Advances in drying techniques for retention of antioxidants in agro produces.

Antioxidants are compounds that are essential for the human body which prevents cell from disease causing free radicals. Antioxidants are present in a wide range of fruits, vegetables, and spices. However, a considerable amount of antioxidants is lost during the post-harvest drying operation of agro produces for their shelf-life enhancement. Hence, retention of antioxidants becomes utmost importance in preserving the nutritional aspects of fruits and vegetables. Compared to conventional hot air drying, methods like freeze drying, vacuum drying, and dehumidified drying helps in the retention of antioxidants. However, the drawbacks prevalent in current drying practices, such as high-power consumption and high capital cost, could be eliminated by adopting novel drying mechanisms. This review focuses on various pretreatment methods like ultra-sonication, high pressure processing, pulsed electric field and ethanol treatment prior to drying operation helps in enhancing the drying efficiency with maximum retention of antioxidants. In addition, hybrid drying technologies such as microwave assisted drying, IR-radiated drying and electro-magnetic assisted drying methods also could significantly improve the retention of antioxidants.HIGHLIGHTSDrying is the most commonly adopted unit operation for enhancing the shelf life of perishable agro produces.However, drying is accompanied by loss of bioactive, color, texture, and sensory attributes.Compared to conventional drying techniques like hot air drying, methods like freeze drying, vacuum drying and dehumidified drying helps in the retention of antioxidants present in agro/food produces.Pretreatment methods like Ozonation, ultra-sonication, and UV radiation prior to drying are also found to improve the drying performance with good retention of antioxidants.Recent developments like microwave-assisted and IR-assisted drying methods perform well in the retention of antioxidants with less energy consumption.

A micro-costing analysis of post-fracture care pathways: results from the International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS).

This study identified the costs and health-related quality of life impacts of several post-fracture multidisciplinary care pathways specific to individual skeletal site (hip, distal forearm, vertebrae, humerus). These care pathways may assist healthcare providers in allocating resources for osteoporotic fractures in more effective and cost-efficient ways. INTRODUCTION: This micro-costing study was undertaken to provide the estimated healthcare costs of several fracture site-specific health service use pathways associated with different trajectories of health-related quality of life (HRQoL) 12-months post-fracture. METHODS: The study included 4126 adults aged ≥ 50 years with a fragility fracture (1657 hip, 681 vertebrae, 1354 distal forearm, 434 humerus) from the International Costs & Utilities Related to Osteoporotic fractures Study (ICUROS). ICUROS participants were asked to recall the frequency and duration (where applicable) of their health and community care service use at 4- and 12-month follow-up visits. Patient-level costs were identified and aggregated to determine the average cost of healthcare use related to the fracture in each care pathway (presented in Australian 2021 dollars). Mean cost differences were calculated and analysed using a one-way analysis of variance (ANOVA) and post hoc Bonferroni correction to determine any statistically significant differences. RESULTS: The total direct cost of fractures was estimated at $89564, $38926, $18333, and $38461AUD per patient for hip, vertebral, wrist, and humeral participants, respectively. A Kruskal-Wallis test yielded a statistically significant difference in cost values between most care pathways (p < 0.001). Of the 20 care pathways, those associated with recovery of HRQoL had lower mean costs per patient across each fracture site. CONCLUSIONS: This study identified the costs and HRQoL impacts of several multidisciplinary care pathways for individual fracture sites based on the health service utilization of an international cohort of older adults. These care pathways may assist healthcare providers in allocating resources for fragility fractures in more effective and cost-efficient ways.

Timing of Low Molecular Weight Heparin Administration in Breast Surgery and Post-Operative Haematoma Formation.

Aims The aims of this study were to: identify current practice regarding low molecular weight heparin (LMWH) prophylaxis in elective breast surgery, to determine if timing of administration of LMWH prophylaxis or specific patient demographic factors impacts the rate of post-operative haematoma formation. Methods Retrospective cohort study involving 100 patients who underwent elective breast surgery in a tertiary centre in Ireland in 2017. Medical charts were reviewed to collect data on; timing of LMWH administration, incidence of post-operative haematoma and patient's age, BMI, smoking status and anti-coagulant use. Statistical analysis was then performed. Results Forty-two patients (42%) received enoxaparin pre-operatively and thirty-one patients (31%) post-operatively. Incidence of post-operative haematoma was 4% (n=4). Of the haematoma group, three patients (75%) received post-operative enoxaparin (p=0.166). Independent patient factors did not significantly impact rate of haematoma formation. Conclusions Post-operative haematoma rate is 4%. Timing of LMWH prophylaxis administration did not significantly affect this rate.

Salmonella source attribution in a subtropical state of Australia: capturing environmental reservoirs of infection.

Salmonellosis is a leading cause of hospitalisation due to gastroenteritis in Australia. A previous source attribution analysis for a temperate state in Australia attributed most infections to chicken meat or eggs. Queensland is in northern Australia and includes subtropical and tropical climate zones. We analysed Queensland notifications for salmonellosis and conducted source attribution to compare reservoir sources with those in southern Australia. In contrast to temperate Australia, most infections were due to non-Typhimurium serotypes, with particularly high incidence in children under 5 years and strong seasonality, peaking in summer. We attributed 65.3% (95% credible interval (CrI) 60.6-73.2) of cases to either chicken meat or eggs and 15.5% (95% CrI 7.0-19.5) to nuts. The subtypes with the strongest associations with nuts were Salmonella Aberdeen, S. Birkenhead, S. Hvittingfoss, S. Potsdam and S. Waycross. All five subtypes had high rates of illness in children under 5 years (ranging from 4/100 000 to 23/100 000), suggesting that nuts may be serving as a proxy for environmental transmission in the model. Australia's climatic range allows us to conduct source attribution in different climate zones with similar food consumption patterns. This attribution provides evidence for environment-mediated transmission of salmonellosis in sub-tropical regions.

Merkel Cell Carcinoma: A Case Series

Introduction Merkel cell carcinoma (MCC) is a rare cutaneous tumour that is clinically aggressive with a high local, regional, and distant metastatic potential. Cases Three male patients presented to University Hospital Limerick (UHL) in 2015 with cutaneous lesions of the thorax, buttock and forearm. Once MCC was confirmed, management included surgical wide local excision (WLE) with regional lymph node dissection followed by adjuvant radiotherapy. One patient is in remission. The second has residual locoregional lymph node disease and is undergoing annual CT surveillance. The third had distant metastatic disease and is deceased from an unrelated condition. Discussion This case series highlights the presentation and management of MCC. We also discus relevant guidelines. The management of MCC is complex and there is a need to establish local or national databases to identify and monitor patients with MCC.

The role of the cytopathologist in subtyping and epidermal growth factor receptor testing in non-small cell lung cancer: An institutional experience.

OBJECTIVE: Approximately 10% of non-small-cell lung cancer (NSCLC) remains unclassifiable as NSCLC-not otherwise specified (NOS), after using a panel of immunomarkers. The present study was undertaken to assess sensitivity and specificity of immunomarkers in sub-typing NSCLC on fine needle aspiration cytology (FNAC). Epidermal growth factor receptor (EGFR) mutations were also detected in these samples. METHODS: Sixty cases of NSCLC including 15 squamous cell carcinoma (SCC), 15 adenocarcinomas (ADC) and 30 NSCLC-NOS reported on FNAC were included in the study. A panel of CK7, CK5/6, TTF-1 and p63 was applied in these cases. DNA was extracted from 54 cases including 14 effusion samples, and EGFR mutations were detected. RESULTS: Classic ADC cases (n=15) showed 73.3% TTF-1 positivity and 100% CK7 positivity. Two cases of ADC showed aberrant expression of p63 and 2 cases showed CK5/6 positivity. 80% of classic SCC cases (n=15) showed strong nuclear p63 positivity and 86.6% were positive for CK5/6. TTF-1 was seen exclusively in ADC cases. Immunohistochemistry (IHC) using two immunomarkers (TTF-1 and p63) helped in subtyping 24/30(80%) cases of NSCLC. EGFR mutations were detected in 9/54 (16.7%) cases, and the most common mutation was short in-frame deletion in Exon 19. CONCLUSIONS: More than 90% of NSCLC can be sub-typed on cytology samples with the help of immunochemistry. The sensitivity of TTF-1, p63, CK5/6 and CK7 was 73.3%, 80%, 100% and 100%, respectively. The specificity of TTF-1, p63, CK5/6 and CK7 was 100%, 86.6%, 86.6% and 93.3%, respectively. TTF-1 is highly specific, and almost 80% of NSCLC-NOS cases can be sub-typed using TTF-1 and p63. EGFR mutations can be detected in cytology samples, and 16.7% samples were positive for EGFR mutations.

Pulmonary infections in immunocompromised patients: the role of image-guided fine needle aspiration cytology.

OBJECTIVE: To evaluate the role of fine needle aspiration cytology (FNAC) in the diagnosis of pulmonary infections in immunocompromised patients and to identify the imaging pattern of infections on computed tomography (CT). MATERIALS AND METHODS: This was a retrospective study of 42 immunocompromised patients who underwent FNAC under image guidance owing to a clinical pulmonary infection. Each patient was evaluated for an underlying immunocompromised condition, cytological diagnosis, CT findings and complications. RESULTS: The most common predisposing condition was diabetes mellitus (n = 11), renal transplant status (n = 11) followed by connective tissue disorders (n = 6) and malignancy (n = 5). There were four patients with renal disease and three had a human immunodeficiency virus (HIV) infection. The most common cytological diagnosis was mucormycosis (n = 13) followed by nocardiosis (n = 8) and necrotising inflammation (n = 7), tuberculosis (n = 6), cryptococcosis (n = 2), aspergillosis(n = 2), histoplasmosis(n = 1) and atypical mycobacterial infection (n = 1). Mucormycosis presented as a pulmonary nodule (n = 7), mass lesion (n = 5) or consolidation (n = 4). The patients with nocardiosis had lung nodules with associated consolidation and cavitation. None of the patients had any major complication. CONCLUSION: FNA is a relatively reliable, safe and quick method of diagnosing pulmonary infection in immunocompromised patients. Cytomorphological features, when aided by special stains, can accurately detect the specific infection which is potentially treatable. Specific infections may be suggested based on specific imaging patterns.

Role of honey after tonsillectomy: a systematic review and meta-analysis of randomised controlled trials.

BACKGROUND: Honey reduced post-tonsillectomy pain, but its effects on awakening at night, inflammation and healing of the tonsillar fossa were controversial. OBJECTIVES: This systematic review and meta-analysis of randomised controlled trials (RCTs) evaluated the effect of oral honey on pain, consumption of painkillers, awakening at night, healing of tonsillar fossa and adverse effects in children after tonsillectomy. METHODS: A search of MEDLINE, EMBASE, Scopus, CINAHL and Cochrane Collaboration Library databases was performed without any restriction of publication year. The end date of search was 30 June 2016. The search was supplemented by search from Google, hand search of cross-references of selected articles and reviews, and contacting the authors of different studies. The inclusion criteria were RCTs comparing the effect of honey with control on different outcomes, in children after tonsillectomy. RESULTS: Our search generated 64 studies, and eight RCTs met our inclusion criteria. The methodological quality of RCTs was poor. Compared to control, honey significantly decreased postoperative pain from day 1 to day 7 (P = 0.05 to <0.0001); consumption of painkillers from days 1 to 5 (P = 0.03 to 0.003) and on day 10 (P = 0.002); and number of awakening at night due to pain on days 2 and 4 after tonsillectomy (P = 0.0001, 0.004). The healing of tonsillar fossa was significantly greater with honey compared to control on days 3-4 (P = 0.02) and days ≥9 (P = 0.01) after tonsillectomy. The adverse effects were not significantly different between honey and control groups. The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) of the evidence for different outcomes varied from 'low' to 'very low'. CONCLUSIONS: Honey improved pain, requirement of painkillers and awakening at night due to pain in children after tonsillectomy. There was little improvement in healing of tonsillar fossa. The GRADE of the evidence varied from 'low' to 'very low'. A good-quality, placebo-controlled RCT of different doses and durations of administration of honey is required to evaluate its clear efficacy and safety in children after tonsillectomy.

Role of multidetector abdominal CT in the evaluation of abnormalities in polyarteritis nodosa.

AIM: To identify arterial and end-organ abnormalities on abdominal computed tomography (CT) in patients with polyarteritis nodosa (PAN). MATERIALS AND METHODS: A prospective study comprising 27 consecutive patients with PAN was conducted from 2007 to 2013. Departmental ethics committee approval was obtained. All patients underwent contrast-enhanced CT comprising an arterial and a portal venous phase. Images were assessed for arterial irregularity, aneurysms, stenosis, and occlusion. End-organ changes, including infarcts, haematoma, and bowel involvement, were also recorded. RESULTS: A positive CT was recorded in 15 patients including eight females. The mean age was 32 years. The most common abnormalities were aneurysms seen in 12 patients. The renal artery was the most common site of aneurysms (n=9). The hepatic (n=3), superior mesenteric (n=3) and splenic arteries (n=1) were also involved. Contour irregularity was noted in four patients involving the hepatic, splenic, and superior mesenteric arteries. Stenosis/occlusion was also noted in seven patients. The most common end-organ abnormality was infarct (n=9), followed by bowel wall thickening (n=3), and perinephric haematoma (n=2). CONCLUSION: A combination of arterial and end-organ abnormalities on abdominal CT enables an accurate diagnosis of PAN in occult cases and may obviate the need for angiography and, sometimes, biopsy.

Heterogeneity in hotspots: spatio-temporal patterns in neglected parasitic diseases.

Cryptosporidiosis and giardiasis have been recognized by the WHO as 'Neglected Diseases'. Minimal attention has been paid to the spatial and temporal distribution of disease incidence patterns. Using disease notification data, we detected spatio-temporal clusters of cryptosporidiosis and giardiasis across three time periods: (i) 1997-2000, (ii) 2001-2004, (iii) 2005-2008. There was substantial variation in the geographical location and timing of recurrent cryptosporidiosis and giardiasis clusters. Statistically significant (P < 0·05) giardiasis clusters tended to occur in predominantly urban areas with little apparent seasonal influence, while statistically significant cryptosporidiosis clusters were detected in spring, in areas with high livestock land use. The location and timing of cryptosporidiosis clusters suggest an influence of livestock production practices, while urban exposures and host behaviour are likely to influence giardiasis clusters. This approach provides a resource-efficient method for public health authorities to prioritize future research needs and areas for intervention.

Induction of labor compared to dilation and evacuation for postmortem analysis.

OBJECTIVE: This study aimed to evaluate the ability to obtain autopsy and cytogenetics after midtrimester termination. METHODS: A retrospective cohort study of women undergoing termination, via induction or dilation and evacuation (D&E), at 16 0/7-23 6/7 weeks was performed. Exclusion criteria were elective termination, preterm labor, PPROM, and no autopsy or cytogenetic exam performed. The ability to obtain cytogenetics and autopsy as well as complications rates were compared between the two groups with Chi-square tests. RESULTS: Of the 469 women who met the inclusion criteria, 158 had an induction and 312 had a D&E. The induction of labor group had higher mean gestational ages, p < 0.01. Successful autopsy was more likely in the induction group, 94.3%, versus D&E group, 34.7%, p = 0.01. There was no difference in ability to obtain cytogenetics between the two groups, 89.1% in the induction group, and 92.3% in D&E group, p = 0.4. There was a difference in the total complication rates between the groups, 9.8% (26) in the induction versus 6.4% (20) in the D&E group, p < 0.01; however, there was no difference in major complications. CONCLUSIONS: Midtrimester terminations by induction were more likely to have successful autopsies when compared with D&E. The ability to obtain cytogenetics was similar regardless of termination mode.

Tracheotomy: an alternative for tracheobronchial foreign body removal.

A 6 years old girl accidentally aspirated a plastic whistle while playing. Computed Tomography of thorax showed foreign body at carina level. Rigid bronchoscope under general anesthesia was attempted but unable to extract the whistle through vocal cord. Tracheostomy was later performed and foreign body was removed.

Sustainable seedling pots: Development and characterisation of banana waste and natural fibre-reinforced composites for horticultural applications.

Plastic pots used in horticultural nurseries generate substantial waste, causing environmental pollution. This study aimed to develop biodegradable composites from banana pseudo-stem reinforced with agricultural residues like pineapple leaves, taro and water hyacinth as eco-friendly substitutes. The aim of this study is to develop optimised banana biocomposite formulations with suitable reinforcements that balance mechanical durability, biodegradation, and seedling growth promotion properties to serve as viable eco-friendly alternatives to plastic seedling pots. This study was carried out by fabricating banana fibre mats through pulping, drying and hot pressing. Composite sheets were reinforced with 50 % pineapple, taro or water hyacinth fibres. The mechanical properties (tensile, yield strength, elongation, bursting strength), hydrophilicity (contact angle, water absorption), biodegradability (soil burial test), and seedling growth promotion were evaluated through appropriate testing methods. The results show that banana-taro composites exhibited suitable tensile strength (25 MPa), elongation (27 %), water uptake (41 %) and 82 % biodegradation in 60 days. It was observed that biodegradable seedling trays fabricated from banana-taro composite showed 95 % tomato seed germination and a 125 cm plant height increase in 30 days, superior to plastic trays. The finding shows that the study demonstrates the potential of banana-taro biocomposites as alternatives to plastic nursery pots, enabling healthy seedling growth while eliminating plastic waste pollution through biodegradation.

Optimization and modeling of vacuum impregnation of pineapple rings and comparison with osmotic dehydration.

The vacuum impregnation (VI) process parameters (vacuum pressure = 20-60 kPa; VI temperature = 35-55°C; concentration of the sucrose solution = 40-60 °Brix; and vacuum process time = 8-24 min) for pineapple rings were optimized based on the moisture content (MC), water loss (WL), solids gain (SG), yellowness index (YI), and total soluble solids (TSS) content of pineapple rings using response surface methodology (RSM). A relationship was developed between the process and response variables using RSM and artificial neural network (ANN) techniques. The effectiveness of VI was evaluated by comparing it with the osmotic dehydration (OD) technique. The optimum condition was found to be 31.782 kPa vacuum pressure, 50.441°C solution temperature, and 60 °Brix sucrose concentration for 20.068 min to attain maximum TSS, YI, SG, and WL, and minimum MC of pineapple rings. The R2 values of RSM models for all variables varied between 0.70 and 0.91, whereas mean square error values varied between 0.76 and 71.58 and for ANN models varied between 0.87-0.93 and 0.53-193.78, respectively. Scanning electron micrographs (SEM) revealed that parenchymal cell rupture was less in VI than in OD. The VI pineapple rings exhibited more pores and high SG, as compared to OD, due to the pressure impregnation. Spectroscopic analysis affirmed that the stretching vibrations of intermolecular and intramolecular interactions were significant in VI as against OD. The VI reduced the drying time by 35% compared to OD, with the highest overall acceptability score and lower microbial load during storage. PRACTICAL APPLICATION: Pineapple is a perishable fruit, which necessitates processing for extended shelf life. This study highlights the potential of the vacuum impregnation process as a promising alternative to conventional preservation methods such as osmotic dehydration for pineapples.

Effect of chitosan-based bio coating on mechanical, structural and physical characteristics of microfiber based paper packaging: An alternative to wood pulp/plastic packaging.

Limnocharis flava is a noxious aquatic weed that poses a threat to paddy cultivation. The high cellulose and low lignin contents in this plant make it a potential raw material for papermaking. Against this backdrop, this study was taken up to develop Limnocharis flava (LF) based sheets containing natural fibres from Banana (B), Pineapple (P), and Rice Straw (RS) as reinforcing agents. The influence of carboxymethyl cellulose (CMC) as a binder on the LF-based sheets was also studied. To enhance the mechanical and moisture resistance properties, a chitosan coating was provided to the sheets. Analytical tests for mechanical properties, water barrier properties, functional groups, structure and microstructure, thermal properties and biodegradability were performed. Among the samples, LF + B showed the highest tensile strength (34.86 Mpa) and bursting strength (13.055 kg/cm2), while LF + R had higher puncture and tearing strengths. Chitosan coating was found to enhance the sheets and improve the water barrier properties mechanically. The contact angle of LF + B increased from 91.6° to 110.65°, while the water vapour transmission rate of LF reduced from 532.18 to 404.47 on providing chitosan coating. The significant interactions of reinforcing agents were confirmed by the results of FTIR and that of the coating by the SEM micrographs. The LF-based sheets were also found to have decent thermal stability. The high value of the crystallinity index in LF + R samples supported their remarkable mechanical properties. This study proclaims the notable suitability of Limnocharis flava in manufacturing paper for packaging applications.

The epidemiology of human salmonellosis in New Zealand, 1997-2008.

This study describes the epidemiology of human salmonellosis in New Zealand using notified, hospitalized and fatal cases over a 12-year period (1997-2008). The average annual incidence for notifications was 42·8/100 000 population and 3·6/100 000 population for hospitalizations. Incidence was about twice as high in summer as in winter. Rural areas had higher rates than urban areas (rate ratio 1·23, 95% confidence interval 1·22-1·24 for notifications) and a distinct spring peak. Incidence was highest in the 0-4 years age group (154·2 notifications/100 000 and 11·3 hospitalizations/100 000). Hospitalizations showed higher rates for Maori and Pacific Island populations compared to Europeans, and those living in more deprived areas, whereas notifications showed the reverse, implying that notifications are influenced by health-seeking behaviours. Salmonella Typhimurium was the dominant serotype followed by S. Enteritidis. For a developed country, salmonellosis rates in New Zealand have remained consistently high suggesting more work is needed to investigate, control and prevent this disease.

Design consideration and modelling studies of ultrasound and ultraviolet combined approach for shelf-life enhancement of pine apple juice.

Although both ultraviolet (UV) radiation and ultrasound (US) treatment have their capabilities in microbial inactivation, applying any one method alone may require a high dose for complete inactivation, which may affect the sensory and nutritional properties of pineapple juice. Hence, this study was intended to analyse and optimise the effect of combined US and UV treatments on microbial inactivation without affecting the selected quality parameters of pineapple juice. US treatment (33 kHz) was done at three different time intervals, viz. 10 min, 20 min and 30 min., after which, juice samples were subjected to UV treatment for 10 min at three UV dosage levels, viz. 1 J/cm2, 1.3 J/cm2, and 1.6 J/cm2. The samples were evaluated for total colour difference, pH, total soluble solids (TSS), titrable acidity (TA), and ascorbic acid content; total bacterial count and total yeast count; and the standardization of process parameters was done using Response Surface Methodology and Artificial Neural Network. The results showed that the individual, as well as combined treatments, did not significantly impact the physicochemical properties while retaining the quality characteristics. It was observed that combined treatment resulted in 5 log cycle reduction in bacterial and yeast populations while the individual treatment failed. From the optimization studies, it was found that combined US and UV treatments with 22.95 min and1.577 J/cm2 ensured a microbiologically safe product while retaining organoleptic quality close to that of fresh juice.

Beam power scale-up in micro-electromechanical systems based multi-beam ion accelerators.

We report on the development of multi-beam radio frequency (RF) linear ion accelerators that are formed from stacks of low cost wafers and describe the status of beam power scale-up using an array of 112 beams. The total argon ion current extracted from the 112-beamlet extraction column was 0.5 mA. The measured energy gain in each RF gap reached as high as 7.25 keV. We present a path toward using this technology to achieve ion currents >1 mA and ion energies >100 keV for applications in material processing.

Antigenic variation of a cysteine-rich protein in Giardia lamblia.

The WB isolate of Giardia lamblia expresses a cysteine-rich 170-kD surface antigen (CRP170) that undergoes antigenic variation. An (6E7), cytotoxic for isolates expressing CRP170, was used in another study to select antigenic variants from clones of the WB isolate of Giardia. CRP170 was replaced by surface-labeled bands ranging in size from approximately 50 to 170 kD. In this study, mAb 6E7 was used to isolate a 1-kb portion of the CRP170 gene (M2-1) from a lambda gt 11 expression library. The M2-1 clone hybridized to a 5.4-kb transcript from isolates expressing CRP170 but did not hybridize to RNA from antigenic variants. Evidence was found for frequent rearrangements at the CRP170 gene locus. DNA sequencing of the M2-1 clone revealed the presence of long tandem repeats. The putative amino acid sequence of M2-1 reveals a 12% cysteine content, and CRP170 is readily labeled in vivo with cysteine.

Glycosylphosphatidylinositol anchors of Plasmodium falciparum: molecular characterization and naturally elicited antibody response that may provide immunity to malaria pathogenesis.

Induction of proinflammatory cytokine responses by glycosylphosphatidylinositols (GPIs) of intraerythrocytic Plasmodium falciparum is believed to contribute to malaria pathogenesis. In this study, we purified the GPIs of P. falciparum to homogeneity and determined their structures by biochemical degradations and mass spectrometry. The parasite GPIs differ from those of the host in that they contain palmitic (major) and myristic (minor) acids at C-2 of inositol, predominantly C18:0 and C18:1 at sn-1 and sn-2, respectively, and do not contain additional phosphoethanolamine substitution in their core glycan structures. The purified parasite GPIs can induce tumor necrosis factor alpha release from macrophages. We also report a new finding that adults who have resistance to clinical malaria contain high levels of persistent anti-GPI antibodies, whereas susceptible children lack or have low levels of short-lived antibody response. Individuals who were not exposed to the malaria parasite completely lack anti-GPI antibodies. Absence of a persistent anti-GPI antibody response correlated with malaria-specific anemia and fever, suggesting that anti-GPI antibodies provide protection against clinical malaria. The antibodies are mainly directed against the acylated phosphoinositol portion of GPIs. These results are likely to be valuable in studies aimed at the evaluation of chemically defined structures for toxicity versus immunogenicity with implications for the development of GPI-based therapies or vaccines.