A review on recent advances towards sustainable development of bio-inspired agri-waste based cellulose aerogels.

Cellulose aerogel (CA) is considered to be the most promising material due to its extraordinary properties like unique microstructure, porosity, large specific surface area, biodegradability, renewable nature and lightweight. Cellulosic aerogels are thus found to have potential applications in different fields especially in water purification and biomedical field. Agricultural waste based cellulose aerogels are recently getting wider attention owing to its sustainability. The synthesis methods of agri-waste based cellulose aerogels, its properties and application in different fields especially in the field of water purification are detailed in a comprehensive manner. This review tries to bring light into the commercialization of value-added products from sustainable, cheap agricultural waste material and tries to motivate young researchers.

Diabetes mellitus susceptibility with varied diseased phenotypes and its comparison with phenome interactome networks.

An emerging area of interest in understanding disease phenotypes is systems genomics. Complex diseases such as diabetes have played an important role towards understanding the susceptible genes and mutations. A wide number of methods have been employed and strategies such as polygenic risk score and allele frequencies have been useful, but understanding the candidate genes harboring those mutations is an unmet goal. In this perspective, using systems genomic approaches, we highlight the application of phenome-interactome networks in diabetes and provide deep insights. LINC01128, which we previously described as candidate for diabetes, is shown as an example to discuss the approach.

Efficacy of the TMPRSS2 inhibitor camostat mesilate in patients hospitalized with Covid-19-a double-blind randomized controlled trial.

BACKGROUND: The trans-membrane protease serine 2 (TMPRSS2) is essential for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cell entry and infection. Efficacy and safety of TMPRSS2 inhibitors in patients with coronavirus disease 2019 (Covid-19) have not been evaluated in randomized trials. METHODS: We conducted an investigator-initiated, double-blind, randomized, placebo-controlled multicenter trial in patients hospitalized with confirmed SARS-CoV-2 infection from April 4, to December 31, 2020. Within 48 h of admission, participants were randomly assigned in a 2:1 ratio to receive the TMPRSS2 inhibitor camostat mesilate 200 mg three times daily for 5 days or placebo. The primary outcome was time to discharge or clinical improvement measured as ≥2 points improvement on a 7-point ordinal scale. Other outcomes included 30-day mortality, safety and change in oropharyngeal viral load. FINDINGS: 137 patients were assigned to receive camostat mesilate and 68 to placebo. Median time to clinical improvement was 5 days (interquartile range [IQR], 3 to 7) in the camostat group and 5 days (IQR, 2 to 10) in the placebo group (P = 0·31). The hazard ratio for 30-day mortality in the camostat compared with the placebo group was 0·82 (95% confidence interval [CI], 0·24 to 2·79; P = 0·75). The frequency of adverse events was similar in the two groups. Median change in viral load from baseline to day 5 in the camostat group was -0·22 log10 copies/mL (p <0·05) and -0·82 log10 in the placebo group (P <0·05). INTERPRETATION: Under this protocol, camostat mesilate treatment was not associated with increased adverse events during hospitalization for Covid-19 and did not affect time to clinical improvement, progression to ICU admission or mortality. ClinicalTrials.gov Identifier: NCT04321096. EudraCT Number: 2020-001200-42.

Familial idiopathic pulmonary fibrosis in a young female.

Idiopathic pulmonary fibrosis is a chronic interstitial lung disease of unknown cause. In the past years there have been observations of clustering of pulmonary fibrosis in families, indicating the disease can be inherited. The most commonly identified mutations are mutations involving proteins from the telomerase complex and the surfactant system, where the mutations from the surfactant protein system are less identified. We report a rare care of familial IPF in a young female at the age of 34 years, in whom genetic testing shows two different heterozygous variants for the surfactant protein system as a probable cause of her interstitial lung disease.

Autoimmune pulmonary alveolar proteinosis in an adolescent successfully treated with inhaled rhGM-CSF (molgramostim).

Autoimmune pulmonary alveolar proteinosis (aPAP) is a rare parenchymal lung disease characterized by accumulation of surfactant in the airways with high levels of granulocyte-macrophage colony stimulating factor (GM-CSF) antibodies in blood. Disease leads to hypoxemic respiratory failure. Whole lung lavage (WLL) is considered the first line therapy, but procedure can be quite demanding, specifically for children. Recently alternative treatment options with inhaled GM-CSF have been described but no consensus about the standard treatment exists. We here describe a unique case of a 14-year-old patient who was successfully treated with WLL and subsequent inhalations with molgramostim - new recombinant human GM-CSF (rhGM-CSF).

A statistical quantification of radiobiological metrics in Intensity Modulated Radiation Therapy evaluation.

UNLABELLED: The dosimetric parameters from the DVH cannot predict the amount of tumor kill and normal tissue complications directly but it can assess the conformity and homogeneity of the physical dose distributions. For example, the D-V parameter V20 (Percentage of lung volume receiving 20Gy) is used to gauge the incidence of grade =2 or grade =3 radiation pneumonitis with the plan. But the complication can be correlated to more than one point in the DVH (eg. V5, V40, D50) and it is treatment technique dependent. The aim of this study is to quantify the uncertainty of physical dose metrics to predict the clinical outcomes of the radiotherapy treatments. METHODS: The radiobiological estimates such as TCP and NTCP were made for a cohort of 50 patients (15-Brain; 20-H and N; 15-Pelvis) using the D-V parameters. A statistical analysis based on Spearman ranking coefficient correlation was performed to determine the correlation of the physical plan quality indicators with that of radiobiological estimates. RESULTS: The correlation between the Conformity Index and the Tumor Control probability was found to be good and the dosimetric parameters for optic nerves, optic chiasm, brain stem, normal brain and parotids correlated well with the Normal Tissue Complication Probability estimates compared to other normal structures. A follow up study (median duration: 28 Months) was also performed. There was no grade 3 or grade 4 normal tissue complications observed. Local tumor control was found to be higher in brain (90%) and pelvic cases (95%) whereas a decline of 75% was noted with Head and Neck cases. CONCLUSIONS: The EUD concept of radiobiological model used in the software determines the TCP and NTCP values which can predict precise outcomes with the use of dose volume data in the voxel level. The uncertainty of using physical dose metrics for plan evaluation is quantified with the statistical analysis. It is also helpful in ranking rival treatment plans.

Psedohypoparathyroidism in newborn - a rare presentation.

A 7-day-old male baby was referred with history of persistent multifocal convulsions from second day of life. He was found to have hypocalcemia, hyperphosphatemia, normal serum magnesium and normal renal function tests. Serum parathormone was found to be elevated. Baby was diagnosed as case of pseudohypoparathyroidism and was treated with calcium supplementation and calcitriol. At 9 months he was asymptomatic on treatment, with normal serum calcium and phosphorus.