Hyaluronidase impacts exposures of long-acting injectable paliperidone palmitate in rodent models

A significant challenge in the development of long-acting injectable drug formulations, especially for anti-infective agents, is delivering an efficacious dose within a tolerable injection volume. Co-administration of the extracellular matrix-degrading enzyme hyaluronidase can increase maximum tolerable injection volumes but is untested for this benefit with long-acting injectable formulations. One concern is that hyaluronidase could potentially alter the tissue response surrounding an injection depot, a response known to be important for drug release kinetics of long-acting injectable formulations. The objective of this pilot study was to evaluate the impact of co-administration of hyaluronidase on the drug release kinetics, pharmacokinetic profiles, and injection site histopathology of the long-acting injectable paliperidone palmitate for up to four weeks following intramuscular injection in mouse and rat models. In both species, co-administration of hyaluronidase increased paliperidone plasma exposures the first week after injection but did not negate the overall long-acting release nature of the formulation. Hyaluronidase-associated modification of the injection site depot was observed in mice but not in rats. These findings suggest that further investigation of hyaluronidase with long-acting injectable agents is warranted.

Protective effect of Achyranthes aspera against compound 48/80, histamine and ovalbumin-induced allergic disorders in murine model

BACKGROUND

Achyranthes aspera L. (family Amaranthaceae) is a plant species valued in Ayurveda for the treatment of respiratory ailments. Scientific validation of its antiallergic potential was aimed.

METHODS AND RESULTS

Three extracts of A. aspera [aqueous (AaAq), hydroalcoholic (AaHA), ethanolic (AaEt)] were evaluated for their potency against C48/80-induced anaphylaxis in mice at 200 mg/kg BW oral dose. The effective dose of the most potent extract was determined through its effect on C48/80-induced anaphylaxis, and was further analyzed through its effect on mast cell degranulation, histamine-induced bronchospasm and ovalbumin (OVA)-induced asthma in a murine model. Among the three extracts, AaAq was found to be most potent at 200 mg/kg BW. AaAq 400 (400 mg/kg BW) was found to be the most effective dose in terms of inhibition of mortality and histamine level. AaAq 400 prevented the peritoneal and mesenteric mast cells from undergoing morphological changes due to degranulation induced by C48/80. Further, AaAq 400 delayed pre-convulsive time in histamine-induced bronchospasm. In the OVA-induced asthma model, AaAq 400 inhibited the level of inflammatory cell count in blood, bronchoalveolar lavage fluid and peritoneal fluid of mice. The Th2 cytokines (IL-4, IL-5, IL-13), TGF-β and OVA-specific IgE were also reduced as evaluated by ELISA. Also, significant reduction in IL-5 (an eosinophilia indicator) transcript abundance and lung inflammatory score was observed. AaAq was safe up to 4000 mg/kg BW.

CONCLUSIONS

Thus AaAq 400 possesses significant antiallergic potential and acts via attenuation of C48/80-induced anaphylaxis and inhibition of mast cell degranulation. It reduces pre-convulsive dyspnea in histamine-induced bronchospasm and Th2 cytokines in asthmatic mice.

The second wave of COVID-19 wreaked havoc: A look at clinical and laboratory parameters of survivors and non-survivors admitted to Intensive Care Unit, a single-centered retrospective study

Background

The second wave of COVID-19 was disastrous and claimed many lives in India and abroad. The most challenging task was to provide the required treatment as per the patient's condition, within a limited span of time. The lack of prognostic predictors at the time of admission led to failure in prioritizing the patient's need for intensive care.

Aim

This study was conducted to find out the clinical and laboratory parameters at the time of admission to ICU as predictors of outcomes in COVID-19 patients, which can help in judicious utilization of the available resources for better patient care.

Subjects and Methods

Study comprises of 161 ICU admitted patients. Study of clinical traits, comorbidities, test results, and demographic variables were carried out among survivors and non-survivor.

Result

Maximum death were patients of age group 21-30 years and male gender. Mortality in hypertensives, diabetics, and patients with sepsis were found to be statistically significant. Patients who developed ARDS and pneumonia or needed ventilation died invariably. High levels of laboratory parameters like IL-6, LDH, PT, INR, aPTT, ferritin, WBC count, and D-dimer were significantly associated with poor outcomes and at a particular cutoff had optimum sensitivity and specificity to predict mortality in ICU admitted COVID-19 patients. At the same time, low lymphocyte count and PaO2/FiO2 ratio was significantly associated with bad prognosis (P < 0.05).

Conclusion

This paper will help in prioritizing patients in ICU who need special attention especially at the time of meager supply of resources.

Teacher professional development for disability inclusion in low- and middle-income Asia-Pacific countries: An evidence and gap map

BACKGROUND

In the Asia-Pacific region, around one-third of the children who are out-of-school have a disability and given that teacher readiness and capability are key contributors for inclusive education, it is high time for a mapping of disability inclusive teacher professional development (TPD) interventions in this region.

OBJECTIVES

The key objective of this evidence and gap map (EGM) is to locate evidence on interventions for in-service TPD focussing on education for the inclusion of students with a disability in low- and middle-income countries (LMICs) in the Asia-Pacific region.

SEARCH METHODS

A broad range of bibliographic databases and repositories were searched electronically to identify the evidence published between January 2000 and December 2021. Key search platforms included the British Education Index (BEI), Education Research Complete (ERC), Education Resources Information Center (ERIC), SCOPUS, 3ie Development Evidence Portal (Evidence Hub) and the Campbell Collaborations Systematic Reviews and EGMs portal (Better evidence for a better world). In addition, potential program evaluations/impact reports, reviews, case studies, and program descriptions/summaries were sought through 'snowballing' based on searching bibliographies and reference lists of papers located during the search process, as well as specific searches of relevant grey literature.

SELECTION CRITERIA

To be eligible for inclusion, studies had to contain sufficient details about TPD interventions that support early childhood educators and kindergarten to Year 12 teachers to understand the needs of students with disabilities and aid them to create inclusive mainstream classrooms and/or provide improved support for students with disabilities in special education settings.

DATA COLLECTION AND ANALYSIS

A total of 820 records were entered into the MS Excel file in which the entire data extraction process was managed. All records were screened against the predefined inclusion and exclusion criteria. Data were extracted independently by two reviewers and any differences were resolved through consultations. All included studies and their characteristics were extracted from the MS Excel file and uploaded to the ACER server in.csv file format. The interactive, online EGM is available here: https://datavis.acer.org/gem/disability-inclusion-TPD/.

MAIN RESULTS

Fifty studies from 16 countries out of the 41 LMICs in the Asia-Pacific region were identified, whereby Thailand had the largest number of studies with evidence (7) followed by China, Vietnam, and India (5 each). Two main gaps in research about professional learning were identified. First, only three studies reported interventions aimed at supporting mental health among students with a disability. Second, no studies were found that reported on how teachers could support positive student behaviour. These gaps are important because research has persistently suggested that experiencing disability is an important risk factor for young people developing mental health conditions.

AUTHORS' CONCLUSIONS

This report illustrates the critical value of evaluating and publishing evidence from disability inclusive TPD interventions in LMICs, including any that are ongoing, or are components of highly resource intensive large-scale education sector programs.

Relation Between HbA1c and Lipid Profile Among Prediabetics, Diabetics, and Non-diabetics: A Hospital-Based Cross-Sectional Analysis

INTRODUCTION

An unusually high blood glucose level is a hallmark of diabetes mellitus, with an imbalance between insulin levels and insulin sensitivity leading to an insulin functional deficit. Since it serves as both a risk indicator and a gauge of long-term glycemic control, the HbA1c concentration is a crucial component of standard diabetes treatment. The use of the HbA1c concentration in the diagnosis of diabetes is expanding as the test's accuracy increases. Dyslipidemic profiles can appear before type 2 diabetes manifests itself and are independent risk factors for the disease. Additionally, dyslipidemia, especially in diabetics, might affect pancreatic beta-cell survival and activity. This study was undertaken with the aim to find out any correlation between HbA1c and lipid profile among diabetics, prediabetics, and non-diabetics.

METHODS

A total of 1,000 individuals with age 18-60 years were included in the study (non-diabetics = 186, prediabetics = 238, diabetics = 576). HbA1c was estimated by capillary electrophoresis and a lipid profile was done using a fully automatic chemistry analyzer.

RESULT

Diabetes was found to be significantly associated with dyslipidemia. In diabetics, a statistically significant increase in the level of triglyceride and very low-density lipoprotein (VLDL) was seen as compared to prediabetics. Diabetic women were found to be significantly more dyslipidemic as compared to diabetic males. The mean HbA1c among diabetics was found to be 8.3.

CONCLUSION

In hyperglycemia-induced dyslipidemia, raised triglyceride and VLDL were the most common findings, and combined lipid abnormalities were more commonly seen as compared to a single abnormality in the lipid profile. Patients with poor glycemic control more commonly develop dyslipidemia, which may be a reason for an increased incidence of cardiovascular catastrophes in such patients.

Agricultural pesticide use and misuse: A study to assess the cognizance and practices among North Indian farmers

Introduction

Farmers' cognizance regarding pesticide use and overuse is limited and their practices for handling of pesticides is unsatisfactory. However, their perception concerning risks and safety of pesticides play a very important role in safe spraying and indirectly protect them from adverse health hazards.

Objective

To assess the cognizance about use and risks of overuse of pesticides and evaluate practices for the storage, preparation, and disposal of pesticides.

Material and Methods

A cross-sectional study was conducted among 387 farmers of Lucknow who fulfilled the inclusion criteria. A multistage random sampling was done to interview the farmers. A pretested structured questionnaire was to collect the information regarding the cognizance about use and risks of overuse of pesticides and evaluate practices for the storage, preparation, and disposal of pesticides.

Results

More than half (55%) of the farmers did not read and follow the pesticide label. Maximum (80.2%) were unaware that pesticides are banned or restricted for use. Thirty-seven percent did not know that some pesticides may cause lethal intoxications. Majority of the farmers (42.6%) stored the pesticides anywhere in the house. More than two-thirds of the farmers (69.7%) mixed only needed pesticides followed by a low percentage of them applying on other crops (15.8%) and dispose in the field (11.7%).

Conclusion

The study concludes that cognizance and practices of the farmers for pesticide use and risks associated with it was not satisfactory and exposes them to adverse health outcomes.

Disparity in Relation to Covid-19 Preventive Behaviour and Associated Myths among Rural and Urban Residents of Lucknow: A Community Based Study

Introduction: For curbing Covid-19 disease, adequate knowledge, attitude, and practices of both rural and urban population for Covid-19 disease prevention is required along with busting of the associated myths. Objectives: To assess the Knowledge, Attitude and Practices of urban and rural residents of Lucknow district regarding covid-19 preventive behaviour and associated myths. Methodology: A community-based study was conducted among 420 rural and 421 urban residents of Lucknow. Multistage random sampling was done to select the study subjects. A pre-designed pretested semi-structured questionnaire was used to collect the information regarding the Knowledge, Attitude and Practices of the residents for covid-19 disease causes, prevention, and treatment. Further, KAP scoring was done to compare the two groups. Results: The mean age of the rural and urban residents was 31.48 ± 12.05 and 30.93 ± 11.96 years respectively. Only 40.4 % urban and 25.5 % rural people had correct knowledge about social distancing (p<0.0001). Knowledge regarding quarantine for covid-19 disease prevention was less among the urban residents (64.6%) as compared to rural (70.5%) (p=0.035). More than one-third (37.6%) of the rural resident believed in the myth that alcohol can prevent the covid-19 disease (p=0.003). 68.8 and 70.5 percent rural and urban residents had positive attitude towards the Indian government’ efforts in curbing the disease. Majority of the urban (90%) and rural (87.6%) residents wore mask when they went out. Only one-fourth of the urban (24.7%) and rural (22.9%) had correct practices for the duration of hand washing. Conclusion: The knowledge was more among the urban people, attitude and practices were almost similar among both the rural and urban residents while myths were more observed among the rural residents.

Structure-Activity Relationship of Penem Antibiotic Side Chains Used against Mycobacteria Reveals Highly Active Compounds

The rise of antibiotic-resistant Mycobacterium tuberculosis and non-tuberculous mycobacterial infections has placed ever-increasing importance on discovering new antibiotics to treat these diseases. Recently, a new penem, T405, was discovered to have strong antimicrobial activity against M. tuberculosis and Mycobacteroides abscessus. Here, a penem library of C2 side-chain variants was synthesized, and their antimicrobial activities were evaluated against M. tuberculosis H₃₇Rv and M. abscessus ATCC 19977. Several new penems with antimicrobial activity stronger than the standard-of-care carbapenem antibiotics were identified with some candidates improving on the activity of the lead compound, T405. Moreover, many candidates showed little or no increase in the minimum inhibitory concentration in the presence of serum compared to the highly protein-bound T405. The penems with the strongest activity identified in this study were then biochemically characterized by reaction with the representative l,d-transpeptidase Ldt_Mt2 and the representative penicillin-binding protein d,d-carboxypeptidase DacB2.

2D-DIGE based urinary proteomics and functional enrichment studies to reveal novel Mycobacterium tuberculosis and human protein biomarker candidates for pulmonary tuberculosis

In the absence of a sensitive and specific diagnostic modality capable of detecting all forms of tuberculosis (TB), proteomics may identify specific Mycobacterium tuberculosis (M.tb) proteins in urine, with a potential as biomarkers. To identify candidate biomarkers for TB, proteome profile of urine from pulmonary TB patients was compared with non-disease controls (NDC) and disease controls (DC, Streptococcus pneumonia infected patients) using a combination of two-dimensional difference gel electrophoresis (2D-DIGE) and liquid chromatography tandem mass spectrometry (LCMS/MS). Eleven differentially expressed host proteins and Eighteen high abundant M.tb proteins were identified. Protein-protein interactome (PPI) and functional enrichment analyses like Gene Ontologies, Reactome pathway etc. demonstrated that the human proteins mainly belong to extracellular space and show physiological pathways for immune response and hematological disorders. Whereas, M.tb proteins belong to the cell periphery, plasma membrane and cell wall, and demonstrated catalytic, nucleotide binding and ATPase activities along with other functional processes. The study findings provide valuable inputs about the biomarkers of TB and shed light on the probable disease consequences as an outcome of the bacterial pathogenicity.

Assessment of knowledge and their practices regarding malaria among members of Village Health Sanitation Committee in rural Uttar Pradesh: A cross-sectional study

Background:

Methodology:

Results:

Conclusion:

Efficacy of Long-Acting Bedaquiline Regimens in a Mouse Model of Tuberculosis Preventive Therapy

RATIONALE

Completion of preventive therapy is a major bottleneck in global tuberculosis control. Long-acting injectable drug formulations would shorten therapy administration and may thereby improve completion rates. Recently, a long-acting formulation of bedaquiline demonstrated anti-tuberculosis activity for up to 12 weeks post-injection in a validated mouse model of preventive therapy.

OBJECTIVES

The objectives of this study were to (i) determine the total duration of activity following an injection of long-acting bedaquiline, and (ii) evaluate the activity of regimens comprised of long-acting bedaquiline plus short (2-4 week) oral companion courses of bedaquiline, with or without rifapentine, using the validated mouse model of tuberculosis preventive therapy.

METHODS

After establishment of a stable Mycobacterium tuberculosis lung infection in BCG-immunized BALB/c mice, treatment was initiated with one of 12 randomly assigned regimens. In addition to positive and negative controls, six regimens included 1 or 2 injections of long-acting bedaquiline (alone or with oral bedaquiline +/- rifapentine), and 4 comparator regimens consisted of oral agents only. Lung bacterial burden was measured monthly for up to 28 weeks.

MEASUREMENTS AND MAIN RESULTS

One injection of long-acting bedaquiline at 160 mg/kg exerted anti-tuberculosis activity for 12 weeks. Compared to the positive control (daily isoniazid-rifapentine for 4 weeks), six regimens had equivalent bactericidal activity (including two all-oral comparator regimens), and two regimens has superior sterilizing activity: one injection with 2 weeks of oral bedaquiline and high-dose rifapentine; and 2 injections with 4 weeks of oral bedaquiline.

CONCLUSION

Long-acting injectable bedaquiline has significant potential for shortening tuberculosis preventive therapy.

PROTOCOL: Teacher professional development for disability inclusion in low- and middle-income Asia-Pacific countries: An evidence and gap map

According to prior research, teacher readiness and capability are key contributors for successful transition towards disability inclusive education, yet in-service teacher professional development for disability inclusion remains an under-researched area. The key objective of this evidence and gap map (EGM) is to locate evidence on interventions for disability inclusion focused teacher professional development (TPD) in low-to-middle-income-countries (LMICs) in the Asia-Pacific region. As such, it will illustrate different levels of evidence for TPD interventions as well as where there is no evidence (i.e., gaps). In other words, the EGM can make agencies aware where they might be operating in an area that is evidence-free or evidence-weak so they can take up interventions that are evidence-based or collect evidence for the intervention they are presently supporting. Thus, the ultimate goal for the EGM is to assist funders and implementing agencies when making decisions as to how to support LMICs in the region to reach their aim of developing quality teachers for the global inclusive education agenda (target SDG 4.c).

In Vitro Activity of Bedaquiline and Imipenem against Actively Growing, Nutrient-Starved, and Intracellular Mycobacterium abscessus

Mycobacterium abscessus lung disease is difficult to treat due to intrinsic drug resistance and the persistence of drug-tolerant bacteria. Currently, the standard of care is a multidrug regimen with at least 3 active drugs, preferably including a β-lactam (imipenem or cefoxitin). These regimens are lengthy and toxic and have limited efficacy. The search for more efficacious regimens led us to evaluate bedaquiline, a diarylquinoline licensed for treatment of multidrug-resistant tuberculosis. We performed in vitro time-kill experiments to evaluate the activity of bedaquiline alone and in combination with the first-line drug imipenem against M. abscessus under various conditions. Against actively growing bacteria, bedaquiline was largely bacteriostatic and antagonized the bactericidal activity of imipenem. Contrarily, against nutrient-starved persisters, bedaquiline was bactericidal, while imipenem was not, and bedaquiline drove the activity of the combination. In an intracellular infection model, bedaquiline and imipenem had additive bactericidal effects. Correlations between ATP levels and the bactericidal activity of imipenem and its antagonism by bedaquiline were observed. Interestingly, the presence of Tween 80 in the media affected the activity of both drugs, enhancing the activity of imipenem and reducing that of bedaquiline. Overall, these results show that bedaquiline and imipenem interact differently depending on culture conditions. Previously reported antagonistic effects of bedaquiline on imipenem were limited to conditions with actively multiplying bacteria and/or the presence of Tween 80, whereas the combination was additive or indifferent against nutrient-starved and intracellular M. abscessus, where promising bactericidal activity of the combination suggests it may have a role in future treatment regimens.

The dilemma of COVID-19 vaccination among Health Care Workers (HCWs) of Uttar Pradesh

Background: Immediately after the outbreak of COVID-19 pandemic, with an unprecedented cooperation between biomedical, pharmaceutical, technological, and political sectors, new vaccines were developed and approved in record times. However, doubts were raised on their efficacy and adverse effects. Globally, it was agreed that the first recipients for vaccines would be the health care workers (HCWs). Logically, it was bound to raise some concerns and result in hesitancy among the HCWs. Aims: The current study was planned to study the proportion of HCWs having hesitancy towards COVID-19 vaccination and factors effecting it. Settings and Design: Cross-sectional study conducted among HCWs of Uttar Pradesh. Methods and Material: The survey was conducted both in online and offline mode and attempted by 254 HCWs eligible for receiving COVID-19 vaccine. Statistical analysis used: t-test, chi-square test, proportion, mean, SD Results: Vaccine hesitancy was present in 35.8% HCWs. Only social factors like caste (p=0.023) and religion (p<0.001) were found to be significantly associated with vaccine hesitancy. Gender, type of health worker, fear of COVID-19 infection, fear of lethality or pre-existing diseases did not affect vaccine hesitancy. The maximum number of HCWs (71.4%) were hesitant because they were unsure of the side-effects followed by the reason of being unsure about its effect on their own health (53.8%). When asked about their attitude towards compulsory COVID-19 vaccination for HCWs, should it be made mandatory by the government, 42.9% were in favour and 40.6% were against any such mandate. Conclusions: The study concluded that social factors like religion and caste are more deterministic for vaccine hesitancy.

Prevalence of dementia and its associated risk factors among elderly patient attending Outpatient Department of a tertiary care hospital in Lucknow

Background: Dementia is a broad category of brain diseases that causes a chronic, progressive and gradual decrease in cognitive function i.e. ability to think and remember that is great enough to affect a person’s daily functioning beyond what might be expected from normal ageing. According to American Psychiatric Association, “Dementia is a syndrome caused by a variety of brain illnesses that affect memory, thinking, behaviour and the ability to perform everyday activities”. Aim & Objectives: To assess the prevalence of dementia among the patients above 60 years of age attending the outpatient department of Tertiary care super specialty hospital. To assess the risk factors associated with occurrence of dementia in patients attending outpatient department of Tertiary care super specialty hospital. Settings and Design: Study design: - Cross-sectional observational study. Study area: - Tertiary care super-specialty hospital. Study setting: - Outpatient department (OPD)of Tertiary care super specialty hospital. Methods and Material: Study population: - Patients above 60 years of age and attending Outpatient Department of the tertiary care super specialty hospital. Duration of Study: - 4 months.  Sample size:- 223 elderly participants from the registration counter of the Outpatient Department of tertiary care hospital. Statistical analysis used: Data was analysed using SPSS, version 24.0. Univariate Logistic Regression, Multivariate Logistic Regression, Odds Ratio. Results: The study was conducted on a total of 223 patients out of which only 210 patients completed the questionnaire and matched our criteria. Thus, 210 patients are analysed for the result. In our study which included the patients above 60 years of age out of which the maximum participants (52.4%) were of age group 65-75. In our study 66.2% participants had normal cognitive functioning while 33.8% of total participants were found to have dementia. Out of these 33.8% participants having impaired cognitive functioning, 13.8% and 20% had severe and borderline dementia respectively. Dementia was found to be more common in females. Conclusions: Statistically significant association of dementia has been found with female gender, rural residence, joint family and a greater number of family members, poor education, pan masala consumption, daytime drowsiness, and problem in sleep pattern, social intolerance and frequent fights.

Assessment of carbapenems in a mouse model of Mycobacterium tuberculosis infection

We present further study of a subset of carbapenems, arising from a previously reported machine learning approach, with regard to their mouse pharmacokinetic profiling and subsequent study in a mouse model of sub-acute Mycobacterium tuberculosis infection. Pharmacokinetic metrics for such small molecules were compared to those for meropenem and biapenem, resulting in the selection of two carbapenems to be assessed for their ability to reduce M. tuberculosis bacterial loads in the lungs of infected mice. The original syntheses of these two carbapenems were optimized to provide multigram quantities of each compound. One of the two experimental carbapenems, JSF-2204, exhibited efficacy equivalent to that of meropenem, while both were inferior to rifampin. The lessons learned in this study point toward the need to further enhance the pharmacokinetic profiles of experimental carbapenems to positively impact in vivo efficacy performance.

Development of a penem antibiotic against Mycobacteroides abscessus

β-lactams are the most widely used antibiotic class to treat bacterial infections in humans. Mycobacteroides abscessus is an emerging pulmonary pathogen resistant to most antibiotics, including penicillins and cephalosporins. With no current FDA-approved treatment and cure rates <50%, there is a pressing need for effective therapies. Here we report T405, a new β-lactam of the penem subclass that exhibits potent activity against M. abscessus and a panel of drug-resistant strains isolated from cystic fibrosis patients. Additionally, in combination with the β-lactamase inhibitor avibactam, the rate of spontaneous resistance of M. abscessus to T405 approached the limit of detection. Lastly, we show the favorable pharmacokinetic profile of T405 in mice and the absence of toxicity at elevated dosage, which support the clinical potential of this compound.

Batchelder et al. report a new penem class antibiotic, T405, which exhibits potent activity against M. abscessus and clinical isolates from cystic fibrosis patients. The development of resistance to T405 is inhibited with the addition of a β-lactamase inhibitor, avibactam. Its clinical potential is further demonstrated by T405 displaying a favourable pharmacokinetic profile in mice with an absence of toxicity.

Metal removal and recovery using bioelectrochemical technology: The major determinants and opportunities for synchronic wastewater treatment and energy production

Microbial fuel cell (MFC) technology has emerged as a new and attractive bioelectrochemical approach in the last one and a half decade that offers an alternative to conventional treatment methods to remove and recover heavy metals and organics from wastewaters with simultaneous energy production. This technique has advantage over the conventional wastewater treatment techniques, which are energy intensive, sludge producing and with little effectivity at high concentrations. Significant work has been done in the recent years on MFC principle, electrode configuration, biofilm composition, application of MFC in wastewater treatment, metal removal or recovery and energy production. Basically, metal in the cathode chamber acts as acceptor of the electrons released from the oxidation of organic matter in the anode chamber by electrogenic microbes. Literature shows that efficacy of MFCs in removal and recovery of metals and power production is significantly influenced by redox potential of the metal, initial concentration, mix metal systems, carbon source in substrate, pH, biocathode, biofilm composition, gaseous environment in cathode, electrode modification and external resistance, which have been critically reviewed for the first time in the present paper to understand the role of the determinant factors that may be explored for improvement of the MFC performance. The paper provides further insights into the techno-economic aspects of MFC technology and suggests research needs for enhanced performance and reduced costs to increase its feasibility for application at commercial level.

Emission characteristics of ultrafine particles from bare and Al2O3 coated graphite for high temperature applications

Owing to its exceptional properties at high temperature, graphite is used in several applications such as structural material and fuel block in high temperature nuclear reactors. Air ingress is one of the serious safety concerns in these reactors. Oxidation of graphite leading to increased porosity affects its mechanical strength and may lead to core collapse resulting in a severe accident. During such a scenario, generation of graphite particles could be the main hazard. Once generated, these particles often in fine and ultrafine sizes, may carry radioactivity to large distances and/or for long times. These particles owing to their higher surface to volume ratio possess an additional inhalation hazard. Ultrafine particles have the potential to enter into respiratory tract and cause damage to body organs. Coating of graphite components is preferred to reduce the oxidation induced damages at high temperatures. In the present work, effect of alumina (Al2O3) coating on the emission characteristics of particles from graphite under high temperature conditions has been investigated. Bare and Al2O3 coated graphite specimens were heated within a closed chamber at varying temperatures during these experiments. Temporal evolution of concentrations of gases (CO and CO2) and particles were measured. The results reveal that Al2O3 coating on the graphite delayed the oxidation behavior and the structure of graphite remained largely intact at high temperatures. A significant reduction in aerosol formation and CO emission was also noticed for the coated specimens.

Nano-enabled biosensing systems for intelligent healthcare: towards COVID-19 management

Biosensors are emerging as efficient (sensitive and selective) and affordable analytical diagnostic tools for early-stage disease detection, as required for personalized health wellness management. Low-level detection of a targeted disease biomarker (pM level) has emerged extremely useful to evaluate the progression of disease under therapy. Such collected bioinformatics and its multi-aspects-oriented analytics is in demand to explore the effectiveness of a prescribed treatment, optimize therapy, and correlate biomarker level with disease pathogenesis. Owing to nanotechnology-enabled advancements in sensing unit fabrication, device integration, interfacing, packaging, and sensing performance at point-of-care (POC) has rendered diagnostics according to the requirements of disease management and patient disease profile i.e. in a personalized manner. Efforts are continuously being made to promote the state of art biosensing technology as a next-generation non-invasive disease diagnostics methodology. Keeping this in view, this progressive opinion article describes personalized health care management related analytical tools which can provide access to better health for everyone, with overreaching aim to manage healthy tomorrow timely. Considering accomplishments and predictions, such affordable intelligent diagnostics tools are urgently required to manage COVID-19 pandemic, a life-threatening respiratory infectious disease, where a rapid, selective and sensitive detection of human beta severe acute respiratory system coronavirus (SARS-COoV-2) protein is the key factor.

Paediatric morphoea: a holistic review. Part 1: epidemiology, aetiopathogenesis and clinical classification

Morphoea, also known as localized scleroderma, is a debilitating fibrosing disorder of uncertain aetiology, affecting the skin and subcutaneous tissues. Paediatric-onset disease is not uncommon and is associated with frequent relapses. The disease has complex pathogenetic mechanisms and multiple clinical subtypes, and affects children of all ages. Recent research has focused on elucidating the disease pathophysiology and identifying measures of disease activity. We performed a literature search on PubMed, MEDLINE and Google Scholar, using keywords such as 'pediatric morphea', 'juvenile localised scleroderma' and 'juvenile systemic sclerosis'. Relevant studies, including randomized trials, reviews of standard current guidelines and original research articles, were selected, and results were analysed before being summarized. In the first of this two-part review, we provide a bird's-eye view of the current literature concerning the epidemiology, aetiopathogenesis and clinical classification of paediatric morphoea; in Part 2, we review the diagnosis, markers of disease activity, management and natural history.

Paediatric morphoea: a holistic review. Part 2: diagnosis, measures of disease activity, management and natural history

Paediatric morphoea is a debilitating fibrosing disorder of uncertain aetiology, affecting the skin and subcutaneous tissues. Defining optimum management strategies in paediatric morphoea remains an ongoing challenge, owing to the varied presentations and a relative paucity of paediatric-specific studies. We performed a literature search on PubMed, MEDLINE and Google Scholar, using keywords such as 'pediatric morphea', 'juvenile localised scleroderma' and 'juvenile systemic sclerosis'. Relevant studies, including randomized trials, reviews of standard current guidelines and original research articles, were selected and results analysed before summarizing them. In Part 1 of this review, we described the epidemiology, aetiopathogenesis and clinical classification; in this part, we discuss the diagnosis, markers of disease activity, management and natural history in paediatric morphoea.

Measuring stigma in children receiving mental health treatment: Validation of the Paediatric Self-Stigmatization Scale (PaedS)

Background:

Research on the impact of stigma associated with mental illness in children is scarce. Considering the known negative effects of stigma associated with mental illness in adults, it is crucial to explore the stigma experienced by children who access mental health treatment. However, no scale measuring self-stigmatization in younger children is available to date. This study aimed to develop and validate such a scale, the Paediatric Self-Stigmatization Scale (PaedS).

Methods:

A total of 156 children (119 receiving outpatient and 37 receiving inpatient treatment), aged 8–12 years, completed the PaedS, the Self-Perception Profile for Children and the Pediatric Quality of Life Inventory (PedsQL – Child Report, ages 8–12). In addition, parents completed the PedsQL (Parent Report for Children, ages 8–12), the Strengths and Difficulties Questionnaire (SDQ) and a modified subscale of the PaedS measuring the children's rejection by others due to their mental health difficulties.

Results:

A confirmatory factor analysis showed that a four-factor structure, comprising Societal Devaluation, Personal Rejection, Self-Stigma and Secrecy scales, had excellent fit to the data (CFI = 0.95; TLI = 0.95; RMSEA = 0.05). Child-reported PaedS scores were positively correlated with parental-reported PaedS scores and negatively with PedsQL, the SDQ, and 5 out of 6 subscales of the Self-Perception Profile for Children, suggesting adequate convergent validity (all P-values < 0.05).

Conclusions:

The PaedS is a valid instrument, which is hoped to advance the understanding of self-stigmatization in children with mental health difficulties and contribute to its prevention.

An Ancient Harappan Genome Lacks Ancestry from Steppe Pastoralists or Iranian Farmers

We report an ancient genome from the Indus Valley Civilization (IVC). The individual we sequenced fits as a mixture of people related to ancient Iranians (the largest component) and Southeast Asian hunter-gatherers, a unique profile that matches ancient DNA from 11 genetic outliers from sites in Iran and Turkmenistan in cultural communication with the IVC. These individuals had little if any Steppe pastoralist-derived ancestry, showing that it was not ubiquitous in northwest South Asia during the IVC as it is today. The Iranian-related ancestry in the IVC derives from a lineage leading to early Iranian farmers, herders, and hunter-gatherers before their ancestors separated, contradicting the hypothesis that the shared ancestry between early Iranians and South Asians reflects a large-scale spread of western Iranian farmers east. Instead, sampled ancient genomes from the Iranian plateau and IVC descend from different groups of hunter-gatherers who began farming without being connected by substantial movement of people.

N-Trifluoromethylthiolated Sulfonimidamides and Sulfoximines: Anti-microbial, Anti-mycobacterial, and Cytotoxic Activity

Herein we demonstrate the expanded utility of a recently described N-trifluoromethylthiolation protocol to sulfonimidamide containing substances. The novel N-trifluoromethylthio sulfonimidamide derivatives thus obtained were evaluated for antibacterial activity against Mycobacterium tuberculosis (M. tb.) and Mycobacterium abscessus and Gram + Ve (Streptococcus aureus, Bacillus subtilis), and Gram - Ve (Escherichia coli, Pseudomonas aeruginosa) bacteria. Two compounds, 13 and 15 showed high antimycobacterial activity with MIC value of 4-8 μg/mL; i.e. comparable to WHO recommended first line antibiotic for TB infection ethambutol. The same compounds were also found to be cytotoxic in HepG2 cells (compound 13 IC₅₀ = 15 μg/mL; compound 15 IC₅₀ = 65 μg/mL). A structure activity relationship, using matched pair analysis, gave the unexpected conclusion that the trifluoromethylthio moiety was responsible for the cellular and bacterial toxicity. Given the increasing use of the trifluoromethylthio group in contemporary medicinal chemistry, this observation calls for considerations before implementation of the functionality in drug design.

P1496Use of strain, strain rate, tissue velocity imaging and endothelial function for early detection of cardiovascular involvement in young diabetics

Background

Subtle structural and functional changes may precede the onset of overt global left ventricular dysfunction and obvious reduction of ejection fraction (EF), especially in young diabetics. Data pertaining to tissue velocity indices (TVI) and strain imaging to assess regional myocardial function and flow mediated vasodilatation is limited in young patients with diabetes.

Purpose

To evaluate conventional echocardiography parameters, tissue doppler indices, global and regional strain, carotid intimal medial thickness (CIMT), endothelial dependent (FMD) and independent function (NMD) of brachial artery in young patients (age <18 years) with type 1 diabetes and compare them with matched controls.

Methods

Conventional echocardiography parameters, tissue velocity indices (TVI) parameters along with strain (S), and strain rate (SR) in basal and mid left ventricular (LV) lateral wall, right ventricular (RV) lateral wall and septum were measured in 50 young diabetics (age 15.16±2.95 years, mean HBA1c 8.15±1.37 gm %) and 25 controls (age 15.60±2.51 years). Flow-mediated dilatation (FMD), nitrate mediated dilatation and carotid intimal media thickness (CIMT) were also estimated.

Results

Conventional echocardiography parameters were similar in patients and controls however deceleration time of the mitral inflow velocity (EDT) was significantly shorter in patients when compared with controls (149.06±31.66 vs. 184.56±19.27 ms, p<0.05). Lateral early diastolic myocardial velocity (LV-Em) was significantly lower (10.30±0.99 vs. 11.67±3.21, p<0.05) whereas lateral late diastolic myocardial velocity (LV-Am) was significantly higher than controls (11.73±1.44 vs. 8.82±1.69, p<0.05), thus a significantly lower ratio of early/late diastolic velocity at the basal segment of lateral LV (LV-Em/Am). Lower strain values at the basal lateral LV (21.39±4.12 vs. 23.78±2.02; p<0.05), mid lateral LV (21.43±4.27 vs. 23.17±1.92; p<0.05), basal septum (20.59±5.28 vs. 22.91±2.00; p<0.05), and mid septum (22.06±4.75 vs. 24.10±1.99; p<0.05) as compared to controls. SR at the basal and mid segments of the lateral LV wall and at the basal septum were also significantly lower in diabetic subjects. Strain rate (SR) in mid septal, basal and mid RV were lower than controls although not statistically significant. Patients also had significantly lower flow mediated dilatation (FMD) (8.36±4.27 vs. 10.57±4.12, p<0.05) implying endothelial dysfunction.

Strain rate in diabetic patient

Conclusion

Left ventricular strain indices are impaired in asymptomatic children and adolescents with type 1 DM despite absence of overt heart failure and normal ejection fraction. Early detection of subclinical regional myocardial dysfunction by deformation analysis including strain and strain rate may be useful in the asymptomatic diabetic population. In addition, evidence of endothelial dysfunction in the form of impaired flow mediated vasodilatation was observed in the diabetic children.

Acknowledgement/Funding

None

In vitro and in vivo activity of biapenem against drug-susceptible and rifampicin-resistant Mycobacterium tuberculosis

Background

Biapenem, a carbapenem antibiotic, has been shown to have synergistic bactericidal anti-TB activity when combined with rifampicin both in vitro and in the mouse model of TB chemotherapy. We hypothesized that this synergy would result in biapenem/rifampicin activity against rifampicin-resistant Mycobacterium tuberculosis .

Objectives

Our objective was to evaluate the synergy of biapenem/rifampicin against both low- and high-level rifampicin-resistant strains of M. tuberculosis , in vitro and in the mouse model.

Methods

Biapenem/rifampicin activity was evaluated using three strains of M. tuberculosis : strain 115R (low-level rifampicin resistance); strain 124R (high-level rifampicin resistance); and the drug-susceptible H37Rv parent strain. Biapenem/rifampicin synergy was evaluated in vitro by chequerboard titration. In vivo , we first conducted a dose-ranging experiment with biapenem against H37Rv in the mouse model. We then evaluated biapenem/rifampicin activity in mice infected with each M. tuberculosis strain.

Results

In vitro , synergy was observed between biapenem and rifampicin against H37Rv and strain 115R. In vivo , biapenem exhibited clear dose-dependent activity against H37Rv, with all biapenem doses as active or more active than rifampicin alone. Biapenem and rifampicin had synergistic bactericidal activity against H37Rv in the mouse model; no synergy was observed in mice infected with either of the rifampicin-resistant strains. Biapenem alone was active against all three strains.

Conclusions

Our preclinical experiments indicate that biapenem has potential for use as an anti-TB drug, including for use against rifampicin-resistant TB. Thus, biapenem has promise for repurposing as a 'new' - and desperately needed - drug for the treatment of drug-resistant TB.

Antioxidant and Hepatoprotective Potential of Swaras and Hima Extracts of Tinospora cordifolia and Boerhavia diffusa in Swiss albino Mice

Background

In Ayurveda, five basic extraction procedures are mentioned in order of their decreasing potency. Swaras is considered as the most potent followed by, kalka, kwatha, fanta and hima.

Objective

Present study was carried out to investigate the antioxidant and hepatoprotective potential of swaras and hima extracts of T.cordifolia and B. diffusa.

Materials and Methods

Swaras and hima extracts of T. cordifolia and B. diffusa were prepared. Phytochemical screening and in vitro antioxidant activities was carried out using standard methods. Hepatoprotective efficacy of extracts were carried out in Swiss albino mice using paracetamol induced hepatotoxicity. Animals were administered with swaras and hima extracts of both plants at 200 mg/kg BW dose for 7 days and on 8^th day hepatotoxicity was induced by intraperitoneal injection of paracetamol at 500 mg/kg BW. The degree of liver protection was determined by measuring the levels of liver enzymes followed by histopathology.

Results and Discussion

The results of phytochemical, antioxidant and hepatoprotective activities showed that there were no significant difference between swaras and hima extracts. Both the extract of T. cordifolia were equally potent in reducing SGOT (P < 0.01) and ALP level (P < 0.001). Similar effects were observed with the Swaras and hima extracts of B. diffusa. Both the extracts reduced SGOT and ALP (P < 0.01). Histopathological findings among all the extracts were also more or less similar in lowering the paracetamol mitigated necrosis.

Conclusion

The present study suggested that T. cordifolia and B. diffusa possess potential hepatoprotective activity irrespective of the extraction procedure.

SUMMARY

Aqueous extracts of Tinospora cordifolia and Boerhavia diffusa exhibited significant antioxidant and hepatoprotective activitiesAqueous extracts of both the plants were extracted using different extraction procedures mentioned in AyurvedaSwaras and hima extracts of both the plants significantly reduced the deleterious effects of paracetamol, suggesting that both the plant extracts are equipotentAcute toxicity of both the plant extracts did not produce any toxic effects. Abbreviations used: TC swaras: T. cordifolia swaras; TC hima: T. cordifolia hima; BD swaras: B. diffusa swaras; BD hima: B. diffusa hima; BW: Body weight; LDL: Low-density lipoprotein; HDL: High-density lipoprotein; SGOT: Serum glutamate oxaloacetate transminase; SGPT: Serum glutamate pyruvate transminase; ALP: Alkaline phosphatase; I.P: Intraperitoneal; TAC: Total antioxidant capacity; DPPH: 2,2-diphenyl-1-picrylhydrazyl; TCA: Trichloro acetic acid; NO: Nitric oxide; TPC: Total phenolic content; NAPQI: N-acetyl-p-benzoquinone imine; PCM: Paracetamol.