A Rare Case of Cephalosporin Anaphylaxis-Induced Reverse Takotsubo.

This case report details an unusual occurrence of reverse takotsubo induced by cefazolin anaphylaxis. While anaphylactic reactions typically manifest with hypotension and bronchospasm, the development of takotsubo is a rare outcome. The patient experienced an episode of cefazolin-induced anaphylaxis during elective shoulder surgery, subsequently developing reverse takotsubo cardiomyopathy (rTTC) during her hospitalization. Initial testing showed a reduced heart function, with an ejection fraction (EF) dropping to 32% from a previously normal EF exceeding 50%. However, a follow-up heart catheterization three weeks later revealed a return to normal heart function. The patient received appropriate management for heart failure. By emphasizing the nuanced features and symptoms, we aim to enhance the recognition and management of this condition. Sharing such cases contributes to the medical community's knowledge and facilitates the advancement of strategies for diagnosing and managing anaphylaxis-induced reverse takotsubo.

Acute global longitudinal strain evaluation in patients with subacute to chronic chest pain: A pilot, observational study.

Background: Global longitudinal strain (GLS) imaging is a multifaceted modality that has been utilized in various fields of clinical cardiology in the recent past; however, its implementation for the assessment of ischemia has been limited. Objectives: This study aimed to document the functional changes in GLS secondary to acute myocardial ischemia in patients with chronic chest pain. Methods: In this unblinded, single-center, investigator-initiated, prospective pilot study, the functional changes in GLS at baseline, during, and immediately following coronary percutaneous intervention were monitored in 10 ambulatory patients who underwent elective catheterization. The exclusion criteria included a low ejection fraction, or a history of chemoradiation, myopathy, and congenital heart disease. Results: The average GLS at baseline, during the balloon intervention (BI), and 1-2 min after BI was -15.4 % ±â€¯3.3 %, -10.2 % ±â€¯3.6 %, and -16.1 % ±â€¯4.2 %, respectively. The average GLS decreased significantly by 5.1 % (95 % CI, -7.9 % to -2.3; P = 0.0013) from baseline to BI, increased by 6.3 % (95 % CI, 3.7 % to 8.9 %; P < 0.001) from BI to immediately post-BI, and increased by 0.7 % from baseline to post-BI (95 % CI, -0.4 % to 2.7 %; P = 0.161). Conclusion: Patients undergoing BI showed a significant decrease in the average GLS within 1-2 min of BI, with GLS returning to baseline subsequently, clearly demonstrating the efficacy of the modality and the clinical significance of data obtained. These functional changes replicate cardiac perfusion to the segments supplied by respective vessels and its effect with reperfusion or ballooning. The slight increase in GLS from baseline to post-intervention was not statistically significant, which could be attributed to the confounding factors. Analyzing our data, we can safely conclude that GLS is potentially a sensitive, temporal, and quantitative tool for identifying patients with acute ischemia with its limitations and need for further perfection of this modality. Therefore, GLS assessments on 2D echo can be used for risk stratification of patients with subacute to chronic chest pain concerning for ischemia in addition to EKG, troponins and other data obtained by non-invasive testing and evaluation.

Targeting T regulatory (Treg) cells in immunotherapy-resistant cancers.

Primary or secondary (i.e., acquired) resistance is a common occurrence in cancer patients and is often associated with high numbers of T regulatory (Treg) cells (CD4+CD25+FOXP3+). The approval of ipilimumab and the development of similar pharmacological agents targeting cell surface proteins on Treg cells demonstrates that such intervention may overcome resistance in cancer patients. Hence, the clinical development and subsequent approval of Cytotoxic T Lymphocyte Antigen-4 (CTLA-4) targeting agents can serve as a prototype for similar agents. Such new agents aspire to be highly specific and have a reduced toxicity profile while increasing effector T cell function or effector T/T regulatory (Teff/Treg) ratio. While clinical development with large molecules has shown the greatest advancement, small molecule inhibitors that target immunomodulation are increasingly entering early clinical investigation. These new small molecule inhibitors often target specific intracellular signaling pathways [e.g., phosphoinositide-3-kinase delta (PI3K-δ)] that play an important role in regulating the function of Treg cells. This review will summarize the lessons currently applied to develop novel clinical agents that target Treg cells.

Association of blood donor characteristics with in vitro platelet storage properties.

BACKGROUND AND OBJECTIVE: The study was planned to determine the association of blood donor characteristics with in vitro quality of platelets. MATERIAL AND METHODS: In the prospective observational study, a total of 85 male whole blood donors in the age group of 18-30 and 45-65 years were enrolled using purposive sampling method. Serum total cholesterol, glycosylated hemoglobin (HbA1c), and LDH levels were performed on donor pre-donation sample. Buffy coat platelet concentrates were prepared from 450 mL quadruple blood bags. Samples from platelets were taken on day one and five of storage and biochemical properties were observed. RESULTS: Median MPV was higher in platelets from older blood donors on day five (9.8 vs 9.4, p = 0.037). Median LDH levels were also higher in platelets on day one and five from older donors (Day one: 204.5 vs 147, p = <0.000; day five: 278 vs 224, p = 0.001 respectively). Platelets from donors with high HbA1c levels had lower median pH (Day one: 7.31 vs 7.37, p = 0.024) and higher median glucose levels on day one of storage (Day one: 358 vs 311, p = 0.001). Higher median lactate levels throughout the storage period were also seen in platelets from donors with higher HbA1c levels (Day one: 7 vs 5.7, p = 0.037; Day five: 16 vs 12.2, p = 0.032). Glucose consumption (108 vs 66, p = 0.025) and lactate production (9 vs 6.4, p = 0.019) was higher in platelets from donors with higher HbA1c levels. CONCLUSION: In vitro platelet storage properties are affected by blood donor characteristics.

Effect of double dose plateletpheresis on target yield and donor platelet recovery

Abstract Introduction The demand for apheresis platelets has increased in the recent past and the shrinking donor pool has shifted the trend to collection of double-dose or higher yield of platelets. Objective The present study aimed to determine the effect of double-dose plateletpheresis on the target yield and donor platelet recovery. Methods The study was conducted on 100 healthy plateletpheresis donors, 50 of whom were in the study group, which underwent double-dose plateletpheresis (DDP), and 50 of whom were in the control group for single-donor plateletpheresis. Pre- and post-procedure samples of donors were subjected to a complete blood count. The DDP product was sampled for platelet yield and then split into two parts. Platelet yield, collection efficiency, collection rate, recruitment factor and donor platelet loss were calculated. Results The mean platelet yield in the SDP was 4.09 ± 1.15 × 1011 and in the DDP, 5.93 ± 1.04 × 1011. There was a significant correlation between the pre-donation platelet count and platelet yield. The total of platelets processed for the SDP were 5.42 ± 1.08 × 1011 and for the DDP, 7.94 ± 0.77 × 1011. The collection efficiency was 71.93 ± 25.14% in the SDP and 72.94 ± 16.28% in the DDP, while the collection rates were 0.78 × 1011 and 0.94 × 1011 per minute, respectively. The average recruitment factor observed was 0.98 in the SDP, while it was 0.99 in the DDP. The mean platelet loss observed in the SDP was 35.55 ± 8.53% and in the DDP, 37.76 ± 8.65%. Conclusion The double-dose plateletpheresis supplements the platelet inventory in developing countries where the apheresis donor pool is limited. It is prudent to ensure stringent donor selection criteria for donors donating high-yield platelet products, thus enhancing donor safety and retention.

Julolidine-hydrazone based chemosensor for detection of Zn2+: Fluorescent in-situ formed Zn2+ complex discriminates PPi from ADP and ATP.

In the present investigation, we have designed and synthesised Zn2+ sensitive Julolidine-hydrazone (JSB) based chemosensor, which crystallised in a monoclinic crystal system with P21/c space group. The bare JSB was nonemissive, but in the presence of Zn2+ ions in solution it showed emission, ascribed to the chelation enhanced emission process, which is also utilised to detect Zn2+ in water samples. Comparing the chromaticity coordinates deduced from the emission colors of the JSB-Zn2+ in solution, powder and hybrid polymer thin film, using CIE (Commission Internationale de I'Eclairage 1931) chromaticity diagram, it was found that compared to the emission of the solution, the emission of the powder was red shifted, while that of the thin film was blue shifted. Further, the sensing of Zn2+ showed reversibility in the presence of pyrophosphate (PPi), which allowed quantification of PPi. Interestingly, in addition to the detection of PPi using the in-situ formed JSB-Zn2+ complex, the process was selective and discriminated PPi from ADP and ATP. The detection of PPi was rationalized via a decomplexation reaction, and translated in the construction of INHIBIT logic gate. Additionally, the possible use of the JSB coated sensor paper for the on-site detection of Zn2+ and subsequent JSB-Zn2+ complex for PPi ions has been demonstrated. The experimental results showed good correlation with the theoretical calculations wherever possible.

Analyte Detection: A Decade of Progress in the Development of Optical/Fluorescent Sensing Probes.

The development of selective and sensitive chemical sensors capable of detecting metal ions, anions, neutral species, explosives and hazardous substances, selectively and sensitively has attracted considerable interest of various research groups. The presence of such analytes within the permissible limits is often beneficial, but the excess amounts may lead to lethal effects to both the environment as well as the living organisms. Owing to the toxicity of the heavy metal ions, toxic anions and nitro-aromatics which are main constituents of explosives, the timely detection of these materials is most desirable to ensure safety and security of the mankind. In this personal account, we present several classes of molecular sensors that were specifically designed in our lab during the past decade for detecting several species in solutions, solid state as well as biological media. Modulation of the optical properties in response to the presence of guest species, led to selective and sensitive detection protocols, and was supported by the theoretical studies wherever possible. We have also extended the application of some of these probes for the on-site detection of analytes by developing the paper strips, glass slides and even the wool and cotton fabrics loaded with probes. One such development represents detection of palladium in human urine and blood samples collected from clinical samples. Additionally, the sensing events in some cases have successfully been reproduced in the live cancer cells. Based on the ease and cost-effective synthesis of the molecular probes, we hope that this account shall provide significant information to researchers in understanding the structure dependent sensing capabilities of the molecular probes.

Revisiting the impact of serial therapeutic phlebotomy in polycythaemia on laboratory and clinical parameters using a fixed interval and fixed volume protocol.

OBJECTIVES: Therapeutic phlebotomy allows for a controlled and gradual decrease in red cell mass leading to improved blood flow and symptomatic relief in polycythaemia. The present study was aimed to determine the impact of serial fixed volume and fixed interval therapeutic phlebotomy protocol on the laboratory and clinical parameters in patients of polycythaemia. MATERIAL AND METHODS: This prospective longitudinal study was conducted over 18 months. The desired haematocrit for polycythemia vera and secondary polycythemia was 45% and 52% respectively. A fixed volume of 350 ml phlebotomy was performed every-three days till the achievement of desired haematocrit. Complete blood count was performed before and after each procedure and iron studies were done at the time of enrolment and after the achievement of desired haematocrit. Post-procedure symptomatic relief was assessed by a 10-point visual analogue scale (VAS). RESULTS: Of the 29 patients enrolled in the study, 3 patients were lost to follow up and data of 26 patients was analyzed. Mean Hb declined from 17.84 ± 1.88 gdL-1 to 14.67 ± 1.14 gdL-1 (p < 0.001) and mean haematocrit decreased from a baseline of 57.11 ± 5.47% to 46.27 ± 3.763% (p < 0.001) upon achievement of desired haematocrit. There was a significant decline in serum iron from the baseline of 132.85 ± 94.136 µg dL-1 to 69.41 ± 58.643 µg dL-1 at desired haematocrit. A significant change in VAS score of almost all clinical parameters was observed. Post phlebotomy hematocrit correlated negatively with the number of procedures (p = 0.015). CONCLUSION: Our protocol yielded rapid and marked improvement in patients of primary and secondary polycythemia with minimal adverse events and significant amelioration of clinical parameters.

Thiazolothiazole based donor-π-acceptor fluorophore: Protonation/deprotonation triggered molecular switch, sensing and bio-imaging applications.

Stimuli modulated photophysical properties of a new asymmetric multifunctional molecular probe, 2-(pyren-1-yl)-5-(pyridin-4-yl)thiazolo [5,4-d]thiazole (PYTZ-P) bearing electron-rich pyrene and electron-deficient pyridine units linked through a π-conjugated thiazolo [5,4-d]thiazole (TTz) bridge are reported. Its sensitivity towards protons (TFA) in solution is manifested in the form of bathochromically shifted emission that spreads all over the visible region, and is related to the increased acceptor strength of pyridine upon protonation and subsequent enhanced magnitude of intramolecular charge-transfer in the probe. Similar modulation of the luminescence behaviour of the probe was also observed in the solid state. These observations are well rationalised by the theoretical calculations. The applicability of the sensitivity of the probe towards TFA has been demonstrated by developing the ready-to-use portable paper strips. Furthermore, PYTZ-P showed different acid/base induced absorption/emission switching property. Interestingly, when the response of the probe was noted in the presence of several cations, modulation of the electronic properties was observed only in the presence of Hg2+ ions, with the lowest detection limit of 8.43 × 10-8 M. Additionally, the sensitivity of the probe towards TFA and Hg2+ ions in solution and solid states is convincingly mimicked in the fluorescence imaging of HeLa and A375 cancer cells.

A fluorene based probe: Synthesis and "turn-on" water sensitivity of the in-situ formed Cu2+ complex: Application in bio-imaging.

A new fluorene based probe (FTH) has been evaluated for its photo-physical properties in solution as well as in the aggregated state/viscous environment. Addition of a poor solvent (water) to the solution of the probe in a good (acetonitrile) solvent significantly enhanced the otherwise weak emission due to aggregation induced emission (AIE). The emission enhancement is also related to the increase in viscosity of the solution, leading to the restricted intramolecular rotation of the peripheral (phenyl) groups. Interestingly, the emission behaviour of the non-emissive in-situ formed Cu2+ complex is drastically modulated in the presence of water. The solution of the putative Cu2+ complex of the probe turns highly emissive (yellow colour) upon addition of a small fraction of water (up to 7.6 wt %), but the yellow emission diminishes upon increasing higher water fraction. We propose that the initially formed Cu2+ complex undergoes hydrolysis in the presence of higher water content releasing the free amine possessing the diaryl amino rotors thus rendering the solution non-emissive. Thus the current probe being reported herein discloses its potential to generate trace water sensitive turn-on Cu2+ complex. Additionally, the bio-imaging potential of FTH for live cancer cells and its sensitivity towards intracellular presence of Cu2+ ions has been demonstrated.

Utility of reticulocyte haemoglobin content and immature reticulocyte fraction in early diagnosis of latent iron deficiency in whole blood donors.

BACKGROUND AND OBJECTIVES: The present study was planned to assess the clinical utility of reticulocyte haemoglobin content (CHr) and immature reticulocyte fraction (IRF) in the early detection of latent iron deficiency in blood donors. MATERIALS AND METHODS: The prospective longitudinal observational study was conducted using the purposive sampling method. Written informed consent was obtained and donors were allocated into the first-time (FTD) and regular donor (RD) group. The enrolled blood donors (n = 205 in each group) were followed up for two subsequent whole blood donations. Haemoglobin (Hb), CHr, IRF and serum ferritin values were recorded at enrolment and two follow-ups. RESULTS: The sensitivity of CHr in detecting iron-deficient erythropoiesis (serum ferritin values ≤ 26 µg/dl) was 45% and 56.7%, specificity 96.7%, positive predictive value (PPV) 85.6% and 90.8% and negative predictive value (NPV) 80.1% and 78.7%, respectively in FTD and RD cohorts. The sensitivity of IRF was 45.1% and 44.8%, specificity 93.4% and 97.1%, PPV 74.8% and 90.4% and NPV 79.6% and 74.5%, respectively in both the cohorts. The sensitivity of CHr in detecting absent iron stores (serum ferritin values ≤ 15 µg/dl) was 66.2% and 74.4%, specificity 92% and 90.6%, PPV 56.7% and 68.7% and NPV 94.5% and 92.8% among FTD and RD cohort, respectively. The sensitivity of IRF was 72.7% and 65.3%, specificity 90.3% and 94.3%, PPV 54.4% and 76% and NPV 95.4% and 90.8%, respectively in both the cohorts. CONCLUSION: Reticulocyte hemoglobin content and IRF can be used along with complete blood count for early detection of iron deficiency in blood donors using the same blood sample at no extra cost.

Assessment of serum iron stores in regular plateletpheresis donors.

BACKGROUND: Iron deficiency anaemia is the most common nutritional deficiency disorder in the world. Iron deficiency is a potential complication in repeated apheresis donation. The present study was aimed to evaluate serum iron stores in regular plateletpheresis donors. MATERIALS AND METHODS: A total of 60 donors were included in this study, which included 30 regular plateletpheresis donors as cases and controls were 30 first time donors. The donor samples were collected before donation for complete hemogram, transfusion transmissible infections screening and serum iron, total iron binding capacity, percentage saturation of transferrin and serum ferritin. RESULTS: Out of 60 donors, more than half of the donors (56.6 %) had serum ferritin less than 30 ng/mL. Out of these 34 donors, 25 were from the case group and 9 donors in the control group. The median serum ferritin level in cases and controls was 11.86 ng/mL (Interquartile range 4.18-17.34 ng/mL) and 37.92 ng/mL (Interquartile range 27.87-86.20 ng/mL) respectively (p < 0.001). The mean serum iron in cases and controls was 71.23 ± 31.32 µg/dL and 93.53 ± 33.53 µg/dL respectively (p = 0.016). The mean percentage saturation in cases and controls was 20.09 ± 9.31 % and 26.26 ± 9.03 % respectively (p = 0.012). A significant decline in mean serum ferritin with increase in number of annual donations and decrease in donation interval was observed. DISCUSSION: Regular plateletpheresis donation may lead to depletion of iron stores and subclinical iron deficiency. Donors with high platelet count are more likely to exhibit iron deficiency. Periodic serum ferritin estimation in donors participating in regular plateletpheresis donation is warranted.

Hepcidin as a diagnostic marker of iron deficiency in blood donors.

BACKGROUND: Blood donors are prone to have iron deficiency. The aim of this study was to determine utility of serum hepcidin as an indicator of iron deficiency in blood donors. METHODS: A total of 200 voluntary, healthy blood donors were included in the study. Donors were categorized into four groups according to the donation frequency. Group I: (n = 50) who donated for the first time, or those who have not donated in the past 2 years (reactivated donors). Group II: (n = 50), who donated blood for the second time and had donated once in the previous 12 months. Group III: (n = 50), who donated blood for third time and had donated twice in the previous 12 months. Group IV: (n = 50) who donated blood for the fourth time and had donated thrice in the previous 12 months. Sera of study participants were evaluated for serum ferritin and serum hepcidin levels based on enzyme linked immunosorbent assay. RESULTS: Serum hepcidin concentration ranged 2.36-15734 pg/mL. Serum hepcidin and serum ferritin were found to be lowest in group IV donors. When serum ferritin concentration of less than 15 ng/mL was considered as gold standard for diagnosing iron deficiency, AUCROC for serum hepcidin as a diagnostic test of iron deficiency was found to be 0.715. Serum hepcidin showed statistical significant correlation with donation frequency(p = 0 .005) and serum ferritin (p = 0.01). Sensitivity and specificity of serum hepcidin was found to be 77.8 %, 79.6 % respectively. CONCLUSION: Effectiveness of Serum hepcidin as a diagnostic marker of iron deficiency still needs to be determined.

Utility of screening tools to differentiate beta thalassemia trait and iron-deficiency anemia - do they serve a purpose in blood donors?

BACKGROUND: The aim of this study was to estimate the prevalence of the beta thalassemia trait (BTT) and differentiate it from iron-deficiency anemia (IDA) among blood donors. METHODS: A total of 1,000 samples from blood donors were subjected to complete hemogram with red blood cell indices. Further, Mentzer index (MI) was calculated for samples with mean corpuscular volume (MCV) below 80 fL and mean corpuscular hemoglobin (MCH) below 27 pg. Samples with Mentzer index ＜12 were subjected to naked-eye single-tube red cell osmotic fragility test (NESTROFT) followed by hemoglobin electrophoresis in positive cases. Serum ferritin was assessed in NESTROFT-negative cases. RESULTS: The prevalence of BTT among blood donors was 3.7% and that of microcytosis among donors was 8.6%. The prevalence of BTT among microcytic donors was 41.8% while that among those with IDA was 11.6%. A value of MI ＜13 was highly sensitive in the diagnosis of BTT. MI ＞13 was found to have both high specificity and high sensitivity for diagnosing IDA. CONCLUSION: A moderately high prevalence of BTT was observed among blood donors. Presently, no screening program is mandatory for screening of BTT among blood donors. Indices like MCV, MCH, and Mentzer Index were thus found to be effective to screen for BTT and IDA among blood donors, and NESTROFT was a cost-effective mass screening method to differentiate BTT and IDA.

Application of tpsDig2 Software in Nasal Angle Measurements.

INTRODUCTION AND OBJECTIVES: Nose is considered to be a conspicuous feature of human face. Its different parameters like shape, size, nasal angles etc may indicate one's gender, age, race, adapted climatic conditions, and the environment to which one belongs to. Furthermore, it is an important component and determinant of an individual's physical outlook and appearance. The current study provides a new approach for the assistance of anthropologists and forensic experts in human identification and sex determination from the nasal angles. METHODOLOGY: The study was performed on a total of 500 subjects (250 males and 250 females) belonging to north India (Mandi, Himachal Pradesh State). In comparison to the classical and manual methods for nasal angle measurements, an automated approach was followed in the present study. A Windows-based software called tpsDig2 was used for nasal angle measurements by utilization of the landmarks (nasion, pronasale, subnasale, and alare). Three nasal angles (nasal prominence angle, inter-alar angle, and nasal tip angle) were measured in all the subjects and each measurement was repeated thrice to reduce the measurement error and increase the specificity and efficiency of the results. Discriminant function statistics was used for determination of sex from different nasal angles. RESULTS AND CONCLUSION: The results of the statistical analysis (ANOVA) performed using SPSS reveal the significant difference between males and females in all the 3 repeated measurements of nasal angles. The final discriminant classification statistics show that 64% of original grouped cases have been correctly classified and the designed statistical model can be used in several forensic scenarios for the sex determination on the basis of the available nasal angles. The study may be further useful in the identification cases pertaining to facial reconstruction. The investigation may also be helpful in providing specific correlation of the nasal angles with the other parts of the face in the cases of remodelling and reformation of craniofacial alterations and reconstructions in plastic surgery and aesthetics.

Aggregation tailored emission of a benzothiazole based derivative: photostable turn on bioimaging.

Herein, we report a benzothiazole based probe which exhibits aggregation induced emission in mixed solvents, v/v THF : water system. The blue emission observed in the solution is ascribed to the enolic emission of the excited state intramolecular proton transfer (ESIPT) prone benzothiazole chromophore, as the aggregation induced by the protic solvent, water, is expected to restrict the phototautomerization of the probe to the keto form which generally emits in the red region. However, the green emission observed in the solid aggregated state is ascribed to its keto emission, as in the solid state the ESIPT process is activated owing to stable intramolecular hydrogen bonding, giving a keto-aggregation induced emission (AIE) coupled emission. The aggregation process is evident from the particle size and the change in morphology predicted by dynamic light scattering (DLS) and scanning electron microscopy (SEM) respectively, in the aggregated state. Interestingly, the emission in the solution, as well as the solid state, is convincingly mimicked in the fluorescence imaging of various live cancer cells and plant roots.

CNS Efficacy of Osimertinib in Patients With T790M-Positive Advanced Non-Small-Cell Lung Cancer: Data From a Randomized Phase III Trial (AURA3).

Purpose In patients with epidermal growth factor receptor ( EGFR) mutation-positive advanced non-small-cell lung cancer (NSCLC), there is an unmet need for EGFR-tyrosine kinase inhibitors with improved CNS penetration and activity against CNS metastases, either at initial diagnosis or time of progression. We report the first comparative evidence of osimertinib CNS efficacy versus platinum-pemetrexed from a phase III study (AURA3; ClinicalTrials.gov identifier: NCT02151981) in patients with EGFR T790M-positive advanced NSCLC who experience disease progression with prior EGFR-tyrosine kinase inhibitor treatment. Methods Patients with asymptomatic, stable CNS metastases were eligible for enrollment and were randomly assigned 2:1 to osimertinib 80 mg once daily or platinum-pemetrexed. A preplanned subgroup analysis was conducted in patients with measurable and/or nonmeasurable CNS lesions on baseline brain scan by blinded independent central neuroradiological review. The CNS evaluable for response set included only patients with one or more measurable CNS lesions. The primary objective for this analysis was CNS objective response rate (ORR). Results Of 419 patients randomly assigned to treatment, 116 had measurable and/or nonmeasurable CNS lesions, including 46 patients with measurable CNS lesions. At data cutoff (April 15, 2016), CNS ORR in patients with one or more measurable CNS lesions was 70% (21 of 30; 95% CI, 51% to 85%) with osimertinib and 31% (5 of 16; 95% CI, 11% to 59%) with platinum-pemetrexed (odds ratio, 5.13; 95% CI, 1.44 to 20.64; P = .015); the ORR was 40% (30 of 75; 95% CI, 29% to 52%) and 17% (7 of 41; 95% CI, 7% to 32%), respectively, in patients with measurable and/or nonmeasurable CNS lesions (odds ratio, 3.24; 95% CI, 1.33 to 8.81; P = .014). Median CNS duration of response in patients with measurable and/or nonmeasurable CNS lesions was 8.9 months (95% CI, 4.3 months to not calculable) for osimertinib and 5.7 months (95% CI, 4.4 to 5.7 months) for platinum-pemetrexed; median CNS progression-free survival was 11.7 months and 5.6 months, respectively (hazard ratio, 0.32; 95% CI, 0.15 to 0.69; P = .004). Conclusion Osimertinib demonstrated superior CNS efficacy versus platinum-pemetrexed in T790M-positive advanced NSCLC.

Development of Human Face Literature Database Using Text Mining Approach: Phase I.

The face is an important part of the human body by which an individual communicates in the society. Its importance can be highlighted by the fact that a person deprived of face cannot sustain in the living world. The amount of experiments being performed and the number of research papers being published under the domain of human face have surged in the past few decades. Several scientific disciplines, which are conducting research on human face include: Medical Science, Anthropology, Information Technology (Biometrics, Robotics, and Artificial Intelligence, etc.), Psychology, Forensic Science, Neuroscience, etc. This alarms the need of collecting and managing the data concerning human face so that the public and free access of it can be provided to the scientific community. This can be attained by developing databases and tools on human face using bioinformatics approach. The current research emphasizes on creating a database concerning literature data of human face. The database can be accessed on the basis of specific keywords, journal name, date of publication, author's name, etc. The collected research papers will be stored in the form of a database. Hence, the database will be beneficial to the research community as the comprehensive information dedicated to the human face could be found at one place. The information related to facial morphologic features, facial disorders, facial asymmetry, facial abnormalities, and many other parameters can be extracted from this database. The front end has been developed using Hyper Text Mark-up Language and Cascading Style Sheets. The back end has been developed using hypertext preprocessor (PHP). The JAVA Script has used as scripting language. MySQL (Structured Query Language) is used for database development as it is most widely used Relational Database Management System. XAMPP (X (cross platform), Apache, MySQL, PHP, Perl) open source web application software has been used as the server.The database is still under the developmental phase and discusses the initial steps of its creation. The current paper throws light on the work done till date.

Integrating a Profile of Frontal Face With Its Mirror Image for Facial Reconstruction.

INTRODUCTION AND OBJECTIVES: Face recognition plays an important role in the field of biometrics, bioinformatics, and forensic identification. Human faces appear bilaterally symmetric. However, asymmetry is a norm in the human body and careful morphological and metric examination of the human face gives an exact idea of the asymmetry present in the face of an individual. Most of the studies on asymmetry of human face have been carried out with regard to evaluation of expressions in psychology, anthropology, and biometrics. In this preliminary study, an idea of the human face symmetry has been used for complete facial reconstruction. Sometimes, in the CCTV cameras and other surveillance systems, the complete face is not visible, but only a half of the frontal face is detectable. In all such cases, the mirror image of the face can be used to reconstruct the complete face of the person in question for representation-based face recognition. In previous studies related to forensic identification and in the discipline of computer science, mirror images have only been used to overcome and deal with the problem of nonsufficient training sample and have not been used for the reconstruction of the full facial profile. METHODOLOGY: In this article, we present a computerized methodology to generate the mirror image from one frontal half of the face (either left or right) and merging the both (input image and generated mirror image) halves to create the full face. The program was designed using METLAB computer program. This procedure is very simple, less time-consuming, and computationally efficient. RESULTS AND CONCLUSION: The results have been presented with regard to generate a complete face in those cases where only one frontal profile, that is, left or right sides of the face is available for examination. The scenario is commonly seen in those cases also where shadow almost hides one half of the face. The proposed methodology would also be useful for improving other facial reconstruction and recognition methods in forensic identification and in other medical fields such as plastic surgery, where creating full face still poses a technical challenge to a plastic surgeon. Some challenges, limitations, and future perspectives of the method have also been discussed in the article.

Segregation of blood inventory: A key driver for optimum blood stock management in a resource-poor setting.

BACKGROUND: Blood inventory management entails maintaining a delicate balance between guaranteeing blood availability and minimizing wastage. The study was conducted to identify and analyze various factors of wastage which can provide insight to ideal inventory management, thus help in formulating policies and improve efficiency of blood transfusion services. MATERIALS AND METHODS: The study was conducted in a tertiary care hospital. To determine various causes of wastage, a retrospective analysis was done over 6 months and preventive strategies adopted. Issuable stock index (ISI) and wastage as percentage of issue (WAPI) were used to compare the effect on blood inventory before and after adoption of strategies. The average number of times each ABO group and Rh type was crossmatched before final transfusion was calculated and compared for randomly selected units over the first 6 months of 2012 and 2013. RESULTS: Outdating was found to be the largest cause, and decrease in discarding rate was observed after adoption of strategies. Mean ISI for different study periods was comparable. However, significant decrease (P = 0.015) was observed for WAPI and WAPI with respect to outdating. Significant decrease in average number of times a unit was crossmatched before final transfusion for all positive blood groups and O-negative blood group was observed over corresponding first 6 months of 2012 and 2013. CONCLUSION: Division of inventory into two parts, enlistment of soon to outdate blood components, and reduction of holding of blood units to minimum period for elective surgery patients are simple measures which can minimize wastage.