Profile and outcome of pregnancy with congenital heart diseases: a retrospective study from a South Indian tertiary care hospital

Background: Women with congenital heart disease who become pregnant form an important subgroup of pregnancy cardiac disorders. The additional stress of pregnancy represents a further challenge.Methods: This was a retrospective study. Patient records between 2011and 2015 pertaining to 77 pregnant women with congenital heart diseases were analysed.Results: There was only one patient aged more than 35 years. The age of the others ranged from 18 to 35 years. The mean age was 24 years. There was a slight rural preponderance with 43 (55.8%) from rural areas. Majority 49 (63.5%) belonged to lower middle socioeconomic status. 71 (92.2%) had NYHA functional Class I. Two patients of Class II had worsening of their status. There were no cases of Atrial Fibrillation and only 2(2.6%) had CCF.ASD closure was the commonest procedure done24 (31.2%). There were 6 (7.8%)cases of device closure of PDA and no cases of VSD. Anemia and GDM were seen in 4 (5.2%). The commonest period of gestation at delivery was 37-40 in 64 (83.1%). ASD was the commonest type of lesion 42 (54.5%). 36 (46.8%) had spontaneous labour and there were 18 23.4%)caesarians. Previous LSCS was the commonest indication for LSCS. Full term normal vaginal delivery was seen in 45 (88.2%). Majority of the newborns 30 (39%) had a birth weight in the range 2.6-3.0 kgs.Conclusions: There is a significant burden of Heart disease with pregnancy afflicting young rural women and those from lower socioeconomic levels. Higher level of specialised care minimizes poor maternal and fetal outcomes

Application of Metallic Strip Gratings for Enhancement of Electromagnetic Performance of A-sandwich Radome

Enhancement of the electromagnetic (EM) performance characteristics of A-sandwich radome wall over X-band using metallic strip gratings is presented in this work. Equivalent transmission line method in conjunction with equivalent circuit model (ECM) is used for modeling the A-sandwich radome panel with metallic strip gratings and the computation of radome performance parameters. Metallic strip grating embedded in the mid-plane of the core and those in the skin-core interface are the configurations considered in the present work. For a given thickness of metallic strip grating, its width and pitch are optimized at different angles of incidence such that the new radome wall configuration offers superior EM performance over the entire X-band as compared to the conventional A-sandwich wall. The EM analysis shows that the superior EM performance of A-sandwich with metallic strip gratings makes it suitable for the design of normal incidence and streamlined airborne radomes.Defence Science Journal, 2013, 63(5), pp.508-514, DOI:http://dx.doi.org/10.14429/dsj.63.245

Impact of CodY protein on metabolism, sporulation and virulence in Clostridioides difficile ribotype 027

Toxin synthesis and endospore formation are two of the most critical factors that determine the outcome of infection by Clostridioides difficile. The two major toxins, TcdA and TcdB, are the principal factors causing damage to the host. Spores are the infectious form of C. difficile, permit survival of the bacterium during antibiotic treatment and are the predominant cell form that leads to recurrent infection. Toxin production and sporulation have their own specific mechanisms of regulation, but they share negative regulation by the global regulatory protein CodY. Determining the extent of such regulation and its detailed mechanism is important for understanding the linkage between two apparently independent biological phenomena and raises the possibility of creating new ways of limiting infection. The work described here shows that a codY null mutant of a hypervirulent (ribotype 027) strain is even more virulent than its parent in a mouse model of infection and that the mutant expresses most sporulation genes prematurely during exponential growth phase. Moreover, examining the expression patterns of mutants producing CodY proteins with different levels of residual activity revealed that expression of the toxin genes is dependent on total CodY inactivation, whereas most sporulation genes are turned on when CodY activity is only partially diminished. These results suggest that, in wild-type cells undergoing nutrient limitation, sporulation genes can be turned on before the toxin genes

Introgression Lines with Improved Resistance to Late Leaf Spot and Rust in Peanut

In an effort to simultaneously transfer and map the genomic regions governing resistance to late leaf spot (LLS) and rust in peanut, two susceptible varieties (lCGS 76 and OH 86) were crossed to two resistant synthetic tetraploids; an amphidiploid, ISATGR 278- 18 (Arachis duranensis x Arachis batizocoi) and an autotetraploid, ISATGR 5B (Arachis magna x Arachis batizocoi). Two cycles of backcrossing with the recurrent parents resulted in the development of a large number of introgression lines (ILs). They (BCl6 and BCl,) were evaluated during the rainy season of 2013 and 2014. ILs differed significantly for LLS and rust resistance, and productivity traits. Twenty seven introgression lines superior over lCGS 76, and three ILs superior over OH 86 for pod yield were selected from respective crosses. Many of them were highly resistant to both LLS and rust. Majority of them carried resistant allele at marker loci linked to LLS and rust. A few ILs also combined high test weight, shelling percentage and sound mature kernel percentage. Of these introgression lines, eleven were also superior over GPBO 4, a national check variety. These genetic resources can be of immense use in peanut breeding or for commercialization

Recent advances and perspectives on starch nanocomposites for packaging applications

Starch nanocomposites are popular and abundant materials in packaging sectors. The aim of this work is to review some of the most popular starch nanocomposite systems that have been used nowadays. Due to a wide range of applicable reinforcements, nanocomposite systems are investigated based on nanofiller type such as nanoclays, polysaccharides and carbonaceous nanofillers. Furthermore, the structures of starch and material preparation methods for their nanocomposites are also mentioned in this review. It is clearly presented that mechanical, thermal and barrier properties of plasticised starch can be improved with well-dispersed nanofillers in starch nanocomposites

Gamma-Linolenic and Stearidonic Acids Are Required for Basal Immunity in Caenorhabditis elegans through Their Effects on p38 MAP Kinase Activity

Polyunsaturated fatty acids (PUFAs) form a class of essential micronutrients that play a vital role in development, cardiovascular health, and immunity. The influence of lipids on the immune response is both complex and diverse, with multiple studies pointing to the beneficial effects of long-chain fatty acids in immunity. However, the mechanisms through which PUFAs modulate innate immunity and the effects of PUFA deficiencies on innate immune functions remain to be clarified. Using the Caenorhabditis elegans–Pseudomonas aeruginosa host–pathogen system, we present genetic evidence that a Δ6-desaturase FAT-3, through its two 18-carbon products—gamma-linolenic acid (GLA, 18:3n6) and stearidonic acid (SDA, 18:4n3), but not the 20-carbon PUFAs arachidonic acid (AA, 20:4n6) and eicosapentaenoic acid (EPA, 20:5n3)—is required for basal innate immunity in vivo. Deficiencies in GLA and SDA result in increased susceptibility to bacterial infection, which is associated with reduced basal expression of a number of immune-specific genes—including spp-1, lys-7, and lys-2—that encode antimicrobial peptides. GLA and SDA are required to maintain basal activity of the p38 MAP kinase pathway, which plays important roles in protecting metazoan animals from infections and oxidative stress. Transcriptional and functional analyses of fat-3–regulated genes revealed that fat-3 is required in the intestine to regulate the expression of infection- and stress-response genes, and that distinct sets of genes are specifically required for immune function and oxidative stress response. Our study thus uncovers a mechanism by which these 18-carbon PUFAs affect basal innate immune function and, consequently, the ability of an organism to defend itself against bacterial infections. The conservation of p38 MAP kinase signaling in both stress and immune responses further encourages exploring the function of GLA and SDA in humans

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline