An insight into the sequestration of tetra and hexavalent actinides by tri ethoxysilyl-amino-propyl-3-oxa-glutaramic acid (SAPOGA) functionalized titania.

Silyl-amino-propyl-3-oxa-glutaramic acid (SAPOGA) functionalized titania has been synthesized for highly efficient solid phase sequestration of thorium and uranyl ions from an aqueous acidic waste stream. The XRD pattern suggested that the grafting was performed on the anatase phase, leading to a rougher surface resulting in better interaction with actinides. The successful grafting of SAPOGA bridging was confirmed using spectroscopic methods. The Langmuir isotherm and the intraparticle diffusion-based kinetics model were found to be operative with sorption capacities of 231 mg g-1 and 458 mg g-1 and rate constants of 51 mg g-1 min-1 and 48 mg g-1 min-1 for U and Th, respectively. The entropy driven sequestration process was thermodynamically favourable (ΔGU = -6.0 kJ mol-1 and ΔGTh = -9.1 kJ mol-1) and endothermic in nature. The experimentally corroborated complexation pattern was assisted by density functional theory (DFT) calculations, which gave further insight into the metal-ligand interaction.

Optical analysis of Sr3 Gd(PO4 )3 :Pr3+ phosphors for lighting applications.

A series of praseodymium (Pr3+ ) ion activated Sr3 Gd(1-x) (PO4 )3 :xPr3+ (0 ≤ x ≤ 2.0 mol%) phosphors were prepared and their structural, compositional and luminescence properties were investigated. The X-ray diffraction profiles indicate that the studied phosphors crystallized into body centred cubic structure and the Pr3+ ions have no influence on Sr3 Gd(PO4 )3 phase. The high-resolution scanning electron microscopy images show the agglomeration of particles that are inter-connected and form irregular shape Sr3 Gd(PO4 )3 structures. The excitation transitions corresponding to Pr3+ :3 H4 → 3 P2,1,0 transitions at 445, 471 and 483 nm, respectively, matched well with the emission of blue-light-emitting diode (LED) chip. The emission spectra show strong reddish-orange luminescence through 1 D2 → 3 H4 transition when excited at 445 nm blue wavelength. The synthesized phosphors have the potential to be used as reddish-orange lighting devices.

Early arrivals: association of maternal obstetric factors with preterm births and their survival in India.

OBJECTIVES: Preterm birth (PTB) increases the risk of various acute and chronic morbidities and premature mortality in children under 5 years of age. The present study examines the association between different maternal obstetric factors and PTB. In addition, this study estimates the risk of neonatal mortality among children born preterm. STUDY DESIGN: Retrospective two-stage stratified sample design. METHODS: The weighted prevalence of PTB was estimated using data on 148,746 most recent institutional births from the National Family Health Survey (NFHS)-4, 2015-16. The Poisson regression model was used to investigate the association between maternal obstetric factors and PTB. Using Cox's proportional hazard model, the risk of neonatal mortality among PTBs was estimated. RESULTS: Maternal obstetric factors, such as minimal antenatal care, delivery complications, history of previous caesarean delivery and delivery at private health facilities, were significantly associated with an increased risk of PTB. The survival probability of preterm babies sharply declined in the first week of life and thereafter was found to stabilise. The risk of mortality in the first 28 days of life increased 2.5-fold if the baby was born preterm. Optimising antenatal care was found to lower the likelihood of PTB and improve their chances of survival. CONCLUSION: Antenatal care services and delivery care practices in private facilities were strongly associated with the incidence and survival of PTB. Evaluating associations of history of caesarean births on future pregnancies can help understand their deleterious effects on PTB. Affordable, accessible and available antenatal care services, in both public and private facilities, can increase the survival rates of PTBs.

Evaluation of weight-based prescription of antiretroviral therapy in children.

OBJECTIVES: The aim of the study was to investigate the extent of and factors associated with incorrect dosing of antiretroviral therapy (ART) in HIV-infected children in Harare, Zimbabwe. METHODS: All children aged 0-10 years and children aged 11-17 years who weighed < 35 kg and taking ART were recruited from the paediatric HIV clinic at Harare Hospital. Their current doses of ART drugs were compared against doses recommended by the national guidelines. RESULTS: Among 309 children recruited [55% male; median age 7 years (interquartile range (IQR) 5-10 years)], the median CD4 count was 899 cells/µL and the median duration of their current ART regimen was 11.2 months (IQR 4.9-17.1 months). Overall, 110 (35.6%) children were prescribed incorrect doses of at least one drug component within their ART regimen; 64 (20.7%) under-dosed and 49 (15.9%) over-dosed on at least one drug. Children receiving a higher than recommended dose of at least one drug were younger compared with correctly dosed children (median 6 versus 7 years, respectively; P = 0.001), had been on their current ART regimen for a shorter time (median 7.2 versus 13 months, respectively; P = 0.003) and were less likely to be receiving a three-drug fixed-dose combination (FDC; 42.9 versus 63.3%, respectively; P = 0.009). Those who were under-dosed were also less likely to be on a three-drug FDC (25 versus 63.3%, respectively; P < 0.001). CONCLUSIONS: Over a third of children were prescribed incorrect doses of ART. Children taking triple-drug FDCs were likely to be correctly dosed. Our study highlights the importance of weight monitoring at each clinical contact, training of health care providers on paediatric drug dosing and the need for wider availability of FDCs for children.

Challenges in the Estimation of the Annual Risk of Mycobacterium tuberculosis Infection in Children Aged Less Than 5 Years.

Accurate estimates of Mycobacterium tuberculosis infection in young children provide a critical indicator of ongoing community transmission of M. tuberculosis. Cross-reactions due to infection with environmental mycobacteria and/or bacille Calmette-Guérin (BCG) vaccination compromise the estimates derived from population-level tuberculin skin-test surveys using traditional cutoff methods. Newer statistical approaches are prone to failure of model convergence, especially in settings where the prevalence of M. tuberculosis infection is low and environmental sensitization is high. We conducted a tuberculin skin-test survey in 5,119 preschool children in the general population and among household contacts of tuberculosis cases in 2012-2014 in a district in northern Malawi where sensitization to environmental mycobacteria is common and almost all children are BCG-vaccinated. We compared different proposed methods of estimating M. tuberculosis prevalence, including a method described by Rust and Thomas more than 40 years ago. With the different methods, estimated prevalence in the general population was 0.7%-11.5% at ages <2 years and 0.8%-3.3% at ages 2-4 years. The Rust and Thomas method was the only method to give a lower estimate in the younger age group (0.7% vs 0.8%), suggesting that it was the only method that adjusted appropriately for the marked effect of BCG-attributable induration in the very young.

Direct comparison of Neuroform and Enterprise stents in the treatment of wide-necked intracranial aneurysms.

AIM: To compare the complications and outcomes of Neuroform and Enterprise stents in the treatment of unruptured wide-necked aneurysms. MATERIALS AND METHODS: Under the auspices of the institutional review board, a review of a prospectively collected patient log identified 130 patients who underwent elective stent-assisted coil embolization of a wide-necked aneurysm, including 53 patients treated with an Enterprise stent and 77 patients treated with a Neuroform stent. Immediate and long-term clinical and radiographic outcomes were recorded for all patients. All patient data were handled in accordance with Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations. RESULTS: The technical success rate was 94%. Overall morbidity was 15% with Enterprise stents and 3% with Neuroform stents (p = 0.020). However, the type of stent used was not predictive of clinical outcomes as measured by the modified Rankin scale. In a multivariate analysis, the use of a Neuroform stent was one of the predictors of retreatment (p = 0.034). CONCLUSION: Multivariate analyses identified the use of Neuroform stents as an independent predictor of the need for retreatment and the use of Enterprise stents as an independent predictor of morbidity. However, the type of stent was not predictive of clinical outcome as measured by the modified Rankin scale.

Heart valve service provision in the United Kingdom and the effect of the COVID 19 pandemic; improved but must do better. A British Heart Valve Society national survey.

BACKGROUND: Outpatient care for patients with heart valve disease (HVD) is best provided by valve clinics delivered by specialists. Modern day practice in the United Kingdom (UK) is currently poorly understood and has not been evaluated for nearly a decade. Furthermore, the COVID 19 pandemic changed the management of many chronic diseases, and how this has impacted patients with heart valve disease is unclear. METHODS: A British Heart Valve Society survey was sent to 161 hospitals throughout the UK. RESULTS: There was a general valve clinic in 46 of the 68 hospitals (68%), in 19 of 23 Heart Centres (83%) and 29 of 45 DGHs (64%). Across all settings, 3824 new patients and 17,980 follow up patients were seen in valve clinics per annum. The mean number of patients per hospital were 197 (median 150, range 48-550) for new patients and 532 (median 400, range 150-2000) for follow up. On the day echocardiography was available in 55% of valve clinics. In patients with severe HVD, serum brain natriuretic peptide (BNP) was measured routinely in 39% of clinics and exercise testing routinely performed in 49% of clinics. A patient helpline was available in 27% of clinics. 78% of centres with a valve clinic had a valve multidisciplinary team meeting (MDT). 45% centres had an MDT co-ordinator and MDT outcomes were recorded on a database in 64%. COVID-19 had a major impact on valve services in 54 (95%) hospitals. CONCLUSIONS: There has been an increase in the number of valve clinics since 2015 from 21 to 68% but the penetration is still well short of the expected 100%, meaning that valve clinics only serve a small proportion of patients requiring surveillance for HVD. COVID-19 had a major impact on the care of patients with HVD in the majority of UK centres surveyed.

Participation of cAMP-dependent protein kinase and MAP kinase pathways during Anabas testudineus oocyte maturation.

Possible involvement of cyclic nucleotide dependent protein kinase (PKA) and MAP kinase (MAPK) pathways during oocyte maturation in Anabas testudineus was investigated. Pre-incubation with phosphodiesterase (PDE) inhibitor, 3-isobutyl-1-methylxanthine (IBMX), inhibited 17α, 20ß-DHP-induced GVBD dose dependently. PKA inhibitor, H89 could induce resumption of meiosis independent of 17α, 20ß-DHP, in dose and duration dependent manner. The maximum response was obtained with the dose of 10 µM of H89 and 95% of cells underwent GVBD within 18 h. Moreover, stimulation with 17α, 20ß-DHP inhibited endogenous PKA activity significantly within first hour and this effect was attenuated by PDE inhibitor IBMX at all time points. The pattern of PKA inhibition corresponded well with kinetics of histone H1 kinase activation and p34cdc2 phosphorylation. These results suggest physiological relevance of cAMP/PKA signaling in perch oocytes undergoing G2/M transition. MAPK was demonstrated as two distinct isoforms (ERK1 and ERK2) which resolved in the range of 42-44 kDa in immunoblot. Though total protein content did not show significant variation, H89 stimulation was able to stimulate phosphorylation of ERK1/2 from 5h onwards and the strongest response was observed between 10 and 18 h. MEK inhibitor, U0126 completely blocked PKA inhibition induced MAPK activation and GVBD. In addition, inhibition of endogenous PKA by a more selective peptide inhibitor [PKI-(6-22)-amide] was sufficient to resume GVBD and MAPK activation in intact perch oocytes. Also, significant ERK1/2 phosphorylation could be stimulated in cell-free extracts of perch oocytes supplemented with PKI-(6-22)-amide. The results suggest an interaction between cAMP/PKA and MAPK pathways in mediating meiosis resumption in perch oocyte.

Quality of 4-hourly ejaculates--levels of calcium and magnesium.

A four-hourly ejaculation study was conducted in which eleven normal healthy subjects participated. Five of them discontinued after submitting three samples. One alone was present for submission at the end of 16 h (fifth ejaculate), which was his last submission. Physical exhaustion was the sole reason for all participants for their discontinuation from the study. The result showed a decrease in semen volume and sperm count from first to last ejaculate. The increase in motility was probably due to reduction in exposure time to sperm motility inhibitory factors. In general, total motile spermatozoa as well as actively motile spermatozoa progressively increased from first to last ejaculate at the cost of sluggish spermatozoa. A significant increase in seminal plasma calcium and magnesium was seen as well as a significant increase in magnesium inside the cell from the first to the fourth ejaculate. Considering the quality of semen, which was good in sperm count and excellent in motility, calcium and magnesium may be helpful in cleaning motility inhibitory factors of spermatozoa.

Modeling and analysis of soybean (Glycine max. L) Cu/Zn, Mn and Fe superoxide dismutases.

Superoxide dismutase (SOD, EC 1.15.1.1) is an important metal-containing antioxidant enzyme that provides the first line of defense against toxic superoxide radicals by catalyzing their dismutation to oxygen and hydrogen peroxide. SOD is classified into four metalloprotein isoforms, namely, Cu/Zn SOD, Mn SOD, Ni SOD and Fe SOD. The structural models of soybean SOD isoforms have not yet been solved. In this study, we describe structural models for soybean Cu/Zn SOD, Mn SOD and Fe SOD and provide insights into the molecular function of this metal-binding enzyme in improving tolerance to oxidative stress in plants.

Relation between Acute Ischemic Stroke and Left Ventricular Systolic Dysfunction.

Stroke is one of the leading causes of mortality and morbidity all over the world. The economic cost for stroke disability and post stroke rehabilitation is a growing concern. Ischemic stroke comprises 80.0 - 85.0% of total stroke cases caused by thrombotic or embolic occlusion of cerebral arteries. The source of embolism may be a larger artery or cardiac. Overt heart failure is an independent predictor of long term unfavorable functional outcome in stroke patients. However, there is little research whether the acute ischemic stroke risk is associated with mild to moderate degree of Left Ventricular Systolic Dysfunction (LVSD). This study was aimed to investigate the relation between LVSD and acute ischemic stroke (AIS) and to evaluate the relation between left ventricular systolic dysfunction and severity of neurological deficits after acute ischemic stroke. This case-control study was carried out in the Department of Neurology and Department of Medicine, Mymensingh Medical College and Hospital, Bangladesh from January 2019 to December 2020. One hundred twenty (120) patients of first ever AIS and 120 age and sex matched apparently healthy controls were enrolled in the study. Severity of stroke was measured by National Institute of Health Stroke Scale (NIHSS). Left ventricular (LV) systolic function was assessed by transthoracic 2-dimensional echocardiography. Mean±SD age was 58.23±9.34 years and 55.92±9.72 years respectively in cases and controls. Male to female ratio was 1.86:1. Left ventricular systolic dysfunction of any degree was more frequent in stroke patients (23.3%) than in controls (5.8%; p<0.001). The mean±SD of LVEF were 59.21±9.68 and 63.54±6.84 among case and control groups respectively. Mild LV dysfunction was observed 16.7% in AIS patients and 5.8% in control group. Moderate LV dysfunction was found in 6.7% in AIS patients. Participants with mild LVSD had significantly higher odds of being in the cases compared to participants with no LVSD (OR: 3.48; 95% CI: 1.41-8.59). Similarly, participants with moderate LVSD were 9.74 times more likely to be in ischemic stroke group compared to participants with no LVSD (OR: 9.74; 95% CI:1.19-19.29). LVSD was associated with AIS even after adjusting for other stroke risk factors (OR: 2.7462; 95CI for OR: 1.0204, 7.3906; p=0.0435). The NIHSS was significantly negatively correlated with LVEF (r=-0.443; p<0.001). The study may conclude that Left ventricular systolic dysfunction of mild to moderate degree, is associated with acute ischemic stroke. AIS patients with higher neurological deficit also had lower LVEF.

Concordance of three approaches for operationalizing outcome definitions for multidrug-resistant TB.

BACKGROUND: The WHO provides standardized outcome definitions for rifampicin-resistant (RR) and multidrug-resistant (MDR) TB. However, operationalizing these definitions can be challenging in some clinical settings, and incorrect classification may generate bias in reporting and research. Outcomes calculated by algorithms can increase standardization and be adapted to suit the research question. We evaluated concordance between clinician-assigned treatment outcomes and outcomes calculated based on one of two standardized algorithms, one which identified failure at its earliest possible recurrence (i.e., failure-dominant algorithm), and one which calculated the outcome based on culture results at the end of treatment, regardless of early occurrence of failure (i.e., success-dominant algorithm).METHODS: Among 2,525 patients enrolled in the multi-country endTB observational study, we calculated the frequencies of concordance using cross-tabulations of clinician-assigned and algorithm-assigned outcomes. We summarized the common discrepancies.RESULTS: Treatment success calculated by algorithms had high concordance with treatment success assigned by clinicians (95.8 and 97.7% for failure-dominant and success-dominant algorithms, respectively). The frequency and pattern of the most common discrepancies varied by country.CONCLUSION: High concordance was found between clinician-assigned and algorithm-assigned outcomes. Heterogeneity in discrepancies across settings suggests that using algorithms to calculate outcomes may minimize bias.

Outcomes of WHO-conforming, longer, all-oral multidrug-resistant TB regimens and analysis implications.

BACKGROUND: Evidence of the effectiveness of the WHO-recommended design of longer individualized regimens for multidrug- or rifampicin-resistant TB (MDR/RR-TB) is limited.OBJECTIVES: To report end-of-treatment outcomes for MDR/RR-TB patients from a 2015-2018 multi-country cohort that received a regimen consistent with current 2022 WHO updated recommendations and describe the complexities of comparing regimens.METHODS: We analyzed a subset of participants from the endTB Observational Study who initiated a longer MDR/RR-TB regimen that was consistent with subsequent 2022 WHO guidance on regimen design for longer treatments. We excluded individuals who received an injectable agent or who received fewer than four likely effective drugs.RESULTS: Of the 759 participants analyzed, 607 (80.0%, 95% CI 77.0-82.7) experienced successful end-of-treatment outcomes. The frequency of success was high across groups, whether stratified on number of Group A drugs or fluoroquinolone resistance, and ranged from 72.1% to 90.0%. Regimens were highly variable regarding composition and the duration of individual drugs.CONCLUSIONS: Longer, all-oral, individualized regimens that were consistent with 2022 WHO guidance on regimen design had high frequencies of treatment success. Heterogeneous regimen compositions and drug durations precluded meaningful comparisons. Future research should examine which combinations of drugs maximize safety/tolerability and effectiveness.

Effect of prolonged storage of seminal plasma on levels of calcium and magnesium.

BACKGROUND: In laboratories, the semen or seminal plasma samples are stored before estimation of different elements without knowing the adverse effect of storing. The present study shows the levels of Ca⁺⁺ and Mg⁺⁺ in the seminal plasma before and after the storage. METHODS: Atomic absorption spectrophotometry (AAS) was used for estimating calcium and magnesium levels in the seminal plasma. Samples were stored for one year in different containers such as polyethylene, plastic, ordinary glass, and borosil glass. Calcium and magnesium levels were estimated after this period by AAS. The total area in contact with containers was considered in the final calculation. RESULTS: After 1-year storage, the levels of calcium and magnesium had changed. The most suitable container for storage of calcium was ordinary glass (P > 0.05) whereas ordinary glass (P > 0.05), polyethylene (P > 0.05), and borosil glass (P > 0.05) are the most suitable for magnesium. CONCLUSION: In any elemental study, the most suitable containers are recommended for storage of the semen/seminal plasma samples.

Genotoxic potential of arsenic at its reference dose.

Arsenic, a highly hazardous contaminant in our drinking water, accounts for various toxic effects (including cancer) in human. However, intake of arsenic @0.3 µg kg(-1)day(-1) through drinking water, containing arsenic at its guideline value or maximum contaminant limit (10 µg L(-1)), has been estimated to pose very little or no measurable risk to cancer in humans. The value also appears to be equal to the human reference dose (or index dose) of arsenic based on human skin toxicity data. The present work was a quantitative assessment of the genotoxic potential of arsenic in mice at doses equivalent to its human reference dose as well as its multiples. Significant increases in the frequencies of chromosome abnormalities in the bone marrow cells were registered over the control level upon exposure to all the doses of arsenic including its reference dose (or index dose). The assessment of arsenic genotoxicity in humans at low doses will therefore be highly instrumental in establishing a permissible limit of arsenic in drinking water.

Central nervous system dysfunction in a mouse model of FA2H deficiency.

Fatty acid 2-hydroxylase (FA2H) is responsible for the synthesis of myelin galactolipids containing hydroxy fatty acid (hFA) as the N-acyl chain. Mutations in the FA2H gene cause leukodystrophy, spastic paraplegia, and neurodegeneration with brain iron accumulation. Using the Cre-lox system, we developed two types of mouse mutants, Fa2h(-/-) mice (Fa2h deleted in all cells by germline deletion) and Fa2h(flox/flox) Cnp1-Cre mice (Fa2h deleted only in oligodendrocytes and Schwann cells). We found significant demyelination, profound axonal loss, and abnormally enlarged axons in the CNS of Fa2h(-/-) mice at 12 months of age, while structure and function of peripheral nerves were largely unaffected. Fa2h(-/-) mice also exhibited histological and functional disruption in the cerebellum at 12 months of age. In a time course study, significant deterioration of cerebellar function was first detected at 7 months of age. Further behavioral assessments in water T-maze and Morris water maze tasks revealed significant deficits in spatial learning and memory at 4 months of age. These data suggest that various regions of the CNS are functionally compromised in young adult Fa2h(-/-) mice. The cerebellar deficits in 12-month-old Fa2h(flox/flox) Cnp1-Cre mice were indistinguishable from Fa2h(-/-) mice, indicating that these phenotypes likely stem from the lack of myelin hFA-galactolipids. In contrast, Fa2h(flox/flox) Cnp1-Cre mice did not show reduced performance in water maze tasks, indicating that oligodendrocytes are not involved in the learning and memory deficits found in Fa2h(-/-) mice. These findings provide the first evidence that FA2H has an important function outside of oligodendrocytes in the CNS.

Integrated tuberculosis and HIV care in a resource-limited setting: experience from the Martin Preuss centre, Malawi.

OBJECTIVES: To describe the development and operation of integrated tuberculosis (TB) and HIV care at the Martin Preuss Centre, a multipartner organization bringing together governmental and non-governmental providers of HIV and TB services in Lilongwe, Malawi. METHODS: We used a case study approach to describe the integrated TB/HIV service and to illustrate successes and challenges faced by service providers. We quantified effective TB and HIV integration using indicators defined by the World Health Organization. RESULTS: The custom-designed building facilitates patient flow and infection control, and other important elements include coordinated leadership; joint staff training and meetings; and data systems prompting coordinated care. Some integrated services have worked well from the outset, such as promoting HIV testing among patients with TB (96% of patients with TB had documented HIV status in 2009). Other aspects of integrated care have been more challenging, for example achieving high uptake of antiretroviral therapy among HIV-positive TB patients and combining data from paper and electronic systems. Good TB treatment outcomes (>85% cure or completion) have been achieved among both HIV-positive and HIV-negative individuals. CONCLUSIONS: High-quality integrated services for TB and HIV care can be provided in a resource-limited setting. Lessons learned may be valuable for service providers in other settings of high HIV and TB prevalence.

QSPR modelling for investigation of different properties of aminoglycoside-derived polymers using 2D descriptors.

The quantitative structure-property relationship (QSPR) method is commonly used to predict different physicochemical characteristics of interest of chemical compounds with an objective to accelerate the process of design and development of novel chemical compounds in the biotechnology and healthcare industries. In the present report, we have employed a QSPR approach to predict the different properties of the aminoglycoside-derived polymers (i.e. polymer DNA binding and aminoglycoside-derived polymers mediated transgene expression). The final QSPR models were obtained using the partial least squares (PLS) regression approach using only specific categories of two-dimensional descriptors and subsequently evaluated considering different internationally accepted validation metrics. The proposed models are robust and non-random, demonstrating excellent predictive ability using test set compounds. We have also developed different kinds of consensus models using several validated individual models to improve the prediction quality for external set compounds. The present findings provide new insight for exploring the design of an aminoglycoside-derived polymer library based on different identified physicochemical properties as well as predict their property before their synthesis.

Determination of antioxidant capacity and flavonoid composition of onion (Allium cepa L.) landrace 'Krishnapuram' bulb using HPLC-ESI-ITMS.

This study reports for the first-time antioxidant activity and flavonoid composition of KP onion landrace which is useful for future breeding programs and to obtain geographical indication (GI) tag for the benefit of farmers. The present study was aimed to determine antioxidant capacity and flavonoid composition of bulbs of red onion (Allium cepa L.) landrace 'Krishnapuram' (KP) from India using high-performance liquid chromatography (HPLC)-Electrospray Ionization (ESI)-multistage Ion Trap Mass Spectrometry (ITMS). The antioxidant activity was assayed by Ferric Reducing Antioxidant Power (FRAP) and hypochlorous acid (HClO)-induced oxidative damage in human erythrocytes. The total phenolic (TPC) contents in KP onion bulb extract (with 80% methanol) found to be 1.10 ± 0.2 mg GAE/g FW and 38.88 ± 1.0 lM QE/g. The FRAP activity measured for the bulb extract was 13.20 ± 0.1 µM QE/g. KP onion bulb extracts protected red blood cells (RBC) effectively (23%) against the oxidative damage induced by HClO. HPLC-ESI-ITMS analysis showed the presence of eight flavonols and five anthocyanins. Quercetin 3,4' -O-diglucoside (384.71 ± 0.49 mg/kg FW) and cyanidin 3-(6″-malonylglucoside) (20.95 ± 0.60 mg/kg FW) were detected as major flavonol and anthocyanin, respectively. The study suggests that KP onion has a considerable antioxidant activity due to the presence of high TPC. Moreover, quercetin glucosides are found to be more abundant than quercetin. The differences in quercetin glycosides content among different red onions could be useful for breeding programmes in the future.

The impact of changing the diagnostic algorithm for TB in Manicaland, Zimbabwe.

SETTING: Governmental health facilities performing TB diagnostics in Manicaland, Zimbabwe. OBJECTIVE: To investigate the effect of making Xpert® MTB/RIF the primary TB diagnostic for all patients presenting with presumptive TB on 1) the number of samples investigated for TB, 2) the proportion testing TB-positive, and 3) the proportion of unsuccessful results over time. DESIGN: This retrospective study used data from GeneX-pert downloads, laboratory registers and quality assurance reports between 1 January 2017 and 31 December 2018. RESULTS: The total number of Xpert tests performed in Manicaland increased from 3,967 in the first quarter of 2017 to 7,011 in the last quarter of 2018. Mycobacterium tuberculosis DNA was detected in 4.9-8.6% of the samples investigated using Xpert, with a higher yield in 2017 than in 2018. The overall proportion of unsuccessful Xpert assays due to "no results", errors and invalid results was 6.3%, and highly variable across sites. CONCLUSION: Roll out of more sensitive TB diagnostics does not necessarily result in an increase of microbiologically confirmed TB diagnosis. While the number of samples tested using Xpert increased, the proportion of TB-positive tests decreased. GeneXpert soft- and hardware infrastructure needs to be strengthened to reduce the rate of unsuccessful assays and therefore, costs and staff time.

LIEU: Centres de soins gouvernementaux réalisant des tests diagnostiques de la TB au Manicaland, Zimbabwe. OBJECTIF: Analyser l'effet de l'utilisation du test Xpert® MTB/RIF en tant que test diagnostique principal de la TB chez tous les patients suspects de TB sur 1) le nombre d'échantillons analysés pour TB, 2) la proportion d'échantillons testés positifs à la TB et 3) la proportion de résultats infructueux au fil du temps. MÉTHODE: Cette étude rétrospective a utilisé les données extraites du système GeneXpert, des registres de laboratoire et des rapports d'assurance qualité entre le 1er janvier 2017 et le 31 décembre 2018. RÉSULTATS: Le nombre total de tests Xpert réalisés au Manicaland a augmenté, de 3 967 au premier trimestre 2017 à 7 011 au dernier trimestre 2018. L'ADN de Mycobacterium tuberculosis a été détecté dans 4,9­8,6% des échantillons analysés par test Xpert, avec un rendement plus élevé en 2017 qu'en 2018. La proportion globale de tests Xpert infructueux en raison d'une « absence de résultat ¼, d'erreurs ou de résultats non valides était de 6,3%, avec une forte variation en fonction des sites. CONCLUSION: Le déploiement de tests diagnostiques de la TB plus sensibles n'entraîne pas nécessairement une hausse des diagnostics de TB confirmés microbiologiquement. Alors que le nombre d'échantillons testés par test Xpert a augmenté, la proportion de tests positifs pour la TB a diminué. L'infrastructure du matériel et du logiciel GeneXpert doit être renforcée pour réduire le taux de tests infructueux, et donc les coûts et le temps consacré par le personnel à la réalisation de ces tests.