Long-term survival following medical management of Aspergillus endocarditis with dissemination as a consequence of steroid therapy in severe COVID-19 pneumonia.

A male in his 40's with no known comorbidities developed severe COVID-19 pneumonia and received a four-week course of methylprednisolone. The patient subsequently developed disseminated Aspergillus endocarditis, manifesting as multiple organ involvement including the heart, eyes, and brain. Despite the poor prognosis generally associated with fungal endocarditis, the patient survived following aggressive medical management with a combination of liposomal amphotericin b and voriconazole therapy and is now doing well for over two years and is off antifungal therapy for a year.

NKX3.1 Expression in Non-Prostatic Tumors and Characterizing its Expression in Esophageal/Gastroesophageal Adenocarcinoma.

The NKX3.1 immunohistochemical stain is widely recognized as a highly sensitive and specific marker for prostate adenocarcinoma. Nevertheless, its expression has been documented in various nonprostatic tissues and malignancies. This review aims to provide an overview of NKX3.1 expression in diverse tumor types, with a specific focus on its aberrant expression in esophageal/gastroesophageal adenocarcinoma (E/GE-ADC). In our investigation, we explored the expression of NKX3.1 in a series of E/GE-ADC to shed light on its prevalence in this tumor category. A total of 50 samples, comprising primary and metastatic E/GE-ADC specimens from 34 patients, were subjected to immunohistochemical analysis. Stained sections were scored based on the intensity and distribution-categorized as negative, weak, moderate, or strong in either a focal or diffuse pattern. Strong staining corresponds to the intensity observed in normal prostate controls, while focal and diffuse staining denote <50% and ≥50% of tumor nuclei staining positive, respectively. Our semiquantitative scoring revealed that 6 (12%) of the primary and metastatic E/GE-ADC specimens exhibited variable positivity for NKX3.1. This finding suggests that E/GE-ADC can sporadically stain positive for NKX3.1, introducing potential challenges in definitively determining the primary site of origin in certain clinical scenarios. Along with a literature review of NKX3.1 expression in other tumor types, our study provides additional important information about the extent to which this immunostain can be seen in E/GE-ADCs, which, to our knowledge, has not been reported.

Comparative Evaluation of Titanium Feedstock Powder Derived from Recycled Battlefield Scrap vs. Virgin Powder for Cold Spray Processing.

Gas-atomization is extensively used to produce metallic feedstock powders for additive manufacturing processes, including gas dynamic cold spray processing. This work explores the potential utility of on-demand recycled titanium scrap feedstock powder as a viable substitute for virgin powder sources. Three recycled titanium powders were atomized from different battlefield scrap sources using a mobile foundry developed by MolyWorks Materials Corporation. Recycled titanium alloy powders were compared against virgin Ti-6Al-4V powder to verify there were no significant variations between the recycled and virgin materials. Powder characterization methods included chemical analysis, particle size distribution analysis, scanning electron microscopy (SEM), Karl Fischer (KF) titration moisture content analysis, X-ray diffraction (XRD) phase analysis, microparticle compression testing (MCT), and nanoindentation. Results indicate that recycled titanium powder provides a viable alternative to virgin titanium alloy powders without compromising mechanical capabilities, microstructural features, or ASTM-specified composition and impurity standards. The results of this work will be used to aid future research efforts that will focus on optimizing cold spray parameters to maximize coating density, mechanical strength, and hardness of recycled titanium feedstock powders. "Cold spray" presents opportunities to enhance the sustainability of titanium component production through the utilization of recycled feedstock powder, mitigating issues of long lead times and high waste associated with the use of conventional virgin feedstock.

Green and sustainable synthesis of CaO nanoparticles: Its solicitation as a sensor material and electrochemical detection of urea.

Urea is recognized as one of the most frequently used adulterants in milk to enhance artificial protein content, and whiteness. Drinking milk having high urea concentrations which causes innumerable health disputes like ulcers, indigestion, and kidney-related problems. Therefore, herein, a simple and rapid electroanalytical platform was developed to detect the presence of urea in milk using a modified electrode sensor. Calcium oxide nanoparticles (CaO NPs) were green synthesized and used as a catalyst material for developing the sensor. Synthesized materials formation was confirmed by different techniques like FTIR, UV-visible, XRD, SEM-EDX, and Raman spectroscopy. The carbon paste electrode (CPE) was modified using the CaO NPs and used as a working electrode during the analysis followed by cyclic voltammetry and differential pulse voltammetry (DPV) techniques. The fabricated calcium oxide modified carbon paste electrode (CaO/CPE) successfully detected the presence of urea in the lower concentration range (lower limit of detection (LLOD) = 0.032 µM) having a wide linear detection range of 10-150 µM. Adsorption-controlled electrode process was achieved at the scan rate variation parameter. The leading parameters like the selectivity, repeatability, and stability of the CaO/CPE were investigated. The relative standard deviation of sensor was ± 3.8% during the interference and stability study.

Characterization and predictive risk scoring of long COVID in a south indian cohort after breakthrough COVID infection; a prospective single centre study.

BACKGROUND: With the World Health Organization (WHO) declaring an end to the COVID-19 pandemic, the focus has shifted to understanding and managing long-term post-infectious complications. "Long COVID," characterized by persistent or new onset symptoms extending beyond the initial phase of infection, is one such complication. This study aims to describe the incidence, clinical features and risk profile of long COVID among individuals in a South Indian cohort who experienced post-ChAdOx1 n-Cov-2 vaccine breakthrough infections. METHODS: A single-centre hospital-based prospective observational study was conducted from October to December 2021. The study population comprised adult patients (> 18 years) with a confirmed COVID-19 diagnosis who had received at least a single dose of vaccination. Data was collected using a specially tailored questionnaire at week 2, week 6, and week 12 post-negative COVID-19 test. A propensity score based predictive scoring system was developed to assess the risk of long COVID. RESULTS: Among the 414 patients followed up in the study, 164 (39.6%) reported long COVID symptoms persisting beyond 6 week's post-infection. The presence of long COVID was significantly higher among patients above 65 years of age, and those with comorbidities such as Type II Diabetes Mellitus, hypertension, dyslipidemia, coronary artery disease, asthma, and cancer. Using backwards selection, a reduced model was developed, identifying age (OR 1.053, 95% CI 0.097-1.07, p < 0.001), hypertension (OR 2.59, 95% CI 1.46-4.59, p = 0.001), and bronchial asthma (OR 3.7176, 95% CI 1.24-11.12, p = 0.018) as significant predictors of long COVID incidence. A significant positive correlation was observed between the symptomatic burden and the number of individual comorbidities. CONCLUSIONS: The significant presence of long COVID at 12 weeks among non-hospitalised patients underscores the importance of post-recovery follow-up to assess for the presence of long COVID. The predictive risk score proposed in this study may help identify individuals at risk of developing long COVID. Further research is needed to understand the impact of long COVID on patients' quality of life and the potential role of tailored rehabilitation programs in improving patient outcomes.

Effect of gypsum waste inclusion on syngas production during CO2-assisted gasification of waste tires.

Syngas production from co-gasification of waste tires and different amounts of drywall waste gypsum (CaSO4) was investigated using CO2 as the gasifying agent in a lab-scale reactor. Gypsum is known to react with carbon feedstocks through solid-solid reactions to produce CaS and CaO, CO, and CO2. The presence of gypsum in waste tires increased the syngas yield from the conversion of char and tars. Gypsum addition to the waste tire also increased syngas quality from increased syngas energy yield. The overall yield of syngas increased by up to 55% while the energy yield (MJ/ kg feedstock) improved by 40% with gypsum addition. The product gas yield, energy, H2, and CH4 yields increased with gypsum addition while CO only increased for lower gypsum concentrations. Higher gypsum addition increased CO2 yields. Aspen Plus simulation results revealed that for waste tires, temperatures < 1200 °C suppressed the transformation of sulfur present in gypsum into SO2 for all waste tires to gypsum feed mass ratios. At 50 wt% gypsum concentrations, only 2% of the sulfur in the feedstock was transferred into SO2. The results showed improved syngas yield and quality, without any increase in sulfur emissions showing the benefits of gypsum waste incorporation in waste tire gasification.

The genome of Symbiodiniaceae-associated Stutzerimonas frequens CAM01 reveals a broad spectrum of antibiotic resistance genes indicating anthropogenic drift in the Palk Bay coral reef of south-eastern India.

An increase in antibiotic pollution in reef areas will lead to the emergence of antibiotic-resistant bacteria, leading to ecological disturbances in the sensitive coral holobiont. This study provides insights into the genome of antibiotics-resistant Stutzerimonas frequens CAM01, isolated from Favites-associated Symbiodiniaceae of a near-shore polluted reef of Palk Bay, India. The draft genome contains 4.67 Mbp in size with 52 contigs. Further genome analysis revealed the presence of four antibiotic-resistant genes, namely, adeF, rsmA, APH (3")-Ib, and APH (6)-Id that provide resistance by encoding resistance-nodulation-cell division (RND) antibiotic efflux pump and aminoglycoside phosphotransferase. The isolate showed resistance against 73% of the antibiotics tested, concurrent with the predicted AMR genes. Four secondary metabolites, namely Aryl polyene, NRPS-independent-siderophore, terpenes, and ectoine were detected in the isolate, which may play a role in virulence and pathogenicity adaptation in microbes. This study provides key insights into the genome of Stutzerimonas frequens CAM01 and highlights the emergence of antibiotic-resistant bacteria in coral reef ecosystems.

Are we providing complete drug information to its users? Status of information adequacy of package insert in India.

Background: Package inserts (PIs) serve detailed information on drug products to the users and primary care physicians, so information should be accurate, reliable, and as per the regulatory guidelines. The study aims to analyze the information adequacy of the PIs available in the Indian market as per Drug and Cosmetic Rule 1945 and US Food and Drug Administration criteria. Materials and Methods: A cross-sectional study was conducted on PIs collected from accessible pharmacy stores. Information provided was recorded as per criteria, and total information adequacy score (IAS) and information deficiency (IDS) score were calculated. The association of factors like single-drug/FDCs, a company of origin Indian/multinational, and route of administration (ROA) with IDS was statistically analyzed. Results: Of 120 PIs, 60%, 86.66%, and 73% were single-drug, prescription-drug, and drugs by Indian manufacturers, respectively. Most PIs provided generic names, ROA, and indications for use. 85%, 12%, 29.16%, and 3.33% provided information on PIs on the ability to drive, drug-food interactions, drug-drug interactions, and addiction potential, respectively. Lacking area was information on use in pediatrics-geriatrics (30%), excipients (28.3%), preclinical (15.83%), post-surveillance data (18.33%), and approval date (2.5%). There was a statistically significant difference between pharmaceutical score (3.22 vs 4.12), therapeutic score (11.5 vs 13.18), and total IAS (14.78 ± 3.39 vs 17.31 ± 2.33) of Indian and multinational companies. IDS was statistically significantly different in both pharmaceutical and therapeutic categories for single-drug vs FDCs (P = 0.00001), OTC vs prescription drugs (P < 0.05), and Indian vs multinational companies' PIs (P = 0.00001). Conclusion: Numerous facets of information are lacking in PIs, and they do not impart whole information, especially of Indian origin, as per objective IDS.

The effect of the COVID-19 pandemic on the gender gap in research productivity within academia.

Using measures of research productivity to assess academic performance puts women at a disadvantage because gender roles and unconscious biases, operating both at home and in academia, can affect research productivity. The impact of the COVID-19 pandemic on research productivity has been the subject of a number of studies, including studies based on surveys and studies based on numbers of articles submitted to and/or published in journals. Here, we combine the results of 55 studies that compared the impact of the pandemic on the research productivity of men and women; 17 of the studies were based on surveys, 38 were based on article counts, and the total number of effect sizes was 130. We find that the gender gap in research productivity increased during the COVID-19 pandemic, with the largest changes occurring in the social sciences and medicine, and the changes in the biological sciences and TEMCP (technology, engineering, mathematics, chemistry and physics) being much smaller.

Improving Information Extraction from Pathology Reports using Named Entity Recognition.

Pathology reports are considered the gold standard in medical research due to their comprehensive and accurate diagnostic information. Natural language processing (NLP) techniques have been developed to automate information extraction from pathology reports. However, existing studies suffer from two significant limitations. First, they typically frame their tasks as report classification, which restricts the granularity of extracted information. Second, they often fail to generalize to unseen reports due to variations in language, negation, and human error. To overcome these challenges, we propose a BERT (bidirectional encoder representations from transformers) named entity recognition (NER) system to extract key diagnostic elements from pathology reports. We also introduce four data augmentation methods to improve the robustness of our model. Trained and evaluated on 1438 annotated breast pathology reports, acquired from a large medical center in the United States, our BERT model trained with data augmentation achieves an entity F1-score of 0.916 on an internal test set, surpassing the BERT baseline (0.843). We further assessed the model's generalizability using an external validation dataset from the United Arab Emirates, where our model maintained satisfactory performance (F1-score 0.860). Our findings demonstrate that our NER systems can effectively extract fine-grained information from widely diverse medical reports, offering the potential for large-scale information extraction in a wide range of medical and AI research. We publish our code at https://github.com/nyukat/pathology_extraction.

Vascular Control in Nose and Paranasal Sinus Tumours.

Effective management of Tumors of Nose and Paranasal Sinuses (PNS) require adequate vascular control of the vessels supplying the tumor to facilitate complete removal and to reduce the complications. To emphasize the role of prior control of feeding vessels in reducing intraoperative blood loss, achieving bloodless fields for endoscopic excision and in facilitating complete excision of tumors of Nose and PNS. A prospective study of 23 patients who were operated for various tumors of Nose and PNS by either Endoscopic or Open approaches for which intraoperative control of the feeding vessels was done based on the Radiological findings. The mean average blood loss was 280 ml and mean Operating time for Endoscopic approach was less than 2 h. All the patients were stable postoperatively and none of the patients had worrisome intraoperative hemorrhage or required multiple blood transfusions. All the patients had complete removal of the tumor. Prior identification of all the vessels that supply the tumor and planning to control them before manipulating the tumor always gives us good results. Tumors supplied by single vessel can be controlled by Embolization or intraoperative clamping, when the tumor is supplied by multiple vessels or when it is not possible to access the vessel by the size of the tumor, Temporary Clamping of the main vessel is a definitive alternative.

Penicilliosis in a Non-HIV Patient: A Case Report.

A 68-year-old female, with a known case of mantle cell lymphoma, came with complaints of persistent cough with expectoration for three months, not responding to multiple courses of antibiotics. Bronchoscopy was done and bronchoalveolar lavage (BAL) culture revealed Penicillium species. She was started on IV liposomal amphotericin B for 14 days and then switched to oral itraconazole which showed a response to treatment. Early diagnosis of penicilliosis and prompt treatment are important as it is rare and associated with a high mortality rate.

Signal amplification in growth cone gradient sensing by a double negative feedback loop among PTEN, PI(3,4,5)P3 and actomyosin.

Axon guidance during neural wiring involves a series of precisely controlled chemotactic events by the motile axonal tip, the growth cone. A fundamental question is how neuronal growth cones make directional decisions in response to extremely shallow gradients of guidance cues with exquisite sensitivity. Here we report that nerve growth cones possess a signal amplification mechanism during gradient sensing process. In neuronal growth cones of Xenopus spinal neurons, phosphatidylinositol-3,4,5-trisphosphate (PIP3), an important signaling molecule in chemotaxis, was actively recruited to the up-gradient side in response to an external gradient of brain-derived neurotrophic factor (BDNF), resulting in an intracellular gradient with approximate 30-fold amplification of the input. Furthermore, a reverse gradient of phosphatase and tensin homolog (PTEN) was induced by BDNF within the growth cone and the increased PTEN activity at the down-gradient side is required for the amplification of PIP3 signals. Mechanistically, the establishment of both positive PIP3 and reverse PTEN gradients depends on the filamentous actin network. Together with computational modeling, our results revealed a double negative feedback loop among PTEN, PIP3 and actomyosin for signal amplification, which is essential for gradient sensing of neuronal growth cones in response to diffusible cues.

Preliminary investigation on stability and hydraulic performance of geotextile sand container breakwaters filled with sand and cement.

Breakwaters are essential constructions providing tranquility to ports and harbour structures, when there is a lack of natural protection measures. Traditionally these massive structures are constructed using natural rocks weighing tonnes. In the present scenario, obtaining huge natural rocks are difficult as well as non-eco-friendly. Geotextiles sand containers (GSCs) emerges as a suitable alternative for the rock armour units of breakwaters and various literatures supports its efficacy. The present investigation aims at analysing the performance of GSCs when filled with a calculated amount of cement and sand. The Hydraulic performance and stability analysis of cement and sand filled geotextile breakwater models are carried out in a 1:30 scaled monochromatic wave flume. When GSC breakwaters are filled with sand and cement, up to 43% increased stability is observed with a considerable decrease in wave runup, rundown and reflection, than sand-alone filled units. As a result, cement-sand filled GSC units can be suggested as a possible alternative to sand alone filled units where vandalism has to be countered.

The shortest distance between the skin and the peritoneal cavity is obtained with fascial elevation: a preliminary prospective laparoscopic entry study.

The purpose of this study was to prospectively compare the measurement of skin-to-fascia distances in the neutral state, during manual elevation and by fascial elevation in patients who underwent laparoscopic surgery. In 53 patients, the distance between the skin and anterior wall of the rectus sheath was measured prospectively in following three different ways: (1) in neutral position, (2) during manual elevation and (3) during elevation of the fascia using forceps following an infraumbilical vertical skin incision. In all patients, subcutaneous tissue up to the fascia was dissected after a vertical skin incision. The skin-to-fascia distance of 30.9 mm (14.0-52.0 mm) in the neutral position decreased to 11.1 mm (0.0-26.0 mm) during the fascial elevation, while the mean distance increased to 40.1 mm (19-70 mm) during manual elevation (p < 0.001). In the closed laparoscopic entry technique in which a Veress needle is inserted into the peritoneum through a small incision, the needle should be introduced from the shortest distance between the skin and the peritoneum. Lifting the fascia with a proper surgical instrument in suitable patients could enable us to achieve this goal.

Prostatic abscess due to blastomycosis.

Blastomycosis is an endemic infection caused by Blastomyces dermatitidis, found primarily in the southeastern, south-central, and Midwest United States. While the majority of infections typically present with pulmonary manifestations, they rarely present with symptoms isolated to the prostate. In order to better understand the clinical presentation, evaluation, and treatment of blastomycosis of the prostate, we present a 59-year-old male with urinary retention and lower urinary tract symptoms (LUTS).

Formulation and evaluation of pH activated dosage form as minitablets in capsule for delivery of fesoterodine.

OBJECTIVES: In the present study, an attempt is made to develop novel multifunctional sustained-release minitablets in a capsule system by film coating Fesoterodine for the treatment of urinary incontinence (increased urinating frequency). METHODOLOGY: The direct compression technique was used to formulate the minitablets, and coating was applied using hydroxypropyl methylcellulose (HPMC) phthalate. The pre-formulation study was performed using tools like differential scanning calorimetry (DSC), infrared spectroscopy (IR) and post-formulation parameters such as hardness, thickness, weight variation, uniformity, and drug release. Drug release kinetics were studied for the formulations F1-F11. RESULTS: All the pre- and post-formulation parameters were found to be within the limits. F1 and F2 result in burst release of the drug within 30 minutes. For the F3, F4, and F5 formulations, HPMC phthalate-coated minitablets show almost 100% drug release in 3, 4, and 5 hours, respectively. F6, F7, and F8 (2.5%, 5%, and 10% formaldehyde-coated minitablets, respectively) show drug releases in the small intestine, and the release was prolonged for 24 hours, whereas F9, F10, and F11 (2.5%, 5%, and 10% glutaraldehyde-coated minitablets, respectively) release in the small intestine, but drug release takes more than 20 hours. CONCLUSION: Film-coated minitablets were satisfactorily developed in terms of various post-compression parameters like hardness, thickness, friability, weight variation, and content uniformity. IR and DSC studies revealed no significant drug excipient interactions. HPMC phthalate-coated minitablets released in the buffer, and it was supposed that the drug releases in the intestine, which leads to better absorption and follows Korsmeyer-Peppas release kinetics.

Revealing the effect of lipopeptide on improving the probiotics characteristics: Flavor and texture enhancer in the formulated yogurt.

Probiotics are beneficial viable microorganisms that protects from pathogens, enhance immunity and health. In this study, a biosurfactant from marine sponge associated bacteria MS48 was used to effectively enhance the survival of starter cultures and thereby improving their functional properties. The biosurfactant MS48 was characterized as lipopeptide based upon the spectroscopic analysis. The GC-MS analysis showed the moiety as l-glutamic acid methyl ester with the mass of m/z 161.16. Probiotics supplemented with lipopeptide showed better survival in the stress tolerance assays includes acid, bile, heat, salt stress and other assays including auto-aggregation, hydrophobicity, microbial adhesion to solvents (MATS), and simulated gastric juice. Yogurt formulated using lipopeptide showed enhanced flavor components, stability, improved characteristics, EPS production, and lower syneresis than the control. Malonic acid, acidity regulator was detected in the mass spectrum of lipopeptide added yogurt. The texture analysis of the lipopeptide added yogurt showed improved textural and sensorial properties when compared to the control.

Study of Endothelial Dysfunction in Patients With Non-alcoholic Fatty Liver Disease.

Background Metabolic syndrome (syndrome X) is the name for a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke. Dilatation of blood vessels following stress is a function of vasodilators produced by the endothelium. Flow-mediated vasodilation assesses endothelial function. In the case of endothelial dysfunction, flow-mediated vasodilation is impaired, resulting in decreased or even absence of vasodilation following stress. The easy availability of ultrasound machines nowadays and the non-invasive nature of the test make this a practical test for assessing endothelial dysfunction and the risk of cardiovascular diseases. Various studies have confirmed the presence of impaired flow-mediated vasodilation in patients with coronary artery disease. However, the presence of impaired flow-mediated vasodilation in individuals with risk factors but no cardiovascular diseases can prove that this can be used to predict individuals at risk. This study tries to confirm the presence of endothelial dysfunction in patients with non-alcoholic fatty liver disease (NAFLD) attending a tertiary center hospital in Kochi. Objectives The study's main aim is to compare flow-mediated dilatation in patients with NAFLD and normal individuals. Materials and methods The comparative study was conducted among 50 patients attending various outpatient departments in Amrita Institute of Medical Sciences, Kochi. History and examination of cases and controls and relevant investigations were done after obtaining consent. In addition, both groups underwent measurement of flow-mediated vasodilation in the radiology department. Data were entered in Microsoft Excel and were analyzed using SPSS. Results Flow-mediated vasodilation was found to be less in patients with fatty liver (7.37 ± 2.75) when compared to individuals with normal liver (12.41 ± 3.71). In addition, flow-mediated vasodilatation was inversely proportional to BMI and age. Conclusion This study has proved that there will be endothelial dysfunction in NAFLD, as shown by the decrease in flow-mediated vasodilation when compared with normal liver.

Anti-diabetic Potential of a Stigmasterol From the Seaweed Gelidium spinosum and Its Application in the Formulation of Nanoemulsion Conjugate for the Development of Functional Biscuits.

The seaweed Gelidium spinosum was selected for the extraction of phytosterol by the Soxhlet method. The extracted phytosterol was chemically characterized as stigmasterol using Fourier-transform infrared spectrometry and gas chromatography-mass spectrometry analysis. The antioxidant and α-amylase inhibitory activity of stigmasterol has been confirmed by in vitro assays. The in vivo studies demonstrated an anti-diabetic effect in streptozotocin (STZ)-induced hyperglycemic rats. Biochemical analysis showed administration of stigmasterol reduced the blood sugar, urea, and creatinine level. The stigmasterol was then nano-emulsified and incorporated into dough for biscuit formulation. The stigmasterol incorporated biscuit showed higher proximate values, low moisture content, lighter color and the textural property revealed lower hardness. Sensorial results showed acceptability when compared to the control. This study demonstrated the stigmasterol reduced hyperglycemic effects and therefore could be used as a supplement in diets for diabetic patients.