Due to its aggressive nature and low survival rate, esophageal cancer is one of the deadliest cancer. While the intestinal microbiome significantly influences human health and disease. This research aimed to investigate and characterize the relative abundance of intestinal bacterial composition in esophageal cancer patients. The fecal samples were collected from esophageal cancer patients (n = 15) and healthy volunteers (n = 10). The PCR-DGGE was carried out by focusing on the V3 region of the 16S rRNA gene, and qPCR was performed for Bacteroides vulgatus, Escherichia coli, Bifidobacterium, Clostridium leptum and Lactobacillus. High-throughput sequencing of the 16S rRNA gene targeting the V3+V4 region was performed on 20 randomly selected samples. PCR-DGGE and High-throughput diversity results showed a significant alteration of gut bacterial composition between the experimental and control groups, which indicates the gut microbial dysbiosis in esophageal cancer patients. At the phylum level, there was significant enrichment of Bacteroidetes, while a non-significant decrease of Firmicutes in the experimental group. At family statistics, a significantly higher level of Bacteroidaceae and Enterobacteriaceae, while a significantly lower abundance of Prevotellaceae and Veillonellaceae were observed. There was a significantly high prevalence of genera Bacteroides, Escherichia-Shigella, while a significantly lower abundance of Prevotella_9 and Dialister in the experimental group as compared to the control group. Furthermore, the species analysis also showed significantly raised level of Bacteroides vulgatus and Escherichia coli in the experimental group. These findings revealed a significant gut microbial dysbiosis in esophageal cancer patients. So, the current study can be used for the understanding of esophageal cancer treatment, disease pathway, mechanism, and probiotic development.

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Introduction: Major depressive disorder (MDD) often goes unrecognized in cancer patients. Some symptoms of major depression mimic signs and symptoms of malignancy due to which it often remains under-diagnosed. Depression has a contributing role in increasing the morbidity of cancer patients which if diagnosed and managed early in the treatment course can have a positive impact on cancer patients. This study focuses on determining the prevalence of major depression among cancer patients admitted in a tertiary care hospital in Lahore, Pakistan. Place & Duration: Mayo Hospital, Lahore. (March 01-30, 2019). Methods: After project approval and consent, a total of 187 patients were recruited in the study. Selection was made based on predefined criteria. Patients ranging between age group of 14-80 years in Mayo Hospital Lahore, Pakistan were included. Interviews were conducted through a pretested questionnaire based on DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) criteria. Data was analyzed with Stata version 13. Patients were considered to be having major depressive disorder if they fulfill DSM-5 criteria for MDD; they must have 5 or more out of following 9 symptoms for ≥2 weeks: low mood, sleep disturbance (insomnia/hypersomnia), loss of interest in daily activities (anhedonia), feelings of guilt, low energy, loss of concentration, appetite changes (increased or decreased), psychomotor agitation/retardation and suicidal ideation. Symptoms should cause significant distress or impairment in social, occupational or other important areas of normal functioning and should not be attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition. The disturbance is not better explained by persistent psychiatric or psychotic disorders like schizophrenia, schizoaffective disorder, delusional disorder or other specified or unspecified schizophrenia spectrum and other psychotic disorders. Patients should not be currently on anti-depressants for any reason. Objectives: To determine the prevalence of major depression among cancer patients. Design: Cross-sectional study. Results: Out of 187 patients (171 in-patient, 16 outpatient), 116 (62%) were males and 71 (38%) were females with mean age of 44 years (SD±17.2). Descriptive analysis shows that 61 (33%) had hematological and 126 (67%) patients had non-hematological malignancies. 110 (59%) patients had low mood, 108 (57.7%) had insomnia, 77 (41%) lost interest in daily activities, 39 (21%) had feelings of guilt, 60 (32%) reported low energy, 13 (07%) were irritable, 120 (64%) noted decrease in appetite, 2 (1.0%) patients had suicidal ideation (not active). Seventy (37.4%) patients fulfilled the criteria to be clinically declared as suffering from major depression. Only 13 (7%) patients had prior knowledge of major depression. All variables showed positive correlation with MDD (ranging between +0.021 to +0.66) except hematological malignancies which were negatively correlated (-0.426). Regression analysis shows that patients having non-hematological malignancies were more likely to have MDD than hematological malignancies (Odds ratio [OR]: 25.07; 95% CI: 7.4-84.7; p<0.001). Stage 3 cancer patients had more odds to have MDD as compared to stage ≤2 (OR: 10.06; 95% CI: 1.17-85.7; p<0.01) and stage 4 cancer patients had even higher odds to be suffering from MDD in comparison to stage ≤2 (OR: 24.6; 95% CI: 2.8-214; p<0.01). Using PASS version 11; 95% CI, with 187 cancer patients, effect size of 0.502 with 1 df (degree of freedom), calculated power of this study is approximately 100%. The effect cells were calculated using cross table made between cancer classification and MDD (Table 2). Conclusion: Major depression is fairly prevalent but under recognized among cancer patients in Pakistani population. Patients having advanced non-hematological malignancies are more likely to have major depression as compared to other malignancy groups. Higher the cancer stage; higher the odds to have MDD. High clinical suspicion, appropriate questioning and psychiatry consultation should be routinely asked if there is high suspicion. Only few patients had the prior knowledge about depression so patients need to be screened and counseled regarding their symptoms and treatment should be tailored accordingly. Disclosures Anwer: In-Cyte: Speakers Bureau; Seattle Genetics: Membership on an entity's Board of Directors or advisory committees.

Low-frequency wideband noise reduction has posed a significant problem to the scientific and technical communities in recent years. A single layer of a parallel-arranged inhomogeneous micro-perforated panel (iMPP) coupled with spider-web designed cavities is offered as a composite acoustic structure in this paper. Three different spider-web shapes have been designed and studied, i.e. circular, octagonal, and square. By controlling the different inhomogeneous patterns, perforation ratio, the thickness of iMPP, and back cavity depths, a broader multipeak low-frequency sound-absorbing performance equivalent to different resonant frequencies can be achieved. To anticipate the sound absorption coefficient of the new design, both theoretical analysis and finite-element method (FEM) simulation are executed. The predicted and FEM simulation sound absorption results of the new composite structure are verified in the experimental investigation using a square-designed sound impedance tube. By a subwavelength thickness of just 100 mm, a highly effective low-frequency broadband sound-absorbing composite structure is successfully attained by integrating many inhomogeneous MPP unit cells supported with spider-web-designed cavities. The average sound absorption coefficient is over 90% ( α = 0.94) within the bandgap of 230 Hz to 470 Hz. Compared to traditional sound-absorbing materials, the composite structure comprises inhomogeneous MPP coupled with spider-web-designed cavities, which may provide good absorption performance while maintaining a modest and robust construction for active low-frequency noise suppression.

Shell and tube heat exchanger (STHX) is an implement that has tremendous applications in numerous industrial processes and research areas. In this study, the commercial software ANSYS is used for 3-D computational fluid dynamics (CFD) to compare the thermo-hydraulic performance of STHXs with recently developed tri-angular (TRI) baffles, and tri-flower (TF) baffles with conventional segmental (SG) baffles at different flow rates. Simulations have been performed to analyze the heat transfer coefficient, pressure drop, and overall thermo-hydraulic performance among the recently developed TRI-STHX, TF-STHX and conventional SG-STHX. The thermo-hydraulic performance of the numerical model of SG-STHX shows the promising results while validating it with the experimental results, Esso and Kern methods. Then the same study is carried out for comparing the two novel baffles with segmental baffle. The results depict that, novel baffles are much appreciable in increasing heat transfer coefficient. The TF-STHX offers a greater heat transfer coefficient than all others but also offers a higher pressure drop at the same flow rate. Computing the comprehensive performance (hs??p), the TRI-STHX offers a prominent increment in thermo-hydraulic performance compared to others. Moreover by inserting twisted tapes at the tube side, there is noticeable increase in heat transfer coefficient which tends to increase the thermo-hydraulic performance of STHX. By comparing the flow patterns of TRI-STHX and SG-STHX, the novel TRI-STHX shows the reduction in shell-side induced vibrations and hence helped to increase the overall efficiency of the STHX.