Search

IntroductionIn resource-limited settings, obstructive sleep apnea (OSA) often goes undiagnosed as polysomnography (PSG) is expensive, time-consuming, and not readily available. Imaging studies of upper airway have been tried as alternatives to PSG to screen for OSA. However, racial differences in upper airway anatomy preclude generalizability of such studies. We sought to test the hypothesis that ultrasonography (USG), an inexpensive, readily available tool to study soft tissue structures of the upper airway, would have predictive value for OSA in South Asian people.MethodsAdult patients with sleep-related complaints suspicious for OSA were taken for overnight PSG. After the PSG, consecutive patients with and without OSA were studied with submental ultrasonography to measure tongue base thickness (TBT) and lateral pharyngeal wall thickness (LPWT).ResultsAmong 50 patients with OSA and 25 controls, mean age was 43.9 ± 11.4 years, and 39 were men. Patients with OSA had higher TBT (6.77 ± 0.63 cm vs 6.34 ± 0.54 cm, P value = 0.004) and higher LPWT (2.47 ± 0.60 cm vs 2.12 ± 0.26 cm, P value = 0.006) compared to patients without OSA. On multivariate analysis, TBT, LPWT, and neck circumference were identified as independent factors associated with OSA. These variables could identify patients with severe OSA with a sensitivity of 72% and a specificity of 76%.ConclusionPatients with OSA have higher tongue base thickness and lateral pharyngeal wall thickness proportionate to the severity of the disease, independent of BMI and neck circumference. These findings suggest that sub-mental ultrasonography may be useful to identify patients with severe OSA in resource-limited settings.

RNA viruses continue to remain a threat for potential pandemics due to their rapid evolution. Potentiating host antiviral pathways to prevent or limit viral infections is a promising strategy. Thus, by testing a library of innate immune agonists targeting pathogen recognition receptors, we observe that Toll-like receptor 3 (TLR3), stimulator of interferon genes (STING), TLR8, and Dectin-1 ligands inhibit arboviruses, Chikungunya virus (CHIKV), West Nile virus, and Zika virus to varying degrees. STING agonists (cAIMP, diABZI, and 2',3'-cGAMP) and Dectin-1 agonist scleroglucan demonstrate the most potent, broad-spectrum antiviral function. Furthermore, STING agonists inhibit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and enterovirus-D68 (EV-D68) infection in cardiomyocytes. Transcriptome analysis reveals that cAIMP treatment rescue cells from CHIKV-induced dysregulation of cell repair, immune, and metabolic pathways. In addition, cAIMP provides protection against CHIKV in a chronic CHIKV-arthritis mouse model. Our study describes innate immune signaling circuits crucial for RNA virus replication and identifies broad-spectrum antivirals effective against multiple families of pandemic potential RNA viruses.

HIV stigma takes a multidimensional toll on a mother's ability to care for herself and subsequently may impact her ability to care for her child, particularly when mother and child are seroconcordant. A cross-sectional analysis was conducted to examine the association between maternal HIV stigma and child CD4 count in rural India. We assessed 108 mother-child dyads and found that a one-unit increase in community stigma fear decreased child CD4 count by 352 cells (95% CI = - 603, - 102), highlighting the need to develop a better understanding of the consequences of HIV-related stigma on the compounded burden of care in households where mother and child both live with HIV.

Loss of lean muscle mass impairs immunity and increases mortality risk among individuals with HIV/AIDS. We evaluated the relative contributions of protein supplementation and nutrition education on body composition among 600 women living with HIV/AIDS in rural Andhra Pradesh, India. We conducted a cluster randomized controlled 2 × 2 factorial trial lasting six months with follow up at twelve and eighteen months. Interventions occurred in the Nellore and Prakasam regions of Andhra Pradesh by trained village women, ASHA (Accredited Social Health Activists), and included: (1) the usual supportive care from ASHA (UC); (2) UC plus nutrition education (NE); (3) UC plus nutritional protein supplementation (NS); (4) combined UC plus NE plus NS. A Bioimpedance Analyzer Model 310e measured body composition. SAS 9.4 analyzed all data. Mixed models using repeated measures evaluated lean mass change from baseline as primary and fat weight and total weight as secondary outcomes. Lean mass change was significantly associated with NS (p = 0.0001), NE (p = 0.0001), and combined NS plus NE (p = 0.0001), with similar associations for secondary outcomes. Stronger associations for total weight were observed with greater ART adherence. Nutritional interventions may improve physiologic response to HIV. Significant increases in lean mass resulted from independent and combined protein supplementation and nutrition education.

The purpose of this study is to examine the possibility of using Coal Mine Overburden (CMOB) material as a secondary aggregate in low volume roadways' sub-base and/or base layer. Such roads usually experience less traffic, which means that weaker materials like CMOB could be used in various layers of the road after stabilization, either alone or in combination with cement or fly ash. After 7 and 28 days of curing, samples taken from Jharkhand mines were used to assess the strength characteristics of the stabilized samples, namely Unconfined Compressive Strength (UCS) and California Bearing Ratio (CBR). The findings demonstrate that the material, which has CBR of 80% or above and UCS of 3 MPa at 6% for Cement-Treated (CT-CMOB) and Cement-Fly Ash-Treated (CFA-CMOB) samples, may be utilized successfully as a secondary aggregate in low-volume road building. The results were then validated through standard acceptance as per IRC provisions and microstructural analysis. Additionally, correlations were established between the 7 and 28-day UCS properties of CT-CMOB and CFA-CMOB samples. This information can be beneficial for pavement engineers to estimate the strength properties associated with the base and subbase layer of pavement using CMOB as a suitable alternative to conventional aggregates. [ABSTRACT FROM AUTHOR]

Due to the depletion of supplies for high-quality aggregates, it has become necessary to incorporate marginally soft materials like moorum in pavement structural layers. This study aimed to investigate the mechanical characteristics of cementitiously stabilised moorum materials (CSMM), which would be relevant during the mechanistic design of pavements. The tests includes the unconfined compressive strength, california bearing ratio in a soaked state, flexural strength, indirect tensile strength, durability and shrinkage behaviour through a comprehensive laboratory investigation procedure. In this investigation, the collected moorum sample was from Bihar, the eastern state of India. Relationships between various mechanical characteristics have been developed for pavement analyses. The properties are achieved as per standards to study the behaviour of the pavement structures. Based on the research findings, the effectiveness of the strength and shrinkage characteristics in determining the acceptability of CSMM as a road base and subbase applications have been discussed. [ABSTRACT FROM AUTHOR]

Background: Chronic pulmonary aspergillosis (CPA) is known to complicate patients with post‐tubercular lung disease. However, some evidence suggests that CPA might co‐exist in patients with newly‐diagnosed pulmonary tuberculosis (P.TB) at diagnosis and also develop during therapy. The objective of this study was to confirm the presence of CPA in newly diagnosed P.TB at baseline and at the end‐of‐TB‐therapy. Materials and Methods: This prospective longitudinal study included newly diagnosed P.TB patients, followed up at third month and end‐of‐TB‐therapy with symptom assessment, anti‐Aspergillus IgG antibody and imaging of chest for diagnosing CPA. Results: We recruited 255 patients at baseline out of which 158 (62%) completed their follow‐up. Anti‐Aspergillus IgG was positive in 11.1% at baseline and 27.8% at end‐of‐TB‐therapy. Overall, proven CPA was diagnosed in 7% at baseline and 14.5% at the end‐of‐TB‐therapy. Around 6% patients had evidence of aspergilloma in CT chest at the end‐of‐TB‐therapy. Conclusions: CPA can be present in newly diagnosed P.TB patients at diagnosis and also develop during anti‐tubercular treatment. Patients with persistent symptoms or developing new symptoms during treatment for P.TB should be evaluated for CPA. Whether patients with concomitant P.TB and CPA, while receiving antitubercular therapy, need additional antifungal therapy, needs to be evaluated in future studies. [ABSTRACT FROM AUTHOR]

A study was undertaken to analyse farmers' access to various agricultural extension service sources, their preferences and to delineate underlying determinants for their access. The study used NSSO 77th survey dataset of 14,782 households of IGP states (Bihar, Haryana, Punjab, Uttar Pradesh, West Bengal). Farmers' preferences varied, with private agencies--particularly input dealers-- emerging as the top choice, followed by traditional mass media channels and the public extension system. Utility of Cooperative model, and farmer-based organizations have not yet been fully explored for information needs. The inputs (seeds, fertilizers, plant protection) were the most sought-after information. However, in an era of changing needs, farmers should strive to acquire additional information on aspects such as marketing, climate change, and post-harvest functions. The type of information sought by the farmers, influences their preferred sources of extension services. Irrespective of the source, the degree of access diminishes with the decreasing landholding. Among the five IGP states, Haryana emerged as the champion of information access for farmers, while Bihar lagged. Multivariate probit analysis reported that the likelihood of access to agricultural information sources was positively influenced by age, gender, education, size of operational landholding, irrigated area, and sale of produce at MSP. The study suggests making the extension services for small and socio-economically marginalized farmers more inclusive. Inclusiveness of extension services is essential for sustainability because it ensures that all farmers, regardless of their landholding, gender, age, caste, etc., have access to knowledge and resources they need to adopt improved agricultural practices and thus, secure prosperous livelihoods. [ABSTRACT FROM AUTHOR]

This investigation is primarily focused on addressing the prevailing uncertainty surrounding the compressive strength of three distinct types of bricks: nanomodified; simple; and commercial. Nanomodified bricks are specifically fabricated using a minute concentration of 0.01% w/w multiwalled carbon nanotubes combined with 1% sodium hexametaphosphate. However, the utilization of both materials in a single brick is currently limited. In view of this constraint, a diligent effort was made in this study to comprehend the effects of multiwalled carbon nanotubes and sodium hexametaphosphate as additive materials for brick construction. It is important to note that the compressive strength of the bricks remains the pivotal and critical characteristic under investigation, and an exhaustive analysis was undertaken employing a probabilistic approach. The findings of the study suggest that the variability observed in the compressive strength parameters of nanomodified, simple, and commercial bricks can be explained by a normal distribution at a significance level of 5%. The calculated values for the characteristic compressive strength were determined to be 24.47, 16.47, and 14.24 N/mm2 , respectively, for the three types of bricks. Further, the regression analysis conducted to assess the relationship between brick compressive strength and the independent variables yielded a cubic fit with R2 (coefficient of determination) values of 0.984, 0.995, and 0.995 for nanomodified, simple, and commercial bricks, respectively. Consequently, the application of multiwalled carbon nanotubes in conjunction with sodium hexametaphosphate in fired clay bricks can be recommended to achieve enhanced compressive strength. [ABSTRACT FROM AUTHOR]