Measurement of energy and directional distribution of neutron ambient dose equivalent for the 7Li(p,n)7Be reaction

Double differential neutron fluence distributions were measured in the 7Li(p,n)7Be reaction for proton beam energies 7, 9 and 12 MeV. Seven liquid scintillator based detectors were employed to measure neutron fluence distributions using the Time of Flight technique. Neutron ambient dose equivalents were determined from the measured fluence distribution using ICRP (International Commission on Radiological Protection) recommended fluence to dose equivalent conversion coefficients. Neutron dose equivalents were also measured using a conventional BF3 detector based REM counter. Ambient dose equivalent measured by the REM counter is found to be in agreement with that determined from the neutron fluence spectra within their uncertainties. Angular distributions of the ambient dose equivalents were also determined from the measured fluence distributions at different angles.

Fe(III) cross-linked cellulose-agar hydrogel beads for efficient phosphate removal from aqueous solutions

Fe(III) cross-linked cellulose agar beads (Fe-CLCAB) were synthesized by sol-gel method and employed as adsorbents for the removal of phosphate ions from aqueous medium. The synthesized Fe-CLCAB was characterized by its swelling property, Fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM), and UV-Vis absorption spectroscopic analysis. Batch adsorption studies were carried out to find out the optimum conditions of phosphate uptake. The adsorption process was found to fit both Langmuir and Freundlich adsorption isotherm model, pseudo-second-order kinetic model, and Elovich kinetic model. Ninety-four percent phosphate adsorption was achieved with 500 beads at pH 5. Maximum monolayer adsorption capacity was 73.13 mg/g. A two-step elution process using sodium chloride solution was suitable for complete desorption of phosphate from Fe-CLCAB. Six cyclic adsorption-desorption tests were conducted using a 0.1 M NaCl solution as desorbing agent. The removal efficiency of regenerated Fe-CLCAB was 42% of its original value after six cycles, which validates good stability and effectiveness of the prepared hydrogel beads. Ion exchange plays a vital role during adsorption/desorption of phosphate.

Practical Guide to Measuring Wetland Carbon Pools and Fluxes

Wetlands cover a small portion of the world, but have disproportionate influence on global carbon (C) sequestration, carbon dioxide and methane emissions, and aquatic C fluxes. However, the underlying biogeochemical processes that affect wetland C pools and fluxes are complex and dynamic, making measurements of wetland C challenging. Over decades of research, many observational, experimental, and analytical approaches have been developed to understand and quantify pools and fluxes of wetland C. Sampling approaches range in their representation of wetland C from short to long timeframes and local to landscape spatial scales. This review summarizes common and cutting-edge methodological approaches for quantifying wetland C pools and fluxes. We first define each of the major C pools and fluxes and provide rationale for their importance to wetland C dynamics. For each approach, we clarify what component of wetland C is measured and its spatial and temporal representativeness and constraints. We describe practical considerations for each approach, such as where and when an approach is typically used, who can conduct the measurements (expertise, training requirements), and how approaches are conducted, including considerations on equipment complexity and costs. Finally, we review key covariates and ancillary measurements that enhance the interpretation of findings and facilitate model development. The protocols that we describe to measure soil, water, vegetation, and gases are also relevant for related disciplines such as ecology. Improved quality and consistency of data collection and reporting across studies will help reduce global uncertainties and develop management strategies to use wetlands as nature-based climate solutions.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13157-023-01722-2.

Verifiable, Secure Mobile Agent Migration in Healthcare Systems Using a Polynomial-Based Threshold Secret Sharing Scheme with a Blowfish Algorithm

A mobile agent is a software application that moves naturally among hosts in a uniform and non-uniform environment; it starts with one host and then moves onto the next in order to divide data between clients. The mobile paradigm is utilized in a wide assortment of medical care applications such as the medical information of a patient, the recovery of clinical information, the incorporation of information pertaining to their wellbeing, dynamic help, telemedicine, obtaining clinical data, patient administration, and so on. The accompanying security issues have grown in tandem with the complexity and improvements in mobile agent technologies. As mobile agents work in an insecure environment, their security is a top priority when communicating and exchanging data and information. Data integrity, data confidentiality and authentication, on-repudiation, denial of service, and access control, are all key security concerns with mobile agent migration. This paper proposes a Verifiable, Secure Mobile Agent Migration model, based on two polynomials (t, n), and an edge secret imparting plan with Blowfish encryption, to enable secure information transmission in clinical medical care.

Early arrivals: association of maternal obstetric factors with preterm births and their survival in India

OBJECTIVES

Preterm birth (PTB) increases the risk of various acute and chronic morbidities and premature mortality in children under 5 years of age. The present study examines the association between different maternal obstetric factors and PTB. In addition, this study estimates the risk of neonatal mortality among children born preterm.

STUDY DESIGN

Retrospective two-stage stratified sample design.

METHODS

The weighted prevalence of PTB was estimated using data on 148,746 most recent institutional births from the National Family Health Survey (NFHS)-4, 2015-16. The Poisson regression model was used to investigate the association between maternal obstetric factors and PTB. Using Cox's proportional hazard model, the risk of neonatal mortality among PTBs was estimated.

RESULTS

Maternal obstetric factors, such as minimal antenatal care, delivery complications, history of previous caesarean delivery and delivery at private health facilities, were significantly associated with an increased risk of PTB. The survival probability of preterm babies sharply declined in the first week of life and thereafter was found to stabilise. The risk of mortality in the first 28 days of life increased 2.5-fold if the baby was born preterm. Optimising antenatal care was found to lower the likelihood of PTB and improve their chances of survival.

CONCLUSION

Antenatal care services and delivery care practices in private facilities were strongly associated with the incidence and survival of PTB. Evaluating associations of history of caesarean births on future pregnancies can help understand their deleterious effects on PTB. Affordable, accessible and available antenatal care services, in both public and private facilities, can increase the survival rates of PTBs.

Role of abiotic factors in enhancing the capacity of mangroves in reducing ocean acidification

The present study investigated the effects of rising carbon dioxide levels in nature and the carbon sequestration potential of dominant mangrove species for reducing the toxic effects of ocean acidification. The study was conducted on the east coast of Odisha, in the western Bay of Bengal. To determine the effect of these ambient parameters on the absorption of carbon dioxide by the mangroves, water temperature, salinity, pH levels of seawater along with soil texture and pH, salinity expressed in electrical conductivity, compactness expressed in bulk density, and soil organic carbon were simultaneously monitored. The aboveground biomass and carbon of the selected species were studied for 2 consecutive years at 10 designated stations. The total carbon calculated for the study area varied from 242.50 ± 49.00 to 1321.29 ± 445.52 tons with a mean of 626.68 ± 174.81 tons for Bhitarkanika and Mahanadi mangrove chunks. This is equivalent to 2299.92 ± 641.55 tons of CO₂ absorbed from the atmosphere. A total of 27 equations were selected as the best fit models for the study area. The equations between mangrove biomass and carbon along with aquatic and edaphic factors governing the pH of water and soil strongly support the positive influence of mangrove photosynthetic activity in shifting the equilibrium toward alkalinity. This calls for conservation of mangrove ecosystem to minimize the pace of acidification of estuarine water. The results indicate that Excoecariaagallocha and Avicennia marina as are the most capable species for combatting maximum carbon dioxide toxicity from the atmosphere; which will be helpful in REDD + programs and carbon-based payments for ecosystem services (PES).

P–391 Role of subcutaneous granulocyte colony-stimulating factor infusion in thin endometrium

Study question

To assess the role of subcutaneous granulocyte colony-stimulating factor (G-CSF) in thin endometrium cases.

Summary answer

G CSF has beneficial role to improve the endometrium thickness in thin endometrium.

What is known already

Endometrium is very important for embryo implantation and the endometrial thickness is the marker of receptivity of the endometrium.

Study design, size, duration

Study design - Retrospective analysis

Size - 88 infertile females with thin endometrium (< 7 mm) in the age group of 23 to 40 years Duration - one year.

Participants/materials, setting, methods

In the group 1 of 44 females, subcutaneous infusion of G CSF (300 mcg/ml) was added along with other supplements and if lining was not more than 7 mm in 72 hours, then second infusion was given. In the group 2 of 44 females, only estradiol valerate and sildenafil were given.The efficacy of G CSF was evaluated by assessing the endometrium thickness before embryo transfer, pregnancy rates and clinical pregnancy rates.

Main results and the role of chance

There was no difference between the two groups regarding demographic variables, egg reserve, sperm parameters, number of embryos transferred and embryo quality. . The pregnancy rate was 60% (24 out of 40 cases) in the group 1 that was significantly higher than in-group 2 that was 31% (9 out of 29 cases) with p value < 0.0001. The clinical pregnancy rate was also significantly higher in-group 1 (55%) as compared to group 2 (24%) with p value < 0.0001.

Limitations, reasons for caution

Further larger cohort studies are required to explore the subcutaneous role of G CSF in thin endometrium.

Wider implications of the findings: Granulocyte colony-stimulating factor has beneficial role to improve the endometrium thickness in thin endometrium. In most of previous studies, the intrauterine infusion of G CSF was given to improve the uterine lining. This is one of the few studies done that showed subcutaneous role of G CSF in thin endometrium.

Trial registration number

Not applicable

Pro-poor policies and improvements in maternal health outcomes in India

BACKGROUND

Since 2005, India has experienced an impressive 77% reduction in maternal mortality compared to the global average of 43%. What explains this impressive performance in terms of reduction in maternal mortality and improvement in maternal health outcomes? This paper evaluates the effect of household wealth status on maternal mortality in India, and also separates out the performance of the Empowered Action Group (EAG) states and the Southern states of India. The results are discussed in the light of various pro-poor programmes and policies designed to reduce maternal mortality and the existing supply side gaps in the healthcare system of India. Using multiple sources of data, this study aims to understand the trends in maternal mortality (1997-2017) between EAG and non EAG states in India and explore various household, economic and policy factors that may explain reduction in maternal mortality and improvement in maternal health outcomes in India.

METHODS

This study triangulates data from different rounds of Sample Registration Systems to assess the trend in maternal mortality in India. It further analysed the National Family Health Surveys (NFHS). NFHS-4, 2015-16 has gathered information on maternal mortality and pregnancy-related deaths from 601,509 households. Using logistic regression, we estimate the association of various socio-economic variables on maternal deaths in the various states of India.

RESULTS

On an average, wealth status of the households did not have a statistically significant association with maternal mortality in India. However, our disaggregate analysis reveals, the gains in terms of maternal mortality have been unevenly distributed. Although the rich-poor gap in maternal mortality has reduced in EAG states such as Bihar, Odisha, Assam, Rajasthan, the maternal mortality has remained above the national average for many of these states. The EAG states also experience supply side shortfalls in terms of availability of PHC and PHC doctors; and availability of specialist doctors.

CONCLUSIONS

The novel contribution of the present paper is that the association of household wealth status and place of residence with maternal mortality is statistically not significant implying financial barriers to access maternal health services have been minimised. This result, and India's impressive performance with respect to maternal health outcomes, can be attributed to the various pro-poor policies and cash incentive schemes successfully launched in recent years. Community-level involvement with pivotal role played by community health workers has been one of the major reasons for the success of many ongoing policies. Policy makers need to prioritise the underperforming states and socio-economic groups within the states by addressing both demand-side and supply-side measures simultaneously mediated by contextual factors.

Aberrant CREB1 activation in prostate cancer disrupts normal prostate luminal cell differentiation

The molecular mechanisms of luminal cell differentiation are not understood well enough to determine how differentiation goes awry during oncogenesis. Using RNA-Seq analysis, we discovered that CREB1 plays a central role in maintaining new luminal cell survival and that oncogenesis dramatically changes the CREB1-induced transcriptome. CREB1 is active in luminal cells, but not basal cells. We identified ING4 and its E3 ligase, JFK, as CREB1 transcriptional targets in luminal cells. During luminal cell differentiation, transient induction of ING4 expression is followed by a peak in CREB1 activity, while JFK increases concomitantly with CREB1 activation. Transient expression of ING4 is required for luminal cell induction; however, failure to properly down-regulate ING4 leads to luminal cell death. Consequently, blocking CREB1 increased ING4 expression, suppressed JFK, and led to luminal cell death. Thus, CREB1 is responsible for the suppression of ING4 required for luminal cell survival and maintenance. Oncogenic transformation by suppressing PTEN resulted in constitutive activation of CREB1. However, the tumor cells could no longer fully differentiate into luminal cells, failed to express ING4, and displayed a unique CREB1 transcriptome. Blocking CREB1 in tumorigenic cells suppressed tumor growth in vivo, rescued ING4 expression, and restored luminal cell formation, but ultimately induced luminal cell death. IHC of primary prostate tumors demonstrated a strong correlation between loss of ING4 and loss of PTEN. This is the first study to define a molecular mechanism whereby oncogenic loss of PTEN, leading to aberrant CREB1 activation, suppresses ING4 expression causing disruption of luminal cell differentiation.

An epidemic of avoidable caesarean deliveries in the private sector in India: Is physician-induced demand at play?

PURPOSE AND SETTING OF RESEARCH

Caesarean section (C-section) rates of over 15% suggest overuse of the surgery which may be difficult to justify on medical grounds. One important contributor to the rise in Csection rates is the rapid expansion of unregulated private-sector providers in number of settings. This study analyses the contribution of private sector in the rapid rise in Csection deliveries in India and the extent to which these can be justified on medical grounds.

METHODS

This is a cross sectional study design using National Family Health Surveys. Logistic regression and propensity score matching (PSM) analyses are performed. The main outcome measured is avoidable C-sections in the private sector.

PRINCIPAL FINDINGS

Our findings suggest that the rising trend in C-section rates in the private sector cannot be explained by medical reasons alone. The odds of C-section among women who chose to deliver in private was over 4 times higher than women who chose to delivery in public facilities. Despite, controlling for medical complications, women's characteristics and preferences, our PSM analysis suggest that the public-private gap has doubled over the years and that the difference cannot be explained by known determinants of C-section. Over supply of avoidable C-section to the extent of 21%, as a result of physician induced demand and perverse financial incentives was observed in the private sector.

CONCLUSIONS

This paper attempts to understand the reason for the high C-section rates in the private sector in India and the extent to which these are avoidable. Our analysis supports the assumption that physician induced demand as a result of perverse financial incentives in the private sector is at play.

A Survey on Fatigue Detection of Workers Using Machine Learning

In the software industry, where the quality of the output is based on human performance, fatigue can be a reason for performance degradation. Fatigue not only degrades quality, but is also a health risk factor. Sleep disorders, depression, and stress are all results of fatigue which can contribute to fatal problems. This article presents a comparative study of different techniques which can be used for detecting fatigue of programmers and data miners who spent lots of time in front of a computer screen. Machine learning can used for worker fatigue detection also, but there are some factors which are specific for software workers. One of such factors is screen illumination. Screen illumination is the light of the computer screen or laptop screen that is casted on the workers face and makes it difficult for the machine learning algorithm to extract the facial features. This article presents a comparative study of the techniques which can be used for general fatigue detection and identifies the best techniques.

Carbon storage potential of tropical wetland forests of South Asia: a case study from Bhitarkanika Wildlife Sanctuary, India

Mangroves are halophytic vegetation comprising the tropics. Bhitarkanika Wildlife Sanctuary, being a local hotspot of mangrove, acts as carbon sink for mitigating increased CO₂ level in the atmosphere. The study estimated total biomass and total carbon in five selected stations of this Wildlife Sanctuary in reference to relevant ambient parameters of water (temperature, pH, and salinity) and soil (temperature, pH, electrical conductivity, bulk density, organic carbon, organic matter, and texture) seasonally. The average values for total biomass and total carbon measured in this study are 866.67 ± 166.10 t ha^-1 and 444.68 ± 83.70 t ha^-1, respectively. The average soil organic carbon recorded was 3.73 ± 2.10 t ha^-1 and average litter carbon was 0.59 ± 0.20 t ha^-1, respectively. Among the components, above-ground biomass constitutes 55-70% of total biomass and total carbon. Significant positive relationship between biomass (above-ground biomass, below-ground biomass, litter biomass, total biomass) and carbon (above-ground carbon, below-ground carbon, litter carbon, soil organic carbon, and total carbon) was obtained with respect to selected physico-chemical variables which proved the significant effect of change in biomass and carbon to changing parameters of the ambient media in the study area. The analysis of variance computed between season and station has also proved the above phenomenon. The study revealed the mangrove carbon storage potential of 21 mangrove species, which is at par with the biomass of South-east Asia and South west Pacific countries. Hence, mangrove conservation programs like REDD+ can be adopted in this wildlife sanctuary being the 2nd largest mangrove patch of India after Sundarbans.

Elastic Scattering and Reaction Cross-section of 8Li on 209Bi

Nuclear physics in the 21st century is driven by a quest to understand the properties of ever more exotic nuclear systems. Unusual structural phenom- ena are observed to arise in light weakly bound nuclei such as 8Li. 8Li has a cluster structure core of 7Li surrounded by a loosely bound neutron which is observed to influence reaction mechanisms near the fusion barrier. Elastic scat- tering provides a vital step towards understanding more complicated reaction mechanisms. In this work, elastic scattering was measured for 8Li + 2°9Bi at energies 2% to 34% above the barrier, allowing extraction of reaction cross- sections. The systematics of the reaction cross-sections of 8Li compared to neighbouring nuclei 6,7,9,11Li are discussed.

Mechanisms Suppressing Superheavy Element Yields in Cold Fusion Reactions

Superheavy elements are formed in fusion reactions which are hindered by fast nonequilibrium processes. To quantify these, mass-angle distributions and cross sections have been measured, at beam energies from below-barrier to 25% above, for the reactions of ^{48}Ca, ^{50}Ti, and ^{54}Cr with ^{208}Pb. Moving from ^{48}Ca to ^{54}Cr leads to a drastic fall in the symmetric fission yield, which is reflected in the measured mass-angle distribution by the presence of competing fast nonequilibrium deep inelastic and quasifission processes. These are responsible for reduction of the compound nucleus formation probablity P_{CN} (as measured by the symmetric-peaked fission cross section), by a factor of 2.5 for ^{50}Ti and 15 for ^{54}Cr in comparison to ^{48}Ca. The energy dependence of P_{CN} indicates that cold fusion reactions (involving ^{208}Pb) are not driven by a diffusion process.

Successful switch (tOPV to bOPV) in India: Tribute to a resilient health system

In accordance with the end game strategies for polio eradication a synchronized switch plan from tOPV to bOPV was implemented globally in 2016. The National Committee for Polio Eradication (NCCPE) validated the switch activities in India. An expert group of 104 academics conducted field visits in 25 states and 2 Union territories for independent verification (after an initial round of verification by the National Polio Surveillance Project [NPSP]). The objectives were to validate withdrawal and disposal of tOPV by screening cold chain points in public and private sector health facilities in both rural and urban areas; additionally, availability of bOPV and IPV was also documented. 34 filled tOPV and 5 empty vials were detected inside cold chain equipment and 17 outside. The disposal mechanism was found to be reasonably adequate. The key strategies -- 'throttling' of vaccine supplies well ahead of the switch date while preventing stock outs at various immunization points, simultaneously working with the regulators to delicense the tOPV on the switch date and helping manufacturers to calibrate vaccine production according to national timelines, and strong and persistent advocacy with professional associations to align with national bOPV and IPV policy facilitated successful accomplishment of the switch process. Effective implementation of the switch strategy in India also bears testimony to the resilience of the health system operating under diverse and heterogeneous governance.

Origins of Incomplete Fusion Products and the Suppression of Complete Fusion in Reactions of ^{7}Li

Above-barrier complete fusion involving nuclides with low binding energy is typically suppressed by 30%. The mechanism that causes this suppression, and produces the associated incomplete fusion products, is controversial. We have developed a new experimental approach to investigate the mechanisms that produce incomplete fusion products, combining singles and coincidence measurements of light fragments and heavy residues in ^{7}Li+^{209}Bi reactions. For polonium isotopes, the dominant incomplete fusion product, only a small fraction can be explained by projectile breakup followed by capture: the dominant mechanism is triton cluster transfer. Suppression of complete fusion is therefore primarily a consequence of clustering in weakly bound nuclei rather than their breakup prior to reaching the fusion barrier. This implies that suppression of complete fusion will occur in reactions of nuclides where strong clustering is present.

Optimization of beam dump shielding for K-130 cyclotron at VECC

A compact and efficient beam dump shield has been designed using Monte Carlo simulation code FLUKA to facilitate low background measurement of neutron and gamma rays using K130 cyclotron at Variable Energy Cyclotron Centre, Kolkata (VECC). Iron, lead and high density Polyethylene (HDPE) were considered in the design of the beam dump shield. Representative FLUKA simulation results have been validated using in-beam experiment performed on the same beam dump constituents. Experimental neutron and gamma-rays energy spectra have been found to be in fair agreement with the simulation results. Activation of various beam dump shield components were also carried out.

Experimental Determination of η/s for Finite Nuclear Matter

We present, for the first time, simultaneous determination of shear viscosity (η) and entropy density (s) and thus, η/s for equilibrated nuclear systems from A∼30 to A∼208 at different temperatures. At finite temperature, η is estimated by utilizing the γ decay of the isovector giant dipole resonance populated via fusion evaporation reaction, while s is evaluated from the nuclear level density parameter (a) and nuclear temperature (T), determined precisely by the simultaneous measurements of the evaporated neutron energy spectra and the compound nuclear angular momenta. The transport parameter η and the thermodynamic parameter s both increase with temperature, resulting in a mild decrease of η/s with temperature. The extracted η/s is also found to be independent of the neutron-proton asymmetry at a given temperature. Interestingly, the measured η/s values are comparable to that of the high-temperature quark-gluon plasma, pointing towards the fact that strong fluidity may be the universal feature of the strong interaction of many-body quantum systems.

Climate change-induced salinity variation impacts on a stenoecious mangrove species in the Indian Sundarbans

The alterations in the salinity profile are an indirect, but potentially sensitive, indicator for detecting changes in precipitation, evaporation, river run-off, glacier retreat, and ice melt. These changes have a high impact on the growth of coastal plant species, such as mangroves. Here, we present estimates of the variability of salinity and the biomass of a stenoecious mangrove species (Heritiera fomes, commonly referred to as Sundari) in the aquatic subsystem of the lower Gangetic delta based on a dataset from 2004 to 2015. We highlight the impact of salinity alteration on the change in aboveground biomass of this endangered species that, due to different salinity profile in the western and central sectors of the lower Gangetic plain, shows an increase only in the former sector, where the salinity is dropping and low growth in the latter, where the salinity is increasing.

SOCS3 induces neurite differentiation and promotes neuronal cell survival

Cytokines and growth factors play an important role in neuronal survival as well as cell death. The family of suppressors of cytokine signalling (SOCS) proteins, which includes SOCS1-7 and cytokine-induced suppressor (CIS), has been shown to act as negative regulators of cytokine-induced signalling. In this report, we highlight the role of SOCS3 in regulating neuronal differentiation and survival. We observed increased SOCS3 expression upon differentiation of PC12 cells as well as neural stem cells. SOCS3 overexpression upregulated differentiation of both neural stem cells and PC12 cells even in the absence of NGF, as evidenced by enhanced neurite outgrowth and upregulation of GAP43, marker associated with neurite outgrowth. siRNA-mediated silencing of SOCS3 confirmed the potential role of SOCS3 in neuritogenesis. We observed that, SOCS3-induced neurite differentiation was mediated via the PI3 kinase pathway. Another interesting observation was that SOCS3 overexpression promoted neuronal cell survival under H2 O2 -mediated stress indicating its fundamental role in cell survival. In conclusion, our results indicate that SOCS3 promotes differentiation and survival of neural cells and could be potentially useful in future therapy for treatment of neurodegenerative disorders. © 2016 IUBMB Life, 68(6):468-476, 2016.

Synthesis and Biological Studies of a Novel CB1 Antagonist

This paper describes the synthesis, early process development, salt selection strategies and pre clinical evaluation of novel, potent and selective CB1 antagonist, 8-Chloro-1-(2,4-dichloro-phenyl)-4,5-dihydro-1H-6-oxa-1,2-diaza-benzo[e]azulene-3-carboxylic acid piperidin-1-ylamide 1. The CB1 antagonism of compound 1 is also confirmed by reversal of CB1 agonist-induced hypothermia in Swiss albino mice. The process for the preparation of the compound 1 as a crystalline solid is also described. The crystalline form of the compound is found to be low bioavailable, therefore attempts have been made to improve its bioavailability through polymorphic transformation and salt formation. None of the salts prepared were found to be suitable for further development. The amorphous form of the compound 1 is found to be better suited. In vivo efficacy study of the amorphous form of compound 1 in 5% sucrose solution intake model in female Zucker fa/fa rats at single oral dose of 10 mg/kg demonstrates better reduction in the sucrose solution consumption than the corresponding crystalline form. The plasma concentration Cmax at AUC exposure of the amorphous form of the compound 1 is significantly improved and better than the Cmax of the corresponding crystalline form of the compound 1. On the basis of the efficacy, pharmacokinetic and toxicological evaluations, the compound 1 in the amorphous form is selected as a pre-clinical lead candidate.

Islet autoantibody status in a multi-ethnic UK clinic cohort of children presenting with diabetes

OBJECTIVE

We prospectively determined islet autoantibody status in children presenting with diabetes to a single UK region in relation to ethnicity.

DESIGN

316 (68.0% non-white) children presenting with diabetes between 2006 and 2013 were tested centrally for islet cell autoantibodies (ICA) and glutamic acid decarboxylase autoantibodies (GAD-65) at diagnosis, and if negative for both, tested for insulin autoantibodies (IAA). The assay used to measure GAD-65 autoantibodies changed from an in-house to a standardised ELISA method during the study.

RESULTS

Even with use of the standardised ELISA method, 25.8% of children assigned a diagnosis of type 1 diabetes still tested negative for all three autoantibodies. 30% of children assigned a diagnosis of type 2 diabetes were autoantibody positive, and these had the highest glycated haemoglobin (HbA1c) levels at 12 months follow-up compared with other groups (p value for analysis of variance <0.001), although the sample size was small. Autoantibody positivity was similar between non-white and white children regardless of assay used (60.0% (n=129) vs 56.4% (n=57), χ(2)=0.9, p=0.35), as was mean GAD-65 autoantibody levels, but fewer non-white children had two or more autoantibodies detectable (13% (n=28) vs 27.7% (n=28), χ(2)=12.1, p=0.001).

CONCLUSIONS

Islet autoantibody positivity was associated with a more severe phenotype, as demonstrated by poorer glycaemic control, regardless of assigned diabetes subtype. Positivity did not differ by ethnic group.