Maternal and neonatal characteristics, operative details and outcomes in COVID-19 positive parturients undergoing cesarean sections: A retrospective observational study.

Background and Aims: There is a marked inclination towards cesarean sections as the preferred mode of delivery in parturients with COVID-19 disease. However, the challenges associated with planning and performing a surgery in the COVID-19 setup are considerable. These factors may lead to widespread changes in obstetric decision-making, operative planning, and perioperative outcomes. Thus, our study aimed to study the clinical and logistical factors involved in cesarean sections in COVID-19 parturients. Material and Methods: This was a retrospective observational study performed at a dedicated COVID-19 tertiary care center in India. All women undergoing cesarean section in the specially earmarked operating room between 1st May 2020 and 31st December 2020 were included in the study. The clinical characteristics, operative details, and neonatal details, along with maternal and fetal outcomes were noted and analyzed. Results: A total of 44 women underwent cesarean section during the study period, with elective and emergency surgeries numbering 22 each. No indication, apart from COVID-19 status, was listed in over one-fourth of the women (13/44). The most common preoperative comorbidity was hypothyroidism (12/44). Median surgical duration was 117.5 min (IQR 100-133), with a median of 7.5 (IQR 6-8.25) healthcare personnel in the OT. Over one-fourth (12/44) of the delivered babies had low birth weight, while 4.5% (2/44) tested positive for SARS-CoV-2. Conclusion: COVID-19 status alone continues to be a common indication for cesarean section. Operative time is increased, but the number of healthcare personnel involved can be trimmed with proper planning. Maternal and fetal outcomes are largely positive, with low transmission rates, but a considerable proportion of low-birth-weight neonates.

Fabrication, Characterization, and Modeling of an Aluminum Oxide-Gate Ion-Sensitive Field-Effect Transistor-Based pH Sensor.

The ion-sensitive field-effect transistor (ISFET) is a popular technology utilized for pH sensing applications. In this work, we have presented the fabrication, characterization, and electrochemical modeling of an aluminum oxide (Al2O3)-gate ISFET-based pH sensor. The sensor is fabricated using well-established metal-oxide-semiconductor (MOS) unit processes with five steps of photolithography, and the sensing film is patterned using the lift-off process. The Al2O3 sensing film is deposited over the gate area using pulsed-DC magnetron-assisted reactive sputtering technique in order to improve the sensor performance. The material characterization of sensing film has been done using x-ray diffraction, field-emission scanning electron microscopy, energy-dispersive spectroscopy, and x-ray photoelectron spectroscopy techniques. The sensor has been packaged using thick-film technology and encapsulated by a dam-and-fill approach. The packaged device has been tested in various pH buffer solutions, and a sensitivity of nearly 42.1 mV/pH has been achieved. A simulation program with integrated circuit emphasis (SPICE) macromodel of the Al2O3-gate ISFET is empirically derived from the experimental results, and the extracted electrochemical parameters have been reported. The drift and hysteresis characteristics of the Al2O3-gate ISFET were also studied, and the obtained drift rates for different pH buffer solutions of 4, 7, and 10 are 0.136 µA/min, 0.124 µA/min, and 0.108 µA/min, respectively. A hysteresis of nearly 5.806 µA has been obtained. The developed sensor has high sensitivity along with low drift and hysteresis.

Metal complexes driven from Schiff bases and semicarbazones for biomedical and allied applications: a review.

Schiff bases are versatile organic compounds which are widely used and synthesized by condensation reaction of different amino compound with aldehydes or ketones known as imine. Schiff base ligands are considered as privileged ligands as they are simply synthesized by condensation. They show broad range of application in medicine, pharmacy, coordination chemistry, biological activities, industries, food packages, dyes, and polymer and also used as an O2 detector. Semicarbazone is an imine derivative which is derived from condensation of semicarbazide and suitable aldehyde and ketone. Imine ligand-containing transition metal complexes such as copper, zinc, and cadmium have shown to be excellent precursors for synthesis of metal or metal chalcogenide nanoparticles. In recent years, the researchers have attracted enormous attention toward Schiff bases, semicarbazones, thiosemicarbazones, and their metal complexes owing to numerous applications in pharmacology such as antiviral, antifungal, antimicrobial, antimalarial, antituberculosis, anticancer, anti-HIV, catalytic application in oxidation of organic compounds, and nanotechnology. In this review, we summarize the synthesis, structural, biological, and catalytic application of Schiff bases as well as their metal complexes.

Selective Synthesis of α or ß-HgS Nanocrystals via Core/Shell Formation Using Surface Modified CdS Quantum Dots.

Chalogenides (CdS, CdSe, ZnSe etc.) are well known to undergo cation exchange reactions with other cations, including metals. The cation exchange methods are highly efficient in obtaining core/shell as well as alloy type of nanostructures. Such synthesis approach is particularly useful for producing CdHgX (X = S, Se) alloys, CdX/HgX core/shell and HgX nanostructures as organometallic mercury precursors are very inconvenient to handle. In this work, we have first synthesized hydrophilic CdS quantum dots using various capping agents and studied its cation exchange reaction with Hg2+ ions. The CdS QDs readily reacts with Hg2+ ions at ambient conditions and neutral pH to form either HgS or CdS/HgS core/shell nanostructures. Interestingly, we have observed that capping agent of CdS QDs plays an crucial role in formation of specific form of HgS (α and ß). The growth of HgS shell on CdS core with systematic increase in Hg ion concentration is also explored.

Interfacial behavior of confined mesogens at smectic-C*-water boundary.

In this paper, we have investigated the behavior of mesogens at smectic-C*-water interface confined in a liquid crystal (LC) cell with interfacial geometry. Polarized optical microscopy was used to probe the appearance of various smectic-C* domain patterns at water interface owing to the reorientation of mesogens. The undulated stripe domains observed at the air interface of smectic-C* meniscus vanished as the water entered into the smectic layers and focal conical domain patterns appeared at smectic-C*-water boundary. A spatially variable electro-optical switching of LC molecules was also observed outside the electrode area of the interfacial cell. The electrode region at the interface, as well as on the water side, was damaged upon application of an electric field of magnitude more than 150 kV/m. The change in dielectric parameters of mesogens was extensively studied at interface after evaporating the water. These studies give fundamental insights into smectic-C*-water interface and also will be helpful in fabricating better LC devices for electro-optical and sensing applications.

Optimal reference genes for RT-qPCR normalization in the newborn.

It is difficult to identify reliable reference genes for transcriptomic analyses in biofluids such as saliva. This situation is particularly relevant for the newborn population, where rapid development is associated with dynamic changes in gene expression. Real-time gene expression monitoring holds great promise for elucidating disrupted pathways that result in morbidities unique to this population, such as retinopathy of prematurity, but its impact depends on identifying stable and consistently expressed genes across a wide range of gestational ages. We extracted total RNA from 400 neonatal saliva samples (postconceptional ages: 32 5/7 to 48 2/7 weeks), converted it to cDNA, and pre-amplified and analyzed it by qPCR for three commonly used reference genes, ACTB, GAPDH, and YWHAZ. Relative quantification was determined using the Δ Ct method. Data were analyzed as a whole and also stratified by age and sex. Descriptive statistics and homogeneity of variance were performed to identify optimal reference genes. Data analyzed from all ages and both sexes showed significant expression variation for ACTB, while GAPDH and YWHAZ showed greater stability. Male infants exhibited increased expression variation compared to females for ACTB, but neither GAPDH nor YWHAZ showed significant variance for either sex. We suggest that ACTB is an unreliable reference gene for the newborn population. Males showed significantly more variation in ACTB expression compared to females, which suggests a sex-specific developmental role for this biomarker. By contrast, GAPDH and YWHAZ were less variable and therefore preferable for use in neonates. Our findings may improve the use of reference genes for the RT-qPCR platform in the newborn over a wide range of gestational ages, thereby minimizing the likelihood of erroneous interpretation of gene expression during rapid growth, development, and differentiation.

Outcome of a screening programme for the prevention of neonatal invasive early-onset group B Streptococcus infection in a UK maternity unit: an observational study.

BACKGROUND: Against a background of failure to prevent neonatal invasive early-onset group B Streptococcus infections (GBS) in our maternity unit using risk-based approach for intrapartum antibiotic prophylaxis, we introduced an antenatal GBS carriage screening programme to identify additional women to target for prophylaxis. OBJECTIVES: To describe the implementation and outcome of an antepartum screening programme for prevention of invasive early-onset GBS infection in a UK maternity unit. DESIGN: Observational study of outcome of screening programme (intervention) with comparison to historical controls (preintervention). SETTING: Hospital and community-based maternity services provided by Northwick Park and Central Middlesex Hospitals in North West London. PARTICIPANTS: Women who gave birth between March 2014 and December 2015 at Northwick Park Hospital. METHODS: Women were screened for GBS at 35-37 weeks and carriers offered intrapartum antibiotic prophylaxis. Screening programme was first introduced in hospital (March 2014) and then in community (August 2014). Compliance was audited by review of randomly selected case records. Invasive early-onset GBS infections were defined through GBS being cultured from neonatal blood, cerebrospinal fluid or sterile fluids within 0-6 days of birth. MAIN OUTCOME: Incidence of early-onset GBS infections. RESULTS: 6309 (69%) of the 9098 eligible women were tested. Screening rate improved progressively from 42% in 2014 to 75% in 2015. Audit showed that 98% of women accepted the offer of screening. Recto-vaginal GBS carriage rate was 29.4% (1822/6193). All strains were susceptible to penicillin but 11.3% (206/1822) were resistant to clindamycin. Early onset GBS rate fell from 0.99/1000 live births (25/25276) in the prescreening period to 0.33/1000 in the screening period (Rate Ratio=0.33; p=0.08). In the subset of mothers actually screened, the rate was 0.16/1000 live births (1/6309), (Rate Ratio=0.16; p<0.05). CONCLUSIONS: Our findings confirm that an antenatal screening programme for prevention of early-onset GBS infection can be implemented in a UK maternity setting and is associated with a fall in infection rates.

Gastrointestinal symptom severity in irritable bowel syndrome, inflammatory bowel disease and the general population.

BACKGROUND: Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) patients report similar gastrointestinal (GI) symptoms, yet comparisons of symptom severity between groups and with the general population (GP) are lacking. METHODS: We compared Patient-Reported Outcomes Measurement Information System (PROMIS® ) GI symptom scales measuring gastro-esophageal reflux (GER), disrupted swallowing, diarrhea, bowel incontinence, nausea/vomiting, constipation, belly pain, and gas/bloating in: (i) USA GP sample, (ii) IBS patients, and (iii) IBD patients from tertiary care and community populations. Symptom severity scores were based on T-score metric with mean 50±10 (standard deviation) relative to the GP. KEY RESULTS: Of 1643 patients enrolled, there were 253 IBS patients (68% F, mean age 45±15 years), 213 IBD patients (46% F, mean age 41±14 years), and 1177 GP subjects (57% F, mean age 46±16 years). IBS patients reported greater severity of GER, disrupted swallowing, nausea/vomiting, belly pain, gas/bloating, and constipation symptoms than their IBD counterparts (all P<.05). Compared to the GP, IBD patients had worse belly pain, gas/bloating, diarrhea, and bowel incontinence, but less severe GER and disrupted swallowing (all P<.05), and IBS patients had more severe nausea/vomiting, belly pain, gas/bloating, and constipation (all P<.05). Women had more severe belly pain and gas/bloating than men, whereas men had more severe bowel incontinence (all P<.05). CONCLUSION & INFERENCES: IBS and IBD are associated with more severe GI symptoms compared to the GP excluding esophageal symptoms. Unlike IBD, IBS is not characterized by observable GI inflammation but patients report more severe upper and lower GI symptoms.

Efficacy of epidural local anesthetic and dexamethasone in providing postoperative analgesia: A meta-analysis.

BACKGROUND: Dexamethasone is a potent anti-inflammatory, analgesic, and antiemetic drug. Individual randomized controlled trials found a possible benefit of epidural dexamethasone. The purpose of this meta-analysis is to estimate the benefit of epidural dexamethasone on postoperative pain and opioid consumption and to formulate a recommendation for evidence-based practice. MATERIALS AND METHODS: Prospective, randomized controlled trials comparing the analgesic efficacy of epidural local anesthetic and dexamethasone combination, with local anesthetic alone for postoperative pain management after abdominal surgery, were planned to be included in this meta-analysis. PubMed, PubMed Central, Scopus, and Central Register of Clinical Trials of the Cochrane Collaboration (CENTRAL) databases were searched for eligible controlled trials using the following search words: "Epidural", "dexamethasone", and "postoperative pain", until February 20, 2015. RESULTS: Data from five randomized control trials have been included in this meta-analysis. Epidural dexamethasone significantly decreased postoperative morphine consumption (mean difference -7.89 mg; 95% confidence interval [CI]: -11.66 to -3.71) and number of patients required postoperative rescue analgesic boluses (risk ratio: 0.51; 95% CI: 0.41-0.63). CONCLUSION: The present data shows that the addition of dexamethasone to local anesthetic in epidural is beneficial for postoperative pain management.

Optimised isolation of polysaccharides from Lentinula edodes strain NCBI JX915793 using response surface methodology and their antibacterial activities.

Mycelial growth in a defined medium by submerged fermentation is a rapid and alternative method for obtaining fungal biomass of consistent quality. Biomass, exopolysaccharides (EPS) and intracellular polysaccharides (IPS) production were optimised by response surface methodology in Lentinula edodes strain LeS (NCBI JX915793). The optimised conditions were pH 5.0, temperature 26°C, incubation period of 25 days and agitation rate of 52 r/min for L. edodes strain LeS. Under the calculated optimal culture conditions, biomass production (5.88 mg mL(-1)), EPS production (0.40 mg mL(-1)) and IPS production (12.45 mg g(-1)) were in agreement with the predicted values for biomass (5.93 mg mL(-1)), EPS (0.55 mg mL(-1)) and IPS production (12.64 mg g(-1)). Crude lentinan exhibited highest antibacterial effects followed by alcoholic, crude and aqueous extracts. The results obtained may be useful for highly effective yield of biomass and bioactive metabolites.

Modification of Optical, Structural and Dielectric Properties of MeV Ions Irradiated PS/Cu Nanocomposites.

In order to study structural, thermal, optical and dielectric behaviors of composites, the films of Cu/polystyrene nanocomposites were synthesized at different concentrations of Cu-nanoparticles. These polymer nanocomposites were irradiated with carbon (85 MeV) and silicon (120 MeV) ions at different fluences. The samples were characterized using different techniques viz: X-ray diffraction, UV-visible spectroscopy, differential scanning calorimetry, and impedance gain phase analyzer. A noticeable increase in the intensity of X-ray diffraction peaks was observed after irradiation with 120 MeV Si-ions, which may be attributed to radiation-induced cross-linking in polymer. Optical properties like band gap was estimated for pure polymer and nanocomposite films from their optical absorption spectra in the wavelength region 200-800 nm. It was found that the band gap value shifted to lower energy (from 4.38 eV to 3.40 eV) on doping with silver nanoparticles and also upon irradiation. Differential scanning calorimetry analysis revealed an increase in the glass transition temperature upon irradiation, which may be attributed to cross linking of polymer chain due to ion beam irradiation which is also corroborated with XRD analysis. Dependence of dielectric properties on frequency, ions and filler concentration was studied. The results revealed the enhancement in dielectric properties after doping nanoparticles and also upon irradiation. It was observed that the effect of Si-beam is more effectual than the C-beam because of large electronic energy loss of heavy ion.

Comparative efficacy and safety of the Ambu(®) AuraOnce(™) laryngeal mask airway during general anaesthesia in adults: a systematic review and meta-analysis.

Previous comparisons between the Ambu(®) AuraOnce(™) and other laryngeal mask airways have revealed different results across various clinical studies. We aimed to perform a systematic review with meta-analysis on the efficacy and safety of the AuraOnce compared with other laryngeal mask airways for airway maintenance in adults undergoing general anaesthesia. Our search of PubMed, PubMed Central, Scopus and the Central Register of Clinical Trials of the Cochrane Collaboration yielded nine randomised controlled trials eligible for inclusion. Comparator laryngeal mask airways were the LMA Unique(™) (four trials), the LMA Classic(®) (five trials) and the Portex(®) Soft Seal(®) (three trials). The AuraOnce provided an oropharyngeal leak pressure higher than the LMA Unique (304 participants, mean (95% CI) difference 3.1 (1.6-4.7) cmH2 O, p < 0.0001) and equivalent to the LMA Classic. The Soft Seal provided a higher leak pressure than the AuraOnce (229 participants, mean (95% CI) difference 3.5 (0.4-6.7) cmH2 O, p = 0.03). Insertion was significantly faster with the AuraOnce than the LMA Unique (304 participants, mean (95% CI) difference 5.4 (2.1-8.71) s, p = 0.001) and Soft Seal (229 participants, mean (95% CI) difference 9.5 (3.0-15.9) s, p = 0.004), but similar to the LMA Classic. The first-insertion success rate of the AuraOnce was equivalent to the LMA Unique, LMA Classic and Soft Seal. We found a higher likelihood of bloodstaining on the cuff with the Soft Seal and a higher incidence of sore throat with the LMA Classic. We conclude that the AuraOnce is an effective alternative to the LMA Classic and LMA Unique, and easier to insert than all three other devices studied.

Chemically designed Pt/PPy nano-composite for effective LPG gas sensor.

Simultaneous in situ reduction of hexachloroplatinic acid by the amine group in the pyrrole monomer and oxidation of pyrrole to form polypyrrole (PPy) was examined. The reactions were performed at various temperatures to understand the degree of reduction of platinum precursor as well as doping of polypyrrole with Pt(II) chloro-complex. Spectroscopic images revealed different morphologies for the Pt/PPy nano-composite prepared at various temperatures. The as-prepared Pt/PPy nano-composite samples were tested for their ability to sense liquefied petroleum gas (LPG) which resulted in excellent sensing at relatively low temperature. The porous nature and ohmic contact between the PPy and platinum nanoparticles makes the as-prepared Pt/PPy nano-composite highly useful for sensors as well as electronic applications.

CD82/KAI expression prevents IL-8-mediated endothelial gap formation in late-stage melanomas.

Melanoma cells facilitate endothelial gap formation, the first step during tumor transendothelial migration, which is mediated by both adhesion and endogenously produced chemokines (in particular, interleukin-8 (IL-8)). Tetraspanins are localized to the cell surface in cancer and participate in various functions including invasion of tissues mediated by secretion of cytokines and matrix metalloproteinases. However, little is known about the role of CD82 tetraspanins in malignant melanomas during cancer cell invasion. In this study, we investigated the functional importance of CD82 expression in melanoma-mediated gap formation by using cDNAs to induce CD82 expression in highly invasive melanoma cell lines. Results showed that CD82 expression inhibited melanoma cell-induced gap formation, melanoma cell extravasation in vitro and subsequent lung metastasis development in vivo. Mechanistic studies showed that inducible expression of CD82 in highly metastatic melanoma cells significantly increased p21 expression upon binding of Duffy antigen receptor group (DARC), inducing tumor cell senescence and interrupting IL-8-mediated vascular endothelial (VE)-cadherin disassembly. Taken together, these studies provide a rationale for using drug therapies that restore CD82 expression and inhibit IL-8 production to inhibit late-stage melanoma cell extravasation and subsequent metastasis development.

Optical and dielectric properties of ion beam irradiated Ag/polymethyl methacrylate nanocomposites.

Changes in the dielectric, optical, structural and thermal properties of PMMA/silver nanocomposites of different concentrations of silver nanoparticles (5%, 10%, 15%) due to swift heavy ion irradiation were studied by means of impedance gain phase analyzer, UV-visible spectroscopy, X-ray diffraction and differential scanning calorimetry. Samples were irradiated with 120 MeV Si-ions at fluences of 1 x 10(11), 1 x 10(12) ions/cm2. Dependence of dielectric properties on frequency, ion beam fluence and filler concentration was studied. The results revealed the enhancement in dielectric properties after dopping nanoparticles and also upon irradiation. Optical properties like band gap was estimated for pure polymer and nanocomposite films from their optical absorption spectra in the wavelength region 200-800 nm. It was found that the band gap value shifted to lower energy (from 4.58 eV to 3.21 eV) on doping with silver nanoparticles. Differential scanning calorimetry analysis revealed a decrease in the glass transition temperature upon irradiation, which may be attributed to scissioning of polymer chain due to ion beam irradiation which is also confirmed with XRD analysis.