Second Malignancy Probabilities in Patients With Breast Cancer Treated With Conventional Versus Hypofractionated External Beam Radiation Therapy in the Adjuvant Setting

AIMS

For women with breast cancer, seminal studies have shown that adjuvant hypofractionated external beam radiation therapy (hEBRT) maintains similar outcomes and may reduce overall costs compared with conventionally fractionated external beam radiation therapy (cEBRT). However, it is unclear whether hEBRT may be associated with differential risk of development of radiation-induced second malignancies compared with cEBRT. Because the occurrence of second malignancies is small, large databases may improve our understanding of the relative risk of second malignancies between hEBRT and cEBRT.

MATERIALS AND METHODS

Using the National Cancer Database, we carried out a retrospective cohort analysis of women diagnosed with non-metastatic, stage 0-III breast cancer from 2004 to 2017. All patients had a lumpectomy or mastectomy and a follow-up time of at least 60 months after diagnosis. The probability of second malignancies in women receiving adjuvant cEBRT or hEBRT was compared using multivariable logistic regression adjusting for sociodemographic, geographical, clinical and treatment factors, allowing for relative (but not absolute) comparison of second malignancy risk. Temporal sensitivity analyses stratified by year of diagnosis and length of follow-up time were also conducted.

RESULTS

Of the 125 228 women in our study, 115 576 (92.3%) received cEBRT and 9652 (7.71%) received hEBRT. The median age of the cohort was 60 (interquartile range 51-68) years at diagnosis and the median follow-up time was 99.61 (interquartile range 77.5-128.49) months. Upon adjusting for sociodemographic and clinical factors, patients who received hEBRT had no difference in relative risk than patients who received cEBRT (odds ratio 0.937, 95% confidence interval 0.869-1.010, P = 0.091). In analyses stratified by year of diagnosis, and stratified by length of follow-up, there was no difference in second malignancy probability between patients who completed hEBRT and patients who completed cEBRT.

CONCLUSIONS

In this analysis of over 120 000 women with non-metastatic breast cancer, hEBRT was not associated with different odds of developing second malignancies compared with cEBRT. Our findings may inform patient counselling in the choice of radiation regimens for breast cancer and further support the safety of hypofractionated regimens for breast cancer.

Trends in Utilization and Medicare Spending on Shorter vs. Longer Radiotherapy Courses for Breast and Prostate Cancer

PURPOSE/OBJECTIVE(S)

Evidence based research supports shorter, similarly efficacious, and potentially more cost-effective hypofractionated treatment regimens in many clinical scenarios for breast cancer (BC) and prostate cancer (PC). However, practice patterns of hospital-affiliated and standalone facilities vary considerably. We used the most recent Centers for Medicare and Medicaid Services data to assess trends in radiotherapy (RT) costs and practice patterns among episodes of BC and PC.

MATERIALS/METHODS

We performed a retrospective cohort analysis of all external beam episodes for BC and PC from 2015-2019. For patients with BC, receipt of shorter-course RT (SCRT) was defined as receiving 11-20 fractions of external beam radiation therapy (including IMRT), and conventional RT as >20 fractions. For patients with PC, SBRT was defined as receipt of <10 fractions and moderate hypofractionation as 10-30 fractions (SCRT defined as SBRT and moderate hypofractionation), and >30 fractions for conventional RT. Total Medicare spending were defined as the sum of winsorized payment for professional and technical services furnished during the episode in 2019 dollars. Multivariable logistic regression defined adjusted odds ratios (ORs) of receipt of SCRT over conventional RT by treatment modality, age, year of diagnosis, type of practice, as well as a time*treatment setting interaction term. Medicare spending was evaluated using multivariable linear regression controlling for duration of RT regimen (SCRT vs conventional) in addition to the covariables above.

RESULTS

Of 47,283 BC episodes and 45,917 PC episodes, 23,705 (50.13%) and 9,125 (19.87%) were SCRT, respectively. Median total spending for SCRT among BC episodes was $9,324 (IQR, $7,916-$10,921) vs. $13,372 (IQR, $11,511-$15,283) for conventional RT. Among PC episodes, median total spending was $12,917 (IQR, $9,551-$15,271) for SBRT, $18,944 (IQR, $16,530-$20,615) for moderate hypofractionation, and $26,935 (IQR, $25,062-$28,959) for conventional RT. For both cancers, total episode spending was reduced with SCRT utilization [(BC adjusted β, -$4,200; p<0.001), (PC adjusted β, -$8,747; p<0.001)], older age, and non-IMRT-based treatment. On logistic regression, receipt of SCRT was associated with older age among both BC and PC episodes (p<0.001), as well as treatment at hospital-affiliated over freestanding sites [(BC OR [95% CI], 1.41 [1.29-1.54], p<0.001), (PC OR, 1.64 [1.39-1.94], p<0.001)].

CONCLUSION

In this evaluation of all BC and PC RT episodes from 2015-2019, we found that shorter-course RT resulted in increased cost-savings vs. conventional RT. SCRT was also more common in hospital-affiliated sites. Further research is needed to devise payment incentives that encourage SCRT when clinically applicable in the two most common sites treated with RT, and to prospectively study cost-effective hypofractionation in other disease sites.

Disparities in Breast-Conserving Therapy vs. Mastectomy among Asian American and Pacific Islander Women

PURPOSE/OBJECTIVE(S)

Multiple randomized trials support the use of breast-conserving therapy (BCT), defined as lumpectomy followed by adjuvant radiotherapy, as an alternative to mastectomy for definitive treatment of early-stage (T1-2N0) breast cancer. However, data suggest that Asian American, Native Hawaiian, and Pacific Islander (AANHPI) may undergo mastectomy at higher rates than BCT and may experience barriers to receipt of BCT. The purpose of this study was to examine BCT utilization by disaggregated AANHPI groups to identify differences in receipt of mastectomy versus BCT.

MATERIALS/METHODS

The 2004-2017 National Cancer Database was queried to identify women age ≥18 years old diagnosed with cT1-2N0M0 breast cancer treated with either BCT or mastectomy without post-mastectomy radiation therapy. Women were classified based on self-reported race. Multivariable logistic regression defined adjusted odds ratios (OR) assessing the association between race and receipt of BCT versus mastectomy for all patients and separately by cT1-2 stage. All models were adjusted for relevant sociodemographic and clinical factors.

RESULTS

Of 794,403 women with cT1-2N0M0 breast cancer, 239,801 (30%) received mastectomy and 554,602 (70%) received BCT. After adjusting for clinical and sociodemographic factors, AANHPI women had greater odds of receiving mastectomy over BCT, compared to White women (OR [95% CI], 1.35 [1.30-1.39]; p<0.001). In contrast, Black women were less likely than White women to receive mastectomy (0.86 [0.84-0.87]; p<0.001). Upon disaggregation, Chinese, Japanese, Filipino, Korean, Vietnamese, and Asian Indian & Pakistani women were more likely to receive mastectomy over BCT compared to White women (p<0.001 for all). Treatment at academic (1.30 [1.27-1.32]), integrated (1.24 [1.21-1.27]), and comprehensive community cancer centers (1.15 [1.13-1.17]) were all associated with greater odds of mastectomy compared to treatment at community cancer programs (all p<0.001). Greater distance from treatment facility (≥50 mi. vs. 0 to <10 mi. [reference], OR 1.50 [1.47-1.53]) and cT2 disease (1.85 [1.82-1.87]) were also associated with greater odds of receiving mastectomy (all p<0.001).

CONCLUSION

In this evaluation of women with early-stage breast cancer, women from several AANHPI groups were more likely to receive mastectomy (as opposed to BCT) compared to White women. While sociocultural preferences, differences in access to and interest in reconstruction, as well as prevalent tumor-to-breast ratios may partially explain the disparities, collectively our data suggest an ongoing need for greater patient involvement in shared-decision making, particularly in vulnerable and understudied Asian populations.

Bioinspired Synthesis of Zinc Molybdate Nanoparticles: An Efficient Material for Growth Inhibition of Escherichia coli, Staphylococcus aureus, and Dye Remediation

Zinc molybdate nanoparticles with molybdate are synthesized through green method with different salt precursors using Moringa oleifera leaf extract. Those nanoparticles had structural, vibrational, and morphological properties, which were determined by X-ray diffraction (XRD). The crystalline size of synthesized zinc molybdate was 24.9 nm. Fourier transform infrared (FTIR) spectroscopy and field emission scanning electron microscopy (FE-SEM) clearly showed the attachment of molybdate with ZnO. The synthesized nanomaterial was also characterized through UV-visible spectroscopy which had 4.40 eV band gap energy. Those nanoparticles were also characterized via thermogravimetric analysis (TGA-DTA) and photoluminance spectroscopy (PL). ZnMoO4 had photocatalytic property via methylene blue dye. After 190 minutes, the dye changed to colourless from blue colour. The degradation efficiency was around 92.8%. It also showed their antibacterial effect via Escherichia coli and Staphylococcusaureus bacterial strains. In the presence of light and air, nanoparticles of ZnMoO4 inhibit the growth of cells of E. coli and S. aureus bacterial strains because of ROS (reactive oxygen species) generation. Because of the formation of singlet oxygen (O2∗-), hydrogen oxide radical (-OH∗), and hydrogen peroxide (H2O2), ZnMoO4 showed photodegradation reaction against aq. solution of methylene blue dye at 6 pH with constant time interval. With time, the activity of ZnMoO4 also decreased because of the generation of a layer of hydrogen oxide (-OH) on nanomaterial surface, which could be washed with ethanol and distilled water. After drying, the catalytic Zinc molybdate nanoparticles could be reused again in the next catalytic reaction.

Doped Carbon Quantum Dots Reinforced Hydrogels for Sustained Delivery of Molecular Cargo

Hydrogels have emerged as important soft materials with numerous applications in fields including biomedicine, biomimetic smart materials, and electrochemistry. Because of their outstanding photo-physical properties and prolonged colloidal stability, the serendipitous findings of carbon quantum dots (CQDs) have introduced a new topic of investigation for materials scientists. CQDs confined polymeric hydrogel nanocomposites have emerged as novel materials with integrated properties of the individual constituents, resulting in vital uses in the realm of soft nanomaterials. Immobilizing CQDs within hydrogels has been shown to be a smart tactic for preventing the aggregation-caused quenching effect and also for manipulating the characteristics of hydrogels and introducing new properties. The combination of these two very different types of materials results in not only structural diversity but also significant improvements in many property aspects, leading to novel multifunctional materials. This review covers the synthesis of doped CQDs, different fabrication techniques for nanostructured materials made of CQDs and polymers, as well as their applications in sustained drug delivery. Finally, a brief overview of the present market and future perspectives are discussed.

Potentialities of graphene and its allied derivatives to combat against SARS-CoV-2 infection

Graphene is a two-dimensional material with sp2 hybridization that has found its broad-spectrum potentialities in various domains like electronics, robotics, aeronautics, etc.; it has recently gained its utilities in the biomedical domain. The unique properties of graphene and its derivatives of graphene have helped them find their utilities in the biomedical domain. Additionally, the sudden outbreak of SARS-CoV-2 has immensely expanded the research field, which has also benefitted graphene and its derivatives. Currently, the world is facing a global pandemic due to the sudden outbreak of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), also known as COVID-19, from its major onset in Wuhan city, China, in December 2019. Presently, many new variants and mutants appear, which is more harmful than previous strains. However, researchers and scientists are focused on understanding the target structure of coronavirus, mechanism, causes and transmission mode, treatment, and alternatives to cure these diseases in this critical pandemic situation; many findings are achieved, but much more is unknown and pending to be explored. This review paper is dedicated to exploring the utilities of graphene and its derivatives in combating the SARS-CoV-2 by highlighting their mechanism and applications in the fabrication of biosensors, personal protection equipment (PPE) kits, 3-D printing, and antiviral coatings. Further, the paper also covers the cytotoxicity caused by graphene and its derivatives and highlights the graphene-based derivatives market aspects in biomedical domains. Thus, graphene and graphene-derived materials are our new hope in this pandemic time, and this review helps acquire broad knowledge about them.

Molecular prevalence of resistance determinants, virulence factors and capsular serotypes among colistin resistance carbapenemase producing Klebsiella pneumoniae: a multi-centric retrospective study

The emergence of colistin-carbapenem-resistant Klebsiella pneumoniae (CCR-Kp) in bloodstream infection results in high mortality, and virulence factor contributes further to the difficulty of treatment. A total of 158 carbapenem-resistant K. pneumoniae (CRKP) isolates causing bloodstream infection were collected from three Indian tertiary care hospitals during the 9-month study period, of which 27 isolates exhibited resistance to both colistin and carbapenem antibiotics. In this study, all the strains were characterized for antimicrobial resistance, virulence factors and capsular serotypes that facilitate the development of colistin and carbapenem-resistant K.pneumoniae (CCR-Kp) in bloodstream infection. Fourteen isolates displayed extremely drug resistance (XDR), susceptible only to tigecycline, and the remaining 13 isolates displayed multidrug resistance (MDR). The gene prevalence analysis for CCR-Kp isolates showed the predominance of bla KPC (81.48%) followed by bla NDM (62.96%), bla VIM (37.03%) and bla IMP (18.51%) genes. The distribution of virulence genes was found to be fimH (81.48%), wabG (59.25%), mrkD (55.56%), entB (48.15%), irp1 (33.33%), and rmpA (18.52%). The capsular serotypes K1, K2, K5 and K54 have been identified in 16 isolates. The absence of plasmid-mediated colistin resistance (mcr) genes implies the involvement of other mechanisms. The ERIC and (GTG)5 molecular typing methods detected 18 and 22 distinct clustering patterns among the CCR-Kp isolates, respectively. A strong correlation between ERIC and (GTG)5 genotyping method was established with antimicrobial resistance patterns and virulence determinants at P < 0.05, while no correlation was found with capsular serotyping. Similar virulence and resistance typing among the isolates suggest hospital-acquired infection in a health care setup. These outcomes will advance our awareness of CCR-Kp outbreaks associated with tertiary care hospitals and help forecast their occurrence in the near future.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s13205-021-03056-4.

Constraints on Dark Matter Properties from Observations of Milky Way Satellite Galaxies

We perform a comprehensive study of Milky Way (MW) satellite galaxies to constrain the fundamental properties of dark matter (DM). This analysis fully incorporates inhomogeneities in the spatial distribution and detectability of MW satellites and marginalizes over uncertainties in the mapping between galaxies and DM halos, the properties of the MW system, and the disruption of subhalos by the MW disk. Our results are consistent with the cold, collisionless DM paradigm and yield the strongest cosmological constraints to date on particle models of warm, interacting, and fuzzy dark matter. At 95% confidence, we report limits on (i) the mass of thermal relic warm DM, m_{WDM}>6.5  keV (free-streaming length, λ_{fs}≲10h^{-1}  kpc), (ii) the velocity-independent DM-proton scattering cross section, σ_{0}<8.8×10^{-29}  cm^{2} for a 100 MeV DM particle mass [DM-proton coupling, c_{p}≲(0.3  GeV)^{-2}], and (iii) the mass of fuzzy DM, m_{ϕ}>2.9×10^{-21}  eV (de Broglie wavelength, λ_{dB}≲0.5  kpc). These constraints are complementary to other observational and laboratory constraints on DM properties.

Is higher power shorter duration radiofrequency energy is better than lower power longer duration strategy in catheter ablation of atrial fibrillation A meta-analysis

Background

An ideal strategy for radiofrequency ablation (RFA) of atrial fibrillation (AF) in the left atrium should be efficient enough to achieve transmural lesions in left atrium with no or minimal collateral tissue damage. Resistive heating of high power short duration (HPSD) RFA has been found to result in lesions larger in width but lesser in depth compared to lower power longer duration (LPLD) RFA in some experimental studies.

Purpose

This meta-analysis was performed to compare procedural, short-term and long-term outcomes of HPSD versus LPLD RFA of AF.

Methods

PubMed, Embase and Cochrane databases were systematically reviewed. Five observational studies meeting criteria were included in the meta-analysis. All the studies scored six or more points in the New-castle Ottawa scale. There were considerable variations in the ablation strategies across the studies. However, radiofrequency power more than 40W was considered as high power. Hypergeometric model with exact likelihood function was utilized for statistical analysis.

Results

Baseline parameters and ablation details have been depicted in Table 1. 740 patients with HPSD and 287 patients with LPLD ablation strategies, were followed up from 6 to 30 months. Total procedural time (P value &lt;0.0001) and ablation time (P value &lt;0.0001) were significantly lower in the HPSD group than LPLD group. However, the fluoroscopy time was similar (P value = 0.09) in both the groups (Table 2). There were no occurrences of atrio-esophageal fistula or pulmonary venous stenosis in any of the studies. Cardiac tamponade (P value = 0.56), stroke (P value = 0.70) and AF recurrences (P value = 0.81), were similar in both groups (Table 2).

Conclusion

Newer HPSD and conventional LPLD RFA, both the strategies are very safe procedure for treatment of RFA with low to no procedural complications. AF recurrence rates were reasonably high irrespective of ablation strategies, however, no strategy scored statistically better over the other one. Large randomized multi-centric studies with long-term follow up are needed to test the theoretical advantage of HPSD ablation over the traditional ablation strategy of AF.

Funding Acknowledgement

Type of funding source: None

Cationic Dye Removal Using Novel Magnetic/Activated Charcoal/β-Cyclodextrin/Alginate Polymer Nanocomposite

New magnetic iron oxide (Fe₃O₄)/activated charcoal (AC)/β-cyclodextrin (CD)/sodium alginate (Alg) polymer nanocomposite materials were prepared by direct mixing of the polymer matrix with the nanofillers. The obtained materials were utilized as nano-adsorbents for the elimination of methylene blue (MB), a hazardous water-soluble cationic dye, from aqueous solutions, and showed excellent regeneration capacity. The formation of the nanocomposites was followed by high-resolution transmission electron microscopy (HRTEM), scanning electron microscopy (SEM) equipped with energy dispersive X-ray spectrometry (EDX), Fourier-transform infrared spectroscopy (FTIR), vibrating sample magnetometer (VSM), X-ray diffraction (XRD) and adsorption of N₂ at −196 °C. The rate of adsorption was investigated varying several factors, namely contact time, pH, amount of adsorbent and MB concentration on the adsorption process. Studies dealing with equilibrium and kinetics were carried out in batch conditions. The obtained results indicated that the removal rate of MB was 99.53% in 90 min. Langmuir’s isotherm fitted better to the equilibrium data of MB. Fe₃O₄/AC/CD/Alg polymer beads shows amazing adsorption capacities in the elimination of cationic dyes (2.079 mg/g for polymer gel beads and 10.63 mg g⁻¹ for dry powder beads), in comparison to other adsorbent materials. The obtained adsorbent is spherical with hydrophobic cross-linked surface properties that enable an easy recovery without any significant weight loss of in the adsorbent used.

Comparison of Antimicrobial Efficacy of Four Different Plant Extracts against Cariogenic Bacteria: An In Vitro Study

Background

Dental caries is an oral disease which is infectious in nature associated with various pathogenic microorganisms and is prevalent across the world.

Aim

To evaluate and compare the anticariogenic properties of the different plant extracts against various cariogenic microorganisms.

Materials and methods

In phase I, the anticariogenic efficacy of four different herbal extracts, namely Ocimum sanctum (Tulsi), Terminalia chebula (Harad), Tinospora cordifolia (Guduchi), and Glycyrrhiza glabra (Licorice), was evaluated against two strains of bacteria viz. Streptococcus mutans and Lactobacillus acidophilus. In the second phase of the study, the overall decay depth was compared.

Results

In phase I, zone of inhibition was significantly higher in G. glabra (Licorice) followed the descending order by O. sanctum (Tulsi), T. chebula (Harad), and T. cordifolia (Guduchi), respectively. In the second phase, it was found that the decay depth was significantly higher in T. cordifolia (Guduchi) followed the descending order by T. chebula (Harad), O. sanctum (Tulsi), and G. glabra (Licorice), respectively.

Conclusion

Glycyrrhiza glabra (Licorice) extract had potent antibacterial efficacy against S. mutans and L. acidophilus.

Clinical significance

Synthetic drugs have many adverse effects, so more attention has been paid to natural remedies because they are safe and effective. Today, the main interest is shifted toward the drugs which is derived from plants, which has led to the screening of many herbal plants for their potential antimicrobial activity and the same can be used clinically as an alternative of synthetic drugs used in dentistry.

How to cite this article

Rai A, Tripathi AM, Saha S, et al. Comparison of Antimicrobial Efficacy of Four Different Plant Extracts against Cariogenic Bacteria: An In Vitro Study. Int J Clin Pediatr Dent 2020;13(4):361–367.

New approaches for post-vaccination surveillance of foot-and-mouth disease

Foot-and-mouth disease (FMD) is a contagious and important transboundary disease of cloven-hoofed animals and ruminants. In ruminants, an animal is considered as a foot-and-mouth disease virus (FMDV) carrier if a live FMDV/FMDV RNA is obtained from the oro-pharyngeal fluid (OPF) beyond 28 days after infection. These carrier animals may pose a risk for causing outbreaks in healthy animals. Moreover, it is important to conduct serosurveillance to know the virus circulation. In the present study, an ELISA was developed using field samples to detect FMDV specific secretory IgA antibodies. These samples were also tested for the presence of FMDV RNA using quantitative real-time PCR (qRT-PCR). It was found that more carrier animals were detected by IgA ELISA in comparison to qRT-PCR. Thus, IgA ELISA is an important tool to detect FMD carriers. An ELISA based on detection of antibodies against FMDV 2B non-structural protein (NSP) was also used to confirm the results obtained from screening of 3AB3 NSP ELISA. These two new approaches (IgA ELISA and 2B ELISA) form important tools for detection of carriers and virus circulation, respectively, during FMD eradication program. Keywords: foot-and-mouth disease virus; carriers; IgA; 2B non-structural protein; 3AB3 non-structural protein.

Cosmological Constraints from Multiple Probes in the Dark Energy Survey

The combination of multiple observational probes has long been advocated as a powerful technique to constrain cosmological parameters, in particular dark energy. The Dark Energy Survey has measured 207 spectroscopically confirmed type Ia supernova light curves, the baryon acoustic oscillation feature, weak gravitational lensing, and galaxy clustering. Here we present combined results from these probes, deriving constraints on the equation of state, w, of dark energy and its energy density in the Universe. Independently of other experiments, such as those that measure the cosmic microwave background, the probes from this single photometric survey rule out a Universe with no dark energy, finding w=-0.80_{-0.11}^{+0.09}. The geometry is shown to be consistent with a spatially flat Universe, and we obtain a constraint on the baryon density of Ω_{b}=0.069_{-0.012}^{+0.009} that is independent of early Universe measurements. These results demonstrate the potential power of large multiprobe photometric surveys and pave the way for order of magnitude advances in our constraints on properties of dark energy and cosmology over the next decade.

Changes in Hemagglutinin and Neuraminidase Genes of pH1N1 Influenza Virus Strains Collected from a North Indian Tertiary Care Hospital during 2015

OBJECTIVE

The study was conducted to analyze changes in HA and NA genes of pandemic pH1N1 strains, collected from North Indian tertiary care hospital during 2015 and studied the nucleotide change since 2009. Differences in clinical features of cases positive and negative for influenza viruses were also studied.

METHODS

All samples referred for H1N1 testing, were tested for influenza viruses. Randomly selected 25 strains of pH1N1 were studied for nucleotide sequences of HA &amp; NA gene. The nucleotide changes occurring since 2009 were studied by mutational and phylogenetic analysis. Clinical details of cases were recorded and analysed.

RESULTS

A total of 3319 cases of acute respiratory infections (ILI/SARI) were tested for influenza viruses during Jan to April 2015, of which 815 cases tested positive for pH1N1. Nucleotide variation of 2015 strains, from influenza A/California/07/2009 strain at HA1 and NA1 gene was 1.9% and 3.8% respectively. Both HA1 and NA1 coding sequence showed eight mutations. Four of HA1(K180Q, S202T, S220T, and A273T) and NA1 (N200S, V241I, N248D, and N270K) mutations were observed in all pH1N1 study strains.

CONCLUSIONS

Strains of pH1N1 isolated during year 2015 diverged from previously circulating strains. Their association with severity of illness needs to be further studied.

Taming Influenza Virus: Role of Antisense Technology

Human Influenza A virus (IAV), a relatively newer threat to mankind, is becoming invincible due to non availability of proper antiviral drug or effective long lasting vaccine against it. All existing measures to control this virus are overpowered by the phenomena of genetic shift and drift shown by Influenza A virus (IAV). Throughout the world, researchers are exploring the therapeutic potential of antisense technology (AST) to fight against this genetically variable virus. Antisense technology refers to the laboratory manipulation and/or modification of DNA or RNA so that its components (nucleotides) hybridize with target nucleic acid or mRNA or protein itself to inhibit the protein finally encoded. RNA inhibitory (RNAi) mechanism (particularly siRNA) seems to be the most promising among the different agents of AST. However, other agents like oligonucleotides, ribozymes and DNAzymes also show great potential. Decoys and aptamers, alone or in conjunction with other agents, are also being explored to inhibit the replication of virus. Presently, most of these agents have passed initial level of in vitro and in vivo experiments, passing through various levels of clinical trials but none of them has been approved for human purpose till date. Present review consolidates the efforts of researchers worldwide in this particular field and discusses the future perspectives this technology holds, to tame this notorious virus. Day by day, various areas of this technology are being explored and the day is not far when this chemical entity will reach from "bench to bedside".

In vitro validation of self designed "universal human Influenza A siRNA"

The genomic variability of Influenza A virus (IAV) makes it difficult for the existing vaccines or anti-influenza drugs to control. The siRNA targeting viral gene induces RNAi mechanism in the host and silent the gene by cleaving mRNA. In this study, we developed an universal siRNA and validated its efficiency in vitro. The siRNA was designed rationally, targeting the most conserved region (delineated with the help of multiple sequence alignment) of M gene of IAV strains. Three level screening method was adopted, and the most efficient one was selected on the basis of its unique position in the conserved region. The siRNA efficacy was confirmed in vitro with the Madin Darby Canine Kidney (MDCK) cell line for IAV propagation using two clinical isolates i.e., Influenza A/H3N2 and Influenza A/pdmH1N1. Of the total 168 strains worldwide and 33 strains from India, 97 bp long (position 137-233) conserved region was identified. The longest ORF of matrix gene was targeted by the selected siRNA, which showed 73.6% inhibition in replication of Influenza A/pdmH1N1 and 62.1% inhibition in replication of Influenza A/H3N2 at 48 h post infection on MDCK cell line. This study provides a basis for the development of siRNA which can be used as universal anti-IAV therapeutic agent.

Wide-Field Lensing Mass Maps from Dark Energy Survey Science Verification Data

We present a mass map reconstructed from weak gravitational lensing shear measurements over 139  deg2 from the Dark Energy Survey science verification data. The mass map probes both luminous and dark matter, thus providing a tool for studying cosmology. We find good agreement between the mass map and the distribution of massive galaxy clusters identified using a red-sequence cluster finder. Potential candidates for superclusters and voids are identified using these maps. We measure the cross-correlation between the mass map and a magnitude-limited foreground galaxy sample and find a detection at the 6.8σ level with 20 arc min smoothing. These measurements are consistent with simulated galaxy catalogs based on N-body simulations from a cold dark matter model with a cosmological constant. This suggests low systematics uncertainties in the map. We summarize our key findings in this Letter; the detailed methodology and tests for systematics are presented in a companion paper.

Genetic changes in influenza A(H3N2) viruses circulating during 2011 to 2013 in northern India (Lucknow)

Genetic variability in the hemagglutinin (HA1) and the neuraminidase (NA) genes of influenza viruses results in the emergence of new strains which differ in pathogenicity and severity. The present study was undertaken for genotypic characterization of the HA1 and NA genes of the influenza A(H3N2) strains, detected during the 2011-2013. A total of fifty five influenza A(H3N2) positive samples [2011 (n = 20), 2012 (n = 4) and 2013 (n = 31)] were studied. The 824 bp segment of HA1 gene and 931 bp segment of NA gene were amplified and sequenced by Big-Dye terminator kit on ABI3130, Genetic analyzer. Molecular and phylogenetic analysis was done by MEGA 5.05 software and PhyML program (v3.0). Mutations were determined by comparing the deduced amino acid sequences of study strains with that of 2009-2013 vaccine strains. The studied influenza A(H3N2) strains showed 98.1-99.6% similarity in HA1 and NA amino acid sequences with the influenza A/Victoria/361/2011 vaccine strain. Four mutations in the HA1 amino acid sequences (T128A, R142G, L157S and N278K) and three unique mutations in the NA amino acid sequences [D251V, S315G and V313A] were found. These mutations were observed only in strains from the year 2013 (cluster II). None of the strains showed the presence of mutations, N294S and R292K, markers of oseltamivir resistance. In conclusion, Lucknow strains have accumulated the significant number of mutations in the antigenic sites of the HA and the NA coding sequences and continue to be evolving from the 2013 vaccine strain [A/Victoria/361/2011], however, mutations specific for oseltamivir resistance were not detected.

Viral aetiology of acute lower respiratory tract illness in hospitalised paediatric patients of a tertiary hospital: one year prospective study

CONTEXT

Acute lower respiratory tract infections (ALRI), ranked as the second leading cause of death are the primary cause of hospitalisation in children. Viruses are the most important causative agents of ALRI.

AIM

To study the viral aetiology of ALRI in children at a tertiary care hospital.

SETTING AND DESIGN

One year prospective observational study in a tertiary care hospital of King George's Medical University, Lucknow.

MATERIAL AND METHODS

Nasopharyngeal aspirate (NPA) was collected from children admitted with signs and symptoms of ALRI who were aged 0-14 years. Samples were transported to the laboratory at 4°C in viral transport media and processed for detection of respiratory syncytial virus (RSV) A and B, influenza virus A and B, adenovirus (ADV), human Boca virus (HBoV), human metapneumo virus (hMPV) and parainfluenzavirus 1, 2, 3 and 4 using mono/multiplex real-time polymerase chain reaction (RT-PCR). STATA was used for statistical analysis.

RESULTS

In one year, 188 NPAs were screened for respiratory viruses, of which 45.7% tested positive. RSV was most commonly detected with 21.3% positivity followed by measles virus (8.5%), influenza A virus (7.4%), ADV (5.3%), influenza B virus (1.6%), hMPV (1.1%) and HBoV (0.5%). Month wise maximum positivity was seen in December and January. Positivity rate of RSV was highest in children aged < 1 year, which decreased with increase in age, while positive rate of influenza virus increased with increasing age.

CONCLUSION

The occurrence of viral predominance in ALRI is highlighted.

Influenza virus genotypes circulating in and around Lucknow, Uttar Pradesh, India, during post pandemic period, August 2010--September 2012

BACKGROUND & OBJECTIVES

During the post influenza pandemic period, continuous surveillance of influenza virus and its subtypes is mandatory to help the policy makers to take effective and appropriate decisions. Therefore, this study was planned to determine the pattern of influenza virus activity in context to various meteorological and clinical parameters in and around Lucknow, Uttar Pradesh, India, during post pandemic period August 2010 - September 2012.

METHODS

Nasal swabs/throat swabs/nasopharyngeal aspirates of 2669 patients were collected. One-step real time PCR for detection of influenza virus was done according to the Centers for Disease Control and Prevention (CDC) protocol.

RESULTS

Influenza positivity was 15.8 per cent (423/2669) in symptomatic patients. Of the 423 total positives, 192 (7.2%) were influenza A and 231 (8.7%) were influenza B. Positivity for influenza virus was significantly (P=0.001, OR=2.9, CI=1.9-4.3) higher in patients with Influenza like illness (ILI) (17.4%, 396/2271) than those with severe acute respiratory illness (SARI) (6.8%, 27/398). Influenza A positive samples were subtyped as; pdmH1N1 (67.2%, 129/192) and seasonal H3N2 (32.8%, 63/192). It significantly correlated with monthly mean rainfall, humidity and dew point while atmospheric pressure was inversely related. No significant association was found with temperature and wind speed. Clinical variations were observed between different strains of Influenza virus.

INTERPRETATION & CONCLUSIONS

The findings provide a clear picture of different clinical presentations of various strains of influenza A and B viruses and epidemiology of influenza infection from Lucknow (UP), India. The seasonality of influenza virus infection showed variation in relation to different environmental factors. Pandemic H1N1 caused more systemic infection than seasonal influenza A/H3N2 virus.

Light induced toxicity of merocyanine 540-silica nanoparticle complex

The electrostatic binding between the negatively charged lipophilic dye Merocyanine 540 and silica nanoparticles having 3-amino propyl groups at the surface has been characterized using absorption and fluorescence spectroscopy. The binding of the dye with the nanoparticle resulted in significant changes in its absorption spectra. Further the fluorescence intensity and lifetime gets enhanced by more than an order of magnitude. The results obtained suggest that this is due to the reduced photoisomerization rate of the dye bound to the nanoparticle. Consistent with the expectation that a reduction in the photoisomerization rate should enhance the singlet oxygen yield of the dye via intersystem crossing, the light induced toxicity of the dye-nanoparticle complex (tested with MCF cells) was observed to be higher compared to the free dye.

Washability and fabric‐staining properties of a novel phospholipid‐structured coal tar formulation

BACKGROUND

Coal tar is one of the most preferred and frequently used medicinal agents in various dermatological diseases. However, the coal tar formulations available for clinical use suffer from the limitation of staining clothes and skin, eventually leading to a high degree of patient non-compliance.

OBJECTIVE

To test the staining property of a lecithinized formulation vis-a-vis a conventional formulation of coal tar employing different types of fabric.

METHODS

Six fabrics with different blends of cotton and polyester were employed to test the staining and washability of two coal tar formulations following application for 24 hours and 48 hours.

RESULTS

The study revealed the distinct superiority of the lecithinized coal tar formulation vis-a-vis the conventional marketed formulation due to its markedly reduced staining and easier washability. A significant reduction in the staining of fabrics containing polyester was observed with the lecithinized formulation, with the stain becoming progressively worse as the proportion of polyester in the fabric increased. The stains washed off completely with detergent in the case of the lecithinized coal tar formulation, whereas stains from the conventional coal tar formulation remained intact.

CONCLUSION

The developed lecithinized formulation, owing to its superior non-staining and washability characteristics, would potentially increase the acceptability of coal tar amongst patients.

Hydrogen Bonding Properties of Coumarin 151, 500, and 35: The Effect of Substitution at the 7-Amino Position

The steady-state spectral properties (absorption and emission) of three structurally similar Coumarin dyes, C151, C500, and C35 were investigated in 13 different solvents. A Kamlet-Taft (KT) analysis of the spectral peak frequencies reveals that, in addition to polarity, hydrogen bonding between the carbonyl oxygen and a protic solvent in the excited state imparts maximum stabilization for C151 and minimum for C35, while that for C500 lies in between. The spectral properties of the three dyes in two solvents, chloroform and THF, which have similar polarity in the KT scale but have only hydrogen-bond donor (chloroform) and hydrogen-bond acceptor (THF) properties, are seen to be sensitive to the substitution pattern at the 7-amino position. In addition, a slow emission spectral relaxation is observed for C151 and C500 having a time constant of approximately 500 ps in chloroform. For C35 this was too fast to be detected by the time resolution of our setup. The exact reason for this slow spectral relaxation in chloroform is unclear at present, and further studies are needed to understand clearly the structural effects on the hydrogen bonding dynamics of these dyes.