Neoadjuvant Chemotherapy in Locally Advanced Sinonasal Teratocarcinosarcoma a Rare Malignancy: An Audit From an Academic Tertiary Care Centre in India.

AIMS: Sinonasal teratocarcinosarcomas (SNTCS) are rare sinonasal malignancies, the incidence of which is less than 1% of all tumors. There is limited data available on SNTCS's, often as case reports and small case series. The management of SNTCS is complicated because of its location, locally aggressive biology, difficulty in achieving complete resection, and limited data on chemotherapy in these malignancies. This audit was performed to understand the role of neoadjuvant chemotherapy (NACT) in SNTCS's, its ability to downstage the disease, achieve complete resection, and impact on long-term survival outcomes. METHODS: This was a retrospective analysis of a prospectively maintained database approved by the Institutional Ethics Committee (IEC). The baseline characteristics, the extent of tumor, Kadish stage, NACT regimen, and adverse events were extracted from the Electronic Medical Records and the patient's case file. Patients with baseline extensive/inoperable disease were referred for NACT from the multidisciplinary joint clinic followed by response assessment (RECIST v1.1). Patients underwent skull-base surgery if respectable post-completion of NACT, however, if deemed unresectable were treated with non-surgical modalities or palliative therapies. RESULTS: The data of 27 patients were evaluated from the year 2015-2022. The median age was 42 years (IQR:30-56) and 85.2% (n = 23) were males. The ECOG-PS was 0-1 in 88.8% (n = 24) patients. All 27 patients received NACT in view of extensive disease at presentation. 74.1% (n = 20) patients received Cisplatin-Etoposide and 25.9% (n = 7) received other chemotherapy regimens. The median number of chemotherapy cycles was 2(IQR:2-3). 96.3% patients (n = 26) completed the planned NACT cycles. 70.4% (n = 19) patients achieved a partial response in post-NACT imaging. 77.8% (n = 18) underwent surgery, 18.5% (n = 5) received CTRT, and 7.4% (n = 2) received definitive-RT alone. The median PFS and OS of the cohort was 19months (95%CI:12.0-25.6) and 23months (95%CI:5.94-40.06) respectively. CONCLUSION: NACT is safe, feasible, and effective with significant response rates, leading to effective downstaging, resectability and improved survival in patients with locally advanced SNTCS's.

The effect of water in THF/water mixtures on CMC, aggregation sizes, and fluorescence quenching of a new calix[4]resorcinarene macrocycle.

This study explores how water content modulates the self-assembly and fluorescence behavior of a novel calixarene, C1. C1 forms large, flattened structures in pure THF, but water addition triggers a transition to smaller, unimodal clusters. A critical micellar concentration (CMC) is identified, decreasing with increasing water content. Fluorescence quenching is observed upon water addition, attributed to nonradiative deactivation. These findings highlight water as a key regulator of C1's assembly and fluorescence, paving the way for further development of water-responsive calixarene systems.

Evidence for chronic headaches induced by pathological changes of myodural bridge complex.

Clinical studies have shown that there may be a certain relationship between pathological changes of the myodural bridge complex (MDBC) and chronic headaches of unknown cause. But there is still a lack of experimental evidence to explain the possible mechanism. This study aims to further confirm this relationship between MDBC and chronic headaches and explore its potential occurrence mechanism in rats. Bleomycin (BLM) or phosphate-buffered saline (PBS) was injected into the myodural bridge fibers of rats to establish the hyperplastic model of MDBC. After 4 weeks, the occurrence of headaches in rats was evaluated through behavioral scores. The immunohistochemistry staining method was applied to observe the expression levels of headache-related neurotransmitters in the brain. Masson trichrome staining results showed that the number of collagen fibers of MDBC was increased in the BLM group compared to those of the other two groups. It revealed hyperplastic changes of MDBC. The behavioral scores of the BLM group were significantly higher than those of the PBS group and the blank control group. Meanwhile, expression levels of CGRP and 5-HT in the headache-related nuclei of the brain were increased in the BLM group. The current study further confirms the view that there is a relationship between pathological changes of MDBC and chronic headaches of unknown cause. This study may provide anatomical and physiological explanations for the pathogenesis of some chronic headaches of unknown cause.

Exceptionally high proton conductivity in Eu2O3 by proton-coupled electron transfer mechanism.

Proton conductors are typically developed by doping to introduce structural defects such as oxygen vacancies to facilitate ionic transport through structural bulk conduction mechanism. In this study, we present a novel electrochemical proton injection method via an in situ fuel cell process, demonstrating proton conduction in europium oxide (Eu2O3) through a surficial conduction mechanism for the first time. By tuning Eu2O3 into a protonated form, H-Eu2O3, we achieved an exceptionally high proton conductivity of 0.16 S cm-1. Distribution of relaxation time (DRT) analysis was employed to investigate the proton transport behavior and reveal the significant contribution of surface proton transport to the overall conductivity of Eu2O3. Remarkably, H-Eu2O3 exhibited a low activation energy for ionic transport, comparable to the best ceramic electrolytes available. The proton-coupled electron transfer (PCET) mechanism describes this novel surficial proton conduction mechanism. These findings provide new possibilities for developing advanced proton conductors with improved performance.

Systemic azithromycin versus amoxicillin/metronidazole as an adjunct in the treatment of periodontitis: a systematic review and meta-analysis.

BACKGROUND: The use of systemic azithromycin (AZT) and amoxicillin/metronidazole (AMX/MTZ) as adjuncts provided additional clinical and microbiological benefits over subgingival instrumentation alone. However, the superiority of one antibiotic regimen over another has not been proven. Therefore, the aim of this systematic review and meta-analyses was to evaluate the clinical efficacy and safety of subgingival instrumentation (SI) in conjunction with the systemic use of AZT or AMX/MTZ for the treatment of periodontitis from current published literature. METHODS: Electronic databases were searched to identify randomized controlled trials (RCTs), controlled clinical trials, prospective and retrospective human studies that compared the adjunctive use of systemic AZT to AMX/MTZ with SI in the treatment of periodontitis. The eligibility criteria were defined based on the participant (who had periodontitis), intervention (SI with adjunctive use of systemic AZT), comparison (SI with adjunctive use of systemic AMX/MTZ), outcomes (primary outcome: changes in probing pocket). The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Data were analysed using a statistical software program. RESULTS: Five studies with 151 participants with periodontitis were included in the present review. Of these, 74 participants received adjunctive AZT, while the remaining participants received AMX/MTZ as an adjunct to SI. The adjunctive use of AZT and AMX/MTZ had comparable changes in probing pocket depths at 1-3 months with no statistically significant difference (mean difference (MD) 0.01; 95% CI -0.20 to 0.22; P = 0.94). The adjunctive use of AZT had significantly fewer number of residual sites with probing pocket depths of ≥5 mm at 1-3 months compared to the adjunctive use of AMX/MTZ (MD -3.41; 95% CI -4.73 to -2.10; P < 0.0001). The prevalence rates of adverse events among participants who received AZT and AMX/MTZ were 9.80% and 14.8%, respectively. The meta-analysis showed that the difference between the two groups was not statistically significant (risk ratio 0.69; 95% CI 0.28 to 1.72; P = 0.43). CONCLUSIONS: Within the limitation of this review, there was no superiority between AZT and AMX/MTZ in terms of mean changes in probing pocket depths, clinical attachment level, bleeding on probing at 1-3 months. AZT seem to be associated with less sites with residual probing pocket depths of ≥5 mm at 1-3 months and fewer adverse events compared with AMX/MTZ. © 2023 Australian Dental Association.

Clinico-epidemiological profile of non-survivors of COVID-19 during the last two waves in a tertiary care hospital of North India: A retrospective descriptive study.

Background: SARS-CoV-causing COVID-19 resulted in mortality, and the clinic-epidemiological profile at the time of admission of patients who died later could provide an insight into pathophysiological consequences due to infection. Method: Retrospective observational study of 64 RTPCR-confirmed COVID-19 non-survivors was conducted from April - June 2021 and January February 2022. Data were analyzed, and a P value<0.05 was taken as significant. Results: 60.94% and 39.06 % were males and females, and 26.57% & 73.43 % of patients had moderate and severe disease, respectively. Fever, cough, and dyspnea were the most common presenting symptoms. 78.12% and 21.88% had pre-existing (diabetes and hypertension were most common) and no co-morbidities, respectively. 65.62 & 17.19 % of patients had bilateral and unilateral ground glass opacities, respectively. Thrombocytopenia, lymphopenia, neutrophilia, elevated monocytes, and neutrophil-lymphocyte ratio (NLR) of 7.52 were hematological findings. D dimer was elevated. ABG showed low PaO2 and SPO2 %. ALT and AST were elevated. Tachycardia was also present. Compared to the first wave, no significant association of gender with severity was found. However, the percentage of male patients was higher. The association of the duration of stay and co-morbidity with disease severity was significant in both the first and subsequent waves of COVID-19. Conclusion: Co-morbidity, disease severity, and radiological lung opacities play a role in the outcome of COVID-19. The associated findings are hematological, renal, liver, cardiovascular, and arterial blood gas derangements.

Suture-fixation of a levonorgestrel-releasing intrauterine device under hysteroscopic guidance.

Background: Abnormal uterine bleeding (AUB) is a common gynaecological condition. The levonorgestrel-releasing Intrauterine device (LNG-IUD) is an effective medical treatment. option which carries a small risk of device expulsion. For those who experience expulsion, some may benefit from a more robust surgical approach. Objectives: To demonstrate the technique for suture fixation of an LNG-IUD under hysteroscopic guidance. Materials and methods: Stepwise video demonstration of the technique using a 5mm hysteroscope and a 3mm laparoscopic needle holder. The Institutional Ethical Committee was consulted, and the requirement for approval was waived because the video described a modified surgical technique. Informed consent was obtained from the patient. Main outcome measures: A 35yr old parous woman with a nine-month history of AUB and severe dysmenorrhoea had an LNG-IUD sited with effective symptom relief. Unfortunately, the device was expelled six months after insertion, and she responded poorly to other medical treatments. Transvaginal ultrasonography (TVUS) suggested posterior wall adenomyosis. Considering her relief of symptoms with the LNG-IUD and history of expulsion, the patient was counselled regarding suture-fixation of the LNG-IUD. Results: She was followed-up at 6 months post insertion. The LNG-IUD was noted in the uterine cavity without displacement or expulsion. Conclusion: Hysteroscopy-guided suture fixation of an LNG-IUD is a minimally invasive, effective option for patients with a history of expulsion of an IUD. However, further studies are required to establish the safety and efficacy of this approach. Learning Objective: To demonstrate LNG -IUD suture fixation technique using hysteroscopy for patients diagnosed with AUB and a history of device expulsion.

Synthesis, biological evaluation and in silico investigations of benzotriazole derivatives as potential inhibitors of NIMA related kinase.

In the current study, a novel compound, bis(3-(2H-benzo[d][1,2,3]triazol-2-yl)-2-(prop-2-yn-1-yloxy)-5-(2,4,4-trimethylpentan-2-yl)phenyl)methane (TAJ1), has been synthesized by the reaction of 6,6'-methylenebis(2-(2H-benzo[d][1,2,3]triazol-2-yl)-4-(2,4,4-trimethylpentan-2-yl)phenol) (1), propargyl bromide (2) and potassium carbonate. Spectroscopic (FTIR, 1H-NMR, 13C-NMR) and single-crystal assays proved the structure of the synthesized sample. XRD analysis confirmed the structure of the synthesized compound, showing that it possesses two aromatic parts linked via a -CH2 carbon with a bond angle of 108.40°. The cell line activity reported a percent growth reduction for different cell types (HeLa cells, MCF-7 cells, and Vero cells) under various treatment conditions (TAJ1, cisplatin, and doxorubicin) after 24 hours and 48 hours. The percent growth reduction represents a decrease in cell growth compared to a control condition. Furthermore, density functional theory (DFT) calculations were utilized to examine the frontier molecular orbitals (FMOs) and overall chemical reactivity descriptors of TAJ1. The molecule's chemical reactivity and stability were assessed by determining the HOMO-LUMO energy gap. TAJ1 displayed a HOMO energy level of -0.224 eV, a LUMO energy level of -0.065 eV, and a HOMO-LUMO gap of 0.159 eV. Additionally, molecular docking analysis was performed to assess the binding affinities of TAJ1 with various proteins. The compound TAJ1 showed potent interactions with NEK2, exhibiting -10.5 kcal mol-1 binding energy. Although TAJ1 has demonstrated interactions with NEK7, NEK9, TP53, NF-KAPPA-B, and caspase-3 proteins, suggesting its potential as a therapeutic agent, it is important to evaluate the conformational stability of the protein-ligand complex. Hence, molecular dynamics simulations were conducted to assess this stability. To analyze the complex, root mean square deviation (RMSD) and root mean square fluctuation analyses were performed. The results of these analyses indicate that the top hits obtained from the virtual screening possess the ability to act as effective NEK2 inhibitors. Therefore, further investigation of the inhibitory potential of these identified compounds using in vitro and in vivo approaches is recommended.

Microbiome Analysis of Organic and Conventional Chickens Processed Using Whole Carcass Enrichment and Rinse Methods.

Investigating the chicken microbiome is important to establish control measures for pathogens to protect consumers. This study aimed at evaluating the comparative efficiency of human pathogen detection through 16S rRNA sequencing of organic and conventional chickens processed using whole carcass enrichment (WCE) and rinse (WCR) methods. Organic and conventional whole broiler carcasses (n = 31) were vigorously shaken with 500 mL buffered peptone water (BPW). For the rinse method, a 30 mL aliquot was mixed with 30 mL of BPW. The rest of the sample, including the carcass, was used for the enrichment method. All samples were incubated at 37°C for 24 h. The samples were divided into five groups [Negative Control: only BPW without chicken (n = 5), Organic-Rinsed (n = 7), -Enriched (n = 8), Conventional-Rinsed (n = 7), and -Enriched (n = 9)]. Fifty milliliters of each sample were subjected to DNA extraction followed by 16S rRNA sequencing. Proteobacteria and Firmicutes predominated the microbiota of both conventional and organic chickens, followed by low abundances of Bacteroidetes and Fusobacterium. While the abundance of Proteobacteria and Firmicutes remained unchanged in organic chicken irrespective of the methods used, a noticeable shift in the Proteobacteria and Firmicutes ratio (59%:39% in rinsed to 38%:60% in enriched) was observed in conventional chicken. Furthermore, the choice of method did not yield any differences in Abundance-Based Coverage Estimator, and Jackknife, among conventional and organic chickens but resulted in a statistically significant difference in the Shannon, Simpson, Chao1, and phylogenetic diversity indices (p < 0.05). The relative abundance of Salmonella and Campylobacter was less than 0.1%. The results suggested the WCE method provides a broad range of information on the chicken microbiome.

Propellant Mass Gauging in a Spherical Tank under Micro-Gravity Conditions Using Capacitance Plate Arrays and Machine Learning.

Propellant mass gauging under micro-gravity conditions is a challenging task due to the unpredictable position and shape of the fuel body inside the tank. Micro-gravity conditions are common for orbiting satellites and rockets that operate on limited fuel supplies. Capacitance sensors have been investigated for this task in recent years; however, the effect of various positions and shapes of the fuel body is not analyzed in detail. In this paper, we investigate this with various fill types, such as annular, core-annular, and stratified fills at different positions. We compare the performance among several curve-fitting-based approaches and a machine-learning-based approach, the latter of which offers superior performance in estimating the fuel content.

P-N heterojunction NiO/ZnO nanowire based electrode for asymmetric supercapacitor applications.

Nickel-based oxides are selected for their inexpensive cost, well-defined redox activity, and flexibility in adjusting nanostructures via optimization of the synthesis process. This communique explores the field of energy storage for hydrothermally synthesized NiO/ZnO nanowires by analysing their capacitive behaviour. The p-type NiO was successfully built onto the well-ordered mesoporous n-type ZnO matrix, resulting in the formation of p-n heterojunction artefacts with porous nanowire architectures. NiO/ZnO nanowire-based electrodes exhibited much higher electrochemical characteristics than bare NiO nanowires. The heterojunction at the interface between the NiO and ZnO nanoparticles, their specific surface area, as well as their combined synergetic influence, are accountable for the high specific capacitance (Cs) of 1135 Fg-1at a scan rate of 5 mV s-1. NiO/ZnO nanowires show an 18% dip in initial capacitance even after 6000 cycles, indicating excellent capacitance retention and low resistance validated by electrochemical impedance spectroscopy. In addition, the specific capacitance, energy and power density of the solid state asymmetric capacitor that was manufactured by employing NiO/ZnO as the positive electrode and activated carbon as the negative electrode were found to be 87 Fg-1, 23 Whkg-1and 614 Wkg-1, respectively. The novel electrode based on NiO/ZnO demonstrates excellent electrochemical characteristics all of which point to its promising application in supercapacitor devices.

Topical Anesthetics and Premature Ejaculation: A Systematic Review and Meta-Analysis.

This meta-analysis was conducted to assess the effectiveness of topical anesthetics in preventing premature ejaculation. We conducted an online database search for original studies comparing topical anesthetic agents with placebo in patients with premature ejaculation. After selecting relevant articles, we extracted data on baseline characteristics and predetermined endpoints. Intravaginal ejaculatory latency time (IELT) was the primary outcome for efficacy. Mean differences and corresponding 95% confidence intervals were used to present continuous data. A random-effects model was used to pool the data, and subgroup analysis was performed based on the type of anesthetic agent used. Eleven randomized controlled trials were examined, involving a total of 2008 participants. After analyzing the combined results, it was found that Severance Secret (SS) cream (CJ CheilJedang Corporation, Seoul, South Korea) demonstrated significantly higher effectiveness than a placebo in increasing IELT (P = 0.001). Similarly, the topical eutectic mixture for premature ejaculation (TEMPE), lidocaine, and the eutectic mixture of local anesthetics (EMLA) were significantly more efficient than a placebo (P<0.00001; P = 0.0001; P<0.00001). Additionally, it was found that lidocaine gel was more efficient than paroxetine or sildenafil (P = 0.04; P<0.00001). In conclusion, topical anesthetics increase IELT in men with premature ejaculation more effectively than placebo, sildenafil, tadalafil, paroxetine, and dapoxetine.

Optimizing oxygen vacancies and electrochemical performance of CeO2-δ nanosheets through the combination of di- and tri-valent doping.

Ceramic fuel cells presently hold an important position in the future of sustainable energy. However, new concepts and designs are vital for each individual cell's component materials to improve the overall power output and stability. The limited ionic conductivity of the electrolyte component is one major challenge among these. In the present work, we developed nanosheets with a cubic fluoride structure of CeO2 and introduced the di- and tri-valent doping of La and Sr to study their impact on oxygen vacancies and its ionic transport, keeping in mind the fact that CeO2 is reduced when exposed to a reducing atmosphere. The attained La- and Sr-doped fluorite structures of CeO2 exhibited good ionic conductivity of >0.05 S cm-1 at low temperature, and their use in a fuel cell resulted in achieving a power output of >900 mW cm-2 while operating at 550 °C. Therefore, we have found that laterally combining di- and tri-valent doping could be textured to give a highly oxygen-deficient CeO2 structure with high ionic transport. Furthermore, various microscopic and spectroscopic analyses, such as HR-TEM, XPS, Raman, UV-visible, EIS, and density functional theory, were applied to investigate the change in structural properties and mechanism of the ionic transport of the synthesized La and Sr co-doped CeO2 electrolyte. This work provides some new insights for designing high-ionic-conductivity electrolytes from low-cost semiconductor oxides for energy storage and conversion devices.

Silver diamine fluoride: A stem cell cytotoxicity and dentin growth factor release in-vitro study.

AIM: To investigate the effect of 38% SDF and its serial dilutions on the Stem cells from Human Exfoliated Deciduous teeth (SHED) and its ability to release growth factors from deciduous dentine. METHODS: The viability of SHED post-exposure to 38%, 3.8%, 0.38%, 0.038%, and 0.0038% SDF were assessed at 2, 5, and 7 days using the CyQuant assay, and results were validated using the MTT assay. The osteogenic differentiation of the cells was also investigated post-exposure to 0.0038% SDF. The release of the growth factors; TGF-ß1, FGF-b, BMP-2, and VEGF from deciduous dentin discs exposed to 38% SDF, 0.0038% SDF, Ca(OH)2, MTA, and 17% EDTA were examined using ELISA. Statistical analysis was performed using means and standard deviations (p < 0.05). Two-way ANOVA compared the means of more than two groups with Tukey's multiple comparison test. The unpaired t-test was also used to compare the differences between the two data sets. CONCLUSION: 38% SDF released dentinogenic growth factors from dentin discs, potentially explaining its role in reactionary dentinogenesis. Moreover, 0.0038% SDF resulted in a non-cytotoxic concentration that enhanced cellular proliferation and released bioactive molecules from dentin comparable to the 38% concentration. After further investigations, the 0.0038% dilution of SDF could present itself as a clinical concentration.

2D MXenes Embedded Perovskite Hydrogels for Efficient and Stable Solar Evaporation.

Solar evaporation is a facile and promising technology to efficiently utilize renewable energy for freshwater production and seawater desalination. Here, the fabrication of self-regenerating hydrogel composed of 2D-MXenes nanosheets embedded in perovskite La 0.6Sr 0.4Co 0.2Fe 0.8O3- δ (LSCF)/polyvinyl alcohol hydrogels for efficient solar-driven evaporation and seawater desalination is reported. The mixed dimensional LSCF/Ti3C2 composite features a localized surface plasmonic resonance effect in the polymeric network of polyvinyl alcohol endows excellent evaporation rates (1.98 kg m-2 h-1) under 1 k Wm-2 or one sun solar irradiation ascribed by hydrophilicity and broadband solar absorption (96%). Furthermore, the long-term performance reveals smooth mass change (13.33 kg m-2) during 8 h under one sun. The composite hydrogel prompts the dilution of concentrated brines and redissolves it back to water (1.2 g NaCl/270 min) without impeding the evaporation rate without any salt-accumulation. The present research offers a substantial opportunity for solar-driven evaporation without any salt accumulation in real-life applications.

Morphological, pathogenic and genetic diversity in Diplodia seriata associated with black rot canker of apple in India.

Apple cankers are extremely destructive diseases threatening the global apple industry through direct and indirect losses. The population structure of the pathogens is of paramount significance for the development of efficient management strategies. Therefore, phenotypic, pathogenic, and genetic diversity of Diplodia seriata causing black rot canker of apple was investigated in this study. All the isolates were included for investigating the in vitro mycelial growth, conidial dimensions, and pathogenic variability on two-year-old potted apple seedlings. The ISSR approach was used to investigate the molecular diversity of D. seriata. Mycelial growth rates were found to vary significantly amongst the isolates; however, there were no major variations seen between the different geographical groupings of isolates. Pathogenicity tests revealed variations in the size of cankers among the isolates indicating the presence of virulence variability. The isolates were segregated into three virulence groups based on canker length. The Bayesian analyses of ISSR data divided the isolates into two genetic clusters. The genetic clustering of the isolates revealed no relationship with geographical origin of the isolates. Furthermore, no direct relationship of genetic clustering was observed with morphological or pathogenic variability. The ISSR primers revealed very high level of variability in D. seriata; however, no distinct populations of the pathogen existed which is an indication of high level of gene flow between the diverse geographical populations. According to our knowledge, this is the first thorough investigation on the diversity of D. seriata associated with apple black rot canker in India.

Toward next-generation fuel cell materials.

The fuel cell's three layers-anode/electrolyte/cathode-convert fuel's chemical energy into electricity. Electrolyte membranes determine fuel cell types. Solid-state and ceramic electrolyte SOFC/PCFC and polymer based PEMFC fuel cells dominate fuel cell research. We present a new fuel cell concept using next-generation ceramic nanocomposites made of semiconductor-ionic material combinations. A built-in electric field driving mechanism boosts ionic (O2- or H+ or both) conductivity in these materials. In a fuel cell device, non-doped ceria or its heterostructure might attain 1 Wcm-2 power density. We reviewed promising functional nanocomposites for that range. Ceria-based and multifunctional semiconductor-ionic electrolytes will be highlighted. Owing to their simplicity and abundant resources, these materials might be used to make fuel cells cheaper and more accessible.