Dimensions of equality in uptake of COVID-19 vaccination in Wales, UK: A multivariable linked data population analysis

Vaccination has proven to be effective at preventing severe outcomes of COVID-19 infection, and uptake in the population has been high in Wales. However, there is a risk that high-level vaccination coverage statistics may mask hidden inequalities in under-served populations, many of whom may be at increased risk of severe outcomes of COVID-19 infection. The study population included 1,436,229 individuals aged 18 years and over, alive and residence in Wales as at 31st July 2022, and excluded immunosuppressed or care home residents. We compared people who had received one or more vaccinations to those with no vaccination using linked data from nine datasets within the Secure Anonymised Information Linkage (SAIL) databank. Multivariable analysis was undertaken to determine the impact of a range of sociodemographic characteristics on vaccination uptake, including ethnicity, country of birth, severe mental illness, homelessness and substance use. We found that overall uptake of first dose of COVID-19 vaccination was high in Wales (92.1 %), with the highest among those aged 80 years and over and females. Those aged under 40 years, household composition (aOR 0.38 95 %CI 0.35-0.41 for 10+ size household compared to two adult household) and being born outside the UK (aOR 0.44 95 %CI 0.43-0.46) had the strongest negative associations with vaccination uptake. This was followed by a history of substance misuse (aOR 0.45 95 %CI 0.44-0.46). Despite high-level population coverage in Wales, significant inequalities remain across several underserved groups. Factors associated with vaccination uptake should not be considered in isolation, to avoid drawing incorrect conclusions. Ensuring equitable access to vaccination is essential to protecting under-served groups from COVID-19 and further work needs to be done to address these gaps in coverage, with focus on tailored vaccination pathways and advocacy, using trusted partners and communities.

Lumbar Spine Injury in Indian Fast Bowlers: 3D Biomechanical Analysis and Prevention Strategies

Background

Lumbar spine injuries are among the most common overuse injuries in a fast bowler. Among various causative factors, bowling action technique is a crucial one. Three-dimensional motion analysis has been accepted as a gold standard tool to identify incorrect techniques. Previous studies have identified key biomechanical variables associated with lumbar injury risk in fast bowlers. Despite the large popularity of the sport, there is limited information available on the subject in Indian fast bowlers. This study aims to analyse the lumbar spine injury risk in Indian fast bowlers with respect to key biomechanical variables, using 3D motion analysis.

Methods

Forty-seven male first class fast bowlers underwent 3D motion analysis in an indoor biomechanics laboratory. Motion capture was done with 3D cameras and 2D video cameras, using a standard marker set. Data processing and analysis was done using proprietary software. Biomechanical variables associated with lumbar spine injury risk including lateral trunk flexion (LTF) and knee angle at front foot contact (KA at FFC) were measured, and peak vertical ground reaction forces (pVGRF) were simultaneously recorded using force plates. Descriptive analysis of the data was done.

Results

26% of bowlers had a high LTF, 29% had low KA at FFC and 43% had high pVGRF. Thus, a large proportion of bowlers in this study were at risk of lumbar spine injury with respect to the assessed variables.

Conclusion

This highlights the role of 3D motion analysis in early identification of injurious techniques, which can be modified by coaching and training interventions to prevent injuries. This study thus has implications on coaching and training of fast bowlers in India.

Prophylaxis for preventing venous thromboembolism in knee arthroscopy and soft tissue reconstruction: consensus statements from an international panel of experts

PURPOSE

There is a lack of consensus regarding need for Venous Thrombo Embolism (VTE) prophylaxis following arthroscopic knee surgery and open soft tissue knee reconstruction. Clear cut guidelines like ones for trauma surgery and arthroplasty do not exist and the published literature is limited to case reports with a few society guidelines. Given this lack of consensus, we conducted a modified Delphi questionnaire of international experts to provide recommendations on this topic.

METHODS

The consensus statements were generated using an anonymised 3 round modified Delphi questionnaire, sent to an international panel of 38 knee surgeons, with an 80% agreement being set as the limit for consensus. The responses were analysed using descriptive statistics with measures like mode, median and box plots. Feedback was provided to all panelists based on responses from the previous rounds to help generate the consensus.

RESULTS

Six consensus statements were generated after the three rounds of Delphi. Patient factors, prolonged surgery duration and family history of thrombogenic events emerged as the main points to be taken into consideration for prophylaxis.

CONCLUSION

It was established through this study, that there exists a select group of patients undergoing arthroscopic surgery that justify the usage of VTE prophylaxis. The expert responses to most of the questions in different scenarios favoured usage of VTE prophylaxis based on patient factors like advanced age, past history of VTE, smoking, oral contraceptive use etc. LEVEL OF EVIDENCE: Level V.

Studies on the influence of natural resource utilization by humans on foraging behavior of honey bees at rural ecosystems

Human utilization of natural resources acts as a main driver in altering the ecosystem service and functions. Apart from indirect influence, these human activities also tempt for the behavioral shift in insects especially in honey bees. The foraging behavior of honey bees from the natural floral resources to the man-made food sources eventually degrade the ecosystem's services and cause declining of the honey bee population. Understanding this foraging behavior of bees could help in opting for viable conservation measures for honey bees. In order to understand the influence of human utilization of natural resources on the foraging behavior of bees and its negative impacts on the bee population, the study was carried out in the sites where humans collect palm sap. Palm sap collectors used different containers (mud pots and pet bottles) to collect the palm sap from Borassus flabellifer. The number of containers per tree, volume of palm sap per container/tree, bee visiting frequency, and bee mortality per container/tree were measured at different ecosystems. Palm saps were collected freshly and volatile compounds of samples were identified using FT-IR and GC-MS analysis. The identified volatile compounds were used to study the interaction between volatile compounds and odorant-binding proteins (OBPs) of honey bees for understanding the foraging behavior of bees using in silico approach. Our results clearly showed that bee visitation frequency was directly correlated (0.94) with bee mortality in palm sap in different study sites. The average number of bee mortality was recorded as 491.2 ± 23.48 bees per container/tree/day. GC-MS analyses revealed the presence of 35 volatile compounds in collected palm sap from different study sites. Furthermore, molecular docking studies were performed for all 35 palm volatile compounds OBPs of honey bees to analyze their binding affinities. Docking studies showed that 1-methylbutylmandelate and 6-(hydroxymethyl)-1,4,4-trimethylbicyclo [3.1.0] hexan-2-ol have high binding affinity with OBP residues of bees. These volatile compounds might act as an attractant for bee populations for their foraging behavior. Based on this study, we conclude that human utilization of palm sap has created new ecological niches which highly alters the foraging behavior of bees and results in declining bee populations.

Rac1 activation can generate untemplated, lamellar membrane ruffles

BACKGROUND

Membrane protrusions that occur on the dorsal surface of a cell are an excellent experimental system to study actin machinery at work in a living cell. Small GTPase Rac1 controls the membrane protrusions that form and encapsulate extracellular volumes to perform pinocytic or phagocytic functions.

RESULTS

Here, capitalizing on rapid volumetric imaging capabilities of lattice light-sheet microscopy (LLSM), we describe optogenetic approaches using photoactivable Rac1 (PA-Rac1) for controlled ruffle generation. We demonstrate that PA-Rac1 activation needs to be continuous, suggesting a threshold local concentration for sustained actin polymerization leading to ruffling. We show that Rac1 activation leads to actin assembly at the dorsal surface of the cell membrane that result in sheet-like protrusion formation without any requirement of a template. Further, this approach can be used to study the complex morpho-dynamics of the protrusions or to investigate specific proteins that may be enriched in the ruffles. Deactivating PA-Rac1 leads to complex contractile processes resulting in formation of macropinosomes. Using multicolour imaging in combination with these approaches, we find that Myo1e specifically is enriched in the ruffles.

CONCLUSIONS

Combining LLSM and optogenetics enables superior spatial and temporal control for studying such dynamic mechanisms. Demonstrated here, the techniques implemented provide insight into the complex nature of the molecular interplay involved in dynamic actin machinery, revealing that Rac1 activation can generate untemplated, lamellar protrusions.

Rapid whole cell imaging reveals a calcium-APPL1-dynein nexus that regulates cohort trafficking of stimulated EGF receptors

The endosomal system provides rich signal processing capabilities for responses elicited by growth factor receptors and their ligands. At the single cell level, endosomal trafficking becomes a critical component of signal processing, as exemplified by the epidermal growth factor (EGF) receptors. Activated EGFRs are trafficked to the phosphatase-enriched peri-nuclear region (PNR), where they are dephosphorylated and degraded. The details of the mechanisms that govern the movements of stimulated EGFRs towards the PNR, are not completely known. Here, exploiting the advantages of lattice light-sheet microscopy, we show that EGFR activation by EGF triggers a transient calcium increase causing a whole-cell level redistribution of Adaptor Protein, Phosphotyrosine Interacting with PH Domain And Leucine Zipper 1 (APPL1) from pre-existing endosomes within one minute, the rebinding of liberated APPL1 directly to EGFR, and the dynein-dependent translocation of APPL1-EGF-bearing endosomes to the PNR within ten minutes. The cell spanning, fast acting network that we reveal integrates a cascade of events dedicated to the cohort movement of activated EGF receptors. Our findings support the intriguing proposal that certain endosomal pathways have shed some of the stochastic strategies of traditional trafficking and have evolved processes that provide the temporal predictability that typify canonical signaling.

The switchable phase transition of sodium sulfate crystals activated by shock waves

A shock-wave-induced reversible phase-transformation from phase-V to phase-III of Na2SO4 is achieved, and the results are evidenced via XRD and Raman spectroscopy.

Spectroscopic assessment on the stability of benzophenone crystals at shock waves loaded condition

In recent years, there have been few thousands of non-linear optical (NLO) materials proposed for a wide array of technological applications. But unfortunately, most of the materials do not fit into the actual standard required for the specific purposes in terms of their efficiency, environmental resistance, cost effectiveness, availability, stability and durability. Hence, searching for the most suitable material for every specific technological application has become the necessity of being a continuous process until it is found. For the present experiment, we have chosen benzophenone crystal for the shock wave recovery experiment. Raman and powder X-ray diffraction (XRD) techniques have been utilized to evaluate the molecular and structural performances of the title material against the impact of shock waves and the obtained crystallographic structural properties are compared with potassium dihydrogen phosphate (KPD) crystal. The obtained Raman and XRD results demonstrate that the title material has high shock resistant property even though it is a mechanically soft material as well as it has very low melting point (48 °C).

Evaluation of regeneration of semitendinosus tendon using ultrasound imaging and isokinetic strength testing after graft harvest for arthroscopic anterior cruciate ligament reconstruction

Background

A lot of the research has been done worldwide evaluating the capacity of the semitendinosus tendon to regenerate which has not been conducted in the Indian population.

Study design

31 patients who underwent unilateral ACL reconstruction with hamstrings were taken into study. All patients underwent ultrasonography imaging of both knees and bilateral isokinetic flexion strength assessment at a one-year postoperative period. Images were obtained at three levels and their dimensions are compared with normal side. Isokinetic testing of the knee is done to evaluate the flexion deficit and is compared to the uninvolved knee.

Results

Out of a total of 31 patients, 14 patients showed no regeneration, 17 showed regeneration at various levels. On isokinetic testing patients with no regeneration showed the highest mean flexion deficit.

Conclusion

The semitendinosus tendon and its regeneration can be visualized well using ultrasonography. After semitendinosus harvesting, the flexion strength will be decreased as compared to the normal knee. The flexion strength in patients who have a regenerated tendon will be higher as compared to those who have no regeneration.

Knee flexion strength deficits correlate with distal extent of tendon regeneration after hamstring harvest. Preliminary data from an Ultrasound based classification

BACKGROUND

As more evidence comes to light that hamstring harvesting may not be as benign a procedure as previously thought, considerable interest is being generated towards corelating the knee flexural strength deficits with the degree of tendon regeneration. The current study aimed to corelate knee flexion strength deficits with ultrasonographically quantified degree of hamstring regeneration after tendon harvest.

STUDY DESIGN

31 patients of ACL reconstruction with hamstring grafts were divided into 2 groups (6 months and 1-year post op) according to time of follow up. Ultrasonography of both the knees to assess Semitendinosus tendon dimensions was done. Regeneration was classified as non-significant, mild (Zone 1, till 4 cm above the lateral joint line), moderate (Zone 2 ,at the level of the lateral joint line) and significant (Zone 3, 1.5 cm below the lateral joint line) as the regenerate happens from proximal to distal. Regenerate dimensions were compared with US measurements from the opposite knee. Bilateral isokinetic strength tests of the knees were done to evaluate flexion strength, and strength deficits were compared with degree of tendon regeneration.

RESULTS

14 (45%) of cases had no regeneration at both time periods. 7 patients (41%) in the 6-month post-op group showed some form of regeneration, and 10 patients (71%) in the 1-year post-op group showed regeneration. 29/31 patients had some flexion strength deficit. Strength deficit correlated with the level and degree of tendon regeneration, with non-significant regeneration cases showing higher strength deficit (mean - 28.51%), and cases with significant regeneration showing least amount of strength deficit (mean - 3.66%).

CONCLUSION

Flexion strength deficits after hamstring harvest are significant and corelate with degree of tendon regeneration, which improves over time. US is adequate to quantify degree of tendon regeneration, which in turn can help prognosticate return of flexion strength.

Influence of pressure on the transport, magnetic, and structural properties of superconducting Cr0.0009NbSe2 single crystal

We investigate the superconducting critical current density (J _c), transition temperature (T _c), and flux pinning properties under hydrostatic pressure (P) for Cr_0.0009NbSe₂ single crystal. The application of P enhances T _c in both electrical resistivity (∼0.38 K GPa^-1: 0 ≤ P ≤ 2.5 GPa) and magnetization (∼0.98 K GPa^-1: 0 ≤ P ≤ 1 GPa) measurements, which leads to a monotonic increase in J _c and flux pinning properties. The field-dependent J _c at various temperatures under P is analyzed within the collecting pinning theory and it shows that δT _c pinning is the crossover to δl pinning above the critical pressure (P _c ∼0.3 GPa). Our systematic analysis of the flux pinning mechanism indicates that both the density of pinning centers and pinning forces greatly increase with the application of P, which leads to an enhancement in the vortex state. Structural studies using synchrotron X-ray diffraction under pressure illustrate a stable hexagonal phase without any significant impurity phase and lattice parameter reduction with P shows highly anisotropic nature.

Understanding pretreatment loss to follow-up of tuberculosis patients: an explanatory qualitative study in Chennai, India

Introduction

Pretreatment loss to follow-up (PTLFU)-dropout of patients after diagnosis but before treatment registration-is a major gap in tuberculosis (TB) care in India and globally. Patient and healthcare worker (HCW) perspectives are critical for developing interventions to reduce PTLFU.

Methods

We tracked smear-positive TB patients diagnosed via sputum microscopy from 22 diagnostic centres in Chennai, one of India's largest cities. Patients who did not start therapy within 14 days, or who died or were lost to follow-up before official treatment registration, were classified as PTLFU cases. We conducted qualitative interviews with trackable patients, or family members of patients who had died. We conducted focus group discussions (FGDs) with HCWs involved in TB care. Interview and FGD transcripts were coded and analysed with Dedoose software to identify key themes. We created categories into which themes clustered and identified relationships among thematic categories to develop an explanatory model for PTLFU.

Results

We conducted six FGDs comprising 53 HCWs and 33 individual patient or family member interviews. Themes clustered into five categories. Examining relationships among categories revealed two pathways leading to PTLFU as part of an explanatory model. In the first pathway, administrative and organisational health system barriers-including the complexity of navigating the system, healthcare worker absenteeism and infrastructure failures-resulted in patients feeling frustration or resignation, leading to disengagement from care. In turn, HCWs faced work constraints that contributed to many of these health system barriers for patients. In the second pathway, negative HCW attitudes and behaviours contributed to patients distrusting the health system, resulting in refusal of care.

Conclusion

Health system barriers contribute to PTLFU directly and by amplifying patient-related challenges to engaging in care. Interventions should focus on removing administrative hurdles patients face in the health system, improving quality of the HCW-patient interaction and alleviating constraints preventing HCWs from providing patient-centred care.

Electrosynthesis of carbon aerogel-modified AuNPs@quercetin via an environmentally benign method for hydrazine (HZ) and hydroxylamine (HA) detection

An ultrasensitive electrochemical sensor fabricated using a hydrothermal and environmentally benign methods for the detection of environmental pollutions, namely, hydrazine (HZ) and hydroxylamine (HA) has been described.

Cordia diffusa K.C. Jacob, the Kovai Manjack (Boraginaceae): a highly threatened steno-endemic species from Coimbatore City, Tamil Nadu, India

Cordia diffusa K.C. Jacob, belonging to Boraginaceae, discovered in 1938 and named by K.C. Jacob in 1944, is a little-known and the only narrow endemic but neglected plant of Coimbatore City.  The lectotype of the steno-endemic is determined and the current status, distribution, potential threats, bioprospecting potential, and suggestions for conservation of the species are discussed.  The collection of steno-endemic plant during intensive exploration in its type locality nearly after 90 years is of phytogeographic and conservation significance.  The endemic is proposed the category of Critically Endangered (CR) based on criterion D of IUCN (as per versions 3.1 & 13).  C. diffusa can be protected by promoting awareness of the rarity of native species and mass propagation through vegetative means so as to introduce it in gardens, parks, and avenues, etc. at once in the city. 

Cordia diffusa K.C. Jacob, the Kovai Manjack (Boraginaceae): a highly threatened steno-endemic species from Coimbatore City, Tamil Nadu, India

Cordia diffusa K.C. Jacob, belonging to Boraginaceae, discovered in 1938 and named by K.C. Jacob in 1944, is a little-known and the only narrow endemic but neglected plant of Coimbatore City.  The lectotype of the steno-endemic is determined and the current status, distribution, potential threats, bioprospecting potential, and suggestions for conservation of the species are discussed.  The collection of steno-endemic plant during intensive exploration in its type locality nearly after 90 years is of phytogeographic and conservation significance.  The endemic is proposed the category of Critically Endangered (CR) based on criterion D of IUCN (as per versions 3.1 & 13).  C. diffusa can be protected by promoting awareness of the rarity of native species and mass propagation through vegetative means so as to introduce it in gardens, parks, and avenues, etc. at once in the city. 

A chitosan grafted mesoporous carbon aerogel for ultra-sensitive voltammetric determination of isoniazid

A screen-printed carbon electrode (SPCE) was modified with chitosan (Chit) supported on carbon aerogel (CA) to obtain an electrochemical sensor for the tuberculosis drug isoniazid (INZ). The interconnected mesoporous structure of Chit/CA provides a large surface area (S_BET = 461 m² g^-1) and good porosity (V_Tot = 0.69 cm³ g^-1). Besides, the modified SPCE displayed enhanced electrocatalytic activity due to the presence of numerous active sites (such as >C=O, -NH-, -NH₂, -OH). Figures of merit include (a) a typical working voltage of 0.28 V (vs. Ag/AgCl), (b) high sensitivity (8.09 μA μM^-1 cm^-2), (c) a wide linear response to INZ (0.01-115 μM) and (d) a low detection limit (8 nM). The modified electrode has successfully been applied to the determination of INZ in spiked serum and urine, and recoveries ranged from 97.8 to 99.8%. Graphical abstract Schematic illustration of preparation and applications of a nanocomposite consisting of chitosan (Chit; CS) supported on carbon aerogel (CA) for electrochemical detection of isoniazid.

Efficient nitrogen-vacancy centers' fluorescence excitation and collection from micrometer-sized diamond by a tapered optical fiber in endoscope-type configuration

Using an optical fiber to both excite the nitrogen-vacancy (NV) center in diamond and collect its fluorescence is essential to build NV-based endoscope-type sensor. Such endoscope-type sensor can reach inaccessible fields for traditional NV-based sensors built by bulky optical components and extend the application areas. Since single NV's fluorescence is weak and can easily be buried in fluorescence from optical fiber core's oxide defects excited by the green laser, fixing a micrometer size diamond containing high-density NVs rather than a nanodiamond containing single NV or several NVs on the apex of an optical fiber to build an endoscope-type sensor is more implementable. Unfortunately, due to small numerical aperture (NA), most of the optical fibers have a low fluorescence collection efficiency, which limits the sensitivity and spatial resolution of the NV-based endoscope-type sensor. Here, using a tapered optical fiber (TOF) tip, we significantly improve the efficiency of the laser excitation and fluorescence collection of the NV ensembles in diamond. This could potentially enhance the sensitivity and spatial resolution of the NV-based endoscope-type sensor. Numerical calculations show that the TOF tip delivers a high NA and has a high NV excitation and fluorescence collection efficiency. Experiments demonstrate that such TOF tip can obtain up to over 7-fold excitation efficiency and over 15-fold fluorescence collection efficiency of that from a flat-ended fiber (non-TOF) tip.

Effect of Bi-functional Hierarchical Flower-like CoS Nanostructure on its Interfacial Charge Transport Kinetics, Magnetic and Electrochemical Behaviors for Supercapacitor and DSSC Applications

Metal sulfides are of great interest for future electrode materials in supercapacitor and solar cell applications owing to their superior electrochemical activity and excellent electrical conductivity. With this scope, a binary transition metal sulfide (CoS) is prepared via one-step hydrothermal synthesis. Hexagonal phase of CoS with space group of P6₃/mmc(194) is confirmed by XRD analysis. Additional cubic Co₃S₄ phase in the prepared sample originates the mixed valence state of Co (Co²⁺ and Co³⁺) is affirmed from XPS analysis. Morphological features are visualized using HRSEM images that shows nanoflower shaped star-anise structure. Employing the prepared CoS as active electrode material, interfacial charge transport kinetics is examined by EIS-Nyquist plot. The supercapacitive performances are tested in two and three-electrode system which exhibited respective specific capacitances of 57 F/g and 348 F/g for 1 A/g. Further, the fabricated asymmetric CoS//AC supercapacitor device delivers an appreciable energy density of 15.58 Wh/kg and power density of 700.12 W/kg with excellent cyclic stability of 97.9% and Coulombic efficiency of 95% over 2000 charge-discharge cycles. In addition, dye-sensitized solar cells are fabricated with CoS counter electrode and the obtained power conversion efficiency of 5.7% is comparable with standard platinum based counter electrode (6.45%). Curie-Weiss plot confirms the transition of paramagnetic nature into ferrimagnetic behavior at 85 K and Pauli-paramagnetic nature at 20 K respectively. Temperature dependent resistivity plot affirms the metallic nature of CoS sample till 20 K and transition to semiconducting nature occurs at <20 K owing to Peierl’s transition effect.

Enhancement of superconducting properties and flux pinning mechanism on Cr0.0005NbSe2 single crystal under Hydrostatic pressure

Superconducting properties of Cr_0.0005NbSe₂ (T_c~6.64 K) single crystals have been investigated through the temperature dependent resistivity (~8 GPa) and DC magnetization (~1 GPa) measurements. Further, the critical current density (J_c) as a function of applied magnetic field has been studied from magnetic isotherms. The vortex pinning mechanisms have also been systematically analyzed using weak collective pinning theory as a function of pressure. The J_c corresponds to the flux flow enhanced by the application of pressure due to increase of T_c and vortex changes. We found that the pressure is responsible for the spatial variations in the charge carrier mean free path (δl pinning). We find that core point pinning is more dominant than surface pinning which is caused by the application of pressure. In addition, J_c(H = 0) increases from 3.9 × 10⁵ (0 GPa) to 1.3 × 10⁶ (1.02 GPa) A/cm² at 2 K as the pressure is increased from normal pressure to 1.02 GPa. The pressure dependence of T_c (dT_c/dP) becomes 0.91 K/GPa and 0.75 K/GPa from magnetization and resistivity measurements respectively. We found that the pressure promotes the anisotropy nature, and decrease of coherence length and resulting in pathetic interface of the vortex core with pinning centers.

The Evidence for External Beam Radiotherapy in High-Risk Neuroblastoma of Childhood: A Systematic Review

AIMS

External beam radiotherapy is widely used in various ways in the management of neuroblastoma. Despite extensive clinical experience, the precise role of radiotherapy in neuroblastoma remains unclear. The purpose of this systematic review was to survey the published literature to identify, without bias, the evidence for the clinical effectiveness of external beam radiotherapy as part of the initial multimodality treatment of high-risk neuroblastoma. We considered four areas: treatment of the tumour bed and residual primary tumour, identification of any dose-response relationship, treatment of metastatic sites, identification of any technical advances that may be beneficial. We also aimed to define uncertainties, which may be clarified in future clinical trials.

MATERIALS AND METHODS

Bibliographic databases were searched for neuroblastoma and radiotherapy. Reviewers assessed 1283 papers for inclusion by title and abstract, with consensus achieved through discussion. Data extraction on 57 included papers was carried out by one reviewer and checked by another. Studies were assessed for their level of evidence and risk of bias, and a descriptive analysis of data was carried out.

RESULTS

Fifteen papers provided some evidence that radiotherapy to the tumour bed and residual tumour may possibly be of value. However, there is a significant risk of bias and no evidence that all subgroups will benefit. There is some suggestion from six papers that dose may be important, but no hard evidence. It remains unclear whether irradiation of metastatic sites is helpful. Technical advances may be of value in radiotherapy of high-risk neuroblastoma.

CONCLUSIONS

There are data that show that radiotherapy is of some efficacy in the management of high-risk neuroblastoma, but there is no level one evidence that shows that it is being used in the best possible way. Prospective randomised trials are necessary to provide more evidence to guide development of optimal radiotherapy treatment schedules.

Pretreatment loss to follow-up of tuberculosis patients in Chennai, India: a cohort study with implications for health systems strengthening

Background

Pretreatment loss to follow-up (PTLFU) is a barrier to tuberculosis (TB) control in India’s Revised National TB Control Programme (RNTCP). PTLFU studies have not been conducted in India’s mega-cities, where patient mobility may complicate linkage to care.

Methods

We collected data from patient registries for May 2015 from 22 RNTCP designated microscopy centers (DMCs) in Chennai and audited addresses and phone numbers for patients evaluated for suspected TB to understand how missing contact information may contribute to PTLFU. From November 2015 to June 2016, we audited one month of records from each of these 22 DMCs and tracked newly diagnosed smear-positive patients using RNTCP records, phone calls, and home visits. We defined PTLFU cases as including: (1) patients who did not start TB therapy within 14 days and (2) patients who started TB therapy but were lost to follow-up or died before official RNTCP registration. We used multivariate logistic regression to identify factors associated with PTLFU.

Results

In the audit of May 2015 DMC registries, out of 3696 patients evaluated for TB, 1273 (34.4%) had addresses and phone numbers that were illegible or missing. Out of 344 smear-positive patients tracked from November 2015 to June 2016, 40 (11.6%) did not start TB therapy within 14 days and 36 (10.5%) started therapy but were lost to follow-up or died before official RNTCP registration, for an overall PTLFU rate of 22.1% (95%CI: 17.8%—26.4%). Of all PTLFU patients, 55 (72.4%) were lost to follow-up and 21 (27.6%) died before starting treatment or before RNTCP registration. In the regression analysis, age > 50 years (OR 2.9, 95%CI 1.4—6.5), history of prior TB (OR 3.9, 95%CI 2.2—7.1), evaluation at a high patient volume DMC (OR 3.2, 95% CI 1.7—6.3), and absence of legible patient contact information (OR 4.5, 95%CI 1.3—15.1) were significantly associated with PTLFU.

Conclusions

In an Indian mega-city, we found a high PTLFU rate, especially in patients with a prior TB history, who are at greater risk for having drug-resistance. Enhancing quality of care and health system transparency is critical for improving linkage of newly diagnosed patients to TB care in urban India.

Electronic supplementary material

The online version of this article (10.1186/s12879-018-3039-3) contains supplementary material, which is available to authorized users.

Development of METAL-ACTIVE SITE and ZINCCLUSTER tool to predict active site pockets

The advent of whole genome sequencing leads to increasing number of proteins with known amino acid sequences. Despite many efforts, the number of proteins with resolved three dimensional structures is still low. One of the challenging tasks the structural biologists face is the prediction of the interaction of metal ion with any protein for which the structure is unknown. Based on the information available in Protein Data Bank, a site (METALACTIVE INTERACTION) has been generated which displays information for significant high preferential and low-preferential combination of endogenous ligands for 49 metal ions. User can also gain information about the residues present in the first and second coordination sphere as it plays a major role in maintaining the structure and function of metalloproteins in biological system. In this paper, a novel computational tool (ZINCCLUSTER) is developed, which can predict the zinc metal binding sites of proteins even if only the primary sequence is known. The purpose of this tool is to predict the active site cluster of an uncharacterized protein based on its primary sequence or a 3D structure. The tool can predict amino acids interacting with a metal or vice versa. This tool is based on the occurrence of significant triplets and it is tested to have higher prediction accuracy when compared to that of other available techniques.

γ-MnS films with 3D microarchitectures: comprehensive study of the synthesis, microstructural, optical and magnetic properties

A simple procedure to synthesize 3D microarchitectures of γ-MnS films at low temperature is described in the present work.

Effect of pressure on normal and superconducting state properties of iron based superconductor PrFeAsO0.6F y (y = 0.12, 0.14)

The effect of high pressure (up to 8 GPa) on normal and superconducting state properties of PrFeAsO_0.6F_0.12, an 1111-type iron based superconductor close to optimal doped region, has been investigated by measuring the temperature dependence of resistivity. Initially, the superconducting transition temperature (T _c ) is observed to increase slowly by about 1 K as pressure (P) increases from 0 to 1.3 GPa. With further increase in pressure above 1.3 GPa, T _c decreases at the rate of ~1.5 K/GPa. The normal-state resistivity decreases monotonically up to 8 GPa. We have also measured the pressure dependence of magnetization (M) on the same piece of PrFeAsO_0.6F_0.12 sample up to 1.1 GPa and observed T _c as well as the size of the Meissner signal to increase with pressure in this low-pressure region. In contrast, for an over-doped PrFeAsO_0.6F_0.14 sample, magnetization measurements up to 1.06 GPa show that both T _c and the Meissner signal decrease with pressure. The present study clearly reveals two distinct regions in the dome-shaped (T _c -P) phase diagram of PrFeAsO_0.6F_0.12.

Enhancement of superconducting critical current density by Fe impurity substitution in NbSe2 single crystals and the vortex pinning mechanism

Magnetization measurements have been used to determine the effect of magnetic impurities (Fe) on the Larkin-Ovchinnikov (LO) 3D collective pinning model in NbSe₂ single crystals. Upon increasing the concentration of Fe impurities, the superconducting critical current density enhances appreciably compared to pure NbSe₂ reflecting the fact that the addition of magnetic impurities assists in improving the practical applicability of NbSe₂. The random pinning potential that is introduced by the Fe impurities also shows a considerable change in the interaction between the vortices and the core region, resulting in a competitive nature of single vortex, small bundle and large bundle pinning regimes in the H-T phase diagram. The intrinsic disorder in pure NbSe₂ single crystals shows δT_c flux pinning; however, the extrinsic disorder created by Fe atoms in NbSe₂ shows δl flux pinning. Furthermore, the field dependence of the pinning force on both NbSe₂ and Fe-incorporated NbSe₂ represents the existence of point pinning and the surface pinning mechanism with a broadening of the f_p curves in the Fe-incorporated single crystals.

Real time molecular detection of Chikungunya and dengue virus in the female Aedes mosquitoes collected in Chennai, Tamilnadu, India

Monsoon favors the breeding sites of many mosquito borne viral vectors resulting in increased outbreaks of vector borne infections, such as Chikungunya and dengue infections in the post monsoon period. Hence a pre-monsoon surveillance study of competent vectors carrying Chikungunya and dengue virus would help in better management of vectors and infections. Thus a surveillance study was carried out in Chennai before the onset of monsoon to study the distribution of competent vectors and detection of Chikungunya and dengue virus in female Aedes mosquitoes. Mosquitoes were collected from north, south, east and west zone of Chennai during March to July 2014. Chikungunya (CHIKV) and Dengue virus (DENV) were detected from the collected mosquitoes by Reverse Transcription Real time PCR (RT-PCR) followed by virus isolation in Vero cells. The most predominant species was Culex quinquefasciatis followed by Culex pipiens in the premonsoon period in our study. Viral infection rate during March to July (Premonsoon period) with respect to CHIKV and DENV virus were 0.456. The central zones of Chennai were highly found to inhabit the Aedes species in comparison to other zones surveyed during the premonsoon period. Viral infection rate of CHIKV and DENV were very low in female Aedes mosquitoes during the Pre-Monsoon period in Chennai.

Crystal Growth, Structure, Resistivity, Magnetic, and Photoelectric Properties of One-Dimensional Selenometallate Ba2 BiFeSe5

Low-dimensional materials have attracted extensive research interest in recent years owing to their interesting structural chemistry and physical properties, which will greatly deepen our knowledge of these materials and could lead to additional breakthroughs in the future. Herein we have synthesized and characterized Ba₂ BiFeSe₅ , which adopts a quasi-one-dimensional structure and possesses some fascinating physical properties. The sharp divergences between the field-cooled (FC) and the zero-field-cooled (ZFC) data and the rather small magnetic moment per Fe³⁺ (0.07 μ_B ) strongly suggest that the title compound is weakly ferromagnetic with a high magnetic transition temperature above room temperature, which is controlled by competing super-exchange interactions within and between [FeBiSe₅ ]_∞ anionic ladders. Moreover, with its narrow bandgap of 0.95 eV, Ba₂ BiFeSe₅ shows photoelectric properties with a photocurrent density of approximately 30 mA cm² at 5 V. Our study demonstrates that Ba₂ FeBiSe₅ might be a new type of multifunctional material that deserves further investigation.

Performance study of a laboratory model shallow solar pond with and without single transparent glass cover for solar thermal energy conversion applications

The thermal performance of a shallow solar pond with and without the single transparent glass cover has been investigated experimentally. This experiment has been performed during the summer season of 2014 under the operational condition for five different storage volumes of water upto a maximum of 10liter. The pond performance is investigated in terms of the rate of energy collected and its collection efficiency. A Low Density Polyethylene (LDPE) black sheet liner of 200μm thickness was laid on all the interior sides of the pond for solar energy absorption. A clear transparent PVC plastic sheet of 150μm thickness was laid over the water surface as evaporation suppressing membrane. Calibrated Copper constantan thermocouples were used to measure the temperatures of the system. A highest temperature of 81.5°C has been achieved for the stored volume of 2liter of water, when the pond was used with a single transparent glass cover of 5mm thickness. When the shallow solar pond was used without the transparent glass cover the system attained a maximum temperature of 62°C for the same stored volume of 2liter. A comparison between the two conditions of with and without the transparent glass cover, on the thermal performance of the SSP has been reported. A shallow solar pond system of the present type could be used us a source of warm water, of desired temperature, below 10°C which are required for the domestic and industrial utilities. The global warming is increased day by day; inorder to reduce global warming a typical method of small scale shallow solar pond has been used to absorb the radiation from the sun to convert it to useful heat energy by the source of water. The SSP is an eco friendly way to generate energy without polluting our environment and in an environment safety manner. Based on environmental safety this study has experimentally investigated the thermal performance of the shallow solar pond.

Use of preoperative gabapentin significantly reduces postoperative opioid consumption: a meta-analysis

OBJECTIVES

Effective postoperative pain management is crucial in the care of surgical patients. Opioids, which are commonly used in managing postoperative pain, have a potential for tolerance and addiction, along with sedating side effects. Gabapentin's use as a multimodal analgesic regimen to treat neuropathic pain has been documented as having favorable side effects. This meta-analysis examined the use of preoperative gabapentin and its impact on postoperative opioid consumption.

MATERIALS AND METHODS

A comprehensive literature search was conducted to identify randomized control trials that evaluated preoperative gabapentin on postoperative opioid consumption. The outcomes of interest were cumulative opioid consumption following the surgery and the incidence of vomiting, somnolence, and nausea.

RESULTS

A total of 1,793 patients involved in 17 randomized control trials formed the final analysis for this study. Postoperative opioid consumption was reduced when using gabapentin within the initial 24 hours following surgery (standard mean difference -1.35, 95% confidence interval [CI]: -1.96 to -0.73; P<0.001). There was a significant reduction in morphine, fentanyl, and tramadol consumption (P<0.05). While a significant increase in postoperative somnolence incidence was observed (relative risk 1.30, 95% CI: 1.10-1.54, P<0.05), there were no significant effects on postoperative vomiting and nausea.

CONCLUSION

The administration of preoperative gabapentin reduced the consumption of opioids during the initial 24 hours following surgery. The reduction in postoperative opioids with preoperative gabapentin increased postoperative somnolence, but no significant differences were observed in nausea and vomiting incidences. The results from this study demonstrate that gabapentin is more beneficial in mastectomy and spinal, abdominal, and thyroid surgeries. Gabapentin is an effective analgesic adjunct, and clinicians should consider its use in multimodal treatment plans among patients undergoing elective surgery.