Sarcoidosis associated with Trastuzumab in a young female with carcinoma of breast.

Trastuzumab is a humanized monoclonal antibody against human epidermal growth factor, useful in breast cancer. It is well tolerated but sometimes may associate with significant adverse effects. Sarcoidosis is a granulomatous disease involving multiple organs with poorly understood aetiology. Mediastinal lymphadenopathy is the most common presenting feature of Sarcoidosis. Reported cases of Sarcoidosis associated with Trastuzumab are quite less in number. High degree of suspicion of the above is thought of in a scenario of malignancy patients receiving chemotherapy. Newly appearing FDG avid lymph node in PET scan may give first impression of metastasis and treatment failure or infection. However correct diagnosis is a must (differentiating metastasis, treatment failure or infection) to provide correct treatment and avoid side effects of inappropriate therapies. Correct diagnosis also helps in appropriate prognostication and unnecessary stoppage of Trastuzumab. Here we are describing Sarcoidosis associated with Trastuzumab in a patient with breast cancer.

Multifactorial role of nanoparticles in alleviating environmental stresses for sustainable crop production and protection.

In the era of dire environmental fluctuations, plants undergo several stressors during their life span, which severely impact their development and overall growth in negative aspects. Abiotic stress factors, especially moisture stress i.e shortage (drought) or excess (flooding), salinity, temperature divergence (i.e. heat and cold stress), heavy metal toxicity, etc. create osmotic and ionic imbalance inside the plant cells, which ultimately lead to devastating crop yield, sometimes crop failure. Apart from the array of abiotic stresses, various biotic stress caused by pathogens, insects, and nematodes also affect production. Therefore, to combat these major challenges in order to increase production, several novel strategies have been adapted, among which the use of nanoparticles (NPs) i.e. nanotechnology is becoming an emerging tool in various facets of the current agriculture system, nowadays. This present review will elaborately depict the deployment and mechanisms of different NPs to withstand these biotic and abiotic stresses, along with a brief overview and indication of the future research works to be oriented based on the steps provided for future research in advance NPs application through the sustainable way.

Morphometric delineation of administrative boundaries and classification of threatened categories of small watersheds in transboundary rivers.

The ecological conservation of large rivers is impossible unless immediate attention is given to protecting their small tributaries at local levels. The natural boundaries of large river basins are shrinking because their tributaries and streams of different orders are disappearing at an unprecedented rate. Delineation of the fixed administrative boundaries (AB) to protect the natural boundary of small rivers and their classification into appropriate threatened categories, the present study was carried out on the 54.08 km long Banki River in the Ganga River basin. The > 70% irreversible loss in the number of streams (Nu), length of streams (Lu), and drainage density (Dd) resulted in the conversion of the 6th order Banki into the 4th order river. The extreme morphometric changes result in the Banki watershed being under the "Critically Endangered" category. The drainage density ratio (DdR) and mean stream width (Msw) were used to determine the width of AB (WAB). The "River Red List Categories and Criteria" are being proposed to strengthen global initiatives at the local levels to protect and conserve inland water bodies and transboundary rivers.

Role of rotational inertia for collective phenomena in active matter.

We investigate the effect of rotational inertia on the collective phenomena of underdamped active systems and show that the increase of the moment of inertia of each particle favors non-equilibrium phase coexistence, known as motility induced phase separation, and counteracts its suppression due to translational inertia. Our conclusion is supported by a non-equilibrium phase diagram (in the plane spanned by rotational inertial time and translational inertial time) whose transition line is understood theoretically through scaling arguments. In addition, rotational inertia increases the correlation length of the spatial velocity correlations in the dense cluster. The fact that rotational inertia enhances collective phenomena, such as motility induced phase separation and spatial velocity correlations, is strongly linked to the increase of rotational persistence. Moreover, large moments of inertia induce non-monotonic temporal (cross) correlations between translational and rotational degrees of freedom truly absent in non-equilibrium systems.

Synergism of endophytic Bacillus subtilis and Klebsiella aerogenes modulates plant growth and bacoside biosynthesis in Bacopa monnieri.

Bacopa monnieri is the main source of pharmaceutically important bacosides; however, the low content of these molecules in planta remains a limiting factor for fulfilling the industrial requirement. The accumulation of secondary metabolites can be enhanced in plants upon inoculation with endophytes. In this study, we isolated and analyzed the culturable endophytes associated with different plant parts. By analyzing their impact on plant growth parameters (in vitro and in vivo) and Bacoside A content, we found few candidates which increased bacoside accumulation significantly. Finally, two promising endophytes namely Bacillus subtilis (OK070745) and Klebsiella aerogenes (OK070774) were co-cultivated with B. monnieri cuttings singly and in combination mode to clarify their effect on bacoside biosynthesis and their accumulation in B. monnieri shoot. Consortium-inoculated plants significantly enhanced the plant biomass and Bacoside A content with respect to single inoculation. The results of real-time quantitative (RT-PCR) revealed significant accumulation of bacoside biosynthetic pathway transcripts (HMGCR, PMVK, FDPS, SQS, and ß-AS) in the case of plants inoculated with microbial combination, while the single inoculation of B. subtilis diverted the plant's machinery toward the synthesis of phenylpropanoid genes like CCR, CAD, CHS, and HST. In addition, higher expression of MYB 2 and WRKY 1 transcription factors in combinational treatment points out their probable role in better physiological and developmental processes. Altogether, this is the first study on B. monnieri-endophyte interaction showing improvement in the accumulation of bacoside A by modulating various genes of metabolic pathway and thus suggests an effective "green approach" for augmenting in planta production of pharmaceutically important bacosides.

Active nonreciprocal attraction between motile particles in an elastic medium.

We show from experiments and simulations on vibration-activated granular matter that self-propelled polar rods in an elastic medium on a substrate turn and move towards each other. We account for this effective attraction through a coarse-grained theory of a motile particle as a moving point-force density that creates elastic strains in the medium that reorient other particles. Our measurements confirm qualitatively the predicted features of the distortions created by the rods, including the |x|^{-1/2} tail of the trailing displacement field and nonreciprocal sensing and pursuit. A discrepancy between the magnitudes of displacements along and transverse to the direction of motion remains. Our theory should be of relevance to the interaction of motile cells in the extracellular matrix or in a supported layer of gel or tissue.

Two-Photon-Induced Fluorescence Study of Rhodamine-6G Dye in Different Sets of Binary Solvents.

This study deals with the effects of different sets of binary solvents on the Two-Photon Induced Fluorescence (TPIF), a non-linear process, of the Rhodamine-6G (Rh6G) dye, which is a well-known xanthene dye. This work examines the importance of inter-molecular interactions, which results in the modulation of the TPIF of the Rh6G. In this work, we have investigated three binary solvent mixtures representing varying polarity and intermolecular interactions. Specific solvent mixtures used are methanol-water, methanol-dimethyl formamide, and methanol-chloroform. Since the solvent polarity across these binary solvents differs, there are significant intermolecular interactions in the binary mixture solvents, which modulate the two-photon process of Rh6G when irradiated with high-intensity laser light at 780 nm. In our studies, we find that Rh6G in the MeOH-H2O binary solvent has maximum red-shift and minimum intensity as compared to other pairs of binary liquids when the volume fraction of methanol decreases due to more extensive hydrogen bonding between the two components. Additionally, at 1:1 ratio of binary mixtures, Rh6G is found to have the highest TPEACS value for methanol-chloroform binary solvent and reason for that is related to the formation of weak H-bond networks between proton donor chloroform and proton acceptor methanol.

Phases and excitations of active rod-bead mixtures: simulations and experiments.

We present a large-scale numerical study, supplemented by experimental observations, on a quasi-two-dimensional active system of polar rods and spherical beads confined between two horizontal plates and energised by vertical vibration. For a low rod concentration Φr, our observations are consistent with a direct phase transition, as bead concentration Φb is increased, from the isotropic phase to a homogeneous flock. For Φr above a threshold value, an ordered band dense in both rods and beads occurs between the disordered phase and the homogeneous flock, in both experiments and simulations. Within the size ranges accessible, we observe only a single band, whose width increases with Φr. Deep in the ordered state, we observe broken-symmetry "sound" modes and giant number fluctuations. The direction-dependent sound speeds and the scaling of fluctuations are consistent with the predictions of field theories of flocking; sound damping rates show departures from such theories, but the range of wavenumbers explored is modest. At very high densities, we see phase separation into rod-rich and bead-rich regions, both of which move coherently.

Trapping and sorting active particles: Motility-induced condensation and smectic defects.

We present an experimental realization of the collective trapping phase transition [Kaiser et al., Phys. Rev. Lett. 108, 268307 (2012)PRLTAO0031-900710.1103/PhysRevLett.108.268307], using motile polar granular rods in the presence of a V-shaped obstacle. We offer a theory of this transition based on the interplay of motility-induced condensation and liquid-crystalline ordering and show that trapping occurs when persistent influx overcomes the collective expulsion of smectic defect structures. In agreement with the theory, our experiments find that a trap fills to the brim when the trap angle θ is below a threshold θ_{c}, while all particles escape for θ>θ_{c}. Our simulations support a further prediction, that θ_{c} goes down with increasing rotational noise. We exploit the sensitivity of trapping to the persistence of directed motion to sort particles based on the statistical properties of their activity.

Deciphering micro-polarity inside the endoplasmic reticulum using a two-photon active solvatofluorochromic probe.

A new class of two-photon active and solvatofluorochromic dyes for the determination of ER polarity is reported. The fluorescent colour spans almost the entire visible spectrum. One of the derivatives is rationally designed for specific ER targeting. Finally, the fluorescence spectral scanning technique has been utilised to determine the micro-polarity inside the ER which is found to be much lower than that of water.

White Light Induced E/Z-Photoisomerization of Diphenylamine-Tethered Fluorescent Stilbene Derivatives: Synthesis, Photophysical, and Electrochemical Investigation.

A facile synthesis and detailed photophysical investigation of E/Z-isomerization of fluorescent diphenylamine tethered stilbene derivatives (DPASs) under white light exposure have been carried out to understand the effect on fluorescence, electrochemical properties, and photostability under various activation/deactivation pathways. In solution state, in the dark, the E-isomer of DPASs (6a-d) exhibited high fluorescence quantum yields (Φfl ≈ 53% to 60% in DMSO). However, on white light exposure, 1H NMR and HPLC studies revealed that pure E-isomer of the DPAS 6a (∼9.5 mM) started converting into its Z-form by photoisomerization until it reaches to nearly equilibrium. At low concentrations (∼10 µM), the absorption band of the pure E-isomer in the range of 350-450 nm gradually decreased to adopt Z-conformation 6a' until a photostationary state was reached. The structure of the E-isomer 6a was unequivocally confirmed by X-ray diffraction analysis. The synthesized DPAS compounds 6a-d possessed positive solvatochromic properties, two photon absorption properties, and good thermal stability. The electrochemical investigations using DPASs showed reversible oxidation resulting in formation of a stable radical cation. Owing to useful photophysical, electrochemical and thermal properties, these DPAS derivatives are suitable for their application in biomedical imaging as well as in fabrication of electroluminescent materials.

Bioprocessing of Biodiesel Industry Effluent by Immobilized Bacteria to Produce Value-Added Products.

Biodiesel industrial effluent rich in crude glycerol (CG) was processed to produce value-added product. Under continuous culture system, Bacillus amyloliquefaciens strain CD16 immobilized within its biofilm, produced 3.2 L H2/day/L feed, over a period of 60 days at a hydraulic retention time of 2 days. The effective H2 yield by B. amyloliquefaciens strain CD16 was 165 L/L CG. This H2 yield was 1.18-fold higher than that observed with non-biofilm forming Bacillus thuringiensis strain EGU45. Bioprocessing of the effluent released after this stage, by recycling it up to 25% did not have any adverse effect on H2 production by strain EGU45; however, a 25% reduction in yield was recorded with strain CD16. Biofilm forming H2 producers thus proved effective as self-immobilizing system leading to enhanced process efficiency.

Video-Assisted Thoracoscopic Surgery for Pediatric Empyema by Two-Port Technique: A Single-Center Experience with 167 Consecutive Cases.

BACKGROUND/PURPOSE: The aim of our study is to determine efficacy, safety, and feasibility of video-assisted thoracoscopic surgery (VATS) in childhood empyema with a technique of only two ports and open instruments at a tertiary care center in India. METHODS: This is a retrospective study of patients below 18 years, with empyema presenting to the Department of Pediatric Surgery of a Tertiary Care Referral Hospital in India, over a period of 9 years who underwent VATS decortication. Only two ports with open surgical instruments were used. The patients were assessed on the basis of mean duration of preoperative symptoms, duration of surgery, average blood loss, postoperative pain relief, complications, and need for redo surgery. RESULTS: A total of 97 patients underwent primary VATS decortications without inserting an intercostal drainage (ICD) tube and 70 patients as a secondary procedure after ICD tube was inserted. Mean duration of symptoms was 11 days. The average blood loss during surgery was estimated to be 170 cc. The mean duration of surgery was 90 min. The most common postoperative complication was air leak seen in 19.16% of patients. Minor leaks usually settled by 24 h. In eight patients, a negative suction had to be applied to the ICD tube for persistent air leak. The average length of postoperative stay was 4 days. Two patients required a repeat open decortication procedure due to nonresolution of symptoms and poor lung expansion after VATS. Patients had minimal pain and excellent cosmetic outcome after VATS. CONCLUSION: Two-port VATS decortication procedure is as feasible and effective as three-port procedure for decortication with better cosmetic result and pain relief.

Broadband Energy Harvester Using Non-linear Polymer Spring and Electromagnetic/Triboelectric Hybrid Mechanism.

Over the years, several approaches have been devised to widen the operating bandwidth, but most of them can only be triggered at high accelerations. In this work, we investigate a broadband energy harvester based on combination of non-linear stiffening effect and multimodal energy harvesting to obtain high bandwidth over wide range of accelerations (0.1 g-2.0 g). In order to achieve broadband behavior, a polymer based spring exhibiting multimodal energy harvesting is used. Besides, non-linear stiffening effect is introduced by using mechanical stoppers. At low accelerations (<0.5 g), the nearby mode frequencies of polymer spring contribute to broadening characteristics, while proof mass engages with mechanical stoppers to introduce broadening by non-linear stiffening at higher accelerations. The electromagnetic mechanism is employed in this design to enhance its output at low accelerations when triboelectric output is negligible. Our device displays bandwidth of 40 Hz even at low acceleration of 0.1 g and it is increased up to 68 Hz at 2 g. When non-linear stiffening is used along with multimodal energy-harvesting, the obtained bandwidth increases from 23 Hz to 68 Hz with percentage increment of 295% at 1.8 g. Further, we have demonstrated the triboelectric output measured as acceleration sensing signals in terms of voltage and current sensitivity of 4.7 Vg-1 and 19.7 nAg-1, respectively.

Ortho-surgical management of skeletal Class III malocclusion.

Class III malocclusions are considered to be one of the most difficult problems to treat. Establishment of the treatment plan is based on the efficacy and thoughtful application by the clinician and easy acceptance by the patient. We are presenting a case report of an adult male patient with skeletal Class III malocclusion who was treated by orthosurgical approach in Department of Orthodontics in collaboration with Department of Oral and Maxillofacial Surgery. The treatment was complete with a positive overbite and acceptable occlusion and satisfactory facial esthetics using a combination approach.

Posterior urethral polyp with type I posterior urethral valves: a rare association in a neonate.

Urethral polyp is a rare cause of bladder outlet obstruction, voiding dysfunction, and hematuria in the pediatric age group. Urethral polyps are rarely associated with other congenital urinary tract anomalies. In this study, we report a case of solitary posterior urethral polyp with type I posterior urethral valve in a 7-day-old neonate presented with urinary retention and deranged renal function. The polyp was diagnosed on cystoscopy. Transurethral resection of the polyp with posterior urethral valve fulguration was performed. Pathologic assessment revealed a fibroepithelial lesion, which was consistent with congenital posterior urethral polyp.

Gluteal flap for omphalocele repair in a case of epigastric heteropagus: A novel approach for surgical management.

Epigastric heteropagus is an extremely rare congenital anomaly, in which there is asymmetrical conjoined twinning, with the parasitic twin attached to the epigastrium. A 2-day-old male, with epigastric heteropagus and omphalocele, was operated in our institution. After excision of the parasitic twin, omphalocele was covered with a gluteal skin flap available from the parasitic twin. Post-operative course was uneventful, except for infection along the edges of the skin flaps, which was managed conservatively. Only 44 cases of epigastric heteropagus twins have been reported previously in world literature. We present a novel surgical approach for the repair of the omphalocele in a case of epigastric heteropagus twins, probably the 45(th) case to be reported in the world literature.

Bilateral pharyngeal apparatus (branchial) sinuses in a set of identical twins--a case report.

Defective closure of the pharyngeal apparatus during the second week of gestation results in pharyngeal arch anomalies. Although pharyngeal apparatus (branchial) anomalies are frequently seen, bilateral cases are rare (only 2% to 3%). Bilaterality has a familial predisposition. Our patients, a set of identical twins, presented with bilateral discharging cervical sinuses noticed at 3 months of age. Physical examination was suggestive of bilateral pharyngeal apparatus (branchial) sinuses. Both patients were managed with surgical excision in the same operative sitting. To the best of our knowledge, ours is the first case of bilateral pharyngeal apparatus (branchial) sinuses in a set of identical twins.

Single-stage Modified Duhamel procedure for Hirschsprung's disease : our experience.

INTRODUCTION: Primary single-stage pull-through for Hirschsprung's disease (HD) has been reported to give comparable surgical outcomes to staged operations with less morbidity. Herein, we present our experience with single-stage Modified Duhamel procedure for management of HD. PATIENTS AND METHODS: This was a review of 48 cases of HD who underwent single-stage Modified Duhamel procedure without a protective colostomy. RESULTS: The age at surgery ranged from 6 months to 10 years (median - 9 months, mean - 2.3 years). The average weight of the child was 7.2 kg (range, 4.9-22 kg). 38 (79.2%) patients had classical rectosigmoid HD, the rest being long segment HD (the proximal most level being the splenic flexure). The average duration of surgery was 175 minutes (range, 130-245 minutes). The average blood loss was 45 ml. The average hospital stay was 7.2 days (range: 6-10 days). The major postoperative complications (n=3) included postoperative adhesive intestinal obstruction, anastomotic leak and persistent constipation due to residual aganglionosis. Each required a re-exploration. Minor complications included surgical site infection (n=3) and post-operative enterocolitis (n=3), which were managed conservatively. Six patients had constipation for a limited period post-operatively. All patients have a satisfactory functional outcome and normal development and growth. CONCLUSIONS: For HD, we recommend that single-stage Modified Duhamel procedure should be the preferred approach in view of its low morbidity, satisfactory functional outcome and avoidance of stoma, multiple surgeries and economic benefit in view of decreased hospital stay.