Surgeons' user experience of telemedicine in surgical consultations during the COVID-19 pandemic, with an emphasis on general surgical consultations.

BACKGROUND: The COVID-19 pandemic and the eventual national lockdown in the UK brought a halt to the face-to-face outpatient appointments at most NHS hospitals. Owing to this, clinicians have had to switch to other means of consultation, to maintain continuity of care. This survey was done to see how surgeons perceive telemedicine as part of their surgical consultations. METHODS: A questionnaire was piloted and re-designed following which an improved questionnaire was circulated among all users of telemedicine in surgical specialties through social media platforms. The results were analysed using smart survey software. RESULTS: Seventy per cent of the respondents had never used telemedicine before the COVID-19 pandemic. Three-quarters of the respondents found difficulty in assessing patients preoperatively. A significant proportion were worried about confidentiality and data security. The other concerns expressed were difficulty in building a rapport and the absence of a legal framework to support the surgeons in the transition. Despite some concerns, most of them were in favour of using telemedicine in the future with some improvements. CONCLUSION: As the pandemic prevented people from attending face-to-face appointments, remote consultations were stepped up to help overcome the difficulties. Screening services were suspended and treatment accumulated. Telemedicine will be a corner-stone service as healthcare systems attempt to tackle this backlog. The already existing software need to be further explored. Future studies must address the use of telemedicine in preoperative consultations. Regulatory bodies must ensure that there is adequate legal framework in place so that clinicians continue to embrace telemedicine.

High level extracellular production of recombinant human interferon alpha 2b in glycoengineered Pichia pastoris: culture medium optimization, high cell density cultivation and biological characterization.

AIMS: The present study was aimed at design of experiments (DoE)- and artificial intelligence-based culture medium optimization for high level extracellular production of a novel recombinant human interferon alpha 2b (huIFNα2b) in glycoengineered Pichia pastoris and its characterization. METHODS AND RESULTS: The artificial neural network-genetic algorithm model exhibited improved huIFNα2b production and better predictability compared to response surface methodology. The optimized medium exhibited a fivefold increase in huIFNα2b titre compared to the complex medium. A maximum titre of huIFNα2b (436 mg l-1 ) was achieved using the optimized medium in the bioreactor. Real-time capacitance data from dielectric spectroscopy were utilized to model the growth kinetics with unstructured models. Biological characterization by antiproliferative assay proved that the purified recombinant huIFNα2b was biologically active, exhibiting growth inhibition on breast cancer cell line. CONCLUSIONS: Culture medium optimization resulted in enhanced production of huIFNα2b in glycoengineered P. pastoris at both shake flask and bioreactor level. The purified huIFNα2b was found to be N-glycosylated and biologically active. SIGNIFICANCE AND IMPACT OF THE STUDY: DoE-based medium optimization strategy significantly improved huIFNα2b production. The antiproliferative activity of huIFNα2b substantiates its potential scope for application in cancer therapy.

Anomalous low-temperature Coulomb drag in graphene-GaAs heterostructures.

Vertical heterostructures combining different layered materials offer novel opportunities for applications and fundamental studies. Here we report a new class of heterostructures comprising a single-layer (or bilayer) graphene in close proximity to a quantum well created in GaAs and supporting a high-mobility two-dimensional electron gas. In our devices, graphene is naturally hole-doped, thereby allowing for the investigation of electron-hole interactions. We focus on the Coulomb drag transport measurements, which are sensitive to many-body effects, and find that the Coulomb drag resistivity significantly increases for temperatures <5-10 K. The low-temperature data follow a logarithmic law, therefore displaying a notable departure from the ordinary quadratic temperature dependence expected in a weakly correlated Fermi-liquid. This anomalous behaviour is consistent with the onset of strong interlayer correlations. Our heterostructures represent a new platform for the creation of coherent circuits and topologically protected quantum bits.

Quantitative dermatoglyphic asymmetry: a comparative study between schizophrenic patients and control groups of West Bengal, India.

Quantitative Fluctuating (FA) and Directional asymmetry (DA) of dermatoglyphics on digito-palmar complex were analyzed in a group of 111 patients (males: 61, females: 50) with schizophrenia (SZ), and compared to an ethnically matched phenotypically healthy control (males: 60, females: 60) through MANOVA, ANOVA and canonical Discriminant analyses. With few exceptions, asymmetries are higher among patients, and this is more prominent in FA than DA. Statistically significant differences were observed between patient and control groups, especially in males. In both sexes, FA of combined dermatoglyphic traits (e.g. total finger ridge count, total palmar pattern ridge count) are found to be a strong discriminator between the two groups with a correct classification of over 83% probability.

Two-dimensional Mott-Hubbard electrons in an artificial honeycomb lattice.

Artificial crystal lattices can be used to tune repulsive Coulomb interactions between electrons. We trapped electrons, confined as a two-dimensional gas in a gallium arsenide quantum well, in a nanofabricated lattice with honeycomb geometry. We probed the excitation spectrum in a magnetic field, identifying collective modes that emerged from the Coulomb interaction in the artificial lattice, as predicted by the Mott-Hubbard model. These observations allow us to determine the Hubbard gap and suggest the existence of a Coulomb-driven ground state.

Inheritance of finger pattern types in MZ and DZ twins.

Digital patterns of a sample on twins were analyzed to estimate the resemblance between monozygotic (MZ) and dizygotic (DZ) twins and to evaluate the mode of inheritance by the use of maximum likelihood based variance decomposition analysis. MZ twin resemblance of finger pattern types appears to be more pronounced than in DZ twins, which suggests the presence of genetic factors in the forming of fingertip patterns. The most parsimonious model shows twin resemblance in count of all three basic finger patterns on 10 fingers. It has significant dominant genetic variance component across all fingers. In the general model, the dominant genetic variance component proportion is similar for all fingertips (about 60%) and the sibling environmental variance is significantly nonzero, but the proportion between additive and dominant variance components was different. Application of genetic model fitting technique of segregation analyses clearly shows mode of inheritance. A dominant genetic variance component or a specific genetic system modifies the phenotypic expression of the fingertip patterns. The present study provided evidence of strong genetic component in finger pattern types and seems more informative compared to the earlier traditional method of correlation analysis.

Quantitative digital and palmar dermatoglyphics: sexual dimorphism in the Chuvashian population of Russia.

With the aim of determining sex dimorphism among the Chuvashian population of Russia, digital and palmar dermatoglyphics of 547 individuals (293 males, 254 females) were analyzed. The sex differences for PII, TRC, and AFRC are similar to Indian and Jewish populations. Correlation coefficients between individual finger ridge counts are a little lower than in Jews but are almost equal to Indian populations. The Mantel test of matrix correlation between sexes for 22 traits shows a very good similarity. However, sex differences of palmar traits display different levels when compared with other human populations. In light of this, our evidence indicates the possible role of environmental (prenatal) factors in the realization of dermatoglyphic sex differences. The development of palmar dermatoglyphics has had a relatively longer growth period compared with fingers [Cummins, H., 1929. The topographic history of the volar pads (walking pads, tast ballen) in the human embryo. Embryol. 20, 103-126]. The palmar dermatoglyphic pattern of affinities therefore corresponds better than fingers to the ethno historical background of the populations, ascertained by numerous studies.

Ghosal type hemato-diaphyseal dysplasia: a rare variety of Engelmann's disease.

Ghosal type hemato-diaphyseal dysplasia is a recently described clinical entity. The authors describe such a case with severe anemia requiring transfusions and with clinical and radiological evidence of diaphyseal dysplasia. Very few such cases are reported in world literature.

Qualitative finger and palmar dermatoglyphics: sexual dimorphism in the Chuvashian population of Russia.

Qualitative finger and palmar dermatoglyphics of 547 individuals (293 males, 254 females) belonging to the Chuvashian population of Russia were studied to determine sexual dimorphism. The pattern types are not uniformly distributed on 10 fingers. Sex difference is homogeneous in all fingers whereas palmar patterns reflect the better sex variations for three palmar configurational areas (II, III, and IV). This is perhaps due to embryological development, having a relatively longer growth period compared with fingers (Cummins 1929). The present results of the Chuvashian population are not similar to the results of the five Indian populations of our previous study (Karmakar et al. 2002), perhaps due to a major ethnic difference.

Genetic determination of head-size-related anthropometric traits in an ethnically homogeneous sample of 373 Indian pedigrees of West Bengal.

The substantial involvement of genetic factors in the determination of head-size and head-shape traits has been firmly established. However, there has been a lack of agreement on a number of specific issues concerning the pattern of inheritance of craniofacial features. In this study we examined some of these issues in a large, ethnically homogeneous sample of Indian pedigrees. The data included 1,263 individuals belonging to 373 nuclear families. Eleven raw head-size traits and two synthetic phenotypes, interpreted as horizontal and vertical head-size components (HOC and VEC, respectively), were used in the analysis. To establish the pattern of inheritance of head traits, we carried out univariate and bivariate analyses. Maximum heritability estimates ranged from 0.41 to 0.83 for the studied head-size phenotypes. The portion of the total residual variance attributable to putative additive genetic factors was 68.3% and 70.3% for HOC and VEC, respectively, and common familial factor effects were found to be nonsignificant. The extent of genetic influences did not differ significantly with respect to sex or between HOC and VEC. The results of bivariate variance decomposition analysis strongly suggest the existence of common genetic factors simultaneously affecting HOC and VEC; 41.8% of the two traits' total residual variance was attributable to the effect of these common genetic factors.

Genetics of dermatoglyphic asymmetry in Vaidyas of West Bengal, India.

In this study of the genetics of dermatoglyphic asymmetry, we collected bilateral finger and palm prints of 824 individuals from 200 families including 2 generations from an endogamous caste (Vaidya) in Barasat, North 24-Parganas District, West Bengal. Two main types of asymmetry (fluctuating asymmetry and directional asymmetry) were calculated between the two hands. The study includes familial correlation between first-degree relatives, principal-components analysis, and maximum-likelihood-based heritabilities (by pedigree analysis). We found, first, that familial correlations in all possible pairs of relationships (except spouse correlation) were weak but positive; some were even statistically significant. No indication of assortative mating was observed, but the influence of maternal environment could not be discarded. The results also showed that X-chromosome linkage does not seem to be involved. A second major finding is that five principal factors could be extracted from all these asymmetric traits, explaining 74.207% of the overall cumulative variance. Asymmetry of finger and palmar areas were clearly separated by factor. In addition, the heritabilities of the extracted five factors were in the range of 8-24%. These estimates are in agreement with some previously published data. The heritabilities of the factors describing palmar asymmetry are slightly lower than those describing finger asymmetry. The present results support the hypothesis that both types of asymmetry have a genetic basis and are influenced by the intrauterine environment.

Jervell-Lange Nielsen syndrome in a family with the long QT Syndrome (LQTS).

A child with Jervell-Lange Nielsen syndrome is presented from Kolkata. Family study showed that the other family members are suffering from long QT syndrome. The child had frequent syncopal attack and very prolonged QT interval requiring left cardiac sympathetic denervation and beta-blocker therapy as patient could not afford implantable defibrillator and cardiac pacing.

Mode of inheritance of dermatoglyphic pattern intensity index on fingers in five Indian populations: a comparative study between individual trait and its factor.

Our previous study (Karmakar et al. 2005 Ann. Hum. Biol. 32:445-468) was on 500 pedigrees of five different populations, with factor 1 comprising quantitative finger dermatoglyphics (including pattern intensity index, PII) and factor 1 controlled by major genes. The present results of a complex segregation analysis of the individual trait PII of the same five populations were compared with previous results to ascertain the extent of variation between individual trait PII and its factor (factor 1) with respect to mode of inheritance. The comparative findings are very similar in five populations, irrespective of different ethnic groups. This result suggests that the variability of their biological relevance is influenced by the same genetic component, thus representing a similar mode of inheritance with major gene involvement in all populations.

Complex segregation analysis of quantitative dermatoglyphic traits in five Indian populations.

OBJECTIVE: Dermatoglyphics is widely used as a genetically determined trait in anthropogenetics although the genetic nature of its inheritance is still inconclusive, due to the lack of any established genetic model to resolve the existing inconsistencies in the literature. However, advanced statistical packages for complex segregation analyses are available and the aim of the present study is to determine the mode of dermatoglyphic trait inheritance in five different ethnic populations. METHODS: Five hundred families (2435 individuals) of two generations were used for principal component analysis, familial correlation and segregation analysis (package MAN-5). RESULTS: The similarity of three factors suggests a common internal structure. Significant familial correlation (except spouse) indicates the involvement of a familial component in the variation of dermatoglyphic traits. Segregation analyses suggest the transmission of a genetic effect in the families which follows the Mendelian model and confirms a major gene effect on factor 1 and factor 2 with two co-dominant alleles. There is no evidence of a major gene effect or environmental effect on factor 3 (a-b ridge counts). The nature of transmission and trait variance (H2) strongly supports the existence of a common nature of dermatoglyphic trait inheritance in populations, irrespective of ethnic and geographic area. CONCLUSION: Major gene involvement in finger dermatoglyphics according to Mendelian models is confirmed.

Asymmetry and diversity of dermatoglyphic traits: population comparison in five endogamous groups of West Bengal, India.

Five different endogamous populations encompassing the main social ranks in the caste hierarchy of West Bengal, India were analyzed. To compare variability in populations with contrasting ethnohistorical backgrounds, analysis of variance, Scheffe's test and cluster analysis were performed, as based on dermatoglyphic variables, namely, 22 quantitative traits and 36 indices of diversity and asymmetry. The present study reveals that: 1. Overall disparities among the 5 populations are expressed only in finger ridge counts on the Ist and Vth digits and PII, in a-b ridge counts, in endings of main lines A and D, and in MLI on the palms; 2. Heterogeneity is greater in fluctuating asymmetry than in directional asymmetry; 3. There is a greater heterogeneity in the 22 quantitative traits than in the 36 indices of diversity and asymmetry, with females contributing more than the males; 4. The highest contribution to population variation is by Lodha among five populations; 5. Inter-group variations are homogeneous in most of the variables, which does not correspond with the relationships to caste hierarchy of these populations; 6. The dendrograms based on dermatoglyphic variables demonstrate that the traditional grouping of Indian populations, based on caste hierarchy, may not be a reflection of their genetic origin, in that the pattern of clustering corresponded best with the known ethnohistorical records of the studied populations; 7. Hence, dermatoglyphic affinities may prove quite useful in tracing the ethnohistorical background of populations.

Mode of inheritance of finger dermatoglyphic traits among Vaidyas of West Bengal, India.

BACKGROUND: It is well established that dermatoglyphics are genetically determined. But, to date, few studies have given attention to the inheritance pattern of dermatoglyphics. Furthermore, despite the existence of different advanced statistical packages, none of these previous studies implemented a model-fitting technique to reveal the mode of inheritance. Thus, the genetic nature of dermatoglyphics is still not clear. AIM: In the present communication, an attempt has been made to provide some information regarding the genetics of finger dermatoglyphics by estimating the magnitude and mode of inheritance of these traits. SUBJECTS AND METHODS: The fingerprints of 824 individuals from 200 families including two generations were collected from Barasat in North 24-Parganas, West Bengal. The study includes familial correlations between first-degree relatives and corresponding heritabilities. In the final stage, segregation analyses by the Pedigree Analysis Package (PAP) were conducted on these data to understand the mode of inheritance. RESULTS: The major findings indicated the following: (a) Familial correlations in all possible relationships (except spouse correlation) were statistically significant and of comparable magnitude. (b) The corresponding heritabilities were in the range between 59% for Pattern Intensity Index (PII) and 77% for Total Finger Ridge Count (TFRC). These estimates were in agreement with previously published data on this subject. (c) By segregation analysis, the 'Sporadic', 'Environmental', 'No major gene effect' as well as 'No polygenic component' models were strongly rejected (p < 0.05) and the hypothesis of a major gene's (MG) influence on all studied traits was accepted, though the proportion of MG variance was low. (d) The Most Parsimonious Mendelian model clearly indicated the contribution of a major gene with dominant (for PII) and additive (for two ridge counts) effects. CONCLUSION: The present report supports the evidence of the existence of a major gene on these dermatoglyphic traits and the transmission of this effect is consistent with Mendelian expectation.

Multivariate analysis of sexual dimorphism in two types of dermatoglyphic traits in five endogamous populations of West Bengal, India.

Five different endogamous populations who encompass the main social rank in the caste hierarchy of West Bengal were analysed for this report. The present approach is to compare the pattern of sex differences/similarities exhibited by two different sets of dermatoglyphic traits. Cluster and discriminant analysis and Mantel test of matrix correlations were performed. The nature of variation between sexes within population groups and two types of variable sets has a good similarity in all five populations. These results strongly suggest that the two categories of dermatoglyphic variables provide similar possibilities to discriminate between the sexes in populations.

Dermatoglyphic sexual dimorphism: finger and palmar qualitative characteristics in five endogamous populations of West Bengal, India.

Five hundred families from five different endogamous populations encompassing the main social rank in the caste hierarchy of the same geographical area of West Bengal, India, were analyzed to present variation in qualitative pattern types on fingers and palms. Sex dimorphism, homogeneous in all populations, suggests common characteristics of dermatoglyphic patterns. The pattern types are not uniformly distributed on 10 fingers and palmar configurational areas. However, most of these observations are homogeneous in nature, in both sexes among 5 populations. But the two sets of results on fingers and palms are not exactly the same. Palmar dermatoglyphic relationship reflects the better caste affinities, perhaps due to embryological development, having relatively a longer growth period compared to fingers (Cummins 1929). The present findings indicate that the qualitative dermatoglyphic affinities conform to the known ethnohistorical background of these populations, which correspond also to the results of quantitative dermatoglyphics as well as serological and biochemical markers of these populations. These observations indicate that these population groups have a common genetic background and thus traditional grouping of Indian populations on the basis of caste hierarchy may not be a reflection of the genetic origin of the population. In dermatoglyphic affinities, both qualitative and quantitative traits therefore may be quite useful in tracing the ethnohistorical background of these populations.

Sexual dimorphism: asymmetry and diversity of 38 dermatoglyphic traits in five endogamous populations of West Bengal, India.

Five hundred families from five different endogamous populations encompass the main social rank in the caste hierarchy of West Bengal, India were analyzed for the present report. With the aim of comparing dermatoglyphic sexual dimorphism among the groups, analysis of variance and principal component analysis were performed, based on 38 dermatoglyphic variables. Sex dimorphism is homogeneous in nature in all populations, indicating common characteristics of dermatoglyphic variables within the same geographic area. But sex differences display different levels when compared with other racial groups. Therefore, sex differences are different in diverse populations. This would explain the existence of the possible role of environmental prenatal factors in the realization of the level of dermatoglyphic sex differences. Sex differences in asymmetry indices are less pronounced, which indicates that Indian populations are less asymmetric compared to Jewish populations. Fluctuating asymmetry, which is greater in females compared to males, support the hypothesis of Livshits and Kobyliansky--"increased heterozygosity is often associated with a decreased phenotypic variability including a diminished fluctuating asymmetry". A common feature of the principal component factor 1 "digital pattern size factor", in diverse populations indicates its degree of universality, and suggests that the variability of finger ridge counts is determined by the same genes which control the pattern types. The factors "finger ridge count diversity factor", "directional asymmetry factor", "fluctuating asymmetry factor", and "bilateral asymmetry factor" was perhaps described in the literature for the first time in Indian populations. The nature of variation of these components among these populations and between sexes, appears with a good similarity which suggests their biological validity of the underlying component structure. The overall homogeneity of sex dimorphism among 5 populations is well pronounced.

Rapid degradation of ferulic acid via 4-vinylguaiacol and vanillin by a newly isolated strain of bacillus coagulans.

A new strain Bacillus coagulans BK07 was isolated from decomposed wood-bark, based on its ability to grow on ferulic acid as a sole carbon source. This strain rapidly decarboxylated ferulic acid to 4-vinylguaiacol, which was immediately converted to vanillin and then oxidized to vanillic acid. Vanillic acid was further demethylated to protocatechuic acid. Above 95% substrate degradation was obtained within 7 h of growth on ferulic acid medium, which is the shortest period of time reported to date. The major degradation products, was isolated and identified by thin-layer chromatography, high performance liquid chromatography and 1H-nuclear magnetic resonance spectroscopy were 4-vinylguaiacol, vanillin, vanillic acid and protocatechuic acid.