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Roth HG, Das M, Sulima A, Luo D, Kaska S, Prisinzano TE, Kerr AT, Jacobson AE, Rice KC. Functional Activity of Enantiomeric Oximes and Diastereomeric Amines and Cyano Substituents at C9 in 3-Hydroxy- N-phenethyl-5-phenylmorphans. Molecules 2024; 29:1926. [PMID: 38731416 PMCID: PMC11085448 DOI: 10.3390/molecules29091926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/17/2024] [Accepted: 04/19/2024] [Indexed: 05/13/2024] Open
Abstract
The synthesis of stereochemically pure oximes, amines, saturated and unsaturated cyanomethyl compounds, and methylaminomethyl compounds at the C9 position in 3-hydroxy-N-phenethyl-5-phenylmorphans provided μ-opioid receptor (MOR) agonists with varied efficacy and potency. One of the most interesting compounds, (2-((1S,5R,9R)-5-(3-hydroxyphenyl)-2-phenethyl-2-azabicyclo[3.3.1]nonan-9-yl)acetonitrile), was found to be a potent partial MOR agonist (EC50 = 2.5 nM, %Emax = 89.6%), as determined in the forskolin-induced cAMP accumulation assay. Others ranged in potency and efficacy at the MOR, from nanomolar potency with a C9 cyanomethyl compound (EC50 = 0.85 nM) to its totally inactive diastereomer, and three compounds exhibited weak MOR antagonist activity (the primary amine 3, the secondary amine 8, and the cyanomethyl compound 41). Many of the compounds were fully efficacious; their efficacy and potency were affected by both the stereochemistry of the molecule and the specific C9 substituent. Most of the MOR agonists were selective in their receptor interactions, and only a few had δ-opioid receptor (DOR) or κ-opioid receptor (KOR) agonist activity. Only one compound, a C9-methylaminomethyl-substituted phenylmorphan, was moderately potent and fully efficacious as a KOR agonist (KOR EC50 = 18 nM (% Emax = 103%)).
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Affiliation(s)
- Hudson G. Roth
- Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, Intramural Research Program, National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, 9800 Medical Center Drive, Bethesda, MD 20892-3373, USA; (H.G.R.); (M.D.); (A.S.)
| | - Madhurima Das
- Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, Intramural Research Program, National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, 9800 Medical Center Drive, Bethesda, MD 20892-3373, USA; (H.G.R.); (M.D.); (A.S.)
| | - Agnieszka Sulima
- Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, Intramural Research Program, National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, 9800 Medical Center Drive, Bethesda, MD 20892-3373, USA; (H.G.R.); (M.D.); (A.S.)
| | - Dan Luo
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, 789 S. Limestone Street, Lexington, KY 40536, USA; (D.L.); (S.K.); (T.E.P.)
| | - Sophia Kaska
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, 789 S. Limestone Street, Lexington, KY 40536, USA; (D.L.); (S.K.); (T.E.P.)
| | - Thomas E. Prisinzano
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, 789 S. Limestone Street, Lexington, KY 40536, USA; (D.L.); (S.K.); (T.E.P.)
| | - Andrew T. Kerr
- Center for Biomolecular Science and Engineering, Naval Research Laboratory, Washington, DC 20375-0001, USA;
| | - Arthur E. Jacobson
- Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, Intramural Research Program, National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, 9800 Medical Center Drive, Bethesda, MD 20892-3373, USA; (H.G.R.); (M.D.); (A.S.)
| | - Kenner C. Rice
- Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, Intramural Research Program, National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, 9800 Medical Center Drive, Bethesda, MD 20892-3373, USA; (H.G.R.); (M.D.); (A.S.)
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Soliman SHA, Iwanaszko M, Zheng B, Gold S, Howard BC, Das M, Chakrabarty RP, Chandel NS, Shilatifard A. Transcriptional elongation control of hypoxic response. Proc Natl Acad Sci U S A 2024; 121:e2321502121. [PMID: 38564636 PMCID: PMC11009653 DOI: 10.1073/pnas.2321502121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/23/2024] [Indexed: 04/04/2024] Open
Abstract
The release of paused RNA polymerase II (RNAPII) from promoter-proximal regions is tightly controlled to ensure proper regulation of gene expression. The elongation factor PTEF-b is known to release paused RNAPII via phosphorylation of the RNAPII C-terminal domain by its cyclin-dependent kinase component, CDK9. However, the signal and stress-specific roles of the various RNAPII-associated macromolecular complexes containing PTEF-b/CDK9 are not yet clear. Here, we identify and characterize the CDK9 complex required for transcriptional response to hypoxia. Contrary to previous reports, our data indicate that a CDK9 complex containing BRD4 but not AFF1/4 is essential for this hypoxic stress response. We demonstrate that BRD4 bromodomains (BET) are dispensable for the release of paused RNAPII at hypoxia-activated genes and that BET inhibition by JQ1 is insufficient to impair hypoxic gene response. Mechanistically, we demonstrate that the C-terminal region of BRD4 is required for Polymerase-Associated Factor-1 Complex (PAF1C) recruitment to establish an elongation-competent RNAPII complex at hypoxia-responsive genes. PAF1C disruption using a small-molecule inhibitor (iPAF1C) impairs hypoxia-induced, BRD4-mediated RNAPII release. Together, our results provide insight into potentially targetable mechanisms that control the hypoxia-responsive transcriptional elongation.
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Affiliation(s)
- Shimaa Hassan AbdelAziz Soliman
- Simpson Querrey Institute for Epigenetics, Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine, Northwestern University, Chicago, IL60611
| | - Marta Iwanaszko
- Simpson Querrey Institute for Epigenetics, Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine, Northwestern University, Chicago, IL60611
| | - Bin Zheng
- Simpson Querrey Institute for Epigenetics, Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine, Northwestern University, Chicago, IL60611
| | - Sarah Gold
- Simpson Querrey Institute for Epigenetics, Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine, Northwestern University, Chicago, IL60611
| | - Benjamin Charles Howard
- Simpson Querrey Institute for Epigenetics, Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine, Northwestern University, Chicago, IL60611
| | - Madhurima Das
- Simpson Querrey Institute for Epigenetics, Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine, Northwestern University, Chicago, IL60611
| | - Ram Prosad Chakrabarty
- Simpson Querrey Institute for Epigenetics, Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine, Northwestern University, Chicago, IL60611
- Division of Pulmonary and Critical Care, Department of Medicine, Northwestern University, Chicago, IL60611
| | - Navdeep S. Chandel
- Simpson Querrey Institute for Epigenetics, Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine, Northwestern University, Chicago, IL60611
- Division of Pulmonary and Critical Care, Department of Medicine, Northwestern University, Chicago, IL60611
| | - Ali Shilatifard
- Simpson Querrey Institute for Epigenetics, Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine, Northwestern University, Chicago, IL60611
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Chaudhury R, Chakraborty A, Rahaman F, Sarkar T, Dey S, Das M. Mycorrhization in trees: ecology, physiology, emerging technologies and beyond. Plant Biol (Stuttg) 2024; 26:145-156. [PMID: 38194349 DOI: 10.1111/plb.13613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 11/30/2023] [Indexed: 01/10/2024]
Abstract
Mycorrhization has been an integral part of plants since colonization by the early land plants. Over decades, substantial research has highlighted its potential role in improving nutritional efficiency and growth, development and survival of crop plants. However, the focus of this review is trees. Evidence have been provided to explain ecological and physiological significance of mycorrhization in trees. Advances in recent technologies (e.g., metagenomics, artificial intelligence, machine learning, agricultural drones) may open new windows to apply this knowledge in promoting tree growth in forest ecosystems. Dual mycorrhization relationships in trees and even triple relationships among trees, mycorrhizal fungi and bacteria offer an interesting physiological system to understand how plants interact with other organisms for better survival. Besides, studies indicate additional roles of mycorrhization in learning, memorizing and communication between host trees through a common mycorrhizal network (CMN). Recent observations in trees suggest that mycorrhization may even promote tolerance to multiple abiotic (e.g., drought, salt, heavy metal stress) and biotic (e.g. fungi) stresses. Due to the extent of physiological reliance, local adaptation of trees is heavily impacted by the mycorrhizal community. This knowledge opens the possibility of a non-GMO avenue to promote tree growth and development. Indeed, mycorrhization could impact growth of trees in nurserys and subsequent survival of the inoculated trees in field conditions. Future studies might integrate hyperspectral imaging and drone technologies to identify tree communities that are deficient in nitrogen and spray mycorrhizal spore formulations on them.
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Affiliation(s)
- R Chaudhury
- Department of Life Sciences, Presidency University, Kolkata, India
| | - A Chakraborty
- Department of Life Sciences, Presidency University, Kolkata, India
| | - F Rahaman
- Department of Life Sciences, Presidency University, Kolkata, India
| | - T Sarkar
- Department of Life Sciences, Presidency University, Kolkata, India
| | - S Dey
- Department of Life Sciences, Presidency University, Kolkata, India
| | - M Das
- Department of Life Sciences, Presidency University, Kolkata, India
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Shukla T, Nirban VS, Chandragiri A, Das M. Health equity and gendered border blindness: an exploration of healthcare services at the international border in Rajasthan. Public Health 2024; 227:148-153. [PMID: 38232562 DOI: 10.1016/j.puhe.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 12/05/2023] [Indexed: 01/19/2024]
Abstract
OBJECTIVES Citizens' access to health care and the delivery of the healthcare services is significantly affected by the spatiality of the regions and the connectedness of the elements of the healthcare system. This network of healthcare system, region and delivery of services faces myriad challenges in the borderland geography, which is characterised by accentuated military presence, poor physical infrastructure, disinterest of habitation near the border, lack of adequate, necessary and allied services such as schools and industry, social seclusion, migration etc. All these factors amalgamate to create an effect of gender-blind phenomenon as well as border-blind phenomenon. This is particularly acute for women and children. STUDY DESIGN A phenomenology research design has been used for the study. It encapsulates qualitative aspects of the views of those who experience marginalisation inclusive of gender-blind experiences. Marginalised women and frontline healthcare workers at the borderland were considered for the inquiry in this study. The study is a composite description of the phenomenon. METHODS The border districts of Rajasthan from the Radcliffe line of Rajasthan have been identified for the purpose of the study. Using narrative ethnography along with interviews, an examination was executed from health professionals and marginalised women to comprehend health care access and equity from the service provider's perspective as well as the beneficiary's perspective. RESULTS The study provides a range of attributions based on which it could be established that health inequities exist in bordering rural areas. CONCLUSIONS The study realises the geopolitical influence of the Radcliffe line, where borderlands are commonly vital to the continuum struggle between the centre and state. Yet, there remains a gap towards implementing various schemes and services due to varied reasons for access from main to far-off border areas, making the situation vulnerable from a resource deficiency point of view. The Health Equity Framework cannot meet Social Determinants of Health in borderland areas of Rajasthan.
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Affiliation(s)
- T Shukla
- Humanities and Social Sciences, BITS Pilani, Rajasthan, India.
| | - V S Nirban
- Humanities and Social Sciences, BITS Pilani, Rajasthan, India.
| | - A Chandragiri
- Humanities and Social Sciences, BITS Pilani, Rajasthan, India.
| | - M Das
- Humanities and Social Sciences, BITS Pilani, Rajasthan, India.
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Das M, Ward GW, Sulima A, Luo D, Prisinzano TE, Imler GH, Kerr AT, Jacobson AE, Rice KC. Potent MOR Agonists from 2'-Hydroxy-5,9-dimethyl- N-phenethyl Substituted-6,7-benzomorphans and from C8-Hydroxy, Methylene and Methyl Derivatives of N-Phenethylnormetazocine. Molecules 2023; 28:7709. [PMID: 38067439 PMCID: PMC10708259 DOI: 10.3390/molecules28237709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 12/18/2023] Open
Abstract
(-)-5,9-Dimethyl-6,7-benzomorphan (normetazocine) derivatives with a para-OH or ortho-F substituent in the aromatic ring of the N-phenethyl moiety were synthesized and found to have subnanomolar potency at MOR, and both were fully efficacious in vitro. These new compounds, (1R,5R,9R)-6,11-dimethyl-3-(2-fluorophenethyl)-1,2,3,4,5,6-hexahydro-2,6-methanobenzo[d]azocin-8-ol and (1R,5R,9R)-6,11-dimethyl-3-(4-hydroxyphenethyl)-1,2,3,4,5,6-hexahydro-2,6-methanobenzo[d]azocin-8-ol, were more potent than the unsubstituted compound N-phenethylnormetazocine and about 30 or 40 times more potent than morphine, respectively. A variety of substituents in the ortho, meta, or para position in the aromatic ring of the N-phenethyl moiety were synthesized, 25 of these compounds, and found to have varying effects on potency and efficacy as determined by the forskolin-induced cAMP accumulation assay. The N-phenethyl moiety was also modified by increasing chain length to form a N-phenylpropyl side chain with and without a para-nitro moiety, and by an N-cinnamyl side chain. Also, an indole ethylamine normetazocine was synthesized to replace the N-phenethylamine side chain in normetazocine. The phenylpropylamine, propenylamine (cinnamyl) and the para-nitropropylamine had little or no MOR potency. The indole-ethylamine on the normetazocine nucleus, however, had moderate potency (MOR EC50 = 12 nM), and was fully efficacious (%Emax = 102%) in the cAMP assay. Retention of the N-phenethyl moiety and the addition of alkyl and alkenyl moieties on C8 in (-)-N-phenethylnormetazocine gave a C8-methylene derivative that had subnanomolar potency at MOR and a C8-methyl analog that had nanomolar potency. Five C8-substituted compounds were synthesized.
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Affiliation(s)
- Madhurima Das
- Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, Intramural Research Program, National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, 9800 Medical Center Drive, Bethesda, MD 20892, USA; (M.D.); (G.W.W.); (A.S.)
| | - George W. Ward
- Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, Intramural Research Program, National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, 9800 Medical Center Drive, Bethesda, MD 20892, USA; (M.D.); (G.W.W.); (A.S.)
| | - Agnieszka Sulima
- Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, Intramural Research Program, National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, 9800 Medical Center Drive, Bethesda, MD 20892, USA; (M.D.); (G.W.W.); (A.S.)
| | - Dan Luo
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, 789 S. Limestone Street, Lexington, KY 40536, USA; (D.L.); (T.E.P.)
| | - Thomas Edward Prisinzano
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, 789 S. Limestone Street, Lexington, KY 40536, USA; (D.L.); (T.E.P.)
| | - Gregory H. Imler
- Center for Biomolecular Science and Engineering, Naval Research Laboratory, Washington, DC 20375, USA; (G.H.I.); (A.T.K.)
| | - Andrew T. Kerr
- Center for Biomolecular Science and Engineering, Naval Research Laboratory, Washington, DC 20375, USA; (G.H.I.); (A.T.K.)
| | - Arthur E. Jacobson
- Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, Intramural Research Program, National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, 9800 Medical Center Drive, Bethesda, MD 20892, USA; (M.D.); (G.W.W.); (A.S.)
| | - Kenner C. Rice
- Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, Intramural Research Program, National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, 9800 Medical Center Drive, Bethesda, MD 20892, USA; (M.D.); (G.W.W.); (A.S.)
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Hui C, Wakelee HA, Neal JW, Ramchandran KJ, Das M, Nagpal S, Roy M, Huang J, Pollom E, Myall N. CNS Control after First-Line Osimertinib in Patients with Metastatic EGFR-Mutant NSCLC. Int J Radiat Oncol Biol Phys 2023; 117:e110. [PMID: 37784648 DOI: 10.1016/j.ijrobp.2023.06.888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Although osimertinib (osi) has excellent intracranial activity in EGFR-mutant metastatic non-small cell lung cancer (NSCLC), there is no consensus regarding whether to continue osi for central nervous system (CNS) control with second-line chemotherapy (chemo) at the time of systemic progression. We aimed to compare CNS outcomes after first-line osi in patients receiving second-line chemo with or without continuation of osi. MATERIALS/METHODS We retrospectively reviewed patients with EGFR-mutant NSCLC with brain metastases (BrM) at the time of initiating first-line osi who experienced progression and started second-line chemo. Cumulative incidence of local and distant CNS progression, and extracranial (EC) progression was calculated from time of second-line chemo initiation with death as a competing risk. Overall survival (OS) was analyzed using Kaplan-Meier. RESULTS We included 52 patients with a median follow up of 9.6 months (range 0.4-36.4). Median OS and CNS progression-free survival (PFS) from the time of starting second-line chemo was 12.5 months (95% CI 8.1-16.9), and 5.3 months (95% CI 3.35-7.26), respectively. The 1-year cumulative incidence of local, distant CNS progression, any CNS progression, and EC progression was 14.4% (95% CI 4.5-24.2), 42.8% (95% CI 22.8-56.8), 42.8% (95% CI 22.8-56.8) and 66.8% (95% CI 53.5-80.2), respectively. After progression on first-line osi, 25 (48.1%) and 27 patients (51.9%) continued and discontinued osi, respectively. Patients who continued osi had significantly higher BrM burden than those who did not, with 17 (68%), 3 (12%), and 5 (20%) versus 26 (96%), 0, and 1 (3.7%) patient having <10 or >11 parenchymal brain lesions, or leptomeningeal disease (LMD) at the time of second line therapy, respectively (p<0.01). In those who continued osi vs those who did not, median OS (10.8 vs 12.5 months; p = 0.37), median intracranial PFS (5.3 vs 4.8 months; p = 0.99), 1-year cumulative incidence of local (8.4% versus 20 % p = 0.26), and 1-year distant CNS progression (24.8% vs 60%; p = 0.08) was not significantly different. CNS complications such as symptomatic, hospitalizations, and steroid initiation for CNS disease, and progression of LMD were not significantly different between the two groups. Eventually, 10 patients underwent salvage RT post first-line osi and median time to salvage RT was 7.8 months (range 2-9.4). Of patients who underwent salvage RT, 2 patients (20%) had continued osi with second-line chemo. Twelve patients (44.4%) who did not continue osi eventually re-started osi for progressive disease. CONCLUSION Patients who continued osi had significantly higher BrM tumor burden. Despite these patients being at higher risk for CNS progression, time to CNS progression and incidence of CNS complications were not significantly different in the two cohorts. Patients who discontinued osi were more likely to undergo salvage RT. Continuation of osi may allow patients to defer salvage RT.
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Affiliation(s)
- C Hui
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - H A Wakelee
- Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - J W Neal
- Stanford University School of Medicine, Stanford, CA
| | | | - M Das
- Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - S Nagpal
- Department of Neurology, Stanford Cancer Institute, Stanford, CA
| | - M Roy
- Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - J Huang
- Department of Medicine, Stanford University, Stanford, CA
| | - E Pollom
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - N Myall
- Department of Medicine, Stanford University School of Medicine, Stanford, CA
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Iyer A, Ndlovu Z, Sharma J, Mansoor H, Bharati M, Kolan S, Morales M, Das M, Issakidis P, Ferlazzo G, Hirani N, Joshi A, Tipre P, Sutar N, England K. Operationalising targeted next-generation sequencing for routine diagnosis of drug-resistant TB. Public Health Action 2023; 13:43-49. [PMID: 37359066 PMCID: PMC10290261 DOI: 10.5588/pha.22.0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 02/24/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Phenotypic drug susceptibility testing (pDST) for Mycobacterium tuberculosis can take up to 8 weeks, while conventional molecular tests identify a limited set of resistance mutations. Targeted next-generation sequencing (tNGS) offers rapid results for predicting comprehensive drug resistance, and this study sought to explore its operational feasibility within a public health laboratory in Mumbai, India. METHODS Pulmonary samples from consenting patients testing Xpert MTB-positive were tested for drug resistance by conventional methods and using tNGS. Laboratory operational and logistical implementation experiences from study team members are shared below. RESULTS Of the total number of patients tested, 70% (113/161) had no history of previous TB or treatment; however, 88.2% (n = 142) had rifampicin-resistant/multidrug-resistant TB (RR/MDR-TB). There was a high concordance between resistance predictions of tNGS and pDST for most drugs, with tNGS more accurately identifying resistance overall. tNGS was integrated and adapted into the laboratory workflow; however, batching samples caused significantly longer result turnaround time, fastest at 24 days. Manual DNA extraction caused inefficiencies; thus protocol optimisations were performed. Technical expertise was required for analysis of uncharacterised mutations and interpretation of report templates. tNGS cost per sample was US$230, while for pDST this was US$119. CONCLUSIONS Implementation of tNGS is feasible in reference laboratories. It can rapidly identify drug resistance and should be considered as a potential alternative to pDST.
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Affiliation(s)
- A Iyer
- Médecins Sans Frontières (MSF), Mumbai, India
| | - Z Ndlovu
- MSF, Southern African Medical Unit, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - J Sharma
- Médecins Sans Frontières (MSF), Mumbai, India
| | - H Mansoor
- Médecins Sans Frontières (MSF), Mumbai, India
| | - M Bharati
- Médecins Sans Frontières (MSF), Mumbai, India
| | - S Kolan
- Médecins Sans Frontières (MSF), Mumbai, India
| | - M Morales
- Médecins Sans Frontières (MSF), Mumbai, India
| | - M Das
- Médecins Sans Frontières (MSF), Mumbai, India
| | - P Issakidis
- MSF, Southern African Medical Unit, Cape Town, South Africa
| | - G Ferlazzo
- MSF, Southern African Medical Unit, Cape Town, South Africa
| | - N Hirani
- Department of Mycobacteriology, Sir JJ Group of Hospitals, Mumbai, India
| | - A Joshi
- Department of Mycobacteriology, Sir JJ Group of Hospitals, Mumbai, India
| | - P Tipre
- National Tuberculosis Elimination Programme, Mumbai, India
| | - N Sutar
- National Tuberculosis Elimination Programme, Mumbai, India
| | - K England
- Independent Consultant, Honolulu, HI, USA
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Wu J, Su C, La J, Corrigan J, Das M, Do N, Brophy M, Ahmed S, Han S, Fillmore N, Kelley M. PP01.05 Impact of PD-L1 Status on Survival on Immunotherapy Monotherapy in Real-World Patients with Poor Performance Status: A US Nationwide Veterans Affairs Study. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Mansoor H, Hirani N, Chavan V, Das M, Sharma J, Bharati M, Oswal V, Iyer A, Morales M, Joshi A, Ferlazzo G, Isaakidis P, Ndlovu Z, England K. Clinical utility of target-based next-generation sequencing for drug-resistant TB. Int J Tuberc Lung Dis 2023; 27:41-48. [PMID: 36853141 PMCID: PMC9879084 DOI: 10.5588/ijtld.22.0138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND: In high TB burden countries, access to drug susceptibility testing is a major bottleneck. Targeted next-generation sequencing (tNGS) is a promising technology for rapid resistance detection. This study assessed the role of tNGS for the diagnosis of drug-resistant TB (DR-TB).METHODS: A total of 161 samples from bacteriologically confirmed TB cases were subjected to tNGS using the Deeplex® Myc-TB kit and sequenced using the MiSeq platform. These samples were also processed for conventional phenotypic DST (pDST) using 13 drugs on Mycobacteria Growth Indicator Tube and line-probe assays (MTBDRplus and MTBDRsl).RESULTS: There were 146 DR-TB and 15 drug-susceptible TB (DS-TB) samples. About 70% of patients with DR-TB had no previous TB treatment history. Overall, 88.2% had rifampicin-resistant/multidrug-resistant TB (RR/MDR-TB), 58.5% pre-extensively drug-resistant TB (pre-XDR-TB) and 9.2% had XDR-TB as defined by the WHO (2020). Around 8% (n = 13) of samples were non-culturable; however, identified 8 were resistant to first and second-line drugs using tNGS. Resistance frequency was similar across methods, with discordance in drugs less reliable using pDST or with limited mutational representation within databases. Sensitivities were aligned with literature reports for most drugs. We observed 10% heteroresistance, while 75% of strains were of Lineages 2 and 3.CONCLUSIONS: Programme data supported tNGS in the diagnosis of DR-TB for early treatment using individualised regimens.
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Affiliation(s)
| | - N. Hirani
- Grant Medical College, Sir Jamshedjee Jeejebhoy Group of Hospitals, Mumbai, India
| | - V. Chavan
- Médecins Sans Frontières, Mumbai, India
| | - M. Das
- Médecins Sans Frontières, Mumbai, India
| | - J. Sharma
- Médecins Sans Frontières, Mumbai, India
| | | | - V. Oswal
- National TB Elimination Programme, Mumbai, India
| | - A. Iyer
- Médecins Sans Frontières, Mumbai, India
| | | | - A. Joshi
- Grant Medical College, Sir Jamshedjee Jeejebhoy Group of Hospitals, Mumbai, India
| | - G. Ferlazzo
- Southern Africa Medical Unit, Médecins Sans Frontières, Cape Town, South Africa
| | - P. Isaakidis
- Southern Africa Medical Unit, Médecins Sans Frontières, Cape Town, South Africa
,Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Z. Ndlovu
- Southern Africa Medical Unit, Médecins Sans Frontières, Cape Town, South Africa
,Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - K. England
- Independent Consultant, Infectious Disease Microbiologist, Honolulu, Hawaii, USA
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10
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Das M, Teli P, Vaidya A, Kale V. Secretome of Young Mesenchymal Stromal Cells Rejuvenates Aged Mesenchymal Stromal Cells by Normalizing Their Phenotype and Restoring Their Differentiation Profile. Stem Cells Dev 2023; 32:12-24. [PMID: 36453235 DOI: 10.1089/scd.2022.0213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
During aging, the proliferation and differentiation ability of mesenchymal stem/stromal cells (MSCs) gets affected, and hence, aged MSCs are not preferred for regenerative purposes. Rapid identification of aging-associated changes within MSCs and the mechanistic pathways involved are necessary to determine optimal cell sources to treat musculoskeletal disorders in older patients. In the present study, we have identified a set of phenotypic markers, namely downregulated expression of CD90 and upregulated expression of CD45, as age-defining markers for the bone marrow-derived MSCs. We also show that these phenotypic changes in aged MSCs correlate with their aging-mediated differentiation defects. We find that oxidative stress signaling leading to the activation of nuclear factor kappa B (NF-κB) plays an essential role in altering the phenotype and differentiation ability of the aged MSCs. We further show that treatment of aged MSCs with the conditioned medium (CM) derived from young MSCs (young-CM) restored their phenotype and differentiation potential to the young-like by ameliorating activation of NF-κB signaling in them. Similar changes could also be achieved by using an inhibitor of NF-κB signaling, showing that oxidative stress-induced NF-κB activation is the causative factor in the aging of MSCs. Additionally, we show that treating young MSCs with hydrogen peroxide mimics all the aging-mediated changes in them, underscoring the involvement of oxidative stress in the aging of MSCs. Overall, our data suggest that the altered expression of CD90 and CD45 surface markers can be used as a primary screen to identify the onset of aging in the MSCs, which can be quickly reversed by their in vitro treatment with young-CM or NF-κB inhibitor. Our study also puts the phenotypic characterization of MSCs in a clinical perspective.
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Affiliation(s)
- Madhurima Das
- Symbiosis Centre for Stem Cell Research, Symbiosis International (Deemed University), Pune, India
| | - Prajakta Teli
- Symbiosis Centre for Stem Cell Research, Symbiosis International (Deemed University), Pune, India
| | - Anuradha Vaidya
- Symbiosis Centre for Stem Cell Research, Symbiosis International (Deemed University), Pune, India.,Symbiosis School of Biological Sciences, Symbiosis International (Deemed University), Pune, India
| | - Vaijayanti Kale
- Symbiosis Centre for Stem Cell Research, Symbiosis International (Deemed University), Pune, India
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11
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Bohra SC, Zonunsanga HT, Das M, Purkayastha J, Biakzuala L, Lalremsanga HT. Morphological and molecular phylogenetic data reveal another new species of bent-toed gecko ( Cyrtodactylus Gray: Squamata: Gekkonidae) from Mizoram, India. J NAT HIST 2022. [DOI: 10.1080/00222933.2022.2119178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Sanath Chandra Bohra
- Help Earth, Guwahati, India
- Wildlife Sciences, Department of Zoology, Gauhati University, Guwahati, Assam, India
| | | | - Madhurima Das
- Help Earth, Guwahati, India
- Department of Zoology, Assam Don Bosco University, Sonapur, India
| | | | - Lal Biakzuala
- Developmental Biology and Herpetology Laboratory, Department of Zoology, Mizoram University, Aizawl, India
| | - Hmar Tlawmte Lalremsanga
- Developmental Biology and Herpetology Laboratory, Department of Zoology, Mizoram University, Aizawl, India
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12
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Raja N, No H, Von Eyben R, Das M, Roy M, Myall N, Chin A, Diehn M, Loo B, Chang D, Pollom E, Vitzthum L. Characterizing Metastatic Non-Small Cell Lung Cancer Presenting to an Academic Medical Center in an Era of Changing Treatment Paradigms. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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13
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Ingavle G, Das M. Bench to Bedside: New Therapeutic Approaches with Extracellular Vesicles and Engineered Biomaterials for Targeting Therapeutic Resistance of Cancer Stem Cells. ACS Biomater Sci Eng 2022; 8:4673-4696. [PMID: 36194142 DOI: 10.1021/acsbiomaterials.2c00484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cancer has recently been the second leading cause of death worldwide, trailing only cardiovascular disease. Cancer stem cells (CSCs), represented as tumor-initiating cells (TICs), are mainly liable for chemoresistance and disease relapse due to their self-renewal capability and differentiating capacity into different types of tumor cells. The intricate molecular mechanism is necessary to elucidate CSC's chemoresistance properties and cancer recurrence. Establishing efficient strategies for CSC maintenance and enrichment is essential to elucidate the mechanisms and properties of CSCs and CSC-related therapeutic measures. Current approaches are insufficient to mimic the in vivo chemical and physical conditions for the maintenance and growth of CSC and yield unreliable research results. Biomaterials are now widely used for simulating the bone marrow microenvironment. Biomaterial-based three-dimensional (3D) approaches for the enrichment of CSC provide an excellent promise for future drug discovery and elucidation of molecular mechanisms. In the future, the biomaterial-based model will contribute to a more operative and predictive CSC model for cancer therapy. Design strategies for materials, physicochemical cues, and morphology will offer a new direction for future modification and new methods for studying the CSC microenvironment and its chemoresistance property. This review highlights the critical roles of the microenvironmental cues that regulate CSC function and endow them with drug resistance properties. This review also explores the latest advancement and challenges in biomaterial-based scaffold structure for therapeutic approaches against CSC chemoresistance. Since the recent entry of extracellular vesicles (EVs), cell-derived nanostructures, have opened new avenues of investigation into this field, which, together with other more conventionally studied signaling pathways, play an important role in cell-to-cell communication. Thus, this review further explores the subject of EVs in-depth. This review also discusses possible future biomaterial and biomaterial-EV-based models that could be used to study the tumor microenvironment (TME) and will provide possible therapeutic approaches. Finally, this review concludes with potential perspectives and conclusions in this area.
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Affiliation(s)
- Ganesh Ingavle
- Symbiosis Centre for Stem Cell Research (SCSCR) and Symbiosis School of Biological Sciences (SSBS), SIU, Lavale, Pune 412115, India
| | - Madhurima Das
- Symbiosis Centre for Stem Cell Research (SCSCR) and Symbiosis School of Biological Sciences (SSBS), SIU, Lavale, Pune 412115, India
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14
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Banks L, Wujcik D, Stricker C, Das M, Shanbhag L, Lin S, Patel M. EP04.02-003 Improving Supportive Care for Patients with Thoracic Cancer. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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15
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Das M, Ogale S, Johnson A, Nguyen C, Bhagwakar J, Jovanoski N, Lee J. EP04.01-017 Cost-Effectiveness of Atezolizumab for Adjuvant Treatment of Patients with Stage II-IIIA PD-L1+ Non-small Cell Lung Cancer. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Das M, Naik KC, Biswal N, Panda RN. Structure and Decay Properties of Th Isotopes Using E-RMFT Formalism. Atom Indo 2022. [DOI: 10.17146/aij.2022.1156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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17
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Ali B, Arnquist I, Baxter D, Behnke E, Bressler M, Broerman B, Chen C, Clark K, Collar J, Cooper P, Cripe C, Crisler M, Dahl C, Das M, Durnford D, Fallows S, Farine J, Filgas R, García-Viltres A, Giroux G, Harris O, Hillier T, Hoppe E, Jackson C, Jin M, Krauss C, Kumar V, Laurin M, Lawson I, Leblanc A, Leng H, Levine I, Licciardi C, Linden S, Mitra P, Monette V, Moore C, Neilson R, Noble A, Nozard H, Pal S, Piro MC, Plante A, Priya S, Rethmeier C, Robinson A, Savoie J, Sonnenschein A, Starinski N, Štekl I, Tiwari D, Vázquez-Jáuregui E, Wichoski U, Zacek V, Zhang J. Results on photon-mediated dark-matter–nucleus interactions from the PICO-60
C3F8
bubble chamber. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.106.042004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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18
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Bates A, Naseer MZ, Taylor M, Denham N, Yue A, Das M, Morris GM, Ullah W. UK multi-centre retrospective study of the learning curve and relative performance of the rhythmia high density mapping system for atrial ablation. Europace 2022. [DOI: 10.1093/europace/euac053.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): University Hospital Southampton
Background
Rhythmia HDx® is a novel ultra-high density electroanatomical mapping system using an innovative 64 electrode basket catheter. A learning curve is a recognised phenomenon for any new technology and was examined in this study.
Purpose
Comparison of performance, long-term success, and complications using Rhythmia for atrial ablation in the UK.
Methods
Retrospective data collection from three centres across the UK from the introduction of Rhythmia. Patients were matched with controls who had undergone ablation using the well-established Carto3 mapping system. Assessed were: fluoroscopy, radiofrequency ablation and procedure times; acute and long term success, and complications.
Results
253 study patients with 253 controls were included. Significant correlations existed between procedural efficiency metrics and centre experience for de novo atrial fibrillation (AF) ablation (procedure time, Spearman’s ρ = -0.624; ablation time, ρ = -0.795), and de novo atrial flutter (AFlut) ablation (ablation time, ρ = -0.566; fluoroscopy time, ρ = -0.520). No such correlations existed for redo AF, redo AFlut, de novo atrial tachycardia (AT), or redo AT cases. For de novo AF and AFlut, procedural efficiency metrics were significantly improved after 10 procedures in each centre, (procedure time [AF only, p = 0.001], ablation time [AF, p < 0.0005; AFlut p < 0.0005] and fluoroscopy time [AFlut only, p = 0.0022]), and became comparable to controls (Figures 1 and 2). Acute success and long-term success did not see significant improvement with experience but were comparable to the control group. There was no relationship between experience and complications, which were comparable to Carto3 (3.6% in both groups).
Conclusion
A short learning curve exists with the use of Rhythmia HDx for standardised procedures (de novo AF / AFlut). Procedural performance improves and becomes comparable to Carto3 following 10 cases at each centre. Clinical outcomes at 6 and 12 months, and complications are not affected by this learning curve and remain comparable with controls.
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Affiliation(s)
- A Bates
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - MZ Naseer
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - M Taylor
- Freeman Hospital, Newcastle-Upon-Tyne, United Kingdom of Great Britain & Northern Ireland
| | - N Denham
- Manchester Royal Infirmary, Manchester, United Kingdom of Great Britain & Northern Ireland
| | - A Yue
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - M Das
- Freeman Hospital, Newcastle-Upon-Tyne, United Kingdom of Great Britain & Northern Ireland
| | - GM Morris
- Manchester Royal Infirmary, Manchester, United Kingdom of Great Britain & Northern Ireland
| | - W Ullah
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
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19
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Abstract
Affordances offered by new media platforms are perceived as revolutionary instruments for removing the inequities of access to health promotion and communication. However, the production and dissemination of health promotional material on digital platforms does not necessarily translate into uniform access across diverse demographics. This article addresses the lacuna when it comes to analyzing Health Promotion initiatives in India, with a specific focus on the governmental publicity carried out on social media during the four phases of COVID-19 national lockdown between 24 March and 31 May 2020. Our intervention examines how governmental social media health promotion in India played a key role in shaping the 'outbreak narrative' during the lockdown across different levels of social and economic privilege. Through a combination of quantitative data analysis and qualitative interview methods, this article analyzes the circulation and impact of official publicity in online and offline spaces, during the COVID-19 lockdown in India. Resultant findings allow for a comprehensive assessment of whether such publicity contributed to democratized citizen science discourses: enabling social protection measures for vulnerable majorities or potentially reified the existing privileges of the economically and socially affluent minority. We find that health promotion campaigns during a pandemic must focus on reaching the widest possible audience in the most efficient manner. Specifically, in the Indian context, health promotion through mass-media like Television and Radio, and participatory media platforms needed to be implemented in tandem with new media platforms, to achieve required engagement with vulnerable communities on key health issues.
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Affiliation(s)
- Dibyadyuti Roy
- Department of Humanities and Social Sciences, Indian Institute Technology (IIT) Jodhpur, Jodhpur, India
| | - Madhurima Das
- Department of Humanities and Social Sciences, Birla Institute of Technology and Sciences (BITS), Pilani, India
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20
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Das M, Hahm KS, LaRocca AA, Luna CA, Mendez K, Hoffman R, Verheyen CA, Kim TG, Wamakima BW, Roche E. A Low-Cost, Easily Deployable Vesicovaginal Fistula Occluding Device for Providing Interim Continence. J Med Device 2022. [DOI: 10.1115/1.4053603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
Vesicovaginal fistulas (VVFs), abnormal openings between the vagina and bladder, disrupt the lives of millions of people worldwide due to resulting incontinence and infections. VVFs are commonly treated with surgery after the fistula has had time to heal over several months. In low-resource areas, the immediate incontinence often leads to ostracization from the community, and can be devastating for the patient. To occlude the fistula and enable full continence until the patient is able to access surgery, we have designed a three-tiered silicone plug consisting of a bladder-dwelling disc, a mid-fistula disc, and a vagina-dwelling cross-shaped tapered plug, all supported on a central stem.
The device withstands typical expulsion forces from the bladder and does not leak under typical bladder filling or urination pressures. The maximum device expulsion force is 3.69 N and it is watertight up to 100 cmH2O or 9.8 kPa. It is designed to be easily deployed by trained community members without medical qualifications.
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Affiliation(s)
- Madhurima Das
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139
| | - Katie S. Hahm
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139
| | - Ava A. LaRocca
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139
| | - Cecilia Alessandra Luna
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139
| | - Keegan Mendez
- Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA 02139
| | - Rachel Hoffman
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139
| | - Connor A. Verheyen
- Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA 02139
| | - Tesia G. Kim
- Gynecology and Reproductive Biology, Beth Israel Deaconess Medical Center, Boston, MA 02215
| | | | - Ellen Roche
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139
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21
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Ghatak A, Pramanik A, Das M. The maiden comprehensive report on emerging trend towards metal free synthesis of biologically potent 2H-Chromenes. Tetrahedron 2022. [DOI: 10.1016/j.tet.2021.132628] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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22
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Gensheimer M, Gee H, Von Eyben R, Shirato H, Taguchi H, Wong S, Brown E, Nguyen N, Liang R, Maxim P, Wakelee H, Neal J, Das M, Loo B, Diehn M. A Phase II Trial of Individualized Stereotactic Ablative Radiotherapy for Lung Tumors (iSABR). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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23
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Devine M, Merriott D, Say C, Yoo C, Yi E, Lau B, Ko R, Shaheen S, Neal J, Wakelee H, Das M, Loo B, Diehn M, Chin A, Vitzthum L. Patterns of Care in Patients With Isolated Nodal Recurrence After Definitive Stereotactic Ablative Radiotherapy for Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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24
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Marar M, Bryant A, Nalawade V, Das M, Jr BL, Diehn M, Chin A, Murphy J, Vitzthum L. Impact of Facility Treatment Volume on Stereotactic Ablative Radiotherapy (SABR) Outcomes in Early-Stage Non-Small Cell Lung Cancer (NSCLC). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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25
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Das M, Ghosh B, Giri TK. Enhanced Floating and Intragastric Release of 5-Flourouracil through Sesame Oil Entrapped Gellan Composite Hydrogel Beads. CDTH 2021. [DOI: 10.2174/1574885516666210521120620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
5-Fluorouracil is an anti-metabolite compound used for several years as
an anti-tumor drug. The development of a gastroretentive drug delivery system of 5-Fluorouracil
may have advantages since they retain in the stomach for an extended time and release the drug in
a sustained manner, which ultimately enhances the absorption of the drug and consequently the
bioavailability.
Objective:
The objective of the present work was to prepare a sesame oil-entrapped gellan gum hydrogel
bead for controlled stomach specific delivery of 5-Fluorouracil.
Methods:
Sesame oil-entrapped gellan gum hydrogel bead was prepared by ionotropic gelation
method. The developed hydrogels were characterized by SEM, FTIR, DSC, and XRD. The entrapment
efficiency, floating ability, swelling and drug release in vitro were also determined.
Results:
Electrostatic interaction between the carboxylic group of polymers and Ca++ was confirmed
by FTIR analysis. The SEM photograph of the hydrogel beads portrayed an approximately
spherical shaped structure. DSC thermogram and XRD spectra exhibited the molecular dispersion
of the drug inside the hydrogel beads. The developed beads of 5-Fluorouracil floated in pH 1.2 buffer
solutions for a prolonged time period and the duration of floating was improved significantly
with increasing the concentration of oil. The developed formulations showed controlled release of
drug and incorporation of oil retarded the release of the drug. Fickian and non-Fickian mechanism
of drug transport was observed from the prepared hydrogel beads.
Conclusion:
Overall, the oil-entrapped gellan matrices could be used for the intragastric delivery
of 5-Fluorouracil to treat stomach cancer.
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Affiliation(s)
- Madhurima Das
- NSHM Knowledge Campus, Kolkata-Group of Institutions, 124 BL Saha Road, Kolkata-700053, West Bengal, India
| | - Balaram Ghosh
- Epigenetics Research Laboratory, Department of Pharmacy, Birla Institute of Technology and Science-Pilani, Hyderabad Campus, Hyderabad-500078, India
| | - Tapan Kumar Giri
- NSHM Knowledge Campus, Kolkata-Group of Institutions, 124 BL Saha Road, Kolkata-700053, West Bengal, India
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26
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Gleeson D, Cliff S, Das M. Eruptive keratoacanthomas associated with dupilumab therapy. Br J Dermatol 2021; 186:376-377. [PMID: 34608625 DOI: 10.1111/bjd.20781] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/28/2021] [Accepted: 09/30/2021] [Indexed: 11/28/2022]
Abstract
We would like to present the case of eruptive keratoacanthomas associated with dupilumab therapy, which occurred in an 85-year-old woman receiving biologic therapy for the treatment of atopic dermatitis. With the increasing prevalence of Dupilumab usage, this is an important potential complication of which clinicians should be aware.
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Affiliation(s)
- D Gleeson
- East Surrey Hospital, Surrey and Sussex Healthcare NHS Trust, Redhill, UK
| | - S Cliff
- East Surrey Hospital, Surrey and Sussex Healthcare NHS Trust, Redhill, UK
| | - M Das
- East Surrey Hospital, Surrey and Sussex Healthcare NHS Trust, Redhill, UK
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27
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Sinha D, Biswas S, Das M, Ghatak A. An eco-friendly, one pot synthesis of tri-substituted imidazoles in aqueous medium catalyzed by RGO supported Au nano-catalyst and computational studies. J Mol Struct 2021. [DOI: 10.1016/j.molstruc.2021.130823] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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28
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Das M, Chen N, LiWang A, Wang LP. Identification and characterization of metamorphic proteins: Current and future perspectives. Biopolymers 2021; 112:e23473. [PMID: 34528703 DOI: 10.1002/bip.23473] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 11/06/2022]
Abstract
Proteins that can reversibly alternate between distinctly different folds under native conditions are described as being metamorphic. The "metamorphome" is the collection of all metamorphic proteins in the proteome, but it remains unknown the extent to which the proteome is populated by this class of proteins. We propose that uncovering the metamorphome will require a synergy of computational screening of protein sequences to identify potential metamorphic behavior and validation through experimental techniques. This perspective discusses computational and experimental approaches that are currently used to predict and characterize metamorphic proteins as well as the need for developing improved methodologies. Since metamorphic proteins act as molecular switches, understanding their properties and behavior could lead to novel applications of these proteins as sensors in biological or environmental contexts.
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Affiliation(s)
- Madhurima Das
- School of Natural Sciences, University of California, Merced, California, USA
| | - Nanhao Chen
- Department of Chemistry, University of California, Davis, California, USA
| | - Andy LiWang
- School of Natural Sciences, University of California, Merced, California, USA.,Department of Chemistry and Biochemistry, University of California, Merced, California, USA.,Center for Cellular and Biomolecular Machines, University of California, Merced, California, USA.,Health Sciences Research Institute, University of California, Merced, California, USA.,Center for Circadian Biology, University of California, San Diego, California, USA
| | - Lee-Ping Wang
- Department of Chemistry, University of California, Davis, California, USA
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29
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Das M, Pethe P. Differential expression of retinoic acid alpha and beta receptors in neuronal progenitors generated from human embryonic stem cells in response to TTNPB (a retinoic acid mimetic). Differentiation 2021; 121:13-24. [PMID: 34419635 DOI: 10.1016/j.diff.2021.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 07/26/2021] [Accepted: 08/09/2021] [Indexed: 02/07/2023]
Abstract
Retinoic acid (RA), an active metabolite of vitamin A, plays a critical role in the morphogenesis and differentiation of various tissues, especially in the central nervous system. RA is the most commonly used morphogen for the differentiation of human embryonic stem cells (hESCs) into neuronal progenitor cells (NPCs), an abundant source of healthy neuronal tissues for regenerative therapy. During the differentiation process, the activity of RA is governed by the involvement of RA receptor subtypes (RAR α, β, and γ) and their isoforms in the nucleus. However, little is known about the involvement of specific RAR subtypes during neuronal differentiation in humans. It is essential to elucidate the dynamic function of different RAR subtypes and their influence on the phenotypic outcome. Here in this study, we used TTNPB, an analog and stabilized form of retinoic acid that potently and selectively activates retinoic acid receptors. Here we determined the optimum concentration of TTNPBfor the efficient generation of early NPCs from hESCs. Using the optimized concentration of -TTNPB, we found that RARα is the functionally dominant subtype and controls the RA-mediated neurogenesis of hESCs. Importantly, we also found that the RARγ subtype also played a role in neuronal differentiation. In contrast, the RARβ subtype negatively correlates with neuronal differentiation. Therefore, pharmacological inhibition of RARβ in the TTNPB-mediated differentiation process could be used as a strategy to generate a large number of NPCs in vitro. In summary, our results show that RARα and RARγ play a vital role in the TTNPB-mediated neuronal differentiation of hESCs, -whereas RARβ acts as a negative regulator.
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Affiliation(s)
- Madhurima Das
- Symbiosis Centre for Stem Cell Research, Symbiosis International (Deemed University), Pune, 412115, India.
| | - Prasad Pethe
- Symbiosis Centre for Stem Cell Research, Symbiosis International (Deemed University), Pune, 412115, India.
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Mahanta G, Das M, Nayak MK, Shaw S. Irreversibility Analysis of 3D Magnetohydrodynamic Casson Nanofluid Flow Past Through Two Bi-Directional Stretching Surfaces with Nonlinear Radiation. j nanofluids 2021. [DOI: 10.1166/jon.2021.1793] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Application of the nanoparticles with different non-Newtonian base fluid has huge application in the industries where the heat generation or energy transform takes place and many such applications are designing the advanced energy system at high temperature, aerodynamics, energy extraction
etc. In the present study, we have analyzed irreversibility for a 3-dimensional MHD, incompressible, electrically conducting Casson nanofluid flow through the two horizontal stretching surfaces. To make it more practical and broad, the flow field has been incorporated with porosity, suction/injection,
non-linear radiation with fall velocity with convective heating conditions at the boundaries and entropy generation which is an important physical phenomenon in thermodynamics. Influence of imperative parameters of the flow field and physical parameters have discussed with the entropy generation.
In a limiting case, a comparison made. It is observed that the suction phenomena boost up the local Nusselt and Sherwood number at the surface while restricted the skin friction. The non-Newtonian rheology (as Casson number) restricted the skin friction and the same phenomena observed for
the local heat and mass transfer. The entropy boosts up with the enhancement of the magnetic parameter, temperature ratio and Brinkman number. Further nanoparticle concentration improve the thermal conductivity leads an improvement in the efficiency of the heat transfer takes place. With the
augment in thermal radiation, magnetic parameter and Brinkman number, the entropy generation of the systems gets accelerated.
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Affiliation(s)
- G. Mahanta
- Department of Mathematics C. V. Raman Global University, Bhubaneswar 752054, India
| | - M. Das
- Department Mathematics, KIIT Deemed to be University, Bhubaneswar 751024, India
| | - M. K. Nayak
- Department of Mathematics C. V. Raman Global University, Bhubaneswar 752054, India
| | - S. Shaw
- Department of Mathematics and Statistical Sciences, Botswana International University of Science and Technology, Private Bag 16, Palapye, Botswana
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Das M, Kale V. Involvement of extracellular vesicles in aging process and their beneficial effects in alleviating aging-associated symptoms. Cell Biol Int 2021; 45:2403-2419. [PMID: 34427351 DOI: 10.1002/cbin.11691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/25/2021] [Accepted: 08/14/2021] [Indexed: 12/16/2022]
Abstract
Aging is a gradual and unavoidable physiological phenomenon that manifests in the natural maturation process and continues to progress from infanthood to adulthood. Many elderly people suffer from aging-associated hematological and nonhematological disorders. Recent advances in regenerative medicine have shown new revolutionary paths of treating such diseases using stem cells; however, aging also affects the quality and competence of stem and progenitor cells themselves and ultimately directs their death or apoptosis and senescence, leading to a decline in their regenerative potential. Recent research works show that extracellular vesicles (EVs) isolated from different types of stem cells may provide a safe treatment for aging-associated disorders. The cargo of EVs comprises packets of information in the form of various macromolecules that can modify the fate of the target cells. To harness the true potential of EVs in regenerative medicine, it is necessary to understand how this cargo contributes to the rejuvenation of aged stem and progenitor populations and to identify the aging-associated changes in the macromolecular profile of the EVs themselves. In this review, we endeavor to summarize the current knowledge of the involvement of EVs in the aging process and delineate the role of EVs in the reversal of aging-associated phenotypes. We have also analyzed the involvement of the molecular cargo of EVs in the generation of aging-associated disorders. This knowledge could not only help us in understanding the mechanism of the aging process but could also facilitate the development of new cell-free biologics to treat aging-related disorders in the future.
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Affiliation(s)
- Madhurima Das
- Symbiosis Centre for Stem Cell Research, Symbiosis International (Deemed University), Pune, India
| | - Vaijayanti Kale
- Symbiosis Centre for Stem Cell Research, Symbiosis International (Deemed University), Pune, India
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Das M, Das AC, Panda S, Greco Lucchina A, Mohanty R, Manfredi B, Rovati M, Giacomello MS, Colletti L, Mortellaro C, Satpathy A, Del Fabbro M. Clinical efficacy of grape seed extract as an adjuvant to scaling and root planing in treatment of periodontal pockets. J BIOL REG HOMEOS AG 2021; 35:89-96. [PMID: 34281305 DOI: 10.23812/21-2supp1-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Grape seed extract (GSE), a naturally producing polyphenolic compound, is found to be a potent hostmodulatory agent and considered for management of periodontal disease. Its anti-bacterial, antioxidant, and anti-inflammatory property may aid in achieving periodontal health. To assess the clinical efficacy of GSE in adjunct to scaling and root planing (SRP) in healing of periodontal pockets. The present study was a longitudinal, parallel design, randomized clinical trial. Seventy-two patients (mean age 39.2±8.6 years) with periodontal pockets were randomly divided into two groups; Test group received intra-pocket delivery of GSE with SRP and Control group received SRP alone. The clinical parameters like Plaque Index (PI), Gingival Index (GI), Probing Depth (PD) and Relative Attachment Level (RAL) were recorded at baseline and 3 months. 64 patients completed the study. Test group at the end of 3 months had statistically significant reduced PD (p=0.002) and RAL (p=0.01). No significant difference was observed for PI and GI at the end of 3 months. Intra-pocket application of GSE with SRP could be beneficial in management of periodontal pockets.
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Affiliation(s)
- M Das
- Department of Periodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan University, K8, Kalinga Nagar, Bhubaneswar, Odisha, India
| | - A C Das
- Department of Periodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan University, K8, Kalinga Nagar, Bhubaneswar, Odisha, India
| | - S Panda
- Department of Periodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan University, K8, Kalinga Nagar, Bhubaneswar, Odisha, India.,Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - A Greco Lucchina
- Saint Camillus International University of Health and Medical Science, Rome, Italy
| | - R Mohanty
- Department of Periodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan University, K8, Kalinga Nagar, Bhubaneswar, Odisha, India
| | - B Manfredi
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - M Rovati
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - M S Giacomello
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - L Colletti
- Department of Periodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan University, K8, Kalinga Nagar, Bhubaneswar, Odisha, India
| | - C Mortellaro
- Saint Camillus International University of Health and Medical Science, Rome, Italy
| | - A Satpathy
- Department of Periodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan University, K8, Kalinga Nagar, Bhubaneswar, Odisha, India
| | - M Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,Dental Clinic, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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Das M, Mamnoon F, Mansoor H, Meneguim AC, Singh P, Shah I, Ravi S, Kalon S, Hossain FN, Ferlazzo G, Isaakidis P, Furin J, Acharya S, Thakur HP. New TB drugs for the treatment of children and adolescents with rifampicin-resistant TB in Mumbai, India. Int J Tuberc Lung Dis 2021; 24:1265-1271. [PMID: 33317670 DOI: 10.5588/ijtld.20.0165] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING: Médecins Sans Frontières (MSF) clinic in Mumbai, India.OBJECTIVE: To determine the final treatment outcomes, culture conversion and adverse events (AEs) during treatment among children and adolescents (0-19 years) with rifampicin-resistant tuberculosis (RR-TB) who received ambulatory injectable-free treatment, including bedaquiline (BDQ) and/or delamanid (DLM) during September 2014-January 2020.DESIGN: This was a retrospective cohort study based on review of routinely collected programme data.RESULTS: Twenty-four patients were included; the median age was 15.5 years (min-max 3-19) and 15 (63%) were females. None were HIV-coinfected. All had fluoroquinolone resistance. Twelve received treatment, including BDQ and DLM, 11 received DLM and one BDQ. The median exposure to BDQ (n = 13) and DLM (n = 23) was 82 (IQR 80-93) and 82 (IQR 77-96) weeks, respectively. Seventeen (94%) patients with positive culture at baseline (n = 18) had negative culture during treatment; median time for culture-conversion was 7 weeks (IQR 5-11). Twenty-three (96%) had successful treatment outcomes: cured (n = 16) or completed treatment (n = 7); one died. Eleven (46%) had 17 episodes of AEs. Two of 12 serious AEs were associated with new drugs (QTcF >500 ms).CONCLUSION: Based on one of the largest global cohorts of children and adolescents to receive new TB drugs, this study has shown that injectable-free regimens containing BDQ and/or DLM on ambulatory basis were effective and well-tolerated among children and adolescents and should be made routinely accessible to these vulnerable groups.
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Affiliation(s)
- M Das
- Médecins Sans Frontières, Mumbai, Tata Institute of Social Sciences, Mumbai
| | | | | | | | - P Singh
- Médecins Sans Frontières, Mumbai
| | - I Shah
- Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - S Ravi
- Médecins Sans Frontières, Mumbai
| | - S Kalon
- Médecins Sans Frontières, Mumbai
| | | | - G Ferlazzo
- Southern Africa Medical Unit, Médecins Sans Frontières, Cape Town, South Africa
| | - P Isaakidis
- Southern Africa Medical Unit, Médecins Sans Frontières, Cape Town, South Africa
| | - J Furin
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - S Acharya
- Mumbai Districts AIDS Control Society, Mumbai
| | - H P Thakur
- Tata Institute of Social Sciences, Mumbai, National Institute of Health and Family Welfare, New Delhi, India
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Affiliation(s)
- Avishek Ghatak
- Department of Chemistry, Dr. A. P. J. Abdul Kalam Government College West Bengal State University) Kolkata 700156 India
| | - Madhurima Das
- Basic Science Department, Pailan College of Management and Technology Maulana Abul Kalam Azad University of Technology) Kolkata 700104 India
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White M, Neal J, Gardner R, Cunanan K, Das M, Padda S, Ramchandran K, Chen T, Wakelee H. 141P Chemotherapy with or without immunotherapy or bevacizumab for EGFR-mutated lung cancer after progression on osimertinib. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01983-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gogoi P, Das M, Begum P, Maji TK. Nature of sorption of trivalent arsenic on novel iron oxyhydroxide stabilized starch/OMMT composite: A mechanistic approach. J Water Health 2021; 19:336-350. [PMID: 33901028 DOI: 10.2166/wh.2021.267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Materials which are chemically, energetically and operationally acceptable for arsenic water treatment are highly required. In this study a hybrid material (SICC) of aminated starch, oxyhydroxide of iron and OMMT clay has been demonstrated for arsenic treatment. This new material was highly efficient in arsenic water treatment which could reduce arsenic concentration far below detection limits. All binding interactions during material preparation and arsenic sorption were exclusively characterized with FT-IR, XRD and other spectroscopic tools. A molecular modeling on the basis of density functional theory was carried out to verify the above findings. Influence of material dose, treatment time, initial ion concentration, varying temperatures, etc., on extent of sorption was studied in detail. The thermodynamic parameters viz. ΔG (>-11 kJ/mol), ΔH (42.48 kJ/mol), ΔS (177.6 JK-1 mol-1) and E a (59.16 kJ/mol) determined the feasibility of the process, its endothermic behavior and most importantly the chemical nature of the sorption accompanied by ion-exchange to some extent. The sorption followed a monolayer chemisorption pattern as determined by the Langmuir model (R2 = 0.973, R L = 0.081) with a qmax = 2.04 at 303 K. The binding of As(III) on the material was governed by a pseudo second order kinetic model.
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Affiliation(s)
- P Gogoi
- Department of Chemistry, Sipajhar College, Darrang, Assam 784145, India
| | - M Das
- Department of Chemical Sciences, Tezpur University, Assam 784028, India E-mail:
| | - P Begum
- Department of Chemistry, Gargaon College, Sivasagar, Assam 785686, India
| | - T K Maji
- Department of Chemical Sciences, Tezpur University, Assam 784028, India E-mail:
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Elsey H, Fieroze F, Shawon RA, Nasreen S, Hicks JP, Das M, Huque R, Hirano I, Wallace HJ, Saidur M. Understanding demand for, and feasibility of, centre-based child-care for poor urban households: a mixed methods study in Dhaka, Bangladesh. BMC Public Health 2020; 20:1899. [PMID: 33302914 PMCID: PMC7727228 DOI: 10.1186/s12889-020-09891-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 11/15/2020] [Indexed: 01/31/2023] Open
Abstract
Background Centre-based child-care has potential to provide multiple health and development benefits to children, families and societies. With rapid urbanisation, increasing numbers of low-income women work with reduced support from extended family, leaving a child-care vacuum in many low- and middle-income countries. We aimed to understand perceptions of, and demand for, centre-based child-care in Dhaka, Bangladesh among poor, urban households, and test the feasibility of delivering sustainable centre-based child-care. Methods We used sequential mixed methods including a household survey (n = 222) and qualitative interviews with care-givers (n = 16), community leaders (n = 5) and policy-makers (n = 5). We co-produced and piloted a centre-based child-care model over ten-months, documenting implementation. A co-design focus group with mothers, parents’ meetings, and qualitative interviews with child-care centre users (n = 5), non-users (n = 3), ex-users (n = 3) and staff (2) were used to refine the model and identify implementation issues. Results We found 24% (95% CI: 16,37%) of care-givers reported turning-down paid work due to lack of child-care and 84% (95% CI:74, 91%) reported wishing to use centre-based child-care and were willing to pay up to 283 Takka (~$3.30) per month. Adjusted odds of reported need for child-care among slum households were 3.8 times those of non-slum households (95% CI: 1.4, 10). Implementation highlighted that poor households needed free child-care with food provided, presenting feasibility challenges. Meta-inference across quantitative and qualitative findings identified the impact of the urban environment on child-care through long working hours, low social capital and fears for child safety. These influences interacted with religious and social norms resulting in caution in using centre-based child-care despite evident need. Conclusion Sustainable provision of centre-based care that focuses on early childhood development requires subsidy and careful design sensitive to the working lives of poor families, particularly women and must respond to the dynamics of the urban environment and community values. We recommend increased research and policy focus on the evaluation and scale-up of quality centre-based child-care, emphasising early-childhood development, to support low-income working families in urban areas.
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Affiliation(s)
- H Elsey
- Department of Health Sciences, University of York, Seebohm Rowntree Building, York, YO10 5DD, UK.
| | - F Fieroze
- ARK Foundation, Suite no C3, C4. House no. 6, Road no 109, Gulshan 2, Dhaka, 1212, Bangladesh
| | - R A Shawon
- Department of Public Health Sciences, Centre for Injury Prevention and Research Bangladesh (CIPRB), House # B-162, Road # 23, New DOHS, Mohakhali, Dhaka, 1206, Bangladesh
| | - S Nasreen
- ARK Foundation, Suite no C3, C4. House no. 6, Road no 109, Gulshan 2, Dhaka, 1212, Bangladesh
| | - J P Hicks
- Nuffield Centre for International Health and Development, University of Leeds, Room 10.31, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - M Das
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - R Huque
- ARK Foundation, Suite no C3, C4. House no. 6, Road no 109, Gulshan 2, Dhaka, 1212, Bangladesh
| | - I Hirano
- Nuffield Centre for International Health and Development, University of Leeds, Worsley Building, Leeds, LS2 9NL, UK.,Present address: Japanese International Cooperation Agency, 5-25 Nibancho, Chiyoda City, Tokyo, 102-0084, Japan
| | - H J Wallace
- School of Medicine, University of Notre Dame Australia, 19 Mouat St, Fremantle, Western Australia, 6959, Australia
| | - M Saidur
- Department of Public Health Sciences, Centre for Injury Prevention and Research Bangladesh (CIPRB), House # B-162, Road # 23, New DOHS, Mohakhali, Dhaka, 1206, Bangladesh
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Meneguim AC, Rebello L, Das M, Ravi S, Mathur T, Mankar S, Kharate S, Tipre P, Oswal V, Iyer A, Mansoor H, Kalon S, Garone D, Ferlazzo G, Isaakidis P. Adapting TB services during the COVID-19 pandemic in Mumbai, India. Int J Tuberc Lung Dis 2020; 24:1119-1121. [PMID: 33126951 DOI: 10.5588/ijtld.20.0537] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
| | | | - M Das
- Médecins Sans Frontières, Mumbai
| | - S Ravi
- Médecins Sans Frontières, Mumbai
| | - T Mathur
- Médecins Sans Frontières, Mumbai
| | - S Mankar
- National Tuberculosis Elimination Programme, Mumbai, India
| | - S Kharate
- National Tuberculosis Elimination Programme, Mumbai, India
| | - P Tipre
- National Tuberculosis Elimination Programme, Mumbai, India
| | - V Oswal
- National Tuberculosis Elimination Programme, Mumbai, India
| | - A Iyer
- Médecins Sans Frontières, Mumbai
| | | | - S Kalon
- Médecins Sans Frontières, Mumbai
| | - D Garone
- Médecins Sans Frontières, Brussels, Belgium
| | - G Ferlazzo
- Southern Africa Medical Unit, Médecins Sans Frontières, Cape Town, South Africa, ,
| | - P Isaakidis
- Southern Africa Medical Unit, Médecins Sans Frontières, Cape Town, South Africa, ,
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Ghosh S, Das M, Basu S, Adhikari J. Gluconeogenic fructose-1,6-bisphosphatase from the mature sporocarps of common aquatic ferns: partial purification and basic characterization of this enzyme from Marsilea minuta (Polypodiopsida). Ukr Bot J 2020. [DOI: 10.15407/ukrbotj77.05.386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The present communication reports substantial activity of gluconeogenic fructose-1,6-bisphosphatase (FBPase; EC 3.1.3.11) in three common heterosporous aquatic ferns (Marsilea minuta, Salvinia natans, and Azolla pinnata) and also describes a protocol for its partial purification from mature sporocarps of Marsilea minuta. The cytosolic FBPase, obtained from Marsilea minuta, Salvinia natans, and Azolla pinnata was recognized as gluconeogenic enzyme due to its drastic catabolic inactivation in presence of externally administered glucose and its insensitivity towards photosynthetic light illumination. Cytosolic gluconeogenic FBPase was partially purified from mature sporocarps of Marsilea minuta to about 22-fold over homogenate following low-speed centrifugation (11, 400 × g), 30–80% ammonium sulfate fractionation followed by subsequent chromatography using matrices like CM-Cellulose, Sephadex G-200, and Ultrogel AcA 34. The profile of partially purified FBPase in PAGE under non-denaturing condition was recorded. The enzyme activity increased linearly with respect to protein concentration to about 100 µg and with respect to time up to 75 minutes. Temperature optimum was found at 35 °C. The effect of substrate concentration and kinetic analyses for FBPase were carried out using D-fructose-1,6-bisphosphate (D-FBP, the substrate) in the range of 0.0 to 1.0 mM at an interval of 0.1 mM concentration. The Km value for D-FBP of FBPase was 0.06129 mM and Vmax was 4525 nmole Pi released (mg)-1 protein h-1 as determined by nonlinear regression kinetics using Prism 8 software (Graph Pad). The enzyme was functional in a constricted pH range of 7.0 to 8.0, giving maxima at pH 7.5. This cytosolic enzyme was significantly stimulated by Mg2+ and strongly inhibited by Hg2+, Cu2+ and Zn2+.
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Salimy MS, Luiselli GA, Yuen M, Healy RC, Shah SG, Giannaris EL, Das M, Wink AE. A case of solitary kidney with duplex collecting systems and renal vascular variants in an adult male cadaver. Folia Morphol (Warsz) 2020; 80:722-725. [PMID: 32748948 DOI: 10.5603/fm.a2020.0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 11/25/2022]
Abstract
We describe a unique solitary kidney with duplex collecting system and vascular variation observed in an 86-year-old white male formaldehyde- and phenol-fixed cadaver during routine academic dissection. The left renal fossa was empty with an intact adrenal gland, and the right renal fossa contained a fused renal mass with apparent polarity between the superior and inferior regions and two renal pelves converging into a single ureter. There were three right renal arteries supplying the renal mass; the superior and middle arteries were noted to be postcaval and the inferior artery was precaval. There were also two right renal veins draining into the inferior vena cava and following a regional distribution with the superior vein draining the inferior portion of the renal mass. Despite generally being asymptomatic, the detection of renal anatomical variants is clinically important for appropriate patient management and surgical interventions.
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Affiliation(s)
- M S Salimy
- University of Massachusetts Medical School, Worcester, MA, United States
| | - G A Luiselli
- University of Massachusetts Medical School, Worcester, MA, United States
| | - M Yuen
- University of Massachusetts Medical School, Worcester, MA, United States
| | - R C Healy
- University of Massachusetts Medical School, Worcester, MA, United States
| | - S G Shah
- University of Massachusetts Medical School, Worcester, MA, United States
| | - E L Giannaris
- University of Massachusetts Medical School, Worcester, MA, United States
| | - M Das
- University of Massachusetts Medical School, Worcester, MA, United States
| | - A E Wink
- University of Massachusetts Medical School, Worcester, MA, United States.
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Das A, Ghosh S, Das K, Dutta I, Basu T, Das M. Re:(In) visible impact of inadequate WaSH Provision on COVID-19 incidences can be not be ignored in large and megacities of India. Public Health 2020; 185:34-36. [PMID: 32521329 PMCID: PMC7253972 DOI: 10.1016/j.puhe.2020.05.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 05/18/2020] [Indexed: 12/20/2022]
Affiliation(s)
- A Das
- Department of Geography, University of Gour Banga, Malda, India.
| | - S Ghosh
- Department of Geography, Kazi Nazrul University, Asansol, India.
| | - K Das
- Department of Geography, University of Gour Banga, Malda, India.
| | - I Dutta
- Department of Geography, University of Gour Banga, Malda, India.
| | - T Basu
- Department of Geography, University of Gour Banga, Malda, India.
| | - M Das
- Department of Geography, University of Gour Banga, Malda, India.
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Eijsvoogel NG, Hendriks BMF, Martens B, Gerretsen SC, Gommers S, van Kuijk SMJ, Mihl C, Wildberger JE, Das M. The performance of non-ECG gated chest CT for cardiac assessment - The cardiac pathologies in chest CT (CaPaCT) study. Eur J Radiol 2020; 130:109151. [PMID: 32650129 DOI: 10.1016/j.ejrad.2020.109151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/03/2020] [Accepted: 06/21/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE Evaluating the prevalence of CAD on non-ECG gated chest CTs, image quality (IQ) and the clinical performance of the CAD-RADS classification for predicting cardiovascular events (CVE). METHODS 215 consecutive patients referred for chest CTs between May 2016 and March 2018 were included (3rd-generation DSCT) using non-ECG gated acquisitions with automated tube voltage selection (110kVqual.ref/40mAsqual.ref), pitch 2.65-3.0 and individualized contrast media injection protocols. Dedicated cardiac post-processing reconstructions (0.6 mm/0.4 mm/Kernel Bv36) were added to standard chest reconstructions. Two independent cardiac radiologists performed a 3-step analysis. In case of discrepancy, a third reader gave the final decision. Step 1: visual presence of calcifications; 2: scans with calcifications assessed for IQ using a 5-point Likert scale (poor/sufficient/moderate/good/excellent); 3: stenosis severity was analysed in detail (if Likert sufficient-excellent using CAD-RADS). Electronic patient files were checked to see if pathology was previously mentioned (incidental) and whether patients developed an CVE during follow-up. RESULTS 1: Calcifications were present in 156/215 cases (72.6 %), 74 of these were incidental. 2: In 68/156 (43.6 %) patients with calcifications IQ was rated sufficient-excellent. 3: CAD-RADS≥3 was seen in 39/68 patients (57.4 %), 12 times (30.8 %) findings were incidental. During follow-up (median 16 [0-35] months), 7/39 (18 %) patients with CAD-RADS≥3 developed a CVE. 17 patients died during follow-up. CONCLUSION Coronary calcification on non ECG-gated chest CTs was detected in 72.6 % of patients, cardiac assessment was feasible in nearly half of these patients. Only patients with a CAD-RADS≥3 developed CVE, therefore the CAD-RADS may help identify and guide patients at risk of future CVE.
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Affiliation(s)
- N G Eijsvoogel
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, P. Debyelaan 25, PO Box 5800, 6202 AZ Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre+, Maastricht, the Netherlands.
| | - B M F Hendriks
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, P. Debyelaan 25, PO Box 5800, 6202 AZ Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre+, Maastricht, the Netherlands.
| | - B Martens
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, P. Debyelaan 25, PO Box 5800, 6202 AZ Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre+, Maastricht, the Netherlands.
| | - S C Gerretsen
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, P. Debyelaan 25, PO Box 5800, 6202 AZ Maastricht, the Netherlands.
| | - S Gommers
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, P. Debyelaan 25, PO Box 5800, 6202 AZ Maastricht, the Netherlands.
| | - S M J van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre+, Maastricht, the Netherlands.
| | - C Mihl
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, P. Debyelaan 25, PO Box 5800, 6202 AZ Maastricht, the Netherlands.
| | - J E Wildberger
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, P. Debyelaan 25, PO Box 5800, 6202 AZ Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre+, Maastricht, the Netherlands.
| | - M Das
- Department of Diagnostic and Interventional Radiology, Helios Kliniken Duisburg, An Der Abtei 7-11, 47166 Duisburg, Germany.
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Das M, Weissenfluh A, Ly N, Trudell ML. Synthesis of Simple 3,3-Diarylazetidines from N-Boc-3-arylazetidinols Using Friedel-Crafts Arylation Conditions. J Org Chem 2020; 85:8209-8213. [PMID: 32449343 DOI: 10.1021/acs.joc.0c00454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A synthesis of 3,3-diarylazetidines from N-Boc-3-aryl-3-azetidinols using Friedel-Crafts arylation conditions with AlCl3 is described. A series of substituted diarylazetidines were readily prepared and isolated as the oxalate salts in high yield and high purity. The 3,3-diarylazetidine oxalates were then easily converted into N-alkyl and N-acyl analogues (RX, NaHCO3/DMF/100 °C) in high overall yields.
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Affiliation(s)
- Madhurima Das
- Department of Chemistry, University of New Orleans, New Orleans, Louisiana 70148 United States
| | - Amber Weissenfluh
- Department of Chemistry, University of New Orleans, New Orleans, Louisiana 70148 United States
| | - Nam Ly
- Department of Chemistry, University of New Orleans, New Orleans, Louisiana 70148 United States
| | - Mark L Trudell
- Department of Chemistry, University of New Orleans, New Orleans, Louisiana 70148 United States
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Das A, Ghosh S, Das K, Basu T, Das M, Dutta I. Modeling the effect of area deprivation on COVID-19 incidences: a study of Chennai megacity, India. Public Health 2020; 185:266-269. [PMID: 32707468 PMCID: PMC7290224 DOI: 10.1016/j.puhe.2020.06.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/06/2020] [Accepted: 06/08/2020] [Indexed: 11/17/2022]
Abstract
Objectives Socio-economic inequalities may affect coronavirus disease 2019 (COVID-19) incidence. The goal of the research was to explore the association between deprivation of socio-economic status (SES) and spatial patterns of COVID-19 incidence in Chennai megacity for unfolding the disease epidemiology. Study design This is an ecological (or contextual) study for electoral wards (subcities) of Chennai megacity. Methods Using data of confirmed COVID-19 cases from May 15, 2020, to May 21, 2020, for 155 electoral wards obtained from the official website of the Chennai Municipal Corporation, we examined the incidence of COVID-19 using two count regression models, namely, Poisson regression (PR) and negative binomial regression (NBR). As explanatory factors, we considered area deprivation that represented the deprivation of SES. An index of multiple deprivations (IMD) was developed to measure the area deprivation using an advanced local statistic, geographically weighted principal component analysis. Based on the availability of appropriately scaled data, five domains (i.e., poor housing condition, low asset possession, poor availability of WaSH services, lack of household amenities and services, and gender disparity) were selected as components of the IMD in this study. Results The hot spot analysis revealed that area deprivation was significantly associated with higher incidences of COVID-19 in Chennai megacity. The high variations (adjusted R2: 72.2%) with the lower Bayesian Information Criteria (BIC) (124.34) and Akaike's Information Criteria (AIC) (112.12) for NBR compared with PR suggests that the NBR model better explains the relationship between area deprivation and COVID-19 incidences in Chennai megacity. NBR with two-sided tests and P <0.05 were considered statistically significant. The outcome of the PR and NBR models suggests that when all other variables were constant, according to NBR, the relative risk (RR) of COVID-19 incidences was 2.19 for the wards with high housing deprivation or, in other words, the wards with high housing deprivation having 119% higher probability (RR = e0.786 = 2.19, 95% confidence interval [CI] = 1.98 to 2.40), compared with areas with low deprivation. Similarly, in the wards with poor availability of WaSH services, chances of having COVID-19 incidence was 90% higher than in the wards with good WaSH services (RR = e0.642 = 1.90, 95% CI = 1.79 to 2.00). Spatial risks of COVID-19 were predominantly concentrated in the wards with higher levels of area deprivation, which were mostly located in the northeastern parts of Chennai megacity. Conclusions We formulated an area-based IMD, which was substantially related to COVID-19 incidences in Chennai megacity. This study highlights that the risks of COVID-19 tend to be higher in areas with low SES and that the northeastern part of Chennai megacity is predominantly high-risk areas. Our results can guide measures of COVID-19 control and prevention by considering spatial risks and area deprivation. COVID-19 cases was modelled using Poisson regression and negative binomial regression. An IMD was devised using geographically weighted principal component analysis. Area deprivation in Chennai has both positive and inverse associations with the COVID-19.
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Affiliation(s)
- A Das
- Department of Geography, University of Gour Banga, Malda, India.
| | - S Ghosh
- Department of Geography, Kazi Nazrul University, Asansol, India.
| | - K Das
- Department of Geography, University of Gour Banga, Malda, India.
| | - T Basu
- Department of Geography, University of Gour Banga, Malda, India.
| | - M Das
- Department of Geography, University of Gour Banga, Malda, India.
| | - I Dutta
- Department of Geography, University of Gour Banga, Malda, India.
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Das A, Das M, Ghosh S. Impact of nutritional status and anemia on COVID-19: Is it a public health concern? Evidence from National Family Health Survey-4 (2015-2016), India. Public Health 2020; 185:93-94. [PMID: 32593053 PMCID: PMC7280132 DOI: 10.1016/j.puhe.2020.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/01/2020] [Indexed: 12/25/2022]
Affiliation(s)
- A Das
- Department of Geography, University of Gour Banga, Malda, West Bengal, India.
| | - M Das
- Department of Geography, University of Gour Banga, Malda, West Bengal, India.
| | - S Ghosh
- Department of Geography, Kazi Nazrul University, Asansol, West Bengal, India.
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Barnett D, Barnett A, Das M, Ng Lai Oon A. P-04-16 “Menstruation, Isn't This Meant for Girls?” a Quantitative Study into Young Adult Male Understanding and Attitudes Towards Menstruation in Malaysia. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Dewi MK, Walaszczyk A, Dookun ER, Martin RI, Richardson GD, Das M. 652The effect of varying irrigation flow rate during irrigated radiofrequency ablation on optimising lesion shape. Europace 2020. [DOI: 10.1093/europace/euaa162.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Investigator Sponsored Research grant from Boston Scientific
Introduction
Irrigated catheters are the standard tool for radiofrequency (RF) ablation in the left atrium and ventricles. However, pathological studies of irrigated RF lesions show a "tear-drop" shape, with the widest diameter some depth below the endocardial surface and relative endocardial sparing. This requires overlap of lesions to achieve contiguity at the endocardial surface. There has been little investigation into the effect of altering irrigation rate on lesion shape and volume.
Purpose
To test the hypothesis that varying the irrigation flow rate would optimise lesion shape by minimising endocardial sparing while maintaining lesion depth.
Methods
In an ex vivo animal heart model, irrigated ablation lesions were performed in porcine ventricular tissue at 30W using an Intellatip MiFi OI catheter with 5 different irrigation protocols: A. fixed rate (30ml/min); B. continuous reduction (30 to 2ml/min over 30s); C. continuous increase (2 to 30ml/min over 30s); D. stepwise reduction (30ml/min (10s) to 16ml/min (10s) to 2ml/min (10s)); E. stepwise increase (2ml/min (10s) to 16ml/min (10s) to 30ml/min (10s). Contact force (10g) and ablation duration (30s) were constant. Steam pops during ablation were recorded. Tissue sections were stained with triphenyltetrazolium chloride (TTC) after ablation to allow accurate measurement of lesion boundaries. Surface diameter, lesion depth, maximum diameter, and depth at maximum diameter were measured using Vernier Calipers to calculate lesion volume. Pictures of lesions were analysed further by ImageJ software to measure the degree of endocardial sparing. The optimal protocol was further tested against fixed-rate irrigation at 20W – 40W.
Results
10-20 lesions were performed for each irrigation protocol. Of the 4 experimental protocols, continuous reduction (protocol B) resulted in the most optimal lesion shape (Figure). With this protocol, endocardial sparing area was significantly reduced compared to fixed-rate irrigation (1.61 vs. 2.64mm2, P < 0.0001), with a trend towards an increase in surface diameter (9.25 vs. 8.46mm, P = 0.08). There was no significant difference in lesion depth (5.35 vs. 4.77mm), lesion volume (374 vs. 332mm3) or maximum diameter (10.3 vs. 10.8mm). Steam pop occurred in 1 of 20 (5%) lesions in each of protocols A and B.
Significantly reduced endocardial sparing with preserved volume/depth was consistent for continuous reduction when compared to fixed-rate irrigation across power settings of 20W (17ml/min), 30 W (17ml/min or 30ml/min) and 40W (30ml/min) (P < 0.0001).
Conclusions
Continuous reduction in irrigation flow rate from 30 to 2ml/min during irrigated RF ablation results in reduced endocardial sparing with preserved lesion depth and volume when compared to fixed-rate irrigation across power settings of 20 – 40W. This may allow for greater lesion spacing while maintaining endocardial contiguity and merits further investigation to improve irrigated RF ablation efficiency.
Abstract Figure
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Affiliation(s)
- M K Dewi
- Newcastle University, Institute of Genetic Medicine, Newcastle Upon Tyne, United Kingdom of Great Britain & Northern Ireland
| | - A Walaszczyk
- Newcastle University, Institute of Genetic Medicine, Newcastle Upon Tyne, United Kingdom of Great Britain & Northern Ireland
| | - E R Dookun
- Newcastle University, Institute of Genetic Medicine, Newcastle Upon Tyne, United Kingdom of Great Britain & Northern Ireland
| | - R I Martin
- Freeman Hospital, Newcastle Upon Tyne, United Kingdom of Great Britain & Northern Ireland
| | - G D Richardson
- Newcastle University, Institute of Genetic Medicine, Newcastle Upon Tyne, United Kingdom of Great Britain & Northern Ireland
| | - M Das
- Freeman Hospital, Newcastle Upon Tyne, United Kingdom of Great Britain & Northern Ireland
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Das M, Luik A, Shepherd E, Sulkin M, Laughner J, Duffy E, Oesterlein T, Meyer C, Jais P, Duchateau J, Yue A, Ullah W, Garcia-Bolao I. 664Local catheter impedance drop during pulmonary vein isolation predicts conduction block in patients with paroxysmal atrial fibrillation: initial results of the LOCALIZE clinical trial. Europace 2020. [DOI: 10.1093/europace/euaa162.249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Boston Scientific
Background
Radiofrequency (RF) catheter ablation for pulmonary vein isolation (PVI) requires resistively heating cardiac tissue to create conduction block. Creation of an RF lesion results in an impedance drop and the magnitude of this drop depends on the temperature and amount of myocardium being heated. Pre-clinical and clinical evaluation of an advanced local impedance (LI) metric found that greater LI drops were indicative of more effective lesion formation.
Purpose
To evaluate whether LI drop is associated with conduction block after first pass encirclement of the PVs in patients with paroxysmal AF.
Methods
LOCALIZE is an ongoing, single-arm, multi-center clinical trial (clinicaltrials.gov NCT03232645). LOCALIZE consists of an index PVI procedure (results presented here) and a 3-month follow-up mapping procedure. In the index procedure, electroanatomical maps of the left atrium were created and ipsilateral PVs were divided into 8 anatomical segments (n = 16 per patient). PVI was performed using point-by-point ablation with blinding of operators to LI. Following initial encirclement and a 20-minute wait period, coronary sinus-paced electroanatomical maps were created to identify gaps within anatomical segments. Gaps were annotated on the map and subsequently ablated. Mean LI drop within each segment was calculated offline as an estimate of regional RF energy delivery (Figure - Left). The diagnostic accuracy of LI drop for predicting segment block was assessed using receiver operating characteristic (ROC) analysis in segments with inter-lesion spacing ≤6mm.
Results
Forty-seven patients with paroxysmal AF underwent PVI at 5 centers (age 62 ± 11 years, male 55.3%). All patients left the index procedure with all PVs isolated. When blinded to LI (n = 3,064 ablations), median baseline LI was 106 (IQR: 97-115) Ω and median LI drop was 18.4 (12.7-24.9) Ω. After first pass encirclement, blocked segments had a significantly larger LI drop (20.2 [14.6-26.0] Ω) than segments with gaps (10.6 [6.9-15.1] Ω, p < 0.01, Figure - Right). The association between LI drop and block was further evaluated along anatomical anterior/posterior wall thickness differences. Anterior block segments were found to have significantly larger LI drops (21.0 [15.9-27.2] Ω) than posterior block segments (16.6 [12.7-23.7] Ω, p < 0.01). ROC analysis of segments with inter-lesion spacing ≤6mm identified optimal LI cut-off values of 16Ω in anterior segments and 11Ω posteriorly, which had positive predictive values for conduction block of 95.6% and 96.7%, respectively.
Conclusions
The magnitude of LI drop is predictive of acute PVI segment conduction block in patients with paroxysmal AF. The thinner posterior wall required smaller LI drops for block compared to the thicker anterior wall. With inter-lesion spacing of ≤6mm, reaching a LI drop of ≥16Ω anteriorly and ≥11Ω posteriorly was highly predictive of acute segment block in de novo PVI.
Abstract Figure. Local impedance drop in de novo PVI
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Affiliation(s)
- M Das
- Freeman Hospital, Newcastle Upon Tyne, United Kingdom of Great Britain & Northern Ireland
| | - A Luik
- Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | - E Shepherd
- Freeman Hospital, Newcastle Upon Tyne, United Kingdom of Great Britain & Northern Ireland
| | - M Sulkin
- Boston Scientific, Arden Hills, United States of America
| | - J Laughner
- Boston Scientific, Arden Hills, United States of America
| | - E Duffy
- Boston Scientific, Arden Hills, United States of America
| | - T Oesterlein
- Boston Scientific, Arden Hills, United States of America
| | - C Meyer
- University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - P Jais
- Hospital Haut Leveque, Bordeaux, France
| | | | - A Yue
- University of Southampton, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - W Ullah
- University of Southampton, Southampton, United Kingdom of Great Britain & Northern Ireland
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Questa K, Das M, King R, Everitt M, Rassi C, Cartwright C, Ferdous T, Barua D, Putnis N, Snell AC, Huque R, Newell J, Elsey H. Community engagement interventions for communicable disease control in low- and lower- middle-income countries: evidence from a review of systematic reviews. Int J Equity Health 2020; 19:51. [PMID: 32252778 PMCID: PMC7137248 DOI: 10.1186/s12939-020-01169-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 03/25/2020] [Indexed: 12/20/2022] Open
Abstract
Background Community engagement (CE) interventions include a range of approaches to involve communities in the improvement of their health and wellbeing. Working with communities defined by location or some other shared interest, these interventions may be important in assisting equity and reach of communicable disease control (CDC) in low and lower-middle income countries (LLMIC). We conducted an umbrella review to identify approaches to CE in communicable disease control, effectiveness of these approaches, mechanisms and factors influencing success. Methods We included systematic reviews that: i) focussed on CE interventions; ii) involved adult community members; iii) included outcomes relevant to communicable diseases in LLMIC; iv) were written in English. Quantitative results were extracted and synthesised narratively. A qualitative synthesis process enabled identification of mechanisms of effect and influencing factors. We followed guidance from the Joanna Briggs Institute, assessed quality with the DARE tool and reported according to standard systematic review methodology. Results Thirteen systematic reviews of medium-to-high quality were identified between June and July 2017. Reviews covered the following outcomes: HIV and STIs (6); malaria (2); TB (1); child and maternal health (3) and mixed (1). Approaches included: CE through peer education and community health workers, community empowerment interventions and more general community participation or mobilisation. Techniques included sensitisation with the community and involvement in the identification of resources, intervention development and delivery. Evidence of effectiveness of CE on health outcomes was mixed and quality of primary studies variable. We found: i) significantly reduced neonatal mortality following women’s participatory learning and action groups; ii) significant reductions in HIV and other STIs with empowerment and mobilisation interventions with marginalised groups; iii) significant reductions in malaria incidence or prevalence in a small number of primary studies; iv) significant reductions in infant diarrhoea following community health worker interventions. Mechanisms of impact commonly occurred through social and behavioural processes, particularly: changing social norms, increasing social cohesion and social capacity. Factors influencing effectiveness of CE interventions included extent of population coverage, shared leadership and community control over outcomes. Conclusion Community engagement interventions may be effective in supporting CDC in LLMIC. Careful design of CE interventions appropriate to context, disease and community is vital.
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Affiliation(s)
- K Questa
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - M Das
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - R King
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK.
| | - M Everitt
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - C Rassi
- Malaria Consortium, London, UK
| | - C Cartwright
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | | | - D Barua
- ARK Foundation, Dhaka, Bangladesh
| | - N Putnis
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - A C Snell
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - R Huque
- ARK Foundation, Dhaka, Bangladesh
| | - J Newell
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - H Elsey
- University of York, York, UK
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