Informing Acceptability and Feasibility of Digital Phenotyping for Personalized HIV Prevention among Marginalized Populations Presenting to the Emergency Department

For marginalized populations with ongoing HIV epidemics, alternative methods are needed for understanding the complexities of HIV risk and delivering prevention interventions. Due to lack of engagement in ambulatory care, such groups have high utilization of drop-in care. Therefore, emergency departments represent a location with those at highest risk for HIV and in highest need of novel prevention methods. Digital phenotyping via data collected from smartphones and other wearable sensors could provide the innovative vehicle for examining complex HIV risk and assist in delivering personalized prevention interventions. However, there is paucity in exploring if such methods are an option. This study aimed to fill this gap via a cross-sectional psychosocial assessment with a sample of N=85 emergency department patients with HIV risk. Findings demonstrate that although potentially feasible, acceptability of digital phenotyping is questionable. Technology-assisted HIV prevention needs to be designed with the target community and address key ethical considerations.

Thermophilic ligno-cellulolytic fungi: The future of efficient and rapid bio-waste management

To accelerate the process of decomposition using consortia of thermophilic ligno-cellulolytic fungi, different crop residues viz. sorghum (SG), soybean (SS), maize (MS), sugarcane (SC), cotton (CS) and pigeon pea (PS) with a varied C:N ratio and sawdust (SD) having high lignin content were collected and used for decomposition process. Compost quality assessed by evaluating different maturity and stability indices at five succeeding stages [first mesophilic (M1), thermophilic (T), second mesophilic (M2), cooling (C) and humification (H)]. A significant reduction was observed in the C:N ratio, biodegradability index, nitrification index, ratio of water-soluble carbon to organic nitrogen (WSC/Org.N) with an increase in concomitant over time while Ash (%), organic matter loss (%), CEC/TOC ratio, cellulose biodegradation ratio (BR) and lignin/cellulose ratio were significantly increased with time. By correlation study, biodegradability index (BI) and fluorescein diacetate (FDA) hydrolysis emerged as the most suitable compost maturity and stability parameters, respectively. Principal component analysis (PCA) results confirmed that BI, BR, WSC/Org. N and FDA can be regarded as key indicators for assessing compost quality. Our findings conclude that fungal consortia of Tricoderma viride, Rhizomucor pusillus, Aspergillus awamori and Aspergillus flavus can accelerate decomposition time from 8 to 12 months (which is normal farming practice) to 120 days.

Endoscopic placement of indigenous plastic esophageal endoprostheses--does it still have a role in the era of expandable metallic stents? A prospective Indian study in 265 consecutive patients

BACKGROUND AND STUDY AIMS

Esophageal endoprosthesis placement is an established method of palliating inoperable esophageal malignancy. However, the prosthesis choice varies, with expandable metal stents recently gaining popularity. We present our experience of using an indigenously developed plastic prosthesis in 265 patients prospectively in the period April 1992 to May 1996.

PATIENTS AND METHODS

An indigenous endoprosthesis made of a medical grade, nontoxic, radiopaque plastic material was placed successfully in 259 patients after serial dilatation of the malignant stricture. Patients were followed up once every month for at least 6 months and also in between if they developed any significant symptoms. The results were analyzed prospectively with special emphasis on the cost of the therapy, technical success of placement, improvement of swallowing and occurrence of complications.

RESULTS

The technical success of placement was 97.7% (259/265 patients). The mean dysphagia score improved from 3.2 to 1.2; 212 patients (81.8%) could swallow semisolids whereas 47 patients (18.2%) could swallow liquids. Though 75 patients (28.3%) had an associated tracheoesophageal fistula and 29.8% had received prior radiotherapy/chemotherapy, immediate complications like perforation, respiratory distress or severe hemorrhage were encountered in only 4.3% of patients. Late complications occurred in 12.7% and 32.8% of the patients complained of mild post-procedure pain in the chest. The overall procedure-related mortality was 3.9%. The average cost of the prosthesis was only US$ 15 per patient.

CONCLUSIONS

Placement of a plastic prosthesis is still a very effective and safe method for relief of malignancy-induced dysphagia. The associated complications can be significantly reduced by modifying the prosthesis material/design and adhering to a careful technique. The extremely low cost of the prosthesis and its safety profile makes this treatment highly cost-effective and widely applicable in developing countries such as India.

Electrocardiographic manifestations following electric injury

A 23-year-old man admitted with electric injury had intermittent episodes of non-sustained ventricular tachycardia, recurrent ventricular premature complexes, atrial fibrillation, supraventricular tachycardia and ST changes suggestive of pericarditis. The non-sustained ventricular tachycardia and ventricular premature complexes responded to intravenous lidocaine, atrial fibrillation and supraventricular tachycardia to intravenous digoxin.

Sucralfate in the short-term treatment of duodenal ulcer. A double-blind comparison with cimetidine and placebo

A phase III randomised, double-blind, placebo controlled study was conducted to compare the efficacy and adverse effects of sucralfate and cimetidine in the short-term management of active duodenal ulcer. Standard therapeutic doses were used. Antacids were permitted on an ad lib basis. Eighty patients with endoscopically proven DU were treated for 4 weeks with sucralfate (SUC) (n = 40), cimetidine (CIM) (n = 20) and placebo (PLA) (n = 20), of whom 60 patients--SUC (32), CIM (14) and PLA (14) completed the trial. Baseline clinical and endoscopic data were comparable amongst the 3 groups. The patients were reexamined clinically at 1, 2 and 4 weeks and endoscopically at 2 and 4 weeks. The data comprising pain and non-pain symptom scores, and ulcer size before and after the trial were analysed using the Mann-Whitney test. There were no significant differences in the rate of ulcer healing between SUC and CIM at 4 weeks. 71.8% of the SUC group had complete healing, as compared with 71.4% in the CIM group and 35% in the PLA group. Both SUC and CIM were superior to PLA. (p less than .05) Non-pain symptom scores at the end of 1 week were significantly lower with CIM (p less than 0.001), but levelled at 4 weeks when compared with SUC. Both SUC and CIM were superior to placebo (p less than .001). Day-time pain relief was significantly better with both SUC and CIM as compared to placebo (p less than 0.1). There was no significant difference in night-pain relief between the 3 groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Electron diffraction of the metallic elements in the pineal organ of a freshwater fish, Mystus vittatus (Bloch.)

By electron diffraction pattern the presence of metallic elements, particularly chromium-nickel, chromium phosphide, copper, aluminum-copper and zinc has been shown in the pineal organ of a freshwater teleost, M. vittatus. It is likely that their occurrence within the pineal is due to binding with the neurosecretory material fractions/ligands.

Seasonal changes in the testes of a hill stream teleost, Garra gotyla (Gray)

The cephalic, middle and posterior regions of the testes in Garra gotyla are identical in structure and function. The spermatogenetic activity starts in the month of October reaching its peak in April and May. Spawning takes place in June and July followed by a brief resting period. Spermiation appears to be intermittent. Six stages of spermatogenesis have been described. New crop of germ cells appears to arise from the resting spermatogonia. Both the interstitial and the lobule boundary cells were observed. The gonosomatic index shows correlatation between the rise in water temperature and the volume of the testes.

Decreased blood platelet MAO activity in unmedicated chronic schizophrenic patients

The authors found lower platelet monoamine oxidase (MAO) activity in 13 unmedicated chronic schizophrenic male patients in comparison to 13 mentally normal control male subjects--a finding that agrees with previous studies showing MAO activity to be low in the platelets of chronic schizophrenic patients. The authors urge that studies exploring endocrine factors and the role of hospitalization be undertaken to attempt to explain this finding.

Effect of glucose administration on the blood sugar and pancreatic islets of the frog, Rana tigrina

Glucose evoked significant hyperglycemia in the frog, Rana tigrina, 0.5 h after the injection and it took a longer time to regain normoglycemia than mammals, thus exhibiting a low glucose tolerance. The islet tissue of injected animals showed degranulation and atrophy of beta-cells only, the alpha-cells remained almost normal. This damage suggests that the beta-cells of this frog are functionally like those of mammals and other vertebrates, and secrete insulin. A single dose of glucose was found incapable of producing permanent diabetes, and beta-cells damage was repairable at later stages. Excess of glucose in the blood seems to stimulate secretion of insulin by the beta-cells.

Effect of glucagon on the principal islets of a fresh-water fish, Channa punctatus (Bloch)

Intramuscular administration of crystalline mammalian glucagon (0.5-2.0 mg/kg body weight) evokes significant cytological alterations in the principal islets of Channa punctatus, a fresh-water fish. Initially there is degeneration of the alpha-cells but later the beta-cells are also atrophied. Regressive changes in some of the alpha-cells have been interpreted to reflect their possible role in glucagon secretion. The degeneration of beta-cells appears to be secondary to the fluctuations in the blood glucose level, induced by exogenous glucagon.

Effect of cobalt salts on the glycemia and islet histology of Channa punctatus (Bloch)

Channa punctatus responds to the intramuscular administration of cobalt chloride and cobalt nitrate by exhibiting an increase in the blood glucose level. The hyperglycemia persists till 120 h, after which the fish become moribund and ultimately die. Cobalt salts evoke degranulation and vacuolization of the alpha-cells in the initial stage but later the beta-cells are also found to be severely damaged. Cobalt chloride has been found to be more toxic than the cobalt nitrate.