Correction: Dhaliwal et al. Developments and Prospects in Imperative Underexploited Vegetable Legumes Breeding: A Review. Int. J. Mol. Sci. 2020, 21, 9615.

In the publication [...].

Long-term Outcome of Coronavirus Disease-associated Mucormycosis: 1-year Follow-up Study from India.

IMPORTANCE: Invasive fungal infections have recently become a public health problem, particularly in India following the second wave of coronavirus disease 2019 (COVID-19). India harbors the world's largest population of patients suffering from diabetes. What prompted the sudden spike of mucormycosis infections in the COVID pandemic needs investigation. OBJECTIVE: To determine if COVID-19 infection prompted the spike in invasive fungal infections in diabetic population. To determine the long-term outcome of COVID-associated mucormycosis. To determine if COVID-19 infection causes diabetes mellitus transiently. DESIGN: The study was a prospective cohort study comprising patients suffering from mucormycosis. The study was planned from 20 May 2021, until 30 November 2022, to investigate the long-term follow-up (1 year) of mucormycosis patients. SETTING: The study setting was a referral hospital. PARTICIPANTS: All the consecutive patients admitted to this hospital for treatment of mucormycosis were included in the study who consented to it. Intervention(s) (for clinical trials) or exposure(s) (for observational studies): All patients suffering with mucormycosis underwent treatment at this hospital with surgery and injectable systemic antifungal drugs alongside diabetes management. MAIN OUTCOME(S) AND MEASURE(S): Primary outcome measurement was in the form of survival with cure of mucormycosis. Hypothesis being tested was formulated during data collection. RESULTS: The data of 98 participants was collected, but analysis was done after excluding the case of cutaneous mucormycosis (infant patient). Mean age for patients was 55.5 years, varying from 28 to 88 years. In our study, 63.3% of patients with mucormycosis were males and 37.8% were females, of which 55.7% (34) and 58.3% (21) were known diabetics, respectively. Previous history of diabetes mellitus was identified as an underlying comorbid condition in 56.7% of patients, while the rest were diagnosed with new-onset diabetes mellitus. Sugar levels ranged (on admission) from 112 to 494 mg/dL (median 212 mg/dL) for known diabetics and from 132 to 356 mg/dL (median 204 mg/dL) for newly diagnosed diabetics. Other comorbidities included hypertension (19.5%), ischemic heart disease (8.2%), chronic renal illness (3.09%), and one case (1.03%) of postoperative renal cell carcinoma (disease-free). The majority of cases (91.8%) were not vaccinated for COVID-19, while only two patients reported a history of vaccination with two doses, and six others had received only a single dose. At the 1-year follow-up, 57.7% of cases were disease-free, 30.9% had expired, and 11.3% were lost to follow-up. The mean glycated hemoglobin (HbA1c) at the time of admission was found to be statistically significant when compared between known diabetics and newly diagnosed ones [confidence interval (CI)-95%, p ≤ 0.01]. A total of seven patients from the newly diagnosed diabetic group no longer required medicines for diabetes at the end of 1 year (CI-95%, p ≤ 0.01). CONCLUSIONS AND RELEVANCE: Diabetes mellitus, particularly with poor glycemic control, was the single most important factor associated with and predictor of outcome. Contrary to the popular hypothesis, industrial oxygen and oxygen masks were not the reasons for the mucormycosis pandemic. Additionally, immunization against COVID provided protection not only from severe COVID but also from COVID-associated mucormycosis. It is recommended that patients with mucormycosis be followed for longer periods as a few patients could be suffering from transient diabetes, particularly against the backdrop of a pandemic.

Older patients (aged ≥60 years) with previously untreated advanced-stage classical Hodgkin lymphoma: a detailed analysis from the phase III ECHELON-1 study.

Effective and tolerable treatments are needed for older patients with classical Hodgkin lymphoma. We report results for older patients with classical Hodgkin lymphoma treated in the large phase III ECHELON-1 study of frontline brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (A+AVD) versus doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). Modified progression-free survival per independent review facility for older versus younger patients (aged ≥60 vs. <60 years) was a pre-specified subgroup analysis; as the ECHELON- 1 study was not powered for these analyses, reported P-values are descriptive. Of 1,334 enrolled patients, 186 (14%) were aged ≥60 years (A+AVD: n=84, ABVD: n=102); results below refer to this age group. Modified progression-free survival per independent review facility was similar in the two arms at 24 months (A+AVD: 70.3% [95% confidence interval (CI): 58.4-79.4], ABVD: 71.4% [95% CI: 60.5-79.8], hazard ratio (HR)=1.00 [95% CI: 0.58-1.72], P=0.993). After a median follow-up of 60.9 months, 5-year progression-free survival per investigator was 67.1% with A+AVD versus 61.6% with ABVD (HR=0.820 [95% CI: 0.494-1.362], P=0.443). Comparing A+AVD versus ABVD, grade 3/4 peripheral neuropathy occurred in 18% versus 3%; any-grade febrile neutropenia in 37% versus 17%; and any-grade pulmonary toxicity in 2% versus 13%, respectively, with three (3%) pulmonary toxicity-related deaths in patients receiving ABVD (none in those receiving A+AVD). Altogether, A+AVD showed overall similar efficacy to ABVD with survival rates in both arms comparing favorably to those of prior series in older patients with advanced-stage classical Hodgkin lymphoma. Compared to ABVD, A+AVD was associated with higher rates of neuropathy and neutropenia, but lower rates of pulmonary-related toxicity. Trials registered at ClinicalTrials.gov identifiers: NCT01712490; EudraCT number: 2011-005450-60.

Brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine in patients with advanced-stage, classical Hodgkin lymphoma: A prespecified subgroup analysis of high-risk patients from the ECHELON-1 study.

Approximately one-third of patients diagnosed with Hodgkin lymphoma presenting with Stage IV disease do not survive past 5 years. We present updated efficacy and safety analyses in high-risk patient subgroups, defined by Stage IV disease or International Prognostic Score (IPS) of 4-7, enrolled in the ECHELON-1 study that compared brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (A + AVD) versus doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) as first-line therapy after a median follow-up of 37.1 months. Among patients treated with A + AVD (n = 664) or ABVD (n = 670), 64% had Stage IV disease and 26% had an IPS of 4-7. Patients with Stage IV disease treated with A + AVD showed consistent improvements in PFS at 3 years as assessed by investigator (hazard ratio [HR], 0.723; 95% confidence interval [CI], 0.537-0.973; p = 0.032). Similar improvements were seen in the subgroup of patients with IPS of 4-7 (HR, 0.588; 95% CI, 0.386-0.894; p = 0.012). The most common adverse events (AEs) in A + AVD-treated versus ABVD-treated patients with Stage IV disease were peripheral neuropathy (67% vs. 40%) and neutropenia (71% vs. 55%); in patients with IPS of 4-7, the most common AEs were peripheral neuropathy (69% vs. 45%), neutropenia (66% vs. 55%), and febrile neutropenia (23% vs. 9%), respectively. Patients in high-risk subgroups did not experience greater AE incidence or severity than patients in the total population. This updated analysis of ECHELON-1 shows a favorable benefit-risk balance in high-risk patients.

Developments and Prospects in Imperative Underexploited Vegetable Legumes Breeding: A Review.

Vegetable legumes are an essential source of carbohydrates, vitamins, and minerals, along with health-promoting bioactive chemicals. The demand for the use of either fresh or processed vegetable legumes is continually expanding on account of the growing consumer awareness about their well-balanced diet. Therefore, sustaining optimum yields of vegetable legumes is extremely important. Here we seek to present d etails of prospects of underexploited vegetable legumes for food availability, accessibility, and improved livelihood utilization. So far research attention was mainly focused on pulse legumes' performance as compared to vegetable legumes. Wild and cultivated vegetable legumes vary morphologically across diverse habitats. This could make them less known, underutilized, and underexploited, and make them a promising potential nutritional source in developing nations where malnutrition still exists. Research efforts are required to promote underexploited vegetable legumes, for improving their use to feed the ever-increasing population in the future. In view of all the above points, here we have discussed underexploited vegetable legumes with tremendous potential; namely, vegetable pigeon pea (Cajanus cajan), cluster bean (Cyamopsis tetragonoloba), winged bean (Psophocarpus tetragonolobus), dolichos bean (Lablab purpureus), and cowpea (Vigna unguiculata), thereby covering the progress related to various aspects such as pre-breeding, molecular markers, quantitative trait locus (QTLs), genomics, and genetic engineering. Overall, this review has summarized the information related to advancements in the breeding of vegetable legumes which will ultimately help in ensuring food and nutritional security in developing nations.

A Comparative Study of Quantitative Smartphone Usages among Controlled and Uncontrolled Type 2 Diabetes Mellitus Population.

BACKGROUND: Smartphones has significantly changed the lifestyle of people and considered as basic need for day to day work. But its usages beyond certain limits adversely affects physical and mental health. Aim of this study is to analyzes the quantitative usages of smartphone among controlled and uncontrolled type 2 diabetes patients. Objective is to correlate the pattern and duration of smartphone usages with the level of glycemic control. METHOD: "RealizD" is a mobile application that observes the pattern of mobile phone usages like 'screen time' (total duration of time spends watching mobile screen for any purpose) and number of times phone picked in a day. It graphically displays the hourly usages and longest duration of phone use in a single stretch. Subjects were patients of type 2 diabetes mellitus(T2DM) divided into 50 "case" with poor glycemic control and 50 "control" with good glycemic control. This application was installed in their smartphones to collect all above data. Subjects were observed for period of 3 months. Demographic data, blood glucose levels and HbA1c was recorded at first and again at second visit 3 months after. Data from application was recorded at second visit as described above. FINDINGS: The average screen time of cases was 160 ± 50.9 minutes per day whereas of controls was 107 ± 22.5 minutes. This difference in the screen time was statistically significant. Higher the screen time more was the HbA1c. The average of number of times a case picked his/her phone in a day was 70.2 ± 20.1 whereas by the controls was 57.3 ± 22.2. The difference was statistically significant. Also, Cases spend 37.3 % versus controls who spend 19.9 % of total screen time between 5 AM to 9 AM. The difference was statistically significant. This indicates that uncontrolled T2DM patients spend more time on phone in morning hours. INTERPRETATION: Smartphones could be best companion if used judiciously. Their unrestricted use adversely affects the health. Among diabetes patient unregulated smartphone usages leads to poor glycemic control and thus could be considered an important factor that need to be addressed.

Patient and physician preferences for first-line treatment of classical Hodgkin lymphoma in Germany, France and the United Kingdom.

First-line treatments for classical Hodgkin lymphoma (HL) include ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) and BEACOPPescalated (escalated dose bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, prednisone). To further improve overall outcomes, positron emission tomography-driven strategies and ABVD or BEACOPP variants incorporating the antibody-drug conjugate brentuximab vedotin (BV) or anti-PD1 antibodies are under investigation in advanced-stage patients. The present study aimed to elicit preferences for attributes associated with ABVD, BEACOPPescalated and BV-AVD (BV, adriamycin, vinblastine and dacarbazine) among patients and physicians. Cross-sectional online discrete choice experiments were administered to HL patients (n = 381) and haematologists/oncologists (n = 357) in France, Germany and the United Kingdom. Included attributes were progression-free survival (PFS), overall survival (OS), and the risk of neuropathy, lung damage, infertility and hospitalisation due to adverse events. Whereas 5-year PFS and OS were the most important treatment attributes to patients, the relative importance of each attribute and preference weights for each level varied among physicians according to the description of the hypothetical patient for whom treatment was recommended. PFS and OS most strongly influenced physicians' recommendations when considering young female patients who did not want children or young male patients. Infertility was more important to physicians' treatment decision than PFS when considering young women with unknown fertility preferences, whereas hospitalisations due to adverse events played the largest role in treatment decisions for older patients.

Effects of Canagliflozin on Abnormal Liver Function Tests in Patients of Type 2 Diabetes with Non-Alcoholic Fatty Liver Disease.

INTRODUCTION: Canagliflozin, a second line OHA is well known to reduce weight. Patients of type 2 diabetes with non-alcoholic fatty liver disease (NAFLD) frequently have abnormal liver functions. We evaluated role of canagliflozin in reducing weight and improving liver function tests (LFT) in type 2 diabetes with NAFLD. AIMS: Effects of canagliflozin on abnormal liver function tests in patients of type 2 diabetes with non-alcoholic fatty liver disease. METHODS: We selected type 2 diabetes patients who were having comorbid NAFLD with abnormal LFT. Subjects were prescribed canagliflozin in dose of 100mg/ day for 6 months. Dose adjustments of other drugs (oral hypoglycemics agents and insulins) was done to monitor glycemic target. Effects of canagliflozin was observed on LFT, vitals and HbA1c. It was an observational study. Subjects who developed major side effects were excluded and managed. RESULTS: One subject was lost to follow up during study and 31 completed the study successfully. Average HbA1c and weight differences were -0·46% and -1·86% respectively. Average ALT reduction was 36 U/L; t= -9·153623, p is < 0·00001. Average AST reduction was 19·0 U/L; t= -8·153600; p is <0·00001. Average GGT reduction was 5·87 U/L; t= -3·286677, p=0·002588. Average ALP reduction was 1·68 U/L; t= -1·295661. p=0·204973. Serum Bilirubin was elevated by 0·04%; t=0·912, p=0·368. With 0·46% reduction in HbA1c there is 37·5% reduction in ALT levels (R=0·1424) and with 1·86% weight reduction there is 37·5% ALT reduction (R=0·3448). CONCLUSIONS: Canagliflozin controls HbA1c and reduce weight in type 2 diabetes. It also significantly improves LFT in co-morbid NAFLD.

Teneligliptin: An Economic and Effective DPP-4 Inhibitor for the Management of Type-2 Diabetes Mellitus: A Comparative Study.

CONTEXT: Increasing diabetic burden worldwide is creating an alarming situation for the management and development of economic resources for it's treatment. Progressive nature of the disease requires allocation of a higher proportion of expenditure on health care initiative of any country. AIM: Present study is designed with an aim to determine the effectiveness of cost-effective DPP-4 inhibitor, Teneligliptin, over the other agent of the same class. MATERIAL AND METHOD: The study was carried out in Postgraduate Department of Medicine, S.N. Medical College, Agra and 112 patients were selected as subjects with a selected inclusion criterion. STATISTICAL ANALYSIS USED: Independent student's t-test was applied to compare the means. Mean standard deviation was calculated for quantitative data. All p values were two-tailed and values p<0.05 were considered statistically significant. RESULT: There was no significant difference in the levels of blood sugar or glycosylated hemoglobin (HbA1c) before and after the treatment of Teneligliptin. CONCLUSIONS: Teneligliptin offered an efficient second line treatment for the management of type-2 Diabetes Mellitus at a reduced average price of INR 39 per day, when compared to other DPP-4 inhibitors.

Sample Preparation from Plant Tissue for Gas Chromatography-Mass Spectrometry (GC-MS)we.

Metabolites are intermediate products formed during metabolism. Metabolites play different roles, including providing energy, supporting structure, transmitting signals, catalyzing reactions, enhancing defense, and interacting with other species. Plant metabolomics research aims to detect precisely all metabolites found within tissues of plants through GC-MS. This chapter primarily focuses on extracting metabolites using chemicals such as methanol, chloroform, ribitol, MSTFA, and TMCS. The metabolic analysis method is frequently used according to the specific kind of sample or matrix being investigated and the analysis objective. Chromatography (LC, GC, and CE) with mass spectrometry and NMR spectroscopy is used in modern metabolomics to analyze metabolites from plant samples. The most frequently used method for metabolites analysis is the GC-MS. It is a powerful technique that combines gas chromatography's separation capabilities with mass spectrometry, offering detailed information, including structural identification of each metabolite. This chapter contains an easy-to-follow guide to extract plant-based metabolites. The current protocol provides all the information needed for extracting metabolites from a plant, precautions, and troubleshooting.

Carotenoid Extraction from Plant Tissues.

Carotenoids are the natural pigments available in nature and exhibit different colors such as yellow, red, and orange. These are a class of phytonutrients that have anti-cancer, anti-inflammatory, anti-oxidant, immune-modulatory, and anti-aging properties. These were used in food, pharmaceutical, nutraceutical, and cosmetic industries. They are divided into two classes: carotenes and xanthophylls. The carotenes are non-oxygenated derivatives and xanthophylls are oxygenated derivatives. The major source of carotenoids are vegetables, fruits, and tissues. Carotenoids also perform the roles of photoprotection and photosynthesis. In addition to the roles mentioned above, they are also involved and act as precursor molecules for the biosynthesis of phytohormones such as strigolactone and abscisic acid. This chapter briefly introduces carotenoids and their extraction method from plant tissue. Proposed protocol describes the extraction of carotenoid using solvents chloroform and dichloromethane. Reverse-phase HPLC can be performed with C30 columns using gradient elution. The column C30 is preferred to the C18 column because the C30 column has salient features, which include selective nature in the separation of structural isomers and hydrophobic, long-chain compounds, and shows the best compatibility with highly aqueous mobile phases. A complete pipeline for the extraction of carotenoids from plant tissue is given in the present protocol.

Fully Automated Agatston Score Calculation From Electrocardiography-Gated Cardiac Computed Tomography Using Deep Learning and Multi-Organ Segmentation: A Validation Study.

To evaluate deep learning-based calcium segmentation and quantification on ECG-gated cardiac CT scans compared with manual evaluation. Automated calcium quantification was performed using a neural network based on mask regions with convolutional neural networks (R-CNNs) for multi-organ segmentation. Manual evaluation of calcium was carried out using proprietary software. This is a retrospective study of archived data. This study used 40 patients to train the segmentation model and 110 patients were used for the validation of the algorithm. The Pearson correlation coefficient between the reference actual and the computed predictive scores shows high level of correlation (0.84; P < .001) and high limits of agreement (±1.96 SD; -2000, 2000) in Bland-Altman plot analysis. The proposed method correctly classifies the risk group in 75.2% and classifies the subjects in the same group. In total, 81% of the predictive scores lie in the same categories and only seven patients out of 110 were more than one category off. For the presence/absence of coronary artery calcifications, the deep learning model achieved a sensitivity of 90% and a specificity of 94%. Fully automated model shows good correlation compared with reference standards. Automating process reduces evaluation time and optimizes clinical calcium scoring without additional resources.

Adaptive STDP-based on-chip spike pattern detection.

A spiking neural network (SNN) is a bottom-up tool used to describe information processing in brain microcircuits. It is becoming a crucial neuromorphic computational model. Spike-timing-dependent plasticity (STDP) is an unsupervised brain-like learning rule implemented in many SNNs and neuromorphic chips. However, a significant performance gap exists between ideal model simulation and neuromorphic implementation. The performance of STDP learning in neuromorphic chips deteriorates because the resolution of synaptic efficacy in such chips is generally restricted to 6 bits or less, whereas simulations employ the entire 64-bit floating-point precision available on digital computers. Previously, we introduced a bio-inspired learning rule named adaptive STDP and demonstrated via numerical simulation that adaptive STDP (using only 4-bit fixed-point synaptic efficacy) performs similarly to STDP learning (using 64-bit floating-point precision) in a noisy spike pattern detection model. Herein, we present the experimental results demonstrating the performance of adaptive STDP learning. To the best of our knowledge, this is the first study that demonstrates unsupervised noisy spatiotemporal spike pattern detection to perform well and maintain the simulation performance on a mixed-signal CMOS neuromorphic chip with low-resolution synaptic efficacy. The chip was designed in Taiwan Semiconductor Manufacturing Company (TSMC) 250 nm CMOS technology node and comprises a soma circuit and 256 synapse circuits along with their learning circuitry.

A Conductance-Based Silicon Synapse Circuit.

Neuron, synapse, and learning circuits inspired by the brain comprise the key components of a neuromorphic chip. In this study, we present a conductance-based analog silicon synapse circuit suitable for the implementation of reduced or multi-compartment neuron models. Compartmental models are more bio-realistic. They are implemented in neuromorphic chips aiming to mimic the electrical activities of the neuronal networks in the brain and incorporate biomimetic soma and synapse circuits. Most contemporary low-power analog synapse circuits implement bioinspired "current-based" synaptic models suited for the implementation of single-compartment point neuron models. They emulate the exponential decay profile of the synaptic current, but ignore the effect of the postsynaptic membrane potential on the synaptic current. This dependence is necessary to emulate shunting inhibition, which is thought to play important roles in information processing in the brain. The proposed circuit uses an oscillator-based resistor-type element at its output stage to incorporate this effect. This circuit is used to demonstrate the shunting inhibition phenomenon. Next, to demonstrate that the oscillatory nature of the induced synaptic current has no unforeseen effects, the synapse circuit is employed in a spatiotemporal spike pattern detection task. The task employs the adaptive spike-timing-dependent plasticity (STDP) learning rule, a bio-inspired learning rule introduced in a previous study. The mixed-signal chip is designed in a Taiwan Manufacturing Semiconductor Company 250 nm complementary metal oxide semiconductor technology node. It comprises a biomimetic soma circuit and 256 synapse circuits, along with their learning circuitries.

Assessing the SpO2 in a random population - Looking for the best among fingers.

Context: Pulse oximetry is one of the most revolutionary methods used to monitor the patients in the clinical setting, particularly intensive care and anesthesia. We usually use the index or middle finger to measure SpO2 values, but little is known about the inter-digital differences that exist between the fingers. Aim: We aim to compare the peripheral capillary oxygen saturation among fingers of both hands. A total of 93 healthy volunteers aged between 18 and 50 years participated in the study. Materials and Methods: Their SpO2 values were recorded from each finger with at least 1 minute of resting interval. Their blood pressure, heart rate, and body temperature were recorded as well. Result: A total of 930 measurements were obtained from 93 volunteers. The highest average SpO2 value of right-handed volunteers was measured from the left little finger (98.48 ± 0.62) of right-handed volunteers, and it was statistically significant when compared with the right ring finger, right little finger, left thumb, left index, left middle finger, and left ring finger. The highest average SpO2 from left-handed volunteers was obtained from the right index finger, but it was statistically insignificant. Conclusion: We assume ethnic and climatic differences to play a role in contradictory results noted from previous studies conducted, and this needs to be investigated further. It is recommended that multiple readings may be obtained from other fingers as well before coming to any conclusion as inter-finger variability cannot be ignored.

Efficacy of Individualized Homeopathic Medicines in the Treatment of Atopic Dermatitis in Adults: A Double-Blind, Randomized, Placebo-Controlled, Preliminary Trial.

INTRODUCTION: Individualized homeopathy (IH) in atopic dermatitis (AD) remained under-researched. OBJECTIVE: We aimed at evaluating efficacy of IH in AD. METHODS: A double-blind, randomized, placebo-controlled, short-term, preliminary trial was conducted in an Indian homeopathy hospital. Patients were randomized to either IH (n = 30) or identical-looking placebo (n = 30) using computerized randomization and allocation. Outcomes were patient-oriented scoring of AD (PO-SCORAD; primary end point), Dermatological Life Quality Index (DLQI) score, and AD burden score for adults (ADBSA; secondary end points), measured monthly for 3 months. An intention-to-treat sample was analyzed after adjusting baseline differences. RESULTS: On PO-SCORAD, improvement was higher in IH against placebo, but nonsignificant statistically (pmonth 1 = 0.433, pmonth 2 = 0.442, pmonth 3 = 0.229). Secondary outcomes were also nonsignificant - both DLQI and ADBSA (p > 0.05). Four adverse events (diarrhea, injury, common cold) were recorded. CONCLUSIONS: There was a small, but nonsignificant direction of effect towards homeopathy, which renders the trial inconclusive. A properly powered robust trial is indicated.