Systematic review and meta-analysis on coronary calcifications in COVID-19.

Chest CT is valuable to detect alternative diagnoses/complications of COVID-19, while its role for prognostication requires further investigation. Non-pulmonary radiological findings such as cardiovascular calcifications could increase the predictivity of clinical outcomes of COVID-19 patients beyond pulmonary involvement. Several observational studies have reported mixed results on the role of coronary calcifications in COVID-19 patients as a predictor of hospitalization, ventilatory support, and mortality. The purpose of the study is to systematically review the available evidence on the predictive role of cardiovascular calcifications in SARS-CoV2 disease. The meta-analysis confirms the prognostic significance of coronary calcifications on hospital mortality, and coronary calcifications (CAC ≠ 0) were associated with an OR for mortality of 2.19 (95% CI 1.36-3.52). CAC was neutral on respiratory outcomes, but it was associated with an increased trend of cardiovascular events. Coronary calcium appears as a promising biomarker imaging even in short-term outcomes (MACEs, hospital mortality) in a non-cardiovascular disease such as Sars-CoV2 infection. Further large studies are needed to confirm promising results of this imaging biomarker in non-cardiovascular disease.

Silicon-on-insulator free-carrier injection modulators for the mid-infrared.

Experimental demonstrations of silicon-on-insulator waveguide-based free-carrier effect modulators operating at 3.8 µm are presented. PIN diodes are used to inject carriers into the waveguides, and are configured to (a) use free-carrier electroabsorption to create a variable optical attenuator with 34 dB modulation depth and (b) use free-carrier electrorefraction with the PIN diodes acting as phase shifters in a Mach-Zehnder interferometer, achieving a VπLπ of 0.052 V·mm and a DC modulation depth of 22 dB. Modulation is demonstrated at data rates up to 125 Mbit/s.

Suspended low-loss germanium waveguides for the longwave infrared.

Germanium is a material of high interest for mid-infrared (MIR) integrated photonics due to its complementary metal-oxide-semiconductor (CMOS) compatibility and its wide transparency window covering the 2-15 µm spectral region exceeding the 4 and 8 µm limit of the silicon-on-insulator platform and Si material, respectively. In this Letter, we report suspended germanium waveguides operating at a wavelength of 7.67 µm with a propagation loss of 2.6±0.3 dB/cm. To the best of our knowledge, this is the first demonstration of low-loss suspended germanium waveguides at such a long wavelength. Suspension of the waveguide is achieved by defining holes alongside the core providing access to the buried oxide layer and the underlying Si layer so that they can be wet etched using hydrofluoric acid and tetramethylammonium hydroxide, respectively. Our MIR waveguides create a new path toward long wavelength sensing in the fingerprint region.

High-speed Si/GeSi hetero-structure Electro Absorption Modulator.

The ever-increasing demand for integrated, low power interconnect systems is pushing the bandwidth density of CMOS photonic devices. Taking advantage of the strong Franz-Keldysh effect in the C and L communication bands, electro-absorption modulators in Ge and GeSi are setting a new standard in terms of device footprint and power consumption for next generation photonics interconnect arrays. In this paper, we present a compact, low power electro-absorption modulator (EAM) Si/GeSi hetero-structure based on an 800 nm SOI overlayer with a modulation bandwidth of 56 GHz. The device design and fabrication tolerant process are presented, followed by the measurement analysis. Eye diagram measurements show a dynamic ER of 5.2 dB at a data rate of 56 Gb/s at 1566 nm, and calculated modulator power is 44 fJ/bit.

Suspended silicon waveguides for long-wave infrared wavelengths.

In this Letter, we report suspended silicon waveguides operating at a wavelength of 7.67 µm with a propagation loss of 3.1±0.3 dB/cm. To our knowledge, this is the first demonstration of low-loss silicon waveguides at such a long wavelength, with loss comparable to other platforms that use more exotic materials. The suspended Si waveguide core is supported by a sub-wavelength grating that provides lateral optical confinement while also allowing access to the buried oxide layer so that it can be wet etched using hydrofluoric acid. We also demonstrate low-loss waveguide bends and s-bends.

Suspended silicon mid-infrared waveguide devices with subwavelength grating metamaterial cladding.

We present several fundamental photonic building blocks based on suspended silicon waveguides supported by a lateral cladding comprising subwavelength grating metamaterial. We discuss the design, fabrication, and characterization of waveguide bends, multimode interference devices and Mach-Zehnder interferometers for the 3715 - 3800 nm wavelength range, demonstrated for the first time in this platform. The waveguide propagation loss of 0.82 dB/cm is reported, some of the lowest loss yet achieved in silicon waveguides for this wavelength range. These results establish a direct path to ultimately extending the operational wavelength range of silicon wire waveguides to the entire transparency window of silicon.

Angled multimode interferometer for bidirectional wavelength division (de)multiplexing.

We have demonstrated a bidirectional wavelength division (de)multiplexer (WDM) on the silicon-on-insulator platform using two 4-channel angled multimode interferometers (AMMIs) sharing the same multimode interference waveguide. An excellent match of the peak transmission wavelength of each channel between the two AMMIs was achieved. The input and output access waveguides were arranged in a configuration such that the propagation of light of one AMMI in the multimode interference waveguide suffered minimal perturbation by the input and output waveguides of the other AMMI. This type of device is ideal for the WDM system for datacom or telecom applications, e.g. an integrated optical transceiver, where the transmission wavelengths are required to match with the receiving wavelengths. The device also benefits from simple fabrication (as only a single lithography and etching step is required), improved convenience for the transceiver layout design, a reduction in tuning power and circuitry and efficient use of layout space. A low insertion loss of 3-4 dB, and low crosstalk of -15 to -20 dB, was achieved.

Study on knowledge, experiences and barriers to mammography among working women from Delhi.

INTRODUCTION: Mammography is not a popular screening tool for deducting breast cancer in India although regular screening is associated with reduced mortality from breast cancer. OBJECTIVE: The objective of this study is to find out knowledge, experiences and barriers to mammography among working women of Delhi. MATERIALS AND METHODS: Cross-sectional descriptive study was conducted from October 2012 to March 2013 among working women from Delhi, India. The study was conducted as a part of ongoing training workshops organized for women on early detection of breast cancer. Total of eight such programs were organized and were attended by a total of 439 women. Each participant got a self-administered questionnaire to fill. Data was entered in Microsoft Excel and analysis was done using Statistical product and service solutions (SPSS) version 21 (IBM). RESULTS: A total of 439 participants were included in the study. 230 (52.4%) of the women were more than 40 years of age. Only four participants (1%) had not heard about the term mammography before. Less than half (45.1%) of the participants knew correctly the purpose of a mammogram. Only 11.8% of the women knew correctly about the age of getting the first baseline mammogram. Knowledge of frequency of getting the mammogram was also low only 95 (21.6%) correctly knew about it. Only 59 (11.9%) correctly responded that one needs to go to an imaging facility located either in a hospital or elsewhere to get mammogram done. Main experience shared by the women regarding mammography was that 42 (95.45%) did not know anything about the procedure when they went for this investigation. Out of a total of 230 women over 40 years of age only 38 (16.5%) had ever got a mammogram carried out. There is a statistically significant association between education status and practice of mammography (P < 0.05). There were 18 women with family history of breast cancer out, of which 10 (55.5%) had got mammography carried out. 192 out of 230 (83.5%) women over 40 years of age had never got a mammogram done. Main reason 74 (38.5%) cited for this was that they did not know/were not aware they were supposed to go for mammography. CONCLUSION: As knowledge and utilization of mammography is low among women, there is a need to have a multipronged strategy to inform women about mammography and bring about a behavioral change along with having a formal national level screening guidelines for breast cancer early detection.

Suspended SOI waveguide with sub-wavelength grating cladding for mid-infrared.

We present a new type of mid-infrared silicon-on-insulator (SOI) waveguide. The waveguide comprises a sub-wavelength lattice of holes acting as lateral cladding while at the same time allowing for the bottom oxide (BOX) removal by etching. The waveguide loss is determined at the wavelength of 3.8 µm for structures before and after being underetched using both vapor phase and liquid hydrofluoric acid (HF). A propagation loss of 3.4 dB/cm was measured for a design with a 300 nm grating period and 150 nm holes after partial removal (560 nm) of BOX by vapor phase HF etching. We also demonstrate an alternative design with 550 nm period and 450 nm holes, which allows a faster and complete removal of the BOX by liquid phase HF etching, yielding the waveguide propagation loss of 3.6 dB/cm.

Mid-infrared wavelength division (de)multiplexer using an interleaved angled multimode interferometer on the silicon-on-insulator platform.

A low-cost and high-performance wavelength division (de)multiplexing structure in the mid-IR wavelength range is demonstrated on the silicon-on-insulator platform using an interleaved angled multimode interferometer (AMMI). As compared to a single AMMI, the channel count was doubled and the channel spacing halved with negligible extra insertion loss and crosstalk and with only a slight increase in device footprint. The device requires only single lithography and etching steps for fabrication. Potential is also shown for achieving improved performance with further optimized design.

Recruitment of trimeric proliferating cell nuclear antigen by G1-phase cyclin-dependent kinases following DNA damage with platinum-based antitumour agents.

BACKGROUND: In cycling tumour cells, the binary cyclin-dependent kinase Cdk4/cyclin D or Cdk2/cyclin E complex is inhibited by p21 following DNA damage to induce G1 cell-cycle arrest. However, it is not known whether other proteins are also recruited within Cdk complexes, or their role, and this was investigated. METHODS: Ovarian A2780 tumour cells were exposed to the platinum-based antitumour agent 1R,2R-diaminocyclohexane(trans-diacetato)(dichloro)platinum(IV) (DAP), which preferentially induces G1 arrest in a p21-dependent manner. The Cdk complexes were analysed by gel filtration chromatography, immunoblot and mass spectrometry. RESULTS: The active forms of Cdk4 and Cdk2 complexes in control tumour cells have a molecular size of ~140 kDa, which increased to ~290 kDa when inhibited following G1 checkpoint activation by DAP. Proteomic analysis identified Cdk, cyclin, p21 and proliferating cell nuclear antigen (PCNA) in the inhibited complex, and biochemical studies provided unequivocal evidence that the increase in ~150 kDa of the inhibited complex is consistent with p21-dependent recruitment of PCNA as a trimer, likely bound to three molecules of p21. Although p21 alone was sufficient to inhibit the Cdk complex, PCNA was critical for stabilising p21. CONCLUSION: G1 Cdk complexes inhibited by p21 also recruit PCNA, which inhibits degradation and, thereby, prolongs activity of p21 within the complex.

Upregulation of p27 and its inhibition of CDK2/cyclin E activity following DNA damage by a novel platinum agent are dependent on the expression of p21.

The cisplatin analogue 1R,2R-diaminocyclohexane(trans-diacetato)(dichloro)platinum(IV) (DAP) is a DNA-damaging agent that will be entering clinical trials for its potent cytotoxic effects against cisplatin-resistant tumour cells. This cytotoxicity may reside in its ability to selectively activate G1-phase checkpoint response by inhibiting CDKs via the p53/p21 pathway. We have now evaluated the role of another CDK inhibitor p27 as a contributor to DAP-mediated inhibition of G1-phase CDK2 activity. Our studies in ovarian A2780 tumour cells demonstrate that p27 levels induced by DAP are comparable to or greater than those seen for p21. The induction of p27 is not through a transcriptional mechanism, but rather is due to a four-fold increase in protein stabilisation through a mechanism dependent on p21. Moreover, DAP-induced p21 promoted the selective increase of p27 in the CDK2 complex, but not in CDK4 complex, and this selective increase contributed to inhibition of the CDK2 kinase activity. The inhibited complex contained either p27 or p21, but not both, with the relative levels of cyclin E associated with p27 and p21 indicating that about 25% of the inhibition of CDK2 activity was due to p27 and 75% due to p21. This study provides the first evidence that p27 upregulation is directly attributable to activation of the p53/p21 pathway by a DNA-damaging agent, and promulgates p53/p21/p27 axis as a significant component of checkpoint response.

Assessment of knowledge about malaria among patients reported with fever: a hospital-based study.

BACKGROUND & OBJECTIVES: Knowledge about malaria, attitude and health seeking behaviour of fever patients attending Medicine Out Patient Department at Safdarjang Hospital, New Delhi were studied from June to August 2003. METHODS: Cross-sectional survey comprising 200 fever cases was done with prestructured and pretested questionnaire. Data on sociodemographic profile, history of fever, health seeking behaviour, etc were recorded. RESULTS: About 83% of fever cases did not approach the doctor even after three days of onset of fever symptom, 25.5% tried self medication and 20.5% approached chemists for treatment. Knowledge about causes and prevention of malaria was found to be inadequate in the study subjects. INTERPRETATION & CONCLUSION: Knowledge about malaria is poor even in persons residing in urban localities and proper health education is required for successful control of malaria. Information, education and communication activities are indicated to create awareness among the community.

Phase I clinical and pharmacological study of intraperitoneal cis-bis-neodecanoato( trans- R, R-1, 2-diaminocyclohexane)-platinum II entrapped in multilamellar liposome vesicles.

PURPOSE: To perform a phase I study of intraperitoneal cis-bis-neodecanoato ( trans- R, R-1, 2-diaminocyclohexane)-platinum II entrapped in multilamellar vesicles (L-NDDP) for peritoneal carcinomatosis or sarcomatosis. METHODS: Eligible patients had normal renal, hematologic, and liver functions. Laparoscopy was performed on the first two courses for evaluation, adhesiolysis, and chemotherapy administration. Afterwards, chemotherapy was administered through a peritoneal catheter. Up to six courses were allowed. Peritoneal imaging with technetium-labeled sulfur colloid was used to determine adequate distribution prior to each course. Volunteering patients underwent pharmacokinetics studies during the second course. RESULTS: Fifteen of 16 registered patients, seven women and eight men (median age 53 years (range 26-76) and median performance status of 1) were assessable. Diagnoses were: malignant mesothelioma (six patients), signet ring cell (three), colon adenocarcinoma, pseudomyxoma peritonei, gastrointestinal stromal tumor (two each), and ovarian carcinoma (one). Median number of courses was two (range, one to six) Dose-limiting toxicity symptoms were fatigue and abdominal pain. Hematologic toxicities were minimal. Peri-operative complications included one colonic perforation requiring primary closure, a peritoneal catheter malfunction, a port site hematoma, and an ascites leak requiring re-suture. Five patients survived at least 3 years. Pharmacokinetics studies indicated a rapid but low absorption of drug into the systemic circulation, with a prolonged retention of platinum in the plasma compartment. Peritoneal L-NDDP exposure was 17 to 49-times greater than in the plasma compartment. CONCLUSIONS: Peritoneal cavity exposure to L-NDDP is prolonged, and systemic absorption is limited, yielding a high peritoneal/plasmatic ratio. The recommended dose for phase II studies is 400 mg/m2 every 28 days.

A study of malnutrition among children aged 6 months to 2 years from a resettlement colony of Delhi.

Nutritional status of 1661 children aged 6 months to 2 years who attended the Well Baby Clinic of UHC Gokulpuri, Delhi during the year 2000 was studied. 60.7% of them were malnourished. Undesirable practices of discarding the colostrum, not exclusively breast feeding the child till at least 4 months of age, delayed weaning, dilution of top milk, use of bottle and nipple for feeding the children are still widely prevalent.

A study of pediculosis capitis among primary school children in Delhi.

A cross-sectional study was conducted among primary school children of four of the government run schools of Delhi during July-October 2001. Out of a total of 940 study subjects studied 156 (16.59%) were found to be infested with head louse. Significantly higher proportions of girls (20.42%) were found to be infested as compared to boys (13.86%). 65.38% of those infested were aware of the infestation. Those who shared both bedding and comb showed a statistically higher significance as compare to others. Manual removal of head louse and nits was practiced by 69.60% of those aware of the infestation. Majority had knowledge of transmission of head louse by comb/brush, 66.08% had knowledge about control of head louse infestation spread by manual removal 7.34% mentioned other means like kerosene oil and lime powder. Since head louse infestation is a common problem of school going children both parents and teachers along with the students should be taught how to recognize the infestation. Also school health teams should be responsible for treatment and prevention of louse infestation besides carrying our other school health service functions.

Bimodal effects of 1R,2R-diaminocyclohexane(trans-diacetato)(dichloro)platinum(IV) on cell cycle checkpoints.

1R,2R-Diaminocyclohexane(trans-diacetato)(dichloro)-platinum(IV) (DACH-acetato-Pt) is a novel platinum-based agent that is highly effective against cisplatin-resistant ovarian tumor cells. To probe its cellular mechanism, the effects of DACH-acetato-Pt (0-6.4 microM) on cell cycle checkpoints were examined using the ovarian cancer A2780 cell line as the model system. We found that DACH-acetato-Pt at > or =0.2 microM dramatically inhibited cell growth and induced cell death. At concentrations < or =0.6 microM (low effective concentrations), DACH-acetato-Pt specifically induced G(1) phase arrest by selectively inhibiting cyclin-dependent kinase 4 (Cdk4) and Cdk2 activities. The Cdc2 activity, which regulates G(2)-M phase progression, was unaffected by the drug at these concentrations. At concentrations >0.6 microM (high effective concentrations), DACH-acetato-Pt first transiently inhibited S-phase progression and then blocked cell cycle progression at both G(1) and G(2) phases. These cell cycle effects were associated with sequential inhibitions of Cdk2/cyclin A activity, Cdk4 and Cdk2 activities, and Cdc2 kinase activity. Following the cell cycle effects, both the low and high effective concentrations of DACH-acetato-Pt induced cell death through apoptosis. These results indicate that DACH-acetato-Pt activates multiple cell cycle checkpoints in a bimodal manner and suggest that the cell cycle effects demonstrated in these studies may be linked to its ability to induce apoptosis.

Life style and morbidity profile of geriatric population in an urbans community of Delhi.

A cross-sectional study was carried to find out the lifestyle pattern and morbidity profile of geriatrics residing in urban community of Vikram Nagar, Delhi. Women constituted 56.25% and men 43.75% of a total of 128 study subjects. Hindus were 89.06% and Sikhs 10.93%. Age group of 60-75 years accounted for most of the study population. 85% of the subjects complained of one or more health problems. 90.62% of them suffered from dental problems. A significantly higher proportion of women suffered from problems of locomotion/joints and anemia as compared to men whereas genitourinary problems were higher in men as compared to women. 42.55 of the women and 30.76% of the men were obese. Current smokers constituted 15.62% of the women and 30.76% of the men were obese. Current smokers constituted 15.62% of the population whereas 30.35% of the men were current consumers of alcohol. 12.5% used tobacco. As low as 10.15% of the population engaged in regular physical activity. 55.46% of the subjects were vegetarian. 22.65% suffered from disturbed sleep pattern. Smoking showed statistically significant association with hypertension and respiratory tract diseases. Physical activity showed association with obesity and disorder of locomotion. Behavior and lifestyle modification in the form of primordial prevention and counseling of the high risk groups should be carried to improve the quality of life of the aged.