ABSTRACT
BACKGROUND: Congenital toxoplasmosis is a treatable, preventable disease, but untreated causes death, prematurity, loss of sight, cognition and motor function, and substantial costs worldwide. OBJECTIVES: We asked whether high performance of an Immunochromatographic-test (ICT) could enable accurate, rapid diagnosis/treatment, establishing new, improved care-paradigms at point-of-care and clinical laboratory. METHODS: Data were obtained in 12 studies/analyses addressing: 1-feasibility/efficacy; 2-false-positives; 3-acceptability; 4-pink/black-line/all studies; 5-time/cost; 6-Quick-Information/Limit-of-detection; 7, 8-acute;-chronic; 9-epidemiology; 10-ADBio; 11,12-Commentary/Cases/Chronology. FINDINGS: ICT was compared with gold-standard or predicate-tests. Overall, ICT performance for 1093 blood/4967 sera was 99.2%/97.5% sensitive and 99.0%/99.7% specific. However, in clinical trial, FDA-cleared-predicate tests initially caused practical, costly problems due to false-positive-IgM results. For 58 persons, 3/43 seronegative and 2/15 chronically infected persons had false positive IgM predicate tests. This caused substantial anxiety, concerns, and required costly, delayed confirmation in reference centers. Absence of false positive ICT results contributes to solutions: Lyon and Paris France and USA Reference laboratories frequently receive sera with erroneously positive local laboratory IgM results impeding patient care. Therefore, thirty-two such sera referred to Lyon's Reference laboratory were ICT-tested. We collated these with other earlier/ongoing results: 132 of 137 USA or French persons had false-positive local laboratory IgM results identified correctly as negative by ICT. Five false positive ICT results in Tunisia and Marseille, France, emphasize need to confirm positive ICT results with Sabin-Feldman-Dye-test or western blot. Separate studies demonstrated high performance in detecting acute infections, meeting FDA, CLIA, WHO REASSURED, CEMark criteria and patient and physician satisfaction with monthly-gestational-ICT-screening. CONCLUSIONS/SIGNIFICANCE: This novel paradigm using ICT identifies likely false positives or raises suspicion that a result is truly positive, rapidly needing prompt follow up and treatment. Thus, ICT enables well-accepted gestational screening programs that facilitate rapid treatment saving lives, sight, cognition and motor function. This reduces anxiety, delays, work, and cost at point-of-care and clinical laboratories. TRIAL REGISTRATION: NCT04474132, https://clinicaltrials.gov/study/NCT04474132 ClinicalTrials.gov.
Subject(s)
Toxoplasmosis, Congenital , Female , Humans , Infant, Newborn , Pregnancy , Antibodies, Protozoan/blood , False Positive Reactions , Immunoglobulin M/blood , Prenatal Diagnosis/methods , Sensitivity and Specificity , Toxoplasma/immunology , Toxoplasmosis, Congenital/diagnosis , Toxoplasmosis, Congenital/prevention & controlABSTRACT
Introduction: Qatar established its Community Forensic Mental Health Team (CFMHT) in 2019 as part of the region's first comprehensive forensic psychiatry service. We present here the data on clinical and offending outcomes since its establishment and compare this with data from before the service was established. Objectives: To compare clinical and offending outcomes in mental health patients with criminal offending histories in Qatar before and after the establishment of CFMHT. Methods: This is a retrospective study comparing the socio-demographical characteristics, clinical outcome and recidivism measures of forensic patients, under the CFMHT for the last 2 years with data from a similar period before the services were in place. Results: Data for 85 patients under the active care of forensic community team were matched with a comparable group before the establishment of the services. The re-admission and reoffending rates after the establishment of the service over 2-year follow-up were 17.6% and 12.9%, respectively, compared with 40% and 32% before the service. Conclusions: Since its inception, the CFMHT has made a significant positive impact on quality of life, mental well-being and safety of patients under its care. Close working relationships with the criminal justice system, families and carers have helped fight stigma and promote safer communities.
ABSTRACT
Background: Dental phenotype shows variation in the form of various metric and non-metric traits, primarily due to gene-environment interplay. It gives an insight into the evolutionary trends, ancestry, and food habits. Recently, it has been explored for genetic affinity with several growth anomalies and development of craniofacial skeleton which is also responsible for dental and skeletal malocclusions. Objectives: the current study aims to investigate the non-metric dental crown traits (NDCTs) using Arizona State University Dental Anthropology system (ASUDAS) in different types of malocclusions in Delhi, National Capital Region (NCR) population. Materials and methods: The study design was observational and retrospective. The total sample comprised of 240 pairs of dental casts divided into four equal groups of 60 subjects each (30 male and 30 female), based on malocclusion. The four groups of malocclusions were: Angle's Class I, Class II division 1, Class II division 2, Class III. The investigator was blinded for patient ID and sex before recording the data. The data for cast were recorded by three observers independently in a modified malocclusion- non-metric dental crown traits (M-NDCT) anthropological variants chart and statistically analyzed for association with different malocclusions and sex. Results: Significant differences were found in the expression of several NDCTs (both in presence and scoring) in different malocclusions. Class I malocclusion showed a predominantly winging, shoveling -upper central and lateral incisor, protostylid, hypoconulid absence in lower second molar, and cusp number. Class II malocclusion showed a double shoveling, interrupted groove, tuberculum dentale, canine mesial ridge, premolar accessory cusp, Carabelli's trait, lingual cusp variation, and seventh cusp in the lower left first molar. Class III malocclusion showed the absence of hypocone in upper second molar, deflecting wrinkle, distal trigonid crest, and Y groove in left lower second molar (26.7%). Besides, sexual dimorphism was seen in shoveling -upper central and lateral incisor, canine mesial ridge, Carabelli's trait, 3-cusp in upper second molar, and cusp number. Conclusions: Significant association was found between non-metric dental traits and malocclusions (Class I, Class division 1, Class II division 2, and Class III). Significant sex-linked differences were also found. Further studies can be performed at multicenter pan-India level with a standard robust protocol and a large sample.
ABSTRACT
Abstract Ananas Comosus (also known as pineapple) is a part of Bromeliaceae family and it is consumed as food as well as folk medicine for the treatment of various diseases. It is reported that pineapple is a rich source of bromelain, a cysteine protease and it is considered as an important enzyme in different industries due to its significant therapeutic and industrial applications such as anticancer, anti-inflammatory and meat tenderizing. Bromelain is mostly present in fruit and stem of pineapple, but it is reported that crown, core, and peels, which constitute the waste of the pineapple plant, also contain bromelain but limited data is available. Therefore, the proposed study aimed at utilizing pineapple waste for the extraction and characterization of bromelain. Firstly, crude bromelain was extracted with phosphate buffer (pH 7), then it was subjected to partial purification using different fractions of ammonium sulphate (NH4)2SO4 such as 30, 40, 50 and 60% followed by desalting and concentration. Enzyme activity was calculated by using casein digesting unit (CDU) method. The results demonstrated that the crown bromelain showed highest purification of 4.34-fold at 30% (NH4)2SO4 saturation, whereas core and peel bromelain showed highest purification of 2.75 and 2.59-fold at 40% (NH4)2SO4 saturation. The molecular weight of crude and partially purified bromelain was determined by SDS-PAGE analysis and found to be 26 KDa. The pH and thermal stability of all the parts of pineapple showed maximum stability at pH 7 and at 35oC temperature.