A Clinicopathological Study with Risk-Stratified Staging of Pediatric Hepatoblastoma: A 5-Year Experience from a Tertiary Cancer Center.

Background & Objective: Hepatoblastoma encompasses 1% of pediatric malignancies and is the most common liver malignancy in children. Ninety percent of cases are younger than 5 years of age. Clinical and pathological risk stratification forms a crucial role in determining the treatment strategy. This study aimed to assess the clinicopathological profile of hepatoblastoma with risk stratification and follow-up in children. Methods: A retrospective evaluation was performed on all pediatric patients diagnosed as hepatoblastoma between 2016 and 2020 in our institution. Clinical, radiological, biochemical, pathological, and treatment data were analyzed. Cases were stratified based on the SIOPEL protocol and compared with the outcome. Results: The median age of all children was 1 year, the male-to-female ratio was 2.3:1, and elevated α-fetoprotein (AFP) was observed in all cases. SIOPEL risk stratification showed that 50% of children were at high risk. The histopathological types were fetal (30%), embryonal (20%), and macrotrabecular (5%) patterns under epithelial type and mixed epithelial and mesenchymal type (45%) with 1 case showing teratoid features. During the follow-up period, 6 out of the 7 children who died, belonged to the high-risk SIOPEL category, and 5 presented a mixed epithelial and mesenchymal pattern. Conclusion: Our study found a significant correlation between clinicopathological data, histopathological patterns, and outcomes. Accordingly, histopathological patterns could be considered one of the criteria for risk stratification. Histopathological risk stratification indicators (such as SIOPEL and PRETEXT) have strong prognostic and predictive outcomes; hence, our study emphasizes such parameters to aid oncologists.

Highly Site-Selective Direct C-H Bond Functionalization of Unactivated Arenes with Propargyl α-Aryl-α-diazoacetates via Scandium Catalysis.

Highly chemo- and regio-selective C-H bond functionalization of unactivated arenes with propargyl α-aryl-α-diazoacetates has been developed using scandium catalysis. A variety of unactivated, mildly deactivated, and electronically activated arenes have been functionalized using this protocol. The synergistic combination of scandium triflate as a catalyst and propargyl α-aryl-α-diazoacetate as a reagent played a pivotal role in the effective C-H bond functionalization of arenes without the assistance of any directing group or ligand. The practicality of the protocol has been demonstrated by the gram-scale synthesis of very useful α,α-diarylacetates including antispasmodic drug-adiphenine. Based on the experimental observations, labeling experiment, and density functional theory calculations, a plausible reaction mechanism has been outlined.

Acceptance of artificial intelligence (AI)-based screening for breast health in urban slums of central Karnataka, India - SWOC analysis.

Background: Artificial intelligence-based imaging is a low-cost, radiation-free solution for the breast imaging process that uses infrared radiation emitted by the body. This is a novel procedure that, when feasible, could be a better solution, particularly in underprivileged communities having low access to breast health care. Aims: To assess the acceptance and explore challenges for an artificial intelligence-based screening solution for breast health among the urban slum population. Settings and Design: A mixed-method study was conducted in urban slums of central Karnataka, India. Material and Methods: The study was carried out for a period of two years in 2019-21 among women in the reproductive age group in urban slums of central Karnataka to understand the acceptance of an artificial intelligence-based imaging solution for screening breast health. In-depth interviews were conducted to identify the strength, weaknesses, opportunities, and challenges (SWOC) screening for breast health. Statistical Analysis Used: Quantitative data were analysed using Statistical Package for the Social Sciences (SPSS) v16.0, and for qualitative data, manual descriptive content analysis was carried out, and the sub-themes were generated. Results: A total of 768 women accessed the thermalytix ® breast imaging services, the majority of them in the age group 31-40 years (35%), belonging to the Muslim religion (68.5%) with a mean monthly family income of Rs. 11,950.67/- SWOC analysis identified reduced cost for the screening services and involvement of female self-help groups (SHGs) as strengths. Weaknesses included poor breast health awareness among women and the stigma associated with breast cancer. Conclusions: Artificial intelligence-based screening is a feasible solution for breast health in low-income, low health access areas like urban slums. Engagement of the local community and active involvement of the health system is of paramount importance for the sustainability of any novel strategy.

Calcium oxide supported gold nanoparticles as catalysts for the selective epoxidation of styrene by t-butyl hydroperoxide.

Gold nanoparticles are deposited on basic CaO supports as catalysts for the selective conversion of styrene into styrene oxide. Synthetic methods, gold loading and calcination temperatures are varied to permit an understanding of their influence on gold nanoparticle size, the presence of cationic gold species and the nature of interaction between the gold nanoparticles and the CaO support. Based on these studies, optimal conditions are designed to make the Au/CaO catalyst efficient for the selective epoxidation of styrene.

Budget impact of rosuvastatin initiation in high-risk hyperlipidemic patients from a US managed care perspective.

INTRODUCTION: Statins reduce low-density lipoprotein cholesterol (LDL-C) levels, which, when elevated, represent a significant risk factor for cardiovascular (CV) disease. Hyperlipidemic patients at risk of CV events initiated on simvastatin or atorvastatin may be less likely to meet LDL-C goals (defined in National Cholesterol Education Program guidelines) and more likely to experience CV events than patients initiated on rosuvastatin. A 3-year budget impact model was developed to estimate the clinical impact and cost to a US managed care organization (MCO) with 1 million members of initiating high-risk hyperlipidemic patients on rosuvastatin rather than simvastatin or atorvastatin. METHODS: A total of 1000 adult patients were assumed to initiate statins. The average baseline LDL-C level was 189 mg/dL. In scenario 1, all patients were initiated on simvastatin or atorvastatin and titrated to a higher dose, or switched to atorvastatin (if initiated on simvastatin) or rosuvastatin; in scenario 2, 50% of the 520 high-risk patients were initiated on rosuvastatin. Drug acquisition and administration costs were considered. Product labeling, clinical trial results, national prescription claims data, and published literature were used to populate the model. RESULTS: Over 3 years, 75 additional patients reached their LDL-C goal in scenario 2, compared with scenario 1 (633 vs 558, respectively), at an increased cost of $240,628 ($1,415,516 vs $1,174,888, respectively). The additional per member per month (PMPM) cost of scenario 2 was $0.007. LIMITATIONS: This analysis assumed that statin efficacy is the same in real life as in trials, and used titration and switching patterns not based on patients' goal attainment. However, sensitivity and scenario analyses showed that the model was less sensitive to these parameters than to cost-related parameters. CONCLUSIONS: Initiating high-risk hyperlipidemic patients on rosuvastatin may increase the number of patients reaching LDL-C goal at a relatively modest increase in PMPM cost to an MCO.

Variation of health-care resource utilization according to GERD-associated complications.

Complications associated with gastroesophageal reflux disease (GERD) can include esophageal stricture, Barrett's esophagus, gastrointestinal hemorrhage, and extraesophageal symptoms. The impact of GERD-associated complications on health-care utilization deserves further evaluation. We identified commercial enrollees 18-75 years old with claims for GERD (International Classification of Diseases, Ninth Revision, Clinical Modification Codes: 530.81 or 530.11) and subsequent usage of proton pump inhibitors from 01/01/05 to 06/30/09. The initial GERD diagnosis date was designated as the index date, and patients were studied for 6 months preindex and postindex. Eligible patients were subsequently stratified based on medical claims for GERD-associated complications as follows: stage A (GERD diagnosis, no other symptoms), stage B (GERD + extraesophageal symptoms), stage C (GERD + Barrett's esophagus), stage D (GERD + esophageal stricture), and stage E (GERD + iron-deficiency anemia or acute upper gastrointestinal hemorrhage). Patient characteristics, health-care utilization, and costs were compared between stage A and each stage with complicated GERD (B-D). Of the 174,597 patients who were eligible for analysis, 74% were classified as stage A, 20% stage B, 1% stage C, 2% stage D, and 3% stage E. Relative to stage A, patients in stages C, D, and E were significantly more likely to visit a gastroenterologist (13% vs. 68%, 71%, and 38%, respectively) and had higher rates of esophageal ulcers (0.3% vs. 8%, 5%, and 3%, respectively) and Nissen fundoplication (0.05% vs. 0.6%, 0.3%, and 0.2%, respectively). Six-month GERD-related costs ranged from $615/patient (stage A) to $1714/patient (stage D); all-cause costs ranged from $4195/patient (stage A) to $11,340/patient (stage E). Compared with stage A, all other cohorts had significantly higher all-cause and GERD-related costs (P < 0.0001 for all comparisons). While patients with more severe GERD represented a relatively small portion of the GERD cohort, they demonstrated significantly greater health-care costs and overall utilization than patients with uncomplicated GERD.

Development of a refractory gastro-oesophageal reflux score using an administrative claims database.

BACKGROUND: Approximately one-third of gastro-oesophageal reflux disease (GERD) patients demonstrate refractory symptoms following treatment with proton pump inhibitor (PPI) therapy. AIM: To develop a refractory GERD score that can be applied to predict patients' healthcare utilisation. METHODS: We enrolled adults (≥18 years) with a diagnosis of GERD. Refractory GERD was evaluated on an 8-point scale where 1 point was given for each of the following criteria: doubling, addition, or switching of GERD medication dose, receipt of a GERD-related endoscopic procedure or surgery, or ≥3 GERD-related outpatient visits. Refractory GERD was defined as the presence of two or more points. RESULTS: A total of 135,139 GERD patients (44% male) were analysed with a mean (±s.d.) age of 52.9 ± 15 years. The mean overall refractory GERD score was 1.12 ± 1.2 (range 0-8 on an 8-point scale); 31% of patients had refractory GERD with a mean score of 2.56 ± 0.82. Among patients with refractory GERD, 31% doubled their GERD medication, 28% added a new GERD medication, 60% switched GERD medications, 54% had a GERD-related procedure and 1% had a GERD-related surgery. Patients with refractory GERD were more likely to be female (59% vs. 55%, P < 0.001) and had a higher co-morbidity score (0.78 vs. 0.56, P < 0.001). The overall mean costs for refractory patients during the study period were significantly higher compared with treatment-responsive patients ($18,088 ± $36,220 vs. $11,044 ± $22,955, P < 0.001). CONCLUSIONS: Refractory GERD was present in approximately one-third of the GERD patients. We created a GERD refractory score that could define need for increased anti-reflux therapy and predict higher healthcare resource utilisation.

Production and characterisation of monoclonal antibodies specific for chicken interleukin-12.

Using genetic immunisation of mice, we produced antibodies against chicken interleukin-12p40 (chIL-12p40), also known as IL-12ß. After a final injection with a recombinant chIL-12p40 protein, several stable hybridoma cell lines were established which secreted monoclonal antibodies (mAbs) to this component of the heterodimeric IL-12 cytokine. Specific binding of three of the mAbs to COS-7 cell-derived recombinant chIL-12p40 and the chIL-12p70 heterodimer was demonstrated in an indirect ELISA, and in dot blots. Two of the mAbs were used to develop a capture ELISA, suitable for detecting both recombinant protein (chIL-12p40 and the heterodimeric p70 protein) and native chIL-12. The mAbs were further characterised to show utility in immunocytochemistry.

Traditional Medicinal Knowledge on Moringa concanensis Nimmo of Perambalur District, Tamilnadu.

Moringa concanensis Nimmo (Moringaceae) is one of the important medicinal plant. It is restricted in its distribution. The present study was aimed at recording traditional knowledge about this plant in various localities of Perambalur district, Tamilnadu. The medicinally useful part, drug preparation, mode of administration and the disease which can be treated have been discussed in this paper.

MACROPROPAGATION OF THE INDIAN MEDICINAL PLANT Premna tomentosa Willd.

Premna tomentosa Willd is a moderate sized deciduous tree of apparently more economic and medicinal values. It is not commonly seen to be used by the medicinemen of Tamil Nadu now-a-days. The plant has been located in the plains and hills of Tamil Nadu, with the help of its varied vernacular names. It is in excessive biotic disturbance. It has been found to be in reproductive isolation, Hence, macropropagation of this plant has been contemplated and tried successfully for the first time. The results are reported.

MASS MULTIPLICATION OF THE INDIAN MEDICINAL PLANT Tylophora Indica (Burm.f.) Merr.

Tylophora indica (Burm.f) Merr. (ASCLEPIDACEAE) is an important Indian medicinal plant. It is called "ASTHMA KODI" OR "NANJARUPPAN" IN Tamil in the Siddha system of medicine. Tamil medical literature reveal that it is an ideal plant medicine for respiratory problems and is also a cardiac tonic. For medicinal purposes it is collected only from the wild. It has not yet been brought under cultivation. Its taxonomy, morphology, ecology and medicinal uses were studied. Since, tissue-culture is a costly technology and requiring a high-tech laboratory a low-cost mass- multiplication technique has been invented through water-culture experiments, in order to make its saplings available to the interested herbal farmers in a larger scale. The results are reported in this paper, which will be of immense help and use to the herbal farmers.

Isolation of Neospora caninum genes detected during a chronic murine infection.

In order to isolate genes coding for antigens of Neospora caninum which are recognised by the host immune system during a chronic murine infection, a cDNA library was immunoscreened with pooled sera from mice which survived three independent infections by N. caninum. Two new genes from N. caninum were isolated and expressed in Escherichia coli. The genes identified include one homologous to GRA1 of Toxoplasma gondii, plus another (NCP20) previously unknown in any taxon. Both genes encode small polypeptides which induced an IgG response in the mouse and were also recognised by IgG from a cow chronically infected with N. caninum. These results are consistent with the hypothesis that the polypeptides encoded by these genes are a target for the host immune system during chronic infections of N. caninum.

Low-Temperature Selective Catalytic Reduction (SCR) of NO with NH3 by Using Mn, Cr, and Cu Oxides Supported on Hombikat TiO2.

A Highly active, time stable, and water resistant, Hombikat TiO2 supported Mn catalyst has been developed for the selective reduction of NO by NH3 [Eq. (1)]. The analogous Cu and Cr supported catalysts also provide 100 % N2 selectivity at ≤120°C. Lewis acidity, redox properties, and a high surface metal oxide concentration are essential for good catalytic performance.

Isolation, characterization and expression of a GRA2 homologue from Neospora caninum.

A cDNA library derived from mRNA of tachyzoites of Neospora caninum (NC-Liverpool strain) was screened with antisera from a cow naturally infected with N. caninum. The DNA sequence of 1 recombinant isolated predicted a significant protein sequence homology of the gene product to the 28 kDa (GRA2) antigen of Toxoplasma gondii. Studies on the N. caninum gene coding for this antigen demonstrated the presence of a single intron flanked by 2 exons; the gene was also highly expressed in culture-derived tachyzoites. The antigen was expressed in Escherichia coli; when injected into mice it stimulated the production of antibodies which detected a 29 kDa antigen of N. caninum. Secondary structure predictions made for the N. caninum protein showed support for several amphipathic helices separated by loops and turns. The available evidence indicates maintenance of protein secondary structure, and not DNA or amino acid sequence, has occurred during the evolution of GRA2 proteins in N. caninum and T. gondii.

Treatment of eye diseases by the healers of marakanam bio-region.

The present study is an attempt to list some of the medicinal plants used by the traditional practitioners of the Marakanam bio-region in the treatment of various eye diseases. The survey of folk medicine men from this bio-region has revelaed that there are 24 medicinal plants locally available for treating both simple and complex eye diseases. Most of these diseases have been identified in Sanskrit and Tamil and are correlated with their English terms.

Effect of foliar fertilisation on growth of solanum trilobatum L.

The effects of the fertilizers, CYTOZYME, MIRACLE, PLANOFIX and VIPUL on Solanum trilobatum were studied CYTOZYME showed improved morphometric performance and the highest yield. VIPUL contributed greater drought resistance to the medicinal plant.