Expecting the Unexpected: Adenocarcinoma of Duodenojejunal Flexure in a 15-Year-Old.

A 15-year-old female patient presented to emergency with bilious vomiting after taking meals for the last 3 months along with intermittent colicky pain in the epigastrium for the last 1 month. Initially, the frequency of vomiting was 2-3 times/week which gradually increased to 4-5 times/day in the last 2 weeks. She had no history of any abdominal pathology or past history of tuberculosis or abdominal surgery. A review of systems showed she had a weight loss of about 10 kgs in the last 3 months along with loss of appetite. Physical examination revealed soft distention of the upper abdomen with mild tenderness in the epigastrium. CT scan of the abdomen showed concentric heterogenous luminal narrowing near duodenojejunal flexure with gross dilatation of the duodenum and stomach. The patient underwent resection of D4 and proximal jejunum with side-to-side D2-jejunum anastomosis. Histopathological examination revealed the luminal lesion to be an adenocarcinoma.

Future prediction of water balance using the SWAT and CA-Markov model using INMCM5 climate projections: a case study of the Silwani watershed (Jharkhand), India.

The aim of this research was to simulate the future water balance of the Silwani watershed, Jharkhand, India, under the combined effect of land use and climate change based on the Soil and Water Assessment Tool (SWAT) and Cellular Automata (CA)-Markov Chain model. The future climate prediction was done based on daily bias-corrected datasets of the INMCM5 climate model with Shared Socioeconomic Pathway 585 (SSP585), which represent the fossil fuel development of the world. After a successful model run, water balance components like surface runoff, groundwater contribution to stream flow, and ET were simulated. The anticipated change in land use/land cover (LULC) between 2020 and 2030 reflects a slight increase (3.9 mm) in groundwater contribution to stream flow while slight decrease in surface runoff (4.8 mm). The result of this research work helps the planners to plan any similar watershed for future conservation.

Impact of soil type and temperature on dissipation dynamics of a new readymix formulation of halauxifen-methyl + pyroxsulam.

The persistence and dissipation of a new readymix formulation of halauxifen-methyl + pyroxsulam was investigated in three soils viz. red lateritic (Soil A), coastal saline (Soil B) and black soil (Soil C) under three incubation temperatures (20, 30 and 40° C). Soil samples were fortified at 1.0 (T1) and 2.0 (T2) mg kg- 1 doses separately for both compounds. The analytical methods showed satisfactory mean recovery, precision and linearity and therefore accepted for analysis. Both molecules followed single first-order kinetics. A significant influence of soil type on the persistence of both herbicides was observed. The order of stability of halauxifen-methyl was Soil A > B > C and for pyroxsulam was Soil B > C > A. Besides, a faster rate of dissipation of halauxifen-methyl and pyroxsulam was recorded at elevated temperatures, regardless of soil type. This research will help to understand the effect of temperature on the fate of the herbicide mixture in soils of diverse agro-climatic regions.

A Rare Case of Blood & Sweat: Hematohidrosis.

Hematohidrosis is an uncommon pathophysiological condition of sweating blood. A young lady with abrupt bleeding from the skin (since January 2017) was brought to the emergency. The bleeding was vanished after mopping with no site of injury, but it reappeared soon enough confirming its nature. Bleeding time (BT), clotting time (CT), and the prothrombin time (PT) was within normal limit. This patient is confirmed as a case of hematohidrosis by the method of exclusion and the presence of blood was finalized by benzidine test as well as biochemical and microscopic examination of it. Now, no treatment is available as per the latest pieces of evidence. Also, the cause of it is not known till date. Psychological anxiety is a predisposing cause for hematohidrosis.

Effect of Soil Type and Temperature on Persistence and Dissipation Kinetics of a New Readymix Formulation of Fomesafen + Quizalofop-ethyl.

The research portrays the fate of a new herbicide mixture of fomesafen and quizalofop-ethyl. The soil samples viz. red lateritic soil (A), coastal saline soil (B) and black soil (C) were fortified separately for fomesafen and quizalofop-ethyl at 0.5 (T1) and 1.0 mg kg-1 (T2) doses and incubated at 20, 30 and 40°C. A satisfactory mean recovery, precision and linearity proved that the methods were accurate. Both the herbicides followed first + first order kinetics. Higher persistence of fomesafen was observed in Soil C than Soil B and Soil A with 22.38-53.75 days half-life, whereas quizalofop-ethyl showed higher stability in Soil A than Soils B and C with half-life of 0.93-12.07 days. Both compounds showed faster rates of dissipation at increased temperature, irrespective of soil type. The current study will help to predict the effect of temperature on the dissipation of herbicides in different soil under real field scenario.

Regional variation of drought parameters and long-term trends over India using standardized precipitation evapotranspiration index.

Analysing historical drought pattern is vital for implementation of efficient drought adaptation and mitigation policies. In this study, we examined the meteorological drought characteristics of India during 1901-2015, using Climate Research Unit (CRU) based Standardized Precipitation Evapotranspiration Index (SPEI) at multiple timescales i.e., 1 month (SPEI01), 3 month (SPEI03), 6 month (SPEI06), 12 month (SPEI12). Here, we applied K-means clustering algorithm on SPEI12 (December) to find out different clusters with distinct drought characteristics. The six different homogeneous regions, i.e., cluster1 (C1), cluster2 (C2), cluster3 (C3), cluster4 (C4), cluster5 (C5), and cluster6 (C6) identified by K mean clustering largely resemble with the clusters mentioned in previous researches. Different drought parameters (duration, frequency, intensity) have been also analysed for each cluster on a monthly, seasonal and interannual basis. The study indicates that northern part of India (C6, C3) experienced frequent droughts at shorter timescales whereas the western (C2) and north eastern (C4) part of the country encountered frequent drought occurrences at longer timescale. It is worthy to mention that the C2 region comprising the semi-arid and arid western part of the country including the great Indian desert, is vulnerable to frequent, prolonged and severe droughts at longer timescale (SPEI12). The study revealed a significant regional variation in drought trends identified by Modified Mann-Kendall (MMK) trend test. The annual trend analysis shows statistically significant (p < 0.05) increasing drought trend over C3 and C4 regions comprising the fertile Gangetic and Brahmaputra plains. The seasonal MMK trend analysis reveals significant increase (p < 0.05) in droughts over C3 (-0.006) and C4 (-0.005) during monsoon. The increasing drought trend over the Gangetic plain (C3) is prominent especially in the months of July (p < 0.05, slope = -0.005) and August (p < 0.001, slope = -0.006). The study provides a region-specific understanding of drought characteristics and long-term trends crucial for preparing adaptive strategies to minimize the cumulative impacts of droughts.

The case for philanthropic investment to increase colorectal cancer screening rates: A novel paradigm to address a public health challenge.

BACKGROUND: Colorectal cancer (CRC) remains a leading cause of cancer-related death despite being highly preventable. Efforts to increase participation in CRC screening have not met national goals. We developed a novel approach: building a business case for philanthropic investment in CRC screening. METHODS: A taskforce representing the public health community, professional societies, charitable foundations, academia, and industry was assembled to: (a) quantify the impact of improving CRC screening rates; (b) identify barriers to screening; (c) estimate the "activation cost" to overcome barriers and screen one additional person; (d) develop a holistic business case that is attractive to philanthropists; and (e) launch a demonstration project. RESULTS: We estimated that of 50 600 CRC deaths annually in the US, 55% occur in 50- to 85-year-olds and are potentially addressable by improvements in CRC screening. Barriers to screening were identified in all patient journey phases, including lack of awareness or insurance and logistical challenges in the pre-physician phase. The cost to activate one person to undergo screening was $25-175. This translated into a cost of $6000-36 000 per CRC death averted by philanthropic investment. Based on this work, the Colorectal Cancer Alliance launched the effort "March Forth" to prevent 100 000 CRC deaths in the US over 10 years, with the first pilot in Philadelphia. CONCLUSIONS: A holistic business plan can attract philanthropy to promote CRC screening. A simple message of "You can save a life from CRC with a $25 000 donation" can motivate demonstration projects in regions with high CRC rates and low screening participation.

Changing pattern of urban landscape and its effect on land surface temperature in and around Delhi.

The last couple of decades have seen remarkable spatial growth in the urban areas of developing countries. The process of urbanization is directly linked with land transformation which can be an effective way to monitor the spatio-temporal pattern of urban growth. New Delhi, the capital city of India has experienced a large-scale urban growth during the last decade. In order to identify the pattern of urban expansion in and around Delhi, the present study aims to assess the process of land transformation using multi-temporal Landsat datasets (1977-2014). The areas under various land use and land cover (LULC) extracted by support vector machine (SVM) hybrid classifier reveal asignificant change in the LULC pattern of the area. A good agreement was found between field-based information and maps generated using satellite images (kappa ≥ 0.84). Land transformation maps indicate rapid growth of few urban centres located outside Delhi National Capital Territory (NCT), like Gurgaon, Gautam Buddha Nagar, Faridabad and Ghaziabad. These centres have been remarkably expanded because of transformation of agricultural and vegetated lands. However, green patches within the city have not been affected by the consequences of urbanization. In tune with the rapid urbanization in the periurban centres of Delhi, the Moderate Resolution Imaging Spectro-radiometer (MODIS)-derived land surface temperature (LST) images revealed significant change in the level of LST. The inter-relationship of impervious surface fraction (ISF) and LST proves a good agreement between them. The increasing trend observed in the long-term (1987-2011) summer temperature data obtained from India Meteorological Department (IMD) indicates the rise of mean summer temperature in the last few decades. Land transformation along with rapid urbanization especially in the periurban areas of Delhi NCT played a key role in the increasing trend of surface temperature.

Superimposed topographic and chemical cues synergistically guide neurite outgrowth.

Guidance of neuronal extensions is a complex process essential for linking neurons into complex functional networks underlying the workings of the neural system. Decades of research have suggested the ability of neuronal growth cones to integrate multiple types of cues during the extension process, but also have raised numerous still unanswered questions about synergy or antagonism between the superimposed chemical and mechanical signaling inputs. In this study, using a novel microfabricated analysis platform, we investigate the response of primary mouse embryonic hippocampal neurons to superimposed topographic and soluble chemical cues. We find that an optimal spatial frequency of topographic cues exists, maximizing the precision of the neurite extension. This optimal frequency can help the extending neurites navigate a topographically complex environment, providing pronounced directional selectivity. We also demonstrate that this cue can synergistically enhance attractive and suppress repulsive guidance by the bi-functional soluble cue Netrin-1, and eliminate the repulsive guidance by a chemorepellent Semaphorin3A (Sema3A). These results suggest that topographic cues can provide optimal periodic input into the guidance signaling processes involved in growth cone chemoattraction and can synergistically interact with chemical gradients of soluble guidance cues, shedding light on complex events accompanying the development of the functional nervous system.

Matrix rigidity controls endothelial differentiation and morphogenesis of cardiac precursors.

Tissue development and regeneration involve tightly coordinated and integrated processes: selective proliferation of resident stem and precursor cells, differentiation into target somatic cell type, and spatial morphological organization. The role of the mechanical environment in the coordination of these processes is poorly understood. We show that multipotent cells derived from native cardiac tissue continually monitored cell substratum rigidity and showed enhanced proliferation, endothelial differentiation, and morphogenesis when the cell substratum rigidity closely matched that of myocardium. Mechanoregulation of these diverse processes required p190RhoGAP, a guanosine triphosphatase-activating protein for RhoA, acting through RhoA-dependent and -independent mechanisms. Natural or induced decreases in the abundance of p190RhoGAP triggered a series of developmental events by coupling cell-cell and cell-substratum interactions to genetic circuits controlling differentiation.

Lab-on-a-chip devices as an emerging platform for stem cell biology.

The advent of stem cell based therapies has brought regenerative medicine into an increased focus as a part of the modern medicine practice, with a potential to treat a myriad of intractable diseases in the future. Stem cells reside in a complex microenvironment presenting them with a multitude of potential cues that are chemical, physical, and mechanical in nature. Conventional techniques used for experiments involving stem cells can only poorly mimic the physiological context, and suffer from imprecise spatial and temporal control, low throughput, lack of scalability and reproducibility, and poor representation of the mechanical and physical cell microenvironment. Novel lab-on-a-chip platforms, on the other hand, can much better mimic the complexity of in vivo tissue milieu and provide a greater control of the parameter variation in a high throughput and scalable manner. This capability may be especially important for understanding the biology and cementing the clinical potential of stem cell based therapies. Here we review microfabrication- and microfluidics-based approaches to investigating the complex biology of stem cell responses to changes in the local microenvironment. In particular, we categorize each method based on the types of controlled inputs it can have on stem cells, including soluble biochemical factors, extracellular matrix interactions, homotypic and heterotypic cell-cell signaling, physical cues (e.g. oxygen tension, pH, temperature), and mechanical forces (e.g. shear, topography, rigidity). Finally, we outline the methods to perform large scale observations of stem cell phenotypes and high-throughput screening of cellular responses to a combination of stimuli, and many new emerging technologies that are becoming available specifically for stem cell applications.