seed priming with three levels (0, 5, 10 and 15 mg L-1) of SeNPs solution on the physio-biochemical characteristics, nutrition, antioxidative defense system and growth of coriander under Cd stress. Cadmium toxicity reduced chlorophyll content, photosynthetic activity and growth of treated plants. Moreover, Cd stressed plants exhibited modulations in proline level, together with decreased water potential, and leaf osmotic potential. However, SeNPs increased growth attributes, chlorophyll content, total soluble sugars, leaf relative water content, and gas exchange parameters in treated plants which were conversely decreased by Cd toxicity. The seeds priming with SeNPs promoted antioxidant response by increasing catalase (CAT), ascorbate peroxidase (APX) and peroxidase (POX) activity and safeguarding cellular structures through scavenging free radicals and reactive oxygen species. Furthermore, Cd stressed plants displayed an upper level of MDA (1.91 fold) while SeNPs improved membranous integrity through detoxification of hydrogen peroxide. Additionally, SeNPs enhanced nutrients contents (P, K, Ca, Mg, Zn), metal tolerance index and diminished Cd content in plants resulting in the improved growth and development of Cd affected coriander plants.

Titanium dioxide nanoparticles mitigate cadmium toxicity in Coriandrum sativum L. through modulating antioxidant system, stress markers and reducing cadmium uptake.

Anthropogenic activities are the foremost reason of metal pollution in soils of the cultivated areas, resulting abnormal physiochemical processes in plants. Among metals contaminants, cadmium (Cd) is one of the most injurious contaminants that deleteriously affect physiological activities, growth and yield of the crop plants. Keeping in view the stress mitigation potential of titanium dioxide (TiO2), the existing research work was premeditated to inspect the beneficial role of seed priming with titanium dioxide nanoparticles (TiO2-NPs) on biochemical, morphological and physiological characteristics of Coriandrum sativum L. (coriander) plants under Cd stress. For this purpose, C. sativum seeds were primed with 0, 40, 80 and 160 mg L-1 TiO2-NPs. Cadmium stress triggered a significant decrease in chlorophyll a content (49%), chlorophyll b content (44%), photosynthetic rate (62%) and plant growth (51%) as compared with control. Tanium dioxide nanoparticles treated seedlings exhibited reduced Cd contents besides improved agronomic traits (seedlings biomass, number of seeds and yield). The TiO2-NPs treatment declined the magnitude of EL and MDA by 1.5 fold and 1.71 fold, respectively. Furthermore, TiO2-NPs diminished oxidative injuries in plants exposed to Cd stress. Additionally, TiO2-NPs enhanced the biosynthesis of osmatic regulators (proline) by 47% which helped in the mitigation of Cd persuaded toxicity in plants. Briefly, treatment of 80 mg L-1 TiO2-NPs perhaps ameliorates the deleterious influence of Cd stress and enhance the yield of coriander.

Selenium seed priming enhanced the growth of salt-stressed Brassica rapa L. through improving plant nutrition and the antioxidant system.

Various abiotic stresses may affect the germination, growth, and yield of direct-seeded vegetable crops. Seed priming with effective antioxidant mediators may alleviate these environmental stresses by maintaining uniformity in seed germination and improving the subsequent health of developing seedlings. Salt-induced stress has become a limiting factor for the successful cultivation of Brassica rapa L., especially in Southeast Asian countries. The present study was performed to elucidate the efficacy of seed priming using selenium (Se) in mitigating salt-induced oxidative stress in turnip crops by reducing the uptake of Na+. In this study, we administered three different levels of Se (Se-1, 75 µmol L-1; Se-2, 100 µmol L-1; and Se-3, 125 µmol L-1) alone or in combination with NaCl (200 mM). Conspicuously, salinity and Se-2 modulated the expression levels of the antioxidant genes, including catalase (CAT), peroxidase (POD), superoxide dismutase (SOD), and ascorbate peroxidase (APX). The upregulated expression of stress-responsive genes alleviated salt stress by scavenging the higher reactive oxygen species (ROS) level. The stress ameliorative potential of Se (Se-2 = 100 µmol L-1) enhanced the final seed germination percentage, photosynthetic content, and seedling biomass production up to 48%, 56%, and 51%, respectively, under stress. The advantageous effects of Se were attributed to the alleviation of salinity stress through the reduction of the levels of malondialdehyde (MDA), proline, and H2O2. Generally, treatment with Se-2 (100 µmo L-1) was more effective in enhancing the growth attributes of B. rapa compared to Se-1 (75 µmo L-1) and Se-3 (125 µmo L-1) under salt-stressed and non-stressed conditions. The findings of the current study advocate the application of the Se seed priming technique as an economical and eco-friendly approach for salt stress mitigation in crops grown under saline conditions.