Role of echocardiography for assessment of cardiovascular haemodynamics during pregnancy

Background: Pregnancy is associated with volume overload producing significant vascular and hemodynamic adaptations in cardiovascular physiology. Present study was designed to follow up gradual adaptations in cardiovascular hemodynamics during the course of pregnancy using Doppler echocardiography which is reproducible and noninvasive technique.Methods: In present prospective study of 50 women, were divided into 2 groups of 25 each: control group & study group (pregnant patient in I trimester, II trimester & III trimester). They were non-invasively analysed for cardiovascular function and systemic hemodynamics using echocardiography and compared with control group. The data was analysed using ANOVA for comparison within the group and student’s t- test for comparison between the groups. p value <0.05 was considered to be significant.Results: Mean age and height in control and study groups were comparable. Weight gain was within the expected range with advancement of pregnancy. Heart rate was increased in I and II trimesters with peak rise in III trimester. The difference between control group and study groups was statistically significant (p < 0.05).Systolic blood pressure was slightly decreased in all the trimesters as compared to control group which was statistically not significant. There was gradual increase in SBP from I to III trimesters. Diastolic blood pressure progressively decreased in I and II trimesters and then increased in III trimester. The difference in DBP between control group and I, II trimesters of pregnancy was significant (p<0.05).Systemic vascular resistance progressively decreased with advancement of pregnancy and difference was statistically significant (p <0.05) . Cardiac output is steadily increased in all trimesters of pregnancy with peak at 36 weeks and was statistically significant (p<0.05). It was due to increase in both heart rate and Stroke volume. Ejection fraction also increased in all trimesters.Conclusions: Present study shows significant functional changes in the cardiovascular dynamics during pregnancy. Doppler echocardiography provides an excellent noninvasive method for the evaluation and serial analysis of hemodynamic changes. These results will help in distinguishing abnormal echocardiographic changes from the normal physiologic changes of pregnancy. Therefore maternal echocardiography should be introduced into the antenatal management protocol, which will help to identify women at high risk to developing cardiovascular complications and there by early intervention.

Aligning Non-Causal Factors for Transformer-Based Source-Free Domain Adaptation

Conventional domain adaptation algorithms aim to achieve better generalization by aligning only the task-discriminative causal factors between a source and target domain. However, we find that retaining the spurious correlation between causal and non-causal factors plays a vital role in bridging the domain gap and improving target adaptation. Therefore, we propose to build a framework that disentangles and supports causal factor alignment by aligning the non-causal factors first. We also investigate and find that the strong shape bias of vision transformers, coupled with its multi-head attention, make it a suitable architecture for realizing our proposed disentanglement. Hence, we propose to build a Causality-enforcing Source-Free Transformer framework (C-SFTrans) to achieve disentanglement via a novel two-stage alignment approach: a) non-causal factor alignment: non-causal factors are aligned using a style classification task which leads to an overall global alignment, b) task-discriminative causal factor alignment: causal factors are aligned via target adaptation. We are the first to investigate the role of vision transformers (ViTs) in a privacy-preserving source-free setting. Our approach achieves state-of-the-art results in several DA benchmarks.Comment: WACV 2024. Project Page: https://val.cds.iisc.ac.in/C-SFTrans

Pigeonpea Baseline and Early Adoption Surveys in South Asia, Insights from TL-II (Phase 1) Project in India.

Pigeonpea is an important pulse crop particularly in the semi-arid tropics of India contributing towards the nutritional security and also generates significant income to small and marginal farmers. Its share in India’s pulse production is around 16%. India is the largest pigeonpea producing country in the world accounting for nearly 67% of the total production. Being a major pigeonpea consumer in the world, India imports around 0.6 million tons of pigeonpea per year to meet the domestic needs from Africa, Nepal and Myanmar. Area and production of pigeonpea in India showed a steady growth until recently. However, the productivity in the country has stagnated between 700 and 800 kg ha-1. Recent initiatives like National Food Security Mission (NFSM), Accelerated Pulse Production Programme (A3P) and enhancement of minimum support price created more interest in pigeonpea growers in the country. Pigeonpea is one of the mandate crops of the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT) and this premier international institute has been contributing significantly to the genetic improvement and crop management in India and Africa during the last four decades. The generous support received from the Bill and Melinda Gates Foundation (BMGF) has provided ICRISAT an opportunity to work more intensively with its research and development partners to demonstrate the potential of new technologies to enhance the yields, raise the profitability and revive the interest of the farmers in pigeonpea crop in India and the strategy chosen is farmer participatory varietal selection (FPVS). This report synthesizes the efforts made under the Tropical Legumes-II Project during the short period of three years (2007-10) in the states of Andhra Pradesh and Maharashtra for pigeonpea crop improvement in India. Overall, the FPVS results established that the new improved varieties outyielded the respective check varieties in the two states. The diffusion and adoption of these varieties increased significantly in the targeted districts. From the past lessons learnt, the report re-focuses on further efforts needed during the second phase of the project to achieve greater success and impact

Integrative Analysis of Clinicopathological Features Defines Novel Prognostic Models for Mantle Cell Lymphoma in the Immunochemotherapy Era: A Report from The North American Mantle Cell Lymphoma Consortium

BACKGROUND: Patients with mantle cell lymphoma (MCL) exhibit a wide variation in clinical presentation and outcome. However, the commonly used prognostic models are outdated and inadequate to address the needs of the current multidisciplinary management of this disease. This study aims to investigate the clinical and pathological features of MCL in the immunochemotherapy era and improve the prognostic models for a more accurate prediction of patient outcomes. METHODS: The North American Mantle Cell Lymphoma Project is a multi-institutional collaboration of 23 institutions across North America to evaluate and refine prognosticators for front-line therapy. A total of 586 MCL cases diagnosed between 2000 and 2012 are included in this study. A comprehensive retrospective analysis was performed on the clinicopathological features, treatment approaches, and outcomes of these cases. The establishment of novel prognostic models was based on in-depth examination of baseline parameters, and subsequent validation in an independent cohort of MCL cases. RESULTS: In front-line strategies, the use of hematopoietic stem cell transplantation was the most significant parameter affecting outcomes, for both overall survival (OS, p \u3c 0.0001) and progression-free survival (PFS, p \u3c 0.0001). P53 positive expression was the most significant pathological parameter correlating with inferior outcomes (p \u3c 0.0001 for OS and p = 0.0021 for PFS). Based on the baseline risk factor profile, we developed a set of prognostic models incorporating clinical, laboratory, and pathological parameters that are specifically tailored for various applications. These models, when tested in the validation cohort, exhibited strong predictive power for survival and showed a stratification resembling the training cohort. CONCLUSIONS: The outcome of patients with MCL has markedly improved over the past two decades, and further enhancement is anticipated with the evolution of clinical management. The innovative prognostic models developed in this study would serve as a valuable tool to guide the selection of more suitable treatment strategies for patients with MCL

Role of echocardiography for assessment of cardiovascular haemodynamics during pregnancy

Background: Pregnancy is associated with volume overload producing significant vascular and hemodynamic adaptations in cardiovascular physiology. Present study was designed to follow up gradual adaptations in cardiovascular hemodynamics during the course of pregnancy using Doppler echocardiography which is reproducible and noninvasive technique.Methods: In present prospective study of 50 women, were divided into 2 groups of 25 each: control group &amp; study group (pregnant patient in I trimester, II trimester &amp; III trimester). They were non-invasively analysed for cardiovascular function and systemic hemodynamics using echocardiography and compared with control group. The data was analysed using ANOVA for comparison within the group and student’s t- test for comparison between the groups. p value &lt;0.05 was considered to be significant.Results: Mean age and height in control and study groups were comparable. Weight gain was within the expected range with advancement of pregnancy. Heart rate was increased in I and II trimesters with peak rise in III trimester. The difference between control group and study groups was statistically significant (p &lt; 0.05).Systolic blood pressure was slightly decreased in all the trimesters as compared to control group which was statistically not significant. There was gradual increase in SBP from I to III trimesters. Diastolic blood pressure progressively decreased in I and II trimesters and then increased in III trimester. The difference in DBP between control group and I, II trimesters of pregnancy was significant (p&lt;0.05).Systemic vascular resistance progressively decreased with advancement of pregnancy and difference was statistically significant (p &lt;0.05) . Cardiac output is steadily increased in all trimesters of pregnancy with peak at 36 weeks and was statistically significant (p&lt;0.05). It was due to increase in both heart rate and Stroke volume. Ejection fraction also increased in all trimesters.Conclusions: Present study shows significant functional changes in the cardiovascular dynamics during pregnancy. Doppler echocardiography provides an excellent noninvasive method for the evaluation and serial analysis of hemodynamic changes. These results will help in distinguishing abnormal echocardiographic changes from the normal physiologic changes of pregnancy. Therefore maternal echocardiography should be introduced into the antenatal management protocol, which will help to identify women at high risk to developing cardiovascular complications and there by early intervention.

Genomic signature of Fanconi anaemia DNA repair pathway deficiency in cancer

Fanconi anaemia (FA), a model syndrome of genome instability, is caused by a deficiency in DNA interstrand crosslink repair resulting in chromosome breakage1–3. The FA repair pathway protects against endogenous and exogenous carcinogenic aldehydes4–7. Individuals with FA are hundreds to thousands fold more likely to develop head and neck (HNSCC), oesophageal and anogenital squamous cell carcinomas8 (SCCs). Molecular studies of SCCs from individuals with FA (FA SCCs) are limited, and it is unclear how FA SCCs relate to sporadic HNSCCs primarily driven by tobacco and alcohol exposure or infection with human papillomavirus9 (HPV). Here, by sequencing genomes and exomes of FA SCCs, we demonstrate that the primary genomic signature of FA repair deficiency is the presence of high numbers of structural variants. Structural variants are enriched for small deletions, unbalanced translocations and fold-back inversions, and are often connected, thereby forming complex rearrangements. They arise in the context of TP53 loss, but not in the context of HPV infection, and lead to somatic copy-number alterations of HNSCC driver genes. We further show that FA pathway deficiency may lead to epithelial-to-mesenchymal transition and enhanced keratinocyte-intrinsic inflammatory signalling, which would contribute to the aggressive nature of FA SCCs. We propose that the genomic instability in sporadic HPV-negative HNSCC may arise as a result of the FA repair pathway being overwhelmed by DNA interstrand crosslink damage caused by alcohol and tobacco-derived aldehydes, making FA SCC a powerful model to study tumorigenesis resulting from DNA-crosslinking damage