A randomised controlled trial to evaluate the effectiveness of a culture and disease-specific, patient-centric multi-component tobacco cessation intervention package for the patients attending non-communicable disease clinics in Punjab, India

BACKGROUND

Developing an infrastructure to support tobacco cessation through existing systems and resources is crucial for ensuring the greatest possible access to cessation services. The present study aims to evaluate the effectiveness of a newly developed multi-component cessation among tobacco users in Non- Communicable Disease (NCD) clinics, functioning under the National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases, & Stroke (NPCDCS) of the Government of India.

METHODS

The intervention package consisting of culture- and disease-specific four face-to-face counselling sessions, pamphlets, and short text messages (bilingual) with follow-ups at 3rd, 6th, and 9th months with an endline assessment at 12th months was delivered to the intervention arm of the two-arm- parallel group randomised controlled trial at two selected NCD clinics. Self-reported seven-day abstinence, frequency of use, expenditure in seven days at each follow-up, FTND score, stage of change and plasma cotinine values were assessed at baseline, follow-ups, and endline (using Liquid Chromatography -Mass Spectrometry), as applicable.

RESULTS

The intervention arm reported a significantly more reduction in self-reported frequency of tobacco use at 6 months (mean: 13.6, 95% CI (7.8-19.4)), 9 months (mean: 20.3, 95% CI (12.2-28.4)) and 12 months (mean: 18.7, 95% CI (8.7-28.7)). The plasma cotinine concentration at endline in the intervention arm was statistically significantly lower than the baseline concentration.

CONCLUSION

Strengthening existing health systems is crucial for offering cessation support in the resource-restraint setting of LMICs to assist in quitting sustainably.

Small Peptides Targeting BACE-1, AChE, and A-β Reversing Scopolamine-Induced Memory Impairment: A Multitarget Approach against Alzheimer's Disease

Based on the biochemical understanding of Alzheimer's disease, here, we report the design, synthesis, and biological screening of a series of compounds against this neuro-disorder. Adopting the multitarget approach, the catalytic processes of BACE-1 and AChE were targeted, and thereby, compounds 15, 22, 25, 26, 27, and 30 were identified with IC50 in the submicromolar range against these two enzymes. Further, compounds 15 and 25 displayed more than 50% inhibition of β-amyloid aggregation. Implying their physiological use, the compounds exhibited appreciable biological membrane permeability as observed through the parallel artificial membrane permeability experiment. Supporting these results, treatment of the mice with the test compounds reversed their scopolamine-affected memory impairment, where the highest healing effect was seen in the case of compound 25. Overall, the combination of molecular modeling and experimental studies provided highly effective molecules against Alzheimer's disease.

High prevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibodies among unvaccinated children of Chandigarh, Northwest India, in a household-based paediatric serosurvey post-second wave of pandemic (June to July 2021)

OBJECTIVE

Current national severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination policy covers children aged >12 years. Unvaccinated, uninfected children remain susceptible to SARS-CoV-2 and play a role in community transmission, as paediatric infection is mostly mild or asymptomatic. To estimate the proportion of susceptible children in a community for public health measures, there is a need to assess the extent of natural infection.

STUDY DESIGN

We performed a cross-sectional household serosurvey of SARS-CoV-2 antibodies in unvaccinated children aged between 6 and 18 years after the second COVID-19 wave.

METHODS

Anti-SARS-CoV-2 immunoglobin G (IgG) testing in serum was done using chemiluminescence immunoassay. We used a logistic regression model to investigate predicted factors of seropositivity.

RESULTS

We observed a high prevalence (weighted average: 68.3%) of anti-SARS-CoV-2 IgG in 2700 enrolled children. Logistic regression for predictors of IgG seropositivity showed lower odds in households with completely vaccinated adults (adjusted odds ratio [OR]: 0.43, 95% confidence interval [CI]: 0.26-0.71, P = 0.0011) compared with households with unvaccinated adults. Other factors for low seropositivity included frontline workers as family members (adjusted OR: 0.69, 95% CI: 0.52-0.91, P = 0.0091) and non-crowded households (adjusted OR: 0.74, 95% CI: 0.61-0.89, P = 0.0019).

CONCLUSION

A high SARS-CoV-2 IgG prevalence in unvaccinated children was indicative of previous exposure to potentially infected contacts. This implies in-person academic activities for children can be continued during future community transmission. Comparatively lower seropositivity in children of completely vaccinated households or frontline workers suggests decreased transmission due to vaccination-induced immunity of family members. Vaccination will still be required in these children to maintain protective IgG levels, particularly in low seroprevalence groups.

Structure and ligand based design for identification of highly potent molecules against 5-LOX

We report here small molecules consisting of dichlorophenyl substituted oxindole that is further tagged with pyrrole/indole moieties. These molecules were designed on the basis of the analysis of binding mode of 5-LOX with arachidonic acid and zileuton. The molecules traverse the active site pocket of the enzyme that otherwise hosts AA and zileuton. Moreover, with a provision of derivatization at pyrrole/indole-N, the physico-chemical properties of the molecules can be adjusted. Appreciable 5-LOX inhibitory activities of the compounds in sub-micromolar range were observed and their aqueous solubility, binding with human serum albumin and stability in blood plasma and liver microsomes were checked. The Michaelis-Menten constants obtained during the binding of the compounds with 5-LOX indicated competitive binding of the compounds with the enzyme. Overall, the combination of molecular modelling and experimental studies identified promising molecules against inflammatory diseases.

Analyzing the Impact of Image Denoising and Segmentation on Melanoma Classification Using Convolutional Neural Networks

Early skin cancer detection and its treatment are crucial for reducing death rates worldwide. Deep learning techniques have been used successfully to develop an automatic lesion detection system. This study explores the impact of pre-processing steps such as data augmentation, contrast enhancement, and segmentation on improving the convolutional neural network (CNN) performance for lesion classification. The classification network was designed from scratch by uniquely organizing its layers and using a different number of kernels, depth of the network, size, and hyperparameters. In addition, the network's performance was improved by pre-processing and segmentation steps. The proposed network was compared with the current state-of-the-art to demonstrate its best performance on the benchmark HAM10000 lesion dataset. The experimental study revealed that the classification network using denoised+segmented data achieved an accuracy (ACC), precision (PRE), recall (REC), specificity (SPE), and F-score of 93.40%, 93.45%, 94.51%, 92.08%, and 93.98%, respectively. To conclude, classification performance can be improved by incorporating pre-processing and segmentation steps.

Diverse communication strategies in bees as a window into adaptations to an unpredictable world

Communication is a fundamental feature of animal societies and helps their members to solve the challenges they encounter, from exploiting food sources to fighting enemies or finding a new home. Eusocial bees inhabit a wide range of environments and they have evolved a multitude of communication signals that help them exploit resources in their environment efficiently. We highlight recent advances in our understanding of bee communication strategies and discuss how variation in social biology, such as colony size or nesting habits, and ecological conditions are important drivers of variation in communication strategies. Anthropogenic factors, such as habitat conversion, climate change, or the use of agrochemicals, are changing the world bees inhabit, and it is becoming clear that this affects communication both directly and indirectly, for example by affecting food source availability, social interactions among nestmates, and cognitive functions. Whether and how bees adapt their foraging and communication strategies to these changes represents a new frontier in bee behavioral and conservation research.

Impaired self-awareness of cognitive deficits in Parkinson's disease relates to cingulate cortex dysfunction

BACKGROUND

Impaired self-awareness of cognitive deficits (ISAcog) has rarely been investigated in Parkinson's disease (PD). ISAcog is associated with poorer long-term outcome in other diseases. This study examines ISAcog in PD with and without mild cognitive impairment (PD-MCI), compared to healthy controls, and its clinical-behavioral and neuroimaging correlates.

METHODS

We examined 63 PD patients and 30 age- and education-matched healthy controls. Cognitive state was examined following the Movement Disorder Society Level II criteria. ISAcog was determined by subtracting z-scores (based on controls' scores) of objective tests and subjective questionnaires. Neural correlates were assessed by structural magnetic resonance imaging (MRI) and 2-[fluorine-18]fluoro-2-deoxy-d-glucose-positron emission tomography (FDG-PET) in 47 patients (43 with MRI) and 11 controls. We analyzed whole-brain glucose metabolism and cortical thickness in regions where FDG-uptake correlated with ISAcog.

RESULTS

PD-MCI patients (N = 23) showed significantly more ISAcog than controls and patients without MCI (N = 40). When all patients who underwent FDG-PET were examined, metabolism in the bilateral superior medial frontal gyrus, anterior and midcingulate cortex negatively correlated with ISAcog (FWE-corrected p < 0.001). In PD-MCI, ISAcog was related to decreased metabolism in the right superior temporal lobe and insula (N = 13; FWE-corrected p = 0.023) as well as the midcingulate cortex (FWE-corrected p = 0.002). Cortical thickness was not associated with ISAcog in these regions. No significant correlations were found between ISAcog and glucose metabolism in controls and patients without MCI.

CONCLUSIONS

Similar to Alzheimer's disease, the cingulate cortex seems to be relevant in ISAcog in PD. In PD-MCI patients, ISAcog might result from a disrupted network that regulates awareness of cognition and error processes.

Perceived stigma among diabetic patients and their caregivers: a review

AIMS

Considerable number of studies in the existing literature indicate the existence of stigma related to many diseases, disabilities, and disorders, but less attention has been given to diabetes-related stigma. This narrative review of literature aims to explore the existence of stigma surrounding type 1 diabetes mellitus (T1DM).

METHODS

Literature were searched using search engines, Google Scholar, PubMed, and Scopus electronic databases published from year 2000 to 2020. Both qualitative and quantitative studies focusing on the stigma associated with T1DM were included. A total of 21 articles met the inclusion criteria. Thematic analysis of collected research material was done.

RESULTS

Results provided substantial evidence that stigma associated with T1DM was experienced by T1DM patients and their caregivers at some point in their lives and it had affected their lives in different domains such as difficulty finding a spouse, discrimination at employment opportunities, educational institutions, management of disease, being misjudged as a druggie, poor quality of life of the patient and caregiver, depressive symptoms among parents of patients, constant worrying of their child's disease management, and so on.

CONCLUSION

Stigma related to T1DM is experienced by individuals suffering from it, and it is widespread. It not only affects the sufferers but their loved ones also. To reduce and cope-up with stigma, there is a need to increase public education and awareness at a mass level. Further research and awareness will serve to build our understanding of the experience of diabetes-related stigma.

Effect of Twin Block Therapy Versus Fixed Functional Appliances on Pharyngeal Airway Space in Skeletal Class II Patients: A Prospective Cephalometric Study

BACKGROUND

Class II malocclusion is one of the most common malocclusion with varied prevalence. Functional therapy with appliances like Twin Block or Fixed functional appliances forms the mainstay of treatment in growing Class II patients. These patients might demonstrate narrow airway due to the retrognathic position of the mandible. This study investigated the effects of twin block and fixed functional appliance therapy (Forsus™ FRD) on the pharyngeal airway space in skeletal Class II patients.

METHODS

Forty patients with Class II malocclusion were selected and divided into two equal groups of 20 patients each for both Twin block and Forsus group. Lateral cephalograms were obtained before and after the functional appliance therapy. Evaluation was done for changes in hyoid bone position, pharyngeal airway dimensions and tongue position.

RESULTS

The variables of the study showed better hyoid position in both the groups. In Twin Block group, an increase in hy-apw2 and hy-PoFH suggested anterior positioning of hyoid and a decrease in H-MP and hy-ML indicated superior positioning. In Forsus group an increase in H-H', hy-FH, hy-ML, hy-NL, hy-NSL and hy-OL suggested inferior positioning of hyoid, while an increase in hy-apw2, hy-CVT, hy-PoFH, hy-RL and hy'-tgo indicated anterior positioning of hyoid bone after functional therapy.

CONCLUSION

Both the twin block and Forsus™ FRD improved the position of the hyoid bone after the functional appliance therapy however the changes were not statistically significant. Twin block and Forsus™ had similar effect on the hyoid bone position, pharyngeal dimensions and the tongue position.

Theoretical constructs of smoking cessation among current tobacco smokers in India: a secondary analysis of Global Adult Tobacco Survey-2 (2016-2017)

BACKGROUND

Quitting tobacco smoking is a complex process, and the transtheoretical model describes the various stages of behaviour change that smokers experience to stop smoking. Predictors of intention to quit and stage of behavioural change could assist policy-makers in establishing tailor-made strategies to offer support.

OBJECTIVE

In the current study, we analysed the determinants of cessation among 9499 current smokers of India recorded during the second Global Adult Tobacco Survey (2016-2017).

METHODS

Bivariate analysis, multivariate analysis (binary logistic regression was performed for past quit attempts and intention to quit smoking in the future; multinomial logistic regression to understand predictors of various stages of change determining cessation behaviour of current smokers) was undertaken.

RESULTS

The majority of the smokers was men (91.0%), in 25-44 years age group, (42.3%), daily wagers (37.4%) and resided in the rural area (73.3%), with bidi being the most commonly smoked product (72%). Nearly 72% tried to quit without any assistance with 36.6% (precontemplation), 27% (contemplation), 28% (preparation (or action)) and 8.1% in (relapse) stage. Men ((1.049); 95% CI 1.047 to 1.051), the primary (1.192; 95% CI 1.190 to 1.193) as well as higher education, being married (1.231; 95% CI 1.229 to 1.234) and urban residence (1.167; 95% CI 1.1.65 to 1.168) were found to be associated with higher prevalence of previous quit attempts. The regression modelling found out that intent to quit reduced with increasing age and was similarly prevalent with any level of education.

CONCLUSION

Understanding stages of behavioural change could assist the stakeholders in developing individualised interventions along with the development of intensive cessation protocols in clinical and public health settings.

Are ecological communities the seat of endosymbiont horizontal transfer and diversification? A case study with soil arthropod community

Maternally inherited endosymbionts of arthropods are one of the most abundant and diverse group of bacteria. These bacterial endosymbionts also show extensive horizontal transfer to taxonomically unrelated hosts and widespread recombination in their genomes. Such horizontal transfers can be enhanced when different arthropod hosts come in contact like in an ecological community. Higher rates of horizontal transfer can also increase the probability of recombination between endosymbionts, as they now share the same host cytoplasm. However, reports of community-wide endosymbiont data are rare as most studies choose few host taxa and specific ecological interactions among the hosts. To better understand endosymbiont spread within host populations, we investigated the incidence, diversity, extent of horizontal transfer, and recombination of three endosymbionts (Wolbachia, Cardinium, and Arsenophonus) in a specific soil arthropod community. Wolbachia strains were characterized with MLST genes whereas 16S rRNA gene was used for Cardinium and Arsenophonus. Among 3,509 individual host arthropods, belonging to 390 morphospecies, 12.05% were infected with Wolbachia, 2.82% with Cardinium and 2.05% with Arsenophonus. Phylogenetic incongruence between host and endosymbiont indicated extensive horizontal transfer of endosymbionts within this community. Three cases of recombination between Wolbachia supergroups and eight incidences of within-supergroup recombination were also found. Statistical tests of similarity indicated supergroup A Wolbachia and Cardinium show a pattern consistent with extensive horizontal transfer within the community but not for supergroup B Wolbachia and Arsenophonus. We highlight the importance of extensive community-wide studies for a better understanding of the spread of endosymbionts across global arthropod communities.

Lesion Border Detection of Skin Cancer Images Using Deep Fully Convolutional Neural Network with Customized Weights

Deep learning techniques have been widely employed in semantic segmentation problems, especially in medical image analysis, for understanding image patterns. Skin cancer is a life-threatening problem, whereas timely detection can prevent and reduce the mortality rate. The aim is to segment the lesion area from the skin cancer image to help experts in the process of deeply understanding tissues and cancer cells' formation. Thus, we proposed an improved fully convolutional neural network (FCNN) architecture for lesion segmentation in dermoscopic skin cancer images. The FCNN network consists of multiple feature extraction layers forming a deep framework to obtain a larger vision for generating pixel labels. The novelty of the network lies in the way layers are stacked and the generation of customized weights in each convolutional layer to produce a full resolution feature map. The proposed model was compared with the top four winners of the International Skin Imaging Collaboration (ISIC) challenge using evaluation metrics such as accuracy, Jaccard index, and dice co-efficient. It outperformed the given state-of-the-art methods with higher values of the accuracy and Jaccard index.

Drug Information Association (DIA) 2021 Global Annual Meeting (June 26-July 1, 2021 - Virtual Meeting)

At the 57th Global Annual Meeting of the Drug Information Association (DIA), attendees met virtually for the second time to support the theme of 'Collaboration without Boundaries.' Sessions included presenters and speakers from regulatory agencies, patient advocacy and academia, with patients at the forefront of discussions. This report covers a number of presentations and panel discussions from the 4-day meeting that primarily focused on the COVID-19 global pandemic.

Phenotypic presentation of PCOS with respect to BMI in a north Indian population

Abstract

PCOS is one of the emerging health issues of women in their reproductive age with a range of associated signs and symptoms. In the present study, 250 PCOS subjects age ranged from 18 to 45 years and residing in the Chandigarh Capital Region (CCR) were selected from the OPD, PGIMER, Chandigarh, (North India). In the present study H+O phenotypic group (NIH criteria) was the most commonly occurring with the prevalence of 50.4% followed by complete PCO or classic PCOS phenotype (P+H+O) with 39.2% prevalence. The ovula-tory PCOS (P+H) and non-hyperandrogenic PCOS (P+O) demonstrated little prevalence of 6% and 4.4% respectively. Maximum overweight/obese PCOS women were recorded in the (H+O) phenotypic group (27.2%) followed by classic PCOS phenotype (20.4%), (P+H) phe-notype (4%) and lowest prevalence in P+O phenotype (1.2%), thereby indicating that hyperandrogenism and oligo-anovulation was common symptoms among overweight/obese PCOS women.

Accounting conservatism and corporate governance: evidence from India

Purpose

The paper aims to study the impact of corporate governance variables on the adoption of accounting conservatism by S&P BSE 500 index firms.

Design/methodology/approach

The period for the study is from 2010–2018. The data has been extracted from the BSE website, annual reports of the sample companies and the Prowess IQ database. Panel data methodology has been used to analyse the impact of the corporate governance variables on accounting conservatism. Accounting conservatism is the dependent variable, which has been measured by using the CONACCR (negative accruals) measure and the independent variables include the characteristics of the board of directors and the audit committee.

Findings

Overall, the relationship between accounting conservatism and corporate governance indicates a significant impact of corporate governance variables, namely, characteristics of the board of directors and the audit committee, on the accounting conservatism policy of the firm.

Originality/value

This research explores the benefits of conservatism in resolving agency conflict. Very few studies have captured the relationship of individual components of corporate governance with accounting conservatism. Moreover, this study contributes to the literature regarding the influence of corporate governance variables on the extent of conservatism used in accounting records.

A Novel Ensemble-based Classifier for Detecting the COVID-19 Disease for Infected Patients

The recently discovered coronavirus, SARS-CoV-2, which was detected in Wuhan, China, has spread worldwide and is still being studied at the end of 2019. Detection of COVID-19 at an early stage is essential to provide adequate healthcare to affected patients and protect the uninfected community. This paper aims to design and develop a novel ensemble-based classifier to predict COVID-19 cases at a very early stage so that appropriate action can be taken by patients, doctors, health organizations, and the government. In this paper, a synthetic dataset of COVID-19 is generated by a dataset generation algorithm. A novel ensemble-based classifier of machine learning is employed on the COVID-19 dataset to predict the disease. A convex hull-based approach is also applied to the data to improve the proposed novel, ensemble-based classifier's accuracy and speed. The model is designed and developed through the python programming language and compares with the most popular classifier, i.e., Decision Tree, ID3, and support vector machine. The results indicate that the proposed novel classifier provides a more significant precision, kappa static, root means a square error, recall, F-measure, and accuracy.

Biodegradation of endocrine disrupting chemicals benzyl butyl phthalate and dimethyl phthalate by Bacillus marisflavi RR014

AIM

The objectives of the present study were to explore the benzyl butyl phthalate (BBP) and dimethyl phthalate (DMP) degradation potential of Bacillus marisflavi RR014 isolated from the tap water of public toilet and also to optimize the phthalates degradation process using response surface methodology.

METHODS AND RESULTS

The minimal salt medium was used for the biodegradation analysis of phthalates. The quantification of phthalates and their intermediate metabolites identification were done by using UHPLC and LC-MS/MS respectively. The results revealed that B. marisflavi RR014 is capable of degrading both the phthalates under varying pH, temperature and salinity conditions. The formation of phthalic acid from the breakdown of BBP and DMP (500 mg l^-1 ) in the medium was observed after 24 h. After 72 h, 61% of BBP and 98·9% of DMP in the medium was degraded as monitored by UHPLC. The identification of intermediate metabolites by LC-MS/MS revealed that hydrolysis of BBP and DMP produces phthalic acid.

CONCLUSIONS

The degradation rate of both the phthalates was increased as the parameters increased up to an optimum level. The three environmental factors (pH, temperature and salt concentration) strongly affect the rate of degradation of both the phthalates. The maximum degradation rate for both the phthalates was achieved at pH 7, temperature 35°C and salt concentration of 1% as observed from the central composite experimental design.

SIGNIFICANCE AND IMPACT OF THE STUDY

It is the first report on the phthalates biodegradation potential of B. marisflavi RR014 isolated from the tap water of public toilet. The bacterium is capable of degrading BBP and DMP under varying pH, temperature and salinity, therefore, ideal to treat the phthalate contaminated environments.

Anti-atherogenic properties of Kgengwe (Citrullus lanatus) seed powder in low-density lipoprotein receptor knockout mice are mediated through beneficial alterations in inflammatory pathways

Kgengwe fruits are commonly consumed in sub-Saharan countries. Recent reports indicated low coronary artery disease rates in those regions. To investigate anti-atherogenic properties and potential mechanisms of action of Kgengwe seed powder (KSP), male low-density lipoprotein receptor knockout (LDL-r-KO) mice were fed with an atherogenic diet supplemented with (treated, n = 10) or without (controls, n = 10) 10% (w/w) KSP for 20 weeks. Proximate analysis revealed that KSP contained 38% fibre and 15% lipids. KSP supplementation was not associated with significant changes in body weight gain rate, food intake, and plasma lipid levels. However, the average atherosclerotic lesion size in the aortic roots in the KSP-treated group was 58% smaller than that in the control group (0.26 vs 0.11 mm2, p < 0.05). This strong anti-atherogenic effect was associated with significant increases in the average plasma levels of certain cytokines such as IL-10 (6 vs 13 pg/mL, p < 0.05), GM-CSF (0.1 vs 0.2 pg/mL, p < 0.05), and EPO (7 vs 16 pg/mL, p < 0.05) along with reductions in the average levels of plasma MCP-1 (19 vs 14 pg/mL, p < 0.05) and MIP-2 (28 vs 13 pg/mL, p < 0.05). Except for relatively high levels of saturated fatty acids, KSP possesses balanced nutrient compositions with strong anti-atherogenic properties, which may be mediated through alterations in inflammatory pathways. Additional studies warrant confirmation and mechanism(s) of action of such effects. Novelty: Kgengwe seeds prevent atherogenesis in LDL-r-KO mice. Kgengwe seeds increase circulating levels of IL-10 and EPO. No reduction in plasma total cholesterol levels.

An integrated fog and Artificial Intelligence smart health framework to predict and prevent COVID-19

Nowadays, COVID-19 is spreading at a rapid rate in almost all the continents of the world. It has already affected many people who are further spreading it day by day. Hence, it is the most essential to alert nearby people to be aware of it due to its communicable behavior. Till May 2020, no vaccine is available for the treatment of this COVID-19, but the existing technologies can be used to minimize its effect. Cloud/fog computing could be used to monitor and control this rapidly spreading infection in a cost-effective and time-saving manner. To strengthen COVID-19 patient prediction, Artificial Intelligence(AI) can be integrated with cloud/fog computing for practical solutions. In this paper, fog assisted the internet of things based quality of service framework is presented to prevent and protect from COVID-19. It provides real-time processing of users' health data to predict the COVID-19 infection by observing their symptoms and immediately generates an emergency alert, medical reports, and significant precautions to the user, their guardian as well as doctors/experts. It collects sensitive information from the hospitals/quarantine shelters through the patient IoT devices for taking necessary actions/decisions. Further, it generates an alert message to the government health agencies for controlling the outbreak of chronic illness and for tanking quick and timely actions.

Identification and characterization of a halocin-producing haloarchaeon isolated from Pachpadra salt lake

Haloarchaea are known to produce antimicrobial proteins, halocins which are generally stable at extreme conditions suggesting their potential biotechnological applications. Here, we report a halocin-producing haloarchaeon isolated from salt lake and identified as Haloferax larsenii HA4 using partial 16S rDNA sequence and biochemical properties. Whole-cell methanolysate showed ether-linked lipids, which is a characteristic feature of haloarchaea. Strain HA4 was able to grow at pH 6·0-10·0 and 15-30% NaCl. The growth response was normal but antimicrobial activity was detected only during the log-phase. Crude halocin HA4 was active in the pH range of pH 2·0-10·0 with stability up to 100°C. Cell-free supernatant (CFS) was also stable in different organic solvents and detergents tested. However, halocin activity was reduced after treatment with proteinase K suggesting the proteinaceous nature of the active compound. Concentrated CFS showed the presence of several proteins from 6·5-66 kDa but bioassay suggested ~14 kDa protein as halocin. Crude halocin preparation showed cytocidal activity against indicator strain, H. larsenii HA10 and inhibited the growth of other related strains such as H. larsenii HA3, HA8, HA9 and HA10.

Nanotechnology and its challenges in the food sector: a review

Antibacterial activity of nanoparticles has received significant attention worldwide because of their great physical and chemical stability, excellent magnetic properties, and large lattice constant values. These properties are predominate in the food science for enhancing the overall quality, shelf life, taste, flavor, process-ability, etc., of the food. Nanoparticles exhibit attractive antibacterial activity due to their increased specific surface area leading to enhanced surface reactivity. When nanoparticles are suspended in the biological culture, they encounter various biological interfaces, resulting from the presence of cellular moieties like DNA, proteins, lipids, polysaccharides, etc., which helps antibacterial properties in many ways. This paper reviews different methods used for the synthesis of nanoparticles but is specially focusing on the green synthesis methods owing to its non-toxic nature towards the environment. This review highlights their antibacterial application mainly in the food sector in the form of food-nanosensors, food-packaging, and food-additives. The possible mechanism of nanoparticles for their antibacterial behavior underlying the interaction of nano-particles with bacteria, (i) excessive ROS generation including hydrogen peroxide (H₂O₂), OH^- (hydroxyl radicals), and O^- ₂ ² (peroxide); and (ii) precipitation of nano-particles on the bacterial exterior; which, disrupts the cellular activities, resulting in membranes disturbance. All these phenomena results in the inhibition of bacterial growth. Along with this, their current application and future perspectives in the food sector are also discussed. Nanoparticles help in destroying not only pathogens but also deadly fungi and viruses. Most importantly it is required to focus more on the crop processing and its containment to stop the post-harvesting loss. So, nanoparticles can act as a smart weapon towards the sustainable move.

Effectiveness of Interventional Strategies in Modulating Knowledge and Attitude of Health Care Professionals for Promoting Organ Donation: A Study in Tertiary Care Public Hospital of North India

Objective:

To evaluate the impact of interventional “educational module” on knowledge and attitude regarding organ donation amongst resident doctors and nurses in the Institute of National Importance.

Study Design:

Interventional and prospective.

Methods:

We devised an interactive educational module covering various aspects of organ donation through a series of audiovisual lectures and information booklets. Resident doctors and nurses posted in those areas of the 1948-bedded Postgraduate Institute of Medical Education and Research (PGIMER), where head injury patients were treated and were subject to intervention using this module. The pre and postinterventional scores of their knowledge and attitude regarding organ donation were compared to find out impact of the intervention.

Results:

A total of 242 nurses and 87 resident doctors participated in this research. Higher knowledge score was observed preintervention amongst doctors as compared to nurses. Significant improvement was seen in total knowledge scores of both groups postintervention. Doctors had better scores for the “concept of organ donation,” while nurses were more familiar with “procedures and protocols.” Both had low knowledge about “clinical criteria for brain death” and “legal issues” preintervention which improved significantly postintervention. The positive impact of intervention was also observed on attitude in both categories. A significant impact of intervention was observed on overall propensity of doctors and nurses to promote organ donation, for pledging their own organs and for counseling of the patient/attendants on this cause.

Conclusion:

Scientifically designed educational modules have a promising role in improving awareness and attitude of health care professionals regarding organ donation and their propensity to be prospective donors, effective counselors, and advocates of organ donation.

Interpregnancy interval and risk of perinatal death: a systematic review and meta-analysis

BACKGROUND

Interpregnancy interval (IPI) <6 months is a potentially modifiable risk factor for adverse perinatal health outcomes.

OBJECTIVE

This systematic review evaluated the international literature on the risk of perinatal death associated with IPI.

SEARCH STRATEGY

Two independent reviewers screened titles and abstracts identified in MEDLINE, EMBASE and Scopus from inception to 4 April 2019 (Prospero Registration #CRD42018092792).

SELECTION CRITERIA

Studies were included if they provided a description of IPI measurement and perinatal death, including stillbirth and neonatal death.

DATA COLLECTION AND ANALYSIS

A narrative review was performed for all included studies. Random effects meta-analysis was used to compare unadjusted odds of perinatal death associated with IPI <6 months and IPI ≥6 months. Analyses were performed by outcome of the preceding pregnancy and study location.

MAIN RESULTS

Of the 624 unique articles identified, 26 met the inclusion criteria. The pooled unadjusted odds ratio of perinatal death for IPI <6 months was 1.34 (95% CI 1.17-1.53) following a previous live birth, 0.85 (95% CI 0.73-0.99) following a previous miscarriage and 1.07 (95% CI 0.84-1.36) following a previous stillbirth compared with IPI ≥6 months. However, few high-income country studies reported an association after adjustment. Fewer studies evaluated the impact of long IPI on perinatal death and what evidence was available showed mixed results.

CONCLUSIONS

Results suggest a possible association between short IPI and risk of perinatal death following a live birth, particularly in low- to middle-income countries.

TWEETABLE ABSTRACT

Short IPI <6 months after a live birth was associated with greater risk of perinatal death than IPI ≥6 months.

Consumers� Attitudes Toward Functional Foods: A�Review

The market for functional foods, fortified with added nutrients such as minerals, vitamins, micronutrients, antioxidants and fibers, is on the rise. In this review, we discuss the concept and nature of functional foods, the constituents or ingredients that are commonly used to fortify these foods, and the purpose of fortification. Finally, the review surveys consumers� attitudes toward functional foods and their importance to help their development and marketing.

Ant behaviour and brain gene expression of defending hosts depend on the ecological success of the intruding social parasite

The geographical mosaic theory of coevolution predicts that species interactions vary between locales. Depending on who leads the coevolutionary arms race, the effectivity of parasite attack or host defence strategies will explain parasite prevalence. Here, we compare behaviour and brain transcriptomes of Temnothorax longispinosus ant workers when defending their nest against an invading social parasite, the slavemaking ant Temnothorax americanus. A full-factorial design allowed us to test whether behaviour and gene expression are linked to parasite pressure on host populations or to the ecological success of parasite populations. Albeit host defences had been shown before to covary with local parasite pressure, we found parasite success to be much more important. Our chemical and behavioural analyses revealed that parasites from high prevalence sites carry lower concentrations of recognition cues and are less often attacked by hosts. This link was further supported by gene expression analysis. Our study reveals that host-parasite interactions are strongly influenced by social parasite strategies, so that variation in parasite prevalence is determined by parasite traits rather than the efficacy of host defence. Gene functions associated with parasite success indicated strong neuronal responses in hosts, including long-term changes in gene regulation, indicating an enduring impact of parasites on host behaviour. This article is part of the theme issue 'The coevolutionary biology of brood parasitism: from mechanism to pattern'.

Was Hawan Designed to Fight Anxiety-Scientific Evidences?

Anxiety is a psychiatric disorder with unknown neurobiology; however, neurotransmitters like gamma-amino butyric acid, norepinephrine and serotonin (5-HT) play crucial roles in mediating anxiety. Present drug modules pose dependence risk to the patient; hence, there is a great need to develop complementary therapies to fight this disorder. Aromatherapy has also been employed in ancient times for a number of mental disorders. Mahamrituanjay Mantra, Om triambkum yajamahe, sughandhim puushtivardhanam, urvarukmev vandhanaat, mrityu mokshay mamritaat!!!!, the part of veda enlightens that aroma gives rise to good health (sughandhim puushtivardhanam). Hawan is a religious practice recommended for mental peace. Hawan is a process in which special herbs are offered in the fire of medicinal woods ignited in a specially designed fire pit. Analysis of literature demonstrates that the components of Hawan are having a number of volatile oils that are specifically useful for prevention and treatment of anxiety through some mechanism of action. Due to high temperature of fire, the vapors of these oils from herbs enter into the central nervous system through nasal route. As per modern science and ancient texts on medicine, nasal drug delivery systems are the best for the diseases related to brain and head. The routine of performing Hawan might keep the threshold value of the therapeutic components in the body and help in preventing anxiety. In the present manuscript, authors highlight and integrate the modern and ancient concepts for treatment and prevention of anxiety through scientific evidences.

An endophytic Penicillium oxalicum isolated from Citrus limon possesses antioxidant and genoprotective potential

AIMS

This study aimed at isolating endophytic fungi from Citrus limon (L.) possessing antioxidative and genoprotective potential.

METHODS AND RESULTS

Endophytic fungi were screened for antioxidant activity using 2,2-diphenyl,1-picryl hydrazyl radical scavenging assay and maximum activity (79·70%) was exhibited by culture MP1 identified to be Penicillium oxalicum on the basis of morphological and molecular characteristics. The ethyl acetate extract of MP1 was subjected to silica column chromatography followed by LH 20 column chromatography for purification of active metabolites. The partially purified active fraction of P. oxalicum MP1 possessed good antioxidant activity as detected using various assays. It also exhibited a strong DNA damage protection potential on pUC19 plasmid DNA treated with Fenton reagent. On exposure to active fraction of MP1 significant reduction (P < 0·05) in nuclear deformities (like nuclear buds, micronuclei, nuclear ridges and binucleated cells) was observed in human lymphocytes pretreated with a toxic concentration of H₂ O₂ . In vivo genoprotectivity studies were conducted in fresh water fish Channa punctatus pretreated with a damaging compound 4-nonyl phenol. The active fraction of P. oxalicum MP1 caused a reduction of 94·7 and 66·60% in micronuclei and aberrant cell formation, respectively. A significant reduction (P < 0·05) in tail length and tail DNA parameters was also observed in comet assay.

CONCLUSION

The endophytic P. oxalicum isolated in this study has the potential to produce metabolites possessing antioxidant and genoprotective activities.

SIGNIFICANCE AND IMPACT OF THE STUDY

The isolated culture can be exploited in the field of therapeutics by virtue of its in vitro and in vivo genoprotective potential.

P263 Characterisation of patients with acute myocardial infarction complicated by left ventricular thrombus

Funding Acknowledgements

None

Background/Introduction

Left ventricular (LV) thrombus is a widely recognized complication of acute myocardial infarction (AMI).  Limited data are available from South East Asian patients with this post-infarction complication nor on whether patients with non-ST segment elevation myocardial infarction (NSTEMI) or STEMI with associated LV thrombosis exhibit differing clinical characteristics and/or outcomes. Left Ventricular Ejection Fraction (LVEF) ≤ 40% is a recognized predictor of LV thrombus formation, but there is limited data on LV thrombus patients with EF &gt; 40% or in NSTEMI patients.

Purpose

This study aims to investigate and compare the clinical characteristics, treatment and outcomes of post-AMI patients with LV thrombus formation, with a particular emphasis on those with EF ≤ 40% and in NSTEMI patients. 

Methods

Among 5829 consecutive echocardiogram results containing the keyword "thrombus" from August 2006 to September 2017, we identified 289 post-AMI patients with acute LV thrombus formation. Demographics, treatment and outcome measures were analysed.

Results

Cardiovascular risk factors such as dyslipidaemia (54.0%) and hypertension (50.5%) were commonly present in post-AMI patients with LV thrombus. Mean LVEF was 33.0 ± 10.4%. The majority (68.0%) of patients received triple therapy and 59.5% achieved thrombus resolution. NSTEMI patients had greater number of co-morbidities including heart failure (p &lt; 0.01), documented history of  ischaemic heart disease preceding the AMI leading to thrombus formation (p &lt; 0.01) and lower LVEF (28.3 ± 9.3% vs. 34.8 ± 10.3% , p &lt; 0.01) compared with STEMI cases. On multivariate analysis, having a lower EF was a significant independent predictor of stroke (HR 0.96, 95% CI 0.93-1.00, p = 0.03) and all-cause mortality (HR 0.95, 95% CI 0.92-0.99, p &lt; 0.01). The categories of STEMI and NSTEMI did not predict thrombus resolution, stroke events or all-cause mortality after adjustment.

Conclusion(s)

  Post-AMI LV thrombus patients with NSTEMI and STEMI differed in terms of their co-morbidities in their demographics and co-morbidities but it was a lower EF that was associated with an increased risk of stroke and all-cause mortality. Further studies on this topic are required.

MSTO1 mutations cause mtDNA depletion, manifesting as muscular dystrophy with cerebellar involvement

MSTO1 encodes a cytosolic mitochondrial fusion protein, misato homolog 1 or MSTO1. While the full genotype–phenotype spectrum remains to be explored, pathogenic variants in MSTO1 have recently been reported in a small number of patients presenting with a phenotype of cerebellar ataxia, congenital muscle involvement with histologic findings ranging from myopathic to dystrophic and pigmentary retinopathy. The proposed underlying pathogenic mechanism of MSTO1-related disease is suggestive of impaired mitochondrial fusion secondary to a loss of function of MSTO1. Disorders of mitochondrial fusion and fission have been shown to also lead to mitochondrial DNA (mtDNA) depletion, linking them to the mtDNA depletion syndromes, a clinically and genetically diverse class of mitochondrial diseases characterized by a reduction of cellular mtDNA content. However, the consequences of pathogenic variants in MSTO1 on mtDNA maintenance remain poorly understood. We present extensive phenotypic and genetic data from 12 independent families, including 15 new patients harbouring a broad array of bi-allelic MSTO1 pathogenic variants, and we provide functional characterization from seven MSTO1-related disease patient fibroblasts. Bi-allelic loss-of-function variants in MSTO1 manifest clinically with a remarkably consistent phenotype of childhood-onset muscular dystrophy, corticospinal tract dysfunction and early-onset non-progressive cerebellar atrophy. MSTO1 protein was not detectable in the cultured fibroblasts of all seven patients evaluated, suggesting that pathogenic variants result in a loss of protein expression and/or affect protein stability. Consistent with impaired mitochondrial fusion, mitochondrial networks in fibroblasts were found to be fragmented. Furthermore, all fibroblasts were found to have depletion of mtDNA ranging from 30 to 70% along with alterations to mtDNA nucleoids. Our data corroborate the role of MSTO1 as a mitochondrial fusion protein and highlight a previously unrecognized link to mtDNA regulation. As impaired mitochondrial fusion is a recognized cause of mtDNA depletion syndromes, this novel link to mtDNA depletion in patient fibroblasts suggests that MSTO1-deficiency should also be considered a mtDNA depletion syndrome. Thus, we provide mechanistic insight into the disease pathogenesis associated with MSTO1 mutations and further define the clinical spectrum and the natural history of MSTO1-related disease.

Evaluation of genotoxic and cytotoxic effects of ethyl acetate extract of Aspergillus flavus on Spodoptera litura

AIM

Recent concerns about the possible adverse effects of agricultural chemicals on health and environment have generated a considerable interest in biological alternatives. This study aimed to test the insecticidal potential of fungus Aspergillus flavus and revealed its genotoxic and cytotoxic effects using Spodoptera litura (Fabricius) as a model.

METHODS AND RESULTS

The fungus was isolated from the surface of the dead insect and investigated for its insecticidal potential against S. litura by bioassay studies. Significant increase in mortality, prolonged development period and reduced adult emergence in S. litura were observed in larva fed on diet supplemented with fungal extract. In addition, fungus was also found to cause oxidative stress, DNA damage and cell death. Significantly higher percentages of necrotic cells and DNA damage were observed in larvae treated with fungal extract. Furthermore, DNA repair studies predicted the longevity of toxic effects induced by fungus. Phytochemical and ultra-high performance liquid chromatography studies revealed the presence of phenolic compounds in the extract and liquid chromatography-mass spectrometry indicated it to be a non-aflatoxin strain of A. flavus. Fungal extract was less toxic to mammalian cell lines as compared to cytotoxic drug doxorubicin (DOX) in the MTT assay.

CONCLUSION

The study highlights the insecticidal potential of A. flavus by revealing its genotoxicity and cytotoxicity causing potential. This is the first report showing the genotoxic and cytotoxic effects of the fungus A. flavus on S. litura.

SIGNIFICANCE AND IMPACT OF THE STUDY

The study provides a useful insight to explore microbial agents as biopesticides in order to reduce various environmental as well as human health problems due to synthetic pesticides.

Patient-Reported Outcome Measures Among Breast Cancer Survivors in Malaysia: A Comparative Study With Patients From High-Income Countries

Background: Patient-reported outcome measures (PROMs) are essential for identifying how patients perceive the outcomes of their cancer treatment, and is the ultimate success of cancer care. Although a growing number of studies have focused on PROMs in high income countries (HICs), outcomes relevant to patients in developing countries are less understood. Furthermore, the lack of standardization in PROMs makes it difficult to interpret these data for research or quality monitoring. Aim: In this study, we compared the results of PROM measures between patients in Malaysia, a middle income country, and those in HICs, using standard PROMs questionnaires. We also explored the differences in perceived importance of patient reported outcomes within the multiracial Malaysian cohort. Methods: Breast cancer patients (n=1063) were recruited in hospitals serving suburban areas of Malaysia. Of these, 969 patients were eligible for analysis. The surveys were conducted through face-to-face interviews (68%) or were self-administered (30%). An outcome was considered important if it was scored between 7-9 on a 9-point Likert scale. We compared PROMs scores between Malaysian patients and data previously collected from patients in HICs using logistic regression models, adjusting for demographic and clinical characteristics. A two-step cluster analysis was conducted to explore differences in the perceived importance of PROMs between clusters of Malaysian patients. Results: Compared with 1777 patients from HICs, Malaysian patients were less likely to rate overall and recurrence free survival, as well as emotional, cognitive, social and sexual functioning as very important outcomes. Interestingly, more Malaysian women reported that pain (50% vs. 39%), breast symptoms (51% vs. 35%), and major complications (60% vs. 44%) were very important outcomes ( P < 0.001). Compared with young, married Malaysian women, the cluster of older married women (mean age of 57 vs. 52), who were less likely to have received breast reconstructive surgery (8.6% vs. 16.8%), was more likely to rate sexual functioning (32.8% vs. 25.0%, P = 0.036), body image (63.9% vs. 42.4%, P < 0.001), and satisfaction with the breast (50.7% vs. 37.0%, P = 0.011) as very important outcomes. Conclusion: The differences in breast cancer patient needs between and within populations should be considered carefully to better clinician-patient relationship, patient care and satisfaction and assess the outcomes of our cancer care. Future research is needed to find suitable targeted interventions to identify and address the diverse needs of breast cancer patients in low and middle income countries.

Effectiveness of Breast Care Nurse Led Video Orientation Programme on Information and Navigation for Newly Diagnosed Breast Cancer Patients at University Malaya Medical Center, Malaysia

Background: Advancement in medical treatment with wider treatment options have made breast cancer (BC) care more complex. Short consultation time with physicians, treatment complexities, patients' fears and poor coping skills at the time of diagnosis may affect patient´s decision that cause treatment delays and nonadherence. Main reasons for advance BC presentation in Malaysia are delay in taking treatment decision and poor breast health literacy on disease and treatment outcomes may contribute to nonadherence to treatments. To address this knowledge gap, a breast care nurse (BCN) led orientation video for new patients to navigate them through complex multimodal treatment processes. This audio-visual educational tool address multimodal treatments and its side effects and in addition navigating admission, discharge and follow-up, advice on diet and exercise to maintain a healthy life style during survivorship period was developed in layperson language in Malay, Mandarin and English. Aim: To assess the effectiveness of BCN led video orientation on the improvement of patient knowledge and satisfaction. Methods: A pilot study was carried out in 50 patients to assess the effectiveness of the video, and found that patients needed a face to face interaction to watch the video. Hence, a BCN led orientation was developed to use the video. A self-administered pre- and postsurvey on 246 newly diagnosed breast cancer patients in University Malaya Medical Center (UMMC) was performed to evaluate expectations, satisfactions and knowledge (a Likert scale response using items 4 number scale was used, 0 means “no knowledge” and 4 means “a great degree of knowledge”). The scoring was done before and after the video orientation was done. A Wilcoxon matched-paired signed-rank test was perform to analyze the changes in the scoring. Results: Among 247 patients, who received the BCN led video orientation program, 79.3% (n= 197) found that the video met or exceeded their expectations. 23.9% (n=59) and 56.3% (139) consecutively found the video very effective and effective in broadening their perspective on BC treatments. And 171 (69.2%) of them overall rated the video highly met their expectations. There were significant improvement in knowledge for treatment options for BC, mean scores (M=0.93 versus M=2.97) before and after watching the video ( P < 0.001). Similar findings were found in different types of operation for BC; procedure for admission in UMMC, information on chemotherapy; radiotherapy; hormone therapy and alternative medicine for BC. It also showed improved knowledge scores for healthy diet; physical activity after treatments and care of the arm after operation ( P < 0.001). Conclusion: Video-based information on treatments and navigating care through a BCN led service had effectively improved patients' knowledge and satisfaction. This approach can be used to educate cancer patients in a middle resource setting.

Exploration of insecticidal potential of an alpha glucosidase enzyme inhibitor from an endophytic Exophiala spinifera

AIM

The present study aimed to isolate and screen endophytes from Trachyspermum ammi with the ability to inhibit alpha glucosidase enzyme and evaluate their insecticidal potential.

METHODS AND RESULTS

Endophytic fungi isolated from T. ammi were screened for alpha glucosidase inhibitory activity. Maximum inhibition (96%) was observed in an isolate AZ-9, identified to be Exophiala spinifera on morphological and molecular basis. Production of fungal metabolites was carried out in malt extract broth followed by extraction with ethyl acetate. Brown coloured gummy residue obtained after evaporation of ethyl acetate was partially soluble in water yielding white precipitates. The precipitate exhibiting α-glucosidase inhibitory activity was purified by repeated washing and centrifugation. The insecticidal activity of inhibitor was evaluated on Spodoptera litura (Fab.) by feeding this pest on diet amended with inhibitor. It resulted in significant larval mortality as well as deformities in emerging adults. A reduction in vivo digestive enzyme activity was also observed. Nutritional analysis revealed the toxic effect of AZ-9 inhibitor on various food utilization parameters of S. litura. A significant reduction was recorded in relative growth and consumption rate of S. litura.

CONCLUSIONS

This is the first report on production of an alpha glucosidase inhibitor from E. spinifera with insecticidal activity.

SIGNIFICANCE AND IMPACT OF THE STUDY

The study highlights the importance of endophytes in providing protection against insect pests to the host. It also suggests the insecticidal potential of alpha glucosidase inhibitor from E. spinifera against polyphagous pest S. litura.