Physical analysis of aspirin in different phases and states using density functional theory.

This study analyzed the aspirin molecule (C9H8O4) using Density Functional Theory (DFT) on Gaussian 09W software. First, the structure of aspirin was optimized using the DFT method with the B3LYP functional and the 6-311+G (d,p) basis set. A global reactivity study was employed to understand the reactivity of aspirin in gas and solvent water for both anion and neutral states. To understand the involvement of orbitals in chemical stability and electron conductivity, we calculated the HOMO-LUMO. The thermodynamic function of a molecule was understood using thermochemistry. Molecular Electrostatic Potential (MEP) was employed to understand the physiochemical properties of aspirin. We observed the Mulliken atomic charge to calculate the atomic charge of aspirin. Finally, the title molecule's UV-Vis, FTIR, and Raman spectra are analyzed and compared with the experimental data.

Quantitative evaluation of the impact of variation of optical parameters on the estimation of blood hematocrit and oxygen saturation for dual-wavelength photoacoustics.

Photoacoustic (PA) spectroscopy is considered to be one of the most effective ways to measure the levels of hematocrit (H) and oxygenation saturation (S O 2) of blood, which are essential for diagnosing blood-related illnesses. This simulation study aims to investigate the impact of individual optical parameters, i.e., optical absorption coefficient (µ a), scattering coefficient (µ s), and anisotropy factor (g), on the accuracy of this technique in estimating the blood properties. We first performed the Monte Carlo simulations, using realistic optical parameters, to obtain the fluence maps for various samples. The wavelengths of the incident light were chosen to be 532, 700, 1000, and 1064 nm. Thereafter, the k-Wave simulations were executed, incorporating those fluence maps to generate the PA signals. The blood properties were obtained using the PA signals. We introduced variations in µ a, µ s, and g ranging from -10% to +10%, -10% to +10%, and -5% to +1%, respectively, at 700 and 1000 nm wavelengths. One parameter, at both wavelengths, was changed at a time, keeping others fixed. Subsequently, we examined how accurately the blood parameters could be determined at physiological hematocrit levels. A 10% variation in µ a induces a 10% change in H estimation but no change in S O 2 determination. Almost no change has been seen for µ s variation. However, a 5% (-5% to 0%) variation in the g factor resulted in approximately 160% and 115% changes in the PA signal amplitudes at 700 and 1000 nm, respectively, leading to ≈125% error in hematocrit estimation and ≈14% deviation in S O 2 assessment when nominal S O 2=70%. It is clear from this study that the scattering anisotropy factor is a very sensitive parameter and a small change in its value can result in large errors in the PA estimation of blood properties. In the future, in vitro experiments with pathological blood (inducing variation in the g parameter) will be performed, and accordingly, the accuracy of the PA technique in quantifying blood H and S O 2 will be evaluated.

A Retrospective and Comparative Analysis of Clinical Outcomes of Kidney Transplant Recipients During First and Second COVID-19 Waves in North-West India.

Introduction Kidney transplant recipients (KTRs) are prone to coronavirus disease 2019 (COVID-19) disease secondary to chronic immunosuppressive therapy. There have been differences in mortality and morbidity amongst the general population with different COVID-19 waves. This study is done to understand the effects of different COVID-19 waves amongst KTRs. Methods This was a retrospective single-centre trial from a high-volume transplant centre in North India. The immunosuppression protocol was changed according to national guidelines, and predictors of survival were evaluated. Results A total of 62 patients got infected during the first COVID-19 wave (March 2020 to February 2021) and 50 patients during the second COVID-19 wave (March 2021 to December 2021). Analysis showed a higher incidence of severe COVID-19 disease (79% vs. 50%) in the first wave, while the rest of the baseline parameters were similar in both waves. Mortality was similar in both groups. In both groups, severe COVID-19 disease, the requirement of hospitalisation, invasive oxygen therapy, and CT score findings were significant predictors of survival. There was no change in survival with respect to immunosuppression modification. Allograft dysfunction was more common in the second wave (7 vs. 1). Baseline creatinine was significantly associated with allograft dysfunction in follow-up. Conclusion Patients had severe COVID-19 disease during the first wave; however, poor availability of healthcare services during the second wave led to more patients with allograft dysfunction. Though immunosuppression change is necessary to prevent flare-ups of COVID-19 infection, it is not associated with survival benefits.

Act Together and Act Now to Overcome Gender Disparity in Organ Transplantation.

Gender disparity refers to the unequal treatment or a perception of individuals based on their gender and arises from differences in socially constructed gender roles. In the field of transplantation, gender inequality arises at different stages, affecting access to medical care, donation practices, and posttransplant followup care. Gender disparity in transplantation is not limited to any geographic region but is thought to be more prevalent in developing nations. An unusually high number of female donations with relatively fewer female recipients is not only attributable to the low economy but a congregation of medical, social, cultural, and psychological factors. Gender disparities can also be shown in transplant-related professional societies. This review highlights the complexities of spousal donation and vulnerability of women, especially in the developing world. There is a growing need to further modify transplant policies to tackle gender disparities, especially in living related donation. Systematic research in the context of gender-related concerns in transplantation will further aid in understanding the complexities and formulating policies for eliminating gender disparities. Gender disparity is a global problem and not merely limited to transplantation.

Prognostic role of PD-L1 expression in head and neck squamous cell carcinoma: An institutional experience from India.

BACKGROUND: Squamous cell carcinoma accounts for > 90% of Head and neck cancers and has a poor 5-year survival rate of only 50%. Immunosuppressive agents like PD-L1 inhibitors have been found to improve survival in many tumour types, including advanced/recurrent head and neck squamous cell carcinoma (HNSCC). The PD-L1 expression in this tumour can also predict clinical outcome. However, this fact still remains to be proven. AIM: The aim was to study the expression of PD-L1 in HNSCC, correlate with clinicopathological parameters and outcome. MATERIAL AND METHOD: This prospective study was conducted between March 2021 to June 2023 in department of Pathology of a tertiary care centre located in northern India. A total of 65 histologically confirmed cases of HNSCC were included. Expression of PD-L1 was determined by immunohistochemistry. The combined positive (CPS) and tumour proportion (TP) scores were calculated. The results were correlated with clinicopathological parameters and outcome using appropriate statistical tools. RESULTS: Considering CPS, 42 (64.6%) cases showed expression of PD-L1. A high score of ≥ 20% was seen in 10 cases (15.4%). PD-L1 expression did not correlate with any of the clinical parameters including age, gender, addiction, site, TNM stage and HPV status. Conventional HNSCC had significantly higher expression of PD-L1. The cases with positive PD-L1 expression had a higher mean survival and a lower mortality, but the difference was not statistically significant. CONCLUSION: PD-L1 expression is more likely to be seen in conventional HNSCC histomorphology. PD-L1 expression is a predictor of better prognosis in HNSCC.

Development of metasurface based hyperthermia lens applicator for heating of cancerous tissues.

Numerous designs and methods have been examined to improve penetration depth (PD), but there is a need for research to explore the potential increase in PD through uniform heating, a compact applicator, and low input power. This paper presents metasurface based hyperthermia lens applicator with water bolus for uniform heating of cancerous tissues. The proposed applicator consists of a stacked spiral antenna and a spiral-shaped frequency selective surface as a superstrate. The spiral antenna and superstrate are optimized on a low cost FR4 substrate having a size of 32 × 32 × 3.27mm3 and 10 × 10 × 1.6mm3 (size of the unit cell), respectively. The proposed applicator is simulated with heterogeneous phantom (skin, fat, and muscle layers) and with the Gustav voxel model with and without a water bolus layer. The number of unit cells in the superstrate is optimized to direct the maximum energy toward the tumor location. The performance study of the applicator is carried out in terms of specific absorption rate, PD, and effective field size. Further, thermal analysis is carried out with 1.9 W of input power at the antenna port, and the highest 44.7 °C temperature rise is obtained. The cancerous tissue's (tumor) surrounding temperature is between 41 and 45 °C, which is adequate for efficient hyperthermia treatment. Finally, the proposed metasurface hyperthermia lens applicator is fabricated and experimentally validated in a mimicked phantom's presence. Supplementary Information: The online version contains supplementary material available at 10.1007/s13534-023-00300-z.

Editorial for Advanced Antennas for Wireless Communication Systems.

In recent years, there has been a significant expansion in wireless communication, evolving into a global network connecting billions of entities, including individuals and enterprises [...].

Metal-free carbon-based anode for electrochemical degradation of tetracycline and metronidazole in wastewater.

Degradation of antibiotics through electrocatalytic oxidation has recently been comprehended as a promising strategy in wastewater treatment. Herein, nitrogen and sulphur doped graphene oxide (N,S-rGO) nanosheets were synthesized and employed as metal-free anodic material for electrochemical degradation of antibiotics, viz. metronidazole (MNZ) and tetracycline (TC). The synthesized anodic material was characterized using various spectral techniques and further the electrochemical behaviour of N,S-rGO was thoroughly examined. Thereafter, the N,S-rGO material was then employed as the anode material towards the electrocatalytic degradation of antibiotics. Parameters such as initial concentration of the antibiotics and current densities were varied and their effect towards the degradation of MNZ and TC were probed. Notably, the N,S-rGO based anode has shown impressive removal efficiency of 99% and 98.5%, after 120 min of reaction time for MNZ and TC, respectively, under optimized conditions. The obtained results including the kinetic parameters, removal efficiency and electrical efficiency ensure that the prepared anodic material has huge prospective towards real-time application for removal of antibiotics from water.

A Multicenter Retrospective Cohort Study on Management Protocols and Clinical Outcomes After ABO-incompatible Kidney Transplantation in India.

BACKGROUND: There is no robust evidence-based data for ABO-incompatible kidney transplantation (ABOiKT) from emerging countries. METHODS: Data from 1759 living donor ABOiKT and 33 157 ABO-compatible kidney transplantations (ABOcKT) performed in India between March 5, 2011, and July 2, 2022, were included in this retrospective, multicenter (n = 25) study. The primary outcomes included management protocols, mortality, graft loss, and biopsy-proven acute rejection (BPAR). RESULTS: Protocol included rituximab 100 (232 [13.18%]), 200 (877 [49.85%]), and 500 mg (569 [32.34%]); immunoadsorption (IA) (145 [8.24%]), IVIG (663 [37.69%]), and no induction 200 (11.37%). Mortality, graft loss, and BPAR were reported in 167 (9.49%), 136 (7.73%), and 228 (12.96%) patients, respectively, over a median follow-up of 36.3 mo. In cox proportional hazard model, mortality was higher with IA (hazard ratio [HR]: 2.53 [1.62-3.97]; P < 0.001), BPAR (HR: 1.83 [1.25-2.69]; P = 0.0020), and graft loss (HR: 1.66 [1.05-2.64]; P = 0.0310); improved graft survival was associated with IVIG (HR: 0.44 [0.26-0.72]; P = 0.0010); higher BPAR was reported with conventional tube method (HR: 3.22 [1.9-5.46]; P < 0.0001) and IA use (HR: 2 [1.37-2.92]; P < 0.0001), whereas lower BPAR was reported in the prepandemic era (HR: 0.61 [0.43-0.88]; P = 0.008). Primary outcomes were not associated with rituximab dosing or high preconditioning/presurgery anti-A/anti-B titers. Incidence of overall infection 306 (17.39%), cytomegalovirus 66 (3.75%), and BK virus polyoma virus 20 (1.13%) was low. In unmatched univariate analysis, the outcomes between ABOiKT and ABOcKT were comparable. CONCLUSIONS: Our largest multicenter study on ABOiKT provides insights into various protocols and management strategies with results comparable to those of ABOcKT.

A Comparative Analysis of Chikungunya in Kidney Transplant Recipients Compared With the General Population: A Multicenter, Retrospective, Cohort Study From India.

OBJECTIVES: Chikungunya is an arboviral illness, with patients presenting with fever, arthralgias, and myalgias. Outbreaks have occurred in tropical regions, and the virus is now endemic to many tropics, including South Asia, with India contributing a large part of the global burden. The presentation and long-term effects on transplant recipients are largely unknown. MATERIALS AND METHODS: In this retrospective analytical study, we compared chikungunya infection in 44 kidney transplant recipients from multiple centers in India and 34 patients from the general population. Data were collected from medical records and patient recall. RESULTS: Differences in presentation were remarkable between the 2 groups, with significantly lower incidence of musculoskeletal symptoms on presentation in transplant recipients compared with the general population. The incidence of acute graft dysfunction was 17.08% in transplant recipients, with return to baseline at the end of 1 month. Acute symptomatology resolved in transplant recipients within 1 month, and insignificant chronic symptoms were reported after 3 months. CONCLUSIONS: Chikungunya in kidney transplant recipients is markedly different from that of the general population, with significantly lower incidence of musculoskeletal symptoms such as arthralgias. The infection caused acute graft dysfunction, but no long-term sequelae were shown at the end of 1 year.

Kidney paired donation in developing countries: A global perspective.

Purpose of review: We review the key principles of kidney paired donation (KPD) and discuss the status and unique considerations for KPD in developing countries. Recent findings: Despite the advantages of KPD programs, they remain rare among developing nations, and the programs that exist have many differences with those of in developed countries. There is a paucity of literature and lack of published data on KPD from most of the developing nations. Expanding KPD programs may require the adoption of features and innovations of successful KPD programs. Cooperation with national and international societies should be encouraged to ensure endorsement and sharing of best practices. Summary: KPD is in the initial stages or has not yet started in the majority of the emerging nations. But the logistics and strategies required to implement KPD in developing nations differ from other parts of the world. By learning from the KPD experience in developing countries and adapting to their unique needs, it should be possible to expand access to KPD to allow more transplants to happen for patients in need world-wide.

Molecular Epidemiology of Rifampicin-Resistant Mycobacterium tuberculosis by GeneXpert MTB/RIF Assay in Renal Transplant Recipients: A Single-Center Experience.

OBJECTIVES: There are scarce data on the incidence and resistance pattern of rifampicin-resistant Mycobacterium tuberculosis among kidney transplant recipients. MATERIALS AND METHODS: This is a retrospective, single- center study of kidney transplantrecipients suspected of M. tuberculosis infection. The GeneXpert assay we used detected mutations in the rpoB gene that confer rifampicin resistance using 5 overlapping probes (A, B, C, D, and E). The probes can detect mutations in the codons 507 to 511 (probe A), 511 to 518 (probe B), 518 to 523 (probe C), 523 to 529 (probe D), and 529 to 533 (probe E).We also detailed the treatment protocol and outcomes of kidney transplantrecipients infected with rifampicin-resistant M. tuberculosis. RESULTS: In total, 2700 samples were processed during the period from October 2018 to February 2022 with successful results in 2640 samples (97.04%). One hundred and ninety (7.19%) samples were positive for M.tuberculosis, and rifampicin resistance was detected in 12 (0.45%) cases (11 pulmonary, 1 genitourinary). The most common rpoB mutation was located in the region of probe E (75.0%), followed by probe A (16.6%) and in 1 combination probe DE (8.33%). The rpoB mutations were not observed in probe B and probe C. Six patients received bedaquiline-based treatmentfor a short course of 11 months, whereas the other 6 patients required a long course of 18 to 20 months. Three patients died, 2 were lost to follow-up, and 7 were cured. During treatment, 4 patients experienced acute rejection, and 1 graft loss was reported. CONCLUSIONS: We report for the first time the incidence and pattern of rifampicin resistance among kidney transplant recipients with tuberculosis infection. Further investigations are required for exploring the molecular and clinical phenotypes.

Nasal leeches and epistaxis: A case series.

Nasal hirudiniasis is uncommon in humans, where a leech invades through the nostrils, adhering to the nasal cavity mucosa. It is rare in urban areas, noted in endemic rural areas, but scarcely documented and, with urbanisation and ecological imbalance has become rarer still. It presents with recurrent epistaxis due to hirudin released by the leech while other symptoms are infinitesimal owing to an analgesic enzyme secreted. A thorough history-taking and examination is of utmost importance as respiratory complications may arise if the leech invades the airways. We present a case series of five patients, within a period of three years.

Optimized study of the annealing effect on the electrical and structural properties of HDLC thin-films.

The plasma-enhanced chemical vapor deposition (PECVD) technique has been utilized for the facile surface deposition of hydrogenated diamond-like carbon (HDLC) thin-films onto Si(100) substrates. The as-deposited film surface is homogenous, free of pinholes, and adheres to the substrate. Annealing of the synthesized HDLC surface in a vacuum was performed in the temperature range of 200 to 1000 °C. A host of instrumental techniques, viz. FTIR spectroscopy, AFM, STM, and EC-AFM, were successfully employed to detect the morphological transformation in the HDLC films upon annealing. EC-AFM studies show irreversible biased behavior after undergoing a surface redox couple reaction and morphological change. Raman spectroscopy was carried out along with STM and EC-AFM to determine the functional nature and conductivity of the annealed surface.

Outcomes of Living Donor Kidney Transplant After SARS-CoV-2 Infection in Both the Donor and the Recipient: A Multicenter Study.

OBJECTIVES: Evidence on living donor kidney transplant procedures when both the donor and recipient have had a history of COVID-19 infection is scarce. MATERIALS AND METHODS: We retrospectively explored the protocol, outcomes, and follow-up of 64 donors and recipients of living donor kidney transplant who had recovered from COVID-19. This was a multicenter (n = 12) study from India that included transplants between October 29, 2020, and December 1, 2021. Induction and immunosuppression regimens forthose with different severities of COVID-19 were similar to standard practice. RESULTS: COVID-19 clinical severity ranged from asymptomatic/mild (not requiring oxygen therapy) in 49 recipients (77%) and 63 donors (95.4%) and moderate/severe (requiring oxygen therapy) in 15 recipients (23%) and 1 donor (4.6%). Mean wait time±SEM (SD)from firstdocumentednegative reverse transcriptase-polymerase chain reaction testto surgery for recipients and donors was 90.9 ± 9.27 (74.1) and 47 ± 4.5 (29.2) days, respectively. Six episodes (9.3%) of biopsy-proven acute rejection were reported at follow-up of 214 ± 14.8 (119) days and median of 227 (interquartile range, 109-309) days. The locally weighted scatter plot smoothing curve for creatinine during follow-up in donor-recipients pairs showed no trends of increased creatinine in the context of wait time from COVID-19 to transplant surgery. No graft loss, death, reactivation/reinfection, and complications related to surgery or COVID-19 were reported. CONCLUSIONS: Our report showed excellent outcomes and follow-up data of living donor kidney transplant in recovered donor-recipient pairs with the standard immunosuppression protocol. To our knowledge, this is the first and the largest study of donor-recipient living donor kidney transplant pairs when both donors and recipients had prior COVID-19.

COVID-19 Vaccination in Solid-Organ Transplant: A Real-World Multicenter Experience.

OBJECTIVES: India ranks third globally in organ procurement and transplant and has the second highest COVID-19 incidence rate, but data regarding COVID-19 vaccination in solid-organ transplant patients are scarce. MATERIALS AND METHODS: We created a cross-sectional, anonymous, online questionnaire and sentinvitations to several transplant centers in India. We surveyed vaccine mandates, immunization coverage and side effects, administration timing, infection severity among solid-organ transplant recipients, and booster dosage recommendations. RESULTS: The survey results showedthat vaccinepolicy is heterogeneous among centers; vaccination is voluntary at some centers (44.7%), but some centers have established COVID-19 vaccination as a requirement for transplant candidates (44.6%). CoviShield was the most common vaccine administered (89.3%), and more than 50% of transplant recipients and donors were fully vaccinated. Survey results showed that the pretransplant wait time after full vaccination (both doses) is 2 to 4 weeks (48.9%), and the optimal time for vaccination after transplant is 3 to 6 months (59.3%). For vaccinated transplant patients, 89.4% of respondents reported an incidence rate for posttransplant breakthrough infection of less than 25%. For unvaccinated patients, 38.3% ofrespondents reported a 25% to 50% incidence rate of posttransplant COVID- 19 infection. Booster doses are recommended at many transplant centers in India, as reported by 89.4% of survey respondents. CONCLUSIONS: The results of the survey suggested that there are no substantial safety concerns Future targets should include increasing efficacy and increasing booster doses of the COVID-19 vaccine.