Mycorrhization in trees: ecology, physiology, emerging technologies and beyond

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.

Health equity and gendered border blindness: an exploration of healthcare services at the international border in Rajasthan

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.

A multi-spectroscopic and molecular docking approach for DNA/protein binding study and cell viability assay of first-time reported pendent azide bearing Cu(II)-quercetin and dicyanamide bearing Zn(II)-quercetin complexes

In the current study, one new quercetin-based Zn(II) complex [Zn(Qr)(CNNCN)(H2O)2] (Complex 1) which is developed by condensation of quercetin with ZnCl2 in the presence of NaN(CN)2 and Cu(II) complex [Cu(Qr)N3(CH3OH)(H2O)] (complex 2) which is developed by the condensation reaction of quercetin and CuCl2 in presence of NaN3, are thoroughly examined in relation to their use in biomedicine. The results of several spectroscopic studied confirm the structure of both the complexes and the Density Functional Theory (DFT) study helps to optimize the structure of complex 1 and 2. After completion of the identification process, DNA and Human Serum Albumin (HSA) binding efficacy of both the investigated complexes are performed by implementing a long range of biophysical studies and a thorough analysis of the results unveils that complex 1 has better interaction efficacy with the macromolecules than complex 2. The binding efficacy of complex 1 is comparatively higher towards both macromolecules because of its pure groove binding mode during interaction with DNA and the presence of an extra H-bond during connection with HSA. The experimental host-guest binding results is fully validated by molecular docking study. Interestingly complex 1 shows better antioxidant properties than complex 2, as well as quercetin, and it has strong anticancer property with minimal damage to normal cells, which is proved by the MTT assay study. Better DNA and HSA binding efficacy of 1 may be the reason for the better anticancer property of complex 1.

CNS Control after First-Line Osimertinib in Patients with Metastatic EGFR-Mutant NSCLC

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.

Operationalising targeted next-generation sequencing for routine diagnosis of drug-resistant TB

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.

Solvent-regulated fluorescence off-on signaling of Ni(II) and Zn(II) with the formation of two mononuclear complexes with an ATP detection ability by Zn(II) assembly

The current study shows that Schiff base HL, (Z)-2,4-dibromo-6-(((piperidin-2-ylmethyl)imino)methyl)phenol, can be used successfully as a selective chemosensor for Zn(II) and Ni(II) among several competing cations in purely aqueous and semi-aqueous media. Under UV light in methanol-water (9 : 1) HEPES buffer, the receptor gives its response by changing its color to cyan color in the presence of Zn(II) and to bluish cyan color in the presence of Ni(II). Surprisingly, the chemosensor can only reliably identify Zn(II) in a hundred percent aqueous medium by changing its color to light yellow. UV and fluorescence studies in both aqueous and semi-aqueous media are used to further investigate this Zn(II) and Ni(II) recognition phenomenon. The high values of the host-guest binding constants, obtained by electronic and fluorescence titration, ensure that a strong bond exists between HL and Ni(II)/Zn(II). As anticipated, two highly luminescent mononuclear, crystalline compounds, complexes 1 and 2, have been developed by a separate reaction of HL and Zn(II)/Ni(II), and the high luminous properties are due to the occurrence of Chelation Enhanced Fluorescence (CHEF). According to the single crystal structure, the asymmetric units of both complexes consist of two deprotonated chemosensor units and one Zn(II)/Ni(II), leading to the formation of an octahedral complex. For Ni(II) and Zn(II) sensing, the predicted LOD is in the nanomolar range. Both complexes 1 and 2 are fluorescence active and studies to check their ATP detection ability, but intriguingly, only complex 2 is capable of detecting ATP in a fully aqueous solution. Finally, the live cell imaging study validates the two sensors' biosensing functionality.

DNA/Protein Binding and Apoptotic-Induced Anticancer Property of a First Time Reported Quercetin-Iron(III) Complex Having a Secondary Anionic Residue: A Combined Experimental and Theoretical Approach

A new quercetin-based iron(III) cationic complex [Fe(Qr)Cl(H₂O)(MeO)] (complex 1) is created in the current study by condensation of quercetin with ferric chloride in the presence of Et₃N. Comprehensive spectroscopic analysis and conductometric measurement are used to pinpoint complex 1. The generated complex's +3-oxidation state has been verified by electron paramagnetic resonance (EPR) research. Density functional theory analysis was used to structurally optimize the structure of complex 1. Before biomedical use, a variety of biophysical studies are implemented to evaluate the binding capacity of complex 1 with DNA and human serum albumin (HSA) protein. The findings of the electronic titration between complex 1 and DNA, as well as the stunning fall in the fluorescence intensities of the HSA and EtBr-DNA/DAPI-DNA domain after complex 1 is gradually added, give us confidence that complex 1 has a strong affinity for both macromolecules. It is interesting to note that the displacement experiment confirms partial intercalation as well as the groove binding mechanism of the title complex with DNA. The time-dependent fluorescence analysis indicates that after interaction with complex 1, HSA will exhibit static quenching. The thermodynamic parameter values in the HSA-complex 1 interaction provide evidence for the hydrophobicity-induced pathway leading to spontaneous protein-complex 1 interaction. The two macromolecules' configurations are verified to be preserved when they are associated with complex 1, and this is done via circular dichroism spectral titration. The molecular docking investigation, which is a theoretical experiment, provides complete support for the experimental findings. The potential of the investigated complex to be an anticancer drug has been examined by employing the MTT assay technique, which is carried out on HeLa cancer cell lines and HEK-293 normal cell lines. The MTT assay results validate the ability of complex 1 to display significant anticancer properties. Finally, by using the AO/PI staining approach, the apoptotic-induced cell-killing mechanism as well as the detection of cell morphological changes has been confirmed.

Clinical utility of target-based next-generation sequencing for drug-resistant TB

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.

Effect of ancillary ligand on DNA and protein interaction of the two Zn (II) and Co (III) complexes: experimental and theoretical study

In the present work we have developed one mononuclear Zn(II) complex [Zn(L)(H2O)] (Complex 1) by utilizing a tetracoordinated ligand H₂L, formed by simple condensation of 2, 2 dimethyl 1,3 diamino propane and 3- ethoxy salicylaldehyde and one newly designed mononuclear Co (III) complex [Co(L)(L1)] (complex 2) by utilizing (H₂L) and 3- ethoxy salicylaldehyde(HL1) as an ancillary ligand. The newly developed complex 2 have been spectroscopically characterized. An interesting phenomenon has been noticed that in presence of ancillary ligand, the solubility in buffer solution and the thermal stability of complex 2 comparatively increases than 1. To check the effect of ancillary ligand, present in complex 2 towards the DNA and HSA binding efficacy, both the complexes have been taken into consideration to inspect their binding potentiality with the macromolecules. The 'on', 'off' fluorescence changes in presence of DNA and HSA, the binding constant values, obtained from electronic spectral titration, iodide induced quenching, competitive binding assay, circular dichroism (CD) spectral titration, time resolved fluorescence experiment unambiguously assure the better binding efficacy of complex 2 with the signal of minor groove binding mode with DNA along with no significant conformational changes of the macromolecules. The strong and spontaneous binding of complex 2 with CT-DNA is further supported by the Isothermal Titration Calorimetry (ITC) study. Furthermore TDDFT calculation of DNA with and without complex 2 significantly authorize the formation of complex 2-DNA adduct during the association. Finally Molecular Docking study properly verifies the experimental findings and provides justified explanation behinds experimental findings.

Response of Ancillary Azide Ligand in Designing a 1D Copper(II) Polymeric Complex along with the Introduction of High DNA- and HAS-Binding Efficacy, Leading to Impressive Anticancer Activity: A Compact Experimental and Theoretical Approach

A new versatile azide-bridged polymeric Cu(II) complex, namely, [Cu(L)(μ_1,3-N₃)]_∞ (1), was synthesized utilizing an N,N,O-donor piperidine-based Schiff base ligand (E)-4-bromo-2-((2-(-1-yl)imino)methyl)phenol (HL), obtained via the condensation reaction of 1-(2-aminoethyl) piperidine and 5-bromo salicylaldehyde. The single-crystal X-ray diffraction analysis reveals that complex 1 consists of an end-to-end azido-bridged polymeric network, which is further rationalized with the help of a density functional theory (DFT) study. After routine characterization with a range of physicochemical studies, complex 1 is exploited to evaluate its biomedical potential. Initially, theoretical inspection with the help of a molecular docking study indicated the ability of complex 1 to effectively bind with macromolecules such as DNA and the human serum albumin (HSA) protein. The theoretical aspect was further verified by adopting several spectroscopic techniques. The electronic absorption spectroscopic analysis indicates a remarkable binding efficiency of Complex 1 with both DNA and HSA. The notable fluorescence intensity reduction of the ethidium bromide (EtBr)-DNA adduct, 4',6-diamidino-2-phenylindole (DAPI)-DNA adduct, and HSA after the gradual addition of complex 1 authenticates its promising binding potential with the macromolecules. The retention of the canonical B form of DNA and α form of HSA during the association of complex 1 was confirmed by implementing a circular dichroism spectral study. The association ability of complex 1 with macromolecules further inspired us to inspect its impact on different cell lines such as HeLa (cervical cancer cell), PA1 (ovarian cancer cell), and HEK (normal cell). The dose-dependent and time-dependent in vitro 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay suggests an effective antiproliferative property of complex 1 with low toxicity toward the normal cell line. Finally, the anticancer activity of complex 1 toward carcinoma cell lines was analyzed by nuclear and cellular staining techniques, unveiling the cell death mechanism.

UK multi-centre retrospective study of the learning curve and relative performance of the rhythmia high density mapping system for atrial ablation

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 &lt; 0.0005; AFlut p &lt; 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.

Entropy Generation in Magneto-Casson Nanofluid Flow Along an Inclined Stretching Sheet Under Porous Medium with Activation Energy and Variable Heat Source/Sink

The current paper deals with the study of magneto-convective and chemically reactive Casson nanofluid flow along an inclined permeable stretching surface embedded in a fluid-saturated uniform porous medium. As a novelty of the work, entropy generation analysis in the presence of multiple slips at the surface and a nonuniform heat source/sink is carried out. Moreover, viscous dissipation, Arrhenius activation energy, Joule dissipation and thermal radiation are included in the investigation. To the best of authors’ knowledge, no such study on Casson nanofluid is reported yet in the literature. Dimensionless similarity transformations have been introduced to convert the regulating model PDEs into ODEs in dimensionless form. As the model equations are highly nonlinear in nature, shooting technique based on the Runge-Kutta Cash-Karp method is used to solve those equations numerically. The updated values of the initial guesses are computed with the help of secant iteration. Profiles for fluid velocity, temperature, nanoparticle concentration and entropy generation have been drawn to explain the impacts of several important parameters on momentum, thermal and mass fields. However, the surface drag force, heat and mass transport rates at the solid wall are illustrated using numerical data displayed in tabular form. Also, a linear regression model is derived for the local Nusselt number and the related physical parameters. Moreover, a comparison table is presented to confirm the correctness of the obtained results. A fantastic correlation of the present results with the existing results is reported. Graphical results reveal that for the rising values of the angle of inclination parameter and magnetic parameter velocity profiles are declined, but for the growing values of Eckert number and thermal radiation parameter temperature profiles are enhanced.

Synthesis and crystal structures of two tri- and tetra-heterometallic Ni(ii)–Mn(ii)/Ni(ii)–Co(iii) complexes from two different Ni(ii)-containing metalloligands: effective catalytic oxidase activity and Schottky device approach

The development of tri- and tetra-nuclear heterometallic Ni(ii)–Mn(ii)/Ni(ii)–Co(iii) complexes with effective catalytic oxidase activity and the Schottky device approach.

Synthesis, characterization and multi-dimensional application approach for two distinctive tetra nuclear, first-time reported, Fe3+/Hg2+ and Fe3+/Cd2+ clusters from a new Fe3+ containing metalloligand

Synthesis of two unique μ oxo-bridged complexes MC2 and MC3 from a metalloligand MC1 results to efficient dye degradation efficacy and effective schottkey device.

Eruptive keratoacanthomas associated with dupilumab therapy

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.

Irreversibility Analysis of 3D Magnetohydrodynamic Casson Nanofluid Flow Past Through Two Bi-Directional Stretching Surfaces with Nonlinear Radiation

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.

Clinical efficacy of grape seed extract as an adjuvant to scaling and root planing in treatment of periodontal pockets

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.

Soret and Dufour Effects on MHD Nonlinear Convective Flow of Tangent Hyperbolic Nanofluid Over a Bidirectional Stretching Sheet with Multiple Slips

The purpose of the present analysis is to investigate the Soret and Dufour effects on steady and incompressible MHD nonlinear convective flow of tangent hyperbolic nanofluid over a permeable stretching surface with multiple slip conditions at the wall. Also, nonlinearly varying thermal radiation, heat generation and chemical reaction along with a vanishing nanoparticle mass flux condition at the surface are taken into account. Further, Rosseland’s approximation for an optically thick and grey medium is used to approximate heat flux due to radiation. Suitable similarity transformations are employed to transform governing PDEs into a system of ODEs. The resulting nonlinear equations are then solved numerically using the shooting technique based on the Runge-Kutta Cash-Karp method. The upshots of various physical parameters on velocity, temperature and concentration distributions are illustrated and displayed through figures. The variations in coefficients of local skin friction, Nusselt and Sherwood numbers are explained and presented in tabular form. The obtained results are validated with the previously reported results for a particular case of the present fluid flow problem, and an outstanding correlation is noticed from the comparison. Graphical results reveal that the nonlinear convection parameters for both temperature and concentration accelerate the primary flow. However, the Dufour number diminishes the fluid temperature near the wall, and the Soret number uplifts the concentration profile within the boundary layer.

New TB drugs for the treatment of children and adolescents with rifampicin-resistant TB in Mumbai, India

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.

Nature of sorption of trivalent arsenic on novel iron oxyhydroxide stabilized starch/OMMT composite: A mechanistic approach

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 q_max = 2.04 at 303 K. The binding of As(III) on the material was governed by a pseudo second order kinetic model.

Active Bromoaniline-Aldehyde Conjugate Systems and Their Complexes as Versatile Sensors of Multiple Cations with Logic Formulation and Efficient DNA/HSA-Binding Efficacy: Combined Experimental and Theoretical Approach

Two fluorescence active bromoaniline-based Schiff base chemosensors, namely, (E)-4-bromo-2-(((4-bromophenyl)imino)methyl)phenol (HL1 ) and (E)-2-(((4-bromophenyl)imino)methyl)phenol (HL2 ), have been employed for the selective and notable detection of Cu2+ and Zn2+ ions, respectively, with the simultaneous formation of two new metal complexes [Cu(L1)2] (1) and [Zn(L2)2] (2). X-ray single crystal analyses indicate that complexes 1 and 2 are tetra-coordinated systems with substantial CH...π/π...π stacking interactions in the solid-state crystal structures. These two complexes are exploited for the next step detection of Al3+ and Hg2+ where complex 2 exhibits impressive results via turn-off fluorescence quenching in (DMSO/H2O) HEPES buffer medium. The sensing phenomena are optimized by UV-vis spectral analyses as well as theoretical calculations (density functional theory and time-dependent density functional theory). The combined detection phenomena of the ligand (HL2 ) and complex 2 are exclusively utilized for the first time to construct a molecular memory device, intensifying their multisensoric properties. Furthermore, the DNA- and human serum albumin (HSA)-binding efficacies of these two complexes are examined by adopting electronic and fluorometric titration methods. Complex 2 shows a higher DNA-binding ability in comparison with complex 1, whereas in the case of HSA, the reverse situation is observed. Finally, the binding modes of both the complexes with DNA and HSA have been investigated through molecular docking studies, suggesting good agreement with the experimental results.

Understanding demand for, and feasibility of, centre-based child-care for poor urban households: a mixed methods study in Dhaka, Bangladesh

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.

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)

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+.

A case of solitary kidney with duplex collecting systems and renal vascular variants in an adult male cadaver

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.

The performance of non-ECG gated chest CT for cardiac assessment - The cardiac pathologies in chest CT (CaPaCT) study

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 (110kV_qual.ref/40mAs_qual.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.

Modeling the effect of area deprivation on COVID-19 incidences: a study of Chennai megacity, India

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 = e^0.786 = 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 = e^0.642 = 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.

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COVID-19 cases was modelled using Poisson regression and negative binomial regression.

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An IMD was devised using geographically weighted principal component analysis.

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Area deprivation in Chennai has both positive and inverse associations with the COVID-19.

652The effect of varying irrigation flow rate during irrigated radiofrequency ablation on optimising lesion shape

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 &lt; 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 &lt; 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

664Local catheter impedance drop during pulmonary vein isolation predicts conduction block in patients with paroxysmal atrial fibrillation: initial results of the LOCALIZE clinical trial

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 &lt; 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 &lt; 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

Community engagement interventions for communicable disease control in low- and lower- middle-income countries: evidence from a review of systematic reviews

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.

Molecular epidemiology, risk factors and hematological evaluation of asymptomatic Theileria annulata infected cattle in Odisha, India

BACKGROUND

Theileria annulata is a tick-borne apicomplexan parasite that affects bovine and causes severe economic losses. Aims: Our study aimed to determine the molecular prevalence of T. annulata infection in asymptomatic carrier cattle in Odisha, India, to study the association of potential risk factors with theileriosis, and to investigate the effect of the parasite infection on hematological parameters in naturally affected animals.

METHODS

A total of 226 cattle blood samples were collected from seven districts of Odisha, India. Molecular diagnoses of tropical theileriosis by polymerase chain reaction (PCR), cloning, sequencing, and phylogenetic analysis of isolated parasites were performed. Potential risk factors were investigated by univariable and multivariable logistic regression statistical analysis. Hematological parameters were compared between positive and negative animals.

RESULTS

All animals included in our study were clinically normal, however, 54.86% (124/226) of examined animals were positive by PCR for T. annulata. The multivariable logistic regression showed that contact with other cattle from different herds during grazing (P<0.0001; OR: 12.75; 95% CI: 5.21-31.21), previous history of clinical signs (P=0.002; OR: 3.31; 95% CI: 1.53-6.31), and frequency of a ectoparasiticides application pre year (P<0.0001; OR: 9.22; 95% CI: 3.03-28.09) were the potential risk factors for the occurrence of tropical theileriosis. Nucleotide sequence identity data demonstrated that T. annulata strain (MN818858) Odisha shared homology of 99.6%, 99.49%, and 99.36% with Uttar Pradesh, India (MF346035), Bahrain (AF214797), and Hyderabad, India (MK034702), respectively.

CONCLUSION

This is the first study to gain insight into the molecular epidemiology, risk factors, phylogeny, and hematological analysis of asymptomatic T. annulata infected cattle from India.