HIV-Differentiated Metabolite N-Acetyl-L-Alanine Dysregulates Human Natural Killer Cell Responses to Mycobacterium tuberculosis Infection

Mycobacterium tuberculosis (Mtb) has latently infected over two billion people worldwide (LTBI) and caused ~1.6 million deaths in 2021. Human immunodeficiency virus (HIV) co-infection with Mtb will affect the Mtb progression and increase the risk of developing active tuberculosis by 10-20 times compared with HIV- LTBI+ patients. It is crucial to understand how HIV can dysregulate immune responses in LTBI+ individuals. Plasma samples collected from healthy and HIV-infected individuals were investigated using liquid chromatography-mass spectrometry (LC-MS), and the metabolic data were analyzed using the online platform Metabo-Analyst. ELISA, surface and intracellular staining, flow cytometry, and quantitative reverse-transcription PCR (qRT-PCR) were performed using standard procedures to determine the surface markers, cytokines, and other signaling molecule expressions. Seahorse extra-cellular flux assays were used to measure mitochondrial oxidative phosphorylation and glycolysis. Six metabolites were significantly less abundant, and two were significantly higher in abundance in HIV+ individuals compared with healthy donors. One of the HIV-upregulated metabolites, N-acetyl-L-alanine (ALA), inhibits pro-inflammatory cytokine IFN-γ production by the NK cells of LTBI+ individuals. ALA inhibits the glycolysis of LTBI+ individuals' NK cells in response to Mtb. Our findings demonstrate that HIV infection enhances plasma ALA levels to inhibit NK-cell-mediated immune responses to Mtb infection, offering a new understanding of the HIV-Mtb interaction and providing insights into the implication of nutrition intervention and therapy for HIV-Mtb co-infected patients.

HIV-differentiated metabolite N-Acetyl-L-Alanine dysregulates human natural killer cell responses to Mycobacterium tuberculosis infection

Background

Mycobacterium tuberculosis ( Mtb ) has latently infected over two billion people worldwide (LTBI) and causes 1.8 million deaths each year. Human immunodeficiency virus (HIV) co-infection with Mtb will affect the Mtb progression and increase the risk of developing active tuberculosis by 10-20 times compared to the HIV-LTBI+ patients. It is crucial to understand how HIV can dysregulate immune responses in LTBI+ individuals.

Methods

Plasma samples collected from healthy and HIV-infected individuals were investigated by liquid chromatography-mass spectrometry (LC-MS), and the metabolic data were analyzed using an online platform Metabo-Analyst. ELISA, surface and intracellular staining, flow cytometry, quantitative reverse transcription PCR (qRT-PCR) were performed by standard procedure to determine the surface markers, cytokines and other signaling molecule expression. Seahorse extra cellular flux assays were used to measure the mitochondrial oxidative phosphorylation and glycolysis.

Results

Six metabolites were significantly less abundant, and two were significantly higher in abundance in HIV+ individuals compared to healthy donors. One of the HIV-upregulated metabolites, N-Acetyl-L-Alanine (ALA), inhibits pro-inflammatory cytokine IFN-□ production by NK cells of LTBI+ individuals. ALA inhibits glycolysis of LTBI+ individuals' NK cells in response to Mtb .

Conclusions

Our findings demonstrate that HIV infection enhances plasma ALA levels to inhibit NK cell-mediated immune responses to Mtb infection, offering a new understanding of the HIV- Mtb interaction and providing the implication of nutrition intervention and therapy for HIV- Mtb co-infected patients.

Combined in vitro and in silico approach to evaluate the inhibitory potential of an underutilized allium vegetable and its pharmacologically active compounds on multidrug resistant Candida species

Candida infections and related mortality have become a challenge to global health. Nontoxic and natural bioactive compounds from plants are regarded as promising candidates to inhibit these multidrug resistant strains. In the present study, in vitro assays and in silico molecular docking approach was combined to evaluate the inhibitory effect of crude extracts from Allium ampeloprasum and its variety A. porrum on Candida pathogens. Phytochemical screening revealed the presence of phenolic acids and flavonoids in higher quantity. Spectral studies of the extracts support the presence of phenols, flavonoids and organosulfur compounds. Aqueous extract of A. ampeloprasum showed a total antioxidant capacity of 68 ± 1.7 mg AAE/ g and an IC50 value of 0.88 ± 2.1 mg/ml was obtained for DPPH radicals scavenging assay. C. albicans were highly susceptible (19.9 ± 1.1 mm) when treated with aqueous A. ampeloprasum extract. Minimum inhibitory concentrations were within the range of 19-40 μg/ml and the results were significant (p ≤ 0.05). In silico molecular docking studies demonstrated that bioactive phytocompounds of A. ampeloprasum and A. porrum efficiently interacted with the active site of Secreted aspartyl proteinase 2 enzyme that is responsible for the virulence of pathogenic yeasts. Rosmarinic acid and Myricetin exhibited low binding energies and higher number of hydrogen bond interactions with the protein target. Thus the study concludes that A. ampeloprasum and A. porrum that remain as underutilized vegetables in the Allium genus are potential anti-candida agents and their pharmacologically active compounds must be considered as competent candidates for drug discovery.

Can Mobile Health Improve Depression Treatment Access and Adherence Among Rural Indian Women? A Qualitative Study

Major Depressive Disorder (MDD) is associated with low rates of treatment and medication non-adherence, more so in low- and middle-income countries (LMICs). Mobile mental health (mHealth) interventions offer promise as a tool to address these problems. However, the feasibility and acceptability of mHealth interventions among rural women in LMICs is unknown. We examined barriers to accessing mental health treatment, reasons for non-adherence, and attitudes towards mHealth solutions among women with MDD in rural south India. Six focus groups were conducted among women with MDD (n = 69) who had been in treatment at a rural community health center. The discussion was transcribed and analyzed using a modified grounded-theory approach. Women perceived limited autonomy within their family structure, and experienced financial and systemic barriers as contributing to poor treatment access and non-adherence. Illiteracy, limited personal access to mobile phones, and preference for in-person clinical consultation were identified as barriers to use of mHealth. This is the first qualitative study, to our knowledge, that examines attitude towards mHealth among women with MDD in a rural setting in India. The study identified contextual barriers that will be important to address before implementing mHealth interventions.

CD1a+ and CD207+ cells are reduced in oral submucous fibrosis and oral squamous cell carcinoma

Background

The objective of this study investigated the distribution of immature dendritic cells (DCs), Langerhans cells and plasmacytoid DCs in oral submucous fibrosis (OSMF), OSMF associated with oral squamous cell carcinoma (OSMF-OSCC), oral leukoplakia (OL), and oral squamous cell carcinoma (OSCC).

Material and Methods

Fourteen cases of OSMF, 9 of OSMF-OSCC, 8 of OL¸ 45 of OSCC and 8 of normal epithelium were retrospectively retrieved and their diagnoses confirmed. Immunoreactions against CD1a, CD207 e CD303 were performed and the number of positive cells quantified.

Results

A significant decrease of CD1a+ was found in OSMF (p≤0.05), OSMF-OSCC (p ≤ 0.01), and OSCC (p ≤ 0.001) when compared to normal epithelium. For CD207+ the significance decrease was observed in OSMF-OSCC (p ≤ 0.05), and OSCC (p ≤ 0.01) when compared with normal epithelium, and in OSMF when compared with OL (p ≤ 0.05). There was no significant difference for CD303, but increased in CD303+ was observed in OSCC when compared with normal epithelium.

Conclusions

The decrease in the number of CD1a+ and CD207+ cells may be associate to the development of oral OSCC, and in OPMDs they might be indicators of malignant transformation.

Key words:Premalignant lesions, oral submucous fibrosis, oral squamous cell carcinoma, immune response.

Wavefront sensing applied to determine the temperature dependence of the refractive index of liquids

A method based on wavefront sensing is described to determine the temperature dependence of the refractive index of liquids. The technique only implies measuring the wavefront of a light beam passing through a micro-vessel containing the liquid. Here, this vessel is a crater made by CO₂ laser processing in a fused silica plate. From the wavefront analysis, the optical path that is related to the refractive index of the liquid can be determined. This measurement can be done at different temperatures to obtain the temperature dependence of the refractive index. This method is applied to three liquids: water, ethanol, and cyclohexane at λ=630  nm. The results show a linear dependence in the range of 17°C-50°C and give coefficients dndT that are in good agreement with values from the literature.

Generating multibreather vector solitons by influencing the Manakov model and its modified forms with the linear self and cross coupling parameters

We have realized for the first time the multibreather vector multi-solitons supporting collision dynamics with many interaction effects (namely reflection, attraction, beating, etc., effects) associated with the coupled nonlinear Schrödinger family equations having multiple applications. Such effects can be suppressed or enhanced by using the soliton parameters. Here each colliding multibreather vector one-soliton is composed with many soliton and antisoliton parts. Our solutions have freedom to control the number of soliton and antisoliton parts used to compose a vector one-soliton with a definite breathing length. It is also interesting to observe that the breathing maps associated with the obtained solutions depend on their free parameters and also the system parameters. All such investigations help us to realize different breathing mechanisms (namely pedaling, toggling, symmetric compression, symmetric elongation, asymmetric compression, asymmetric elongation, etc.) supported by the colliding one-solitons. An existing breathing mechanism of a given vector breather one-soliton can be suppressed or switched into another mechanism by tuning certain parameters appropriately. Because of such features we believe that this kind of study will further give impetus on the Lindner-Fedyanin system in the continuum limit, and find the potential applications in fiber coupler and also in Bose-Einstein condensates.

Hypolipidemic Effect of Psidium guajava Leaf Extract Against Hepatotoxicity in Rats

BACKGROUND

Plant-based natural extracts cure several diseases in human. However, the extract of Psidium guajava leaf is not yet evaluated on changes of lipid profile in hepatic disease affected rats.

OBJECTIVE

The present study was aimed to evaluate the mitigation effect of the ethanolic extract of P. guajava leaf and its isolated quercetin fraction on hepatotoxic rats.

MATERIALS AND METHODS

Carbon tetrachloride (CCl4) was injected to rats for hepatic disease induction and silymarin drug was used as positive control to compare plant ethanolic extract. The lipid profiles were assessed in both plasma and liver tissue of diseased and control rats.

RESULTS

Levels of total cholesterol, triglycerides, free fatty acids, phospholipids, and low-density lipoprotein cholesterol were increased and the level of high-density lipoprotein cholesterol (HDL-C) was decreased in CCl4-induced hepatotoxic rats. The treatment of P. guajava (100, 200, and 300 mg/kg, bw) and isolated quercetin fraction (20 mg/kg, bw) doses decreased the elevated levels of all these parameters in diseased rats and restored the normal concentration of HDL-C.

CONCLUSION

The results of the present study concluded that the P. guajava leaf and its isolated quercetin fraction can significantly regulate lipid metabolism in CCl4-induced hepatotoxic rats and decrease the disease rate.

SUMMARY

Psidium guajava leaf extract reduces the hepatotoxicity and disease rate in ratsQuercetin fraction of leaf extract significantly regulates lipid profile in hepatic diseased rats. Abbreviations used: CCl4: Carbon tetrachloride; FFA: Free fatty acids; HDL-C: High-density lipoprotein cholesterol; LCAT: Lecithin cholesterol acyltransferase; LDL-C: Low-density lipoprotein cholesterol; PL: Phospholipids; TC: Total cholesterol; TG: Triglycerides; VLDL-C: Very low-density lipoprotein cholesterol.

Prenatal Factors Associated with Postnatal Brain Injury in Infants with Congenital Diaphragmatic Hernia

BACKGROUND AND PURPOSE

Approximately 60% of infants with congenital diaphragmatic hernia have evidence of brain injury on postnatal MR imaging. It is unclear whether any brain injury is present before birth. In this study, we evaluated fetal MR imaging findings of brain injury and the association of congenital diaphragmatic hernia severity with postnatal brain injury.

MATERIALS AND METHODS

Fetal MR imaging and postnatal brain MR imaging were retrospectively evaluated in 36 cases of congenital diaphragmatic hernia (from 2009 to 2014) by 2 pediatric neuroradiologists. Brain injury on postnatal MR imaging and brain injury and congenital diaphragmatic hernia severity on fetal MR imaging were recorded. Correlations between brain abnormalities on fetal and postnatal brain MR imaging were analyzed. Postnatal brain injury findings correlating with the severity of congenital diaphragmatic hernia were also assessed.

RESULTS

On fetal MR imaging, enlarged extra-axial spaces (61%), venous sinus distention (21%), and ventriculomegaly (6%) were identified. No maturational delay, intracranial hemorrhage, or brain parenchymal injury was identified on fetal MR imaging. On postnatal MR imaging, 67% of infants had evidence of abnormality, commonly, enlarged extra-axial spaces (44%). Right-sided congenital diaphragmatic hernia was associated with a greater postnatal brain injury score (P = .05). Low observed-to-expected lung volume was associated with postnatal white matter injury (P = .005) and a greater postnatal brain injury score (P = .008). Lack of liver herniation was associated with normal postnatal brain MR imaging findings (P = .03).

CONCLUSIONS

Fetal lung hypoplasia is associated with postnatal brain injury in congenital diaphragmatic hernia, suggesting that the severity of lung disease and associated treatments affect brain health as well. We found no evidence of prenatal brain parenchymal injury or maturational delay.

Efficacy of corrective exercise strategy in subjects with hyperkyphosis

BACKGROUND

Age-related hyperkyphosis causes deleterious effects on health, physical function, and quality of life. Recently, health care providers recognized it as a major health concern.

OBJECTIVE

To identify the effect of corrective exercise strategy on hyperkyphosis and compare it with that of conventional exercise.

METHODS

Subjects were randomly categorized into two groups. Each group comprised 30 subjects. Group A received the corrective exercise strategy, and group B received conventional exercises for 8 weeks of the study duration (15 repetitions of each exercise for three sessions/day for a total duration of 45 min and 4 days/week. Pre- and post-interventional hyperkyphosis were analyzed according to posture number using the Posture Pro 8 postural analysis software. In addition, pectoralis minor flexibility was assessed using the ruler scale method in centimeters.

RESULTS

Both groups showed highly significant postural alteration and changes in pectoralis minor muscle length (p< 0.001)CONCLUSIONS:The corrective exercise strategy seems to promote scapular stability and produce a more upright posture of the upper thoracic spine.

Implication of Posture Analysing Software to Evaluate the Postural Changes after Corrective Exercise Strategy on Subjects with Upper Body Dysfunction-A Randomized Controlled Trial

INTRODUCTION

The postural adaptation is very common now a days in school going children, office desk oriented job, computer users and frequent mobile users, and in all major industrial workers. Several studies have documented a high incidence of postural abnormalities in a given population; however, methods of postural measurement were poorly defined. The implication of postural pro software to analyse the postural imbalance of upper body dysfunction is very rare and literature studies says that the kinematic changes in particular segment will produce pain/discomfort and thereby lesser productivity of subjects.

AIM

To evaluate the postural changes in subjects with upper body dysfunction after a corrective exercise strategy using postural analysis software and pectoralis minor muscle length testing.

MATERIALS AND METHODS

After explaining the procedure and benefits, informed consent was taken from the participating subjects (age 25-55 years). Subjects with upper body dysfunction were randomly allocated into two groups (each group 30 subjects). The Group-A received the corrective exercise strategy and Group-B received the conventional exercise for eight weeks of study duration (15 reps each exercise, total duration of 40 min; four days/week. Pre and Post posture analysis were analysed using posture pro software along with flexibility of pectoralis minor was assessed using ruler scale method.

RESULTS

After interpretation of data, both the group showed the postural alteration and pectoralis minor muscle length changes, p-value (p<0.01) of both group showed highly significant changes. But comparing the both groups, the subjects who received the corrective exercise strategy shown more percentage of improvement in posture alteration (56.25%), pectoralis minor muscle length changes (68.69%) than the conventional exercise received subjects in posture alteration (24.86%) and pectoralis minor muscle length changes (21.9%).

CONCLUSION

Altered postural changes and pectoralis minor muscle flexibility before and after the corrective exercise strategy evaluated by postural analysis software method shown to be a significant tool in clinical practice, which is easier and reproducible method.

Motion of a nano-spheroid in a cylindrical vessel flow: Brownian and hydrodynamic interactions

We study the motion of a buoyant or a nearly neutrally buoyant nano-sized spheroid in a fluid filled tube without or with an imposed pressure gradient (weak Poiseuille flow). The fluctuating hydrodynamics approach and the deterministic method are both employed. We ensure that the fluctuation-dissipation relation and the principle of thermal equipartition of energy are both satisfied. The major focus is on the effect of the confining boundary. Results for the velocity and the angular velocity autocorrelations (VACF and AVACF), the diffusivities and the drag and the lift forces as functions of the shape, the aspect ratio, the inclination angle and the proximity to the wall are presented. For the parameters considered, the boundary modifies the VACF and AVACF such that three distinct regimes are discernible - an initial exponential decay followed by an algebraic decay culminating in a second exponential decay. The first is due to the thermal noise, the algebraic regime is due both to the thermal noise and the hydrodynamic correlations, while the second exponential decay shows the effect of momentum reflection from the confining wall. Our predictions display excellent comparison with published results for the algebraic regime (the only regime for which earlier results exist). We also discuss the role of the off-diagonal elements of the mobility and the diffusivity tensors that enable the quantifications of the degree of lift and margination of the nanocarrier. Our study covers a range of parameters that are of wide applicability in nanotechnology, microrheology and in targeted drug delivery.

Osteoporotic fractures in patients with systemic lupus erythematosus and end stage renal disease

Background The incidence of end stage renal disease (ESRD) in patients with systemic lupus erythematosus (SLE) is rising. However, the relationship between osteoporotic fractures and SLE in the setting of ESRD remains uninvestigated. The purpose of this study was to compare the frequency of incident osteoporotic fractures in patients with ESRD with and without SLE, to identify risk factors for fractures in patients with SLE and ESRD, and to examine the contribution of these fractures to mortality. Methods Retrospective cohort study of patients with SLE ( n = 716) and a 5% random sample of controls without SLE ( n = 4176) in the United States Renal Data System (USRDS) from years 2006-2008 enrolled in Medicare Part D. Results Fractures occurred in 10.6% ( n = 76) of patients with SLE and ESRD and 12.1% ( n = 507) of patients with ESRD without SLE ( p = 0.24). Older age (adjusted relative risk 1.02, 95% confidence interval 1.01-1.04) was associated with an increased risk for fracture in patients with SLE and ESRD. In multivariable analyses, vertebral and hip fractures more than doubled the risk for mortality. Conclusions The frequency of osteoporotic fractures in patients with SLE and ESRD is similar to the general population of patients with ESRD. Vertebral and hip fractures are significant contributors to mortality in patients with SLE and ESRD. Fracture prevention, in particular, for elderly patients with SLE and ESRD, should be considered. Summary SLE is not an independent risk factor for fractures in patients with ESRD. However, among patients with SLE and ESRD, vertebral and hip fractures are significant contributors to mortality.

Effect of Thoracic Correction Exercises in Upper Body Dysfunction of 94-Year-old Male Participant - A Case Report

The case report has been presented to show the effects of thoracic correction exercises on flexed posture in older men with upper body dysfunction using posture analysis software and pectoralis minor muscle length test. The present case is that of a 94-year-old male. He was guided for a specific thoracic correction exercises for 12 weeks. The program included breathing correction, thorax mobility, scapular stability and passive stretching of Pectoralis major and minor, performed thrice a week, 30 min each session, for 12 weeks. Outcome measures included the upper body dysfunction changes by posture analysis software and pectoralis minor muscle length test. The Pre and Post-test of the patient demonstrated significantly greater improvements in hyperkyphosis (forward head posture) and pectoralis minor muscle length. This case study provides a promising exercise intervention that may improve flexed posture in older men with age-related upper body dysfunction.

Profiling cardiac arrhythmia and heart failure patients in India: The Pan-arrhythmia and Heart Failure Observational Study

Background

The PANARrhythMia and Heart Failure Registry (PANARM HF) characterized demographic, clinical and interventional therapy indication profiles of cardiac arrhythmia (CA) and heart failure (HF) patients in India.

Methods

Consulting Physicians (CP) who medically manage CA and HF patients enrolled patients with one or more of the following: syncope, pre-syncope, dyspnea, palpitation, fatigue and LV dysfunction. The CPs were trained by interventional cardiologists (IC) to identify CA/HF patients indicated for implantable device/radiofrequency ablation (RFA). 59 CP’s, 16 IC’s & 2205 patients from 12 cities participated. Demographic, clinical, device/RFA indication and referral-consultation profiles were created. IC’s provided device/RFA recommendations based on these profiles.

Results

The CA/HF distribution of patients was: HF – 58%, bradyarrhythmia – 15%, atrial fibrillation – 15%, other supraventricular tachyarrhythmia – 10% and ventricular tachycardia/fibrillation – 4.5%. 62% of the CA/HF population was male and 45% were below age 60. Coronary artery disease (52%), hypertension (44%), diabetes (30%) & myocardial infarction (20%) were prominent. 1011 (46%) of the CA/HF population were potential device/RFA candidates according to the IC’s. However, only 700 (69%) of these patients were referred to the IC by the CP. Of referred patients, only 177 (25%) consulted the IC and were recommended therapy. Thus, 824 (83%) of patients indicated for interventional therapy were not advised therapy or did not opt for it.

Conclusion

The India PANARM HF study provides new information and insights into the demographic, clinical, interventional therapy, referral and consultation pattern profiles of CA/HF patients in India.

Curvature-Driven Migration of Colloids on Tense Lipid Bilayers

Inspired by proteins that generate membrane curvature, sense the underlying membrane geometry, and migrate driven by curvature gradients, we explore the question: Can colloids, adhered to lipid bilayers, also sense and respond to membrane geometry? We report the migration of Janus microparticles adhered to giant unilamellar vesicles elongated to present spatially varying curvatures. In our experiments, colloids migrate only when the membranes are tense, suggesting that they migrate to minimize membrane area. By determining the energy dissipated along a trajectory, the energy field is inferred to depend on the local deviatoric curvature, like curvature driven capillary migration on interfaces between immiscible fluids. In this latter system, energy gradients are larger, so colloids move deterministically, whereas the paths traced by colloids on vesicles have significant fluctuations. By addressing the role of Brownian motion, we show that the observed migration is analogous to curvature driven capillary migration, with membrane tension playing the role of interfacial tension. Since this motion is mediated by membrane shape, it can be turned on and off by dynamically deforming the vesicle. While particle-particle interactions on lipid membranes have been considered in many contributions, we report here an exciting and previously unexplored modality to actively direct the migration of colloids to desired locations on lipid bilayers.

Adequacy of examining one sputum specimen in tuberculosis drug resistance surveys

OBJECTIVE/BACKGROUND

Collection of one spot and one morning sputum specimen is recommended for tuberculosis (TB) drug resistance surveys. This was a retrospective analysis of Mycobacterium tuberculosis cultures isolated from two spot sputum specimens collected from smear positive TB patients in a TB drug resistance survey. It was conducted to understand the value of a second specimen.

METHODS

A TB drug resistance survey was conducted in the state of Tamil Nadu, India, to estimate the prevalence of drug resistance among new sputum smear-positive (NSP) and previously treated (PT) patients diagnosed in Revised National Tuberculosis Control Program microscopy centers. A total of 2425 patients (1524 NSP and 901 PT cases) were enrolled in the study. From these patients, two spot sputum specimens (C and D) were collected within a period of 2h. No preservative was added to sputum. The samples were transported at ambient conditions without cold storage to the central laboratory for culture of M. tuberculosis. Culture yield from each sample was computed and analyzed.

RESULTS

The proportion of cultures retrieved from C and D specimens among NSP cases (89.3% and 89.7%) and PT cases (90.8% and 90.3%) were similar. The culture grades of C and D samples were comparable (chi-square test, 3560.135; p<.001) and the agreement was moderate (kappa test, 0.454).

CONCLUSION

The findings of the study reveal the adequacy of single spot sputum specimen from smear positive pulmonary TB patients for bacteriological examination in a quality-assured TB laboratory to determine precisely the level of drug resistance in a province of India.

Postmodernism and the Rest of the World

Postmodernism is the expression of a profound contradiction: deterritorialization and a borderless world on the one hand, and, on the other, the return of nationalism and the exacerbation of the gap between the `developed' and the `underdeveloped' worlds. The freedom that is associated with postmodernism is, in fact, an abject surrender to the dominance of capitalism. This essay argues that the significance of postmodernism has to be determined globally and world-historically and not merely within the confines of the metropolitan West. Secure in its dominance, postmodernism travels the world over in the name of knowledge, theory and epistemology. The pervasive epistemics of the `post-' sanctions the domination of other knowledges by the knowledge of the West. In a world polarized into the West and the Rest, the rest of the world has the ethico-political responsibility as well as authority to ensure that postmodernism does not mandate itself as the universal human condition.

Correlation of MRI Brain Injury Findings with Neonatal Clinical Factors in Infants with Congenital Diaphragmatic Hernia

BACKGROUND AND PURPOSE

Infants with congenital diaphragmatic hernia are reported to have evidence of brain MR imaging abnormalities. Our study aimed to identify perinatal clinical factors in infants with congenital diaphragmatic hernia that are associated with evidence of brain injury on MR imaging performed before hospital discharge.

MATERIALS AND METHODS

MRIs performed before hospital discharge in infants with congenital diaphragmatic hernia were scored for brain injury by 2 pediatric neuroradiologists. Perinatal variables and clinical variables from the neonatal intensive care unit stay were analyzed for potential associations with brain MR imaging findings.

RESULTS

Fifty-three infants with congenital diaphragmatic hernia (31 boys) were included. At least 1 abnormality was seen on MR imaging in 32 infants (60%). The most common MR imaging findings were enlarged extra-axial spaces (36%), intraventricular hemorrhage (23%), ventriculomegaly (19%), white matter injury (17%), and cerebellar hemorrhage (17%). The MR imaging brain injury score was associated with extracorporeal membrane oxygenation (P = .0001), lack of oral feeding at discharge (P = .012), use of inotropes (P = .027), and gastrostomy tube placement before hospital discharge (P = .024). The MR imaging brain injury score was also associated with a large diaphragmatic defect size (P = .011).

CONCLUSIONS

Most infants with congenital diaphragmatic hernia have at least 1 abnormality identified on MR imaging of the brain performed before discharge. The main predictors of brain injury in this population are a requirement for extracorporeal membrane oxygenation, large diaphragmatic defect size, and lack of oral feeding at discharge.

Energy-exchange collisions of dark-bright-bright vector solitons

We find a dark component guiding the practically interesting bright-bright vector one-soliton to two different parametric domains giving rise to different physical situations by constructing a more general form of three-component dark-bright-bright mixed vector one-soliton solution of the generalized Manakov model with nine free real parameters. Moreover our main investigation of the collision dynamics of such mixed vector solitons by constructing the multisoliton solution of the generalized Manakov model with the help of Hirota technique reveals that the dark-bright-bright vector two-soliton supports energy-exchange collision dynamics. In particular the dark component preserves its initial form and the energy-exchange collision property of the bright-bright vector two-soliton solution of the Manakov model during collision. In addition the interactions between bound state dark-bright-bright vector solitons reveal oscillations in their amplitudes. A similar kind of breathing effect was also experimentally observed in the Bose-Einstein condensates. Some possible ways are theoretically suggested not only to control this breathing effect but also to manage the beating, bouncing, jumping, and attraction effects in the collision dynamics of dark-bright-bright vector solitons. The role of multiple free parameters in our solution is examined to define polarization vector, envelope speed, envelope width, envelope amplitude, grayness, and complex modulation of our solution. It is interesting to note that the polarization vector of our mixed vector one-soliton evolves in sphere or hyperboloid depending upon the initial parametric choices.

Medical Management and Diagnostic Testing among Stable Angina Patients in India: The STable Angina obseRvational (STAR) Registry

OBJECTIVE

To study the practice pattern in the management of patients with stable angina (SA) in India.

METHODS

The Stable Angina obseRvational Registry (STAR) prospectively enrolled patients provisionally diagnosed with SA by non-interventional practicing internists in India. Patients were followed for 3 months after enrollment to assess medical treatment, diagnostic management, and interventional treatment of coronary artery disease (CAD). At the study conclusion, a statistical analysis retrospectively categorized patients not at risk of CAD by the Morise-Jalisi scale though this was not part of the study protocol.

RESULTS

Between January and May 2012, 2079 patients were enrolled at 131 centres. Mean age was 57 ± 11 years, 62% were men, and 40% had a history of diabetes. Over 90% of patients completed follow-up visit, >85% received statins and antiplatelet medications, >70% received beta blockers, and >60% received angiotensin-converting-enzyme inhibitors or angiotensin receptor blockers. Diagnostic testing rates were low: 93% for electrocardiogram, 44% echocardiogram, 42% chest radiography, 12% stress test, and 8% underwent noninvasive CT or invasive coronary angiography, of which, 86% had abnormal results. After the study, the Morise-Jalisi probability of CAD was intermediate in 42% and high in 51% of patients. Only 3.4% of all patients had coronary revascularization.

CONCLUSIONS

In a large cohort of Indian patients with SA, disease severity and probability of CAD were high. Clinicians used evidence-based care for medical management, but underutilized diagnostic testing. Patients with SA in India need to be risk-stratified for probability and severity of CAD and, if indicated, receive additional diagnostic testing.

Enterobacter asburiae KE17 association regulates physiological changes and mitigates the toxic effects of heavy metals in soybean

This study aimed to elucidate the role played by Enterobacter asburiae KE17 in the growth and metabolism of soybeans during copper (100 μm Cu) and zinc (100 μm Zn) toxicity. When compared to controls, plants grown under Cu and Zn stress exhibited significantly lower growth rates, but inoculation with E. asburiae KE17 increased growth rates of stressed plants. The concentrations of plant hormones (abscisic acid and salicylic acid) and rates of lipid peroxidation were higher in plants under heavy metal stress, while total chlorophyll, carotenoid content and total polyphenol concentration were lower. While the bacterial treatment reduced the abscisic acid and salicylic acid content and lipid peroxidation rate of Cu-stressed plants, it also increased the concentration of photosynthetic pigments and total polyphenol. Moreover, the heavy metals induced increased accumulation of free amino acids such as aspartic acid, threonine, serine, glycine, alanine, leucine, isoleucine, tyrosine, proline and gamma-aminobutyric acid, while E. asburiae KE17 significantly reduced concentrations of free amino acids in metal-affected plants. Co-treatment with E. asburiae KE17 regulated nutrient uptake by enhancing nitrogen content and inhibiting Cu and Zn accumulation in soybean plants. The results of this study suggest that E. asburiae KE17 mitigates the effects of Cu and Zn stress by reprogramming plant metabolic processes.

Two-year Randomized, Controlled Clinical Trial of a Flowable and Conventional Composite in Class I Restorations

OBJECTIVES

This study evaluated the two-year clinical performance and volumetric wear of a flowable resin composite compared to a conventional highly filled composite resin in Class I restorations.

METHODS AND MATERIALS

In this single-center, single-blinded, comparator-controlled clinical study (Institutional Review Board approved), 120 carious teeth distributed in 60 patients were randomly assigned to four calibrated practitioners who placed occlusal restorations (n=60 flowable and n=60 conventional composite). Direct and indirect assessment at baseline, six months, one year, and two years occurred during which the modified Cvar and Ryge criteria were evaluated. Volumetric wear was determined by superimposition of profilometer scans of baseline and two-year casts.

RESULTS

At two years, there was no significant difference in anatomic form (p=0.80), color match (p=0.08), marginal adaptation (p=0.89), marginal discoloration (p=0.79), surface integrity (p=0.18), secondary caries (p=0.66), cold sensitivity (p=0.522), occlusal sensitivity (p=0.818), or volumetric wear (p=0.661) between materials. Both materials showed a decrease in all criteria except secondary caries (p=0.95) over time. Two-year mean volumetric wear was 3.16 ± 2.38 mm(3) for the flowable composite and 3.43 ± 2.50 mm(3) for the conventional composite.

CONCLUSIONS

The flowable and conventional composites used in this study have similar clinical efficacy after two years of service when placed as Class I occlusal restorations having isthmus widths less than one-half the intercuspal distance.

High rates of ofloxacin resistance in Mycobacterium tuberculosis among both new and previously treated patients in Tamil Nadu, South India

Periodic drug resistance surveillance provides useful information on trends of drug resistance and effectiveness of tuberculosis (TB) control measures. The present study determines the prevalence of drug resistance among new sputum smear positive (NSP) and previously treated (PT) pulmonary TB patients, diagnosed at public sector designated microscopy centers (DMCs) in the state of Tamil Nadu, India. In this single-stage cluster-sampling prevalence survey, 70 of 700 DMCs were randomly selected using a probability-proportional to size method. A cluster size of 24 for NSP and a varying size of 0 to 99 for PT cases were fixed for each selected DMC. Culture and drug susceptibility testing was done on Lowenstein-Jensen medium using the economic variant of proportion sensitivity test for isoniazid (INH), rifampicin (RMP), ofloxacin (OFX) and kanamycin (KAN). Human Immunodeficiency Virus (HIV) status was collected from patient records. From June 2011 to August 2012, 1524 NSP and 901 PT patients were enrolled. Any RMP resistance and any INH resistance were observed in 2.6% and 15.1%, and in 10.4% and 30% respectively in NSP and PT cases. Among PT patients, multi drug resistant TB (MDR-TB) was highest in the treatment failure (35%) group, followed by relapse (13%) and treatment after default (10%) groups. Extensively drug resistant TB (XDRTB) was seen in 4.3% of MDR-TB cases. Any OFX resistance was seen in 10.4% of NSP, 13.9% of PT and 29% of PT MDR-TB patients. The HIV status of the patient had no impact on drug resistance levels. RMP resistance was present in 2.6% of new and 15.1% of previously treated patients in Tamil Nadu. Rates of OFX resistance were high among NSP and PT patients, especially among those with MDR-TB, a matter of concern for development of new treatment regimens for TB.

Content discovery and retrieval services at the European Nucleotide Archive

The European Nucleotide Archive (ENA; http://www.ebi.ac.uk/ena) is Europe's primary resource for nucleotide sequence information. With the growing volume and diversity of public sequencing data comes the need for increased sophistication in data organisation, presentation and search services so as to maximise its discoverability and usability. In response to this, ENA has been introducing and improving checklists for use during submission and expanding its search facilities to provide targeted search results. Here, we give a brief update on ENA content and some major developments undertaken in data submission services during 2014. We then describe in more detail the services we offer for data discovery and retrieval.

Generalized dark-bright vector soliton solution to the mixed coupled nonlinear Schrödinger equations

We have constructed a dark-bright N-soliton solution with 4N+3 real parameters for the physically interesting system of mixed coupled nonlinear Schrödinger equations. Using this as well as an asymptotic analysis we have investigated the interaction between dark-bright vector solitons. Each colliding dark-bright one-soliton at the asymptotic limits includes more coupling parameters not only in the polarization vector but also in the amplitude part. Our present solution generalizes the dark-bright soliton in the literature with parametric constraints. By exploiting the role of such coupling parameters we are able to control certain interaction effects, namely beating, breathing, bouncing, attraction, jumping, etc., without affecting other soliton parameters. Particularly, the results of the interactions between the bound state dark-bright vector solitons reveal oscillations in their amplitudes under certain parametric choices. A similar kind of effect was also observed experimentally in the BECs. We have also characterized the solutions with complicated structure and nonobvious wrinkle to define polarization vector, envelope speed, envelope width, envelope amplitude, grayness, and complex modulation. It is interesting to identify that the polarization vector of the dark-bright one-soliton evolves on a spherical surface instead of a hyperboloid surface as in the bright-bright case of the mixed coupled nonlinear Schrödinger equations.

Assembly information services in the European Nucleotide Archive

The European Nucleotide Archive (ENA; http://www.ebi.ac.uk/ena) is a repository for the world public domain nucleotide sequence data output. ENA content covers a spectrum of data types including raw reads, assembly data and functional annotation. ENA has faced a dramatic growth in genome assembly submission rates, data volumes and complexity of datasets. This has prompted a broad reworking of assembly submission services, for which we now reach the end of a major programme of work and many enhancements have already been made available over the year to components of the submission service. In this article, we briefly review ENA content and growth over 2013, describe our rapidly developing services for genome assembly information and outline further major developments over the last year.

EBI metagenomics--a new resource for the analysis and archiving of metagenomic data

Metagenomics is a relatively recently established but rapidly expanding field that uses high-throughput next-generation sequencing technologies to characterize the microbial communities inhabiting different ecosystems (including oceans, lakes, soil, tundra, plants and body sites). Metagenomics brings with it a number of challenges, including the management, analysis, storage and sharing of data. In response to these challenges, we have developed a new metagenomics resource (http://www.ebi.ac.uk/metagenomics/) that allows users to easily submit raw nucleotide reads for functional and taxonomic analysis by a state-of-the-art pipeline, and have them automatically stored (together with descriptive, standards-compliant metadata) in the European Nucleotide Archive.

Blinded rechecking of acid-fast bacilli smears by light-emitting diode microscopy

BACKGROUND

Blinded rechecking of auramine-stained acid-fast bacilli (AFB) sputum smears using fluorescence microscopy (FM), especially FM using light-emitting diode (LED), is not well understood.

OBJECTIVE

To examine the rechecking of auramine-stained sputum smears without restaining within a month using LED FM.

METHODS

A total of 4799 centrifuged smears of sputum samples were stained by the auramine phenol method and examined using LED FM; 564 systematically selected smears were subjected to blinded rechecking without restaining by controllers. The initial results of the readers were compared to those of the controllers. Discrepancies were resolved by a referee. The quality of LED FM was assessed by the referee using the culture result as gold standard.

RESULTS

Among the rechecked smears, one high false-negative error was made by a reader, while one high false-positive error and 19 high false-negative errors were made by the controllers. The errors were resolved by culture. Smear results for 18 slides were not available due to AFB fading.

CONCLUSION

AFB colour fading using LED FM, which affected the accurate evaluation of blinded rechecking of AFB smears without restaining within a month, is confirmed in this large study.

MODELING OF A NANOPARTICLE MOTION IN A NEWTONIAN FLUID: A COMPARISON BETWEEN FLUCTUATING HYDRODYNAMICS AND GENERALIZED LANGEVIN PROCEDURES

A direct numerical simulation adopting an arbitrary Lagrangian-Eulerian based finite element method is employed to simulate the motion of a nanocarrier in a quiescent fluid contained in a cylindrical tube. The nanocarrier is treated as a solid sphere. Thermal fluctuations are implemented using two different approaches: (1) fluctuating hydrodynamics; (2) generalized Langevin dynamics (Mittag-Leffler noise). At thermal equilibrium, the numerical predictions for temperature of the nanoparticle, velocity distribution of the particle, decay of the velocity autocorrelation function, diffusivity of the particle and particle-wall interactions are evaluated and compared with analytical results, where available. For a neutrally buoyant nanoparticle of 200 nm radius, the comparisons between the results obtained from the fluctuating hydrodynamics and the generalized Langevin dynamics approaches are provided. Results for particle diffusivity predicted by the fluctuating hydrodynamics approach compare very well with analytical predictions. Ease of computation of the thermostat is obtained with the Langevin approach although the dynamics gets altered.

Hypoglycaemic effects of alcoholic root extract of Borassus flabellifer (Linn.) in normal and diabetic rats

The objective of the study was to investigate the alcoholic (ALEBF) extract of B. flabellifer for their hypoglycaemic effects in normal and diabetic rats. Diabetes was induced in rats by single dose administration of alloxan (120 mg/kg, i.p.) or by injecting dexamethasone (10 mg/kg, i.p.) for 10 days. In normal rats, ALEBF (100, 200 and 400 mg/kg) had significantly decreased the blood glucose level in a dose dependent manner after repeated administration for 7 days. In alloxan induced diabetic rats, extract (ALEBF) had decreased blood sugar level and improved glucose tolerance in alloxan induced diabetic rats at the end of 1st, 2nd , 3rd and 4th week after test extract treatment. However, the insulin levels of extract treated group did not significantly change after 28 days treatment with the extract. It did not alter the insulin levels. In alloxan model, repeated dose administration of ALEBF had showed significant increase in body weight, prevention of elimination of sugar in urine and reduced the mortality rate induced by alloxan. In dexamethasone induced insulin resistance diabetic rats, repeated administration of ALEBF inhibited the increase in blood glucose level, improved glucose tolerance and reduced the insulin levels as compared dexamethasone induced diabetic rats.

Temporal Multiscale Approach for Nanocarrier Motion with Simultaneous Adhesion and Hydrodynamic Interactions in Targeted Drug Delivery

We present a fluctuating hydrodynamics approach and a hybrid approach combining fluctuating hydrodynamics with generalized Langevin dynamics to resolve the motion of a nanocarrier when subject to both hydrodynamic interactions and adhesive interactions. Specifically, using these approaches, we compute equilibrium probability distributions at constant temperature as well as velocity autocorrelation functions of the nanocarrier subject to thermal motion in a quiescent Newtonian fluid medium, when tethered by a harmonic spring force mimicking a tether due to a single receptor-ligand bond. We demonstrate that the thermal equipartition of translation, rotation, and spring degrees of freedom are preserved by our formalism while simultaneously resolving the nature of the hydrodynamic correlations. Additionally, we evaluate the potential of mean force (or free energy density) along a specified reaction coordinate to faciltate extensive conformational sampling of the nanocarrier motion. We show that our results are in excellent agreement with analytical results and Monte Carlo simulations, thereby validating our methodologies. The frameworks we have presented provide a comprehensive platform for temporal multiscale modeling of hydrodynamic and microscopic interactions mediating nanocarrier motion and adhesion in vascular targeted drug delivery.

Chemopreventive efficacy of Aegle marmelos on murine transplantable tumors

Emerging trends for cancer chemotherapy show promising developments with the better understanding of molecules delivering more potent and powerful capabilities. But these are severely limited because of increased side effects and higher probability of tumor recurrence. In this scenario, putative exploration of the indigenous and untapped resources modulating immune system to deliver adequate but potent chemopreventive effects appeals considerable interest. However, these require rigorous scientific validation with regard to potency compared with the existing drugs. Aegle marmelos (Linnaeus) Correa (family Rutaceae), a plant component of polyherbal formulation, Indukantha Ghritha, is known for its widespread medicinal values. But the chemopreventive potential has not been explored in comparison to existing anticancer agents. Our attempt contributes the scientific evidence for beneficial immunoprophylactic and antitumor functions in mice challenged with ascites tumors, Dalton's lymphoma ascites, and Ehrlich's ascites carcinoma either alone or in combination with cyclophosphamide and 5-fluorouracil. Specifically, the petroleum ether extracts of this plant (AM(PE)) prophylactically activated a cascade of host defense mechanisms by stimulating or restoring total white blood cell count, macrophage phagocytosis, hematopoiesis, lymphocyte proliferation and functions (CD4+ and CD8+) either naturally or under conditions of impaired immunity like in ascites tumor or during standard agent chemotherapy. Overall, AM(PE) also elicited strong antitumor effects by increasing median survival time and life span, while reducing murine ascites tumor volume and viable tumor counts on par with cyclophosphamide and 5-fluorouracil especially when administered prophylactically. This study also identified 2 putative components, xanthorrhizol and marmelosin, which could be imparting the immunoprophylactic and antitumor effects in transplantable tumor models. Thus, our attempts provide sufficient proof to warrant further to test this drug in higher animal models or in patients with high risk for tumor recurrence and/or immunocompromised diseases.

Vascularized mandibular anterior ameloblastoma - an entity still unresolved

Vascularized ameloblastoma is a bewildering entity whose existence is questionable from its origin to nosology and its very characterization as a distinct variant of ameloblastoma. This uncertainty is largely because of a fewer number of documented cases and loss of long-term follow-up. The current paper describes two cases of ameloblastoma in the mandibular anterior region, which had features of so-called "hemangiomatous ameloblastoma" as it was originally described. Understanding its pathophysiology based on various views and clinical implications in terms of its biologic behavior are brought to light in this paper.

Nanocarrier-Cell Surface Adhesive and Hydrodynamic Interactions: Ligand-Receptor Bond Sensitivity Study

A hybrid approach combining fluctuating hydrodynamics with generalized Langevin dynamics is employed to study the motion of a neutrally buoyant nanocarrier in an incompressible Newtonian stationary fluid medium. Both hydrodynamic interactions and adhesive interactions are included, as are different receptor-ligand bond constants relevant to medical applications. A direct numerical simulation adopting an arbitrary Lagrangian-Eulerian based finite element method is employed for the simulation. The flow around the particle and its motion are fully resolved. The temperatures of the particle associated with the various degrees of freedom satisfy the equipartition theorem. The potential of mean force (or free energy density) along a specified reaction coordinate for the harmonic (spring) interactions between the antibody and antigen is evaluated for two different bond constants. The numerical evaluations show excellent comparison with analytical results. This temporal multiscale modeling of hydrodynamic and microscopic interactions mediating nanocarrier motion and adhesion has important implications for designing nanocarriers for vascular targeted drug delivery.