Ethyl 2-​amino-​5,​6,​7,​8-​tetrahydro-​4H-​cyclohepta[b]​thiophene-​3-​carboxylate.

Crystals of the title compd. are monoclinic, space group P21/c, with a 9.580(3)​, b 9.552(2)​, c 13.677(4) Å, β 99.489(4)​°; Z = 4, dc = 1.288; R = 0.038, Rw(F2) = 0.102 for 2487 reflections. The terminal ester group lies in the plane of the thiophene ring system. The cycloheptene ring adopts a half-​chair conformation. There are intramol. N-​H···O and C-​H···O interactions, and intermol. N-​H···O and C-​H···π interactions

Antioxidant activity and production of secondary metabolites of adult plant and in vitro calli of Anodendron paniculatum

The members of the family Apocynaceae are the rich in alkaloids, terpinoids, flavonoids, phenolic compounds and hydrocarbons. Anodendron paniculatum Roxb. is an woody climber, the roots of which have been used to control vomiting and cough. In the present study, adult plant and tissue culture plant extracts of A. paniculatum collected from Eastern Ghats, Araku, Andhra Pradesh were used for the production of their secondary metabolites and antioxidant activity. Methanol extracts of calli showed high contents of total phenol and alkaloid with 25.53 and 25.98 mg/g respectively. Methanol extract of tissue culture plant at higher concentrations showed better antioxidant activity with reference to standard ascorbic acid.  For this study different concentrations (12.5, 25, 50, 100 and 200 µg/ml) of extracts were prepared by using four different solvents. Tissue culture extracts from methanol showed maximum scavenging activity with 231.9±1.39 % at 200 µg/ml of concentration, while that of adult plant extracts showed the scavenging activity of 189.1±0.74% only. These results on high antioxidant activity of the methanol extract of A. paniculatum calli can be attributed to the presence of high phenolic and alkaloid contents in calli when compared to that of adult plant extract

Phyllosoma larvae from the Indian Ocean collected by the Dana expedition 1928-1930

The systematics of the phyllosoma larval forms collected by the Dana Expedition in 1928-30 from the Indian Ocean region is dealt with in the contribution. Out of the 1983 larvae, 1087 were those of species belonging to the family Palinuridae and 896 of the family Scyllaridae. Among the palinurids, 10 species belonging to 4 genera, namely, Panulirus versicolor, P. homarus, P. longipes, P. ornatus, Palinurellus weineclcii, Panulirus polyphagus, P. penicillatus, Palinustus mossambicus, Panulirus sp. I and Puerulus angulatus were recorded in the order of abundance. The scyllarids belonged to 12 species under 5 genera and in their order of abundance they were Scyllarus martensii, S. rugosus, S. cuttrifer S. amabilis, S. batei, Parribacus antarcticus, Scyllarides sp., Scyllarus sp. I, Thenus orientalis, Scyllarus sp. II, Scyllarus sp. Ill and Evibacus sp. Based on the material available in the collection and in a few cases on descriptions of certain stages given by earlier authors, the salient features in the different stages of development of the different species are summarised in Tables. A higher concentration of larvae contributed by palinurids was observed in the western half of the Indian Ocean

Diagnostic accuracy of a clinical diagnosis of idiopathic pulmonary fibrosis: An international case-cohort study

We conducted an international study of idiopathic pulmonary fibrosis (IPF) diagnosis among a large group of physicians and compared their diagnostic performance to a panel of IPF experts. A total of 1141 respiratory physicians and 34 IPF experts participated. Participants evaluated 60 cases of interstitial lung disease (ILD) without interdisciplinary consultation. Diagnostic agreement was measured using the weighted kappa coefficient (\u3baw). Prognostic discrimination between IPF and other ILDs was used to validate diagnostic accuracy for first-choice diagnoses of IPF and were compared using the Cindex. A total of 404 physicians completed the study. Agreement for IPF diagnosis was higher among expert physicians (\u3baw=0.65, IQR 0.53-0.72, p20 years of experience (C-index=0.72, IQR 0.0-0.73, p=0.229) and non-university hospital physicians with more than 20 years of experience, attending weekly MDT meetings (C-index=0.72, IQR 0.70-0.72, p=0.052), did not differ significantly (p=0.229 and p=0.052 respectively) from the expert panel (C-index=0.74 IQR 0.72-0.75). Experienced respiratory physicians at university-based institutions diagnose IPF with similar prognostic accuracy to IPF experts. Regular MDT meeting attendance improves the prognostic accuracy of experienced non-university practitioners to levels achieved by IPF experts

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019

Background: Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. Methods: We distinguished the overall HAQ Index (ages 0–74 years) from scores for select age groups: the young (ages 0–14 years), working (ages 15–64 years), and post-working (ages 65–74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development. Findings: Between 1990 and 2019, the HAQ Index increased overall (by 19·6 points, 95% uncertainty interval 17·9–21·3), as well as among the young (22·5, 19·9–24·7), working (17·2, 15·2–19·1), and post-working (15·1, 13·2–17·0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30·7 (28·6–33·0) on average in low-SDI countries to 83·4 (82·4–84·3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40·4–89·0), working (33·8–82·8), and post-working (30·4–79·1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries. Interpretation: Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young. Funding: Bill & Melinda Gates Foundation