BST2 regulates interferon gamma-dependent decrease in invasion of HTR-8/SVneo cells via STAT1 and AKT signaling pathways and expression of E-cadherin

The mechanism by which interferon-gamma (IFN-γ) downregulates trophoblast invasion needs further investigation. Treatment of HTR-8/SVneo cells with IFN-γ led to a decrease in their invasion concomitant with an increased expression of BST2. Silencing of BST2 by siRNA showed a significant increase in their invasion and spreading after treatment with IFN-γ as well as downregulated expression of E-cadherin. Further, STAT1 silencing inhibited the IFN-γ-dependent increase in the expression of BST2 and E-cadherin. Treatment of HTR-8/SVneo cells with IFN-γ led to the activation of AKT, and its inhibition with PI3K inhibitor abrogated IFN-γ-mediated decrease in invasion/spreading and downregulated BST2 and E-cadherin expression. Collectively, IFN-γ decreases the invasion of HTR-8/SVneo cells by STAT1 and AKT activation via increased expression of BST2 and E-cadherin.

Genetic Gains in Pearl Millet in India: Insights Into Historic Breeding Strategies and Future Perspective

Pearl millet (Pennisetum glaucum R. Br.) is an important staple and nutritious food crop in the semiarid and arid ecologies of South Asia (SA) and Sub-Saharan Africa (SSA). In view of climate change, depleting water resources, and widespread malnutrition, there is a need to accelerate the rate of genetic gains in pearl millet productivity. This review discusses past strategies and future approaches to accelerate genetic gains to meet future demand. Pearl millet breeding in India has historically evolved very comprehensively from open-pollinated varieties development to hybrid breeding. Availability of stable cytoplasmic male sterility system with adequate restorers and strategic use of genetic resources from India and SSA laid the strong foundation of hybrid breeding. Genetic and cytoplasmic diversification of hybrid parental lines, periodic replacement of hybrids, and breeding disease-resistant and stress-tolerant cultivars have been areas of very high priority. As a result, an annual yield increase of 4% has been realized in the last three decades. There is considerable scope to further accelerate the efforts on hybrid breeding for drought-prone areas in SA and SSA. Heterotic grouping of hybrid parental lines is essential to sustain long-term genetic gains. Time is now ripe for mainstreaming of the nutritional traits improvement in pearl millet breeding programs. New opportunities are emerging to improve the efficiency and precision of breeding. Development and application of high-throughput genomic tools, speed breeding, and precision phenotyping protocols need to be intensified to exploit a huge wealth of native genetic variation available in pearl millet to accelerate the genetic gains.

miR-27b-5p inhibits BeWo cells fusion by regulating WNT2B and enzyme involved in progesterone synthesis

PROBLEM

The miRNAs show placenta-specific expression patterns, which alter during pregnancy-related complications. In present study, the role of miR-27b-5p during forskolin-mediated BeWo cells fusion has been investigated.

METHOD OF STUDY

The fusion of BeWo cells in response to forskolin treatment (25 µM) was studied by desmoplakin I+II staining. Expression profile of miR-27b-5p by qRT-PCR and its targets HSD3β1 and WNT2B by qRT-PCR and in Western blot were studied. The effect of overexpression of miR-27b-5p and silencing of HSD3β1 & WNT2B by siRNA on forskolin-mediated BeWo cells fusion and secretion of hCG and progesterone by ELISA was investigated.

RESULTS

Time-dependent down-regulation in the expression of miR-27b-5p in forskolin-treated BeWo cells has been confirmed by qRT-PCR. Overexpression of miR-27b-5p significantly inhibits forskolin-mediated BeWo cells fusion as well as hCG & progesterone secretion. HSD3β1 and WNT2B were identified as targets of miR-27b-5p and are up-regulated in forskolin-treated BeWo cells. Overexpression of miR-27b-5p in BeWo cells downregulates their expression. Further, luciferase reporter assay revealed that miR-27b-5p directly target expression of both HSD3β1 and WNT2B. Silencing of both HSD3β1 and WNT2B leads to a significant reduction in forskolin-mediated BeWo cells fusion with concomitant decrease in the secretion of progesterone or/and hCG. Decrease in forskolin-mediated cells fusion observed in miR-27b-5p mimic transfected BeWo cells could be rescued by the overexpression of both HSD3β1 and WNT2B.

CONCLUSION

These observations suggest that reduced miR-27b-5p in forskolin-treated BeWo cells leads to increased secretion of progesterone and hCG due to loss of repressional control on HSD3β1 and WNT2B.

Generation of the Compression-induced Dedifferentiated Adipocytes (CiDAs) Using Hypertonic Medium

Current methods to obtain mesenchymal stem cells (MSCs) involve sampling, culturing, and expanding of primary MSCs from adipose, bone marrow, and umbilical cord tissues. However, the drawbacks are the limited numbers of total cells in MSC pools, and their decaying stemness during in vitro expansion. As an alternative resource, recent ceiling culture methods allow the generation of dedifferentiated fat cells (DFATs) from mature adipocytes. Nevertheless, this process of spontaneous dedifferentiation of mature adipocytes is laborious and time-consuming. This paper describes a modified protocol for in vitro dedifferentiation of adipocytes by employing an additional physical stimulation, which takes advantage of augmenting the stemness-related Wnt/β-catenin signaling. Specifically, this protocol utilizes a polyethylene glycol (PEG)-containing hypertonic medium to introduce extracellular physical stimulation to obtain higher efficiency and introduce a simpler procedure for adipocyte dedifferentiation.

Human Zona Pellucida Glycoproteins: Binding Characteristics With Human Spermatozoa and Induction of Acrosome Reaction

Human zona pellucida (ZP) matrix is composed of four glycoproteins designated as ZP glycoprotein -1 (ZP1), -2 (ZP2), -3 (ZP3), and -4 (ZP4). Mutations in the genes encoding human ZP glycoproteins are one of the causative factors leading to abnormal ZP matrix and infertility in women. Relevance of the human ZP glycoproteins in 'sperm-oocyte' binding has been delineated by using either transgenic animal models expressing human zona proteins or purified native/recombinant human zona proteins. Studies based on the purified native/recombinant human zona proteins revealed that ZP1, ZP3, and ZP4 primarily bind to the capacitated acrosome-intact human spermatozoa whereas ZP2 binds to acrosome-reacted spermatozoa. On the contrary, human spermatozoa binds to the eggs obtained from transgenic mouse lines expressing human ZP2 but not to those expressing human ZP1, ZP3, and ZP4 suggesting that ZP2 has an important role in human 'sperm-oocyte' binding. Further studies using transgenic mouse lines showed that the N-terminus of human ZP2 mediate the taxon-specific human sperm-oocyte binding. Both glycans and protein-protein interactions have a role in human gamete interaction. Further studies have revealed that the purified native/recombinant human ZP1, ZP3, and ZP4 are competent to induce acrosome reaction. Human sperm binds to the mouse transgenic eggs expressing human ZP1-4 instead of mouse ZP1-3 proteins, penetrated the ZP matrix and accumulated in the perivitelline space, which were acrosome-reacted suggesting that human ZP2 in transgenic mouse model also induce acrosome reaction. In humans N-linked glycosylation of zona proteins have been shown to play an important role in induction of the acrosome reaction. Hence in humans, based on studies using transgenic mouse model as well as purified native/recombinant zona proteins, it is likely that more than one zona protein is involved in the 'sperm-oocyte' binding and induction of the acrosome reaction.

Clinical utility of procalcitonin in bacterial infections in patients undergoing hematopoietic stem cell transplantation

BACKGROUND

Infections are major contributor to morbidity and mortality in patients undergoing bone marrow transplant (BMT).

OBJECTIVE

To assess role of serum procalcitonin (PCT) as a useful biomarker for the infections and outcomes in these patients.

METHODS

Retrospective observational study.

RESULTS

Total 47 patients with febrile episodes were enrolled. Twenty patients underwent autologous BMT and 27 underwent allogeneic BMT. Bacterial infections were documented in 18/47 (38%) patients. Forty patients were neutropenic. The median fever duration was 10 days (range 3-30 days) in positive procalcitonin level group whereas it was 4 days (range 1-18) in negative group. This was statistically significant (P=0.000). Procalcitonin levels were high in 8/9 episodes of sepsis (P=0.029). Intensive care unit transfers and death were significantly higher in PCT positive group as compared to PCT negative group.

CONCLUSION

Serum procalcitonin levels provide prognostic information of worse outcome in patients undergoing HSCT.

Alkylated benzimidazoles: Design, synthesis, docking, DFT analysis, ADMET property, molecular dynamics and activity against HIV and YFV

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New benzimidazole analogs synthesized as antivirals against HIV-1 and yellow fever virus.

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Molecular dynamics simulation studies indicated a stable ligand-protein complex of compound 3a within NNIBP of HIV-RT.

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DFT analysis confirmed the stability of hydrogen bonding interaction between the TRP 229 residue of HIV-RT and compound 3a.

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Molecules were tested for their anti-HIV and broad spectrum antiviral properties against different DNA and RNA viruses.

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Antiviral properties and cytotoxicity determined using MTT assay.

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Compound 3a showed anti-HIV activity and compound 2b showed excellent inhibition property against yellow fever virus.

A series of alkylated benzimidazole derivatives was synthesized and screened for their anti-HIV, anti-YFV, and broad-spectrum antiviral properties. The physicochemical parameters and drug-like properties of the compounds were assessed first, and then docking studies and MD simulations on HIV-RT allosteric sites were conducted to find the possible mode of their action. DFT analysis was also performed to confirm the nature of the hydrogen bonding interaction of active compounds. The in silico studies indicated that the molecules behaved like possible NNRTIs. The nature – polar or non-polar and position of the substituent present at fifth, sixth, and N-1 positions of the benzimidazole moiety played an important role in determining the antiviral properties of the compounds. Among the various compounds, 2-(5,6-dibromo-2-chloro-1H-benzimidazol-1-yl)ethan-1-ol (3a) showed anti-HIV activity with an appreciably low IC₅₀ value as 0.386 × 10⁻⁵μM. Similarly, compound 2b, 3-(2-chloro-5-nitro-1H-benzimidazol-1-yl) propan-1-ol, showed excellent inhibitory property against the yellow fever virus (YFV) with EC₅₀ value as 0.7824 × 10⁻²μM.

IFTAK technique: An advanced Ksharsutra technique for management of fistula in ano

Fistula in ano is mostnotorious disease among all the ano-rectal disorders since antiquity. Over the past few decades, various techniques are being evaluated in terms to prevent its recurrence and complications, but despite more than two millennia of efforts, fistula in ano still remains a perplexing surgical disease. The sign and symptoms of fistula in ano resembles with Bhagandara described in Ayurveda classics. For the management of this painful disease many treatment modalities are enumerated in Ayurveda classics and Ksharsutra therapy is one among them which is proved to be gold standard. Though Ksharsutra therapy is big revolution in the field of fistula in ano, but it has some disadvantages like it is time consuming process, severe post-procedural pain, big scar mark. So, in present era IFTAK is emerging as an advanced innovative technique for the management of fistula in ano along with betterment in the consequences of conventional method of Ksharsutra therapy. In the present case report, IFTAK (Interception of Fistulous tract and application of Ksharsutra) technique is used in trans sphincteric fistula in ano which showed a great potential in management by minimizing the duration of treatment, mild post procedural pain and minimum scar mark.

Hyperinsulinemia and Hypoadiponectinemia are Associated with Increased Risk for Occurrence of Ovarian Cancer in Non-diabetic Women of North Indian Population

Ovarian cancer has been emerged as a most common and lethal gynecological malignancy in India. High serum insulin and low adiponectin have been associated with increased risk of ovarian cancer. But their role in development of ovarian cancer is conflicting and little evidence is available. We aimed to evaluate blood levels of insulin and adiponectin in epithelial ovarian cancer (EOC) patients and their association with the risk to develop EOC. The study included following three groups; Group 1: fifty cases of cytohistopathologically confirmed cases of EOC, Group 2: fifty age matched cases of benign ovarian conditions and Group 3: fifty ages matched healthy controls with no evidence of any benign or malignant ovarian pathology as ruled out by clinical examination and relevant investigations. Cytohistopathologically confirmed and newly diagnosed cases of EOC and benign ovarian cancer were included in this study. The median value of fasting serum insulin was significantly high (15.0 µlU/ml, P = 0.02) and adiponectin were significantly low (5.1 µg/ml, P < 0.001) in ovarian cancer patients compared to benign ovarian tumors and healthy controls group. A significant increase risk of ovarian cancer was found in high tertile (≥ 18.7 µlU/ml) of serum insulin level (OR = 2.7; 95% CI = 1.00-6.67, P = 0.04) and lower tertile (≤ 5.45 µg/ml) of adiponectin level (OR = 3.2; 95% CI = 1.10-9.71, P = 0.03). High serum insulin level and low adiponectin levels were significantly associated with increased risk for development of ovarian cancer.

Development and analysis of a sustainable garbage disposal model for environmental management under uncertainty

Environmental management is one of the most challenging tasks due to growing population and urbanization. Quadratic programming (QP) in operations research happens to be well equipped to deal with such issues. The present study develops and analyzes a generalized concave QP optimization model having interval parameters with an aim to handle garbage disposal model having a sustainable futuristic vision. Moreover, the model does away with the fundamental requirement of segregated waste at the source itself. The proposed algorithm finds the infimum and supremum of the objective function by first splitting it into two bi-level submodels. Both of the submodels are then investigated subject to the interval parameters in the objective function as well as in the constraints. The solution methodology of the proposed algorithm is explained with the help of a numerical example dealing with concave optimization followed by its application to environmental management. The comparison through figures with the existing models establishes its ecological and economical sustainability through prospective expansion.

Decompressive craniectomy in pediatric non-traumatic intracranial hypertension: a single center experience

Purpose: To study the clinical profile and predictors of outcome in children undergoing decompressive craniectomy (DC) for non-traumatic intracranial hypertension (ICH).Materials and methods: Mixed observational study of children, aged 1 month-12 years, who underwent DC for non-traumatic ICH in a tertiary care pediatric intensive care unit from 2012 to 2017. Data on clinical profile and outcome were retrieved retrospectively and survivors were assessed prospectively. The primary outcome was neurological outcome using Glasgow Outcome Scale-Extended (GOS-E) at minimum 6 months' post-discharge. GOS-E of 1-4 were classified as a poor and 5-8 as a good outcome.Results: Thirty children, median (IQR) age of 6.5 (2, 50) months, underwent DC; of which 26 (86.7%) were boys. Altered sensorium (n = 26, 86.7%), seizures (n = 25, 83.3%), pallor (n = 19, 63.3%) and anisocoria (n = 14, 46.7%) were common signs and symptoms. Median (IQR) Glasgow Coma Scale at admission was 9 (6,11). Commonest etiology was intracranial bleed (n = 24; 80%). Median (IQR) time to DC was 24 (24,72) h. Eight (26.7%) children died; 2 during PICU stay and 6 during follow-up. Neurological sequelae at discharge (n = 28) were seizures (n = 25; 89.2%) and hemiparesis (n = 16; 57.1%). Twenty-one children were followed-up at median (IQR) duration of 12 (6,54) months. Good neurological outcome was seen in 14/29 (48.2%) and hemiparesis in 10/21 (47.6%) patients. On regression analysis, anisocoria at admission was an independent predictor of poor outcome [OR 7.33; 95%CI: 1.38-38.87; p = 0.019].Conclusions: DC is beneficial in children with non-traumatic ICH due to a focal pathology and midline shift. Evidence on indications and timing of DC in NTC is still evolving.

Identification of heterotic groups in South-Asian-bred hybrid parents of pearl millet

Pearl millet breeding programs can use this heterotic group information on seed and restorer parents to generate new series of pearl millet hybrids having higher yields than the existing hybrids. Five hundred and eighty hybrid parents, 320 R- and 260 B-lines, derived from 6 pearl millet breeding programs in India, genotyped following RAD-GBS (about 0.9 million SNPs) clustered into 12 R- and 7 B-line groups. With few exceptions, hybrid parents of all the breeding programs were found distributed across all the marker-based groups suggesting good diversity in these programs. Three hundred and twenty hybrids generated using 37 (22 R and 15 B) representative parents, evaluated for grain yield at four locations in India, showed significant differences in yield, heterosis, and combining ability. Across all the hybrids, mean mid- and better-parent heterosis for grain yield was 84.0% and 60.5%, respectively. Groups G12 B × G12 R and G10 B × G12 R had highest heterosis of about 10% over best check hybrid Pioneer 86M86. The parents involved in heterotic hybrids were mainly from the groups G4R, G10B, G12B, G12R, and G13B. Based on the heterotic performance and combining ability of groups, 2 B-line (HGB-1 and HGB-2) and 2 R-line (HGR-1 and HGR-2) heterotic groups were identified. Hybrids from HGB-1 × HGR-1 and HGB-2 × HGR-1 showed grain yield heterosis of 10.6 and 9.3%, respectively, over best hybrid check. Results indicated that parental groups can be formed first by molecular markers, which may not predict the best hybrid combination, but it can reveal a practical value of assigning existing and new hybrid pearl millet parental lines into heterotic groups to develop high-yielding hybrids from the different heterotic groups.

Effect of Yoga Ocular Exercises on Eye Fatigue

Background

Comfortable working at near and intermediate tasks depend on the efficiency as well as coordination of accommodation and vergence systems. At present, the need for near and intermediate visual tasks has been dramatically increased, requiring prolonged computer- and gazette-related works. It demands excessive working of the extraocular and ciliary muscles. It may cause eye fatigue and other associated asthenopic symptoms. Globally, eye fatigue is one of the most commonly reported conditions in nonpresbyopic population with asthenopic symptoms. It is necessary to get relief from eye fatigue for better near and intermediate tasks.

Materials and Methods

Thirty-two undergraduate optometry students who were symptomatic based on a validated eye fatigue questionnaire were included after a baseline comprehensive eye examination. Based on the eye fatigue symptoms score, they were equally assigned to a control group and an exercise group with sixteen participants in each. The exercise group performed yoga ocular exercises for up to 6 weeks after which the eye fatigue symptoms were reassessed in both groups.

Results

In the exercise group, there was a statistically significant reduction in eye fatigue scores (P = 0.003), whereas the eye fatigue scores showed significant increment in the control group after 6 weeks (P = 0.044).

Conclusions

Yoga ocular exercises reduce the eye fatigue symptoms score by increasing the efficiency of extraocular muscles. Hence, it could be considered as a therapeutic and nonpharmacologic intervention for reducing the eye fatigue and associated asthenopic symptoms.

Cell swelling, softening and invasion in a three-dimensional breast cancer model

Sculpting of structure and function of three-dimensional multicellular tissues depend critically on the spatial and temporal coordination of cellular physical properties, yet the organizational principles that govern these events, and their disruption in disease, remain poorly understood. Using a multicellular mammary cancer organoid model, here we map in three dimensions the spatial and temporal evolution of positions, motions, and physical characteristics of individual cells. Compared with cells in the organoid core, cells at the organoid periphery and the invasive front are found to be systematically softer, larger and more dynamic. These mechanical changes are shown to arise from supracellular fluid flow through gap junctions, suppression of which delays transition to an invasive phenotype. Together, these findings highlight the role of spatiotemporal coordination of cellular physical properties in tissue organization and disease progression.

Compression-induced dedifferentiation of adipocytes promotes tumor progression

Dysregulated physical stresses are generated during tumorigenesis that affect the surrounding compliant tissues including adipocytes. However, the effect of physical stressors on the behavior of adipocytes and their cross-talk with tumor cells remain elusive. Here, we demonstrate that compression of cells, resulting from various types of physical stresses, can induce dedifferentiation of adipocytes via mechanically activating Wnt/β-catenin signaling. The compression-induced dedifferentiated adipocytes (CiDAs) have a distinct transcriptome profile, long-term self-renewal, and serial clonogenicity, but do not form teratomas. We then show that CiDAs notably enhance human mammary adenocarcinoma proliferation both in vitro and in a xenograft model, owing to myofibrogenesis of CiDAs in the tumor-conditioned environment. Collectively, our results highlight unique physical interplay in the tumor ecosystem; tumor-induced physical stresses stimulate de novo generation of CiDAs, which feedback to tumor growth.

Next-generation sequencing reveals significant variations in bacterial compositions across the gastrointestinal tracts of the Indian major carps, rohu (Labeo rohita), catla (Catla catla) and mrigal (Cirrhinus cirrhosis)

Bacterial communities strongly influence the digestion, health and immune status of fish. This study investigates the microbial distribution of the anterior, middle and distal gut sections of three economically important carp species in Bangladesh, rohu, catla and mrigal (commonly known as Indian major carps), using 16S rRNA-based Illumina sequencing technology. The alpha-diversity measurement with one-way ANOVA indicated high species richness, Shannon and Simpson indices in the middle and distal gut, while the anterior gut of IMCs had the lowest diversity. At the phylum level, there was high abundance of Proteobacteria in the GITs of rohu and mrigal, whereas Fusobacteria was dominant in the anterior and middle guts of catla. At the genus level, diverse microbial communities were identified across the three GIT sections, with six indicator genera found in rohu, catla and mrigal, as revealed by linear discriminant analysis (LDA) at a 0·05 level of significance. Of the 218 genera identified, only 33 were common across the anterior, middle and distal guts of all three species. Bacterial diversity was significantly higher (P < 0·05) in mrigal, followed by catla and rohu, respectively. Alongside the common bacteria Aeromonas, Enterobacter and Serratia, the overwhelming abundance of Cetobacterium, Shewanella and Plesiomonas warrants further investigation. SIGNIFICANCE AND IMPACT OF THE STUDY: This study investigates the microbial communities of the gastrointestinal tracts (GITs) of three Indian major carp (IMC) species-rohu, catla and mrigal, obtained from a polyculture pond under the same feeding regime. Diverse microbial communities were found, with significantly different relative abundances and diversities of phyla and genera. The results provide valuable information on GIT microbial communities that may be useful for nutrition and health management in IMCs.

Immunogenicity and contraceptive efficacy of recombinant fusion protein encompassing Sp17 spermatozoa-specific protein and GnRH: Relevance of adjuvants and microparticles based delivery to minimize number of injections

PROBLEM

Requirement of multiple injections of contraceptive vaccines to achieve infertility is one of the important impediments for their application. In the present study, attempts have been made to reduce the number of injections of contraceptive vaccine.

METHOD OF STUDY

Fusion protein encompassing C-terminus fragment of sperm protein Sp17 (aa residues 76-126) and two copies of gonadotropin-releasing hormone along with T-cell epitopes and dilysine linkers (abbreviated as Sp17_C -GnRH₂ ) was expressed in Escherichia coli. Its immunogenicity and contraceptive efficacy have been evaluated in female FVB/J mice using different adjuvants and delivery platforms.

RESULTS

Immunization of female mice with recombinant Sp17_C -GnRH₂ (25 μg/injection/mouse) emulsified with squalene-arlacel A following two injections schedule led to failure of 88.8% immunized animals to conceive, which was not significantly different from mice immunized with same protein along with alum following three injections schedule. To make single-dose vaccine, poly d,l-lactic acid-based microparticles (PLA-MPs) entrapping Sp17_C -GnRH₂ were prepared. Immunization of female mice with a combination of soluble Sp17_C -GnRH₂ (12.5 μg/injection/mouse) along with Sp17_C -GnRH₂ entrapped in PLA-MPs (12.5 μg/injection/mouse) in alum showed higher antibody titres and contraceptive efficacy as compared to mice immunized with Sp17_C -GnRH₂ entrapped in PLA-MPs alone in alum. Immunization with recombinant Sp17_C -GnRH₂ led to long-term infertility as second mating (150 days after immunization) of various groups of immunized mice showed similar infertility as observed during first mating.

CONCLUSION

Single-dose immunization with PLA-MPs entrapping Sp17_C -GnRH₂ along with soluble recombinant protein in alum generated long-lasting infertility in female mice.

Spontaneous intracranial haemorrhage in children-intensive care needs and predictors of in-hospital mortality: a 10-year single-centre experience

PURPOSE

Spontaneous intracranial haemorrhage (SICH) in children, although uncommon, is associated with significant mortality and morbidity. Paediatric data is however limited.

MATERIAL AND METHODS

Case records of 105 children with SICH, > 1 month to 12 years, admitted to a tertiary level PICU of a teaching and referral hospital between January 2009 and May 2018 were analysed retrospectively. In-hospital mortality was the primary outcome. Variables between survivors and non-survivors were compared to  determine predictors of mortality.

RESULTS

The median (IQR) age of subjects was 6 (2.25, 70) months. Common clinical features were altered sensorium (n = 87, 82.9%), seizures (n = 73, 69.5%), pallor (n = 66, 62.9%) and bulging anterior fontanelle (n = 52, 49.5%). Median (IQR) Glasgow Coma Scale (GCS) at admission was 10 (6, 13) with herniation noted in 27 (25.7%) children. Vitamin K deficiency bleeding (VKDB) and arteriovenous malformation (AVM) were the most common etiology for bleeding among infants and older children respectively. The most common site of bleeding was intracerebral (n = 47, 44.8%) followed by subdural (n = 26; 24.8%). Sixteen (15.2%) children died during hospital stay. On univariate analysis, GCS < 8, Pediatric Risk of Mortality score (PRISM III) > 20, need for intubation, thiopentone coma for refractory intracranial pressure (ICP) and progression to shock and acute kidney injury (AKI) predicted mortality. Seizures were favourably associated with survival. Age, site of bleeding, etiology or type of management for raised ICP (conservative versus decompressive craniectomy) did not affect the outcome. On multivariable analysis, progression to AKI (OR 5.86; 95% CI, 1.53-22.4; p 0.01) predicted poor outcome. Seizures, however, were associated with better odds for survival (OR 0.12; 95% CI, 0.03-0.47; p 0.002).

CONCLUSIONS

VKDB and AVM were the common etiologies among infants and older children respectively. Age, site, etiology of bleeding and type of management did not affect outcome. Severe decompensation at presentation, thiopentone for refractory ICP and progression to multiorgan dysfunction determined mortality.

Depression and all-cause mortality risk in HIV-infected and HIV-uninfected US veterans: a cohort study

OBJECTIVES

The contribution of depression to mortality in adults with and without HIV infection is unclear. We hypothesized that depression increases mortality risk and that this association is stronger among those with HIV infection.

METHODS

Veterans Aging Cohort Study (VACS) data were analysed from the first clinic visit on or after 1 April 2003 (baseline) to 30 September 2015. Depression definitions were: (1) major depressive disorder defined using International Classification of Diseases, Ninth Revision (ICD-9) codes; (2) depressive symptoms defined as Patient Health Questionnaire (PHQ)-9 scores ≥ 10. The outcome was all-cause mortality. Covariates were demographics, comorbid conditions and health behaviours.

RESULTS

Among 129 140 eligible participants, 30% had HIV infection, 16% had a major depressive disorder diagnosis, and 24% died over a median follow-up time of 11 years. The death rate was 25.3 [95% confidence interval (CI) 25.0-25.6] deaths per 1000 person-years. Major depressive disorder was associated with mortality [hazard ratio (HR) 1.04; 95% CI 1.01, 1.07]. This association was modified by HIV status (interaction P-value = 0.02). In HIV-stratified analyses, depression was significantly associated with mortality among HIV-uninfected veterans but not among those with HIV infection. Among those with PHQ-9 data (n = 7372), 50% had HIV infection, 22% had PHQ-9 scores ≥ 10, and 28% died over a median follow-up time of 12 years. The death rate was 27.3 (95% CI 26.1-28.5) per 1000 person-years. Depressive symptoms were associated with mortality (HR 1.16; 95% CI 1.04, 1.28). This association was modified by HIV status (interaction P-value = 0.05). In HIV-stratified analyses, depressive symptoms were significantly associated with mortality among veterans with HIV infection but not among those without HIV infection.

CONCLUSIONS

Depression was associated with all-cause mortality. This association was modified by HIV status and method of depression ascertainment.

Measurement of the Electrical Properties of a Thundercloud Through Muon Imaging by the GRAPES-3 Experiment

The GRAPES-3 muon telescope located in Ooty, India records rapid (∼10  min) variations in the muon intensity during major thunderstorms. Out of a total of 184 thunderstorms recorded during the interval of April 2011-December 2014, the one on December 1, 2014 produced a massive potential of 1.3 GV. The electric field measured by four well-separated (up to 6 km) monitors on the ground was used to help estimate some of the properties of this thundercloud, including its altitude and area that were found to be 11.4 km above mean sea level and ≥380  km^{2}, respectively. A charging time of 6 min to reach 1.3 GV implied the delivery of a power of ≥2  GW by this thundercloud that was moving at a speed of ∼60  km h^{-1}. This work possibly provides the first direct evidence for the generation of gigavolt potentials in thunderclouds that could also possibly explain the production of highest-energy (100 MeV) gamma rays in the terrestrial gamma-ray flashes.

Prevalence and association of co-morbidities in diabetic patients along with prescription patterns in Delhi-NCT, India

BACKGROUND

Diabetes is rising at an alarming rate in India and the national capital forms a significant part of the nation's diabetic population. The metabolic disorder is no more a disease specific to the rich countries but has also markedly spread its roots in middle-income countries.

OBJECTIVE

To ascertain the prevalence of associated co-morbidities in the diabetic population of Delhi, a metropolitan city in India. Moreover, this study was conducted to help with adding information to the limited shreds of evidence of diabetes prevalence in Delhi along with the usually preferred therapies.

MATERIALS AND METHODS

A cross-sectional, observational, survey-based study was conducted on people (n = 798) of different age groups (18 years and above) belonging to different regions of Delhi. All subjects were enrolled after obtaining oral consent. Detailed information about clinical, demographic and metabolic profiles was obtained with the help of a pre-structured, open-ended questionnaire. The data were analyzed, and the correlation between diabetes and several other fields was drawn.

RESULTS

Out of the 798 diabetic patients 458 (57.39%) were males and 340 (42.60%) were females. The presence of diabetes was higher in the age group of 50-60 years irrespective of the gender.

CO-MORBIDITIES

54.13% of patients suffered with additional co-morbidities which is significantly high. The associated co-morbidities found in the survey included Hypertension, Hypothyroidism, Dyslipidemia, Obesity, Coronary Artery Diseases etc. About 30.57% of patients suffered from hypertension making it the most commonly associated co-morbidity. The other diseases included hypothyroidism (11.52%), Dyslipidemia (10.27%), Obesity (9.27%) etc. MEDICATION: Majority of patients i.e about 60.65% received oral hypoglycemic agents (including patients receiving both insulin and oral hypoglycemic agents). About 19.92% of patients were prescribed with insulin. 14.16% of patients were found to be following diet control and yoga with about 3.13% more females the males. A small percentage of patients (5.25%) were also following alternative systems (Ayurvedic/Unani/Homeopathic) of treatment. Overall, amongst oral hypoglycemic agents, the combination of metformin and DPP4 inhibitors (Vildagliptin, Sitagliptin) was being prescribed majorly i.e 16.41%.

CONCLUSION

The number of diabetic population is high in Delhi. It was evident that a significant percentage of diabetic patients suffered from additional diseases that may lead to worsening of the health conditions. Thus, there is an urgent need to educate and spread awareness amongst the masses about the potential benefits of lifestyle modifications like the incorporation of a healthy diet and physical activities. Additionally, continuous and regular tests should be taken to avoid further complications.

Microscopic characterisation of photodetectors used in the hadron calorimeter of the Compact Muon Solenoid experiment

The Hybrid Photodetector (HPD) is a hybrid unit with a single accelerating gap between a common photocathode and an array of PIN diodes. Customised HPDs with 19 channels were used to detect scintillation light from hadron calorimeter in the Compact Muon Solenoid (CMS) experiment. In this paper, we present results on radiation damage studies carried out on the used HPDs in the outer hadron (HO) and the end-cap hadron (HE) calorimeter of the CMS experiment operating at CERN. The calorimeter is made of alternating layers of scintillating tiles and metals, such as brass or iron. The scintillating light was transmitted to the HPDs by means of optical fibres. Due to excessive exposure to scintillation light and ionising radiation during data taking at the Large Hadron Collider, the performance of the HPDs was expected to degrade significantly in the HE detector. Independent studies on radiation damage of these used photosensors were important to assess the degradation in the performance of the calorimeter. Microscopic scans of relative photon detection efficiencies for two HPDs (one each from HO and HE detector) were made using micron resolution optical scanner. The scanner was specially designed and built for microscopic characterisation of photosensors. Imprints of each fibre (∼1 mm in diameter) on the photocathode with varying damage within the same pixel of the HPD were observed. The localised damage of the photocathode was determined to vary with the amount of scintillation (or calibration) light transmitted by optical fibres to the HPD.