Longitudinal Study of Cognitive Function in People with HIV and Toxoplasmic Encephalitis or Latent toxoplasma Infection.

BACKGROUND: Neurocognitive impairment (NCI) may occur during and persist even after recovery from HIV-related CNS co-infections such as toxoplasmic encephalitis (TE). The long-term cognitive effects of TE and latent toxoplomasmic infections (LTI) among persons with HIV (PWH) are unknown. We measured longitudinal effects on NC functioning in PWH with TE compared to LTI or no toxoplasmal infection. METHODS: PWH (n = 345) followed in two longitudinal cohort studies underwent comprehensive neurocognitive assessments and an anti-Toxoplamic IgG assay. Participants were classified into one of three groups: TE+ (n = 39), LTI+ (n = 34), LTI- (n = 272). The primary outcome was change in neurocognitive function between baseline and 7-year visit. RESULTS: The mean age was 48 ±â€Š11 years, mean educational level 13 ±â€Š3 years, and 13% were female. TE+ patients were less likely to have undetectable viral loads (≤50 copies/mL) and had lower absolute CD4 counts. The TE+ group had the highest prevalence of NCI globally and in domains of verbal, executive function, learning, recall, working memory, processing speed and motor at baseline and at 7-year follow-up. Changes in longitudinal NC function over 7 years were small and did not differ significantly among all groups, except that speed of information processing improved more in TE+ compared with LTI- participants. CONCLUSIONS: PWH with a history of TE had cognitive impairment over a broad range of severity at both baseline and last follow-up. Changes in cognition from baseline to last examination in all groups were minimal and did not differ significantly among the groups with the exception of speed of information processing.

Cu Based Dilute Alloys for Tuning the C2+ Selectivity of Electrochemical CO2 Reduction.

Electrochemical CO2 reduction is a promising technology for replacing fossil fuel feedstocks in the chemical industry but further improvements in catalyst selectivity need to be made. So far, only copper-based catalysts have shown efficient conversion of CO2 into the desired multi-carbon (C2+) products. This work explores Cu-based dilute alloys to systematically tune the energy landscape of CO2 electrolysis toward C2+ products. Selection of the dilute alloy components is guided by grand canonical density functional theory simulations using the calculated binding energies of the reaction intermediates CO*, CHO*, and OCCO* dimer as descriptors for the selectivity toward C2+ products. A physical vapor deposition catalyst testing platform is employed to isolate the effect of alloy composition on the C2+/C1 product branching ratio without interference from catalyst morphology or catalyst integration. Six dilute alloy catalysts are prepared and tested with respect to their C2+/C1 product ratio using different electrolyzer environments including selected tests in a 100-cm2 electrolyzer. Consistent with theory, CuAl, CuB, CuGa and especially CuSc show increased selectivity toward C2+ products by making CO dimerization energetically more favorable on the dominant Cu facets, demonstrating the power of using the dilute alloy approach to tune the selectivity of CO2 electrolysis.

Utility of Asymmetric Multilevel Pontes Osteotomy in Ankylosing Spondylitis with Scoliosis using Ultrasonic Bone Scalpel: Case Report.

Introduction: Ankylosing spondylitis is a spondyloarthropathy that commonly involves the axial skeleton with predilection to the sacro-iliac joints and spine. The disease frequently results in a smooth globular kyphotic deformity of the spine; however, a coronal plane scoliotic deformity is extremely rare. We present a unique case of scoliotic deformity in a patient diagnosed with ankylosing spondylitis. To the best of our knowledge, following a review of the literature, this appears to be the first report of this kind. Case Report: A 23-year-old male patient presented with chronic back pain, stiffness, and a truncal shift of the body. He had a rigid left-sided thoracolumbar curve measuring 41° with a coronal imbalance of 3.6 cm. We present a case report on scoliosis deformity correction performed with a four-level asymmetric pontes osteotomy using a bone scalpel with excellent correction of the scoliotic deformity that was well maintained at 2-year follow-up. Conclusion: Scoliosis in ankylosing spondylitis has not been documented in literature. We report the complete correction of the deformity, which is well maintained at the 2-year follow-up.

Optimizing nutrients from fly ash-amended soil through microbial-assisted phytoremediation using response surface methodology.

Nutrients are vital ingredients to boost plant health. The availability of nutrients is limited in fly ash (FA) waste to properly implement phytoremediation. The research explored the integration of microbes and treated wastewater irrigation in phytoremediation to provide the necessary nutrients for plant growth in fly ash-amended soils. The Box-Behnken method was used to design the experimental layout for the pot study. Response surface methodology (RSM) was applied as the optimization approach to model predictions for nutrient accumulation. The implemented pot study attained the highest morphological indicators with a plastochron index of 33.40, an absolute growth rate of 2.63 cm/day, and a leaf area of 2681.68 cm2 and attained maximum biomass of 24.91 g for the treatments that included a mid-range of the variables. The combination of FA 14.98%, microbial dose 4.07 mL, and treated wastewater as the irrigation source was found to be the optimized combination for nitrogen and phosphorus accumulation of 212.4 and 8.867 mg/L.

Case series of central retinal artery occlusion in COVID-19-associated rhino-orbital-cerebral mucormycosis.

Rhino orbital Mucormycosis caused by filamentous fungus of mucoraceae family was considered a rare disease affecting immunocompromised and diabetics with ketoacidosis until the recent COVID 19 pandemic. We are presenting a series of six cases of Rhino orbital cerebral Mucormycosis with central retinal artery occlusion. All six cases had common history of COVID 19 infection in recent past with sinusitis, proptosis and total ophthalmoplegia with central retinal artery occlusion on presentation. MR imaging showed invasive pan sinusitis with orbital and cerebral involvement. Urgent debridement was done and histopathological examination showed broad, filamentous aseptate fungi suggestive of Mucormycosis. All patients inspite of intravenous Amphotericin B with local debridement did not show any improvement and expired within a week of presentation. Hence our study shows poor prognosis of post covid 19 associated Mucormycosis with central retinal artery occlusion.

O-arm Navigated en bloc Excision of a Solitary Subaxial Cervical Osteochondroma Presenting as Myelo-radiculopathy: A Case Report.

Introduction: Vertebral osteochondroma is a rare entity. It presents with varied complaints ranging from palpable mass to myeloradiculopathy. En bloc excision is the gold standard treatment option for symptomatic patients. Real-time intraoperative navigation has increased the accuracy and safety of tumor excision. We report a case of cervical subaxial osteochondroma with myelo-radiculopathy, treated with excision, and monosegmental fusion under O-arm-based real-time navigation. Case Report: A 32-year-old male presented with complaints of axial neck pain with the right upper limb radiculopathy for 18 months. On examination, signs of myelopathy were identified without sensory-motor deficit. Magnetic resonance imaging and computed tomography scans were suggestive of solitary C6 osteochondroma compressing spinalcord. O-arm navigated en-bloc tumor excision with C5 hemilaminectomy and monosegmental fusion was done. Conclusion: The use of O-arm navigation aids in accurate intraoperative en bloc excision without any residual tumor and with better safety.

Ubiquitin-independent proteasomal degradation driven by C-degron pathways.

Although most eukaryotic proteins are targeted for proteasomal degradation by ubiquitination, a subset have been demonstrated to undergo ubiquitin-independent proteasomal degradation (UbInPD). However, little is known about the molecular mechanisms driving UbInPD and the degrons involved. Utilizing the GPS-peptidome approach, a systematic method for degron discovery, we found thousands of sequences that promote UbInPD; thus, UbInPD is more prevalent than currently appreciated. Furthermore, mutagenesis experiments revealed specific C-terminal degrons required for UbInPD. Stability profiling of a genome-wide collection of human open reading frames identified 69 full-length proteins subject to UbInPD. These included REC8 and CDCA4, proteins which control proliferation and survival, as well as mislocalized secretory proteins, suggesting that UbInPD performs both regulatory and protein quality control functions. In the context of full-length proteins, C termini also play a role in promoting UbInPD. Finally, we found that Ubiquilin family proteins mediate the proteasomal targeting of a subset of UbInPD substrates.

Alzheimer's disease-associated mutant ubiquitin (UBB+1) is secreted through an autophagosome-like vesicle-mediated unconventional pathway.

Misfolded protein aggregation at both intracellular and extracellular milieus is thought to be the major etiology of Alzheimer's disease (AD). UBB+1, a frameshift variant of the ubiquitin B gene (UBB) results in a folded ubiquitin domain fused to a flexible unstructured extension. Accumulation of UBB+1 in extracellular plaques in the brains of AD patients undoubtedly suggests a role of the ubiquitin-proteasome system in AD. However, the exact mechanism of extracellular secretion of UBB+1 remains unknown. In an attempt to understand the molecular mechanism of UBB+1 secretion, we performed a survey of secretory pathways and identified the involvement of unconventional autophagosome-mediated UBB+1 secretion. Expression of UBB+1 was sufficient to stimulate LC3B/Atg8 conversion from LC3B-I to LC3B-II, which indicates initiation of the autophagy pathway. Furthermore, deficiency of ATG5 - a key player in autophagosome formation - inhibited UBB+1 secretion. Based on immunofluorescence 3D structured illumination (SIM) microscopy and co-immunoprecipitation, we provide evidence that UBB+1 is associated with the secretory autophagosome marker, SEC22B, while HSP90 possibly acts as a carrier. Using LC-MS/MS and mutagenesis we found that in cells, UBB+1 is ubiquitinated on lysine 11, 29, and 48, however, this ubiquitination does not contribute to its secretion. By contrast, proteasome or lysosome inhibition slightly enhanced secretion. Taken together, this study suggests that by ridding cells of UBB+1, secretory autophagosomes may alleviate the cellular stress associated with UBB+1, yet simultaneously mediate the spreading of a mutant specie with disordered characteristics to the extracellular milieu.

Response surface method for optimization of process variables for bioaccumulation of metals with Jatropha curcas on fly ash-amended soil.

Heavy metal contamination is a serious rising issue with the dumping of fly ash (FA). A recent focus of researches and practices tends towards reutilization of FA with bioremediation technique using various plants. The present research aimed to investigate optimum metal extraction in fly ash-amended soil using microbes and treated wastewater with Jatropha curcas plant using response surface methodology (RSM). The Box-Behnken design was used to determine the optimum condition for maximum metal remediation with three levels and three variables, viz., fly ash percentage (5, 12.5, 20%), microbial dose (0.5, 5.25, 10 ml), and contaminant level of water to irrigate the plant (freshwater, treated wastewater, untreated wastewater). The approach adopted was to set fly ash percentage as "maximum," microbial dose as "minimum," and contaminant level of water to irrigate the plant as "in range." The outcome of the present research provided the best prediction models, integrated the process variables, and developed rotational curves for analyzing metal remediation in 360° rotation for Fe, Mn, Zn, Cu, and Al as responses of interest. The optimum conditions for maximum bioremediation from fly ash-amended soils by bioaccumulation on Jatropha curcas plant worked out as 13.866% fly ash, 4.088 ml microbial dose, and treated wastewater as type of water to irrigate the plant that bioaccumulated Fe, Mn, Zn, Cu, and Al as to 26.904, 0.760, 0.160, 0.162, and 12.895 mg/l.

A simple technique of meibography for morphological and functional evaluation of meibomian glands in dry eye conditions.

Purpose: Dry eye disease (DED) is because of a decrease in the tear film's volume or a change in the composition of tears. Evaporative dry eye is the most common type, which is due to meibomian gland dysfunction (MGD). In this study, the morphology of meibomian glands was evaluated in all kinds of dry eyes to look for any loss of meibomian glands, assess the function of remaining glands, and investigate the relationship between anatomy, function, and severity of DED. Methods: A total of 300 patients were included in the study, with 150 eyes in the study group and 150 in the control group. Meibomian gland morphology was assessed by examining the tarsal plate after everting the eyelids. Tear film function was evaluated using tear film break-up time (TBUT) and Schirmer's test (SCH I and II). Meibomian gland morphology was examined with a slit-lamp under magnification, a transilluminator using a small light emitting diode (LED) bulb, and non-contact meibography using an auto refracto-keratometer (ARK). Results: Females had a higher prevalence of dry eyes in our study. In all, 103 eyes (68.6%) in the study group had evaporative dry eye, making it the most prevalent type. Among the 150 controls, 104 controls with 69.3% had no dry eye symptoms, and in those with symptoms, the evaporative type was the most common, with a 28% prevalence. Conclusion: TBUT should be performed in all patients with detectable MG abnormality. Meibography has high specificity and sensitivity to diagnose MGD and in turn dry eyes and should be considered a routine screening modality.

Comparing the efficacy of sodium hyaluronate eye drops and carboxymethylcellulose eye drops in treating mild to moderate dry eye disease.

Purpose: Aim of this study was to compare the efficacy of sodium hyaluronate (SH) and carboxymethyl cellulose (CMC) eye drops in treating mild to moderate dry eye disease in terms of relief of symptoms, mean change in tear film breakup time, Schirmer's test, and impression cytology of conjunctiva from baseline. Methods: An observational study was carried out during a 2-year period in our tertiary referral hospital. The study consisted of 60 patients randomly allotted to two groups to receive SH and CMC eye drops for an 8-week period. Ocular surface disease index, tear film breakup time, and Schirmer's test were performed at baseline visit and 4 and 8 weeks of treatment, and impression cytology of conjunctiva was performed at baseline and 8 weeks. Results: Significant improvement in patient symptoms, tear film breakup time, and Schirmer's test from baseline was seen in both SH and CMC groups at 8 weeks posttreatment, whereas impression cytology of conjunctiva in both groups did not show significant improvement at 8 weeks of treatment. Data analysis using unpaired t-test showed comparable results. Conclusion: Both CMC and SH demonstrated equal efficacy in treating mild to moderate dry eye disease.

Assessment of homozygosity in transgenic plants using selectable markers.

Production of homozygous transgenic plants is a prerequisite for the phenotypic analysis and/or for the commercial release of transgenic plants for cultivation. Here we present a simple protocol for the selection of homozygous transgenics using antibiotics as a selectable marker. The protocol has been used to select homozygous rice transgenic plants using hygromycin antibiotic. However, the described protocol can be used for selction of homozygous in any transgenic plants using a appropriate selectable marker. For complete details on the use and execution of this protocol, please refer to Passricha et al. (2016).1.

Effect of coinfections on neurocognitive functioning among people with clade C HIV infection in Zambia.

Despite the fact that many coinfections in people with HIV (PWH) are treatable or suppressible, they may still impact neurocognitive (NC) functioning. Here, we aim to evaluate the presence of latent/treated coinfections and their association with NC functioning in a cohort of PWH in Zambia. We carried out a cross-sectional, nested study involving 151 PWH with viral suppression, and a normative sample of 324 adults without HIV. Plasma samples from PWH who underwent a comprehensive NC assessment were evaluated for the presence of treated/latent coinfections that are common in Zambia. Information about treated pulmonary tuberculosis (TB) was obtained from participants' clinical charts. Overall, PWH differed significantly from the HIV seronegatives on all neuropsychological domains except for fine motor control. ANOVA comparisons of all 3 HIV + groups' demographically corrected mean NC T-scores showed that the HIV + /TB + group had the poorest NC functioning in the following domains: executive functioning (F = 4.23, p = 0.02), working memory (F = 5.05, p = 0.002), verbal fluency (F = 4.24, p = 0.006), learning (F = 11.26, p < 0.001), delayed recall (F = 4.56, p = 0.01), and speed of information processing (F = 5.16, p = 0.005); this group also was substantially worse on the total battery (global mean T-scores; F = 8.02, p < 0.001). In conclusion, treated TB coinfection in PWH was associated with worse NC performance compared to both those with antibodies against other coinfections and without. PWH with antibodies for other coinfections (HIV + /CI +) showed somewhat better NC performance compared to those without (HIV + /CI -), which was not expected, although comparisons with the HIV + /CI + group are limited by its lack of specificity regarding type of coinfection being represented.

Obesity-induced vena cava compression syndrome: a case report of a rare precipitant of a type 2 myocardial infarction in a patient with critical aortic stenosis.

Background: Obesity is a global health problem of increasing prevalence with a broad range of multisystem complications. An under-recognized complication of severe obesity is the potential haemodynamic compromise that may arise due to pathological external compression of the inferior vena cava whilst lying in the supine position, a phenomenon known as obesity-induced vena cava compression syndrome. Case summary: A 56-year-old independent woman presented to a rural Australian hospital for routine dressing care for bilateral lymphoedema on a background of class III morbid obesity (weight 197 kg, body mass index 68.55 kg/m3) and aortic stenosis. Whilst laid in the supine position with both legs elevated to aid lower limb venous return, the patient developed angina with associated troponin rise (15 to 75 to 332 ng/L) and inferolateral territory ischaemic changes on electrocardiogram. The pain then resolved shortly after restoring the patient to the upright position. A transthoracic echocardiogram showed critical bicuspid aortic stenosis. Computerized tomography coronary angiogram showed no significant coronary artery disease. Following multidisciplinary discussions, a transcatheter aortic valve insertion was performed via a transfemoral approach. Post-procedure, she went into atrial fibrillation, she was cardioverted into a sinus rhythm with new left bundle branch block. There were no complications otherwise, and the patient was discharged home following a brief period of convalescence. Discussion: We describe a case of suspected obesity-induced vena cava compression syndrome precipitating a type 2 myocardial infarction in a pre-load dependent patient with critical bicuspid valve aortic stenosis. This case highlights a potential haemodynamic consequence of morbid obesity in the supine position.

Utilization of isolated microbe and treated wastewater for enhanced growth of Jatropha curcas for bioremediation of fly ash amended soil.

The generation of Fly Ash (FA) waste is continuously piling up with the increasing energy demand. Recent research is focused towards reutilizing this fly ash waste through bioremediation practices. But fly ash retards the growth of plants and holds back to support the bioremediation process due to a deficiency of essential main nutrients. The present research envisages overcoming this problem by providing a novel concept of inducing isolated microbes and treated wastewater which provides necessary nutrients and promotes better plant growth and metal extraction. A pot experimental study was executed with treatments T1 (FA amended soil), T2 (FA with isolated microbe), and T3 (FA with microbes and treated wastewater). As an outcome of the present research, T3 gained relatively higher morphological characteristics viz. Leaf area (29.8%), absolute growth rate (61.7%), plastochron index (18.6%), biomass yield (47.3%) and enhanced metal extraction for Fe (34.4%), Al (27.1%), Mn (72.0%), Zn (17.5%) in comparison to the control. Treatment T3 also gained higher Remediation Efficiency (RE) and Bio-Concentration Factor (BCF) values for Al, Fe, and Mn. The involvement of nutrients via treated wastewater energizes the process mechanism and increases the working zone for the microbes thereby, enhancing the bioremediation.

A comparison of sub-tenon block with peribulbar block in small-incision cataract surgery.

Purpose: To compare the efficacy and safety of sub-tenon block to peribulbar block with respect to analgesia, akinesia, and complications. Methods: It is an observational study conducted at a government hospital in Karnataka. Seventy patients who came to the ophthalmology OPD for small-incision cataract surgery (SICS) under local anesthesia were included in the study. The participants were divided into two groups of 35 as per the surgeon. The pain was evaluated at the time of administration of the block, during the surgery, and during the postoperative period of 4 h. Akinesia was noted in both the groups and the time of onset of akinesia was noted. Any complications associated with the block such as chemosis or subconjunctival hemorrhage were also noted. Statistical analysis was done using PSS version 25.0, where P < 0.05 was considered significant. Results: The baseline pain score was higher in the peribulbar group (1.57). The onset of akinesia was faster in sub-tenons (90.34 s). Complete akinesia was achieved in 82.9% of patients after peribulbar block. There was no significant difference in complications in both groups. Conclusion: Sub-tenons block is an effective and safer technique of ocular anesthesia for SICS. It can be considered as an alternative to the conventional peribulbar block for SICS.

The association of testis-specific hTAF7L gene variants with idiopathic azoospermic and severe oligozoospermic male infertility.

Spermatogenesis is regulated by complex tissue specific gene expression in the testis to achieve normal male fertility. X-chromosome specific TATA binding protein (TBP)-associated factor 7L (hTAF7L) is one of the transcriptional regulator genes considered essential for spermatogenesis. The aim of this study was to evaluate the role of variants/mutations in the testis-specific hTAF7L gene in non-obstructive azoospermia and severe oligozoospermia male infertility. We studied 156 idiopathic non-obstructive azoospermic, severe oligozoospermic infertile males and 50 fertile proven controls. Infertile males and control subjects were genotyped for variants of the hTAF7L gene using polymerase chain reaction and a direct Sanger sequencing approach. The odds ratio evaluated the association of hTAF7L gene variants with idiopathic male infertility. The variants found in the hTAF7L gene were subjected to an in-silico analysis study. In infertile study subjects, we observed 11 single base pair nucleotide changes at various exons and three frameshift variants at exon 10 in the hTAF7L gene. We also found more than one variant in some non-obstructive azoospermia and severe oligozoospermia infertile males along with control subjects. All these variants changed the amino acid sequences in the hTAF7L gene. However, similar changes were also seen in fertile subjects, and the differences were not statistically significant. In-silico tools also predicted that the variants were likely to be benign. The variants in cDNA of the hTAF7L gene were typical SNPs. It is found that the hTAF7L gene is highly polymorphic and these missense variants are not directly associated with male infertility. However, we feel that more studies are needed to elucidate the role of multiple variants of the hTAF7L gene in the process of normal spermatogenesis.

Sustainable amelioration of fly ash dumps linking bio-energy plantation, bioremediation and amendments: A review.

Disposal of fly ash in dumps is posing serious environmental problem causing air pollution, groundwater contamination, and loss of valuable land making it unproductive dumpsites. Cultivation of plants using bioremediation technique is looked upon as one of the sustainable remedial solution to these fly ash dumpsites. In recent years, researches on the plantation of bio-energy crops over the fly ash dumpsites is creating renewed interest, as it serves remediation along with distinct energy outcomes creating a win-win situation. The issue of the slow growth of plants, due to lack of nutrients and microbial activities is being resolved through advances in bioremediation research done in conjunction with organic matter, microbial inoculants, and inclusion of wastewater. New researches are being done with different plants and microbes in the matrix combination and use wastewater to supplement nutrients requirement to find eco-friendly & sustainable solutions. The present paper critically reviews the research on bioremediation and amendments with specific to bio-energy plantation on fly ash dumps.