Evaluation of the outcome of right subumbilical transverse incision approach for the management of complicated appendicitis in paediatric age group - A multi-institutional retrospective study.

Aim: The aim is to evaluate the outcome of right subumbilical transverse incision approach for the management of complicated appendicitis in paediatric age group. Materials and Methods: This is a retrospective multi-institutional study which was conducted in the Department of Paediatric Surgery, I Q City Medical College and Hospital, Durgapur, West Bengal, India and the Department of Paediatric Surgery, Rajiv Gandhi Super Speciality Hospital/Raichur Institute of Medical Sciences, Raichur, Karnataka, India. In this study, a review of 77 paediatric patients operated for complicated appendicitis using a right subumbilical transverse incision approach was done for a period of 3 years (from December 2017 to December 2020). All patients had proven complicated appendicular pathology like appendicular perforation, appendicular abscess or complicated appendicular lumps on ultrasonography or computed tomography scan, which mandated exploration. Results: There was no mortality. Average operative time was 1 h 48 min (ranging from 58 min to 3 h 12 min). Average length of hospital stay was 9 days (ranging from 5 days to 13 days). There was no incidence of fecal fistula. Seventeen (22%) patients developed superficial surgical site infection which subsided with regular dressings. There was no incidence of wound dehiscence or burst abdomen. Five (6.5%) patients required the incision to be extended beyond the midline to the left side to deal with the pathology and to access the entire peritoneal cavity. Nine (11.6%) patients required loop ileostomies, which was fashioned on the lateral aspect of the transverse incision. Only one patient had a doubtful caecal injury which was repaired and loop ileostomy was done. Six patients (7.7%) had adhesive intestinal obstruction postoperatively, of which three required re-exploration. There was no incidence of incisional hernia or any stoma-related complications. Conclusion: Complicated appendicitis is a condition which lacks standardisation of approach for management, and is inherently associated with complications. However, with a more logical incision and intra-operative approach we can keep the complications to minimum and improve outcomes to great extent in those patients requiring surgical intervention. We have been using the subumbilical transverse incision in all sizes of patients ranging from small children to adolescents with excellent results, and we believe that the same approach can be applied even in adult patients in similar clinical scenarios.

Mastering the Trans-Labrynthine Approach to Internal Acoustic Meatus: A Cadaveric Temporal Bone Study.

The Trans-labrynthine approach, through Otic capsule gives direct approach to the cerebellopontine angle (CPA) and internal auditory meatus (IAM) with preservation of the facial nerve. Mastering the approach to IAM in a cadaver with anatomical landmarks is important to the budding Otologist & Neurotologist to approach the CPA with functional preservation of the Facial nerve in patients with Vestibular Schwannoma & other procedures. Transitioning surgical skills and anatomic knowledge from surgical anatomy textbooks and laboratory training to the operative room is challenging. 30 adult wet human cadaveric temporal bones were studied by performing Trans-labrynthine approach to the IAM by using ZEISS microscope in a temporal bone dissection lab. Photographs were taken by HD phone camera, imported into computer & labeled the anatomical landmarks. Wide exposure & 3D visualization of complex anatomical landmarks were noted in each step by step approach from basic to advanced procedure of Trans-labrynthine approach to IAM. The step by step approach to the IAM from basic to advanced procedure in a cadaveric temporal bone offers great orientation & opportunity to become a master of the complex surgical anatomy of IAM and in acquiring a 3D orientation of the critical structures.

Functional and biotechnological cues of potassium homeostasis for stress tolerance and plant development.

Potassium (K+) is indispensable for the regulation of a plethora of functions like plant metabolism, growth, development, and abiotic stress responses. K+ is associated with protein synthesis and entangled in the activation of scores of enzymes, stomatal regulation, and photosynthesis. It has multiple transporters and channels that assist in the uptake, efflux, transport within the cell as well as from soil to different tissues, and the grain filling sites. While it is implicated in ion homeostasis during salt stress, it acts as a modulator of stomatal movements during water deficit conditions. K+ is reported to abate the effects of chilling and photooxidative stresses. K+ has been found to ameliorate effectively the co-occurrence of drought and high-temperature stresses. Nutrient deficiency of K+ makes leaves necrotic, leads to diminished photosynthesis, and decreased assimilate utilization highlighting the role it plays in photosynthesis. Notably, K+ is associated with the detoxification of reactive oxygen species (ROS) when plants are exposed to diverse abiotic stress conditions. It is irrefutable now that K+ reduces the activity of NADPH oxidases and at the same time maintains electron transport activity, which helps in mitigating the oxidative stress. K+ as a macronutrient in plant growth, the role of K+ during abiotic stress and the protein phosphatases involved in K+ transport have been reviewed. This review presents a holistic view of the biological functions of K+, its uptake, translocation, signaling, and the critical roles it plays under abiotic stress conditions, plant growth, and development that are being unraveled in recent times.

Genome-wide identification and multiple abiotic stress transcript profiling of potassium transport gene homologs in Sorghum bicolor.

Potassium (K+) is the most abundant cation that plays a crucial role in various cellular processes in plants. Plants have developed an efficient mechanism for the acquisition of K+ when grown in K+ deficient or saline soils. A total of 47 K+ transport gene homologs (27 HAKs, 4 HKTs, 2 KEAs, 9 AKTs, 2 KATs, 2 TPCs, and 1 VDPC) have been identified in Sorghum bicolor. Of 47 homologs, 33 were identified as K+ transporters and the remaining 14 as K+ channels. Chromosome 2 has been found as the hotspot of K+ transporters with 9 genes. Phylogenetic analysis revealed the conservation of sorghum K+ transport genes akin to Oryza sativa. Analysis of regulatory elements indicates the key roles that K+ transport genes play under different biotic and abiotic stress conditions. Digital expression data of different developmental stages disclosed that expressions were higher in milk, flowering, and tillering stages. Expression levels of the genes SbHAK27 and SbKEA2 were higher during milk, SbHAK17, SbHAK11, SbHAK18, and SbHAK7 during flowering, SbHAK18, SbHAK10, and 23 other gene expressions were elevated during tillering inferring the important role that K+ transport genes play during plant growth and development. Differential transcript expression was observed in different tissues like root, stem, and leaf under abiotic stresses such as salt, drought, heat, and cold stresses. Collectively, the in-depth genome-wide analysis and differential transcript profiling of K+ transport genes elucidate their role in ion homeostasis and stress tolerance mechanisms.

Improvement of small seed for big nutritional feed.

Exploding global population, rapid urbanization, salinization of soils, decreasing arable land availability, groundwater resources, and dynamic climatic conditions pose impending damage to our food security by reducing the grain quality and quantity. This issue is further compounded in arid and semi-arid regions due to the shortage of irrigation water and erratic rainfalls. Millets are gluten (a family of proteins)-free and cultivated all over the globe for human consumption, fuel, feed, and fodder. They provide nutritional security for the under- and malnourished. With the deployment of strategies like foliar spray, traditional/marker-assisted breeding, identification of candidate genes for the translocation of important minerals, and genome-editing technologies, it is now tenable to biofortify important millets. Since the bioavailability of iron and zinc has been proven in human trials, the challenge is to make such grains accessible. This review encompasses nutritional benefits, progress made, challenges being encountered, and prospects of enriching millet crops with essential minerals.

Preliminary investigation of drug impurities associated with the anti-influenza drug Favipiravir - An insilico approach.

The role of repurposed or modified antiviral drugs has become more significant during the current global pandemic of SARS Covid-19. In the present study, four structurally analogous impurity molecules of antiviral drug Favipiravir are selected for preliminary computational investigation for assessing the structure-activity relationship. The optimized geometry and the electronic structures of the compounds are computed using Density Functional Theory as a precursor to evaluating their physical, chemical and spectral properties. The frontier orbitals analysis is performed to obtain global reactivity parameters namely, the chemical potential, absolute electronegativity, global softness, global hardness, electrophilicity, etc. The natural Bond Orbital (NBO) analysis and Mulliken analysis provided an understanding of the charge-transfer interactions of molecules. The possibilities of intermolecular interactions of the drug systems with the receptors are also visualized using the electrostatic potential maps (MEP) derived from the DFT computations. The physiochemical properties are assessed computationally using SwissADME webtool to correlate the structural aspects of the compounds with their biological responses. Useful parameters namely flexibility, lipophilicity, size, polarity, solubility and saturation were also computed to evaluate the therapeutic activity or drug-likeness.

Evaluation of BenzoDODA grafted polymeric resin for rapid and reliable assaying of plutonium in sediment samples.

The paper reports a new rapid radioanalytical procedure for the determination of plutonium (Pu) in sediments by solid phase extraction chromatography (SPEC) using Bis-(2-ethylhexyl) carbamoyl methoxy phenoxy-bis-(2-ethylhexyl) grafted resin, abbreviated as Benzodioxodiamide (BenzoDODA) grafted resin. The resin was synthesized and evaluated for its sorption behaviour towards Pu in batch and column mode to determine its efficacy for selective recovery of Pu from sediment samples. The analytical procedure was based on the radiochemical separation of samples by acid digestion, followed by preconcentration of actinides by co-precipitation with Fe(OH)3 and finally selective recovery of Pu by SPEC using a column filled with BenzoDODA grafted resin. Pu was then radiometrically assayed by preparing alpha disc sources with electro-deposition followed by alpha spectrometry. The method was further validated with IAEA reference materials. This method gives reliable and reproducible results for the activity concentration of Pu in sediment samples within 24 h.

An insight into the role of silicon on retaliation to osmotic stress in finger millet (Eleusine coracana (L.) Gaertn).

Finger millet, a vital nutritional cereal crop provides food security. It is a well-established fact that silicon (Si) supplementation to plants alleviates both biotic and abiotic stresses. However, precise molecular targets of Si remain elusive. The present study attempts to understand the alterations in the metabolic pathways after Si amendment under osmotic stress. The analysis of transcriptome and metabolome of finger millet seedlings treated with distilled water (DW) as control, Si (10 ppm), PEG (15%), and PEG (15%) + Si (10 ppm) suggest the molecular alterations mediated by Si for ameliorating the osmotic stress. Under osmotic stress, uptake of Si has increased mediating the diversion of an enhanced pool of acetyl CoA to lipid biosynthesis and down-regulation of TCA catabolism. The membrane lipid damage reduced significantly by Si under osmotic stress. A significant decrease in linolenic acid and an increase of jasmonic acid (JA) in PEG + Si treatment suggest the JA mediated regulation of osmotic stress. The relative expression of transcripts corroborated with the corresponding metabolites abundance levels indicating the activity of genes in assuaging the osmotic stress. This work substantiates the role of Si in osmotic stress tolerance by reprogramming of fatty acids biosynthesis in finger millet.

Does Endoscopic Sinus Surgery (ESS) Retrieve Mucociliary Clearance of Maxillary Sinus: Prospective Study at a Tertiary Care Hospital.

To correlate Saccharin clearance time before and after endoscopic sinus surgery (ESS) in chronic maxillary sinusitis patients. Hospital based prospective study done in the department of otorhinolaryngology at our tertiary care hospital from January 2017 to December 2017. We selected 40 patients based on inclusion and exclusion criteria. Saccharin clearance time was measured by the subjective perception of sweet taste following placement of saccharin pellet over the anterior end of inferior turbinate. It was measured preoperatively and postoperatively after 3 months of ESS and the values are compared with normal uninvolved sinuses of the patients. Out of 40 patients, 26 were male and 14 were female. Normal Saccharin Clearance Time was found to be 9.50 and 9.89 min with a standard deviation of 2.76 and 2.62 on the left and right side respectively. There was no significant difference between right and left side mucociliary clearance values. The respective mean preoperative and postoperative mucociliary clearance values of right and left side together were 39.5 min and 17.6 min among unilateral maxillary sinusitis patients, 49.69 min and 20.87 min among unilateral CRS with polyposis patients, 69.42 min and 25.97 min among bilateral maxillary sinusitis patients, 63.71 min and 24.21 min among CRS with bilateral polyposis patients. ESS not only treats the pathology of paranasal sinuses but also helps in returning the normal mucociliary function.

EpiViewer: an epidemiological application for exploring time series data.

BACKGROUND: Visualization plays an important role in epidemic time series analysis and forecasting. Viewing time series data plotted on a graph can help researchers identify anomalies and unexpected trends that could be overlooked if the data were reviewed in tabular form; these details can influence a researcher's recommended course of action or choice of simulation models. However, there are challenges in reviewing data sets from multiple data sources - data can be aggregated in different ways (e.g., incidence vs. cumulative), measure different criteria (e.g., infection counts, hospitalizations, and deaths), or represent different geographical scales (e.g., nation, HHS Regions, or states), which can make a direct comparison between time series difficult. In the face of an emerging epidemic, the ability to visualize time series from various sources and organizations and to reconcile these datasets based on different criteria could be key in developing accurate forecasts and identifying effective interventions. Many tools have been developed for visualizing temporal data; however, none yet supports all the functionality needed for easy collaborative visualization and analysis of epidemic data. RESULTS: In this paper, we present EpiViewer, a time series exploration dashboard where users can upload epidemiological time series data from a variety of sources and compare, organize, and track how data evolves as an epidemic progresses. EpiViewer provides an easy-to-use web interface for visualizing temporal datasets either as line charts or bar charts. The application provides enhanced features for visual analysis, such as hierarchical categorization, zooming, and filtering, to enable detailed inspection and comparison of multiple time series on a single canvas. Finally, EpiViewer provides several built-in statistical Epi-features to help users interpret the epidemiological curves. CONCLUSION: EpiViewer is a single page web application that provides a framework for exploring, comparing, and organizing temporal datasets. It offers a variety of features for convenient filtering and analysis of epicurves based on meta-attribute tagging. EpiViewer also provides a platform for sharing data between groups for better comparison and analysis. Our user study demonstrated that EpiViewer is easy to use and fills a particular niche in the toolspace for visualization and exploration of epidemiological data.

The vacuolar proton pyrophosphatase gene (SbVPPase) from the Sorghum bicolor confers salt tolerance in transgenic Brahmi [Bacopa monnieri (L.) Pennell].

Plants overcome the effect of Na+ toxicity either by excluding Na+ at the plasma membrane or by sequestering them into the vacuoles. Influx of Na+ ions into the plant vacuoles is usually driven by H+ generated by vacuolar-type H+-ATPase as well as vacuolar proton pyrophosphatse (VPPase). In the present study, we have developed Bacopa monnieri transgenics via Agrobacterium tumefaciens containing the recombinant vector pCAMBIA2300-SbVPPase gene. Transformants were produced using nodal explants. Transformants were confirmed by PCR and DNA blot analysis. qPCR analysis showed higher transcript levels of SbVPPase compared to untransformed control (UC). Higher VPPase activity was recorded in transgenics compared to UC. Under 150 mM salt stress, transgenic shoots showed enhanced Na+ accumulation with better biomass production, increased glycine betaine content, and total soluble sugar levels than UC. Transgenic shoots showed 2.9-3.8-folds lower levels of malondialdehyde content indicating lesser membrane damage. Increase in antioxidant enzyme activities (1.4-3.2-folds) was observed in transgenics compared to UC. Transgenics also displayed 7.3-9.0-folds enhanced accumulation of the medicinally important compound bacoside A. Increased biomass production, accumulation of Na+, osmolytes (glycine betaine, sugars etc.), and elevated antioxidant enzyme activities indicate better osmotic adjustment in transgenics by compartmentalization of Na+ into the vacuoles under salt stress conditions. Thus, overexpression of SbVPPase in Bacopa alleviated salt stress by sequestering Na+.

Genome-Wide Identification and Analysis of Arabidopsis Sodium Proton Antiporter (NHX) and Human Sodium Proton Exchanger (NHE) Homologs in Sorghum bicolor.

Na⁺ transporters play an important role during salt stress and development. The present study is aimed at genome-wide identification, in silico analysis of sodium-proton antiporter (NHX) and sodium-proton exchanger (NHE)-type transporters in Sorghum bicolor and their expression patterns under varied abiotic stress conditions. In Sorghum, seven NHX and nine NHE homologs were identified. Amiloride (a known inhibitor of Na⁺/H⁺ exchanger activity) binding motif was noticed in both types of the transporters. Chromosome 2 was found to be a hotspot region with five sodium transporters. Phylogenetic analysis inferred six ortholog and three paralog groups. To gain an insight into functional divergence of SbNHX/NHE transporters, real-time gene expression was performed under salt, drought, heat, and cold stresses in embryo, root, stem, and leaf tissues. Expression patterns revealed that both SbNHXs and SbNHEs are responsive either to single or multiple abiotic stresses. The predicted protein⁻protein interaction networks revealed that only SbNHX7 is involved in the calcineurin B-like proteins (CBL)- CBL interacting protein kinases (CIPK) pathway. The study provides insights into the functional divergence of SbNHX/NHE transporter genes with tissue specific expressions in Sorghum under different abiotic stress conditions.

Combining Participatory Influenza Surveillance with Modeling and Forecasting: Three Alternative Approaches.

BACKGROUND: Influenza outbreaks affect millions of people every year and its surveillance is usually carried out in developed countries through a network of sentinel doctors who report the weekly number of Influenza-like Illness cases observed among the visited patients. Monitoring and forecasting the evolution of these outbreaks supports decision makers in designing effective interventions and allocating resources to mitigate their impact. OBJECTIVE: Describe the existing participatory surveillance approaches that have been used for modeling and forecasting of the seasonal influenza epidemic, and how they can help strengthen real-time epidemic science and provide a more rigorous understanding of epidemic conditions. METHODS: We describe three different participatory surveillance systems, WISDM (Widely Internet Sourced Distributed Monitoring), Influenzanet and Flu Near You (FNY), and show how modeling and simulation can be or has been combined with participatory disease surveillance to: i) measure the non-response bias in a participatory surveillance sample using WISDM; and ii) nowcast and forecast influenza activity in different parts of the world (using Influenzanet and Flu Near You). RESULTS: WISDM-based results measure the participatory and sample bias for three epidemic metrics i.e. attack rate, peak infection rate, and time-to-peak, and find the participatory bias to be the largest component of the total bias. The Influenzanet platform shows that digital participatory surveillance data combined with a realistic data-driven epidemiological model can provide both short-term and long-term forecasts of epidemic intensities, and the ground truth data lie within the 95 percent confidence intervals for most weeks. The statistical accuracy of the ensemble forecasts increase as the season progresses. The Flu Near You platform shows that participatory surveillance data provide accurate short-term flu activity forecasts and influenza activity predictions. The correlation of the HealthMap Flu Trends estimates with the observed CDC ILI rates is 0.99 for 2013-2015. Additional data sources lead to an error reduction of about 40% when compared to the estimates of the model that only incorporates CDC historical information. CONCLUSIONS: While the advantages of participatory surveillance, compared to traditional surveillance, include its timeliness, lower costs, and broader reach, it is limited by a lack of control over the characteristics of the population sample. Modeling and simulation can help overcome this limitation as well as provide real-time and long-term forecasting of influenza activity in data-poor parts of the world.

Comparative evaluation of the tensile bond strength of two silicone based denture liners with denture base resins.

BACKGROUND: To evaluate and compare tensile bond strength of two silicone based liners with heat cure and heat cure high impact denture base resin at baseline and after storage in artificial saliva for 30 and 60 days. METHOD: Heat cure conventional and high impact acrylic blocks (120 blocks each) prepared with final test specimen of two blocks of each resin with a liner. The baseline samples and those tested after 30 and 60 days interval stored in artificial saliva in thermal incubator, all were pulled apart in UTM at 20 mm/min. The tensile bond strength and mode of failure (adhesive/cohesive) were assessed. Mean, SD determined and analysis using one way ANOVA and paired 't' test. RESULTS: The highest mean tensile bond strength (1.028 MPa) and the least i.e. 0.289 MPa was observed with Permaflex silicone liner against heat cure PMMA after storage in artificial saliva at 37 ± 1 °C. CONCLUSION: The study rejected the null hypothesis because storage time in artificial saliva affected the bond strength of the resilient liners examined. The results revealed a statistically significant difference (p < 0.05) of artificial saliva storage on the bond strength of both the liners. After storage in artificial saliva for 30 days and 60 days at 37 ± 1 °C, all the specimens showed a significant reduction in the tensile bond strength.

Osmotin: a plant sentinel and a possible agonist of mammalian adiponectin.

Osmotin is a stress responsive antifungal protein belonging to the pathogenesis-related (PR)-5 family that confers tolerance to both biotic and abiotic stresses in plants. Protective efforts of osmotin in plants range from high temperature to cold and salt to drought. It lyses the plasma membrane of the pathogens. It is widely distributed in fruits and vegetables. It is a differentially expressed and developmentally regulated protein that protects the cells from osmotic stress and invading pathogens as well, by structural or metabolic alterations. During stress conditions, osmotin helps in the accumulation of the osmolyte proline, which quenches reactive oxygen species and free radicals. Osmotin expression results in the accumulation of storage reserves and increases the shelf-life of fruits. It binds to a seven-transmembrane-domain receptor-like protein and induces programmed cell death in Saccharomyces cerevisiae through RAS2/cAMP signaling pathway. Adiponectin, produced in adipose tissues of mammals, is an insulin-sensitizing hormone. Strangely, osmotin acts like the mammalian hormone adiponectin in various in vitro and in vivo models. Adiponectin and osmotin, the two receptor binding proteins do not share sequence similarity at the amino acid level, but interestingly they have a similar structural and functional properties. In experimental mice, adiponectin inhibits endothelial cell proliferation and migration, primary tumor growth, and reduces atherosclerosis. This retrospective work examines the vital role of osmotin in plant defense and as a potential targeted therapeutic drug for humans.

Comparison of articulating paper markings and T Scan III recordings to evaluate occlusal force in normal and rehabilitated maxillofacial trauma patients.

BACKGROUND: Prosthodontic Rehabilitation of Treated Maxillofacial Trauma Cases by Evaluating Occlusal Force Distribution Using Computerized Occlusal Analysis. METHOD: 30 patients were selected for the study. 15 normal and 15 treated trauma patients were subjected to T Scan analysis and evaluated for the occlusal force distribution. RESULTS: The results take into consideration the two parameters. Firstly the largest articulating paper mark (photographed) and secondly the T scan of the same patient. Comparison was made between the largest articulating paper mark and highest force tooth in the quadrant using T Scan. The matches and no matches were then tabulated for statistical analysis assessing the frequency of the matches to the no matches. CONCLUSION: The ultimate advantage of a T Scan III analysis is that it can detect the amount of force as well as location of the highest intensity contacts of a single tooth which is very specific.

Network effects of risk behavior change following prophylactic interventions.

We formulated a network-based model to understand how risk behavior change in conjunction with failure of prophylactic interventions can lead to unintended outcomes where "less (intervention) is more (effective)." Our model captures the distinction between one- and two-sided risk behavior change. In one-sided situations (e.g. influenza/H1N1) it is sufficient for either individual in an interaction to exhibit risk behavior change whereas in two-sided situations (e.g. AIDS/HIV) it is necessary for both individuals in the interaction to exhibit risk behavior change, for a potential transmission of the disease. A central discovery is that this phenomenon occurs at differing levels of intervention coverage depending upon the "sidedness" of the interaction. We find that for one-sided interactions, sufficiently high vaccination coverage is necessary for mitigating the effects of risk behavior; for two-sided interactions, it is essential to combine prophylactic treatments with programs aimed at reducing risky behavior. Furthermore, again dependent on the "sidedness," targeting highly connected nodes can be strictly worse than uniformly random interventions at the same level of coverage.