Prevalence of Abnormal Radiological Findings in Health Care Workers with Latent Tuberculosis Infection and Correlations with T Cell Immune Response

More than half of all health care workers (HCWs) in high TB-incidence, low and middle income countries are latently infected with tuberculosis (TB). We determined radiological lesions in a cohort of HCWs with latent TB infection (LTBI) in India, and determined their association with demographic, occupational and T-cell immune response variables.We obtained chest radiographs of HCWs who had undergone tuberculin skin test (TST) and QuantiFERON-TB Gold In Tube (QFT), an interferon-gamma release assay, in a previous cross-sectional study, and were diagnosed to have LTBI because they were positive by either TST or QFT, but had no evidence of clinical disease. Two observers independently interpreted these radiographs using a standardized data form and any discordance between them resolved by a third observer. The radiological diagnostic categories (normal, suggestive of inactive TB, and suggestive of active TB) were compared with results of TST, QFT assay, demographic, and occupational covariates.A total of 330 HCWs with positive TST or QFT underwent standard chest radiography. Of these 330, 113 radiographs (34.2%) were finally classified as normal, 206 (62.4%) had lesions suggestive of inactive TB, and 11 (3.4%) had features suggestive of active TB. The mean TST indurations and interferon-gamma levels in the HCWs in these three categories were not significantly different. None of the demographic or occupational covariates was associated with prevalence of inactive TB lesions on chest radiography.In a high TB incidence setting, nearly two-thirds of HCWs with latent TB infection had abnormal radiographic findings, and these findings had no clear correlation with T cell immune responses. Further studies are needed to verify these findings and to identify the causes and prognosis of radiologic abnormalities in health care workers

Elastic Shape Models for Face Analysis Using Curvilinear Coordinates

International audienceThis paper studies the problem of analyzing variability in shapes of facial surfaces using a Rie- mannian framework, a fundamental approach that allows for joint matchings, comparisons, and deformations of faces under a chosen metric. The starting point is to impose a curvilinear coordinate system, named the Darcyan coordinate system, on facial surfaces; it is based on the level curves of the surface distance function measured from the tip of the nose. Each facial surface is now represented as an indexed collection of these level curves. The task of finding optimal deformations, or geodesic paths, between facial surfaces reduces to that of finding geodesics between level curves, which is accomplished using the theory of elastic shape analy- sis of 3D curves. Elastic framework allows for nonlinear matching between curves and between points across curves. The resulting geodesics provide optimal elastic deformations between faces and an elastic metric for comparing facial shapes. We demonstrate this idea using examples from FSU face databas

Benefit of Tympanoplasty with or without Cortical Mastoidectomy in Active Mucosal Otitis Media – A Comparative Study

Introduction: Chronic otitis media (COM) is amongst the most common diseases treated by ENT surgeons in India. It has been advocated in lot of research articles that there is no significant difference in tympanoplasty done in active and inactive COM. The objective was to see if cortical mastoidectomy in cases of active mucosal COM, improves the success rate of tympanoplasty measured as per the following parameters: improvement in the hearing threshold by 15 dB, increased graft uptake and reduction in retraction of tympanic membrane in post operative period. Materials and Methods:             This study comprises of 120 patients coming to the ENT OPD from October 2016 to October 2017 with active mucosal COM with central perforation requiring tympanoplasty. These patients were randomly assigned to two groups: Group 1 of 60 subjects in which tympanoplasty without mastoidectomy was done, Group 2 of 60 subjects in which tympanoplasty with mastoidectomy was done. Patients were evaluated after a post operative period of 3 months. Results: The Results were the hearing improvement was 73.33% in group 1 while 83.33% in group 2, graft uptake was 63.33% in group 1 and 80% in group 2, graft retraction was 33.33% and 23.33% in group 1 and group 2 respectively. Conclusion: There was statistically significant difference in results in group with and without mastoidectomy in active mucosal chronic otitis media with respect to graft uptake and improved hearing

Survey to Specify SGLT2 Inhibitor Choice in T2DM Management

Objective: There are no major head-to-head comparative studies till date to compare the differences in glycemic efficacy, safety, or cardio-renal effects within SGLT2 inhibitors. This survey was conducted to understand the different parameters that clinicians identify while choosing an SGLT2 inhibitor in routine clinical practice. Materials and methods: A cross-sectional questionnaire-based survey of healthcare professionals (HCP) was conducted across India. Data were analyzed and expressed as descriptive statistics. Results: In clinical practice, the majority of HCPs identified a history of cardiovascular disease (CVD) as the most important factor for prescribing SGLT2 inhibitors in patients with T2DM. The majority of HCPs opined that among all the SGLT2 inhibitors, canagliflozin had the strongest effect on HbA1c reduction (56%), reduction in body weight (59%), and renal benefit (66%), whereas empagliflozin was associated with CV benefits (48%). In terms of heart failure, canagliflozin, empagliflozin, and dapagliflozin were similarly preferred. Conclusions: This survey gives us an understanding of the current clinical practice prevalent among Indian physicians as far as the prescription pattern of SGLT2 inhibitors is concerned

A Phase 2b randomised, controlled, partially blinded trial of the HIV Nucleoside Reverse Transcriptase Inhibitor BMS-986001 (AI467003): Weeks 24 and 48 Efficacy, Safety, Bone and Metabolic Results

Background BMS-986001 is a thymidine analogue nucleoside reverse transcriptase inhibitor (NRTI) designed to maintain in-vitro antiviral activity while minimising off-target effects. We assessed the efficacy and safety of BMS-986001 versus tenofovir disoproxil fumarate in treatment-naive patients with HIV-1. Methods In this phase 2b, randomised, active-controlled trial (AI467003), we recruited treatment-naive (no current or previous exposure to an antiretroviral drug for >1 week) adults (aged at least 18 years) with HIV-1 from 47 sites across Asia, Australia, Europe, North America, South Africa, and South America. Patients with plasma HIV-1 RNA greater than 5000 copies per mL and CD4 counts greater than 200 cells per μL were randomly assigned (2:2:2:3) to receive BMS-986001 100 mg, 200 mg, or 400 mg once a day or to receive tenofovir disoproxil fumarate 300 mg once a day; each allocation was given with efavirenz 600 mg once a day and lamivudine 300 mg once a day. Both patients and investigators were masked to BMS-986001 dose (achieved with similar looking placebo tablets), but not allocation up to and including week 48. The primary endpoints were the proportion of patients with plasma HIV-1 RNA less than 50 copies per mL and safety events (serious adverse events and adverse events leading to discontinuation) through week 24; the main analysis was with a modified intention-to-treat population. Resistance analysis was a secondary endpoint, and additional safety parameters were exploratory endpoints. This trial is registered with ClinicalTrials.gov, number NCT01489046, and the European Clinical Trials Database, number EudraCT 2011-003329-89. Findings Patients were recruited between Jan 25, 2012, and Oct 3, 2012; 757 patients were assessed for eligibility and 301 were randomly assigned to receive either BMS-986001 once a day (67 patients to 100 mg, 67 to 200 mg, and 66 to 400 mg) or tenofovir disoproxil fumarate (n=101). 297 patients received at least one dose of study drug. At week 24, 57 (88%) of 65 patients for whom there were data in the 100 mg group, 54 (81%) of 67 in the 200 mg group, 62 (94%) of 66 in the 400 mg group achieved HIV-1 RNA less than 50 copies per mL, compared with 88 (89%) of 99 in the tenofovir disoproxil fumarate group (modified intention-to-treat population). BMS-986001 was generally well tolerated through week 48. Two patients had BMS-986001-related serious adverse events (atypical drug eruption and thrombocytopenia) and two in the tenofovir disoproxil fumarate group had study drug-related serious adverse events (potential drug-induced liver injury and depression or lipodystrophy) that led to discontinuation. NRTI resistance-associated mutations were reported in four (2%) of 198 patients, and non-NRTI mutations in 17 (9%) of 198 patients receiving BMS-986001 versus none of 99 and one (1%) of 99 patients receiving tenofovir disoproxil fumarate, respectively. Compared with tenofovir disoproxil fumarate, individuals in the BMS-986001 groups showed a smaller decrease in lumbar spine and hip bone mineral density but greater accumulation of limb and trunk fat, subcutaneous and visceral adipose tissue, and increased total cholesterol. Interpretation BMS-986001 had similar efficacy to that of tenofovir disoproxil fumarate and was associated with a smaller decrease in bone mineral density; however, greater resistance and gains in both peripheral and central fat accumulation were recorded for the investigational drug. Bristol-Myers Squibb has discontinued its involvement in the development of BMS-986001, and future decisions on development will be made by Oncolys BioPharma

Evaluation of an Electricity-free, Culture-based Approach for Detecting Typhoidal Salmonella Bacteremia during Enteric Fever in a High Burden, Resource-limited Setting

Background: In many rural areas at risk for enteric fever, there are few data on Salmonella enterica serotypes Typhi (S. Typhi) and Paratyphi (S. Paratyphi) incidence, due to limited laboratory capacity for microbiologic culture. Here, we describe an approach that permits recovery of the causative agents of enteric fever in such settings. This approach involves the use of an electricity-free incubator based upon use of phase-change materials. We compared this against conventional blood culture for detection of typhoidal Salmonella. Methodology/Principal Findings: Three hundred and four patients with undifferentiated fever attending the outpatient and emergency departments of a public hospital in the Kathmandu Valley of Nepal were recruited. Conventional blood culture was compared against an electricity-free culture approach. Blood from 66 (21.7%) patients tested positive for a Gram-negative bacterium by at least one of the two methods. Sixty-five (21.4%) patients tested blood culture positive for S. Typhi (30; 9.9%) or S. Paratyphi A (35; 11.5%). From the 65 individuals with culture-confirmed enteric fever, 55 (84.6%) were identified by the conventional blood culture and 60 (92.3%) were identified by the experimental method. Median time-to-positivity was 2 days for both procedures. The experimental approach was falsely positive due to probable skin contaminants in 2 of 239 individuals (0.8%). The percentages of positive and negative agreement for diagnosis of enteric fever were 90.9% (95% CI: 80.0%–97.0%) and 96.0% (92.7%–98.1%), respectively. After initial incubation, Salmonella isolates could be readily recovered from blood culture bottles maintained at room temperature for six months. Conclusions/Significance: A simple culture approach based upon a phase-change incubator can be used to isolate agents of enteric fever. This approach could be used as a surveillance tool to assess incidence and drug resistance of the etiologic agents of enteric fever in settings without reliable local access to electricity or local diagnostic microbiology laboratories.Boston Children's Hospital (Frederick H. Lovejoy Fund)Harvard Global Health InstituteNational Institute of Allergy and Infectious Diseases (U.S.) (Grant AI100023)National Institute of Allergy and Infectious Diseases (U.S.) (Grant AI077883

Monomeric and dimeric oxidomolybdenum(V and VI) complexes, cytotoxicity, and DNA interaction studies: molybdenum assisted C═N bond cleavage of salophen ligands

Four novel dimeric bis-μ-imido bridged metal–metal bonded oxidomolybdenum(V) complexes [MoV2O2L′21–4] (1–4) (where L′1–4 are rearranged ligands formed in situ from H2L1–4) and a new mononuclear dioxidomolybdenum(VI) complex [MoVIO2L5] (5) synthesized from salen type N2O2 ligands are reported. This rare series of imido- bridged complexes (1–4) have been furnished from rearranged H3L′1–4 ligands, containing an aromatic diimine (o-phenylenediamine) “linker”, where Mo assisted hydrolysis followed by −C═N bond cleavage of one of the arms of the ligand H2L1–4 took place. A monomeric molybdenum(V) intermediate species [MoVO(HL′1–4)(OEt)] (Id1–4) was generated in situ. The concomitant deprotonation and dimerization of two molybdenum(V) intermediate species (Id1–4) ultimately resulted in the formation of a bis-μ-imido bridge between the two molybdenum centers of [MoV2O2L′21–4] (1–4). The mechanism of formation of 1–4 has been discussed, and one of the rare intermediate monomeric molybdenum(V) species Id4 has been isolated in the solid state and characterized. The monomeric dioxidomolybdenum(VI) complex [MoVIO2L5] (5) was prepared from the ligand H2L5 where the aromatic “linker” was replaced by an aliphatic diimine (1,2-diaminopropane). All the ligands and complexes have been characterized by elemental analysis, IR, UV–vis spectroscopy, NMR, ESI- MS, and cyclic voltammetry, and the structural features of 1, 2, 4, and 5 have been solved by X-ray crystallography. The DNA binding and cleavage activity of 1–5 have been explored. The complexes interact with CT-DNA by the groove binding mode, and the binding constants range between 103 and 104 M–1. Fairly good photoinduced cleavage of pUC19 supercoiled plasmid DNA was exhibited by all the complexes, with 4 showing the most promising photoinduced DNA cleavage activity of ∼93%. Moreover, in vitro cytotoxic activity of all the complexes was evaluated by MTT assay, which reveals that the complexes induce cell death in MCF-7 (human breast adenocarcinoma) and HCT-15 (colon cancer) cell lines

From Moscow with love

One of the less researched aspects of postcolonial India’s “progressive” culture is its Soviet connection. Starting in the 1950s and consolidating in the 1960s, the Union of Soviet Socialist Republics invested in building up “committed” networks amongst writers, directors, actors, and other theater- and film-practitioners across India. Thus, an entire generation of cultural professionals was initiated into the anticolonial solidarity of emerging Afro-Asian nations that were seen, and portrayed, by the Soviets as being victims of “Western” imperialism. The aspirational figure of the New Soviet Man was celebrated through the rise of a new form of “transactional sociality” (Westlund 2003). This paper looks at selected cases of cultural diplomacy—through the lens of cultural history—between the USSR and India for two decades after India’s Independence, exploring the possibility of theorizing it from the perspective of an anticolonial cultural solidarity that allowed agency to Indian interlocutors