Syntheses and Properties of Hole-Transporting Biindenofluorenes.

Described herein is a straightforward approach to synthesizing three biindenofluorene (BIF) derivatives, composed of antiaromatic indenofluorene units, which are the first non-alternant congeners of known bipentacene. Dimerization of indeno[1,2-b]fluorene and indeno[2,1-c]fluorene units by connecting carbons 3 and 3' and carbons 2 and 2', respectively, is shown to influence the highest occupied and lowest unoccupied molecular orbital energy levels of the resulting BIFs, affording band gaps (1.5-1.6 eV) that are smaller than that of a known indenofluorene polymer (2.3 eV). The hole mobilities of BIFs were determined to be ∼10-2 cm2 V-1 s-1.

Human Natural Killer Cells Cryopreserved without DMSO Sustain Robust Effector Responses.

Natural killer (NK) cell-based immunotherapy has benefitted from the multiple strengths that NK cells offer in adoptive transfer settings, not the least of which is their safety and potential for allogeneic use. Such use, however, necessitates the cryopreservation of NK cell-based therapy products to support logistical efforts in deploying these cells in different locations, decentralized from the point of collection or manufacturing. DMSO, the most commonly used cryoprotective agent (CPA), has been effective in protecting immune cells during freezing and thawing, but its ability to induce molecular and genetic changes to immune cells as well as its toxicity has stimulated interest in alternative CPAs. However, replacing DMSO's ability to act intracellularly has been difficult, and the sensitivity of human peripheral blood-derived NK cells to freezing and thawing-induced damage has meant that investigations into the potential of replacing DMSO are lacking. As a first step toward establishing the feasibility of cryopreserving human NK cells with CPAs' alternative to DMSO, we investigate the potential of using noncell-penetrating and cell-penetrating CPAs to recover NK cells post-thaw without DMSO. Here, we find that cryoprotection using cell-penetrating CPAs can retain the viability of human peripheral blood-derived NK cells to a comparable degree to DMSO. In addition, non-DMSO-cryopreserved human NK cells were as cytotoxic as those cryopreserved with DMSO and displayed a comparable level of surface markers of activation. In summary, we present the first example of the potential of developing non-DMSO CPA formulations that could be deployed in future cell therapy regimens.

Advancements in robotic surgery: innovations, challenges and future prospects.

The use of robots has revolutionized healthcare, wherein further innovations have led to improved precision and accuracy. Conceived in the late 1960s, robot-assisted surgeries have evolved to become an integral part of various surgical specialties. Modern robotic surgical systems are equipped with highly dexterous arms and miniaturized instruments that reduce tremors and enable delicate maneuvers. Implementation of advanced materials and designs along with the integration of imaging and visualization technologies have enhanced surgical accuracy and made robots safer and more adaptable to various procedures. Further, the haptic feedback system allows surgeons to determine the consistency of the tissues they are operating upon, without physical contact, thereby preventing injuries due to the application of excess force. With the implementation of teleoperation, surgeons can now overcome geographical limitations and provide specialized healthcare remotely. The use of artificial intelligence (AI) and machine learning (ML) aids in surgical decision-making by improving the recognition of minute and complex anatomical structures. All these advancements have led to faster recovery and fewer complications in patients. However, the substantial cost of robotic systems, their maintenance, the size of the systems and proper surgeon training pose major challenges. Nevertheless, with future advancements such as AI-driven automation, nanorobots, microscopic incision surgeries, semi-automated telerobotic systems, and the impact of 5G connectivity on remote surgery, the growth curve of robotic surgery points to innovation and stands as a testament to the persistent pursuit of progress in healthcare.

Dibenzoheterole-Fused s-Indacenes.

Heterole (pyrrole, thiophene, furan, thiophene-S,S-dioxide)-fused s-indacenes are known for their enhanced paratropic ring-current strength. However, the outcome of the antiaromatic properties for dibenzoheterole-fused s-indacene antiaromatics remained underexplored. Carbazole-, dibenzothiophene-, dibenzofuran-, and dibenzo[b,d]thiophene-5,5-dioxide-fused s-indacenes 1-4, respectively, were synthesized and characterized by experimental (NMR, single-crystal, UV-vis, CV) and computational (DFT) approaches to study the ground-state antiaromatic properties. Sulfone-containing 4 showed the weakest paratropic ring-current strength for the s-indacene unit, while 1-3 showed a relatively greater paratropicity for the s-indacene unit, as evidenced by the changes in 1H NMR chemical shifts of s-indacene protons. Such observation was explained by the electron-withdrawing effect of the sulfone group and loss of 4n + 2 aromaticity of the heterole unit for 4 reducing its s-indacene paratropicity strength as the nonaromaticity of the heterole unit reduces the π-bond character at the dibenzo[b,d]thiophene-5,5-dioxide/s-indacene fusion site to avoid antiaromatic s-indacene ring formation. The modulation of the paratropic ring-current strength of s-indacene for 1-4 was further supported by the NICS(1)zz and ring-current (ACID) calculations.

Vascular multiple sclerosis: addressing the pathogenesis, genetics, pro-angiogenic factors, and vascular abnormalities, along with the role of vascular intervention.

Dysfunction in the epithelium, breakdown of the blood-brain barrier, and consequent leukocyte and T-cell infiltration into the central nervous system define Vascular Multiple Sclerosis. Multiple sclerosis (MS) affects around 2.5 million individuals worldwide, is the leading cause of neurological impairment in young adults, and can have a variety of progressions and consequences. Despite significant discoveries in immunology and molecular biology, the root cause of MS is still not fully understood, as do the immunological triggers and causative pathways. Recent research into vascular anomalies associated with MS suggests that a vascular component may be pivotal to the etiology of MS, and there can be actually a completely new entity in the already available classification of MS, which can be called 'vascular multiple sclerosis'. Unlike the usual other causes of MS, vascular MS is not dependent on autoimmune pathophysiologic mechanisms, instead, it is caused due to the blood vessels pathology. This review aims to thoroughly analyze existing information and updates about the scattered available findings of genetics, pro-angiogenetic factors, and vascular abnormalities in this important spectrum, the vascular facets of MS.

Comparative study on Saliva and Nasopharyngeal swabs and the outcome of RT-PCR test in patients with mild symptoms of SARS-CoV-2 / Estudio comparativo de muestras de saliva y nasofaríngeas y el resultado de la prueba RT-PCR en pacientes con síntomas leves de SARS-CoV-2

Aim A simple and reliable method for diagnosing COVID 19 infections is the needed. The role of saliva in the transmission of the infection has already been established. Method Saliva and nasopharyngeal swabs from patients suspected to have COVID 19 infections were taken simultaneously, and the results of the RT-PCR were compared. Result Total 405 samples were collected, of which 250 males and 155 females. In the 391 samples included for analysis, 370 (94.63%) samples were found to have concordance results, and 21 (5.37%) samples had discordant results. Conclusion The use of saliva to diagnose COVID 19 infection is reliable, and its use can be recommended. (AU)

Objetivo Un método simple y confiable para diagnosticar infecciones por COVID 19 es necesario. Ya se ha establecido el papel de la saliva en la transmisión de la infección. Método Se tomaron simultáneamente hisopos de saliva y nasofaríngeos de pacientes con sospecha de infección por COVID 19 y se compararon los resultados de la RT-PCR. Resultado Se recogieron 405 muestras, de las cuales 250 hombres y 155 mujeres. En las 391 muestras incluidas para el análisis, se encontró que 370 (94,63%) muestras tenían resultados de concordancia y 21 (5,37%) muestras tenían resultados discordantes. Conclusión El uso de la saliva para diagnosticar la infección por COVID 19 es confiable y se puede recomendar su uso. (AU)

The Benefit of YouTube Videos as a Source of Information on Tinnitus for Patients

Abstract Introduction Tinnitus is one of the most common otological complaints encountered. Patients often use the internet, especially YouTube videos, as a source of information regarding their health condition. There is a need to analyze the standard and quality of information in these videos so that the patients receive correct information. Objective The purpose of the present study was to evaluate the reliability and utility of YouTube videos on tinnitus. Methods The first 100 videos on YouTube using the search terms tinnitus and ringing in the ear were identified. Three subject experts assessed the reliability using the modified five-point DISCERN score and utility using a usefulness score. Various indices like view ratio, like ratio, video power index, and interaction index were also calculated. Results Out of the 100 videos selected, 34 were excluded; collectively the remaining 66 videos were viewed 12,797,730 times. The most common upload sources were hospital/physician (39%), paramedic health care providers (19%), and alternative medicine (19%). The discern score was the highest in hospital/physician group (mean 19.3) and lowest in patient experience group (mean 13.4). A negative correlation was observed between the number of views (correlation coefficient -0.214), number of likes (correlation coefficient -0.242), number of comments (correlation coefficient -0.242), and the usefulness score. Conclusion Although there are multiple videos on YouTube regarding tinnitus, the overall educational content and reliability of the videos are poor. Video popularity is not associated with usefulness. Healthcare providers should counsel patients regarding videos on YouTube and try to create more comprehensive videos.

The Benefit of YouTube Videos as a Source of Information on Tinnitus for Patients.

Introduction Tinnitus is one of the most common otological complaints encountered. Patients often use the internet, especially YouTube videos, as a source of information regarding their health condition. There is a need to analyze the standard and quality of information in these videos so that the patients receive correct information. Objective The purpose of the present study was to evaluate the reliability and utility of YouTube videos on tinnitus. Methods The first 100 videos on YouTube using the search terms tinnitus and ringing in the ear were identified. Three subject experts assessed the reliability using the modified five-point DISCERN score and utility using a usefulness score. Various indices like view ratio, like ratio, video power index, and interaction index were also calculated. Results Out of the 100 videos selected, 34 were excluded; collectively the remaining 66 videos were viewed 12,797,730 times. The most common upload sources were hospital/physician (39%), paramedic health care providers (19%), and alternative medicine (19%). The discern score was the highest in hospital/physician group (mean 19.3) and lowest in patient experience group (mean 13.4). A negative correlation was observed between the number of views (correlation coefficient -0.214), number of likes (correlation coefficient -0.242), number of comments (correlation coefficient -0.242), and the usefulness score. Conclusion Although there are multiple videos on YouTube regarding tinnitus, the overall educational content and reliability of the videos are poor. Video popularity is not associated with usefulness. Healthcare providers should counsel patients regarding videos on YouTube and try to create more comprehensive videos.

Rigid Bronchoscopy-Brief Insight and Encounters in a Tertiary Hospital.

A brief insight of Rigid Bronchoscopy and methodology in current times in a tertiary care centre and a series of 3 recent unusual encounters of foreign body removed through rigid bronchoscopy.

Primary Thyroid Lymphoma Diagnosed on Rapid Onsite and Cytology: A Rare Case Report.

Introduction: Rapid on-site evaluation (ROSE) is an essential component of thyroid cytopathology, particularly important in thyroid lymphoma, anaplastic carcinoma, metastasis to avoid unnecessary surgery. Follicular epithelial neoplasms are the most common tumors arising from the thyroid, whereas primary thyroid lymphomas are uncommon, accounting for less than 5% of all thyroid malignancies. Case description: A 45-year-old male patient presented to our ENT outpatient department with swelling in the anterior neck for 3 years duration. Non-aspirational needling was done along with rapid on-site evaluation using 1% aq. toluidine blue and was reported as Malignant thyroid neoplasm- possibility of Non-Hodgkin lymphoma (NHL). Cellblock sample also confirmed as B-cell NHL followed by Immunohistochemistry. Discussion: Primary thyroid lymphomas (PTL) are uncommon malignant neoplasms. They represent < 5% of all thyroid malignancies and 1-2% of all extra-nodal lymphomas. If diagnosed cytologically, unnecessary surgery can be avoided in thyroid lymphoma. ROSE helps in the rapid diagnosis and sample adequacy. Cellblock can avoid the biopsy procedure used for confirmation and subtyping of lymphoma.

A Thiophenoradialene-Embedded Polycyclic Heteroterphenoquinone Exhibiting Dominant Antiaromatic Traits.

A thiophenoradialene-embedded polycyclic heteroterphenoquinone (PHTPQ) derivative of diindeno[1,2-b:2',1'-d]thiophene-2,8-dione, with antiaromatic characteristics, was synthesized by dehydrogenating its fluorescent dihydro PHTPQ precursor. The antiaromatic character was evidenced by the visible absorption band with a weakly intense tail extending to 800 nm in the near-infrared region (forbidden HOMO → LUMO transition) and non-emissive and amphoteric redox properties. Single-crystal and (anti)aromaticity analyses found a non-aromatic thiophene core while suggesting antiaromaticity/paratropicity of the pentafulvene subunits dominating the overall ground state properties.

Constructing 1-Ethoxyphenanthro[9,10-e]acephenanthrylene for the Synthesis of a Polyaromatic Hydrocarbon Containing a Formal Azulene Unit.

peri-Acenoacenes are attractive synthetic targets, but their non-benzenoid isomeric counterparts were unnoticed. 1-Ethoxyphenanthro[9,10-e]acephenanthrylene 8 was synthesized and converted to azulene-embedded 9, which is a tribenzo-fused non-alternant isomeric motif of peri-anthracenoanthracene. Aromaticity and single-crystal analyses suggested a formal azulene core for 9, which showed a smaller highest occupied molecular orbital (HOMO)-lowest unoccupied molecular orbital (LUMO) energy gap with a charge-transfer absorption band and brighter fluorescence than 8 (quantum yield (Φ): 9 = 41.8%, 8 = 8.9%). The reduction potentials of 8 and 9 were nearly identical, and the observations were further supported by density functional theory (DFT) calculations.

Dominating Antiaromatic Character of as-Indacene Decides Overall Properties of a Formally Aromatic Dicyclopenta[c]fluorenothiophene.

Dicyclopenta[c]fluorenothiophene 5 was synthesized as the isoelectronic polycyclic heteroarene analogue of an as-indacenodifluorene with a (4n + 2)π-electron perimeter. Single-crystal and 1H NMR analyses indicated a quinoidal ground state for 5, which was supported by theoretical calculations while suggesting a degree of antiaromaticity of the as-indacene subunit greater than that for s-indacenodifluorene 3. The dominant antiaromaticity for 5 was evidenced by the broad weakly intense absorption tail reaching the near-IR region, four-stage redox amphotericity, and small HOMO-LUMO energy gap.

Comparative study on Saliva and Nasopharyngeal swabs and the outcome of RT-PCR test in patients with mild symptoms of SARS-CoV-2.

AIM: A simple and reliable method for diagnosing COVID 19 infections is the needed. The role of saliva in the transmission of the infection has already been established. METHOD: Saliva and nasopharyngeal swabs from patients suspected to have COVID 19 infections were taken simultaneously, and the results of the RT-PCR were compared. RESULT: Total 405 samples were collected, of which 250 males and 155 females. In the 391 samples included for analysis, 370 (94.63%) samples were found to have concordance results, and 21 (5.37%) samples had discordant results. CONCLUSION: The use of saliva to diagnose COVID 19 infection is reliable, and its use can be recommended.

Persistent positional perceptual dizziness in clinical practice: a scoping review.

INTRODUCTION: Dizziness is an important symptom presenting in routine practice and the life time prevalence ranges from 17 to 30%. Persistent positional perceptual dizziness (PPPD) is a common cause of chronic dizziness and has often been labeled as psychogenic dizziness in the past. DISCUSSION: PPPD is diagnosed based on clinical criteria laid down by the Barany society. The vestibular function tests and imaging of the brain and the inner ear are often normal. Most of the patients have an underlying anxiety trait and most cases of PPPD arise following an attack of acute vertigo like Meniere's disease and vestibular neuritis. It is important to differentiate the condition from bilateral vestibulopathy. There is no role of vestibular sedative in the treatment of such condition. Vestibular rehabilitation therapy (VRT), cognitive behavioral therapy (CBT), and selective serotonin reuptake inhibitors (SSRI) like sertraline have shown benefits. However, long-term outcome is not known. CONCLUSION: PPPD is a relatively new entity in the ever-expanding field of neurotology that requires a multimodality approach for effective management. The otologists and general physicians must identify the condition so that favorable outcome can be achieved. The long-term effects of treatment with CBT and VRT are not known. It is important to formulate standard guidelines for treatment. Further research is necessary to identify the role of endogenous biomarkers in the outcome of treatment.

A Cross-Sectional Study on the Effect of Chronic Noise Exposure on the Vestibular Function of Traffic Policemen and Automobile Drivers.

Introduction: Noise is a preventable occupational hazard for certain professions like automobile drivers and traffic police personnel. The harmful auditory effects of noise are well known. However, little is known about the status of the vestibular function in chronic noise exposure without noise induced hearing loss. Our objective was to assess the vestibular function in chronic noise exposure. Methodology: : The study was conducted with a sample size of 242 (chronic noise exposure group - 121, group without chronic noise exposure - 121). Noise estimation was carried out across various traffic intersections to assess the noise exposure levels of the exposed group. All participants underwent a detailed vestibular evaluation in the clinical vestibulometry laboratory. Results: There was no difference in nystagmus, saccades, caloric function between the two groups. The latency and amplitude of vestibular evoked myogenic potentials (VEMP) were similar in both the groups. However, dynamic posturography showed a significant difference in the Adaptation test between the two groups (P < 0.05). We also found a statistically significant difference between the static and dynamic subjective visual vertical (SVV) and the dynamic visual acuity (DVA) between the two groups (P < 0.05). Conclusion: We did not find any clinical evidence of vestibular dysfunction in the noise exposed group. However, the statistical significance of SVV and DVA as seen in this study needs to be evaluated further as an early marker for vestibular dysfunction. It remains to be seen whether the statistically significant prolongation is reversible after the noise exposure is withdrawn.

Current Treatment Strategies Against Multidrug-Resistant Bacteria: A Review.

There are several bacteria called superbugs that are resistant to multiple antibiotics which can be life threatening specially for critically ill and hospitalized patients. This article provides up-to-date treatment strategies employed against some major superbugs, like methicillin-resistant Staphylococcus aureus, carbapenem-resistant Enterobacteriaceae, vancomycin-resistant Enterococcus, multidrug-resistant Pseudomonas aeruginosa, and multidrug-resistant Escherichia coli. The pathogen-directed therapeutics decrease the toxicity of bacteria by altering their virulence factors by specific processes. On the other hand, the host-directed therapeutics limits these superbugs by modulating immune cells, enhancing host cell functions, and modifying disease pathology. Several new antibiotics against the global priority superbugs are coming to the market or are in the clinical development phase. Medicinal plants possessing potent secondary metabolites can play a key role in the treatment against these superbugs. Nanotechnology has also emerged as a promising option for combatting them. There is urgent need to continuously figure out the best possible treatment strategy against these superbugs as resistance can also be developed against the new and upcoming antibiotics in future. Rational use of antibiotics and maintenance of proper hygiene must be practiced among patients.

Revisiting indeno[1,2-b]fluorene by steric promoted synthesis while isolating the second stable 4nπ indeno[2,1-a]fluorene.

Described herein are the steric promoted synthesis and characterization of symmetric, unsymmetric, and benzo-extended indeno[1,2-b]fluorenes 1-5, including the isolation of stable 4nπ indeno[2,1-a]fluorene 6. Single-crystal XRD analyses of 5 and 6 gave the unambiguous confirmation of unsymmetrical [1,2-b]IF and [2,1-a]IF motifs, respectively. The different ground state antiaromaticity of 5 and 6 was explained by Gimarc's approach for topological charge destabilization. The electronic properties of unsymmetrical IFs 2-5 mostly lie midway between 1 and its other known symmetrical counterparts.