Cautionary tale of right ventricular perforation during Micra™ leadless pacemaker insertion.

Transcatheter pacing systems are self-contained, leadless, devices that offer the potential benefits of avoiding complications related to pectoral pocket and upper extremity vascular access. These systems in preapproval trials demonstrated excellent safety profile with the incidence of device-related cardiac perforation as low as 1.6% with Micra™ (Medtronic) and 1.3% in Nanostim (Abbott). In post-approval registry of Micra™ TPS, the rate of major complications was even lower than in the investigational study ranging from 0.63% to 0.77%. Recently, published report found much higher rates of need for rescue surgery, shock, tamponade, and death among patients implanted with the Micra™ device when compared with transvenous devices. This case report describes two cases of major right ventricular perforation requiring surgical intervention.

Mitigation co-benefits of carbon sequestration from MGNREGS in India.

Mahatma Gandhi Rural Employment Guarantee Scheme a large social security programme being implemented in India, with an average annual investment of US$ 7 billion. The bulk of the activities under this programme are focused on natural resources such as land, water and trees, which provide adaptation benefits. In this study an attempt is made to estimate the carbon sequestration achieved and future potential, as a co-benefit, from MGNREGS. The total mean carbon sequestered at the national level, considering the cumulative number of natural resource based activities, for the year 2017-18 was estimated to be 102 MtCO2. The annual mean carbon sequestration is projected to increase to about 132 MtCO2 by 2020 and 249 MtCO2 by 2030. Drought proofing is one of the activities implemented under MGNREGS and it includes tree planting, relevant to achieving the NDC carbon sink target. The cumulative carbon sink created by drought proofing activities is projected to be 56 MtCO2 in 2020, 281 MtCO2 in 2025 and 561 MtCO2 in 2030. This study demonstrates the significant carbon sink potential of MGNREGS and highlights the importance of estimation and reporting climate mitigation co-benefits of adaptation actions such as MGNREGS under the Paris Agreement.

Vulnerability of Forests in India: A National Scale Assessment.

Forests are subjected to stress from climatic and non-climatic sources. In this study, we have reported the results of inherent, as well as climate change driven vulnerability assessments for Indian forests. To assess inherent vulnerability of forests under current climate, we have used four indicators, namely biological richness, disturbance index, canopy cover, and slope. The assessment is presented as spatial profile of inherent vulnerability in low, medium, high and very high vulnerability classes. Fourty percent forest grid points in India show high or very high inherent vulnerability. Plantation forests show higher inherent vulnerability than natural forests. We assess the climate change driven vulnerability by combining the results of inherent vulnerability assessment with the climate change impact projections simulated by the Integrated Biosphere Simulator dynamic global vegetation model. While 46% forest grid points show high, very high, or extremely high vulnerability under future climate in the short term (2030s) under both representative concentration pathways 4.5 and 8.5, such grid points are 49 and 54%, respectively, in the long term (2080s). Generally, forests in the higher rainfall zones show lower vulnerability as compared to drier forests under future climate. Minimizing anthropogenic disturbance and conserving biodiversity can potentially reduce forest vulnerability under climate change. For disturbed forests and plantations, adaptive management aimed at forest restoration is necessary to build long-term resilience.

Bilateral renal angiomyolipomas with invasion of the renal vein: a case report.

An angiomyolipoma (AML) is usually a benign, rare, and, more commonly, a unilateral renal tumour. Bilateral tumours are very rare, particularly in the absence of tuberous sclerosis complex. Only in a few isolated cases have features of malignancy been associated with an AML. We present a unique case of bilateral AMLs mimicking invasive tumours in the absence of any other features of tuberous sclerosis complex.

Toxicity, bioaccumulation and metabolism of phenol in the freshwater fish Oreochromis mossambicus.

The acute toxicity of phenol was determined to be 35.0 mg/l in Oreochromis mossambicus. The fish were exposed to two sublethal concentrations of phenol (2.3 and 3.5 mg/l) for 30 days. The effects of exposure were studied on the bioaccumulation and elimination of phenol from the kidney and biochemical parameters of liver, gill, and muscle at intervals of 10, 20, and 30 days. A statistically significant increase in phenol concentration was noted in tissues from all treated fish groups. Bioaccumulation and biochemical changes were dose and duration dependant. Recovery in fish after post exposure was observed after transferring these fish to normal tap water for 30 days. Elimination of phenol was noted, although the concentration of phenol remained significantly higher than the control after 30 days of the experiment. Total protein, total carbohydrate, and total lipids in the tissues of liver, gill, and muscle of fish decreased greatly. The longer the exposure time, the greater was the percentage reduction of organic matter of the fish exposed to the sublethal concentration of phenol.

Establishment of the need for oestrogen during implantation in non-human primates.

Deprivation of oestrogen during post-ovulatory mated cycles in proven fertile female bonnet monkeys by tamoxifen, aromatase inhibitor or oestrogen antiserum resulted in inhibition of pregnancy establishment in all three groups of animals. However, more than 85% of the animals became pregnant within three exposures to proven fertile males in the control group. These results suggest the requirement for oestrogen in pregnancy establishment in primates. Based on this conclusion, it is suggested that use of a suitable and potent anti-oestrogenic compound can be exploited as an alternative approach to contraception.

Patient satisfaction with nurse-led telephone consultation for the follow-up of patients with prostate cancer.

Prostate cancer is being diagnosed earlier and in higher numbers than ever before. The nature of the disease means many patients have to be monitored regularly and for a prolonged period leading to increased pressure on urology outpatient resources and inconvenience for the patient. Here we investigate patient satisfaction with a nurse-led telephone-based follow-up clinic and compare it to satisfaction with traditional outpatient consultations. A Consultation Satisfaction Questionnaire (CSQ) evaluating four domains, namely General Satisfaction (GS), Professional Care (PC), Depth of Relationship (DR) and Perceived Time (PT) was used to assess satisfaction in three groups. Group 1 consisted of 299 patients attending the outpatient department before commencing telephone consultations; Group 2 consisted of 163 men attending outpatients after commencement of the telephone consultations; and Group 3 was the telephone group (234 men). We demonstrated no significant difference in GS or PC between Group 1 and Group 3 or Group 2 and Group 3, although DR and PT was significantly lower in the telephone group compared with Group 1. We also found that waiting times were significantly shorter in the telephone group. In conclusion, telephone follow-up appears to be an acceptable alternative to outpatient follow-up in terms of GS and PC and appears to be more convenient for the patient, although these benefits come at the expense of loss of DR and PT with the clinician.

Outcome of inguinal hernia repair at two rural hospitals in northern Scotland.

INTRODUCTION: Audit of inguinal hernia repair is important in view of the magnitude of the problem and the fact that it is a common operation often performed by surgical trainees. Due to the disparity of the results of various workers with regard to the rate of complications, individual surgeons have been advised to audit their patients' outcomes. METHOD: Retrospective audit was performed, of all the inguinal hernias repaired between 1997 and 2003 inclusive, at two rural hospitals in northern Scotland, under a single consultant. Data were gathered from a hospital database and by means of postal questionnaire specifically aimed at wound complications, recurrence and chronic groin pain. RESULTS: One hundred and sixty-three inguinal hernias were repaired during this period. One hundred and fifty-eight questionnaires were sent to patients ascertained to be living at the time of audit initiation with a response from 129 (86%). At a mean follow-up of 4.34 years, no recurrences were noted and eight patients complained of chronic groin pain of whom only three (1.5%) were experiencing moderate to severe pain. The results achieved by senior house officers were comparable to those obtained by the senior surgeon. CONCLUSION: The incidence of recurrence of hernia after open mesh repair of inguinal hernias is very low. Excellent outcomes can be obtained for inguinal hernia even at remote and rural hospitals in the hands of both experienced and trainee surgeons

Effect of phenol on the metabolism and biochemical composition of the freshwater fish Cyprinus carpio.

The effect of phenol on the fish Cyprinus carpio and the metabolic changes in oxygen consumption and total carbohydrate, total protein and total lipids in the tissues of liver, gills, muscle, brain, and intestine were investigated for sublethal exposure. The oxygen consumption decreased significantly in both toxicants exposed to acute toxicity. Following sublethal exposure to phenol total protein, total carbohydrate, and total lipids in the tissues of liver, gills, muscle, brain and intestine of the fish decreased greatly. The longer the exposure time, the greater was the percentage reduction of organic matter of the fish exposed to sublethal concentration of phenol. Lipid content was not reduced much in exposure when compared with the control.

Clerodane diterpenoids from Pulicaria wightiana.

Five clerodane diterpenoids have been isolated from the aerial parts of Pulicaria wightiana along with 3'5,6-trihydroxy-3,4',7-trimethoxyflavone and 2-methyl-5-hydroxy-chroman-4-one. The structures and stereochemistry of the compounds were established from spectral (mainly 1D and 2D NMR) studies. The last two compounds were not reported earlier from this plant. The antibacterial activity of the diterpenoids were studied.

Deoxypreussomerins from Jatropha curcas: are they also plant metabolites?

Three deoxypreussomerins, palmarumycins CP1, JC1 and JC2, have been isolated from a collection of the stems of Jatropha curcas. The second and third compounds are antibacterial constituents which were characterized from spectral evidence. The X-ray crystallographic structure of palmarumycin JC1 was also studied. Deoxypreussomerins have been obtained here from a plant source in appreciable quantities.

Pseudoguaianolides from the flowers of Parthenium hysterophorus.

Chemical investigation on the flowers of Parthenium hysterophorus has resulted in the isolation of four new pseudoguaianolides, hysterones A-D along with the known compounds, parthenin, coronopilin, 2beta-hydroxycoronopilin and tetraneurin-A. The structures of the new compounds were established by interpretation of their spectral (1D and 2D NMR) data. The X-ray crystallographic analysis of hysterones A and C was also carried out.

Simple, efficient, and selective deprotection of phenolic methoxymethyl ethers using silica-supported sodium hydrogen sulfate as a heterogeneous catalyst.

A simple and efficient method has been developed for chemoselective deprotection of phenolic methoxymethyl (MOM) ethers using silica-supported sodium hydrogen sulfate as a heterogeneous catalyst. The conversions occur at room temperature, and the yields of the deprotected phenols are excellent. The method is suitable for deprotection of phenolic MOM ethers of multifunctional bioactive natural products.

Charminarone, a seco-pseudoguaianolide from Parthenium hysterophorus.

A novel sesquiterpenoid, charminarone, the first seco-pseudoguaianolide, has been isolated along with several known compounds from the whole plant of Parthenium hysterophorus. The structure of the new compound has been settled as 1,10-seco-dihydroisoparthenin 1,10-dione from its spectral data as well as from its conversion by reductive coupling reaction with Zn/TiCl(4) reagent to the known compound, anhydrodihydroisoparthenin. The reagent Zn/TiCl(4) has been used here for the first time to construct the seven membered ring of a pseudoguaianolide sesquiterpenoid.

The role of sustainable agriculture and renewable-resource management in reducing greenhouse-gas emissions and increasing sinks in China and India.

This paper contains an analysis of the technical options in agriculture for reducing greenhouse-gas emissions and increasing sinks, arising from three distinct mechanisms: (i) increasing carbon sinks in soil organic matter and above-ground biomass; (ii) avoiding carbon emissions from farms by reducing direct and indirect energy use; and (iii) increasing renewable-energy production from biomass that either substitutes for consumption of fossil fuels or replaces inefficient burning of fuelwood or crop residues, and so avoids carbon emissions, together with use of biogas digesters and improved cookstoves. We then review best-practice sustainable agriculture and renewable-resource-management projects and initiatives in China and India, and analyse the annual net sinks being created by these projects, and the potential market value of the carbon sequestered. We conclude with a summary of the policy and institutional conditions and reforms required for adoption of best sustainability practice in the agricultural sector to achieve the desired reductions in emissions and increases in sinks. A review of 40 sustainable agriculture and renewable-resource-management projects in China and India under the three mechanisms estimated a carbon mitigation potential of 64.8 MtC yr(-1) from 5.5 Mha. The potential income for carbon mitigation is $324 million at $5 per tonne of carbon. The potential exists to increase this by orders of magnitude, and so contribute significantly to greenhouse-gas abatement. Most agricultural mitigation options also provide several ancillary benefits. However, there are many technical, financial, policy, legal and institutional barriers to overcome.

Expression of Notch pathway components in spermatogonia and Sertoli cells of neonatal mice.

Members of the Notch gene family have been shown to play an important role in the control of cell fate in many developmental systems. We hypothesized that the fate of the male germ line stem cells may also be mediated through the Notch signaling pathway. We therefore sought to determine whether the components of the Notch pathway are expressed in the mouse testis. Western blot analysis revealed the expression of three Notch receptors (Notch 1, Notch 2, and Notch 3), Notch ligands (Jagged 1, Jagged 2, and Delta 1), and presenilin 1 (PS1) in neonatal mouse testis. We then examined their cellular localization by immunohistochemical analysis of cocultures of spermatogonia and Sertoli cells. The 3 Notch receptors were found to be expressed in spermatogonia. Sertoli cells expressed only Notch 2 receptor. Among the Notch ligands, Delta 1 and Jagged 1 were localized exclusively in spermatogonia and Sertoli cells, respectively. PS1 was apparent in both spermatogonia and Sertoli cells. The presence of Notch receptors and Notch ligands in spermatogonia and Sertoli cells indicates that these cells are capable of responding to and eliciting Notch signaling during the process of spermatogenesis. Key words: Cell fate, delta, jagged, presenilin, spermatogenesis.

Androgen depletion activates telomerase in the prostate of the nonhuman primate, Macaca mulatta.

BACKGROUND: The activity of telomerase, an enzyme that synthesizes telomeric repeats at the ends of chromosomes, is not detectable in normal human prostate. However, the majority of human prostate cancers exhibit telomerase activity. Since androgens play a major role in prostate tumorigenesis, we investigated the effect of androgen-depletion on the expression of telomerase activity in the prostate. METHODS: Adult male rhesus monkeys were either bilaterally castrated or subjected to sham surgery (n = 5 each). Approximately 6 weeks later, the animals were killed and the different regions of the prostate gland were removed and frozen immediately. Telomerase activity was assayed using the telomeric repeat amplification protocol. RESULTS: All five regions of the prostate from sham operated control animals failed to exhibit telomerase activity. In the castrated monkey, all regions of the prostate, except for the anterior lobe, expressed high levels of telomerase activity. CONCLUSIONS: Our results indicate that in monkeys, androgen-ablation leads to up-regulation of telomerase activity. The negative-regulation of telomerase activity by androgens is probably lost during prostate tumorigenesis.

Epidermal growth factor modulates the expression of vascular endothelial growth factor in the human prostate.

The growth and dissemination of tumors in the body has been associated with angiogenesis. Vascular endothelial growth factor (VEGF) is an angiogenic factor that stimulates endothelial cell growth and enhances vascular permeability. VEGF exerts its action by binding to specific cell surface receptors. Three receptors, VEGFR-1 (flt-1), VEGFR-2 (flk-1), and VEGFR-3 (flt-4) have been identified. Very little information on the coordinated expression of VEGF and its receptors in normal prostate, benign prostatic hyperplasia (BPH), and prostate carcinoma is available. Therefore, we examined the immunohistochemical localization of VEGF and its receptors in tissues derived from normal human prostate, BPH, and prostatic carcinoma. Immunostaining for VEGF was absent in the normal prostate. Epithelium lining the glands of prostate derived from patients with BPH exhibited strong immunostaining. The intensity of staining was relatively less in prostate carcinoma. It is interesting that VEGFR-1 and VEGFR-3 were strongly expressed in both stromal and epithelial tissues in normal prostate, BPH, and carcinoma. In comparison, VEGFR-2 was not localized to normal prostate and its expression in the stroma of BPH and epithelium of carcinoma was very weak. Because progression of prostate cancer is accompanied by altered expression of epidermal growth factor (EGF) and its receptor (EGFR) in malignant cells, we investigated the effect of EGF on VEGF gene expression by Northern blot analysis in 2 human prostate cancer cell lines that express EGFR. EGF greatly enhanced the expression of VEGF messenger RNA in DU145 and PC3 cell lines in a dose-dependent manner. The EGF induction of VEGF gene expression suggests a mechanism by which angiogenesis could be accelerated in BPH and prostate carcinoma.

Calcium confusion--is the variability in calcium response by Sertoli cells to specific hormones meaningful or simply redundant?

When results of more than ten different studies on hormone-induced calcium signals in Sertoli cells are taken together, a wide variety of responses emerges. The reported changes range from increased concentrations, via no response at all, to decreased calcium concentrations. Minor variations in cell isolation techniques, culture conditions, or techniques for measuring the intracellular calcium could explain some of these differences. However, erratic variations in response are also observed within research groups under very similar experimental conditions. Such 'negative' findings are mainly reported orally and do not further penetrate the scientific community. As hormone-dependent calcium responses evidently may depend very much on the context of the cells, calcium transients would appear to be unreliable bioassay principles with which to detect the primary actions of FSH and effectors such as androgens on Sertoli cells. A more important biological question is whether these sometimes opposed calcium transients are connected with a particular cellular response. To date there is no evidence for such a tight coupling in Sertoli cells, implying that, at least under in vitro conditions, calcium signals might even be redundant altogether. Such calcium variability is probably not unique to Sertoli cells, and the aim of this commentary is to promote an open debate that may help to transform the current state of 'calcium confusion' into a better understanding of the intracellular calcium language.