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BACKGROUND: Diarrhea is one of the common gastrointestinal (GI) adverse events after solid organ transplantation. Diarrhea may be caused by infectious or non-infectious etiology. The infectious etiology of diarrhea varies according to the location and duration of diarrhea. Non-infectious etiologies include drugs, inflammatory bowel disease, neoplasia. The objective of this study was to evaluate the etiological profile of diarrhea in solid organ transplant recipients presenting to a tertiary care center in Southern India. METHODS: This was a retrospective analysis of prospectively collected data of all solid organ transplantation recipients referred to the Department of Medical Gastroenterology for evaluation of diarrhea from April 2012 till May 2014. All patients had stool evaluated by wet mount examination, modified acid fast (AFB) stain, trichrome stain, culture, and Clostridium difficile toxin assay. EDTA plasma was collected for quantitative Cytomegalovirus (CMV) detection by real-time PCR. If the diarrhea was acute (<2 wk), and no etiological agent was identified, empirical antibiotic therapy was instituted and followed up. If persistent or chronic diarrhea (>2-4 wk), endoscopic evaluation (upper GI endoscopy and/or colonoscopy with biopsies), depending on the clinical type of diarrhea was done. If no specific etiological diagnosis was established after endoscopic evaluation, breath test for SIBO and celiac serology were done. If no specific etiology was identified after the above investigations, dose of immunosuppressive drugs was reduced. If diarrhea responded to dose reduction, it was considered to be drug related. RESULTS: Fifty-eight episodes of diarrhea occurred in 55 solid organ transplant recipients during the study period. Renal transplant recipients constituted the majority (70%). Most (79%) of patients included in the study had their transplant > 6 mo ago. Infective diarrhea was the etiology in 46%, drug-related diarrhea in 29.3%. No specific etiology was identified in 22.4% of patients. Parasites accounted for 69% of all infective diarrhea. Stool evaluation was the main investigation in establishing diagnosis in acute diarrhea. Endoscopic evaluation was required in two thirds of patients to establish diagnosis in chronic diarrhea. CONCLUSION: GI infections and drug-related diarrhea were the common causes of diarrhea in solid organ transplant recipients. Parasites were the most common infectious etiology of diarrhea. Step-wise evaluation was able to identify the etiology in ~ 77% of patients. Overall, 98% of diarrheal episodes resolved.
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Diarrea , Trasplante de Órganos , Diarrea/epidemiología , Diarrea/etiología , Humanos , Trasplante de Órganos/efectos adversos , Estudios Retrospectivos , Centros de Atención Terciaria , Receptores de TrasplantesRESUMEN
Data searching and retrieval is one of the fundamental functionalities in many Web of Things applications, which need to collect, process and analyze huge amounts of sensor stream data. The problem in fact has been well studied for data generated by sensors that are installed at fixed locations; however, challenges emerge along with the popularity of opportunistic sensing applications in which mobile sensors keep reporting observation and measurement data at variable intervals and changing geographical locations. To address these challenges, we develop the Geohash-Grid Tree, a spatial indexing technique specially designed for searching data integrated from heterogeneous sources in a mobile sensing environment. Results of the experiments on a real-world dataset collected from the SmartSantander smart city testbed show that the index structure allows efficient search based on spatial distance, range and time windows in a large time series database.
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Blackgram, a protein-rich pulse crop (24%), is crucial for combating food insecurity, particularly in malnourished and economically weak countries. Enhancing blackgram production requires improved, input-saving management practices. Given the challenges of climate change and population growth, efficient water management is vital for increasing pulse productivity and water use efficiency with minimal investment. This study aimed to identify cost-effective irrigation methods to optimise blackgram yields. Experiments were conducted at the National Pulses Research Centre in Vamban, Pudukkottai, and the Agricultural College and Research Institute in Kumulur, Tiruchirappalli, during the kharif season of 2021 and 2022. The study compared different treatments of irrigation methods, such as check basin, raised bed, drip, sprinkler and rain hose irrigation. Results showed that the rain hose system maintained the highest soil moisture (23.93% at 10 cm depth and 19.71% at 20 cm depth). Even though drip irrigation resulted in a higher seed yield (1363 kg ha-1), the rain hose system proved to be more cost-effective, saving 27.09% in costs and achieving a 15.23% higher benefit-cost ratio. These findings suggest that the rain hose method, combined with current agronomic practices, is a viable low-cost technique for sustainable blackgram cultivation, optimising water use and maximising profits. This research provides valuable insights into water-saving irrigation methods for pulse crops.
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Bananas (Musa spp.) are one of the most highly consumed fruits globally, grown in the tropical and sub-tropical regions. We evaluated 856 Musa accessions from the breeding programs of the International Institute of Tropical Agriculture of Nigeria, Tanzania, and Uganda; the National Agricultural Research Organization of Uganda; the Brazilian Agricultural Research Corporation (Embrapa); and the National Research Centre for Banana of India. Accessions from the in vitro gene bank at the International Transit Centre in Belgium were included to provide a baseline of available global diversity. A total of 16,903 informative single nucleotide polymorphism markers were used to estimate and characterize the genetic diversity and population structure and identify overlaps and unique material among the breeding programs. Analysis of molecular variance displayed low genetic variation among accessions and diploids and a higher variation among tetraploids (p < 0.001). Structure analysis revealed two major clusters corresponding to genomic composition. The results indicate that there is potential for the banana breeding programs to increase the diversity in their breeding materials and should exploit this potential for parental improvement and to enhance genetic gains in future breeding efforts.
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PURPOSE: A definite diagnosis of psychogenic nonepileptic seizures (PNES) usually requires in-patient video-electroencephalography (EEG) monitoring. Previous research has shown that convulsive psychogenic nonepileptic seizures (PNES) demonstrate a characteristic pattern of rhythmic movement artifact on the EEG. Herein we sought to examine the potential for time-frequency mapping of data from a movement-recording device (accelerometer) worn on the wrist as a diagnostic tool to differentiate between convulsive epileptic seizures and PNES. METHODS: Time-frequency mapping was performed on accelerometer traces obtained during 56 convulsive seizure-like events from 35 patients recorded during in-patient video-EEG monitoring. Twenty-six patients had PNES, eight had epileptic seizures, and one had both seizure types. The time-frequency maps were derived from fast Fourier transformations to determine the dominant frequency for sequential 2.56-s blocks for the course of each event. KEY FINDINGS: The coefficient of variation (CoV) of limb movement frequency for the PNES events was less than for the epileptic seizure events (median, 17.18% vs. 52.23%; p < 0.001). A blinded review of the time-frequency maps by an epileptologist was accurate in differentiating between the event types, that is, 38 (92.7%) of 41 and 6 (75%) of 8 nonepileptic and epileptic seizures, respectively, were diagnosed correctly, with seven events classified as "nondiagnostic." Using a CoV cutoff score of 32% resulted in similar classification accuracy, with 42 (93%) of 45 PNES and 10 (91%) of 11 epileptic seizure events correctly diagnosed. SIGNIFICANCE: Time-frequency analysis of data from a wristband movement monitor could be utilized as a diagnostic tool to differentiate between epileptic and nonepileptic convulsive seizure-like events.
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Mapeo Encefálico , Trastornos de Conversión/diagnóstico , Epilepsia/diagnóstico , Extremidades/fisiopatología , Movimiento/fisiología , Trastornos Psicofisiológicos/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Trastornos de Conversión/psicología , Electroencefalografía , Epilepsia/psicología , Femenino , Humanos , Cinetocardiografía , Masculino , Persona de Mediana Edad , Periodicidad , Trastornos Psicofisiológicos/psicología , Estudios Retrospectivos , Factores de Tiempo , Adulto JovenRESUMEN
AIMS: The present study was carried out to screen the phylloplane bacteria from tea for antagonism against grey blight caused by Pestalotiopsis theae and blister bight caused by Exobasidium vexans and to further evaluate the efficient isolates for disease control potential under field condition. METHODS AND RESULTS: A total of 316 morphologically different phylloplane bacteria were isolated. Among the antagonists, the isolates designated as BMO-075, BMO-111 and BMO-147 exhibited maximum inhibitory activity against both the pathogens under in vitro conditions and hence were selected for further evaluation under microplot field trial. Foliar application of 36-h-old culture of BMO-111 (1 × 10(8) colony-forming units ml(-1) ) significantly reduced the blister blight disease incidence than the other isolates. The culture of BMO-111 as well as its culture filtrate effectively inhibited the mycelial growth of various fungal plant pathogens. The isolate BMO-111 was identified as Ochrobactrum anthropi based on the morphological and 16S rDNA sequence analyses. CONCLUSIONS: It could be concluded that the biocontrol agent O. anthropi BMO-111 was effective against blister blight disease of tea. SIGNIFICANCE AND IMPACT OF THE STUDY: Further study is required to demonstrate the mechanism of its action and formulation for the biocontrol potential against blister blight disease of tea.
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Basidiomycota , Agentes de Control Biológico , Camellia sinensis/microbiología , Ochrobactrum anthropi/fisiología , Enfermedades de las Plantas/prevención & control , Secuencia de Bases , India , Datos de Secuencia Molecular , Ochrobactrum anthropi/genética , Ochrobactrum anthropi/aislamiento & purificación , Enfermedades de las Plantas/microbiología , Hojas de la Planta/microbiología , ARN Ribosómico 16S/genética , TéRESUMEN
AIMS: The present study was aimed to evaluate the integration of Ochrobactrum anthropi BMO-111 and chemical fungicides (copper oxychloride and hexaconazole) against blister blight disease of tea. METHODS AND RESULTS: Application of the liquid culture of O. anthropi BMO-111 (36-h-old culture broth) was found to be effective in combined sprays with individual chemical fungicides (copper oxychloride and hexaconazole). Spray application of O. anthropi BMO-111 to tea bushes improved the biochemical parameters such as the levels of chlorophyll, polyphenols, and catechins in the harvestable tea shoots. Moreover, in the microplot and large scale trials, the integrated treatment of every two O. anthropi BMO-111 sprays followed by a single fungicides spray was found to be more efficient than the stand alone O. anthropi BMO-111 or chemicals sprays. Further, pathogenicity study employing Swiss albino mice showed no mortality in the test animals when challenged with O. anthropi BMO-111 through oral, intravenous and intranasal routes. CONCLUSIONS: The field trials clearly established that O. anthropi BMO-111 has capability to reduce incidence in integrated management of blister blight disease of tea and safe to use in the field. SIGNIFICANCE AND IMPACT OF THE STUDY: The results indicate that O. anthropi BMO-111 can be used as an agricultural input in the integrated crop protection systems.
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Basidiomycota/crecimiento & desarrollo , Agentes de Control Biológico , Camellia sinensis/microbiología , Fungicidas Industriales/farmacología , Ochrobactrum anthropi/fisiología , Enfermedades de las Plantas/microbiología , Animales , Cafeína/análisis , Catequina/análisis , Cobre/farmacología , India , Masculino , Ratones , Fenoles/análisis , Enfermedades de las Plantas/prevención & control , Hojas de la Planta/química , Triazoles/farmacologíaRESUMEN
Objective: Ankle foot orthosis (AFO) commonly prescribed to manage foot-drop following stroke restricts ankle mobility. Commercially available functional electrical stimulation (FES) is an expensive alternative to achieve desired dorsiflexion during swing phase of the gait cycle. An in-house cost-effective innovative solution was designed and developed to address this problem.The aim of the study was to compare spatiotemporal gait characteristics of patients with foot-drop following stroke using commercially available FES against in-house developed versatile single sensor-based FES. Material and Methods: Ten patients with cerebrovascular accident of at least 3 months duration and ambulant with/without AFO were recruited prospectively. They were trained with Device-1 (Commercial Device) and Device-2 (In-house developed, Re-Lift) for 7 h over 3 consecutive days with each device. Outcome measures included timed-up-and-go-test (TUG), six-minute-walk-test (6MWT), ten-meter-walk-test (10MWT), physiological cost index (PCI), instrumented gait analysis derived spatiotemporal parameters, and patient satisfaction feedback questionnaire. We calculated intraclass correlation between devices and median interquartile range. Statistical analysis included Wilcoxon-signed-rank-test and F-test (P < 0.05 was considered statistically significant). Bland Altman and scatter plots were plotted for both devices. Results: Intraclass correlation coefficient for 6MWT (0.96), 10MWT (0.97), TUG test (0.99), and PCI (0.88) reflected high agreement between the two devices. Scatter plot and Bland Altman plots for the outcome parameters showed good correlation between two FES devices. Patient satisfaction scores were equal for both Device-1 and Device-2. There was statistically significant change in swing phase ankle dorsiflexion. Conclusions: The study demonstrated good correlation between commercial FES and Re-Lift suggestive of the utility of low-cost FES device in clinical setting.
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Pancreastatin (PST), a chromogranin A-derived potent physiological dysglycemic peptide, regulates glucose/insulin homeostasis. We have identified a nonsynonymous functional PST variant (p.Gly297Ser; rs9658664) that occurs in a large section of human populations. Association analysis of this single nucleotide polymorphism with cardiovascular/metabolic disease states in Indian populations (n = 4,300 subjects) displays elevated plasma glucose, glycosylated hemoglobin, diastolic blood pressure, and catecholamines in Gly/Ser subjects as compared with wild-type individuals (Gly/Gly). Consistently, the 297Ser allele confers an increased risk (â¼1.3-1.6-fold) for type 2 diabetes/hypertension/coronary artery disease/metabolic syndrome. In corroboration, the variant peptide (PST-297S) displays gain-of-potency in several cellular events relevant for cardiometabolic disorders (e.g., increased expression of gluconeogenic genes, increased catecholamine secretion, and greater inhibition of insulin-stimulated glucose uptake) than the wild-type peptide. Computational docking analysis and molecular dynamics simulations show higher affinity binding of PST-297S peptide with glucose-regulated protein 78 (GRP78) and insulin receptor than the wild-type peptide, providing a mechanistic basis for the enhanced activity of the variant peptide. In vitro binding assays validate these in silico predictions of PST peptides binding to GRP78 and insulin receptor. In conclusion, the PST 297Ser allele influences cardiovascular/metabolic phenotypes and emerges as a novel risk factor for type 2 diabetes/hypertension/coronary artery disease in human populations.
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Enfermedades Cardiovasculares/genética , Cromogranina A/genética , Predisposición Genética a la Enfermedad/genética , Enfermedades Metabólicas/genética , Secuencia de Aminoácidos , Animales , Catecolaminas/sangre , Línea Celular , Línea Celular Tumoral , Cromogranina A/química , Cromogranina A/metabolismo , Enfermedad de la Arteria Coronaria/genética , Diabetes Mellitus Tipo 2/genética , Chaperón BiP del Retículo Endoplásmico/metabolismo , Estudios de Asociación Genética/métodos , Células Hep G2 , Humanos , Hipertensión/genética , India , Péptidos/química , Péptidos/genética , Péptidos/metabolismo , Polimorfismo de Nucleótido Simple/genética , Ratas , Receptor de Insulina/metabolismoRESUMEN
BACKGROUND & OBJECTIVES: Mosquitoes transmit serious human diseases, causing millions of deaths every year and the development of resistance to chemical insecticides resulting in rebounding vectorial capacity. Plants may be alternative sources of mosquito control agents. The present study assessed the role of larvicidal activities of hexane, chloroform, ethyl acetate, acetone, and methanol dried leaf and bark extracts of Annona squamosa L., Chrysanthemum indicum L., and Tridax procumbens L. against the fourth instar larvae of malaria vector, Anopheles subpictus Grassi and Japanese encephalitis vector, Culex tritaeniorhynchus Giles (Diptera: Culicidae). METHODS: Larvicidal activities of three medicinal plant extracts were studied in the range of 4.69 to 1000 mg/l in the laboratory bioassays against early 4 th instar larvae of An. subpictus and Cx. tritaeniorhynchus. The mortality data were subjected to probit analysis to determine the lethal concentrations (LC50 and LC90) to kill 50 and 90 per cent of the treated larvae of the respective species. RESULTS: All plant extracts showed moderate effects after 24 h of exposure; however, the highest toxic effect of bark methanol extract of A. squamosa, leaf ethyl acetate extract of C. indicum and leaf acetone extract of T. procumbens against the larvae of An. subpictus (LC 50 = 93.80, 39.98 and 51.57 mg/l) and bark methanol extract of A. squamosa, leaf methanol extract of C. indicum and leaf ethyl acetate extract of T. procumbens against the larvae of Cx. tritaeniorhynchus (LC50 =104.94, 42.29 and 69.16 mg/l) respectively. INTERPRETATION & CONCLUSIONS: Our data suggest that the bark ethyl acetate and methanol extract of A. squamosa, leaf ethyl acetate and methanol extract of C. indicum, acetone and ethyl acetate extract of T. procumbens have the potential to be used as an ecofriendly approach for the control of the An. subpictus, and Cx. tritaeniorhynchus.
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Annona/química , Anopheles/efectos de los fármacos , Asteraceae/química , Chrysanthemum/química , Culex/efectos de los fármacos , Insecticidas/farmacología , Corteza de la Planta/química , Extractos Vegetales/farmacología , Acetatos/química , Animales , Relación Dosis-Respuesta a Droga , Humanos , Insecticidas/química , Larva/efectos de los fármacos , Malaria/prevención & control , Metanol/química , Extractos Vegetales/químicaRESUMEN
BACKGROUND & OBJECTIVES: Mosquito control is facing a threat due to the emergence of resistance to synthetic insecticides. Insecticides of plant origin may serve as suitable alternative biocontrol techniques in the future. The purpose of the present study was to assess the ethyl acetate, acetone and methanol extracts of Andrographis paniculata, Eclipta prostrata and Tagetes erecta leaves tested for oviposition-deterrent, ovicidal and repellent activities against malaria vector, Anopheles subpictus Grassi (Diptera: Culicidae). METHODS: The dried leaves of the three plants were powdered mechanically and extracted with ethyl acetate, acetone and methanol. One gram of crude extract was first dissolved in 100 ml of acetone (stock solution). From the stock solution, test solution concentrations of 31.21- 499.42 mg/l for oviposition- deterrence assay and repellency and 15.60 - 998.85 mg/l were used in ovicidal assay. The percentage oviposition- deterrence, hatching rate of eggs and protection time were calculated. One-way analysis of variance was used for the multiple concentration tests and for per cent mortality to determine significant treatment differences. RESULTS: The percentage of effective oviposition repellency was highest at 499.42 mg/l and the lowest at 31.21 mg/l in ethyl acetate, acetone and methanol extracts of A. paniculata, E. prostrata and T. erecta. The oviposition activity index (OAI) value of ethyl acetate, acetone and methanol extracts of A. paniculata, E. prostrata and T. erecta at 499.42 mg/l were -0.91, -0.93, -0.84, -0.84, -0.87, -0.82, -0.87, -0.89 and -0.87, respectively. Mortality (no egg hatchability) was 100 per cent with ethyl acetate and methanol extracts of A. paniculata, E. prostrata and T. erecta at 998.85 mg/l. The maximum adult repellent activity was observed at 499.42 mg/l in ethyl acetate extracts of A. paniculata, E. prostrata and methanol extracts of T. erecta, and the mean complete protection time ranged from 120 to 150 min with the different extracts tested. INTERPRETATION & CONCLUSIONS: The acetone extract of A. paniculata, methanol extract of E. prostrata and T. erecta showed good oviposition-deterrent, ovicidal and repellent activities respectively. These results suggest that the leaf extracts of A. paniculata, E. prostrata and T. erecta may have the potential to be used as an ideal eco-friendly approach for the control of the An. subpictus.
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Andrographis/química , Anopheles/efectos de los fármacos , Eclipta/química , Insectos Vectores/efectos de los fármacos , Control de Mosquitos/métodos , Extractos Vegetales/farmacología , Hojas de la Planta/química , Tagetes/química , Acetatos , Acetona , Análisis de Varianza , Animales , India , Metanol , Oviposición/efectos de los fármacos , Óvulo/efectos de los fármacosRESUMEN
BACKGROUND: Ever since the Coronavirus disease (COVID-19) outbreak emerged in China, there has been several attempts to predict the epidemic across the world with varying degrees of accuracy and reliability. This paper aims to carry out a short-term projection of new cases; forecast the maximum number of active cases for India and selected high-incidence states; and evaluate the impact of three weeks lock down period using different models. METHODS: We used Logistic growth curve model for short term prediction; SIR models to forecast the maximum number of active cases and peak time; and Time Interrupted Regression model to evaluate the impact of lockdown and other interventions. RESULTS: The predicted cumulative number of cases for India was 58,912 (95% CI: 57,960, 59,853) by May 08, 2020 and the observed number of cases was 59,695. The model predicts a cumulative number of 1,02,974 (95% CI: 1,01,987, 1,03,904) cases by May 22, 2020. As per SIR model, the maximum number of active cases is projected to be 57,449 on May 18, 2020. The time interrupted regression model indicates a decrease of about 149 daily new cases after the lock down period, which is statistically not significant. CONCLUSION: The Logistic growth curve model predicts accurately the short-term scenario for India and high incidence states. The prediction through SIR model may be used for planning and prepare the health systems. The study also suggests that there is no evidence to conclude that there is a positive impact of lockdown in terms of reduction in new cases.
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BACKGROUND: Since the onset of the COVID-19 in China, forecasting and projections of the epidemic based on epidemiological models have been in the centre stage. Researchers have used various models to predict the maximum extent of the number of cases and the time of peak. This yielded varying numbers. This paper aims to estimate the effective reproduction number (R) for COVID-19 over time using incident number of cases that are reported by the government. METHODS: Exponential Growth method to estimate basic reproduction rate R0, and Time dependent method to calculate the effective reproduction number (dynamic) were used. "R0" package in R software was used to estimate these statistics. RESULTS: The basic reproduction number (R0) for India was estimated at 1.379 (95% CI: 1.375, 1.384). This was 1.450 (1.441, 1.460) for Maharashtra, 1.444 (1.430, 1.460) for Gujarat, 1.297 (1.284, 1.310) for Delhi and 1.405 (1.389, 1.421) for Tamil Nadu. In India, the R at the first week from March 2-8, 2020 was 3.2. It remained around 2 units for three weeks, from March 9-29, 2020. After March 2020, it started declining and reached around 1.3 in the following week suggesting a stabilisation of the transmissibility rate. CONCLUSION: The study estimated a baseline R0 of 1.379 for India. It also showed that the R was getting stabilised from first week of April (with an average R of 1.29), despite the increase in March. This suggested that in due course there will be a reversal of epidemic. However, these analyses should be revised periodically.
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BACKGROUND: Although multiple variables have been shown to affect outcomes in pediatric lithotripsy (ESWL), there is no consensus on the same. Nomograms combine multiple variables and provide an objective prediction of outcomes. Two nomograms have been previously described and validated in two studies from the same geographical area. External validation in multiple settings is needed, as a nomogram's performance may vary with time, geographical area and clinical scenario. OBJECTIVES: This study aimed to identify variables influencing pediatric ESWL outcomes, validate published nomograms and describe the clinical and metabolic profile of Indian children treated with ESWL. DESIGN: This retrospective cohort study included all children who underwent ESWL from 2002 to 2019 at a single centre. ESWL was performed under general anaesthesia. Mid and lower ureteric calculi were treated in prone and the rest in supine position. 1500-2000 shocks were delivered at a voltage of 12-16 kV. Data pertaining to patient characteristics, metabolic evaluation, imaging, ESWL details and post-procedure outcomes were obtained from the hospital information system and these variables, along with Onal and Dogan scores, were correlated with stone clearance. Cut-offs for Onal and Dogan scores were determined using receiver operator characteristic (ROC) curve analysis and compared with area under the curve (AUC). Complications, ancillary procedures and metabolic abnormalities were recorded. RESULTS: A total of 66 children (76 renal units) were included. Mean age was 5.5 years (Range 6 months-14 years) and median stone size, 12 mm (IQR 9, 15.25). Average treatment sessions were 1.8 ± 0.99. Median shocks in the stone-free group and those who failed treatment were 1750 (IQR 1500, 3000) and 3250 (IQR 1750, 4750) respectively. The remaining variables are depicted in Table 1. The stone free rate was 63.2%. Fragments <4 mm were seen in 19 (25%). Efficacy Quotient was 40. The AUC for Dogan nomogram (cut-off <199.5) was 0.761 while that for Onal nomogram (cut-off <2.5) was 0.762 and 0.771 after one and three shocks respectively. On multivariate analysis, age, multiple calculi, Onal and Dogan scores were predictive of clearance. Dogan score had higher specificity. Complications were seen in 16 (21%) and ancillary procedures needed in 7 (9.2%). Metabolic abnormalities were seen in 84.8%, the commonest being hyperoxaluria. Mixed stones were most frequent. CONCLUSIONS: Lithotripsy in children is safe and effective. Older age, presence of multiple calculi, higher Onal and Dogan scores are predictive of treatment failure.
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Cálculos Renales , Litotricia , Cálculos Ureterales , Anciano , Niño , Humanos , Lactante , Cálculos Renales/terapia , Nomogramas , Estudios Retrospectivos , Resultado del Tratamiento , Cálculos Ureterales/terapiaRESUMEN
BACKGROUND: To further characterize survival benefit with first-line nivolumab plus ipilimumab with two cycles of chemotherapy versus chemotherapy alone, we report updated data from the phase III CheckMate 9LA trial with a 2-year minimum follow-up. PATIENTS AND METHODS: Adult patients were treatment naïve, with stage IV/recurrent non-small-cell lung cancer, no known sensitizing EGFR/ALK alterations, and an Eastern Cooperative Oncology Group performance status ≤1. Patients were randomized 1 : 1 to nivolumab 360 mg every 3 weeks plus ipilimumab 1 mg/kg every 6 weeks with two cycles of chemotherapy, or four cycles of chemotherapy. Updated efficacy and safety outcomes are reported, along with progression-free survival (PFS) after next line of treatment (PFS2), treatment-related adverse events (TRAEs) by treatment cycle, and efficacy outcomes in patients who discontinued all treatment components in the experimental arm due to TRAEs. RESULTS: With a median follow-up of 30.7 months, nivolumab plus ipilimumab with chemotherapy continued to prolong overall survival (OS) versus chemotherapy. Median OS was 15.8 versus 11.0 months [hazard ratio 0.72 (95% confidence interval 0.61-0.86)]; 2-year OS rate was 38% versus 26%. Two-year PFS rate was 20% versus 8%. ORR was 38% versus 25%, respectively; 34% versus 12% of all responses were ongoing at 2 years. Median PFS2 was 13.9 versus 8.7 months. Improved efficacy outcomes in the experimental versus control arm were observed across most subgroups, including by programmed death-ligand 1 and histology. No new safety signals were observed; onset of grade 3/4 TRAEs was mostly observed during the first two treatment cycles in the experimental arm. In patients who discontinued all components of nivolumab plus ipilimumab with chemotherapy treatment due to TRAEs (n = 61) median OS was 27.5 months; 56% of responders had an ongoing response ≥1 year after discontinuation. CONCLUSIONS: With a 2-year minimum follow-up, nivolumab plus ipilimumab with two cycles of chemotherapy provided durable efficacy benefits over chemotherapy with a manageable safety profile and remains an efficacious first-line treatment of advanced non-small-cell lung cancer.
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Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Humanos , Ipilimumab/efectos adversos , Neoplasias Pulmonares/tratamiento farmacológico , Recurrencia Local de Neoplasia , Nivolumab/efectos adversosRESUMEN
The present study was conducted to develop bacterial cellulose nanofibers (BCNF) and to evaluate its ability as a carrier material for the incorporation of the probiotic bacteria Lactobacillus acidophilus 016. Bacterial cellulose (5%) dissolved in trifluoroacetic acid (TFA) solution was amended with an equal volume of polyvinyl alcohol (PVA) solution to produce nanofibers via electrospinning. Fourier-transform infrared spectra of BCNF confirmed the absence of TFA used in the dissolution process. Mechanical properties, including tensile strength, surface area, pore-volume, and pore diameter, and thermal analysis of BCNF revealed that the nanofibers could be incorporated in food for the delivery of probiotics. L. acidophilus 016 was successfully immobilized onto the BCNF through the adsorption-incubation technique. SEM micrograph revealed that the immobilized bacteria sustained without any damage during the storage for up to 24 days. Further, the viability studies confirmed the survival of 71% population during the storage at 35 °C. These observations recommended the possibility of BCNF based probiotics for various commercial applications.
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Celulosa/química , Portadores de Fármacos/química , Lactobacillus acidophilus/metabolismo , Nanofibras/química , Probióticos/metabolismo , Lactobacillus acidophilus/química , Viabilidad Microbiana , Probióticos/químicaRESUMEN
A technique has been developed for fabrication of ultrahydrophobic Ti-6Al-4V surface by vacuum process. This report has the data related to the article "Hybrid laser and vacuum process for rapid ultrahydrophobic Ti-6Al-4â¯V surface formation" on the fabrication of ultrahydrophobic Ti-6Al-4V by Vacuum process (Jagdheesh et al., 2019). The present data consist of X-ray photo electron spectroscopy spectrums recorded for the laser patterned ultrahydrophobic samples, droplet image and surface chemical composition of laser patterned Ti-6Al-4V samples before vacuum process(b. v. p.) and after vacuum process (a. v. p.) for 120â¯min. The presented data give a clear idea about the chemical modification evolved during the vacuum process.
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OBJECTIVE: Accurate differentiation between epileptic seizures (ES) and psychogenic non-epileptic seizures (PNES) can be challenging based on history alone. Inpatient video EEG monitoring (VEM) is often needed for a definitive diagnosis. However, VEM is highly resource intensive, is of limited availability, and cannot be undertaken over long periods. Previous research has shown that time-frequency analysis of accelerometer data could be utilized to differentiate between ES and PNES. Using a seizure detection and classification algorithm, we sought to examine the diagnostic utility of an automated analysis with an ambulatory accelerometer. METHODS: A wrist-worn device was used to collect accelerometer data from patients during VEM admission, for diagnostic evaluation of convulsive seizures. An automated process, that involved the use of K-means clustering and support vector machines, was used to detect and classify each seizure as ES or PNES. The results were compared with VEM diagnoses determined by epileptologists blinded to the accelerometer data. RESULTS: Twenty-four convulsive seizures, consisting of at least 20 seconds of sustained continuous activity, recorded from 11 patients during inpatient VEM (13 PNES from five patients and 11 ES from six patients) were included for analysis. The automated system detected all convulsive seizures (ES, PNES) from >661 hours of recording with 67 false alarms (2.4 per 24 hours). The sensitivity and specificity for classifying ES from PNES were 72.7% and 100%, respectively. The positive and negative predictive values for classifying PNES were 81.3% and 100%, respectively. There was no significant difference between the classification results obtained from the automation process and the VEM diagnoses. SIGNIFICANCE: This automated system can potentially provide a wearable out-of-hospital seizure diagnostic monitoring system.
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Kombucha tea is a fermented tea beverage produced by fermenting sugared black tea with tea fungus (kombucha). Free-radical scavenging abilities of kombucha tea prepared from green tea (GTK), black tea (BTK) and tea waste material (TWK) along with pH, phenolic compounds and reducing power were investigated during fermentation period. Phenolic compounds, scavenging activity on DPPH radical, superoxide radical (xanthine-xanthine oxidase system) and inhibitory activity against hydroxyl radical mediated linoleic acid oxidation (ammonium thiocyanate assay) were increased during fermentation period, whereas pH, reducing power, hydroxyl radical scavenging ability (ascorbic acid-iron EDTA) and anti-lipid peroxidation ability (thiobarbituric assay) were decreased. From the present study, it is obvious that there might be some chances of structural modification of components in tea due to enzymes liberated by bacteria and yeast during kombucha fermentation which results in better scavenging performance on nitrogen and superoxide radicals, and poor scavenging performance on hydroxyl radicals.
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Recently there has been an increased demand for functional foods to reduce the risk of cardiovascular diseases mainly related to hypercholesterolemia, because of undesirable side effects of traditional drugs (statins). Hence, in the quest for natural and safer alternatives, this work is aimed to bring together the health-promoting properties of probiotics, soymilk, bovine milk and green tea into one product, i.e., soy-fortified green tea curd (GTC). This study includes isolation and characterization of microbes for probiotic attributes, from locally made curd which could reduce cholesterol and produce angiotensin-converting enzyme inhibitors in vitro. The best isolate was used for the production of soy-fortified GTC, and the effect of refrigerated storage on bacterial viability, tea polyphenol contents, and organoleptic properties was investigated. CI1 (Enterococcus faecium) depicted best probiotic potential amongst the 15 isolates. Soy-fortified GTC depicted higher probiotic viability for a longer duration during refrigerated storage and greater ACEI activity than unfortified GTC.