Language in tuberculosis services: can we change to patient-centred terminology and stop the paradigm of blaming the patients?

The words 'defaulter', 'suspect' and 'control' have been part of the language of tuberculosis (TB) services for many decades, and they continue to be used in international guidelines and in published literature. From a patient perspective, it is our opinion that these terms are at best inappropriate, coercive and disempowering, and at worst they could be perceived as judgmental and criminalising, tending to place the blame of the disease or responsibility for adverse treatment outcomes on one side-that of the patients. In this article, which brings together a wide range of authors and institutions from Africa, Asia, Latin America, Europe and the Pacific, we discuss the use of the words 'defaulter', 'suspect' and 'control' and argue why it is detrimental to continue using them in the context of TB. We propose that 'defaulter' be replaced with 'person lost to follow-up'; that 'TB suspect' be replaced by 'person with presumptive TB' or 'person to be evaluated for TB'; and that the term 'control' be replaced with 'prevention and care' or simply deleted. These terms are non-judgmental and patient-centred. We appeal to the global Stop TB Partnership to lead discussions on this issue and to make concrete steps towards changing the current paradigm

Dual variables for the SU(2) lattice gauge theory at finite temperature

We study the three-dimensional SU(2) lattice gauge theory at finite temperature using an observable which is dual to the Wilson line. This observable displays a behaviour which is the reverse of that seen for the Wilson line. It is non-zero in the confined phase and becomes zero in the deconfined phase. At large distances, it's correlation function falls off exponentially in the deconfined phase and remains non-zero in the confined phase. The dual variable is non-local and has a string attached to it which creates a Z(2) interface in the system. It's correlation function measures the string tension between oppositely oriented Z(2) domains. The construction of this variable can also be made in the four-dimensional theory where it measures the surface tension between oppositely oriented Z(2) domains.Comment: 13 pages, LaTeX, 4 figures are included in the latex fil

A nexus of intrinsic dynamics underlies translocase priming

The cytoplasmic ATPase SecA and the membrane-embedded SecYEG channel assemble to form the Sec translocase. How this interaction primes and catalytically activates the translocase remains unclear. We show that priming exploits a nexus of intrinsic dynamics in SecA. Using atomistic simulations, smFRET, and HDX-MS, we reveal multiple dynamic islands that cross-talk with domain and quaternary motions. These dynamic elements are functionally important and conserved. Central to the nexus is a slender stem through which rotation of the preprotein clamp of SecA is biased by ATPase domain motions between open and closed clamping states. An H-bonded framework covering most of SecA enables multi-tier dynamics and conformational alterations with minimal energy input. As a result, cognate ligands select preexisting conformations and alter local dynamics to regulate catalytic activity and clamp motions. These events prime the translocase for high-affinity reception of non-folded preprotein clients. Dynamics nexuses are likely universal and essential in multi-liganded proteins.</p

The timing of death in patients with tuberculosis who die during anti-tuberculosis treatment in Andhra Pradesh, South India

Background: India has 2.0 million estimated tuberculosis (TB) cases per annum with an estimated 280,000 TBrelated deaths per year. Understanding when in the course of TB treatment patients die is important for determining the type of intervention to be offered and crucially when this intervention should be given. The objectives of the current study were to determine in a large cohort of TB patients in India:- i) treatment outcomes including the number who died while on treatment, ii) the month of death and iii) characteristics associated with “early” death, occurring in the initial 8 weeks of treatment. Methods: This was a retrospective study in 16 selected Designated Microscopy Centres (DMCs) in Hyderabad, Krishna and Adilabad districts of Andhra Pradesh, South India. A review was performed of treatment cards and medical records of all TB patients (adults and children) registered and placed on standardized anti-tuberculosis treatment from January 2005 to September 2009. Results: There were 8,240 TB patients (5183 males) of whom 492 (6%) were known to have died during treatment. Case-fatality was higher in those previously treated (12%) and lower in those with extra-pulmonary TB (2%). There was an even distribution of deaths during anti-tuberculosis treatment, with 28% of all patients dying in the first 8 weeks of treatment. Increasing age and new as compared to recurrent TB disease were significantly associated with “early death”. Conclusion: In this large cohort of TB patients, deaths occurred with an even frequency throughout anti-TB treatment. Reasons may relate to i) the treatment of the disease itself, raising concerns about drug adherence, quality of anti-tuberculosis drugs or the presence of undetected drug resistance and ii) co-morbidities, such as HIV/ AIDS and diabetes mellitus, which are known to influence mortality. More research in this area from prospective and retrospective studies is needed

Preproteins couple the intrinsic dynamics of SecA to its ATPase cycle to translocate via a catch and release mechanism

Protein machines undergo conformational motions to interact with and manipulate polymeric substrates. The Sec translocase promiscuously recognizes, becomes activated, and secretes >500 non-folded preprotein clients across bacterial cytoplasmic membranes. Here, we reveal that the intrinsic dynamics of the translocase ATPase, SecA, and of preproteins combine to achieve translocation. SecA possesses an intrinsically dynamic preprotein clamp attached to an equally dynamic ATPase motor. Alternating motor conformations are finely controlled by the γ-phosphate of ATP, while ADP causes motor stalling, independently of clamp motions. Functional preproteins physically bridge these independent dynamics. Their signal peptides promote clamp closing; their mature domain overcomes the rate-limiting ADP release. While repeated ATP cycles shift the motor between unique states, multiple conformationally frustrated prongs in the clamp repeatedly “catch and release” trapped preprotein segments until translocation completion. This universal mechanism allows any preprotein to promiscuously recognize the translocase, usurp its intrinsic dynamics, and become secreted

Exploited and potential resources of tunas of Lakshadweep

Oceanic species of tunas such as skipjack (Katsuwonus pelamis) and yellowfin tuna (Thunnus albacares) constitute the major tuna resources taken from the Lakshadweep waters. They are being exploited from these islands by pole and line fishery. The paper detailed about the potential of tuna resources of Lakshadweep including the Strategies for future development

Stock assessment: squids and cuttlefishes at selected centres

Stock assessment studies have been made on the squid Loligo duvaucelii of Madras and Cochin areas, the cuttlefish Sepia aculeata of Madas area and Sepia pharaorUs of Vizhiiyam area. The exploitation rate, total mortality, instantaneous mortality, average annual stock and standing stock have been estimated and discussed. The study shows that in Vizhinjam area there is scope for increasing production in the existing fishing grounds

A lattice model with a theta term in three dimensions

We study a three-dimensional abelian lattice model in which the analogue of a theta term can be defined. This term is defined by introducing a neutral scalar field and its effect is to couple magnetic monopoles to the scalar field and vortices to the gauge field. An interesting feature of this model is the presence of an exact duality symmetry that acts on a three parameter space. It is shown that this model has an interesting phase structure for non-zero values of theta. In addition to the usual confinement and vortex phases there are phases in which loops with composite charges condense. The presence of novel point like excitations also alters the physical properties of the system.Comment: 32 pages in latex and three figure

How to obtain division algebras used for fast-decodable space-time block codes

We present families of unital algebras obtained through a doubling process from a cyclic central simple algebra D, employing a K-automorphism tau and an invertible element d in D. These algebras appear in the construction of iterated space-time block codes. We give conditions when these iterated algebras are division which can be used to construct fully diverse iterated codes. We also briefly look at algebras (and codes) obtained from variations of this method