Estimation of prakriti (body constitution) in women of Eastern Maharashtra tribal belt of central India featuring early and premature menopause.

Introduction: Prakriti (body constitution) is the essential fundamental of Ayurveda. In female physiology, it plays a crucial role in determining the age of menarche and menopause. Recent research has shown that early menopause occurs in tribal women. Vagbhata states that a kapha dosha pradhan prakriti female has a longer menstrual life [i.e., reproductive period] compared to the vata and pitta prakriti females. This study was done to estimate prakriti in females who attain early and premature menopause in the tribal population to provide optimal care for tribal women through primary and whole health systems. Materials and Methods: This cross-sectional questionnaire survey study was carried out in four villages of Nagpur district territory of Eastern Maharashtra, the central zone of India after seeking permission from IEC. A multistage sampling technique was used to select the 80%, and above tribal people, 169 married women who attained early or premature menopause were included. Post-menopausal women were selected for the study, and females with hysterectomy, secondary amenorrhea, and other major illnesses were excluded from the study. Data were collected by survey method with the help of a pre-validated questionnaire. Observation and Result: Out of 169 females 57.98% of females were of vata prakriti, 24.85% of females were of pitta prakriti, and 17.15% of females were of kapha prakriti. The prevalence of early or premature menopause of vata prakriti females is 57.98. Discussion: Vata dosha characteristics such as ruksha, laghu, sheeta, and khara in vata prakriti females lead to early or premature menopause. To avoid early or premature menopause in tribal females, ghee (ghrit) and milk can be included in dietary habits, lifestyle modification, and awareness counseling may prove beneficial. Conclusion: Early or premature menopause is observed largely in vata prakriti females of Nagpur district, Eastern Maharashtra, tribal zone of Central Inda.

GeTe/MoTe2 Van der Waals Heterostructures: Enabling Ultralow Voltage Memristors for Nonvolatile Memory and Neuromorphic Computing Applications.

Advanced electronic semiconducting Van der Waals heterostructures (HSs) are promising candidates for exploring next-generation nanoelectronics owing to their exceptional electronic properties, which present the possibility of extending their functionalities to diverse potential applications. In this study, GeTe/MoTe2 HS are explored for nonvolatile memory and neuromorphic-computing applications. Sputter-deposited Ag/GeTe/MoTe2/Pt HS cross-point devices are fabricated, and they demonstrate memristor behavior at ultralow switching voltages (VSET: 0.15 V and VRESET: -0.14 V) with very low energy consumption (≈30 nJ), high memory window, long retention time (104 s), and excellent endurance (105 cycles). Resistive switching is achieved by adjusting the interface between the Ag top electrode and the heterojunction switching layer. Cross-sectional transmission electron microscope images and conductive atomic force microscopy analysis confirm the presence of a conducting filament in the heterojunction switching layer. Further, emulating various synaptic functions of a biological synapse reveals that GeTe/MoTe2 HS can be utilized for energy-efficient neuromorphic-computing applications. A multilayer perceptron is implemented using the synaptic weights of the Ag/GeTe/MoTe2/Pt HS device, revealing high pattern accuracy (81.3%). These results indicate that HS devices can be considered a potential solution for high-density memory and artificial intelligence applications.

Anaplastic sarcoma of the kidney (DICER1-sarcoma of the kidney): A report from the International Pleuropulmonary Blastoma/DICER1 Registry.

BACKGROUND: Anaplastic sarcoma of the kidney (ASK) is a DICER1-related neoplasm first identified as a distinctive tumor type through the evaluation of unusual cases of putative anaplastic Wilms tumors. Subsequent case reports identified the presence of biallelic DICER1 variants as well as progression from cystic nephroma, a benign DICER1-related neoplasm. Despite increasing recognition of ASK as a distinct entity, the optimal treatment remains unclear. METHODS: Individuals with known or suspected DICER1-related tumors including ASK were enrolled in the International Pleuropulmonary Blastoma/DICER1 Registry. Additionally, a comprehensive review of reported cases of ASK was undertaken, and data were aggregated for analysis with the aim to identify prognostic factors and clinical characteristics to guide decisions regarding genetic testing, treatment, and surveillance. RESULTS: Ten cases of ASK were identified in the Registry along with 37 previously published cases. Staging data, per Children's Oncology Group guidelines, was available for 40 patients: 13 were stage I, 12 were stage II, 10 were stage III, and five were stage IV. Outcome data were available for 37 patients. Most (38 of 46) patients received upfront chemotherapy and 14 patients received upfront radiation. Two-year event-free survival (EFS) for stage I-II ASK was 81.8% (95% confidence interval [CI]: 67.2%-99.6%), compared with 46.6% EFS (95% CI: 24.7%-87.8%) for stage III-IV (p = .07). Two-year overall survival (OS) for stage I-II ASK was 88.9% (95% CI: 75.5%-100.0%), compared with 70.0% (95% CI: 46.7%-100.0%) for stage III-IV (p = .20). Chemotherapy was associated with improved EFS and OS with hazard ratios of 0.09 (95% CI: 0.02-0.31) and 0.08 (95% CI: 0.02-0.42), respectively. CONCLUSION: ASK is a rare DICER1-related renal neoplasm. In the current report, we identify clinical and treatment-related factors associated with outcome including the importance of chemotherapy in treating ASK. Ongoing data collection and genomic analysis are indicated to optimize outcomes for children and adults with these rare tumors.

Evaluation of an emergency department opt-out provider-driven HIV and syphilis screening and linkage-to-care program.

OBJECTIVE: While the effectiveness of emergency departments (ED) in screening for HIV and syphilis is understood, less is known about dual screening programs. We aim to evaluate the impact of an opt-out provider-initiated HIV and syphilis program on screening, diagnosis, and linkage to care outcomes. METHODS: We performed a retrospective review of patients screened pre (2014-2017) and post (2017-2021) program implementation. Primary outcomes include HIV and syphilis screening, incidence of positive tests, and proportion of patients linked to care. Secondary outcomes included pre-exposure prophylaxis (PrEP) referral and successful linkage rates for HIV-negative syphilis-positive patients. RESULTS: Pre-implementation, 882 HIV tests were performed, of which 22 (2.49%) were new cases and 18 (81.82%) were linked to care; 754 syphilis tests were performed, of which 33 (4.38%) were active infections and 30 (90.91%) were treated. No eligible patients received PrEP referral. Post-implementation, 12,999 HIV tests were performed, of which 73 (0.56%) were new cases and 55 (75.34%) were linked to care; 10,885 syphilis tests were performed, of which 216 (1.98%) were active infections and 188 (87.04%) were treated. 25 (9.09%) eligible patients were referred for PrEP, and four (16.0%) attended their appointment. CONCLUSIONS: Post-implementation, there was a 1373.81% and 1343.63% increase in screening, and a 231.82% and 554.55% increase in positive cases of HIV and syphilis, respectively. Dual screening programs can be successfully implemented within the existing ED framework to increase screening and early detection for HIV and syphilis.

Pediatricians as Childhood Development Advocacy Champions in Kenya and Tanzania: A Case Study.

Early childhood development (ECD) is instrumental to shaping educational, emotional, and economic trajectories; alleviating poverty; and achieving gender equality. Pediatricians are experts in children's health and trusted sources of guidance for families and clinicians and thus are optimal ECD champions. This case study describes collaboration by the American Academy of Pediatrics, Kenya Pediatric Association, and Pediatric Association of Tanzania to activate pediatricians as ECD champions in Kenya and Tanzania. From July 2020 through January 2021, the collaborators assessed ECD needs by interviewing 20 key informants per country from governmental ministries, nongovernmental organizations, and clinical practice and assessing datasets and policy documents. In 2021, the societies recruited 15 pediatricians per country as champions; surveyed their knowledge, attitudes, and practices; and trained them on 4 core competencies: understanding early brain development science; developmental and behavioral screening, surveillance, and diagnosis; integration of ECD promotion into clinical practice; and advocacy skills for ECD and nurturing care. In 2021, each society established advocacy-in-action projects to advance ECD. In Kenya, the cohort surveyed clinicians on barriers to ECD, implemented a 2-day in-person training for 90 providers, and developed a 5-week Fundamentals of ECD course, taken by 113 pediatricians from 7 African countries. In Tanzania, champions conducted ECD training workshops for 78 health managers and 189 health care providers in 9 facilities in 7 regions and established 9 ECD corners with toys and information in health care facilities. These results highlight considerations for supporting ECD, including building on existing strengths, infrastructure, and networks; strengthening ECD knowledge among pediatricians; and advocacy skill-building.

Evaluation and Outcomes of Hearing Loss in Temporal Bone Fractures: A Prospective Study.

Background Fractures of the skull base occur in 3-30% of head injury presentations to the emergency department. Overall, 9-40% of the cases have temporal bone fractures (TBFs). This fracture may disrupt the intervening structures causing edema, hematoma, bleeding, hearing loss, dizziness, cerebrospinal fluid otorrhea, and facial nerve paralysis. This study aims to evaluate the type of TBF, its correlation with hearing loss, and the outcomes of hearing loss. Methodology A prospective observational study was done among 50 patients who presented to the emergency department following trauma with clinical features and CT of the temporal bone suggestive of TBF. A complete evaluation of the patients was done, and patients were managed as per the departmental protocol. The patients were followed up for six months and monitored for otological symptoms. Periodic assessment of hearing loss by pure tone audiometry (PTA) was performed at the end of one week, one month, and six months. Results The most common type of fracture in our study was longitudinal TBF (72%), followed by transverse TBF (20%) and mixed TBF (8%). According to the newer classification, otic capsule-sparing fracture was more common than otic capsule-violating fracture. Most patients presented with conductive hearing loss (60%) following the TBF. On follow-up, there was a statistically significant improvement in hearing loss at the end of six months. Conclusions Our study found that in most cases hearing loss improved over time. Patients with conductive hearing loss showed maximum improvement in comparison to patients with sensorineural and mixed hearing loss.

Synthesis, biological evaluation and docking studies of silicon incorporated diarylpyrroles as MmpL3 inhibitors: An effective strategy towards development of potent anti-tubercular agents.

Growing global demand for new molecules to treat tuberculosis has created an urgent need to develop novel strategies to combat the menace. BM212 related compounds were found to be potent anti-TB agents and they inhibit mycolic acid transporter, MmpL3, a known potent drug target from Mycobacterium tuberculosis. In order to enhance their inhibitory potency, several silicon analogues of diarylpyrroles related to BM212 were designed, synthesized, and evaluated for anti-tubercular activities. In Alamar blue assay, most of the silicon-incorporated compounds were found to be more potent than the parent compound (BM212), against Mycobacterium tuberculosis (MIC = 1.7 µM, H37Rv). Docking results from the crystal structure of MmpL3 and silicon analogues as pharmacophore model also strongly correlate with the biological assays and suggest that the incorporation of silicon in the inhibitor scaffold could enhance their potency by stabilizing the hydrophobic residues at the binding pocket. The best docking hit, compound 12 showed an MIC of 0.1 µM against H37Rv with an acceptable in vitro ADME profile and excellent selectivity index. Overall, the present study indicates that, the designed silicon analogues, especially compound 12 could be a good inhibitor for an intrinsically flexible drug-binding pocket of MmpL3 and has potential for further development as anti-tubercular agents.

Review of Electrochemically Synthesized Resistive Switching Devices: Memory Storage, Neuromorphic Computing, and Sensing Applications.

Resistive-switching-based memory devices meet most of the requirements for use in next-generation information and communication technology applications, including standalone memory devices, neuromorphic hardware, and embedded sensing devices with on-chip storage, due to their low cost, excellent memory retention, compatibility with 3D integration, in-memory computing capabilities, and ease of fabrication. Electrochemical synthesis is the most widespread technique for the fabrication of state-of-the-art memory devices. The present review article summarizes the electrochemical approaches that have been proposed for the fabrication of switching, memristor, and memristive devices for memory storage, neuromorphic computing, and sensing applications, highlighting their various advantages and performance metrics. We also present the challenges and future research directions for this field in the concluding section.

Flexible Memristive Organic Solar Cell Using Multilayer 2D Titanium Carbide MXene Electrodes.

Hybrid systems have attracted significant attention within the scientific community due to their multifunctionality, which has resulted in increasing demands for wearable electronics, green energy, and miniaturization. Furthermore, MXenes are promising two-dimensional materials that have been applied in various areas due to their unique properties. Herein, a flexible, transparent, and conductive electrode (FTCE) based on a multilayer hybrid MXene/Ag/MXene structure that can be applied to realize an inverted organic solar cell (OSC) with memory and learning functionalities is reported. This optimized FTCE exhibits high transmittance (84%), low sheet resistance (9.7 Ω sq-1 ), and reliable operation (even after 2000 bending cycles). Moreover, the OSC using this FTCE achieves a power conversion efficiency of 13.86% and sustained photovoltaic performance, even after hundreds of switching cycles. The fabricated memristive OSC (MemOSC) device also exhibits reliable resistive switching behavior at low operating voltages of 0.60 and -0.33 V (similar to biological synapses), an excellent ON/OFF ratio (103 ), stable endurance performance (4 × 103 ), and memory retention properties (104 s). Moreover, the MemOSC device can mimic synaptic functionalities on a biological time scale. Thus, MXene can potentially be used as an electrode for highly efficient OSCs with memristive functions for future intelligent solar cell modules.

TB patients: Is sputum disinfection important?

BACKGROUND: Patients with pulmonary tuberculosis (TB) may produce large amount of infectious sputum which needs to be handled carefully both in health care and household settings. As mycobacteria may survive for long duration in sputum; proper collection, disinfection and disposal is necessary to avoid potential disease transmission. We aimed to assess the efficacy of bedside disinfectant treatment of sputum produced by TB patients using easily available disinfectants that can be used both in TB wards and household settings, to sterilize the infected sputum and compared it with sputum without disinfectant treatment. METHODS: It was a prospective case control study. Sputum of total 95 patients with sputum smear positive pulmonary tuberculosis was collected in sputum containers with lids. Patients on anti-tubercular treatment for more than 2 weeks were excluded. Each patient was given 3 sterile sputum containers to expectorate, Container A containing 5% Phenol solution, Container B containing 4.8% Chloroxylenol and Container C without any disinfectant, acting as a control. Thick sputum was liquified with Mucolytic agent N-acetyl cysteine (NAC). Aliquots of the sputum were sent for culture in Lowenstein-Jensen medium on day 0 (to confirm alive mycobacteria) and on day 1 i.e., after 24 hours (to evaluate effective sterilization). Drug resistance testing was done on all grown mycobacteria. RESULTS: If the samples on day 0 did not grow mycobacteria (indicating non-viable mycobacteria) or day 1 sample grew contaminants in any of the three containers, they were excluded from the analysis (15/95). In remaining 80 patients, bacilli were alive on day 0 and remained alive even after 24 hours (day 1) in control samples (without disinfectants). The sputum was effectively disinfected resulting in no growth after 24 hours (day 1) in 71/80 (88.75%) containing 5% Phenol and 72/80 (90%) with 4.8% Chloroxylenol. The efficacy of disinfection was 71/73 (97.2%) and 72/73 (98.6%) for drug sensitive mycobacteria respectively. The mycobacteria however remained alive with these disinfectants in all 7 samples of drug-resistant mycobacteria with an efficacy of 0%. CONCLUSION: We recommend use of simple disinfectants like 5% Phenol or 4.8% Chloroxylenol for safe disposal of sputum of pulmonary tuberculosis patients. It is necessary as sputum collected without disinfection remained infectious after 24 hours. Resistance of all drug resistant mycobacteria to disinfectants was a novel chance finding. This needs further confirmatory studies.

ACR-ARS Practice Parameter for the Performance of Total Body Irradiation.

OBJECTIVES: This practice parameter was revised collaboratively by the American College of Radiology (ACR) and the American Radium Society (ARS). This practice parameter provides updated reference literature regarding both clinical-based conventional total body irradiation and evolving volumetric modulated total body irradiation. METHODS: This practice parameter was developed according to the process described under the heading The Process for Developing ACR Practice Parameters and Technical Standards on the ACR website ( https://www.acr.org/Clinical-Resources/Practice-Parameters-and-Technical-Standards ) by the Committee on Practice Parameters-Radiation Oncology of the ACR Commission on Radiation Oncology in collaboration with the ARS. RESULTS: This practice parameter provides a comprehensive update to the reference literature regarding conventional total body irradiation and modulated total body irradiation. Dependence on dose rate remains an active area of ongoing investigation in both the conventional setting (where instantaneous dose rate can be varied) and in more modern rotational techniques, in which average dose rate is the relevant variable. The role of imaging during patient setup and the role of inhomogeneity corrections due to computer-based treatment planning systems are included as evolving areas of clinical interest notably surrounding the overall dose inhomogeneity. There is increasing emphasis on the importance of evaluating mean lung dose as it relates to toxicity during high-dose total body irradiation regimens. CONCLUSIONS: This practice parameter can be used as an effective tool in designing and evaluating a total body irradiation program that successfully incorporates the close interaction and coordination among the radiation oncologists, medical physicists, dosimetrists, nurses, and radiation therapists.

Serious Illness Communication Training Among Radiation Oncology Residents.

PURPOSE: Education and specific training on serious illness communication skills for radiation oncology residents is lacking. The Accreditation Council for Graduate Medical Education requires radiation oncology residents to demonstrate interpersonal and communication skills; however, implementing specific training to address this poses an ongoing challenge. This study assesses the feasibility and effectiveness of a radiation oncology specific serious illness communication curriculum at a single radiation oncology residency program. METHODS AND MATERIALS: The primary objectives were to assess observable communication skills among radiation oncology residents and their perceived level of preparedness and comfort with patient encounters surrounding serious illness. Each resident participated in a baseline simulated patient encounter. Two virtual half-day experience-based learning sessions led by faculty experts trained in teaching serious illness communication were held. The training consisted of brief didactic teaching, with the emphasis on small group guided practice with simulated patients in scenarios specific to radiation oncology. Each resident participated in a postcourse simulated patient encounter. Three blinded faculty trained in serious illness communication completed objective assessments of observable communication skills to compare pre- and postcourse performance. RESULTS: A t test based on validated assessments reviewed by blinded faculty demonstrated significant improvement in overall observable communication skills among radiation oncology residents in the postcourse encounter compared with the precourse encounter (P = .0067). Overall, 8 of 9 (89%) residents felt more comfortable and prepared with radiation oncology-specific serious illness communication after the course compared with prior. The simulated patients rated the overall average resident performance higher on the postcourse assessment (Likert 4.89/5) compared with the precourse assessment (Likert 4.09/5), which trended toward a significant improvement (P = .0515). CONCLUSIONS: Radiation oncology residents had a significant improvement in observable communication skills after participating in an experience-based training curriculum. This course can serve as an adaptable model that may be implemented by other radiation oncology residency programs.

Optimizing Palliative Focal Radiation Therapy Dose in Cutaneous T-Cell Lymphoma: How Low Can You Go?

PURPOSE: Primary cutaneous T-cell lymphomas (CTCLs) are radiosensitive tumors with variable and often relapsing courses. Local disease can be treated with low-dose focal palliative radiation therapy (RT), though little data supports the use of a specific dose. This study assesses clinical outcomes after focal RT to a total dose of 4 Gy, 8 Gy, or 12 Gy. METHODS AND MATERIALS: An International Review Board-approved, retrospective, single-institution study was performed of 225 lesions in 41 patients with primary CTCL treated with low-dose focal RT from 2015 to 2020. Patient, tumor, and treatment characteristics were reviewed. The primary outcome was freedom from treatment failure (FFTF), defined as time to requiring local retreatment, and secondary outcomes included response rates and toxicities. RESULTS: Of the 225 lesions, 90 received 4 Gy, 106 received 8 Gy, and 29 received 12 Gy. Lesions treated with 12 Gy (96%) or 8 Gy (92%) had a significantly higher 1-year FFTF compared with 4 Gy (77%) (P = .034). Overall response rate and complete response rate were not significantly different between different doses (P = .117), though there was a trend toward higher overall response rate at initial assessment with 8 Gy versus 4 Gy (91.5% vs 82.2%, P = .057). Toxicity was low, with 7.1% of lesions having grade 2 or higher radiation dermatitis. CONCLUSIONS: In primary CTCL lesions treated with focal palliative RT, a dose response was noted favoring 8 to 12 Gy, with 1-year FFTF rates over 90%. However, 4 Gy resulted in substantially better outcomes than previously reported, with 77% requiring no further treatment at 1 year and comparable response rates to higher doses. While our data substantiates 8 to 12 Gy as the standard of care, it also suggests that 4 Gy should be considered an acceptable alternative in situations with concern for radiation toxicities, such as with fragile or heavily pretreated skin.

Postmodification of voxelotor (GBT 440) via [Rh]-catalyzed cross dehydrogenative coupling with olefins.

The directed Rh(III)-catalyzed cross dehydrogenative coupling of the pyrazole unit of the GBT-440 scaffold has been explored with simple as well as conjugated olefins to synthesize post-functionalized GBT-440 analogues. The screening of these synthesized compounds for improving the oxygen binding efficiency of the hemoglobin isolated from the sickled red blood cells revealed that some of these compounds are as good as GBT-440.

Unraveling the Effect of the Water Content in the Electrolyte on the Resistive Switching Properties of Self-Assembled One-Dimensional Anodized TiO2 Nanotubes.

The applied potential, time, and water content are crucial factors in the electrochemical anodization process because the growth of one-dimensional nanotubes can be accelerated by enhancing the corrosive effect. We investigated the effect of the water content on the resistive switching (RS) properties of Ti foils by anodizing the foils and varying the water content in an electrolyte (1-10 vol %). By increasing the water content, we facilitated a slow transition from nanopores to nanotubes and realized an increase in the tube wall diameter and tube length. All of the fabricated memristive devices exhibited a reliable and reproducible bipolar resistive switching effect. The optimized device exhibited bipolar RS properties with good dc endurance (104 cycles) and data retention capability (105 s). Our results suggest that as the water content increases to 5 vol %, the RS process improves; further increases in the water content impair the RS process.

Acceptance of HIV pre-exposure prophylaxis (PrEP) referral among a sample of PrEP-eligible emergency department patients.

OBJECTIVE: Pre-exposure prophylaxis (PreP) reduces the rate of HIV transmission in high-risk groups. Emergency departments (EDs) frequently encounter patients at risk for HIV acquisition who are eligible for PrEP. ED HIV screening programs have prioritized testing and linkage to care for patients who test positive, but fail to refer HIV-negative patients to PrEP clinicians. Our objective was to estimate referral acceptance to a PrEP clinician among a sample of at-risk ED patients. METHODS: This single-center cross-sectional study electronically queried a prospectively acquired dataset of survey responses from a sample of patients presenting to an urban academic ED from March 2019 to February 2020. Patients completed a risk assessment as part of the HIV screening program. PrEP eligibility was based off survey responses in accordance with 2017 CDC PrEP eligibility criteria. Identified PrEP-eligible patients completed a PrEP questionnaire. The primary outcome was the proportion of PrEP-eligible patients who accepted referral to a PrEP clinician during their ED encounter. We secondarily report patient participant characteristics including the proportion of PrEP-eligible patients who were aware of and were knowledgeable about PrEP as a method to prevent transmission of HIV. RESULTS: In total, 360 patients completed a PrEP questionnaire, of which 287 (80%) were not currently taking PrEP and eligible for PrEP referral. 57% were males, with 41% Black/African American. Of the 287 eligible for PrEP, 61 (21.3%, 95% CI: 16.8-26.5) indicated awareness of PrEP, of which, 49 (80.3%, 95% CI: 67.8-89.0) demonstrated accurate knowledge of PrEP. PrEP referral was offered to 238 (82.9%, 95% CI: 78.0-87.0) patients, of which, 76 (31.9%, 95% CI: 26.1-38.3) accepted. CONCLUSIONS: Approximately one third of PrEP-eligible ED patients accepted PrEP referral during their ED encounter, demonstrating an opportunity for increased PrEP education and intentional referral for eligible patients. Variability in PrEP acceptability by demographic and risk subgroup may be an important consideration in efforts to expand PrEP utilization.

Changes in physiological traits and expression of key genes involved in sugar signaling pathway in rice under high temperature stress.

Efficient assimilate partitioning between the source and sink organs to achieve increased grain weight is coordinated by the sugar signaling mechanism. The expression of the genes involved in sugar signaling mainly hexokinases 2 (OsHXK2), Sucrose-nonfermentation1-related protein kinase1 (OsSnRK1), trehalose-6-phosphate synthase 1 (OsTPS1) and target of rapamycin (OsTOR) under high temperature stress was examined in tolerant (NL-44) and susceptible (Vandana) varieties of rice. The photosynthetic rate, stomatal conductance, water-use efficiency, photochemical efficiency (Fv/Fm), quantum yield (ϕPSII), pollen viability, spikelet fertility and 1000 grain weight were significantly higher in NL-44 compared to Vandana under stress. The difference in the gene expression levels in the vegetative and grain-filling phases as well as between the tolerant and susceptible varieties, revealed unique pathways of sugar signaling under heat stress. In the vegetative phase, the expression of OsTOR seems to be the difference between NL-44 and Vandana for their differed heat stress tolerance whereas, in the grain-filling phase, the difference between the varieties lay in the regulation of OsHXK2. The comparative changes in the expression levels between the genes under the varying conditions indicate the sugar status in the source and sink organs that are available for translocation or remobilization.

Primary central nervous system lymphoma: a real-world comparison of therapy access and outcomes by hospital setting.

Background: This study analyzes sociodemographic barriers for primary CNS lymphoma (PCNSL) treatment and outcomes at a public safety-net hospital versus a private tertiary academic institution. We hypothesized that these barriers would lead to access disparities and poorer outcomes in the safety-net population. Methods: We reviewed records of PCNSL patients from 2007-2020 (n = 95) at a public safety-net hospital (n = 33) and a private academic center (n = 62) staffed by the same university. Demographics, treatment patterns, and outcomes were analyzed. Results: Patients at the safety-net hospital were significantly younger, more commonly Black or Hispanic, and had a higher prevalence of HIV/AIDS. They were significantly less likely to receive induction chemotherapy (67% vs 86%, P = .003) or consolidation autologous stem cell transplantation (0% vs. 47%, P = .001), but received more whole-brain radiation therapy (35% vs 16%, P = .001). Younger age and receiving any consolidation therapy were associated with improved progression-free (PFS, P = .001) and overall survival (OS, P = .001). Hospital location had no statistical impact on PFS (P = .725) or OS (P = .226) on an age-adjusted analysis. Conclusions: Our study shows significant differences in treatment patterns for PCNSL between a public safety-net hospital and an academic cancer center. A significant survival difference was not demonstrated, which is likely multifactorial, but likely was positively impacted by the shared multidisciplinary care delivery between the institutions. As personalized therapies for PCNSL are being developed, equitable access including clinical trials should be advocated for resource-limited settings.

A Combined Biomarker of Bright CD38 and MYC ≥55% Is Highly Predictive of Double-/Triple-Hit High-Grade B-Cell Lymphoma.

OBJECTIVES: Diagnosis of high-grade B-cell lymphoma with MYC and BCL2 or BCL6 rearrangements (double-/triple-hit lymphoma [DTHL]) appears to mandate fluorescence in situ hybridization (FISH) testing for all large B-cell lymphoma (LBCL). Given the low incidence of DTHL, we aimed to identify flow cytometry (FC) and immunohistochemistry (IHC) features of DTHL that could be used to develop an optimal screening strategy. This combined FC-IHC approach has not yet been studied. METHODS: We compared features of 40 cases of DTHL and 39 cases of diffuse LBCL (DLBCL) without MYC rearrangement. RESULTS: Bright CD38 expression (CD38bright) by FC, high MYC expression (≥55%), and double-expressor phenotype by IHC were significantly associated with DTHL. The biomarker combining FC and IHC, CD38bright and/or MYC ≥55%, was superior to FC and IHC markers alone in predicting DTHL. Restricting FISH testing to approximately 25% of LBCL based on CD38brightand/or MYC ≥55% would detect approximately 95% of DTHL-BCL2 and approximately 75% of DHL-BCL6. CONCLUSIONS: Our study demonstrated that the novel biomarker of CD38bright and/or MYC ≥55% is highly predictive of DTHL. Awareness of the advantages and limitations of this screening strategy would facilitate development of a rational diagnostic workflow to provide high-quality patient care.

Amorphous Boron Nitride Memristive Device for High-Density Memory and Neuromorphic Computing Applications.

Although two-dimensional (2D) nanomaterials are promising candidates for use in memory and synaptic devices owing to their unique physical, chemical, and electrical properties, the process compatibility, synthetic reliability, and cost-effectiveness of 2D materials must be enhanced. In this context, amorphous boron nitride (a-BN) has emerged as a potential material for future 2D nanoelectronics. Therefore, we explored the use of a-BN for multilevel resistive switching (MRS) and synaptic learning applications by fabricating a complementary metal-oxide-semiconductor (CMOS)-compatible Ag/a-BN/Pt memory device. The redox-active Ag and boron vacancies enhance the mixed electrochemical metallization and valence change conduction mechanism. The synthesized a-BN switching layer was characterized using several analyses. The fabricated memory devices exhibited bipolar resistive switching with low set and reset voltages (+0.8 and -2 V, respectively) and a small operating voltage distribution. In addition, the switching voltages of the device were modeled using a time-series analysis, for which the Holt's exponential smoothing technique provided good modeling and prediction results. According to the analytical calculations, the fabricated Ag/a-BN/Pt device was found to be memristive, and its MRS ability was investigated by varying the compliance current. The multilevel states demonstrated a uniform resistance distribution with a high endurance of up to 104 direct current (DC) cycles and memory retention characteristics of over 106 s. Conductive atomic force microscopy was performed to clarify the resistive switching mechanism of the device, and the likely mixed electrochemical metallization and valence change mechanisms involved therein were discussed based on experimental results. The Ag/a-BN/Pt memristive devices mimicked potentiation/depression and spike-timing-dependent plasticity-based Hebbian-learning rules with a high pattern accuracy (90.8%) when implemented in neural network simulations.