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Byline: R. Nerli, S. Jali, A. Guntaka, P. Malur, B. Anita, M. Hiremath Sir, A 14-year-old male child presented to pediatric services of the hospital with the complaints of frequency, [...]

Aims: To examine the effect of pump vs injection therapy on the lipid profile of children with Type 1 diabetes mellitus. Methods: A cross‐sectional analysis of the lipid profile of children aged ≤ 18 years with Type 1 diabetes mellitus from SWEET, an international diabetes registry, was conducted with a focus on the effect of treatment regimen. Dyslipidaemia was defined as LDL cholesterol ≥2.6 mmol/l or non‐HDL cholesterol ≥3.1 mmol/l. LDL and non‐HDL cholesterol values among 14 290 children (52% boys, 51% receiving pump therapy) from 60 SWEET centres were analysed by linear and logistic regression analysis adjusted for sex, age, diabetes duration, HbA1c and BMI‐standard deviation score group, region, and common interactions between age, sex, HbA1c and BMI. Results: This study confirmed the established associations of increased lipids with female sex, age, diabetes duration, HbA1c and BMI. LDL and non‐HDL cholesterol levels were lower in the pump therapy group compared to the injection therapy group [LDL cholesterol: injection therapy 2.44 mmol/l (95% CI 2.42 to 2.46) vs pump therapy 2.39 mmol/l (95% CI 2.37–2.41), P<0.001; non‐HDL cholesterol: injection therapy 2.88 mmol/l (95% CI 2.86 to 2.90) vs pump therapy 2.80 mmol/l (95% CI 2.78–2.82), both P<0.0001]. Similarly, the odds ratios for LDL cholesterol ≥2.6 mmol/l [0.89 (95% CI 0.82–0.97)] and non‐HDL cholesterol ≥3.1 mmol/l [0.85 (0.78 to 0.93)] were significantly lower in the pump therapy group, even after all adjustments. Conclusions: Our results indicate that pump therapy is associated with a better lipid profile. What's new?: People with Type 1 diabetes mellitus have an increased risk of cardiovascular disease.Dyslipidaemia is one of the major factors contributing to cardiovascular morbidity.Pump treatment has been associated with lower cardiovascular mortality, but the association with lipids has not been investigated.In a large cohort of children with Type 1 diabetes, pump treatment was associated with a better lipid profile compared to injection treatment. This association remained significant even after adjustments for major confounding factors.The use of an insulin pump may independently lead to a better lipid profile and thus a lower cardiovascular risk in people with Type 1 diabetes. [ABSTRACT FROM AUTHOR]

Packaging materials are used to protect consumer goods, such as food, drinks, cosmetics, healthcare items, and more, from harmful gases and physical and chemical damage during storage, distribution, and handling. Synthetic plastics are commonly used because they exhibit sufficient characteristics for packaging requirements, but their end lives result in environmental pollution, the depletion of landfill space, rising sea pollution, and more. These exist because of their poor biodegradability, limited recyclability, etc. There has been an increasing demand for replacing these polymers with bio-based biodegradable materials for a sustainable environment. Cellulosic nanomaterials have been proposed as a potential substitute in the preparation of packaging films. Nevertheless, their application is limited due to their poor properties, such as their barrier, thermal, and mechanical properties, to name a few. The barrier properties of materials play a pivotal role in extending and determining the shelf lives of packaged foods. Nanofillers have been used to enhance the barrier properties. This article reviews the literature on the barrier properties of cellulose/clay nanocomposite polymers. Cellulose extraction stages such as pretreatment, bleaching, and nanoparticle isolation are outlined, followed by cellulose modification methods. Finally, a brief discussion on nanofillers is provided, followed by an extensive literature review on the barrier properties of cellulose/clay nanocomposite polymers. Although similar reviews have been presented, the use of modification processes applied to cellulose, clay, and final nanocomposites to enhance the barrier properties has not been reviewed. Therefore, this article focuses on this scope.

Recent breeding efforts in Brassica have focused on the development of new oilseed feedstock crop for biofuels (e.g., ethanol, biodiesel, bio-jet fuel), bio-industrial uses (e.g., bio-plastics, lubricants), specialty fatty acids (e.g., erucic acid), and producing low glucosinolates levels for oilseed and feed meal production for animal consumption. We identified a novel opportunity to enhance the availability of nutritious, fresh leafy greens for human consumption. Here, we demonstrated the efficacy of disarming the 'mustard bomb' reaction in reducing pungency upon the mastication of fresh tissue-a major source of unpleasant flavor and/or odor in leafy Brassica . Using gene-specific mutagenesis via CRISPR-Cas12a, we created knockouts of all functional copies of the type-I myrosinase multigene family in tetraploid Brassica juncea . Our greenhouse and field trials demonstrate, via sensory and biochemical analyses, a stable reduction in pungency in edited plants across multiple environments. Collectively, these efforts provide a compelling path toward boosting the human consumption of nutrient-dense, fresh, leafy green vegetables.

In spite of advances in chelation therapy and screening of blood, mortality associated with the most common life-threatening noncommunicable disease of children in India, transfusion-dependent thalassemia (TDT), remains poorly defined. This study aims at estimating death rates and mortality risk factors associated with TDT. The clinical records of 1087 patients from 5 thalassemia centers in India were retrospectively analyzed from 2011 to 2018. Median patient age was 8.5 years, with 107 patients older than 18 years; 656 patients were male and 431 were female. Demographic details and clinical parameters were analyzed at presentation and at last visit. With 41 recorded deaths, actuarial survival at 26.9 years was 50%, and under-5 mortality was 7 times higher than in the general population. Patients with transfusion-transmitted infections (TTIs) had 3.4 times higher risk for death (P = .031). Serum ferritin higher than 4000 ng/dL had 4.6 times higher risk for mortality compared with ferritin lower than 1000 ng/dL (P = .00063). A hemoglobin drop lower than 2 g/dL per week had 7.7 times higher mortality risk compared with a drop of less than 1 g/dL per week (P < .0001). Social determinants (sex, economic status, and distance from center), splenectomy, and even cardiac complications were not associated with higher mortality risk. Main causes of death were infection, iron overload, TTIs, and allo-immunization. Patients who received more than 4 years of adequate care had more than 66% mortality risk reduction (P < .0001). TDT in India continues to result in high mortality. Ineffective transfusion, TTIs, and chelation continue to be the most significant risk factors. Comprehensive care in dedicated day care centers from early age is likely to improve outcomes., (© 2020 by The American Society of Hematology.)

Background: Frequent use of modern diabetes technologies increases the chance for optimal type 1 diabetes (T1D) control. Limited reimbursement influences the access of patients with T1D to these modalities and could worsen their prognosis. We aimed to describe the situation of reimbursement for insulins, glucometers, insulin pumps (CSII) and continuous glucose monitoring (CGM) for children with T1D in European countries participating in the SWEET Project and to compare data from EU countries with data from our previous study in 2009., Methods: The study was conducted between March 2017 and August 2017. First, we approached diabetes technology companies with a survey to map the reimbursement of insulins and diabetic devices. The data collected from these companies were then validated by members of the SWEET consortium., Results: We collected data from 29 European countries, whereas all types of insulins are mostly fully covered, heterogeneity was observed regarding the reimbursement of strips for glucometers (from 90 strips/month to no limit). CSII is readily available in 20 of 29 countries. Seven countries reported significant quota issues or obstacles for CSII prescription, and two countries had no CSII reimbursement. CGM is at least partially reimbursed in 17 of 29 countries. The comparison with the 2009 study showed an increasing availability of CSII and CGM across the EU., Conclusions: Although innovative diabetes technology is available, a large proportion of children with T1D still do not benefit from it due to its limited reimbursement., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Successful models of information and communication technology (ICT) applied to cost-effective delivery of quality care in low- and middle-income countries (LMIC) are an increasing necessity. Severe thalassemia is one of the most common life-threatening noncommunicable diseases of children globally., Objective: The aim was to study the impact of ICT on quality of care for severe thalassemia patients in LMIC., Methods: A total of 1110 patients with severe thalassemia from five centers in India were followed over a 1-year period. The impact of consistent use of a Web-based platform designed to assist comprehensive management of severe thalassemia (ThalCare) on key indicators of quality of care such as minimum (pretransfusion) hemoglobin, serum ferritin, liver size, and spleen size were assessed., Results: Overall improvements in initial hemoglobin, ferritin, and liver and spleen size were significant (P<.001 for each). For four centers, the improvement in mean pretransfusion hemoglobin level was statistically significant (P<.001). Four of five centers achieved reduction in mean ferritin levels, with two displaying a significant drop in ferritin (P=.004 and P<.001). One of the five centers did not record liver and spleen size on palpation, but of the remaining four centers, two witnessed a large drop in liver and spleen size (P<.01), one witnessed moderate drop (P=.05 for liver; P=.03 for spleen size), while the fourth witnessed a moderate increase in liver size (P=.08) and insignificant change in spleen size (P=.12)., Conclusions: Implementation of computer-assisted treatment planning and performance assessment consistently and positively impacted indexes reflecting effective delivery of care to patients suffering from severe thalassemia in LMIC., (©Rajat Kumar Agarwal, Amit Sedai, Kumari Ankita, Lalith Parmar, Rakesh Dhanya, Sunil Dhimal, Reshma Sriniwas, Ashwini Gowda, Pooja Gujjal, Pushpa H, Suman Jain, J Dasaratha Ramaiah, Sujata Jali, Neelavva Rayappa Tallur, Stalin Ramprakash, Lawrence Faulkner. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 23.01.2019.)

Objective: To assess the prevalence of underweight (UW), overweight (OW), and obesity in children and adolescents with type 1 diabetes (T1D)., Methods: An international cross-sectional study including 23 026 T1D children (2-18 years, duration of diabetes ≥1 year) participating in the SWEET prospective, multicenter diabetes registry. Body mass index SD score (BMI-SDS) was calculated using the World Health Organization BMI charts. Children were categorized as UW (BMI-SDS < -2SD), OW (+1SD < BMI-SDS ≤ +2SD), and obese (OB) (BMI-SDS > +2SD). Hierarchic regression models were applied with adjustment for sex, age, and duration of diabetes., Results: The prevalence of UW, OW, and obesity was: 1.4%, 22.3%, and 7.3% in males and 0.6%, 27.2%, and 6.8% in females. Adjusted BMI-SDS was significantly higher in females than in males (mean ± SEM: 0.54 ± 0.05 vs 0.40 ± 0.05, P < 0.0001). In males, BMI-SDS significantly decreased by age (P < 0.0001) in the first three age categories 0.61 ± 0.06 (2 to <10 years), 0.47 ± 0.06 (10 to <13 years), 0.34 ± 0.05 (13 to <16 years). In females, BMI-SDS showed a U-shaped distribution by age (P < 0.0001): 0.54 ± 0.04 (2 to <10 years), 0.39 ± 0.04 (10 to <13 years), 0.55 ± 0.04 (13 to <16 years). BMI-SDS increased by diabetes duration (<2 years: 0.38 ± 0.05, 2 to <5 years: 0.44 ± 0.05, and ≥5 years: 0.50 ± 0.05, P < 0.0001). Treatment modality did not affect BMI-SDS. Adjusted HbA1c was significantly higher in females than in males (8.20% ± 0.10% vs 8.06% ± 0.10%, P < 0.0001). In both genders, the association between HbA1c and BMI-SDS was U-shaped with the highest HbA1c in the UW and obesity groups., Conclusions: The high rate of OW and obesity (31.8%) emphasize the need for developing further strategies to prevent and treat excess fat accumulation in T1D., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

A method using comprehensive (2) DGC with flame ionisation detection was developed to quantify 17 low-molecular-weight oxygenates in three different matrices, namely water, oil and gas, using a single calibration. The method was required for the pilot-plant experiments of a chemical process unit. From an analytical perspective, the first task was to find a suitable analytical method with sufficient selectivity and sensitivity to analyse the selected oxygenates at low levels in the presence of high levels of hydrocarbons. The second was the accurate quantitation of oxygenates in the water, oil and gas fractions, using the same instrument and calibration. Both these requirements were met by using comprehensive (2) DGC in the inverse configuration and calibrating the detector with the number of moles injected versus response. The method was successfully applied for the characterisation of the reactor product stream of the chemical process unit and made it possible to determine the fate of the selected oxygenates after passing through the reactor. The development of the method and some of the results are described in this paper., (© 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Introduction: The Mitrofanoff principle was originally described as a method to provide an alternative means to access the bladder. It creates a conduit to the bladder through which patients with a sensitive, absent, or traumatized urethra can perform clean intermittent catheterization (CIC) easily. We report our experience with complete laparoscopic Mitrofanoff appendicovesicostomy to promote a catheterizable abdominal stoma., Materials and Methods: A 4-port transperitoneal approach was used to create a complete laparoscopic Mitrofanoff appendicovesicostomy., Results: Six children with a mean age of 12.8 years (range 9-16 years) underwent laparoscopic Mitrofanoff appendicovesicostomy. Mean operative time was 139.6 min and Mean estimated blood loss was 46 cc. No cases of urinary leaks were noted. There have been no cases of either stomal stenosis or appendicovesical stenosis noted., Conclusions: Pure laparoscopic Mitrofanoff appendicovesicostomy is feasible and is associated with reasonable outcome with early recovery, resumption of normal activities and excellent cosmesis.

Objective: A cross-sectional institutional-based study was undertaken to know the prevalence of Gestational Diabetes Mellitus (GDM) among Indian pregnant women., Subjects and Methods: 325 pregnant women were screened for evidence of diabetes who were previously not known to be diabetic. They underwent 75 g, 2 hour, oral glucose tolerance test (OGTT). Chi-square test was done for statistically association of variables in GDM., Results and Conclusions: The results of this study indicate that bad obstetrics history, obese patient on high calorie diet especially non vegetarian diet with less physical activity are highly prone to develop GDM.

In the title compound, [Mo(C(5)H(5))(CO)(2)(C(3)H(9)P)(2)]CF(3)SO(3), the cationic complex displays a classical four-legged piano-stool square-pyramidal geometry with a trans configuration of the basal ligands around the Mo atom. The cyclo-penta-dienyl (Cp) ligand occupies the apical position of the piano-stool configuration. The average Mo-P bond length of the two trans PMe(3) ligands is 2.474 (5) Å and the Mo-Cp centroid distance is 2.003 (2) Å.

The synthesis and X-ray structure of two diasteriomeric heptapeptides [Ac-Ala-Ala-Ala-(R/S)-Cage-Ala-Ala-Ala-NH2] with a trishomocubane amino acid as a beta-turn scaffold are reported. The amino acid was synthesized as a racemate and two diastereomeric peptides were obtained. The two peptides were separated by preparative high-pressure liquid chromatography and crystals suitable for X-ray analysis were grown for both diasteriomeric peptides. In general, both the peptides satisfy the criteria for beta-turn conformations. Five of the six Ala residues of both cage peptide crystals satisfy the criteria for 3(10)-helix characteristics and the cage amino acid residue satisfied the alpha-helix classification. These experimental results confirm previous theoretical studies in our laboratory which predicted that the cage moiety would be a strong/active beta-turn inducer.