Clinical relevance of major histocompatibility complex class I chain–related molecule A (MICA) antibodies in live donor renal transplantation – Indian Experience

Antibody-mediated rejections (AMR) in the absence of circulating anti-HLA-DSA have highlighted the role of non-HLA antibodies, particularly those directed against endothelial cells. Of these, MICA (major histocompatibility complex class I chain–related molecule A) antibodies are the most notable and important because of their potential in promoting graft rejections. Limited studies have focused on the impact of MICA donor-specific antibodies (DSA) on graft outcome as compared to those that are not donor-specific (NDSA). We evaluated pre- and post-transplant sera at POD 7, 30, 90, 180 and the time of biopsy from 206 consecutive primary live donor renal transplant recipients for anti-MICA and anti-HLA antibodies using single antigen bead assay on a Luminex platform. Recipients who developed MICA antibodies and their donors were phenotyped for MICA alleles. For the purpose of antibody analysis, patients were categorized into three major groups: biopsy-proven AMR, acute cellular rejection (ACR) and those with no rejection episodes (NRE). During the mean follow-up period of 17.37 ± 6.88 months, 16 of the 206 recipients developed AMR, while ACR was observed in only 13 cases. A quarter (25%) of the AMR cases had anti-MICA antibodies as compared to 7.7% of those experiencing ACR and 6.2% of the NRE group. Allelic typing revealed that all MICA Ab +ve AMR cases were due to the presence of donor-specific antibodies. MICA-DSA even in the absence of HLA-DSA was significantly associated with AMR but not with ACR when compared with the NRE group (P = <.01).     

A low-cost and scalable process for harvesting microalgae using commercial-grade flocculant

A low-cost and scalable harvesting process was demonstrated for Chlorella sp. FC2 IITG, which offered an improved process economy for the production of a microalgal biomass feedstock via (i) the utilization of a cheaper commercial grade chemical flocculant; (ii) the recycling of post-harvested nutrient-rich spent water for the successive growth of the FC2 cells and (iii) the modulation of the flocculant dose, resulting in the non-requirement of a pH adjustment of the spent water and separate inoculum development step. Ferrous sulphate and ferric chloride were screened from a pool of four commercial grade flocculants, resulting in high harvesting efficiencies of 99.83% and 99.93% at the lower flocculant doses (g of flocculant g of dry biomass⁻¹) of 2.5 and 3, respectively. The effect of the recycled nutrient-rich spent water and treated non-flocculated microalgal cells after harvesting was evaluated for the growth performance of the FC2 cells in six successive batches. It was found that ferrous sulphate was superior over ferric chloride in terms of the recyclability of the spent water for more number of batches, offering similar growth kinetics and nutrient recovery efficiency as compared with that of the control sample. The scale-up feasibility of the harvesting process was evaluated with a 5 L photobioreactor under indoor conditions and a 350 L open raceway pond under outdoor conditions with a modulated flocculant dose of 1.5 g ferrous sulphate. g dry biomass⁻¹. The harvesting cost of 1 kg biomass using commercial grade ferrous sulphate was estimated to be in the range of 0.17–0.3 USD and was significantly lower as compared to that of analytical grade ferrous sulphate.

A low-cost and scalable microalgal harvesting process with high harvesting efficiency has been demonstrated using a commercial flocculant and spent-water recycling.     

胃、结直肠癌术前区域性动脉化疗几个相关问题

胃、结直肠癌根治性切除术复发转移是严重影响术后5 a生存率提高的重要原因.以手术为主综合治疗已成为新的趋势,其中术前区域性动脉化疗(preoperative regional-arterial chemotherapy,PRAC)尤为值得重视.本文介绍了术前PRAC的概念、作用机制和影响区域性动脉化疗疗效的相关因素,并就术前区域性动脉化疗在胃、结直肠癌综合治疗中的评价进行讨论.     

Selective inhibition of protein synthesis by synthetic and vaccinia virus-core synthesized poly(riboadenylic acids)

Studies were undertaken to compare the effect of poly(A)s from various sources on selective inhibition of protein synthesis in the reticulocyte lysate system programmed with viral and cellular mRNAs. RNA synthesized in vitro by vaccinia virus cores in the presence of only ATP inhibited overall HeLa cell polypeptide synthesis by over 80% with a minimal effect on translation of vaccinia virus mRNAs. Hybridization of the [alpha-32P]AMP-labeled RNA made in vitro by vaccinia virus cores in the presence of only ATP, showed no complementary to HindIII restriction fragments of vaccinia virus DNA indicating that the in vitro product was poly(A). Fractionation of synthetic and core-synthesized poly(A) into three size classes showed that the larger the size of poly(A), the greater its inhibitory activity of protein synthesis in the cell-free system. Inhibition of translation of mRNAs from vaccinia virus-infected HeLa cells was also observed in the presence of poly(A). However, virus-induced polypeptide synthesis was more resistant to the effect of poly(A) than were cellular polypeptides. Oligo(dT) when added to the reticulocyte lysate system was capable of reversing the inhibition of protein synthesis caused by both core-synthesized poly(A) and core-transcribed RNAs. These results indicate that poly(A) synthesized by the virion-associated enzyme has inhibitory properties similar to those of synthetic poly(A).     

The Concept of Diminished Responsibility in Supranational Criminal Law (Psychiatric Approach)

The role of the community management order (CMO) in the management of mental illness has been associated with controversy. There is uncertainty as to the effectiveness of such involuntary treatment. Review of outcomes of involuntary community treatment has shown varied results, and in the remote areas of Australia the issue becomes more complex, and outcomes more difficult to measure. The Northern Territory's Mental Health Act 2000 has broadened criteria for detention. The decision to impose follow-up and case management on an individual (who may reside in a community several hundred kilometres from an in-patient facility) requires careful consideration of its ethical, professional and psychosocial implications. The trend toward increasing use of mental health legislation in the Northern Territory — particularly for Indigenous people — deserves close scrutiny in order that culturally appropriate and sensitive treatment plans are developed.     

can the special care neonatal unit admission cut-off be lowered down to 1500g babies?

Objective  

The study was conducted to find out whether there is any significant difference in outcome if low birth weight babies weighing between 1500g and 1800g are managed by keeping them with their mothers, i.e., without special care neonatal unit (SCNU) admission.