Evaluation of functional outcome of distal tibial fractures stabilized with distal tibial locking plate

Background: The present study is an attempt to evaluate the results of locking compression plate for distal tibia in lower tibial fractures using open reduction internal fixation and minimally invasive plate osteosynthesis technique.Methods: Prospective and retrospective study was conduct on patients attending the outpatient department (OPD)/Emergency OPD in Indira Gandhi Medical College, Shimla during September 2015 to August 2016 with distal tibial fractures. The patients treated with locking compression plates using minimally invasive plate osteosynthesis (MIPO) or open reduction internal fixation (ORIF) are reviewed for inclusion and exclusion criteria. All data were collected and analyzed by Epi-info software.Results: Out of 52 patients, 48.4% patients undergo open reduction internal fixation had excellent results and 28.6% patients undergo surgery by MIPPO technique had excellent results. p value is 0.352 which is not significant. Overall, 40.4% patients had excellent results. In our study, 32.6% patients having AO/OTA type A fractures had excellent score while type B and C had 1.9% excellent score. This is attributed to more comminution and involvement of ankle joint. Overall, 40.4% patients had excellent score. P value is 0.863 which is insignificant.Conclusions: We observed excellent/ good functional outcome in 65.3% of patients

Mechanistic Insight into the Enzymatic Reduction of Truncated Hemoglobin N of Mycobacterium tuberculosis: role of the CD loop and pre-A Motif in electron cycling

Background: The HbN of Mycobacterium tuberculosis carries a potent nitric-oxide dioxygenase activity despite lacking a reductase domain. Results: The NADH-ferredoxin reductase system acts as an efficient partner for the reduction of HbN. Conclusion: The interactions of HbN with the reductase are modulated by its CD loop and the Pre-A region. Significance: The present study provides new insights into the mechanism of electron transfer during nitric oxide detoxification by HbN.Fil: Singh, Sandeep. Institute of Microbial Technology; IndiaFil: Thakur, Naveen. Institute of Microbial Technology; IndiaFil: Oliveira, Ana. Universidad de Barcelona; EspañaFil: Petruk, Ariel Alcides. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química, Física de los Materiales, Medioambiente y Energía. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química, Física de los Materiales, Medioambiente y Energía; ArgentinaFil: Hade, Mangesh Dattu. Institute of Microbial Technology; IndiaFil: Sethi, Deepti. Institute of Microbial Technology; IndiaFil: Bidon Chanal, Axel. Universidad de Barcelona; EspañaFil: Marti, Marcelo Adrian. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química, Física de los Materiales, Medioambiente y Energía. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química, Física de los Materiales, Medioambiente y Energía; ArgentinaFil: Datta, H.. Institute of Microbial Technology; IndiaFil: Parkesh, R.. Institute of Microbial Technology; IndiaFil: Estrin, Dario Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química, Física de los Materiales, Medioambiente y Energía. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química, Física de los Materiales, Medioambiente y Energía; ArgentinaFil: Luque, F. Javier. Universidad de Barcelona; EspañaFil: Dikshit, Kanak L.. Institute of Microbial Technology; Indi

Deep neural network for prediction and control of permeability decline in single pass tangential flow ultrafiltration in continuous processing of monoclonal antibodies

Single-pass tangential flow filtration (SPTFF) is a crucial technology enabling the continuous manufacturing of monoclonal antibodies (mAbs). By significantly increasing the membrane area utilized in the process, SPTFF allows the mAb process stream to be concentrated up to the desired final target in a single pass across the membrane surface without the need for recirculation. However, a key challenge in SPTFF is compensating for flux decline across the membrane due to concentration polarization and surface fouling phenomena. In continuous downstream processing, flux decline immediately impacts the continuous process flowrates. It reduces the concentration factor achievable in a single pass, thereby reducing the final concentration attained at the outlet of the SPTFF module. In this work, we develop a deep neural network model to predict the NWP in real-time without the need to conduct actual NWP measurements. The developed model incorporates process parameters such as pressure and feed concentrations through inline sensors and a spectroscopy-coupled data model (NIR-PLS model). The model determines the optimal timing for membrane cleaning steps when the normalized water permeability (NWP) falls below 60%. Using SCADA and PLC, a distributed control system was developed to integrate the monitoring sensors and control elements, such as the NIRS sensor for concentration monitoring, the DNN model for NWP prediction, weighing balances, pressure sensors, pumps, and valves. The model was tested in real-time, and the NWP was predicted within <5% error in three independent test cases, successfully enabling control of the SPTFF step in line with the Quality by Design paradigm

Ebolavirus species-specific interferon antagonism mediated by VP24

Members of the Ebolavirus genus demonstrate a marked differences in pathogenicity in humans with Ebola (EBOV) being the most pathogenic, Bundibugyo (BDBV) less pathogenic, and Reston (RESTV) is not known to cause a disease in humans. The VP24 protein encoded by members of the Ebolavirus genus blocks type I interferon (IFN-I) signaling through interaction with host karyopherin alpha nuclear transporters, potentially contributing to virulence. Previously, we demonstrated that BDBV VP24 (bVP24) binds with lower affinities to karyopherin alpha proteins relative to EBOV VP24 (eVP24), and this correlated with a reduced inhibition in IFN-I signaling. We hypothesized that modification of eVP24-karyopherin alpha interface to make it similar to bVP24 would attenuate the ability to antagonize IFN-I response. We generated a panel of recombinant EBOVs containing single or combinations of point mutations in the eVP24-karyopherin alpha interface. Most of the viruses appeared to be attenuated in both IFN-I-competent 769-P and IFN-I-deficient Vero-E6 cells in the presence of IFNs. However, the R140A mutant grew at reduced levels even in the absence of IFNs in both cell lines, as well as in U3A STAT1 knockout cells. Both the R140A mutation and its combination with the N135A mutation greatly reduced the amounts of viral genomic RNA and mRNA suggesting that these mutations attenuate the virus in an IFN-I-independent attenuation. Additionally, we found that unlike eVP24, bVP24 does not inhibit interferon lambda 1 (IFN-λ1), interferon beta (IFN-β), and ISG15, which potentially explains the lower pathogenicity of BDBV relative to EBOV. Thus, the VP24 residues binding karyopherin alpha attenuates the virus by IFN-I-dependent and independent mechanisms

Computed tomography texture-based radiomics analysis in gallbladder cancer: initial experience

Aim of the study: To investigate computed tomography (CT) texture parameters in suspected gallbladder cancer (GBC) and assess its utility in predicting histopathological grade and overall survival. Material and methods: This retrospective pilot study included consecutive patients with clinically suspected GBC. CT images, clinical, and histological or cytological data were retrieved from the database. CT images were reviewed by two radiologists. A single axial CT section in the portal venous phase was selected for texture analysis. Radiomic feature extraction was done using commercially available research software. Results: Thirty-eight patients (31 females, mean age 53.1 years) were included. Malignancy was confirmed in 29 patients in histopathology or cytology analysis, and the rest had no features of malignancy. Exophytic gallbladder mass with associated gallbladder wall thickening was present in 22 (58%) patients. Lymph nodal, liver, and omental metastases were present in 10, 1, and 3 patients, respectively. The mean overall survival was 9.7 months. There were significant differences in mean and kurtosis at medium texture scales to differentiate moderately differentiated and poorly differentiated adenocarcinoma (p < 0.05). The only texture parameter that was significantly associated with survival was kurtosis (p = 0.020) at medium texture scales. In multivariate analysis, factors found to be significantly associated with length of overall survival were mean number of positive pixels (p = 0.02), skewness (p = -0.046), kurtosis (0.018), and standard deviation (p = 0.045). Conclusions: Our preliminary results highlight the potential utility of CT texture-based radiomics analysis in patients with GBC. Medium texture scale parameters including both mean and kurtosis, or kurtosis alone, may help predict the histological grade and survival, respectively

Arabinose as an overlooked sugar for microbial bioproduction of chemical building blocks

The circular economy is anticipated to bring a disruptive transformation in manufacturing technologies. Robust and industrial scalable microbial strains that can simultaneously assimilate and valorize multiple carbon substrates are highly desirable, as waste bioresources contain substantial amounts of renewable and fermentable carbon, which is diverse. Lignocellulosic biomass (LCB) is identified as an inexhaustible and alternative resource to reduce global dependence on oil. Glucose, xylose, and arabinose are the major monomeric sugars in LCB. However, primary research has focused on the use of glucose. On the other hand, the valorization of pentose sugars, xylose, and arabinose, has been mainly overlooked, despite possible assimilation by vast microbial communities. The present review highlights the research efforts that have explicitly proven the suitability of arabinose as the starting feedstock for producing various chemical building blocks via biological routes. It begins by analyzing the availability of various arabinose-rich biorenewable sources that can serve as potential feedstocks for biorefineries. The subsequent section outlines the current understanding of arabinose metabolism, biochemical routes prevalent in prokaryotic and eukaryotic systems, and possible products that can be derived from this sugar. Further, currently, exemplar products from arabinose, including arabitol, 2,3-butanediol, 1,2,3-butanetriol, ethanol, lactic acid, and xylitol are discussed, which have been produced by native and non-native microbial strains using metabolic engineering and genome editing tools. The final section deals with the challenges and obstacles associated with arabinose-based production, followed by concluding remarks and prospects

Gallbladder reporting and data system (GB-RADS) for risk stratification of gallbladder wall thickening on ultrasonography:an international expert consensus

The Gallbladder Reporting and Data System (GB-RADS) ultrasound (US) risk stratification is proposed to improve consistency in US interpretations, reporting, and assessment of risk of malignancy in gallbladder wall thickening in non-acute setting. It was developed based on a systematic review of the literature and the consensus of an international multidisciplinary committee comprising expert radiologists, gastroenterologists, gastrointestinal surgeons, surgical oncologists, medical oncologists, and pathologists using modified Delphi method. For risk stratification, the GB-RADS system recommends six categories (GB-RADS 0–5) of gallbladder wall thickening with gradually increasing risk of malignancy. GB-RADS is based on gallbladder wall features on US including symmetry and extent (focal vs. circumferential) of involvement, layered appearance, intramural features (including intramural cysts and echogenic foci), and interface with the liver. GB-RADS represents the first collaborative effort at risk stratifying the gallbladder wall thickening. This concept is in line with the other US-based risk stratification systems which have been shown to increase the accuracy of detection of malignant lesions and improve management. Graphical abstract: [Figure not available: see fulltext.]

Feasibility of implementing public-private mix approach for tuberculosis case management in Pokhara Metropolitan City of western Nepal: a qualitative study

BackgroundThe Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public health care providers in the fight against tuberculosis using international health care standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal.MethodsWe conducted key informant interviews with 20 participants, 14 of whom were from private clinics, polyclinics, and hospitals where the PPM approach was used, two from government hospitals, and four from policymakers. All data were audio-recorded, transcribed, and translated into English. The transcripts of the interviews were manually organized, and themes were generated and categorized into 1. TB case detection, 2. patient-related barriers, and 3. health-system-related barriers.ResultsA total of 20 respondents participated in the study. Barriers to PPM were identified into following three themes: (1) Obstacles related to TB case detection, (2) Obstacles related to patients, and (3) Obstacles related to health-care system. PPM implementation was challenged by following sub-themes that included staff turnover, low private sector participation in workshops, a lack of trainings, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies.ConclusionGovernment stakeholders can significantly benefit by applying a proactive role working with the private in monitoring and supervision. The joint efforts with private sector can then enable all stakeholders to follow the government policy, practice and protocols in case finding, holding and other preventive approaches. Future research are essential in exploring how PPM could be optimized

Tinospora cordifolia and polyvinylpyrrolidone encapsulated dual doped Ni-Cu TiO2 emerging nanocatalyst for the removal of organic dyes from wastewater and its free radical assay activity

In this study, a microwave-assisted method was used to encapsulate dual doped nickel-copper titanium dioxide (TiO2) nanoparticles (Ni-Cu TNPs) with polymer polyvinylpyrrolidone (PVP) and plant Tinospora Cordifolia (TC). The catalytic efficiency of encapsulated TNPs was performed through photocatalytic activity against Methyl Orange (MO) and Methylene Blue (MB) dyes as considered as water pollutants released by textiles industries. Also, these encapsulated TNPs were incubated in scavenging activity to eliminate the free radicals 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay. The physicochemical properties of the encapsulated TNPs were analyzed using different characterization techniques. X-Ray Diffraction (XRD revealed that the encapsulated dual doped Ni-Cu TNPs had a tetragonal crystal lattice structure. The scanning electron microscopy (SEM) confirms the spherical morphology of encapsulated dual doped Ni-Cu TNPs with an average particle size ranging from 33 to 41 nm. The bandgap of the encapsulated dual doped Ni-Cu TNPs was found to be between 3.47 and 3.54 eV. Under UV radiation, the photocatalytic activity was performed with using control experiment and using encapsulated dual doped Ni-Cu TNPs against MO and MB dyes. The rate of degradation reached up to 99% for both dyes on increasing with an increase in TNPs catalyst dosage. Also, the encapsulated dual doped Ni-Cu TNPs demonstrated antioxidant activity of up to 93% against the DPPH assay