A Novel Way of Standardization of ICG Lymphangiography Reporting

Background  Indocyanine green (ICG) lymphangiography is being increasingly employed to assess the severity of lymphedema, locate the areas of patent linear lymphatics and dermal backflow and plan treatment. This study suggests a novel method of reporting ICG findings in extremities to enable easy understanding among surgeons and physiotherapists and avoid repeat testing when a patient visits a disparate lymphedema center or clinician. Methods  A reporting protocol was developed in the lymphedema clinic of the plastic surgery department, and patients were asked to bring along the report in every subsequent review. The ICG findings were recorded on the fluorescence imaging system as well. The report was prepared by one and analyzed by two different clinicians without repeating the test on 10 consecutive patients. Results  The interrater reliability of findings in the report was found to be 98.7% among the three clinicians. Conclusion  The reporting system was found to be illustratable and reproducible     

An ultra-low-profile 0.85 mm Nano Hydro balloon to treat wire-crossable balloon-uncrossable lesions: A useful tool in CTO armamentarium

Balloon uncrossable lesions are commonly encountered during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). A sequential strategy and planning are required to tackle such lesions. We present a case series of severely calcified, device uncrossable lesions where the traditional strategies failed and an ultra-low-profile (0.85 mm) balloon was crucial to successful PCI. To our best knowledge, this is the first case series describing the use of this balloon in real world.     

Factors associated with hip cartilage volume measured by magnetic resonance imaging: the Tasmanian Older Adult Cohort Study

OBJECTIVE: To compare associations between anthropometric and lifestyle factors and femoral head cartilage volume/thickness and radiographic features of osteoarthritis (OA) and to provide evidence of construct validity for magnetic resonance imaging (MRI) assessment of femoral cartilage volume and thickness. METHODS: We studied a cross-sectional sample of 151 randomly selected subjects (79 men, 72 women; mean age 63 years) from the Tasmanian Older Adult Cohort Study. A sagittal T1-weighted fat-suppression MRI scan of the right hip was performed to determine femoral head cartilage volume, cartilage thickness, and size. An anteroposterior radiograph of the pelvis with weight bearing was performed and scored for radiographic evidence of OA in the right hip. Other factors measured were height, weight, leg strength, serum vitamin D levels, and bone mineral density. RESULTS: Hip cartilage volume was significantly associated with female sex, body mass index, and femoral head size, whereas hip cartilage thickness was significantly associated only with the size of the femoral head. Only female sex was significantly associated with the total radiographic OA score and the joint space narrowing (JSN) score, but not the osteophyte score. Radiographic JSN of the hip, especially axial JSN (but not osteophytes), was significantly correlated with hip cartilage volume and thickness. CONCLUSION: Femoral head cartilage volume and thickness have modest but significant construct validity when correlated with radiographic findings. Furthermore, the generally stronger associations with volume compared with radiographic OA suggest that MRI may be superior at identifying risk factors for hip OA.     

Subtype B and subtype C HIV type 1 recombinants in the northeastern state of Manipur, India

The predominant HIV-1 strain circulating in India is subtype C. However, subtype A and B strains of HIV-1 have also been reported in India. In 1999, the first A/C recombinant strain was reported from Pune in India. Intravenous drug users (IVDUs) from the northeastern region of India have a high HIV-1 seroprevalence. Studies carried out in intravenous drug users in the northeastern region of India have shown that HIV-1 subtype C is the predominant strain infecting IVDUs. Fourteen blood samples were collected from HIV-1-infected individuals from the northeastern region of India and screened by env and gag heteroduplex mobility assays (HMA). Where the env and gag HMA results from a sample yielded different subtypes, sequencing of env and gag PCR products was carried out to confirm the presence of HIV-1 recombinants. Of the 14 samples subtyped, nine samples belonged HIV-1 subtype C (gag C/env C), one to HIV-1 subtype B (gag B/env B), and the remaining were B/C recombinants (gag C/env B). This is the first report of HIV-1 B/C recombinants from India.     

Preliminary analysis testing the accuracy of radiographic visibility of root pulp in the mandibular first molars as a maturity marker at age threshold of 18 years

International Journal of Legal Medicine - Forensic age estimation, after completion of third molar mineralization, regressive features such as apposition of secondary dentin, which is seen as...     

A novel site-II directed glycoprotein estimation ELISA to aid rabies vaccine manufacture for veterinary and human use

Although the World Health Organization recommends the use of in vitro techniques to qualify rabies vaccine lot release, very limited proposals have been made to arrive at a harmonized approach for wide scale usage. The present study proposed and evaluated the use of a novel avidin–biotin ELISA as an alternative to these in vivo tests in rabies vaccine manufacture. This assay utilized a neutralizing pan reactive monoclonal antibody (mAb) reactive with the conserved site-II of the natively folded rabies glycoprotein. Linear regression analysis of the in vitro glycoprotein estimates with the in vivo potency values, showed a good correlation (r² = 0.8) with veterinary vaccines, but a poor correlation (r² = 0.2) with human vaccines. However, we could qualitatively arrive at cut-off glycoprotein estimates from the ELISA, above which all the vaccines were declared to be protective by mouse challenge studies (>2.5 IU/dose).     

Temperature protocols to guide selective self-assembly of competing structures

Multicomponent self-assembly mixtures offer the possibility of encoding multiple target structures with the same set of interacting components. Selective retrieval of one of the stored structures has been attempted by preparing an initial state that favors the assembly of the required target, through seeding, concentration patterning, or specific choices of interaction strengths. This may not be possible in an experiment where on-the-fly reconfiguration of the building blocks to switch functionality may be required. In this paper, we explore principles of inverse design of a multicomponent, self-assembly mixture capable of encoding two competing structures that can be selected through simple temperature protocols. We design the target structures to realize the generic situation in which one of the targets has the lower nucleation barrier, while the other is globally more stable. We observe that, to avoid the formation of spurious or chimeric aggregates, the number of neighboring component pairs that occur in both structures should be minimal. Our design also requires the inclusion of components that are part of only one of the target structures. We observe, however, that to maximize the selectivity of retrieval, the component library itself should be maximally shared by the two targets, within such a constraint. We demonstrate that temperature protocols can be designed that lead to the formation of either one of the target structures with high selectivity. We discuss the important role played by secondary aggregation products in improving selectivity, which we term “vestigial aggregates.”

Self-assembly is a fundamental manufacturing mechanism of Nature. Many mesoscale cellular structures required for biological functionality, such as membranes, microtubules, actin fibrils, ribosomes, etc., are formed through self-assembly, often driven by nonequilibrium forces (1, 2). Even though the cytoplasm contains thousands of molecular components, the various cellular structures self-assemble with remarkable precision and may even share components (3). However, in rare cases, they can misassemble, leading to impaired function or even diseases (4, 5). Mechanisms for controlling synthesis in the cell, such as molecular chaperones and compartmentalization of enzymatic action (6–8), are widely studied.When designing self-assembling systems, one must contend with unwanted “off-target” structures. It is therefore important to understand what causes misassembly and how it can be avoided, both at the design stage and during assembly. On the other hand, an ability to reuse the same building blocks to assemble different structures can be extremely useful to create smart materials that can change their functionality in response to an external stimulus. Often, such materials are designed to change their shape and functionality through conformational or morphological changes of their building blocks (9–15). However, it is also possible to have multiple structures that differ in the spatial arrangement of their building blocks. Multicomponent mixtures not only allow for such a design (16–20), but can also form finite structures with arbitrary complexity (21, 22). Experiments with DNA bricks have shown a way of self-assembling complex structures with hundreds of distinct components (23, 24). Such an addressable assembly, where each component and its position in the target structure are uniquely defined, is made possible because of the complementarity of the DNA hybridization process.Here, we investigate the generic problem of designing two competing target structures of distinct shape, a feature that we show involves new nontrivial challenges. By designing the location of components and the strength of their interactions, we show that the nucleation behavior of the target structures can be tuned such that either of them can be assembled using distinct time-varying temperature protocols. Further, such a design shows that to avoid chimeric aggregation, the neighborhood of the individual components in the two structures should be maximally different. We show that the design of the competing structure requires the inclusion of components that form part of only one of the two structures. However, in order to maximize the selectivity of self-assembly, the component library should be maximally shared by the targets, within the constraints imposed by the design.We begin by noting that even with a single target structure, multicomponent systems assemble quite differently from classical nucleation, due to the fact that the components need to bind in certain specific ways to form the correct structure (25, 26). Numerical evidence and theoretical analyses have shown that multicomponent self-assembly proceeds via a nonclassical nucleation process (27–30). For successful assembly, the theories also predict a protocol that allows for slow nucleation followed by completion of growth at a lower temperature (30, 31). Due to incidental interactions between components, there may also be numerous undesired ways in which they can aggregate, which increases the probability of formation of undesired structures. Thus, the designed interactions should be made sufficiently strong, so as to offset this entropic effect (32, 33). Some studies suggested that a narrow distribution of designed interactions is required for error-free self-assembly (32, 33). However, other studies showed that variable bond strengths may improve the kinetics and diminish the competition between fragments that are incorporated at an early stage (30, 34). To avoid the formation of off-target structures, it is important that the self-assembling structure can anneal during growth. This implies that the assembly should take place under thermodynamic conditions, where the growth is almost reversible (30, 35). As a consequence, the range of thermodynamic parameters within which self-assembly can be made error-free is significantly reduced (24, 27, 36, 37).Focusing now on strategies to design multiple target structures from the same building blocks, the two most pertinent questions are: 1) how to design the targets while avoiding misaggregation; and 2) how to guide their self-assembly into specific target structures. The simplest examples of distinct targets that form from the same building blocks are objects that have the same shape, but differ in the spatial arrangement of building blocks (16–18). Components that are neighbors in any of the multiple targets are assigned attractive interactions. If the interactions are of equal strength, then the retrieval of any specific target from the mixture requires a target-specific seeding procedure or concentration pattern. Selective retrieval by strengthening a few bonds specific to the desired target has also been attempted (16, 18), in which case the system always favors the formation of one structure over others.