Synthesis of Ag-DLC coatings for biomedical implants

The diamond-like carbon (DLC) coating has the potential to increase the lifetime of metal on polymer (MoP) type hip joints due to its good tribological and mechanical properties as well as excellent biocompatibility. However, the high internal compressive stress of DLC films limits their adhesion with CoCrMo alloy. The high internal stress can be minimized by doping the DLC coating with metals like Ti, Cu, W, Nb and many more. In the present thesis work, silver (Ag) doped diamond-like carbon (DLC) coatings were prepared on the CoCrMo alloy using direct current (DC) magnetron sputtering for biomedical implants. The silver concentration was varied in the DLC matrix by varying the DC power to the silver target from 12 W to 18 W. Raman spectroscopy was carried out to evaluate the structural changes in the carbon matrix. X-ray photoelectron spectroscopy (XPS) was used to measure the concentration of Ag and sp3 carbon hybridization in the coatings. The hardness, tribological behavior, and adhesion properties were characterized using nano-indentation, wear testing, and Rockwell C indentation, respectively. The hardness values show that initially, with a low percentage of silver, the residual stresses decrease drastically, whereas the hardness values decrease slightly. The lowest wear rate was observed for the coating doped with 7.4 at% of silver among all coatings, and improved adhesion was observed for all the Ag-DLC coating on CoCrMo alloy. The results showed that silver doped DLC coating is promising for a total hip joint replacement application

Association of Age, Gender and Body Mass Index with Proprioception in Knee Joint in Healthy Individuals

Background: The word proprioception is derived from Latin word “proprius” means it is one’s own and “reception” means it receives. In Musculoskeletal rehabilitation, proprioception plays significant role in maintaining normal motor control. The proprioception is an important non-invasive clinical procedure which helps in diagnosing pre-existing and treating knee conditions. Proprioception assessment is foremost because loss in proprioception will lead to altered weight bearing at joints and alteration of normal body movement causing fall or injury. Purpose of this study is to find out the association of knee joint proprioception with age, gender and BMI in healthy individuals. Methods: Total 132 participants are included in the study. Their height and weight was measured to calculate their BMI. After that, proprioception was assessed with the help of goniometer mounted on the stand. Knee joint proprioception was measured for Test angles 30°, 45° and 60° toward extension. At all angles test was performed three times in sequence. Result: The collected data were analyzed in SPSS software version 21.0. At 30° correlations between both side of knee joint proprioception with Age, Gender and BMI was non-significant except left side of proprioception with gender. However, at 45° correlations between both side of knee joint proprioception with Age, Gender and BMI was found significant. Additionally, similar of most result was found at 60° except left side of knee joint proprioception was found not significant with BMI. Conclusion: Knee joint proprioception decreases with ageing and are more in females than males. This study finds weak to moderate correlation with BMI

E-Learning Hub (Online)

E-Learning is the use of technology to enable people to learn anytime and anywhere. E-learning is basically the computer and network-enabled transmission of skills and knowledge. E-learning system include Web based learning, computer based learning, i.e. Virtual Education over Web. Content are delivered via the internet or intranet/extranet. It can be self-paced or instructor-led and includes media in the form of text, image, streaming audio-video lectures. Digital Signal Processing and Image Processing will be used to solve the limitations of a limited network bandwidth. Algorithms will attempt to code videos in smaller size thereby reducing the buffering of videos. Adaptive testing will use item response theory to be equitable to the examinees level

Functional genomic and transformation resources for commercially important red macroalgae (Rhodophyta)

Red macroalgae underpin many commercially important food, pharmaceutical and other important industries. To date, research into these species has generally focused on improving seaweed cultivation, developing new methods to extract useful compounds, or identify novel applications. Due to their economic importance, there is a requirement to develop a more complete understanding of the genome and metabolic pathways in these key seaweed species. This review describes progress in genomics, transcriptomics, protoplast isolation, and transformation approaches. It also explores the potential of genome editing using the CRISPR/Cas system to further our understanding of gene function related to different metabolic pathways and resolving unexplored aspects of macroalgal physiology traits linked to crop improvement. The application of functional genomics is essential to gain a complete understanding of both physiological and metabolomic processes, that will ultimately enhance the commercial resilience of macroalgae related industries that are subject to numerous pressures, including climate change. Although the use of genetic manipulation to alter growth characteristics or composition in seaweed will not readily apply to the macroalgae industry in the short term, it is likely to be critical for sustaining future commercial growth. The functional characterisation of macroalgal genes through the CRISPR/ Cas approach promises to open new avenues for translational research on utilising macroalgal resources for the sustainable development of these aquaculture systems

Effect of percutaneous balloon mitral valvuloplasty on left ventricular function in rheumatic mitral stenosis

Objective: Patients with rheumatic mitral stenosis, despite having normal left ventricular ejection fraction (LV EF), have ventricular dysfunction in the form of impaired longitudinal excursion. Tissue Doppler velocity is a useful indicator for assessment of long-axis ventricular shortening and lengthening. The aim of our study was to evaluate the effect of percutaneous balloon mitral valvuloplasty (PBMV) on LV function in rheumatic MS and to study echocardiographic parameters with M-Mode and Tissue Doppler Imaging pre PBMV, post PBMV and on follow-up to determine predictors of LV function. Methods: We analysed 52 patients with severe mitral stenosis with normal LV EF, who underwent PBMV at our institute. Baseline parameters of LV function were compared with immediate post PBMV and at three months follow up. Results: The mean age of the patients was 33.73 (10.87) years with female preponderance. The mean mitral valve area before PBMV was 0.92 (0.13) cm2 which increased to 1.65 (0.21) cm2 after PBMV and at 3 month it was 1.61 (0.23) cm2 (p0.05). Mitral valve E’ was 8.71 (1.54) cm/s which increased to 10.13 (1.68) cm/s post PBMV and at 3 month it was 10.83 (1.34) cm/s (p<0.001).. Mitral annular systolic velocity (MASV), before PBMV was 7.90 (0.96) cm/s which increased to 9.31 (1.68) cm/s after PBMV and at 3 month it was 10.13 (0.96) cm/s (p<0.001). Myocardial performance index (MPI) before PBMV was 0.54 (0.48) which decreased post PBMV to 0.47 (0.06) and at 3 month it was 0.38 (0.04) (p=0.01). Pre PBMV MPI value <0.48 predicted improvement in LV function (sensitivity: 81%, specificity: 58.1%). Conclusion: Thus, PBMV leads to improvement in LV function in patients with severe MS with normal LV EF

Clinical and epidemiological characterization of severe Plasmodium vivax malaria in Gujarat, India.

The mounting evidence supporting the capacity of Plasmodium vivax to cause severe disease has prompted the need for a better characterization of the resulting clinical complications. India is making progress with reducing malaria, but epidemics of severe vivax malaria in Gujarat, one of the main contributors to the vivax malaria burden in the country, have been reported recently and may be the result of a decrease in transmission and immune development. Over a period of one year, we enrolled severe malaria patients admitted at the Civil Hospital in Ahmedabad, the largest city in Gujarat, to investigate the morbidity of severe vivax malaria compared to severe falciparum malaria. Patients were submitted to standard thorough clinical and laboratory investigations and only PCR-confirmed infections were selected for the present study. Severevivax malaria (30 patients) was more frequent than severe falciparum malaria (8 patients) in our setting, and it predominantly affected adults (median age 32 years, interquartile range 22.5 years). This suggests a potential age shift in anti-malarial immunity, likely to result from the recent decrease in transmission across India. The clinical presentation of severe vivax patients was in line with previous reports, with jaundice as the most common complication. Our findings further support the need for epidemiological studies combining clinical characterization of severe vivax malaria and serological evaluation of exposure markers to monitor the impact of elimination programmes

SWOG 1815: A phase III randomized trial of gemcitabine, cisplatin, and nab-paclitaxel versus gemcitabine and cisplatin in newly diagnosed, advanced biliary tract cancers

Background: Biliary tract cancers (BTCs) are a heterogeneous group of malignancies with a dismal prognosis. Gemcitabine-based regimens are the standard of care in advanced disease, but median overall survival (OS) is roughly 12 months. The addition of albumin-bound paclitaxel to gemcitabine and cisplatin (GAP) demonstrated promising efficacy in a 60 patient, single-arm phase II study (Shroff et al, JAMA Oncol 2019), with observed median OS of 19.2 months. Methods: SWOG 1815 is a randomized, open-label, phase III trial comparing GAP to gemcitabine/cisplatin (GC). The study included newly diagnosed advanced BTC patients (pts), randomized 2:1 to GAP vs. GC. GAP included gemcitabine at 800 mg/m2, cisplatin at 25 mg/m2 and albumin-bound paclitaxel at 100 mg/m2 on days 1 and 8 of a 21-day cycle. GC included standard dosing of gemcitabine at 1000 mg/m2 and cisplatin at 25 mg/m2 on days 1 and 8 of a 21-day cycle. Pts were treated until progression. The primary endpoint was overall survival (OS) with a target hazard ratio of 0.7 with 90% power and a 1-sided alpha of 0.025; randomization was stratified by disease site (intrahepatic cholangiocarcinoma [CCA] vs gallbladder adenocarcinoma [GBC] vs extrahepatic CCA), disease stage (locally advanced vs metastatic), and Zubrod PS 0 vs 1. Results: Of 441 eligible pts randomized, 55% were female. 67% of patients had intrahepatic CCA, 16% had GBC and 17% had extrahepatic CCA. Most pts had metastases (73%). Median OS with GAP vs. GC was 14 vs. 12.7 mo respectively (HR 0.93, 95% CI 0.74-1.19, p=0.58), ORR (confirmed and unconfirmed) 34% vs25% (p=0.11) and median PFS 8.2 vs 6.4 mo (HR 0.92, 95% CI 0.72-1.16, p=0.47), respectively. Grade 3 and 4 treatment related adverse events (TRAEs) in ≥10% of pts for GAP and GC were anemia, neutropenia, and thrombocytopenia. GAP had more ≥ grade 3 hematologic AEs compared to the GC arm (60% vs. 45%, p=0.003). Discontinuation due to toxicity was at 24% vs 19% (p=0.26) with GAP vs GC. In exploratory subset analyses, GAP vs GC improved OS in pts with locally advanced disease (medians 19.2 vs 13.7 mo; HR 0.67, 95% CI 0.42- 1.06, p=0.09) and in GBC pts (medians 17.0 vs 9.3 mo; HR 0.74, 95% CI 0.41-1.35, p=0.33). ORR for GAP vs GC in GBC was 50% vs 24% (p=0.09) and for locally advanced disease 28 vs 21% p=0.74. Conclusions: SWOG 1815 did not result in a statistically significant improvement in median OS with GAP vs. GC. The GAP regimen had higher rates of TRAEs without a statistically significant difference in discontinuation rates. Pts with locally advanced disease and GBC may benefit from the use of GAP. Further analyses are ongoing to understand potential benefit of GAP in subsets of BTC pts. Funding: NIH/National Cancer Institute grants CA180888, CA180819, CA180820, CA180821, and CA180868; and in part by Celgene Corporation, Summit, NJ (subsidiary of Bristol Myer Squibb)

Prediction of overall survival for patients with metastatic castration-resistant prostate cancer : development of a prognostic model through a crowdsourced challenge with open clinical trial data

Background Improvements to prognostic models in metastatic castration-resistant prostate cancer have the potential to augment clinical trial design and guide treatment strategies. In partnership with Project Data Sphere, a not-for-profit initiative allowing data from cancer clinical trials to be shared broadly with researchers, we designed an open-data, crowdsourced, DREAM (Dialogue for Reverse Engineering Assessments and Methods) challenge to not only identify a better prognostic model for prediction of survival in patients with metastatic castration-resistant prostate cancer but also engage a community of international data scientists to study this disease. Methods Data from the comparator arms of four phase 3 clinical trials in first-line metastatic castration-resistant prostate cancer were obtained from Project Data Sphere, comprising 476 patients treated with docetaxel and prednisone from the ASCENT2 trial, 526 patients treated with docetaxel, prednisone, and placebo in the MAINSAIL trial, 598 patients treated with docetaxel, prednisone or prednisolone, and placebo in the VENICE trial, and 470 patients treated with docetaxel and placebo in the ENTHUSE 33 trial. Datasets consisting of more than 150 clinical variables were curated centrally, including demographics, laboratory values, medical history, lesion sites, and previous treatments. Data from ASCENT2, MAINSAIL, and VENICE were released publicly to be used as training data to predict the outcome of interest-namely, overall survival. Clinical data were also released for ENTHUSE 33, but data for outcome variables (overall survival and event status) were hidden from the challenge participants so that ENTHUSE 33 could be used for independent validation. Methods were evaluated using the integrated time-dependent area under the curve (iAUC). The reference model, based on eight clinical variables and a penalised Cox proportional-hazards model, was used to compare method performance. Further validation was done using data from a fifth trial-ENTHUSE M1-in which 266 patients with metastatic castration-resistant prostate cancer were treated with placebo alone. Findings 50 independent methods were developed to predict overall survival and were evaluated through the DREAM challenge. The top performer was based on an ensemble of penalised Cox regression models (ePCR), which uniquely identified predictive interaction effects with immune biomarkers and markers of hepatic and renal function. Overall, ePCR outperformed all other methods (iAUC 0.791; Bayes factor >5) and surpassed the reference model (iAUC 0.743; Bayes factor >20). Both the ePCR model and reference models stratified patients in the ENTHUSE 33 trial into high-risk and low-risk groups with significantly different overall survival (ePCR: hazard ratio 3.32, 95% CI 2.39-4.62, p Interpretation Novel prognostic factors were delineated, and the assessment of 50 methods developed by independent international teams establishes a benchmark for development of methods in the future. The results of this effort show that data-sharing, when combined with a crowdsourced challenge, is a robust and powerful framework to develop new prognostic models in advanced prostate cancer.Peer reviewe

Various methods to assess knee proprioception: A review

Introduction: Proprioception is a vital aspect of motor control and when degraded or lost can have a profound impact on function in diverse clinical populations. This systematic review aimed to identify clinically related tools to measure proprioceptive acuity. The major purpose of this systematic review was to identify and categorise the methods that have been developed and utilised to test proprioceptive accuracy in a comprehensive manner. Methods: The pub med, Scopus, Web of Science and the other search engine/databases used: Cochrane database / SCIRE / PEDro / CINAHL/ EMBASE, ERIC were systematically searched. Conclusions: The TTDPM method has less relative ecological validity, but has high conceptual purity, Although JPR tests may have less relative test validity, but more clinically feasible, The AMEDA method appears to have better ecological validity and relatively better test validity and data validity