Employability assessment of computerized fatigue avoidance tool used with and without actigraphy among naval aircrew.

Background: Fatigue Avoidance Scheduling Tool (FAST) is a computerized fatigue prevention tool, which was developed based on a Bio-mathematical model called SAPTE (Sleep, Activity, Performance and Task Effectiveness). Similarly, actigraphy technology is used as a tool for sleep evaluation. This study was an attempt to assess the employability of FAST (both independently and integrated with actigraphy) for detecting operational fatigue by determining the 'Measures for diagnostic accuracy'. Methods: 103 pre-flight medical checks from 51 aircrew were evaluated to detect fatigue both clinically and by using objective measures (FAST and actigraphy integrated FAST). The 'measures of diagnostic accuracy' namely sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio positive (LR +ve), likelihood ratio negative (LR -ve) and Youden's Index were determined and compared. Results: The diagnostic measures for FAST were: sensitivity (68.4%), specificity (92.8%), PPV (68.4%), NPV (92.8%), LR+ve (9.5), LR-ve (0.34) and Youden's Index (0.61). For actigraphy integrated FAST these values were: sensitivity (84.2%), specificity (96.4%), PPV (94.2%), NPV (94.4%), LR+ve (23.5), LR-ve (0.16) and Youden's Index (0.80). Conclusion: The increase in sensitivity (from 68.4% to 84.2%), specificity (from 92.8% to 96.4%), PPV (from 68.4% to 94.2%), NPV (92.8% to 94.4%), LR+ve (9.5 to 23.5) and Youden's Index (0.61 to 0.80) indicated that actigraphy integrated FAST is a better screening tool in comparison to the independently employed FAST.

The Boiling Phenomena and their Proper Identification and Discrimination Methodology.

The proper identification of the existence of the boiling phenomena in a process from the trend of the Nukiyama pool-boiling curve (Q versus ∆T) is not appropriate as it does not always reveal right information. All the heating and cooling around the boiling point mimic the boiling behavior; however, these are not always actually a part of the boiling process. Therefore, the proper identification and discrimination among boiling methodologies need to be revealed as the information on the discussed issues are not available in the open literature. Hence, an attempt has been made to develop a condition describing the existence of boiling behavior in heating or quenching process and protocol to identify various boiling regimes. In the current work, the developed conditions (1/ St) are validated with various type of boiling processes and the protocol (i.e. based on the slope of h versus ∆T curve rather than boiling curve) is also valid for the identification of proper boiling regime.

Intussusception in children aged under two years in India: Retrospective surveillance at nineteen tertiary care hospitals.

OBJECTIVE: Intussusception has been linked with rotavirus vaccine (RVV) as a rare adverse reaction. In view of limited background data on intussusception in India and in preparation for RVV introduction, a surveillance network was established to document the epidemiology of intussusception cases in Indian children. METHODS: Intussusception in children 2-23 months were documented at 19 nationally representative sentinel hospitals through a retrospective surveillance for 69 months (July 2010 to March 2016). For each case clinical, hospital course, treatment and outcome data were collected. RESULTS: Among the 1588 intussusception cases, 54.5% were from South India and 66.3% were boys. The median age was 8 months (IQR 6, 12) with 34.6% aged 2-6 months. Seasonal variation with higher cases were documented during March-June period. The most common symptoms and signs were vomiting (63.4%), bloody stool (49.1%), abdominal pain (46.9%) and excessive crying (42.8%). The classical triad (vomiting, abdominal pain, and blood in stools) was observed in 25.6% cases. 96.4% cases were diagnosed by ultrasound with ileocolic location as the commonest (85.3%). Management was done by reduction (50.8%) and surgery (41.1%) and only 1% of the patients' died. 91.1% cases met Brighton criteria level 1 and 3.3% Level 2. Between 2010 and 2015, the case load and case ratio increased across all regions. CONCLUSION: Intussusception cases have occurred in children across all parts of the country, with low case fatality in the settings studied. The progressive rise cases could indicate an increasing awareness and availability of diagnostic facilities.

Health status of the elderly population among four primitive tribes of Orissa, India: a clinico-epidemiological study.

Primitive tribal groups (PTGs) are the most marginalised and vulnerable communities in India. Clinico-epidemiological studies on morbidity patterns among the elderly primitive tribe members are essential to recommend special intervention programmes to improve the health of the elderly in these communities. A community-based cross-sectional study was carried out among the elderly populations of four different PTGs, namely Langia Saora (LS), Paudi Bhuiyan (PB), Kutia Kondh (KK) and Dongria Kondh (DK) living in the forests of Orissa, India. Clinical and anthropometric data were collected using standard methods and haemoglobin was estimated by the cyanomethaemoglobin method. The average number of illnesses per person was 3.0. Common disabilities like vision and hearing impairment and mobility-related problems were found in considerable numbers. Gastrointestinal problems like acid peptic disease were found among 2.6% to 20% of cases. Non-specific fever was marked in 10.2% to 24.2% of individuals. The iodine deficiency disorder, namely goitre, was found among 4.2% to 6.0% of individuals. Diseases of the respiratory tract, like upper and lower respiratory tract infection, asthma, tuberculosis and leprosy, were found in small numbers. The prevalence of hypertension among males and females was 31.8% and 42.2%, respectively. The LS had the highest prevalence of hypertension (63% among men and 68% among women). With regard to anaemia status, severe anaemia was marked in 70% of males and 76.7% of females in the LS, while in other groups the prevalence of severe anaemia ranged from 15% to 33%. Although the prevalence of severe anaemia in other tribal communities is lower than in the LS, mild to moderate anaemia was found to range from 60% to 80%. The present study revealed a high prevalence of physical disabilities with both non-communicable as well as communicable diseases among the elderly primitive tribal members. This warrants the implementation of a special health care strategy to reduce suffering at this crucial age and improve quality of life.

Assessment of the therapeutic efficacy of chloroquine in the treatment of uncomplicated Plasmodium falciparum malaria in a tribal block of the Kalahandi district of Orissa, India.

The study on therapeutic efficacy of chloroquine was carried out in a tribal dominated block of Kalahandi district of Orissa, India. It revealed 94% treatment failure with standard dose of chloroquine in the treatment of uncomplicated P. falciparum malaria cases. The study warrants the change to alternate antimalarials in this region.

Three- and Four-Dimensional Spheroid and FiSS Tumoroid Cultures: Platforms for Drug Discovery and Development and Translational Research.

There have been remarkable improvements in our understanding of cancer biology. However, therapeutic improvements, with a few exceptions, have been minimal. Also, significant challenges remain in translating fundamental discoveries in cancer biology and genetics into effective drugs and cures. Traditional two-dimensional monolayer cell cultures lack predictive value, resulting in a >90% failure rate of compounds in clinical trials. A developing cancer is a symbiotic tissue consisting of cancer cells, including cancer stem cells (CSCs), and cohabitating with the components of its environment to form a tumor microenvironment (TME) niche. Throughout the process of tumorigenesis, ubiquitous autocrine and paracrine signaling between the cellular and noncellular components of the TME dictates the milieu and structure of this niche. Arising out of such interactions are the cancer cell's phenotypic characteristics, such as stemness, epithelial mesenchymal transformation (EMT), and drug resistance which in turn greatly affect the response of these cells to drug therapy. For these reasons, in order to delineate the mechanism of tumorigenesis and in the process discover drugs that will have greatest impact on tumor growth, it becomes imperative to study the cancer cell in context of its microenvironment. In the present review, we enumerate the advantages of three- and four-dimensional (3D and 4D) cell cultures and describe the various cell culture platforms that are being used to study tumorigenesis in vitro. These culture systems will not only aid in the study of tumor progression complexities in a cost-effective and rapid manner; they also are expected to facilitate the discovery and delivery of therapeutic regimens that will have more success making it to the clinic.

Single step method to fabricate durable superliquiphobic coating on aluminum surface with self-cleaning and anti-fogging properties.

The development of self-cleaning and anti-fogging durable superliquiphobic coatings for aluminum surfaces has raised tremendous interest in materials science. In this study, a superliquiphobic coating is fabricated on an aluminum surface by a single-step dip-coating method using 1H,1H,2H,2H-Perfluorooctyltrichlorosilane-modified SiO2 nanoparticles. The successful implementation of the aforesaid coating in different applications requires extensive investigations of its characteristics and stability. To understand the properties of the coating, surface morphology, contact angle, self-cleaning, anti-fogging, and water repellency were investigated under perturbation conditions. Additionally, the dynamics of water and oil on the coated sample also were studied. Furthermore, the durability of the coating also was examined by performing thermal, chemical, and mechanical stability tests. It was found that the coating is superliquiphobic for water, ethylene glycol, glycerol and hexadecane, and shows thermal, chemical, and mechanical stability. Further, it exhibits self-cleaning and anti-fogging properties. This approach can be applied to any size and shape aluminum surface; thus, it has great industrial applications.

Neonatal sepsis in rural India: timing, microbiology and antibiotic resistance in a population-based prospective study in the community setting.

OBJECTIVE: To examine the timing and microbiology of neonatal sepsis in a population-based surveillance in the Indian community setting. STUDY DESIGN: All live born infants in 223 villages of Odisha state were followed at home for 60 days. Suspect sepsis cases were referred to study hospitals for further evaluation including blood culture. RESULTS: Of 12 622 births, 842 were admitted with suspected sepsis of whom 95% were 4 to 60 days old. Culture-confirmed incidence of sepsis was 6.7/1000 births with 51% Gram negatives (Klebsiella predominating) and 26% Gram positives (mostly Staphylococcus aureus). A very high level of resistance to penicillin and ampicillin, moderate resistance to cephalosporins and extremely low resistance to Gentamicin and Amikacin was observed. CONCLUSION: The bacterial burden of sepsis in the Indian community is not high. Judicious choice of empiric antibiotics, antibiotic stewardship and alternate modalities should be considered for the management or prevention of neonatal sepsis in India.

Mapping of antibody binding epitopes of a recombinant Poa p IX allergen.

Antibody binding epitopes of a recombinant Poa p IX allergen were delineated using recombinant DNA and solid-phase peptide synthesis procedures. The full-length cDNA clone KBG60 and its four overlapping recombinant fragments, KBG60.1, KBG60.2, KBG8.3 and KBG10 which spanned the entire molecule were synthesized in E. coli with aid of the plasmid expression vector, pWR590.1. The antigenic and allergenic sites of these recombinant proteins were analyzed by ELISA using human IgE and murine IgG antibodies. It was thus demonstrated that although the epitopes were found on all the fragments tested, the majority of these were located on a C-terminal fragment, rKBG8.3. Furthermore, synthetic peptides were also employed to identify the epitopes of rKBG60 protein. The use of antisera raised against native KBG pollen extract and the recombinant KBG8.3 protein to scan a total of 56 overlapping deca-penta peptides, covering the entire rKBG60 protein, revealed that 10 positive peptides involved in the antibody-binding site(s). Taken together, the results of these studies indicate that rKBG60 protein possesses at least 10 antibody binding epitopes.

Differential cytokine mRNA expression in Dermatophagoides farinae allergen-sensitized and respiratory syncytial virus-infected mice.

The interaction between mite allergen sensitization and respiratory syncytial virus (RSV) infection at the level of cytokine mRNA expression was examined in a murine model in the present study. Primary RSV infection enhances expression of inflammatory cytokines such as IL-6, IFN-gamma, and eotaxin in the lung and upregulates the expression of Th2-like cytokines IL-10 and IL-13 in the spleen in BALB/c mice. Mite antigen-sensitized and RSV-infected (ASRSV) mice show enhanced (P < 0.05) total serum IgE compared to antigen-sensitized mice. However, the levels of viral mRNA in the lung tissues are comparable between RSV-infected and ASRSV mice. It is concluded that compartmentalization of cytokine expression following RSV infection plays a role in the augmentation of Th2-like and IgE antibody response to RSV.

Evidence for the existence of IL-4 and IFN gamma secreting cells in the T cell repertoire of naive mice.

The kinetics with which IgE responses develop in vivo following immunization of experimental animals indirectly support the existence of IL-4-secreting T cells as a normal component of the T cell repertoire. At the same time, studies of IL-4-secreting cell frequencies directly ex vivo have argued that T cells with the potential to become IL-4 secretors exist in vivo, in the form of precursors requiring stimulation and 4-12 days of culture as well as restimulation with mitogen or Ag before they become detectable as lymphokine-secreting cells. We demonstrate here that intravenous administration of low doses of anti-CD3 mAb 145-2C11 results in IL-4 production within 60 min of stimulation as demonstrated by Northern analysis of mRNA and a sensitive, selective bioassay (CT.4S cell proliferation) of biologically active IL-4 protein. Production of IL-4 is paralleled by IFN gamma synthesis, displaying similar kinetics. These findings, consistent with the presence of mature cells capable of IL-4 and IFN gamma synthesis in the T cell repertoire of naive mice, are supported by the observation that stimulation of spleen cells from naive mice with anti-CD3 mAb in vitro for 12 h also results in strong IL-4 and IFN gamma mRNA and protein synthesis. The data support and extend those obtained through analysis of cytokine mRNA synthesis alone, thereby providing evidence that "fresh" T cells are indeed capable of producing IL-4 directly ex vivo and are consistent with the existence of IL-4-secreting cells as a normal component of the T cell repertoire of naive mice.

Allergology and clinical immunology--XVII International Congress.

A quarter of the world's population has a genetic predisposition to atopy and suffers from one kind of allergy or another. Allergic diseases, including allergic rhinitis, atopic dermatitis, asthma, and anaphylaxis, were first identified as being important at the beginning of the 20th century. Since the discovery of allergens as agents that induce 'reaginic' (now known as IgE) antibodies, there have been spectacular advances in our knowledge of the various effector cells and molecules involved in allergic diseases. This international meeting, held every three years, provides a forum for the discussion of major advances in the field. There was no unifying theme, and the topics covered range from epidemiology and genetics, effector cells and molecules, to immunomodulatory and pharmacotherapeutic treatment.

Cationic poly(lactide-co-glycolide) nanoparticles as efficient in vivo gene transfection agents.

Poly(lactide-co-glycolide) (PLGA), a biocompatible and biodegradable polyester co-polymer of PLA and PGA, has been recognized for its ability to deliver genes. However, gene delivery by PLGA nanoparticles is limited by their negative charge and their poor transport through mucosal barriers. In this study, PLGA nanoparticles were surface modified with cationic chitosan in an effort to improve their gene delivery capability. PLGA nanoparticles were synthesized by emulsion-diffusion-evaporation technique using PVA-chitosan (PLGA1) or PVA-chitosan-PEG (PLGA2) blend as stabilizers. This method is reproducible and produces nanoparticles with hydrodynamic diameter <200 nm. The nanoparticles were characterized by zetasizer, photon correlation spectroscopy and atomic force microscopy. A549 epithelial cells were transfected in vitro with PLGA particles complexed with a reporter plasmid encoding green fluorescent protein. PLGA particles transferred EGFP gene, but were less efficient than the lipofectamine control. The nanoparticles were also tested for their ability to transport across the nasal mucosa in vivo in mice. The results show that both PLGA1 and PLGA2 facilitate gene delivery and expression in vivo with increased efficiency and without causing inflammation, as measured by IL-6. Together, these results indicate that chitosan-modified PLGA nanoparticles have greater potential as gene carriers.

Cationic silica nanoparticles as gene carriers: synthesis, characterization and transfection efficiency in vitro and in vivo.

The potential of cationic SiO2 nanoparticles was investigated for in vivo gene transfer in this study. Cationic SiO2 nanoparticles with surface modification were generated using amino-hexyl-amino-propyltri-methoxysilane (AHAPS). The zeta potential of the nanoparticles at pH = 7.4 varied from -31.4 mV (unmodified particles; 10 nm) to +9.6 mV (modified by AHAPS). Complete immobilization of DNA at the nanoparticle surface was achieved at a particle ratio of 80 (w/w nanoparticle/DNA ratio). The surface modified nanoparticle had a size of 42 nm with a distribution from 10-100 nm. The ability of these particles to transfect pCMVbeta reporter gene was tested in Cos-1 cells, and optimum results were obtained in the presence of FCS and chloroquine at a particle ratio of 80. These nanoparticles were tested for their ability to transfer genes in vivo in the mouse lung, and a two-times increase in the expression levels was found with silica particles in comparison to EGFP alone. Very low or no cell toxicity was observed, suggesting silica nanoparticles as potential alternatives for gene transfection.

Detection of early dividing forms of Plasmodium falciparum in peripheral blood.

P. falciparum schizonts were found in peripheral blood of six malaria patients including two infants who were moderately ill, with parasitaemia ranging from 33920 to 410800 per cubic mm. The patients lived in villages located at an altitude of 680 m and the phenomenon was observed during the cold season when transmission was high. Appearance of these forms was independent of host age.

Detection of Plasmodium ovale in Koraput district, Orissa state.

We report for the first time the detection of P. ovale infection in three patients in two hilly villages of Koraput district, Orissa state, India. The identification of the parasite was confirmed by the Imperial Colleage of Science and Technology, London.

Malaria & other common ailments among upper Bonda tribals in Koraput district, Orissa.

A malariometric survey carried out among the upper Bonda tribals of Koraput district showed that malaria is the major cause of morbidity followed by worm infestation and malnutrition. A total of individuals 1,409 (32.2% of the population) were sampled and 771 were found positive for malaria parasites. Plasmodium falciparum was the predominant parasite (73.7%) followed by P. vivax (10.6%) and P. malariae (5.2%) among the positive cases. Mixed infection was observed in 10.5 per cent of positive individuals. The infant parasite rate was 60.0 per cent and the average enlarged spleen among the children between 2-9 yr was 2.11. The age specific parasite rate indicated high degree transmission and high level of acquired resistance among the tribals.

Microlevel epidemiological variations in malaria & its implications on control strategy.

Microlevel epidemiological variations in designing malaria control strategies were studied. Quantitative and qualitative variations were observed between two physiographic zones and between four different ecotypes within the zones of the Koraput district. While the peak transmission occurred in rainy season in the 600 m plateau (Jeypore zone), the same was observed in cold season in 150 m plateau (Malkangiri zone). The age specific parasite prevalence indicated a high degree of transmission and high level of acquired immunity in top- and foot-hill villages of both zones as compared to plain and riverine villages. Transmission was perennial in top-hill and foot-hill villages while it was of short period (indicated by infant parasite rate) in others. Since the period and intensity of transmission vary, an uniform residual insecticidal spray schedule as followed at present is not necessary. Majority of fever patients in top-hill villages were positive for Plasmodium falciparum and therefore may be treated for malaria without slide collection and examination. Evaluations may be done by sample surveys. These steps can optimize the malaria control operation in the district.

Parasitological aspects of malaria persistence in Koraput district Orissa, India.

A sample survey in 37 villages covering 10,733 people in 1986-87 in the Koraput district, Orissa showed that the malaria prevalence is of a much higher order than that reported by the National Malaria Eradication Programme (annual parasite incidence between 14.3 and 26.8 during 1981-86). Out of 833 positives detected 714 had Plasmodium falciparum, 86 had P. vivax, 12 had P. malariae and 21 had mixed infections. There were 650 asymptomatic parasite carriers and 127 gametocyte carriers. The infant parasite rate was 15.82 per cent and average enlarged spleen (AES) in 2 to 9 yr old children was 1.98. In a year round fever survey in 22 villages, 5520 blood smears were collected and 1364 were found positive for malaria, with 77.3 per cent P. falciparum. In a mass blood survey conducted in a labour camp at an irrigation project, 610 people were examined, and 181 were positive. Nearly 40 per cent of migrants and 22 per cent of locals were positive, P. falciparum being dominant.