Ultra-compact polarization rotation in integrated silicon photonics using digital metamaterials.

Polarization controlling devices such as polarization splitters and rotators are critical elements in integrated-photonic circuits that function via polarization-diversity schemes. Here, we present the design of an ultra-compact nanophotonic-polarization rotator (NPR) that rotates the polarization state from TE to TM with a simulated extinction ratio of 23dB over a coupling length of 5µm and an operating bandwidth of 40nm. This all-silicon device can be fabricated in a single lithography step and we have fabricated and characterized a preliminary device exhibiting 9dB extinction ratio.

Consensus on "Basal insulin in the management of Type 2 Diabetes: Which, When and How?".

Introduction: Type 2 diabetes mellitus (T2DM) has attained epidemic proportions and continues to increase despite the availability of a number of oral antidiabetic medications and major advances made in insulin delivery since its discovery nearly a hundred years ago. One, amongst many other reasons responsible for the inability to achieve adequate glycaemic control in a substantial proportion of T2DM patients is the delayed initiation and inappropriate intensification of insulin treatment. Appropriate initiation and intensification of insulin is critical for the successful achievement of tight glycaemic control.

Stapled Transabdominal Ostomy Reinforcement with retromuscular mesh (STORRM): Technical details and early outcomes of a novel approach for retromuscular repair of parastomal hernias.

Background: Parastomal hernia repair (PHR) remains a challenge with no optimal repair technique. During retromuscular hernia repair, traversing the stomal conduit through the abdominal wall can result in angulation and compression. Widening of traditional cruciate incisions in mesh and/or fascia likely contributes to recurrences.

Fifteen new risk loci for coronary artery disease highlight arterial-wall-specific mechanisms.

Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide. Although 58 genomic regions have been associated with CAD thus far, most of the heritability is unexplained, indicating that additional susceptibility loci await identification. An efficient discovery strategy may be larger-scale evaluation of promising associations suggested by genome-wide association studies (GWAS).

From the Cover: AstrocytesAre Protective Against Chlorpyrifos Developmental Neurotoxicity in Human Pluripotent Stem Cell-Derived Astrocyte-Neuron Cocultures.

Human neural progenitor cells are capable of independent, directed differentiation into astrocytes, oligodendrocytes and neurons and thus offer a potential cell source for developmental neurotoxicity (DNT) systems. Human neural progenitor-derived astrocyte-neuron cocultured at defined ratios mimic cellular heterogeneity and interaction in the central nervous system. Cytochrome P450 enzymes are expressed at a relatively high level in astrocytes and may play a critical role in the biotransformation of endogenous or exogenous compounds, including chlorpyrifos, an organophosphate insecticide that affects the central nervous system.

Is old age a contraindication to elective ventral hernia repair?

Background: Ventral hernia repair (VHR) is a frequent problem in the expanding aging population. However, advanced age is often viewed as a contraindication to elective hernia surgery. We aimed to analyze outcomes of VHR in a large cohort of elderly patients.

Oral Anticancer Agents: An Intervention to Promote Medication Adherence and Symptom Management .

Symptom burden and poor adherence to oral anticancer agents remain significant clinical problems. This study examined feasibility, preliminary efficacy, and satisfaction with ADHERE, a nurse practitioner intervention that promotes symptom management and adherence among patients prescribed oral agents. The intervention group (which received one semistructured, face-to-face session followed by three weekly telephone sessions using motivational interviewing, brief cognitive-behavioral therapy, and a toolkit to promote self-management) had significantly lower symptom severity postintervention.

Thyroid profile and autoantibodies in Type 1 diabetes subjects: A perspective from Eastern India.

Context: There has been a rise in the incidence of type 1 diabetes mellitus (T1DM) in India. The prevalence of thyroid autoantibodies and thyroid dysfunction is common in T1DM.

Aims: The aim of this study is to determine the incidence of thyroid dysfunction and thyroid autoantibodies in T1DM subjects, without any history of thyroid disease, and the prevalence of glutamic acid decarboxylase (GAD) antibody, Islet antigen-2 antibody (IA2), thyroid peroxidase (TPO), and thyroglobulin autoantibodies (Tg-AB) in T1DM subjects.

Outcome and preferences in male-to-female subjects with gender dysphoria: Experience from Eastern India.

Context: Gender dysphoria (GD) is an increasingly recognized medical condition in India, and little scientific data on treatment outcomes are available.

Aims: Our objective is to study the therapeutic options including psychotherapy, hormone, and surgical treatments used for alleviating GD in male-to-female (MTF) transgender subjects in Eastern India.

Subjects And Methods: This is a retrospective study of treatment preferences and outcome in 55 MTF transgender subjects who were presented to the endocrine clinic.

Hypermethylation: Causes and Consequences in Skeletal Muscle Myopathy.

A detrimental consequence of hypermethylation is hyperhomocysteinemia (HHcy), that causes oxidative stress, inflammation, and matrix degradation, which leads to multi-pathology in different organs. Although, it is well known that hypermethylation leads to overall gene silencing and hypomethylation leads to overall gene activation, the role of such process in skeletal muscle dysfunction during HHcy condition is unclear. In this study, we emphasized the multiple mechanisms including epigenetic alteration by which HHcy causes skeletal muscle myopathy.

High content imaging quantification of multiple in vitro human neurogenesis events after neurotoxin exposure.

Background: Our objective was to test neural active compounds in a human developmental neurotoxicity (DNT) model that represents neural tube stages of vulnerability. Previously we showed that 14 days in vitro (DIV 14) was sufficient to generate cryopreserved neuronal cells for post thaw neurite recovery assays. However, short exposure and assessment may not detect toxicants that affect an early neurogenesis continuum, from a mitotic human neural progenitor (hNP) cell population through the course of neurite outgrowth in differentiating neurons.

Histone chaperone APLF regulates induction of pluripotency in murine fibroblasts.

Induction of pluripotency in differentiated cells through the exogenous expression of the transcription factors Oct4, Sox2, Klf4 and cellular Myc involves reprogramming at the epigenetic level. Histones and their metabolism governed by histone chaperones constitute an important regulator of epigenetic control. We hypothesized that histone chaperones facilitate or inhibit the course of reprogramming.

Automatic Facial Expression Recognition System Using Deep Network-Based Data Fusion.

This paper presents a novel automatic facial expressions recognition system (AFERS) using the deep network framework. The proposed AFERS consists of four steps: 1) geometric features extraction; 2) regional local binary pattern (LBP) features extraction; 3) fusion of both the features using autoencoders; and 4) classification using Kohonen self-organizing map (SOM)-based classifier. This paper makes three distinct contributions.

Evaluation of antibiotic pressurized pulse lavage for contaminated retromuscular abdominal wall reconstruction.

Background: Despite patient risk factors such as diabetes and obesity, contamination during surgery remains a significant cause of infections and subsequent wound morbidity. Pressurized pulse lavage (PPL) has been utilized as a method to reduce bacterial bioburden with promising results in many fields. Although existing methods of lavage have been utilized during abdominal operations, no studies have examined the use of PPL during complex hernia repair.

A carbon nanotube based x-ray detector.

X-ray detectors based on metal-oxide semiconductor field effect transistors couple instantaneous measurement with high accuracy. However, they only have a limited measurement lifetime because they undergo permanent degradation due to x-ray beam exposure. A field effect transistor based on carbon nanotubes (CNTs), however, overcomes this drawback of permanent degradation, because it can be reset into its starting state after being exposed to the x-ray beam.

Different dehydrins perform separate functions in Physcomitrella patens.

Dehydrins, PpDHNA and PpDHNB from Physcomitrella patens provide drought and cold tolerance while PpDHNC shows antimicrobial property suggesting different dehydrins perform separate functions in P. patens. The moss Physcomitrella patens can withstand extremes of environmental condition including abiotic stress such as dehydration, salinity, low temperature and biotic stress such as pathogen attack.

POEM is a cost-effective procedure: cost-utility analysis of endoscopic and surgical treatment options in the management of achalasia.

Background: Achalasia is a rare motility disorder of the esophagus. Treatment is palliative with the goal of symptom remission and slowing the progression of the disease. Treatment options include per oral endoscopic myotomy (POEM), laparoscopic Heller myotomy (LM) and endoscopic treatments such as pneumatic dilation (PD) and botulinum toxin type A injections (BI).

Comparative analysis of biologic versus synthetic mesh outcomes in contaminated hernia repairs.

Background: Contaminated operative fields pose significant challenges for surgeons performing ventral hernia repair. Although biologic meshes have been utilized increasingly in these fields, recent evidence suggests that synthetic meshes represent a viable option. We analyzed the outcomes of biologic and synthetic mesh utilized in patients undergoing major ventral hernia repair in clean-contaminated/contaminated fields.

Evaluation of the Antimicrobial Efficacy of a Novel Rifampin/Minocycline-Coated, Noncrosslinked Porcine Acellular Dermal Matrix Compared With Uncoated Scaffolds for Soft Tissue Repair.

Background Despite meticulous aseptic technique and systemic antibiotics, bacterial colonization of mesh remains a critical issue in hernia repair. A novel minocycline/rifampin tyrosine-coated, noncrosslinked porcine acellular dermal matrix (XenMatrix AB) was developed to protect the device from microbial colonization for up to 7 days. The objective of this study was to evaluate the in vitro and in vivo antimicrobial efficacy of this device against clinically isolated methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli.

Development of a novel murine model for treatment of infected mesh scenarios.

Background: Indications regarding hernia repair after removal of previously infected prostheses remain unclear. Patients may receive staged primary repair or single-stage reconstructions, neither of which may be ideal. Although animal models have simulated contamination by direct inoculation of implants with bacteria, there remains a paucity of literature, which simulates a field following mesh infection and removal.

Outcomes of Retromuscular Porcine Biologic Mesh Repairs Using Transversus Abdominis Release Reconstruction.

Background: Optimal mesh reinforcement and operative technique for major abdominal wall reconstructions (AWR) remain debatable. Posterior component separation via transversus abdominis release (TAR) allows for wide sublay mesh reinforcement with durable reconstruction, and has been gaining popularity in recent years. Although biologic mesh has been associated with mixed results, outcomes of AWR with bioprosthetics have not been well elucidated to date.

Outcomes of Retromuscular Approach for Abdominal Wall Reconstruction in Patients with Inflammatory Bowel Disease.

Ventral hernia repair (VHR) in patients with inflammatory bowel disease (IBD) presents unique surgical challenges including impaired wound healing, concomitant intestinal operations, along with likely future abdominal surgeries. Appropriate techniques and mesh choices in these patients remain under active debate. Herein we report our experience with using a retromuscular approach for major VHR in a consecutive cohort of IBD patients.