Analytic Evaluation of Nonadiabatic Couplings within the Complex Absorbing Potential Equation-of-Motion Coupled-Cluster Method.

We present the theory for the evaluation of nonadiabatic couplings (NACs) involving resonance states within the complex absorbing potential equation-of-motion coupled-cluster (CAP-EOM-CC) framework implemented within the singles and doubles approximation. Resonance states are embedded in the continuum and undergo rapid decay through autodetachment. In addition, nuclear motion can facilitate transitions between different resonances and between resonances and bound states. These nonadiabatic transitions affect the chemical fate of resonances and have distinct spectroscopic signatures. The NAC vector is a central quantity needed to model such effects. In the CAP-EOM-CC framework, resonance states are treated on the same footing as bound states. Using the example of fumaronitrile, which supports a bound radical anion and several anionic resonances, we analyze the NAC between bound states and pseudocontinuum states, between bound states and resonances, and between two resonances. We find that the NAC between a bound state and a resonance is nearly independent of the CAP strength and thus straightforward to evaluate, whereas the NAC between two resonance states or between a bound state and a pseudocontinuum state is more difficult to evaluate.

A Real-World Study of Safety, Immunogenicity and Efficacy of Bevacizumab in Patients With Solid Malignancies: A Phase IV, Post-Marketing Study in India.

Objective: The aim of this study was to evaluate the post-marketing safety, tolerability, immunogenicity and efficacy of Bevacizumab (manufactured by Hetero Biopharma) in a broader population of patients with solid tumors. Patients And Methods: This phase IV, prospective, multi-centric clinical study was carried out in Indian patients with solid malignancies (metastatic colorectal cancer, non-squamous non-small-cell lung cancer, metastatic renal cell carcinoma) treated with Bevacizumab between April 2018 and July 2019. This study included 203 patients from 16 tertiary care oncology centers across India for safety assessment, of which a subset of 115 patients who have consented were also evaluated for efficacy and immunogenicity. This study was prospectively registered in the Clinical Trial Registry of India (CTRI), and was commenced only after receiving approval from the competent authority (Central Drugs Standard Control Organization, CDSCO). Results: Out of the 203 enrolled patients, 121 (59.6%) patients reported 338 adverse events (AEs) during this study. Of 338 reported AEs, 14 serious adverse events (SAEs) were reported by 13 patients including 6 fatal SAEs, assessed as unrelated to the study medication and 7 non-fatal SAEs, 5 assessed as related, and 3 unrelated to Bevacizumab. Most AEs reported in this study (33.9%) were general disorders and administration site conditions, followed by gastrointestinal disorders (29.1%). The most frequently reported AEs were diarrhea (11.3%), asthenia (10.3%), headache (8.9%), pain (7.4%), vomiting (7.9%), and neutropenia (5.9%). At the end of the study, 2 (1.75%) of 69 patients reported antibodies to Bevacizumab without affecting safety and efficacy. However, at the end of 12 months, no patient had reported antibodies to Bevacizumab. Complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) were reported in 18.3%, 22.6%, 9.6%, and 8.7% of patients, respectively. The overall response rate (CR + PR) was reported in 40.9% of patients at the end of the study. Disease control rate (DCR), also known as the clinical benefit rate (CBR) was reported in 50.4% of patients. Conclusions: Bevacizumab (Cizumab, Hetero Biopharma) was observed to be safe, well tolerated, lacking immunogenicity, and efficacious in the treatment of solid tumors. The findings of this phase IV study of Bevacizumab, primarily as a combination therapy regimen suggest its suitability and rationality for usage in multiple solid malignancies. Clinical Trial Registry Number: CTRI/2018/4/13371 [Registered on CTRI http://ctri.nic.in/Clinicaltrials/advsearch.php : 19/04/2018]; Trial Registered Prospectively.

Gravitational Test beyond the First Post-Newtonian Order with the Shadow of the M87 Black Hole.

The 2017 Event Horizon Telescope (EHT) observations of the central source in M87 have led to the first measurement of the size of a black-hole shadow. This observation offers a new and clean gravitational test of the black-hole metric in the strong-field regime. We show analytically that spacetimes that deviate from the Kerr metric but satisfy weak-field tests can lead to large deviations in the predicted black-hole shadows that are inconsistent with even the current EHT measurements. We use numerical calculations of regular, parametric, non-Kerr metrics to identify the common characteristic among these different parametrizations that control the predicted shadow size. We show that the shadow-size measurements place significant constraints on deviation parameters that control the second post-Newtonian and higher orders of each metric and are, therefore, inaccessible to weak-field tests. The new constraints are complementary to those imposed by observations of gravitational waves from stellar-mass sources.

Extended Second-Order Multireference Algebraic Diagrammatic Construction Theory for Charged Excitations.

We report a new implementation of multireference algebraic diagrammatic construction theory (MR-ADC) for simulations of electron attachment and ionization in strongly correlated molecular systems (EA/IP-MR-ADC). Following our recent work on IP-MR-ADC [J. Chem. Theory Comput. 2019, 15, 5908], we present the first implementation of the second-order MR-ADC method for electron attachment (EA-MR-ADC(2)) and two extended second-order approximations (EA- and IP-MR-ADC(2)-X) that incorporate a partial treatment of third-order electron correlation effects. Introducing a small approximation for the second-order amplitudes of the effective Hamiltonian, our implementation of EA- and IP-MR-ADC(2)-X has a low O(M5) computational scaling with the basis set size M. Additionally, we describe an efficient algorithm for solving the first-order amplitude equations in MR-ADC and partially contracted second-order N-electron valence perturbation theory (NEVPT2) which completely avoids computation of the four-particle reduced density matrices without introducing any approximations or imaginary-time propagation. For a benchmark set of eight small molecules, a carbon dimer, and a twisted ethylene, we demonstrate that EA- and IP-MR-ADC(2)-X achieve an accuracy similar to that of strongly contracted NEVPT2 while having a lower computational scaling with the active space size and providing efficient access to transition properties.

Second-Order Multireference Algebraic Diagrammatic Construction Theory for Photoelectron Spectra of Strongly Correlated Systems.

We present a second-order formulation of multireference algebraic diagrammatic construction theory [ Sokolov , A. Yu. J. Chem. Phys. 2018 , 149 , 204113 ] for simulating photoelectron spectra of strongly correlated systems (MR-ADC(2)). The MR-ADC(2) method uses second-order multireference perturbation theory (MRPT2) to efficiently obtain ionization energies and intensities for many photoelectron transitions in a single computation. In contrast to conventional MRPT2 methods, MR-ADC(2) provides information about ionization of electrons in all orbitals (i.e., core and active) and allows computation of transition intensities in a straightforward and efficient way. Although equations of MR-ADC(2) depend on four-particle reduced density matrices, we demonstrate that computation of these large matrices can be completely avoided without introducing any approximations. The resulting MR-ADC(2) implementation has a lower computational scaling compared to conventional MRPT2 methods. We present results of MR-ADC(2) for photoelectron spectra of small molecules, a carbon dimer, and equally spaced hydrogen chains (H10 and H30) and outline directions for future developments.

Estrogen receptor and progesterone receptor status of breast cancer patients of eastern India: A multi-institutional study.

CONTEXT: There is a paucity of any significant data on the estrogen receptor (ER) and progesterone receptor (PR) status of breast cancer patients from the eastern part of India. AIMS: This study aims to document the ER and PR status of breast cancer patients in the eastern Indian population, as catered by two premier tertiary care hospitals in Kolkata. SUBJECTS AND METHODS: All breast cancer patients registered between January 1, 2013 and December 31, 2015, in the Departments of Oncology, of IPGMER and SSKM Hospitals and R. G. Kar Medical College and Hospital, Kolkata, who had at least undergone a core biopsy or surgery, were analyzed retrospectively for documentation of their ER and PR status, using the 2010 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) interpretation guidelines. RESULTS: Over a period of 3 years, a total of 927 patients were included for the study. A total of 825 (89%) patients had their ER and PR data available for evaluation. ER and PR positive was seen in 312 (37.82%) patients, ER and PR negative in 399 (48.36%) patients, ER positive and PR negative in 71 (8.6%) patients, and ER negative and PR positive results was found in 43 (5.21%) patients. CONCLUSIONS: This is the first multi-institutional documentation of ER and PR status from eastern India, having a modest number of patients and one of the earliest documentations using the latest ASCO/CAP interpretation guidelines. These findings resemble the data from the south and also reiterate the fact that majority of the Indian breast cancer patients are still ER and PR negative in spite of the changes in the interpretation guidelines.

Regional reporting of the incidence of Anaplastic Lymphoma Kinase mutation in 379 non-small-cell lung cancer patients from Kolkata: Using immunohistochemistry as the diagnostic modality in a significant subset.

CONTEXT: Regional epidemiology of anaplastic lymphoma kinase (ALK) mutation in non-small-cell lung cancer (NSCLC) is an unmet need in India, and so is the knowledge of its incidence based on immunohistochemistry (IHC). AIMS: Reporting the incidence of ALK mutation in NSCLC from Kolkata, incorporating IHC as the diagnostic modality in a considerable subset of patients. SUBJECTS AND METHODS: It is a retrospective observational study done on NSCLC patients with adenocarcinoma histology, unselected by epidermal growth factor receptor, whose samples were tested for ALK mutation status between March 1, 2013, and March 15, 2017. The study involved all cancer facilities in Kolkata, except Tata Medical Centre. Up to June 2015, the tests were done by fluorescence in situ hybridization (FISH) and from July 2015 to the end, tests were done using IHC, as per the standard testing guidelines existing during the respective time periods. Results were documented in a de-identified manner to analyze the incidence of ALK mutations. RESULTS: A total of 379 patients was tested for ALK mutations. March 2013 to June 2015, 200 (52.77%) patients were tested by FISH, 17 (8.5%) samples were unreportable and 4 patients [(2.19%) 4/183] tested positive for ALK mutations. From July 2015 to March 2017, 179 (47.22%) patients were tested by IHC, 9 (5.02%) samples were unreportable, and 10 patients [(5.88%) 10/170] tested positive for ALK mutations. Overall, 26 (6.8%) samples were unreportable and 14 [(3.9%) 14/353] patients tested positive for ALK mutations. CONCLUSIONS: The overall incidence of ALK mutation positive NSCLC in Kolkata is 3.9%. The incidence by IHC is 5.88% and by FISH is 2.19%, in the subset of patients tested by these two modalities respectively.

A minimalistic approach to static and dynamic electron correlations: Amending generalized valence bond method with extended random phase approximation correlation correction.

A perfect-pairing generalized valence bond (GVB) approximation is known to be one of the simplest approximations, which allows one to capture the essence of static correlation in molecular systems. In spite of its attractive feature of being relatively computationally efficient, this approximation misses a large portion of dynamic correlation and does not offer sufficient accuracy to be generally useful for studying electronic structure of molecules. We propose to correct the GVB model and alleviate some of its deficiencies by amending it with the correlation energy correction derived from the recently formulated extended random phase approximation (ERPA). On the examples of systems of diverse electronic structures, we show that the resulting ERPA-GVB method greatly improves upon the GVB model. ERPA-GVB recovers most of the electron correlation and it yields energy barrier heights of excellent accuracy. Thanks to a balanced treatment of static and dynamic correlation, ERPA-GVB stays reliable when one moves from systems dominated by dynamic electron correlation to those for which the static correlation comes into play.

A randomized controlled pilot study to compare capecitabine-oxaliplatin with 5-FU-leucovorin as neoadjuvant concurrent chemoradiation in locally advanced adenocarcinoma of rectum.

CONTEXT: Established as an adjuvant chemotherapy, CapeOX has recently been shown to have radiosensitizer property in a phase I and II studies, with appreciable downstaging and tolerable toxicities. AIMS: The study was designed to evaluate whether the capecitabine-oxaliplatin combination was superior to 5-fluorouracil (5-FU)-leucovorin as radiosensitizer for neoadjuvant chemoradiation in downstaging locally advanced rectal adenocarcinoma and to compare the toxicities between the two arms. SETTINGS AND DESIGN: Single institutional, double blinded, prospective, noncrossover, randomized control pilot study. SUBJECTS AND METHODS: In arm A (n = 21), patients received capecitabine (1,000 mg/m(2) daily) in twice dailydoseon days 1-14 and 25-38 and oxaliplatin (85 mg/m(2)) intravenous ( IV) over 2 h, on D1 and D29. In arm B (n = 21), patients received leucovorin (20 mg/m(2)) and 5-FU (350 mg/m(2)) from D1-5 and D29-33. Patient in both the arms received concurrent radiation (50.4 Gy in 28 #, in conventional fractionation of 1.8 Gy per fraction). Six to eight weeks after concurrent chemoradiation, patients underwent assessment and surgery with total mesorectal resection. Postoperatively, adjuvant chemotherapy with m-FOLFOX 6 of 4 months was given to all patients. STATISTICAL ANALYSIS USED: Chi-square test was used to compare categorical variables between the groups. RESULTS: Objective response rate (ORR) in arm A was 80.95% compared to arm B which had 66.66% (P = 0.3055). Pathological complete response (pCR) rate of arm A was comparable to arm B (23.8 vs 14.28%, P value = 0.6944). Surgery with R0 resection was possible in 80.95% cases of arm A compared to 66.66% cases of arm B (P = 0.4827). Grade III toxicities were quite comparable between two treatment arms. CONCLUSIONS: In terms of ORR, pCR rate, R0 resection, and toxicity profile; both the arms were comparable.

How accurate is the strongly orthogonal geminal theory in predicting excitation energies? Comparison of the extended random phase approximation and the linear response theory approaches.

Performance of the antisymmetrized product of strongly orthogonal geminal (APSG) ansatz in describing ground states of molecules has been extensively explored in the recent years. Not much is known, however, about possibilities of obtaining excitation energies from methods that would rely on the APSG ansatz. In the paper we investigate the recently proposed extended random phase approximations, ERPA and ERPA2, that employ APSG reduced density matrices. We also propose a time-dependent linear response APSG method (TD-APSG). Its relation to the recently proposed phase including natural orbital theory is elucidated. The methods are applied to Li2, BH, H2O, and CH2O molecules at equilibrium geometries and in the dissociating limits. It is shown that ERPA2 and TD-APSG perform better in describing double excitations than ERPA due to inclusion of the so-called diagonal double elements. Analysis of the potential energy curves of Li2, BH, and H2O reveals that ERPA2 and TD-APSG describe correctly excitation energies of dissociating molecules if orbitals involved in breaking bonds are involved. For single excitations of molecules at equilibrium geometries the accuracy of the APSG-based methods approaches that of the time-dependent Hartree-Fock method with the increase of the system size. A possibility of improving the accuracy of the TD-APSG method for single excitations by splitting the electron-electron interaction operator into the long- and short-range terms and employing density functionals to treat the latter is presented.

Magnetic norbornene polymer as multiresponsive nanocarrier for site specific cancer therapy.

A site-specific, stimuli-responsive nanocarrier has been synthesized by conjugating folate, magnetic particles and doxorubicin to the backbone of norbornene polymer. Monomers, namely, cis-5-norbornene-6-(diethoxyphosphoryl)hexanote (mono 1), norbornene grafted poly(ethyleneglycol)-folate (mono 2), and norbornene derived doxorubicin (mono 3) are carefully designed to demonstrate the smart nanorcarrier capabilities. The synthesis and complete characterization of all three monomers are elaborately discussed. Their copolymerization is done by controlled/living ring-opening metathesis polymerization (ROMP) to get the triblock copolymer PHOS-FOL-DOX. NMR spectroscopy and gel permeation chromatography confirm the formation of the triblock copolymer, while FT-IR spectroscopy, thermogravimetric analysis, along with transmission electron microscope confirm the anchoring of iron particle (Fe3O4) to the PHOS-FOL-DOX. Drug release profile shows the importance of having the hydrazone linker that helps to release the drug exactly at the mild acidic conditions resembling the pH of the cancerous cells. The newly designed nanocarrier shows greater internalization (about 8 times) due to magnetic field. Also, increased intracellular DOX release is observed due to the folate receptor. From these results, it is clear that PHOS-FOL-DOX has the potential to act as a smart nanoreservoir with the magnetic field guidance, folate receptor targeting, and finally pH stimulation.

Excitation energies from extended random phase approximation employed with approximate one- and two-electron reduced density matrices.

Starting from Rowe's equation of motion we derive extended random phase approximation (ERPA) equations for excitation energies. The ERPA matrix elements are expressed in terms of the correlated ground state one- and two-electron reduced density matrices, 1- and 2-RDM, respectively. Three ways of obtaining approximate 2-RDM are considered: linearization of the ERPA equations, obtaining 2-RDM from density matrix functionals, and employing 2-RDM corresponding to an antisymmetrized product of strongly orthogonal geminals (APSG) ansatz. Applying the ERPA equations with the exact 2-RDM to a hydrogen molecule reveals that the resulting (1)Σ(g)(+) excitation energies are not exact. A correction to the ERPA excitation operator involving some double excitations is proposed leading to the ERPA2 approach, which employs the APSG one- and two-electron reduced density matrices. For two-electron systems ERPA2 satisfies a consistency condition and yields exact singlet excitations. It is shown that 2-RDM corresponding to the APSG theory employed in the ERPA2 equations yields excellent singlet excitation energies for Be and LiH systems, and for the N(2) molecule the quality of the potential energy curves is at the coupled cluster singles and doubles level. ERPA2 nearly satisfies the consistency condition for small molecules that partially explains its good performance.

The genetic factors influencing the development of trichotillomania.

Trichotillomania (TTM), an obsessive-compulsive spectrum disorder (OCSD), is a psychiatric condition characterized by repetitive hair pulling. Evidence from family and twin studies suggest a heritable link of TTM. Functional polymorphisms in genes involved in neuronal pathways might influence the susceptibility to TTM. This review is an attempt to compile the genetic factors reported to modify the development of TTM.

Spindle cell sarcoma of the maxillary antrum.

Maxillary antral malignancies are mostly squamous cancers. Sarcomas in this region are rare. The head and neck region houses around 8.9% of all sarcomas and spindle cell sarcomas of the maxillary antrum had rarely been reported.The presentation, pathology, clinical findings, management and short term response to treatment of a left maxillary antral spindle cell sarcoma, in a Muslim, male tobacco chewer is reported here.

CASP8 promoter polymorphism is associated with high-risk HPV types and abnormal cytology but not with cervical cancer.

Only a small fraction of women infected with human papillomavirus (HPV) progress to cervical cancer pointing to additional risk factors including host genetics that might play a role in development of cervical cancer. Caspase-8 (encoded by CASP8 gene) is crucial in generating cell death signals to eliminate potentially malignant cells. Genetic variation in CASP8 might influence the susceptibility to cancer. CASP8 -652 6N ins/del polymorphism has been previously reported to influence the progression to several cancers including cervical cancer. This polymorphism was investigated in 445 women of black African and Mixed Ancestry origin with invasive cervical cancer and 1,221 controls matched (1:3) by age, ethnicity, and domicile status. Genotyping for CASP8 -652 6N ins/del was done by PCR-RFLP. In the control women cervical disease was detected by cervical cytology. The CASP8 -652 6N del/del genotype did not show any significant association (P=0.948) with cervical cancer. Further analysis within the controls showed a weak association (P=0.048) of this polymorphism with abnormal cytology in both ethnicities and high-risk HPV infection (P=0.030) only in the black Africans. This is the first study of the role of CASP8 -652 6N ins/del polymorphism in cervical cancer in an African population. These results show that CASP8 -652 6N del/del genotype increases the risk of abnormal cytology and high-risk HPV infection but does not show an association with cervical cancer. This result points towards an important role of CASP8 in HPV infection and in the development of pre-cancers.

Ovarian germ cell neoplasm in a true hermaphrodite.

True hermaphrodites are extremely rare. The incidence of malignancies in cases of true hermaphrodites range between 1.9-2.6%, and is almost exclusively associated with cytogenetic mosaicism. All of the malignancies reported till date are germ cell neoplasms, namely, seminoma, gonadoblastoma or teratoma, mostly in the male phenotype. In this case we Illustrate a rare occurrence of a dysgerminoma of the ovary, its treatment and responses, in a 35-year-old true hermaphrodite with a female phenotype, and cytogenetic mosaicism.

A Fas gene polymorphism influences herpes simplex virus type 2 infection in South African women.

Herpes simplex virus type 2 (HSV-2) is a common sexually transmitted infection (STI) worldwide that causes genital infection. Among several factors responsible, host genetic factors may play an important role in susceptibility to HSV-2 infection. Apoptosis is a vital mechanism in eliminating virus-infected cells and controlling viral infections. Apoptosis can be regulated and triggered by the interaction between Fas and Fas Ligand (FasL). Polymorphisms in genes encoding Fas and FasL might result in altered apoptosis and contribute in susceptibility to viral infections. Two polymorphisms in Fas gene (FasR-1377G > A, FasR-670A > G) and one in FasL gene (FasL-844T > C) have been well studied and associated with different diseases. These polymorphisms were investigated in 407 South African women of black African and mixed-ancestry origin to determine if they were associated with HSV-2 seropositivity. Two hundred sixty-five women were HSV-2 infected and 142 were non-infected. HSV-2 was detected using HerpeSelect ELISA test and genotyping was performed using TaqMan assay. FasR-1377A allele showed a statistically significant association (P = 0.008) with reduced risk of HSV-2 infection. Analyzing the FasR haplotypes also showed a statistically significant association (P = 0.0001) with FasR-1377/FasR-670 AG haplotype and reduced risk of HSV-2 infection. There was no significant association found with FasR-670A > G and FasL-844T > C polymorphisms and risk of HSV-2 infection. This is, to our knowledge, the first time a non-HLA genetic link with HSV-2 infection has been reported.

CCR2-V64I polymorphism is associated with increased risk of cervical cancer but not with HPV infection or pre-cancerous lesions in African women.

BACKGROUND: Cervical cancer, caused by specific oncogenic types of human papillomavirus (HPV), is the second most common cancer in women worldwide. A large number of young sexually active women get infected by HPV but only a small fraction of them have persistent infection and develop cervical cancer pointing to co- factors including host genetics that might play a role in outcome of the HPV infection. This study investigated the role of CCR2-V64I polymorphism in cervical cancer, pre-cancers and HPV infection in South African women resident in Western Cape. CCR2-V64I polymorphism has been previously reported to influence the progression to cervical cancer in some populations and has also been associated with decreased progression from HIV infection to AIDS. METHODS: Genotyping for CCR2-V64I was done by PCR-SSP in a case-control study of 446 women (106 black African and 340 mixed-ancestry) with histologically confirmed invasive cervical cancer and 1432 controls (322 black African and 1110 mixed-ancestry) group-matched (1:3) by age, ethnicity and domicile status. In the control women HPV was detected using the Digene Hybrid Capture II test and cervical disease was detected by cervical cytology. RESULTS: The CCR2-64I variant was significantly associated with cervical cancer when cases were compared to the control group (P = 0.001). Further analysis comparing selected groups within the controls showed that individuals with abnormal cytology and high grade squamous intraepitleial neoplasia (HSIL) did not have this association when compared to women with normal cytology. HPV infection also showed no association with CCR2-64I variant. Comparing SIL positive controls with the cases showed a significant association of CCR2-64I variant (P = 0.001) with cervical cancer. CONCLUSIONS: This is the first study of the role of CCR2-V64I polymorphism in cervical cancer in an African population. Our results show that CCR2-64I variant is associated with the risk of cervical cancer but does not affect the susceptibility to HPV infection or HSIL in South African women of black and mixed-ancestry origin. This result implies that the role of CCR2 is important in invasive cancer of the cervix but not in HPV infection or in the development of pre-cancers.

Host genetic factors in susceptibility to HIV-1 infection and progression to AIDS.

HIV-1 infection has rapidly spread worldwide and has become the leading cause of mortality in infectious diseases. The duration for development of AIDS (AIDS progression) is highly variable among HIV-1 infected individuals, ranging from 2-3 years to no signs of AIDS development in the entire lifetime. Several factors regulate the rate at which HIV-1 infection progresses to AIDS. Host genetic factors play an important role in the outcome of such complex or multifactor diseases as AIDS and are also known to regulate the rate of disease progression. This review focuses on the major host genes reported to affect the progression to AIDS in HIV-1 infected individuals.

Case report of two sisters suffering from Weill-Marchesani syndrome with pulmonary stenosis.

We report two sisters having a rare congenital anomaly-Weill-Marchesani syndrome having disproportionate short height, restriction of joint movements, brachydactyly, dislocation of lens, bilateral glaucomatous optic atrophy, and pulmonary stenosis.