Bronchiectasis in India:results from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) and Respiratory Research Network of India Registry

BACKGROUND: Bronchiectasis is a common but neglected chronic lung disease. Most epidemiological data are limited to cohorts from Europe and the USA, with few data from low-income and middle-income countries. We therefore aimed to describe the characteristics, severity of disease, microbiology, and treatment of patients with bronchiectasis in India. METHODS: The Indian bronchiectasis registry is a multicentre, prospective, observational cohort study. Adult patients ( 6518 years) with CT-confirmed bronchiectasis were enrolled from 31 centres across India. Patients with bronchiectasis due to cystic fibrosis or traction bronchiectasis associated with another respiratory disorder were excluded. Data were collected at baseline (recruitment) with follow-up visits taking place once per year. Comprehensive clinical data were collected through the European Multicentre Bronchiectasis Audit and Research Collaboration registry platform. Underlying aetiology of bronchiectasis, as well as treatment and risk factors for bronchiectasis were analysed in the Indian bronchiectasis registry. Comparisons of demographics were made with published European and US registries, and quality of care was benchmarked against the 2017 European Respiratory Society guidelines. FINDINGS: From June 1, 2015, to Sept 1, 2017, 2195 patients were enrolled. Marked differences were observed between India, Europe, and the USA. Patients in India were younger (median age 56 years [IQR 41-66] vs the European and US registries; p<0\ub70001]) and more likely to be men (1249 [56\ub79%] of 2195). Previous tuberculosis (780 [35\ub75%] of 2195) was the most frequent underlying cause of bronchiectasis and Pseudomonas aeruginosa was the most common organism in sputum culture (301 [13\ub77%]) in India. Risk factors for exacerbations included being of the male sex (adjusted incidence rate ratio 1\ub717, 95% CI 1\ub703-1\ub732; p=0\ub7015), P aeruginosa infection (1\ub729, 1\ub710-1\ub750; p=0\ub7001), a history of pulmonary tuberculosis (1\ub720, 1\ub707-1\ub734; p=0\ub7002), modified Medical Research Council Dyspnoea score (1\ub732, 1\ub725-1\ub739; p<0\ub70001), daily sputum production (1\ub716, 1\ub703-1\ub730; p=0\ub7013), and radiological severity of disease (1\ub703, 1\ub701-1\ub704; p<0\ub70001). Low adherence to guideline-recommended care was observed; only 388 patients were tested for allergic bronchopulmonary aspergillosis and 82 patients had been tested for immunoglobulins. INTERPRETATION: Patients with bronchiectasis in India have more severe disease and have distinct characteristics from those reported in other countries. This study provides a benchmark to improve quality of care for patients with bronchiectasis in India. FUNDING: EU/European Federation of Pharmaceutical Industries and Associations Innovative Medicines Initiative inhaled Antibiotics in Bronchiectasis and Cystic Fibrosis Consortium, European Respiratory Society, and the British Lung Foundation

Enhancing positive-affect by autobiographical method in subjects balanced on positive and negative mood

A physiological, cognitive and expressive activity channelized through the autonomic nervous system of the body is called affect. For many decades, researchers have been trying to induce affect experimentally. In the present research study, positive mood enhancement was experimentally done with the help of the autobiographical recall method in the sample of 160 college-going students from the Delhi-NCR region, who were balanced on positive and negative affect based on their scores of positive and negative affect on the PANAS. The mean age of the research subjects was 22.28 years (SD=2.89). All the subjects were rated on subjective mood rate, pulse rate, and oxygen saturation before and after the autobiographical recall. The significance of the difference between means of pre and postcondition on all three measures was verified by paired sample t-test. The results indicated that the mood induction method was effective which enhanced positive affect and reduced pulse rate significantly after the autobiographical recall. The differences in oxygen saturation were not beyond chance. It was verified in persons having a balance of positive and negative mood for the last one week and all were given a session of deep-breathe relaxation before the experimental intervention

Emerging Technologies and IPR: A Cross-Jurisdictional Examination of AI and Patent Laws in India and the USA

413-421The rapid development of Artificial Intelligence (AI) is swiftly reaching a critical juncture, which will greatly affect a multitude of sectors such as business, healthcare, and agriculture. While the enhanced capabilities of AI offer considerable potential for beneficial outcomes, they also present a substantial obstacle to current legal structures regulating patents. This conundrum carries extensive consequences for creativity, economic growth, and the broader community.1 In light of this, it is critical that stakeholders, including patent experts, policymakers, and academics, engage in robust dialogues to develop strategies for encouraging innovation and navigating the complex legal terrain that arises from patent law in the AI paradigm.2 The stakes are high, and the consequences of failing to address these challenges could be dire. In light of the current context, this paper examines various facets of patent law as they relate to AI creations, encompassing patent eligibility principles, the patentability of AI in the United States and India, and the more extensive consequences of AI and patent law's convergence. The paper offers a comparative analysis of the legal structures in these two nations, illuminating the similarities and distinctions in how AI is addressed in each legal system. The paper proposes a set of suggestions for modifying legal frameworks to keep up with the swift advancements in AI technology. By concentrating on the difficulties that emerge from the interplay of AI and patent law, the paper underscores the necessity for continuous discussion and cooperation among all parties involved, ensuring that creativity flourishes in this rapidly changing and exhilarating domain

Biotechnological advancements in microplastics degradation in drinking water: Current insights and Future perspectives

Microplastics (MPs) have emerged as persistent toxicants in the recent decade. MPs are reported to present in different samples such as soil, water, wastewater, and human samples including placenta, urine etc. Recent studies have reported its presence in drinking water. MPs presence in the drinking water is of concern to the research because MPs are associated with several toxicities in animal models including human. The presented review is focused on understanding MPs abundance, sources, detection, analysis, and biotechnological approaches for its degradation. The paper discusses MPs sources, distribution, and transport in drinking water. In addition, it discusses the MPs identification in drinking water, and advances in biotechnological, metagenomics, system, and synthetic biology approaches for MPs degradation. Moreover, it discusses critically the major challenges associated with the MPs degradation in drinking water. Heterogeneity in the MPs size and shape makes it its identification difficult in the drinking water. Most of the methods available for MPs analysis are based on the dried samples analysis. Development of MPs in liquid samples may bring a breakthrough in the research

CD8 Encephalitis: A Diagnostic Dilemma

CD8+ encephalitis is a subacute encephalopathy associated with HIV infection. Pathophysiology is thought to be auto-reactive CD8+ cells attacking on HIV infected CD4+ cells and ‘viral escape’ phenomena (replication of CD8+ cells in CSF). We present a case of a 45-year-old man with well controlled HIV who developed CD8 encephalitis following Herpes simplex encephalitis. He had persistent encephalopathy for several weeks with status epilepticus and agitated delirium, and diagnosis remained elusive until a brain biopsy confirmed the diagnosis