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Objective: To Compare performance of combined creatinine and cystatin C-based equation with equations based on either cystatin C or creatinine alone, in early chronic kidney disease. Design: Diagnostic accuracy study. Setting: Tertiary-care hospital. Patients: One hundred children with chronic kidney disease who underwent 99mTc diethylenetriamine pentaacetic acid (DTPA) glomerular filtration rate measurement. Methods: Estimating equations for glomerular filtration rate (GFR) based on serum cystatin C alone and in combination with serum creatinine were generated using regression analyses. These equations and the creatinine-based equation [0.42 × height/creatinine] were validated in 42 children with glomerular filteration rate between 60 and 90 mL/min/1.73 m. Bias, precision and accuracy of estimating equations using DTPA glomerular filteration rate as gold standard. Results: Cystatin C-based equation (GFR=96.9-30.4 x cystatin) overestimated while the combined cystatin C-and creatininebased equation [GFR=11.45 x (height/creatinine) 0.356 x (1/cystatin) 0.188] underestimated the measured GFR. Cystatin Cbased equation had less bias (1.9 vs. 12.4 ml/min/1.73 m), and higher precision (13.1 vs. 25.6 mL/min/1.73 m) and accuracy (92.1% vs. 75.7%) than creatinine-based equation. The combined cystatin C and creatinine equation had bias (−1.4 mL/ min/1.73 m) precision (15.2 mL/min/1.73 m) and accuracy (91.2%) similar to cystatin C-based equation. Conclusions: Cystatin C-based equation has a better performance in estimating glomerular filtration rate than creatinine-based equation in children with early chronic kidney disease. Addition of creatinine equation does not improve the performance of the cystatin C-based equation. [ABSTRACT FROM AUTHOR]

Electrostatic ion cyclotron waves are excited by axial ion beam in a dusty plasma via Cerenkov and slow cyclotron interaction. The dispersion relation of the instability is derived in the presence of positively/negatively charged dust grains. The minimum beam velocity needed for the excitation is estimated for different values of relative density of negatively charged dust grains. It is shown that the minimum beam velocity needed for excitation increases as the charge density carried by dust increases. Temperature of electrons and ions, charge and mass of dust grains, external static magnetic field and finite boundary of dusty plasma significantly modify the dispersion properties of these waves and play a crucial role in the growth of resonant ion cyclotron instability. The ion cyclotron modes with phase velocity comparable to the beam velocity possess a large growth rate. The maximum value of growth rate increases with the beam density and scales as the one-third power of the beam density in Cerenkov interaction and is proportional to the square root of beam density in slow cyclotron interaction. [ABSTRACT FROM AUTHOR]

Lower hybrid wave excitation in magnetized plasma by an ion beam via Cerenkov interaction is studied. The lower hybrid modes showed maximum growth rate of the instability when phase velocity of the lower hybrid mode along the magnetic field is comparable to the electron thermal velocity. We have derived the expression for the maximum growth rate and found that the growth rate of the instability increases with beam density. Moreover, the maximum growth rate of the instability scales as the one-third power of the beam density. The real part of the frequency of the unstable wave increases as almost the square root of the beam energy. [ABSTRACT FROM PUBLISHER]

This paper studies the surface plasma wave excitation via Cerenkov and fast cyclotron interaction by a density modulated electron beam propagating through a magnetized dusty plasma cylinder. The dispersion relation of surface plasma waves has been derived and it has been shown that the phase velocity of waves increases with increase in relative density δ(= nio/ne0, where ni0 is the ion plasma density and ne0 is the electron plasma density) of negatively charged dust grains. The beam radius is taken slightly less than the radius of dusty plasma cylinder. The frequency and the growth rate of the unstable wave instability increases with increase in the value of δ and normalized frequency ω/ωpe. The growth rate of the instability increases with the beam density and scales as one-third power of the beam density in Cerenkov interaction and square root of beam density in fast cyclotron interaction. The dispersion relation of surface plasma waves has been retrieved from the derived dispersion relation by considering that the beam is absent and there are no dust grains in the plasma cylinder. [ABSTRACT FROM PUBLISHER]

An ion beam drives lower hybrid waves to instability in a magnetized dusty plasma via Cerenkov interaction. A dispersion relation and the growth rate of the lower hybrid waves have been derived taking into account the dust charge fluctuations. The frequency and the growth rate of the unstable wave instability increase with relative density of negatively charged dust grains. The lower hybrid modes with phase velocity comparable to the beam velocity possess a large growth rate. Moreover, the growth rate of the instability increases with beam density and scales as the one-third power of the beam density. [ABSTRACT FROM AUTHOR]

An electron beam propagating through a magnetized dusty plasma drives electrostatic lower hybrid waves to instability via Cerenkov interaction. A dispersion relation and the growth rate of the instability for this process have been derived taking into account the dust charge fluctuations. The frequency and the growth rate of the unstable wave increase with the relative density of negatively charged dust grains. Moreover, the growth rate of the instability increases with beam density and scales as the one-third power of the beam density. In addition, the dependence of the growth rate on the beam velocity is also discussed. [ABSTRACT FROM AUTHOR]

Abstract: Independent and combined effects of 2g/d long chain omega-3 fatty acids (omega-3) from fish oil (capsules) and 2g/d plant sterol (yogurt drink) on LDL-C and non-HDL-C levels in Indian subjects were compared. Following a 2-week run-in period, 200 mildly hypercholesterolemic (total cholesterol 5.0–8.0mmol/l) adults (35–55years) were randomized into one of four groups [(1) both placebo (2) active omega-3 (3) active plant sterol (4) both active] of a 2×2 factorial, double-blind, placebo-controlled trial. Blood samples were obtained before and after the 4-week intervention (n =178). Lipid levels were analyzed using ANCOVA models with relevant baseline measurements as covariates; adjusted means were compared across groups. While plant sterols significantly lowered LDL-C (−4.5%; P =0.017) and non-HDL-C (−7.9%; P =0.0019) levels, omega-3 did not demonstrate any such impact. The combination resulted in 4.2% and 3.9% reduction (non-significant), respectively. Thus, the beneficial effects of the omega-3-PS combination on lipid levels demonstrated earlier (lowered triacylglycerols by 15%, increased HDL-C by 5.4%) in addition to the present findings could make this combination a useful alternative for lowering coronary heart disease risk in Indian adults. [Copyright &y& Elsevier]

Background: Dried blood may be a convenient method of sample collection in epidemiological studies; however, the method needs evaluation in a field settings. In the present study, feasibility of using dried blood for measurement of cholesterol and triglycerides was evaluated in multicenter surveillance study for noncommunicable disease (NCD). Methods: Samples were collected in a cross-sectional study for NCD risk factor surveillance conducted in six centers in India. For every tenth subject recruited, a blood sample was also collected on filter paper. These 10% serum samples and dried blood spots were analyzed for cholesterol and triglycerides. Results: The mean coefficient of variation (CV) for cholesterol was less than 10% between dried blood and serum in five of the six participating centers. Only one center showed a high CV of 14%. Similarly, the mean bias was less than 10% in five centers. The intraclass correlation between cholesterol values in dried blood and serum were greater than 0.638 in all centers, which suggests a good homogeneity of results. The mean CV for triglycerides ranged from 0.36% to 17.97%. The intraclass correlation between triglyceride values in dried blood and serum ranged from 0.756 to 0.880 in the six centers. Conclusion: In conclusion, dried blood would be a good method for collection of blood for measurement of cholesterol and triglycerides for population health surveys. However, the benefits of blood spot analysis should be weighed against potential sources of errors attributable to sampling and other factors, such as temperature and humidity, in a country like India. [Copyright &y& Elsevier]

Abstract: Aim: To determine the glycosylated haemoglobin (HbA1c) cut-points for diabetes and impaired fasting glucose (IFG) among Asian Indians. Methods: Participants (n =525) were a random sample selected from the India Health Study. Based on history and fasting plasma glucose (FPG), participants were classified into known diabetes, newly diagnosed diabetes (NDD), impaired fasting glucose (IFG) [ADA and WHO criteria] or normal fasting glucose (NFG). Receiver Operating Characteristic curves were used to identify the optimum sensitivity and specificity for defining HbA1c cut-points for NDD and IFG against the FPG criteria. Results: There were 64 participants with a known history of diabetes. Of the remaining 461, IFG was present in 44.7% (ADA) and 18.2% (WHO), and 10.4% were NDD. Mean HbA1c were 5.4 (±0.04)% for NFG; 5.7 (±0.06)% among IFG-ADA, 5.8 (±0.09)% among IFG-WHO; 7.5 (±0.33)% for NDD and 8.4 (±0.32)% for known diabetes. Optimal HbA1c cut-point for NDD was 5.8% (sensitivity=75%, specificity=75.5%, AUC=0.819). Cut-point for IFG (ADA) was 5.5% (sensitivity=59.7%, specificity=59.9%, AUC=0.628) and for IFG (WHO) was 5.6% (sensitivity=60.7%, specificity=65.1%, AUC=0.671). Conclusion: In this study population from north and south regions of India, the HbA1c cut-point that defines NDD (≥5.8%) was much lower than that proposed by an international expert committee and the American Diabetes Association (≥6.5%). A cut-point of ≥5.5% or ≥5.6% defined IFG, and was slightly lower than the ≥5.7% for high risk proposed, but accuracy was less than 70%. [Copyright &y& Elsevier]

Introduction: Inflammation, the key regulator of C-reactive protein (CRP) synthesis, plays a pivotal role in atherothrombotic cardiovascular disease. Methods: High sensitivity CRP (hsCRP) analysis was carried out in randomly selected 600 individuals from the sentinel surveillance study in Indian industrial population (SSIP). The hsCRP was measured quantitatively by turbid metric test using kits from SPINREACT, Spain. We analyzed the association between hsCRP and traditional CVD risk factors in this sub-sample. Results: Complete risk factor data and CRP levels were available from 581/600 individuals. One half (51.2%) of the study subjects were males. Mean age of the study group was 39.2 ± 11.2 years. The Pearson correlation coefficients were in the range of 0.12 for SBP (p = 0.004) to 0.55 for BMI (p < 0.001). The linear regression coefficients ranged from 0.01 for SBP, PG and TC (p < 0.001) to 0.55 for logeTAG (p < 0.001) after adjustment for age, sex and education. The mean of logehsCRP significantly increased (P < 0.001) from individuals with ≤1 risk factors (-0.50) to individuals with three or more risk factors (0.60). In the multivariate model, the odds ratios for elevated CRP (CRP ≥ 2.6 mg/dl) were significantly elevated only in females in comparison to males (1.63, 95% CI; 1.02-2.58), overweight individuals in comparison to normal weight individuals (3.90, 95% CI; 2.34-6.44, p < 0.001), and abdominal obese individuals (1.62, 95% CI; 1.02-2.60, p = 0.04) in comparison to non-obese individuals. Conclusion: Clinical measurements of adiposity (body mass index and abdominal obesity) correlate well and can be surrogate for systemic inflammatory state of individuals. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the trends, proportions, risk factors, resource utilization, and outcomes of neonatal birth trauma in the US.Study Design: This cross-sectional study of in-hospital births used the Nationwide Inpatient Sample for 2006-2014. We divided the cases by type of birth trauma: scalp injuries and major birth trauma. Linear regression for yearly trends and logistic regression were used for risk factors and outcomes. A generalized linear model was used, with a Poisson distribution for the length of stay and a gamma distribution for total spending charges.Results: A total of 982 033 weighted records with neonatal birth trauma were found. The prevalence rate increased by 23% from (from 25.3 to 31.1 per 1000 hospital births). Scalp injuries composed 80% of all birth traumas and increased yearly from 19.87 to 26.46 per 1000 hospital births. Major birth trauma decreased from 5.44 to 4.67 per 1000 hospital births due to decreased clavicular fractures, brachial plexus injuries, and intracranial hemorrhage. There were significant differences in demographics and risk factors between the 2 groups. Compared with scalp injuries, major birth trauma was associated with higher odds of hypoxic-ischemic encephalopathy, seizures, need for mechanical ventilation, meconium aspiration, and sepsis. Length of stay was increased by 56%, and total charges were almost doubled for major birth trauma.Conclusions: Neonatal birth trauma increased over the study period secondary to scalp injuries. Major birth trauma constitutes a significant health burden. Scalp injuries are also associated with increased morbidity and might be markers of brain injury in some cases. [ABSTRACT FROM AUTHOR]

[Display omitted] • (Carboxymethyl)-stevioside generated with increased hydrophilicity. • Carboxymethylation had no deteriorating effect on the biological property of stevioside. • The modification was conducive for increased heat generation on AMF exposure. • The nano-magnets were employed for repeated exposure to hyperthermia. • Magnetic dots exhibited an inhibitory effect on glioma cell migration. The use of different types of biomaterials as surfactant moities has a defined role in magnetic hyperthermia-mediated cancer therapy (MHCT). In this work, we present carboxymethyl-stevioside (CMS)-modified magnetic dots (MDs) as efficient magnetic hyperthermia agents for glioma therapy. The synthesized MDs with CMS biosurfactant coating exhibited significant water stability that resulted in a remarkable specific absorption rate of 209.25 W/g on application of alternating magnetic field of strength 359 kHz and 188 Oe. The MDs further demonstrated significant anti-migratory and anti-invasive effect on glioma C6 cells by inhibiting the gene expression of matrix metalloproteinases-2 and -9. The effect of immediate and long term hyperthermia treatment was then evaluated after repetitive exposure to hyperthermia, in terms of glioma cell viability, the effect of treatment on cell morphology, the cell cycle distribution and oxidative stress generation. The results obtained suggest the promising potential of CMS-modified nano-heaters for excellent magnetic hyperthermia-mediated glioma therapy. [ABSTRACT FROM AUTHOR]

Objective: Trans-fat, an invariable component of industrial fat is considered as one of the major dietary factors associated with CVD. Although the use of trans-fat is completely banned in some of the high-income countries where the CVD epidemic is declining, it is widely used in LMIC. We aimed to investigate the association of trans fatty acid in serum with risk markers of CVD in an industrial population in India. Participants were randomly selected from a study conducted in an industrial setting among employees and their family members. Information related to their demographic profile, anthropometric measurements, oil intake were recorded. Fasting samples were collected and stored at − 80 °C for analysis. Their lipid profile and hs CRP were measured and fatty acids analyzed using gas chromatography (GC) with flame ionization detector (FID). Results: Complete data was available for 176 participants. Among trans fatty acids, mono trans fatty acid was significant predictor of serum triglycerides [Unadjusted β (95% CI) 22.9 (2.6, 43.2); Adjusted β (95% CI) 20.4 (3.5, 37.3)]. None of the other trans fatty acids either individually or in group correlated with any of the biochemical markers studied. [ABSTRACT FROM AUTHOR]

Background Evidence suggests a role for elevated serum calcium in dysregulated glucose metabolism, linked through low-level chronic inflammation. Objectives We investigated the association of elevated serum calcium concentrations (corrected for albumin) with markers of dysregulated glucose metabolism and type II diabetes and tested if these associations were accounted for by chronic inflammation in a rural Indian population. Methods A cross-sectional analysis of participants aged 40–84 y from the Andhra Pradesh Children and Parents Study (APCaPS; n  = 2699, 52.2% women) was conducted. Comprehensive information on household, sociodemographic, and lifestyle factors; medical and family history; physical measurements; blood measurements including fasting plasma glucose (FPG), fasting insulin (FI), serum calcium, albumin, phosphorous, vitamin D (in a subset), and creatinine were analyzed. Additionally, in a random sample of healthy participants (n  = 1000), inflammatory biomarkers (interleukins 6 and 18, soluble intercellular adhesion molecule 1, adiponectin, and high-sensitivity C-reactive protein) were measured and an inflammatory score (IScore) calculated. Results After adjustments for sociodemographics, lifestyle factors, and anthropometry the highest calcium quartile (Q4 compared with Q1) was associated with FI (β = 1.4 µU/ml; 95% CI: 1.2, 1.5 µU/ml; P -trend < 0.001), the homeostasis model assessment for insulin resistance (HOMA-IR) (β = 1.4; 95% CI: 1.2, 1.5; P -trend < 0.001), and was modestly associated with FPG (β = 2.1 mg/dL; 95% CI: −0.9, 5.2 mg/dL; P -trend = 0.058) and prevalent type II diabetes (OR = 1.6; 95% CI: 1.0, 2.6; P -trend= 0.020). In the healthy subgroup, the association of the highest calcium quartile was similar for FI and HOMA-IR. Additional adjustment with IScore did not alter the associations. Further, in a subset, all these associations were independent of endogenous regulators of calcium metabolism (serum vitamin D, phosphorus, and creatinine). Independently, after accounting for potential confounders, the highest IScore quartile (Q4 compared with Q1) was positively associated with FPG, FI, HOMA-IR, and prevalent prediabetes, and also with serum calcium concentrations in men. Conclusions Elevated serum calcium was positively associated with markers of dysregulated glucose metabolism and prevalent type II diabetes in a rural Indian population. Chronic inflammation did not mediate this association but was independently associated with markers of dysregulated glucose metabolism. Inflammation might be responsible for elevated serum calcium concentrations in men. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests a strong association between nutrition during the first 1000 days (conception to 2 years of life) and cognitive development. Maternal docosahexaenoic acid (DHA) supplementation has been suggested to be linked with cognitive development of their offspring. DHA is a structural component of human brain and retina, and can be derived from marine algae, fatty fish and marine oils. Since Indian diets are largely devoid of such products, plasma DHA levels are low. We are testing the effect of pre- and post-natal DHA maternal supplementation in India on infant motor and mental development, anthropometry and morbidity patterns.Methods: DHANI is a double-blinded, parallel group, randomized, placebo controlled trial supplementing 957 pregnant women aged 18-35 years from ≤20 weeks gestation through 6 months postpartum with 400 mg/d algal-derived DHA or placebo. Data on the participant's socio-demographic profile, anthropometric measurements and dietary intake are being recorded at baseline. The mother-infant dyads are followed through age 12 months. The primary outcome variable is infant motor and mental development quotient at 12 months of age evaluated by Development Assessment Scale in Indian Infants (DASII). Secondary outcomes are gestational age, APGAR scores, and infant anthropometry. Biochemical indices (blood and breast-milk) from mother-child dyads are being collected to estimate changes in DHA levels in response to supplementation. All analyses will follow the intent-to-treat principle. Two-sample t test will be used to test unadjusted difference in mean DASII score between placebo and DHA group. Adjusted analyses will be performed using multiple linear regression.Discussion: Implications for maternal and child health and nutrition in India: DHANI is the first large pre- and post-natal maternal dietary supplementation trial in India. If the trial finds substantial benefit, it can serve as a learning to scale up the DHA intervention in the country.Trial Registration: The trial is retrospectively registered at clinicaltrials.gov ( NCT01580345 , NCT03072277 ) and ctri.nic.in ( CTRI/2013/04/003540 , CTRI/2017/08/009296 ). [ABSTRACT FROM AUTHOR]

In this paper, we investigate the impact of an external magnetic field on the Weibel instability driven by temperature anisotropy in a magnetized plasma. The study provides the influence of electron temperature anisotropy, considering both cold as well as warm ions. We derive expressions for the growth rate Γ (s−1) in each case to quantify the effect of some specific parameters on the instability. For example, the growth rate is plotted against the magnetic field for three distinct cases: considering only electrons, including cold ions, and incorporating warm ions. It is observed that the growth rate decreases as the applied magnetic field increases. Furthermore, the addition of both cold and warm ions to the plasma significantly influences the observed effects. It can be explained as follows: in the presence of cold ions, the growth rate is decreased with an increase in the wave number kz (cm−1). In addition, a decrease in the growth rate is observed with an increasing wave number in the case of warm ions. Therefore, it can be seen that the Weibel instability, propelled by thermal anisotropy, holds significant implications owing to its prevalence in both astrophysical and laboratory plasmas. The findings presented here are expected to contribute to the advancements in magnetic field generation and particle acceleration in various astrophysical phenomena, including gamma-ray bursts, relativistic collisionless shock fronts, radio supernovae, and pulsar winds. [ABSTRACT FROM AUTHOR]

Background: The lemongrass (LG) leaves could be a useful source of cellulose after its oil extraction, which is still either dumped or burned, not considered as a cost-effective approach. The synthesis of cellulose nanofibers (CNF) from LG waste has emerged as a beneficial alternative in the value-added applications. The non-toxicity, biodegradability, and biocompatibility of CNF have raised the interest in its manufacturing. Method: In the present study, we have isolated and characterized CNFs using enzymatic hydrolysis. We also explored the cytotoxic properties of the final material. The obtained products were characterized using dynamic light scattering (DLS), fourier transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), transmission electron microscopy (TEM), x-ray diffraction (XRD), and thermogravimetric/differential thermal gravimetric analysis (TG/DTG). The cytotoxicity of CNF was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay against three different cancer cell lines NCIH460, PA1, and L132 cells. Results: The FT-IR results showed that the resulting sample was of cellulose species, and CNF was found free from the non-cellulosic components like lignin and hemicellulose. The SEM micrographs of the cellulose showed a bundle like structure. The TEM micrographs of CNF showed diverse long fibers structure with 105.7 nm particle size analysed using DLS. The TGA analysis revealed that the thermal stability was slightly lower, compared to cellulose. Additionally, CNF did not show the cytotoxic effect at the tested concentrations (~10-1000 μg/ml) in any of the cell lines. Conclusion: Overall, the results concluded that LG waste-derived CNF is a potential sustainable material and could be employed as a favourable reinforcing agent or nanocarriers in diverse areas, mainly in food and drug delivery sectors. [ABSTRACT FROM AUTHOR]

Google Scholar Crossref Search ADS PubMed WorldCat 11 Enas EA, Mohan V, Deepa M, Farooq S, Pazhoor S, Chennikkara H. The metabolic syndrome and dyslipidemia among Asian Indians: a population with high rates of diabetes and premature coronary artery disease. Tablet-based questionnaires facilitate the easier acquisition of data (eliminates the transfer of data from paper forms to electronic databases), execution of skip patterns and application of instant data-checking rules. [Extracted from the article]

• Superparamagnetic Iron oxide nanoparticles (SPIONs) were synthesized using Pimenta dioica leaf extract. • In-vitro cytotoxicity assay on HeLa cells shows the biocompatibility of SPIONs. • SPIONs showed potential to be used as a green alternative of contrast agents for OCT. • Green synthesized SPIONs efficiently produced magnetic hyperthermia responses on HeLa, cancerous cells. A green chemistry-based approach to nanoparticle synthesis is an eco-friendly, simple, and cost-effective way to fabricate nanoparticles. This study aims at the biomedical applications of green synthesized near-infrared (NIR) active superparamagnetic iron oxide nanoparticles (SPIONs). The SPIONs obtained by the green synthesis route are non-toxic and their surface is free from any chemical impurity. The MTT [3-(4, 5-Dimethylthiazol-2-yl)-2, 5-Diphenyltetrazolium Bromide] assay was accomplished on human cervical cancer (HeLa) cells and shows that the SPIONs are biocompatible and thus safe for cells even at higher concentrations up to 500 μg/ml. The synthesized SPIONs display an absorbance in the tissue transparent NIR wavelength region. The SPIONs exhibit a superparamagnetic behavior with high saturation magnetization of 66 emu/g. Owing to their excellent optical and magnetic properties, the potential of these green synthesized SPIONs as an exogenous contrast agent in deep-tissue magnetomotive optical coherence tomography (MM-OCT) imaging was evaluated ex-vivo using chicken breast tissue. A significant enhancement in the contrast and the penetration depth was observed with time. The heating response of green synthesized SPIONs was evaluated under the application of an external magnetic field. The results suggest that these SPIONs could be used as theranostic agents for deep tissue biomedical imaging and therapeutic applications. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 is caused by severe acute respiratory syndrome coronavirus 2. Primarily an infection of the lower respiratory tract, it is now well known to cause multisystem abnormalities. Hematologic manifestations constitute a significant area of concern. Severe acute respiratory syndrome coronavirus 2 infects monocytes and endothelial cells leading to a complex downstream cascade, cytokine storm, and eventual intravascular thrombosis. Coronavirus disease 2019 causes lymphopenia, neutrophilia, and thrombocytopenia. Prophylactic anticoagulation is vital in patients with coronavirus disease 2019, as its effect on the coagulation system is associated with significant morbidity and mortality. The disease can cause both arterial and venous thromboses, especially pulmonary embolism and pulmonary microthrombi. A high index of suspicion is indispensable in recognizing these complications, and timely institution of therapeutic anticoagulation is vital in treating them. Virus-induced disseminated intravascular coagulation is uncommon but shares some similarities to sepsis-induced disseminated intravascular coagulation. Marked elevations in hematologic biomarkers such as lactate dehydrogenase, D-dimer, ferritin, and C-reactive protein are associated with worse outcomes. Understanding the pathophysiology and recognizing factors associated with poor prognosis are crucial in improving patient outcomes with coronavirus disease 2019. [ABSTRACT FROM AUTHOR]

Introduction: Most Indians are vegetarian or eat very little meat, which could imply high potassium intake. Because a high-potassium diet could counterbalance the adverse health effects of high-sodium intake, this study aimed to describe potassium relative to sodium intake and investigate the relationship between blood pressure and potassium intake relative to sodium intake in rural and urban India.Methods: Investigators collected 24-hour urines from 1,445 participants in a subset of 2 population-based surveys in North India in 2012-2013. Standardized questionnaires were used to collect information on demography, behaviors (tobacco, alcohol consumption, physical activity, and diet [food frequency and 24-hour recall]), and medical history. After evaluating expected versus measured creatinine excretion, the authors calculated median urine potassium excretion and sodium/potassium ratio, according to sex and urban or rural residence, and estimated least square means for the urine measures by participant demographics and comorbidities, after accounting for caloric intake. Two-year blood pressure follow-up data were available in the urban study, and ANCOVA regression was used to determine the association with urine measures. All the statistical analyses of the data were done in January 2019.Results: Acceptable 24-hour urine collections were available in 1,397 participants (rural, n=730). Median urine potassium excretions were 1,492 (IQR=1,012-2,063) and 975 (615-1,497) mg/day; sodium/potassium ratios met the recommended target of <1 in 2.9% rural and 6.6% urban participants. Rural participants did not have higher potassium or lower (better) sodium/potassium ratios when diagnosed with hypertension or other cardiovascular conditions. Higher potassium excretion was associated with lower blood pressure during follow-up among the urban participants (mean systolic blood pressure, 129 vs 133 mm Hg in highest vs lowest potassium excretion tertiles; p=0.029).Conclusions: Low potassium intake in India warrants dietary policies promoting intake of potassium-rich foods to improve heart health. This approach may be more acceptable than programs focused on sodium reduction alone. [ABSTRACT FROM AUTHOR]

Background: While data from the latter part of the twentieth century consistently showed that immigrants to high-income countries faced higher cardio-metabolic risk than their counterparts in low- and middle-income countries, urbanization and associated lifestyle changes may be changing these patterns, even for conditions considered to be advanced manifestations of cardio-metabolic disease (e.g., chronic kidney disease [CKD]). Methods and findings: Using cross-sectional data from the Center for cArdiometabolic Risk Reduction in South Asia (CARRS, n = 5294) and Mediators of Atherosclerosis in South Asians Living in America (MASALA, n = 748) studies, we investigated whether prevalence of CKD is similar among Indians living in Indian and U.S. cities. We compared crude, age-, waist-to-height ratio-, and diabetes- adjusted CKD prevalence difference. Among participants identified to have CKD, we compared management of risk factors for its progression. Overall age-adjusted prevalence of CKD was similar in MASALA (14.0% [95% CI 11.8–16.3]) compared with CARRS (10.8% [95% CI 10.0–11.6]). Among men the prevalence difference was low (prevalence difference 1.8 [95% CI -1.6,5.3]) and remained low after adjustment for age, waist-to-height ratio, and diabetes status (-0.4 [-3.2,2.5]). Adjusted prevalence difference was higher among women (prevalence difference 8.9 [4.8,12.9]), but driven entirely by a higher prevalence of albuminuria among women in MASALA. Severity of CKD—-i.e., degree of albuminuria and proportion of participants with reduced glomerular filtration fraction-—was higher in CARRS for both men and women. Fewer participants with CKD in CARRS were effectively treated. 4% of CARRS versus 51% of MASALA participants with CKD had A1c < 7%; and 7% of CARRS versus 59% of MASALA participants blood pressure < 140/90 mmHg. Our analysis applies only to urban populations. Demographic—-particularly educational attainment—-differences among participants in the two studies are a potential source of bias. Conclusions: Prevalence of CKD among Indians living in Indian and U.S. cities is similar. Persons with CKD living in Indian cities face higher likelihood of experiencing end-stage renal disease since they have more severe kidney disease and little evidence of risk factor management. [ABSTRACT FROM AUTHOR]

Magnetic nanocomposites are extensively used for biomedical applications such as drug delivery, diagnosis, and therapeutics, etc. Here we report a green synthesis of biocompatible, superparamagnetic, and near-infrared absorbing, iron oxide-gold composite nanoparticles (IO–Au NPs) using aqueous leaf extract of a medicinal plant Pimenta dioica for biomedical applications. The MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay was performed to assess the cytotoxicity of the IO-Au NPs in-vitro. Results of the MTT assay show that the green synthesized IO-Au NPs are safe for cells up to a high concentration of 500 μg/ml. The IO-AuNPs exhibit a superparamagnetic behavior with a large magnetization of 65 emu/g. These IO-Au NPs exhibit a high relaxivities ratio (r2/r1) of 13.20 (r1 = 10.67 s−1 mM−1 and r2 = 140.87 s−1 mM−1 respectively), indicating the potential of these IO-Au NPs as a T2 contrast agent. Magnetic resonance imaging of chicken tissue and poultry heart has been done to confirm the contrast enhancement performance of these nanoparticles. Moreover, the magnetic heating efficacy of the green synthesized IO-Au NPs has been evaluated in an external magnetic field. Owing to their excellent optical property, these green synthesized IO-Au NPs have great potential for NIR photothermal applications. The results of this study suggest that these IO-Au NPs could be used as theranostic agents for in-vivo biomedical imaging and therapeutics. • Superparamagnetic Iron oxide-gold composite nanoparticles (IO–Au NPs) were synthesized using Pimenta dioica leaf extract. • In-vitro cytotoxicity assay on HeLa cells shows the biocompatibility of IO-Au NPs. • IO-Au NPs showed potential to be used as a green alternative of contrast agents for MRI. • Green synthesized IO-Au NPs showed an excellent magnetic hyperthermia and photothermal therapeutic efficiency. [ABSTRACT FROM AUTHOR]

India is experiencing an alarming rise in the burden of noncommunicable diseases, but data on the incidence of chronic kidney disease (CKD) are sparse. Using the Center for Cardiometabolic Risk Reduction in South Asia surveillance study (a population-based survey of Delhi and Chennai, India) we estimated overall, and age-, sex-, city-, and diabetes-specific prevalence of CKD, and defined the distribution of the study population by the Kidney Disease Improving Global Outcomes (KDIGO) classification scheme. The likelihood of cardiovascular events in participants with and without CKD was estimated by the Framingham and Interheart Modifiable Risk Scores. Of the 12,271 participants, 80% had complete data on serum creatinine and albuminuria. The prevalence of CKD and albuminuria, age standardized to the World Bank 2010 world population, was 8.7% (95% confidence interval: 7.9-9.4%) and 7.1% (6.4-7.7%), respectively. Nearly 80% of patients with CKD had an abnormally high hemoglobin A1c (5.7 and above). Based on KDIGO guidelines, 6.0, 1.0, and 0.5% of study participants are at moderate, high, or very high risk for experiencing CKD-associated adverse outcomes. The cardiovascular risk scores placed a greater proportion of patients with CKD in the high-risk categories for experiencing cardiovascular events when compared with participants without CKD. Thus, 1 in 12 individuals living in two of India's largest cities have evidence of CKD, with features that put them at high risk for adverse outcomes. [ABSTRACT FROM AUTHOR]

Metabolic emergencies in neonates can present with nonspecific signs and symptoms. Sudden acute deterioration in a neonate should prompt consideration of metabolic disease. Common metabolic emergencies in the Neonatal Intensive Care Unit (NICU) include hypoglycemia, hyperammonemia, hyperbilirubinemia, metabolic acidosis, adrenal insufficiency, and electrolyte imbalances. These emergencies often require prompt recognition and intervention to prevent serious complications. Appropriate management depends on the diagnosis. However, initial resuscitation and stabilization can be started without a definitive diagnosis. Confirmatory testing and long-term management vary by condition and should be guided by symptoms and endocrinologist input., Competing Interests: Declaration of competing interest The authors declare that there are no conflicts of interest to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: Air pollution presents a major public health threat to India, affecting more than three quarters of the country's population. In the current project, GEOHealth Health Effects of Selected Environmental Exposomes Across the Life CourSe-India, we aim to study the effect of environmental exposomes-fine particulate matter (PM 2.5 ), nitrogen dioxide (NO 2 ), ozone (O 3 ) and extremes of temperature-on multiple health outcomes using a modified life course approach. The associated training grant aims to build capacity in India to address the unique environmental health problems., Methods and Analysis: The project aims to (A) Develop exposure assessments in seven cities, namely Delhi, Chennai, Sonipat, Vizag, Pune, Hyderabad and Bikaner, for: (1) A fine-scale spatiotemporal model for multiple pollutants (PM 2.5 , NO 2 , O 3, temperature); (2) Combined ground monitoring and modelling for major chemical species of ambient PM 2.5 at seven cities; and (3) Personal exposure assessment in a subsample from the six cities, except Pune, and (B) Conduct health association studies covering a range of chronic non-communicable diseases and their risk factors leveraging a unique approach using interdigitating cohorts. We have assembled existing pregnancy, child, adolescent, adult and older adult cohorts across India to explore health effects of exposomes using causal analyses. We propose to use Bayesian kernel machine regression to assess the effects of mixtures of all pollutants including species of PM 2.5 on health while accounting for potential non-linearities and interactions between exposures. This builds on earlier work that constructed a fine spatiotemporal model for PM 2.5 exposure to study health outcomes in two Indian cities., Ethics and Dissemination: Ethical clearance for conduct of the study was obtained from the Institutional Ethics Committee (IEC) of the Centre for Chronic Disease Control, and all the participating institutes and organisations. National-level permission was provided by the Indian Council of Medical Research. The research findings will be disseminated through peer-reviewed publications, policy briefs, print and social media, and communicating with the participating communities and stakeholders. Training of Indian scientists will build the capacity to undertake research on selected adverse environmental exposures on population health in India., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Wolfram syndrome is a rare genetic disease caused by mutations in the WFS1 or CISD2 gene. A primary defect in Wolfram syndrome involves poor ER Ca 2+ handling, but how this disturbance leads to the disease is not known. The current study, performed in primary neurons, the most affected and disease-relevant cells, involving both Wolfram syndrome genes, explains how the disturbed ER Ca 2+ handling compromises mitochondrial function and affects neuronal health. Loss of ER Ca 2+ content and impaired ER-mitochondrial contact sites in the WFS1- or CISD2-deficient neurons is associated with lower IP 3 R-mediated Ca 2+ transfer from ER to mitochondria and decreased mitochondrial Ca 2+ uptake. In turn, reduced mitochondrial Ca 2+ content inhibits mitochondrial ATP production leading to an increased NADH/NAD + ratio. The resulting bioenergetic deficit and reductive stress compromise the health of the neurons. Our work also identifies pharmacological targets and compounds that restore Ca 2+ homeostasis, enhance mitochondrial function and improve neuronal health., (© 2024. The Author(s).)

The induction of heat stress response (HSR) mediated by the generation of heat shock proteins (HSPs) on exposure to magnetic hyperthermia-mediated cancer therapy (MHCT) decreases the efficacy of localized heat treatment at the tumor site, and thus therapy remains a significant challenge. Hence, the present study examined differential HSR elicited in glioma cells post-MHCT under different tumor microenvironment conditions (2D monolayers, 3D monoculture, and coculture spheroids) to recognize target genes that, when downregulated, could enhance the therapeutic effect of MHCT. Gene expression analysis following MHCT revealed that HSP90 was upregulated as compared to HSP70. Hence, to enhance the efficacy of the treatment, a combinatorial strategy using 17-DMAG as an inhibitor of HSP90 following MHCT was investigated. The effects of combinatorial therapy in terms of cell viability, HSP levels by immunofluorescence and gene expression analysis, oxidative stress generation, and alterations in cellular integrity were evaluated, where combinatorial therapy demonstrated an enhanced therapeutic outcome with maximum glioma cell death. Further, in the murine glioma model, a rapid tumor inhibition of 65 and 53% was observed within 8 days at the primary and secondary tumor sites, respectively, in the MCHT + 17-DMAG group, with abscopal effect-mediated complete tumor inhibition at both the tumor sites within 20 days of MHCT. The extracellularly released HSP90 from dying tumor cells further suggested the induction of immune response supported by the upregulation of IFN-γ and calreticulin genes in the MHCT + 17-DMAG group. Overall, our findings indicate that MHCT activates host immune systems and efficiently cooperates with the HSP90 blockade to inhibit the growth of distant metastatic tumors.

Introduction: Associations between markers of impaired kidney function and adverse outcomes among South Asians is understudied and could differ from existing data derived mostly from North American or European cohorts., Methods: We conducted a prospective analysis of 9797 participants from the ongoing cardiometabolic risk reduction study in South Asia, India. We examined the associations between baseline spot urine albumin-to-creatinine (UACR) ratio and creatinine-based estimated glomerular filtration rate (eGFR) estimating equations with all-cause mortality using Cox proportional hazards regression, adjusting for baseline age, sex, diabetes, systolic blood pressure, tobacco, history of cardiovascular disease, and cholesterol. Additionally, we calculated population attributable fraction (PAF) for both markers., Results: Over a median 7-year follow-up, with 66,909 person-years, 791 deaths occurred. At baseline, the weighted prevalence of UACR ≥ 30 mg/g and eGFR CKD-EPI 2009  <60 ml/min per 1.73 m 2 was 6.6% and 1.6%, respectively. The risk for mortality was increased with higher UACR (10-30 hazard ratio [HR]: 1.6 [1.2-2.1]), 30-300 HR: 2.4 [1.8-3.1]), and ≥300 (HR: 6.0 [3.8-9.4] relative to UACR <10 mg/g). Risk for mortality was also higher with lower eGFR CKD-EPI 2009 (44-30; HR: 4.5 [2.5-8.3] and <30 HR: 7.0 [3.7-13.0], relative to 90-104 ml/min per 1.73 m 2 ). PAF for mortality because of UACR ≥30 mg/g and eGFR CKD-EPI 2009  <45 ml/min per 1.73 m 2 were 24.4% and 13.4%, respectively., Conclusion: Single-time point assessment of UACR ≥30 mg/g or eGFR CKD-EPI 2009  <45 ml/min per 1.73 m 2 portends higher mortality risk among urban South Asians. Because albuminuria is common and associated with accelerated decline in GFR, screening and targeted efforts to reduce albuminuria are warranted., (© 2024 International Society of Nephrology. Published by Elsevier Inc.)

Aims: To study the association of pro-inflammatory markers with incident diabetes in India., Methods: We did a nested case-control study within the CARRS (Centre for Ardiometabolic Risk Reduction in South Asia) cohort. Of the 5739 diabetes-free individuals at the baseline, 216 participants with incident diabetes and 432 age-, gender- and city-matched controls at 2-year follow-up were included. We measured high sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 ( MCP-1), adiponectin, leptin and fetuin-A in the stored baseline blood samples. We did multivariate conditional logistic regression to estimate association of inflammatory markers (as quartiles) and incident diabetes. Covariates were baseline fasting plasma glucose (FPG) and lipids, body mass index (BMI), family history of diabetes, smoking and alcohol use., Results: Baseline hsCRP and TNF-α were higher, and IL-6 and adiponectin were lower among cases vs. controls. In multivariate conditional logistic regression models, only quartile-3 (odds ratio [OR]: 2.96 [95% CI:1.39, 6.30]) and quartile-4 (OR: 2.58 [95% CI: 1.15, 5.79]) of TNF-α and quartile-4 of MCP-1 (OR: 2.55 [95% CI: 1.06, 6.16]) were positively associated with diabetes after adjusting for baseline FPG and BMI. These associations did not remain after adjusting for family history. High level (quartile-4) of IL-6 was negatively associated with diabetes after adjusting for all factors (OR: 0.18 [95% CI: 0.06, 0.55])., Conclusions: Higher TNF-α and MCP-1 levels and lower IL-6 were associated with higher risk of developing diabetes. Better understanding and potential methods of addressing these biomarkers, especially in relation to family history, are needed to address diabetes in South Asians., (© 2024. Springer-Verlag Italia S.r.l., part of Springer Nature.)

Objectives: This study aimed to describe resuscitation practices in level-IV neonatal intensive care units (NICUs) and identify possible areas of improvement., Study Design: This study was a cross-sectional cohort survey and conducted at the Level-IV NICUs of Children's Hospital Neonatal Consortium (CHNC). The survey was developed with consensus from resuscitation and education experts in the CHNC and pilot tested. An electronic survey was sent to individual site sponsors to determine unit demographics, resuscitation team composition, and resuscitation-related clinical practices., Results: Of the sites surveyed, 33 of 34 sites responded. Unit average daily census ranged from less than 30 to greater than 100, with the majority (72%) of the sites between 30 and 75 patients. A designated code response team was utilized in 18% of NICUs, only 30% assigned roles before or during codes. The Neonatal Resuscitation Program (NRP) was the exclusive algorithm used during codes in 61% of NICUs, and 34% used a combination of NRP and the Pediatric Advanced Life Support (PALS). Most (81%) of the sites required neonatal attendings to maintain NRP training. A third of sites (36%) lacked protocols for high-acuity events. A code review process existed in 76% of participating NICUs, but only 9% of centers enter code data into a national database., Conclusion: There is variability among units regarding designated code team presence and composition, resuscitation algorithm, protocols for high-acuity events, and event review. These inconsistencies in resuscitation teams and practices provide an opportunity for standardization and, ultimately, improved resuscitation performance. Resources, education, and efforts could be directed to these areas to potentially impact future neonatal outcomes of the complex patients cared for in level-IV NICUs., Key Points: · Resuscitation practice is variable in level-IV NICUs.. · Resuscitation algorithm training is not uniform. · Standardized protocols for high-acuity low-occurrence (HALO) events are lacking., Competing Interests: None declared., (Thieme. All rights reserved.)

Background: Defining lipid goals solely on low-density lipoprotein-cholesterol (LDL-C) levels in Indian population may cause misclassification due to high prevalence of hypertriglyceridemia and small dense LDL-C particles. International guidelines now recommend Apoliporotein-B (Apo-B) and non-high-density lipoprotein-cholesterol (non-HDL-C) levels as alternative targets. In this study, we used a cross-sectional representative population database to determine Apo-B and non-HDL-C cut-offs corresponding to identified LDL-C targets and compared them to international guidelines., Methods: A community-based survey carried out in urban Delhi and adjacent rural Ballabhgarh provided lipid values for 3047 individuals. The Spearman correlation coefficient was used to evaluate the degree of relationship between Apo-B and LDL-C and non-HDL-C. Cut-off values for Apo-B and non-HDL-C were established using receiver operator curve analysis correlating with guideline-recommended LDL-C targets., Results: Spearman's rank correlations between Apo-B and LDL-C (0.82) and non-HDL-C and LDL-C (0.93) were significant (p < 0.05). Proposed corresponding cut-off values for LDL-C of 55, 70,100,130 and 160 mg/dl for Apo-B and non-HDL-C in our population were 75.3, 75.5, 91.3, 107.6, 119.4 mg/dL and 92.5,96.5, 123.5, 154.5, 179.5 mg/dL respectively. However, in those with triglycerides >150 mg/dl the corresponding Apo-B and non-HDL-C values were 85.1, 92.7, 103.5, 117.5 and 135 mg/dL and 124.5, 126.5, 147.5, 167.5 and 190.5 mg/L respectively., Conclusion: Based on this study we provide Apo-B and non-HDL cut-offs corresponding to target LDL-C values in Indian patients with and without high triglycerides. It is noted that in individuals with triglycerides ≥ 150 mg/dl, the Apo-B levels are much higher than the values recommended by guidelines., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Dr. Dorairaj Prabhakaran reports financial support was provided by Indian Council of Medical Research. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this., (Copyright © 2024. Published by Elsevier, a division of RELX India, Pvt. Ltd.)

The Asian Indian Beta Cell function (ABCs) in Infants Study examined the associations of maternal weight on infant pancreatic beta cell function across 7 months postpartum. Pregnant women aged 18-35 years were recruited in Hyderabad, India. Women were classified by first trimester weight as underweight (UW), BMI < 18.5 kg/m 2 ; normal weight (NW), BMI 18.5-22.9 kg/m 2 ; or overweight (OW), BMI 23.0 through <28.5 kg/m 2 . At age > 7 months, infants had an oral glucose tolerance test (OGTT, 1.75 g glucose/kg bodyweight) following a 3 h fast. Infant blood samples were assayed for C-peptide and glucose. Infant beta cell function (HOMA2-B; disposition index, DI) and insulin resistance (HOMA2-IR) were compared across maternal weight groups. Mothers (UW n = 63; NW n = 43; OW n = 29) had similar age at delivery and second trimester 50 g glucose challenge test results. Cord HOMA2-B values were 51% greater for I UW (83.5, SD 55.2) and 44% greater for I OW (79.9, SD 60.8) vs. I NW (55.4, SD 51.5), forming a U-shaped relationship between maternal weight and HOMA2-B. No qualitative differences in HOMA2-IR were found at birth. However, at 7 months postpartum, HOMA2-IR changed most within I UW (-64% median reduction) and changed the least in I OW (-7% median reduction). At seven months postpartum, DI was higher in I UW vs. the other groups (geometric mean I UW 1.9 SD 2.5; I NW 1.3 SD 2.6 or vs. I OW mean 1.2 SD 3.7), reflecting a +49% difference in DI. Evidence from this study illustrates adaptations in the pancreatic functional response of infants associated with the maternal nutritional environment.