Recent advancement of novel marine fungi derived secondary metabolite fibrinolytic compound FGFC in biomedical applications: a review.

For several decades, products derived from marine natural sources (PMN) have been widely identified for several therapeutic applications due to their rich sources of bioactive sub-stances, unique chemical diversity, biocompatibility and excellent biological activity. For the past 15 years, our research team explored several PMNs, especially fungi fibrinolytic compounds (FGFCs). FGFC is an isoindolone alkaloid derived from marine fungi, also known as staplabin analogs or Stachybotrys microspora triprenyl phenol (SMTP). For instance, our previous studies explored different types of FGFCs such as FGFC 1, 2, 3 and 4 from the marine fungi Stachybotrys longispora FG216 derived metabolites. The derivatives of FGFC are potentially employed in several disease treatments, mainly for stroke, cancer, ischemia, acute kidney injury, inflammation, cerebral infarction, thrombolysis and hemorrhagic activities, etc. Due to the increasing use of FGFCs in pharmaceutical and biomedical applications, it is important to understand the fundamental signaling concept of FGFCs. Hence, for the first time, this review collectively summarizes the background, types, mode of action and biological applications of FGFCs and their current endeavors for future therapies.

Knowledge, attitude and perceived barriers related to directly observed treatment, short-course among patients and caregivers attending tuberculosis clinics: a cross-sectional survey.

Tuberculosis (TB) is a major worldwide health problem, particularly in India, where it accounts for a quarter of infections. Adherence to the directly observed treatment, short-course (DOTS), which is necessary for TB treatment, is difficult in resource-limited circumstances. This study addressed the knowledge, attitude, and perceived barriers related to TB and DOTS adherence among patients and caregivers. A cross-sectional survey was undertaken at the selected TB clinics between November 2023 and March 2024. Purposive sample yielded 180 patients and 217 caregivers. Data were obtained using validated, self-structured questionnaires that assessed knowledge, attitude, and perceived barriers to TB and DOTS adherence. Statistical analysis was carried out with IBM SPSS version 23.0. The study found that caregivers had considerably greater TB knowledge than patients (p<0.05). Many patients misunderstood the cause of TB (50.6%) and embraced various misconceptions about the disease, such as TB spreading by shaking hands or sharing food, swimming in a holy river to cure diseases, and TB being the result of sin or karmic retribution. Distance to treatment facilities (95.6%), the necessity to take time off from work (91.7%), and social stigma (65.0%) were identified as the top three barriers to DOTS adherence. The study highlighted considerable gaps in knowledge, distant healthcare facilities, busy work schedules, and social stigma as barriers to TB treatment adherence in Deoghar, Jharkhand. Addressing these challenges via focused education and support activities is essential for enhancing DOTS adherence and TB treatment outcomes.

Doping of Mn2+ ion into boron quantum dots with enhanced fluorescence properties for sensing of L-thyroxine biomarker and bioimaging applications.

L-thyroxine serves as a primary biomarker for diagnosing hypothyroidism and it is also utilized in hormone replacement therapy. Regular assessment of thyroxine levels is crucial for preventing health issues in hypothyroid patients, suggesting the requirement of a facile analytical tool for the detection of L-thyroxine. In this work, a straightforward and efficient synthetic method is introduced for in-situ preparation of Mn2+-doped boron quantum dots (Mn2+@B-QDs) derived from boron powder through a solvothermal reaction. The introduction of Mn2+ ion into B-QDs not only enhances fluorescence efficiency but also provides favorable sites within the QDs, expanding their potential applications in analytical chemistry. The blue fluorescent Mn2+ @B-QDs exhibited excellent performance for the selective recognition of L-thyroxine via a dynamic quenching mechanism. Under ideal conditions, a good linear relation was observed between the fluorescence emission intensity ratio of Mn2+@B-QDs and the concentration of L-thyroxine in the range of 0.125-5 µM, with a lower detection limit of 59.86 nM. The Mn2+@B-QDs exhibited the negligible cytotoxicity against A549 lung cancer cell lines and demonstrated good biocompatibility toward Saccharomyces cerevisiae cells.

Considering User Experience and Behavioral Approaches in the Design of mHealth Interventions for Atrial Fibrillation: Systematic Review.

BACKGROUND: Atrial fibrillation (AF) is a leading chronic cardiac disease associated with an increased risk of stroke, cardiac complications, and general mortality. Mobile health (mHealth) interventions, including wearable devices and apps, can aid in the detection, screening, and management of AF to improve patient outcomes. The inclusion of approaches that consider user experiences and behavior in the design of health care interventions can increase the usability of mHealth interventions, and hence, hopefully, yield an increase in positive outcomes in the lives of users. OBJECTIVE: This study aims to show how research has considered user experiences and behavioral approaches in designing mHealth interventions for AF detection, screening, and management; the phases of designing complex interventions from the UK Medical Research Council (MRC) were referenced: namely, identification, development, feasibility, evaluation, and implementation. METHODS: Studies published until September 7, 2022, that examined user experiences and behavioral approaches associated with mHealth interventions in the context of AF were extracted from multiple databases. The PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines were used. RESULTS: A total of 2219 records were extracted, with only 55 records reporting on usability, user experiences, or behavioral approaches more widely for designing mHealth interventions in the context of AF. When mapping the studies onto the phases of the UK MRC's guidance for developing and evaluating complex interventions, the following was found: in the identification phase, there were significant differences between the needs of patients and health care workers. In the development phase, user perspectives guided the iterative development of apps, interfaces, and intervention protocols in 4 studies. Most studies (43/55, 78%) assessed the usability of interventions in the feasibility phase as an outcome, although the data collection tools were not designed together with users and stakeholders. Studies that examined the evaluation and implementation phase entailed reporting on challenges in user participation, acceptance, and workflows that could not be captured by studies in the previous phases. To realize the envisaged human behavior intended through treatment, review results highlight the scant inclusion of behavior change approaches for mHealth interventions across multiple levels of sociotechnical health care systems. While interventions at the level of the individual (micro) and the level of communities (meso) were found in the studies reviewed, no studies were found intervening at societal levels (macro). Studies also failed to consider the temporal variation of user goals and feedback in the design of long-term behavioral interventions. CONCLUSIONS: In this systematic review, we proposed 2 contributions: first, mapping studies to different phases of the MRC framework for developing and evaluating complex interventions, and second, mapping behavioral approaches to different levels of health care systems. Finally, we discuss the wider implications of our results in guiding future mHealth research.

Gene inactivation of lysyl oxidase in smooth muscle cells reduces atherosclerosis burden and plaque calcification in hyperlipidemic mice.

BACKGROUND AND AIMS: Lysyl oxidase (LOX) catalyzes the crosslinking of collagen and elastin to maintain tensile strength and structural integrity of the vasculature. Excessive LOX activity increases vascular stiffness and the severity of occlusive diseases. Herein, we investigated the mechanisms by which LOX controls atherogenesis and osteogenic differentiation of vascular smooth muscle cells (SMC) in hyperlipidemic mice. METHODS: Gene inactivation of Lox in SMC was achieved in conditional knockout mice after tamoxifen injections. Atherosclerosis burden and vascular calcification were assessed in hyperlipidemic conditional [Loxf/fMyh11-CreERT2ApoE-/-] and sibling control mice [Loxwt/wtMyh11-CreERT2ApoE-/-]. Mechanistic studies were performed with primary aortic SMC from Lox mutant and wild type mice. RESULTS: Inactivation of Lox in SMCs decreased > 70 % its RNA expression and protein level in the aortic wall and significantly reduced LOX activity without compromising vascular structure and function. Moreover, LOX deficiency protected mice against atherosclerotic burden (13 ± 2 versus 23 ± 1 %, p < 0.01) and plaque calcification (5 ± 0.4 versus 11.8 ± 3 %, p < 0.05) compared to sibling controls. Interestingly, gene inactivation of Lox in SMCs preserved the contractile phenotype of vascular SMC under hyperlipidemic conditions as demonstrated by single-cell RNA sequencing and immunofluorescence. Mechanistically, the absence of LOX in SMC prevented excessive collagen crosslinking and the subsequent activation of the pro-osteogenic FAK/ß-catenin signaling axis. CONCLUSIONS: Lox inactivation in SMC protects mice against atherosclerosis and plaque calcification by reducing SMC modulation and FAK/ß-catenin signaling.

Synthesis of Carbon Dots from Peltophorum Pterocarpum Flowers for Selective Fluorescence Detection of Carbendazim.

In this study, carbon dots (CDs) were synthesized from Peltophorum pterocarpum flowers as the precursor material using the hydrothermal method. The fluorescence emission spectra of the resulting Peltophorum pterocarpum CDs (PP-CDs) exhibited excitation-independent behavior, showing the fluorescence emission peak at 410 nm when excited at 330 nm. This method is simple, rapid and well consistent with the green chemistry and sustainable analytical method development. The as-synthesized PP-CDs acted as a promising fluorescent probe for detecting carbendazim (CBZ) via aggregation-induced emission mechanism, showing a linear response to CBZ concentrations ranging from 1 to 30 µM, with a detection limit of 5.41 nM. This method was successfully applied to quantify CBZ in food samples, achieving excellent recoveries of 99% with a relative standard deviation (RSD) of less than 2%.

Ir(III)-Catalyzed Tandem Annulation of Aromatic Amides with 1,6-Diynes via Dual C-H Bond Activation.

An Ir(III)-catalyzed annulation of aryl amides with 1,6-diynes via ortho- as well as meta-dual C-H bond activation reaction is reported. The scope of the annulation reaction was examined with various substituted aryl amides, as well as 1,6-diynes. In this protocol, 1,6-diynes exhibit diverse reactivity compared with internal alkynes. It is important to note that the three C-C bond formation takes place consecutively via ortho followed by meta-dual C-H bond annulation by using a weak chelating group in one pot. A possible catalytic reaction mechanism was proposed to account for the annulation reaction.

Effects of ECM protein-coated surfaces on the generation of retinal pigment epithelium cells differentiated from human pluripotent stem cells.

Retinal degeneration diseases, such as age-related macular degeneration (AMD) and retinitis pigmentosa (RP), initially manifest as dysfunction or death of the retinal pigment epithelium (RPE). Subretinal transplantation of human pluripotent stem cell (hPSC)-derived RPE cells has emerged as a potential therapy for retinal degeneration. However, RPE cells differentiated from hPSCs using current protocols are xeno-containing and are rarely applied in clinical trials. The development of hPSC-derived RPE cell differentiation protocols using xeno-free biomaterials is urgently needed for clinical applications. In this study, two protocols (the activin A and NIC84 protocols) were selected for modification and use in the differentiation of hiPSCs into RPE cells; the chetomin concentration was gradually increased to achieve high differentiation efficiency of RPE cells. The xeno-free extracellular matrix (ECM) proteins, laminin-511, laminin-521 and recombinant vitronectin, were selected as plate-coating substrates, and a Matrigel (xeno-containing ECM)-coated surface was used as a positive control. Healthy, mature hPSC-derived RPE cells were transplanted into 21-day-old Royal College of Surgeons (RCS) rats, a model of retinal degeneration disease. The visual function of RCS rats was evaluated by optomotor response (qOMR) and electroretinography after transplantation of hPSC-derived RPE cells. Our study demonstrated that hPSCs can be efficiently differentiated into RPE cells on LN521-coated dishes using the NIC84 protocol, and that subretinal transplantation of the cell suspensions can delay the progression of vision loss in RCS rats.

The Tale of Designing a Clinical-Cases Manual for Rotations and Mixed Methods Analysis of Students' Participatory Experience in Co-Creation.

Introduction: The post-pandemic era ignited the concepts of virtual learning, enhancing a strong need for a specific clinical case manual of commonly encountered scenarios in internal medicine. In this article, we describe the process for creating a clinical cases manual which can be followed for any other clinical science. Further, we report the participatory experience of students in the co-creation of manual. Methods: The hand-written notes of the teacher during the rotation of internal medicine were improvised, and created into a digital version. The editorial team which included mainly student volunteers participated in digitization and reviewing the content, diagrams and flowcharts. We describe the process of designing the clinical-cases manual for rotations in internal medicine, which includes handwritten notes, review of the notes, formation of editorial team, digitization of text and artwork, editing and book release. It can be replicated for any other clinical sciences in rotations. In addition, the online survey with both quantitative and qualitative type of questions was used to assess the students' participatory experiences in co-creating manual. Results: The clinical-cases manual for rotations in internal medicine was released and received well. The online survey responses revealed that the participating students benefited in terms of professional and personal development. There was an inter-item statistical difference implying that all the participants were agreeing or strongly agreeing to survey questions. All participants agreed on the usefulness of the manual. The main themes identified through qualitative analysis were technical skills acquisition, lifelong learning and teaching, self-assessment, discipline, time management, teamwork and communication skills. Conclusion: The creation of a clinical case manual for rotation, specific to the local needs can be done through a systematic process, that can be enriched by involving students. Encouraging the participation of students in co-creation is an important academic exercise that contributes to professional and personal development.

A Current Trend in Efficient Biopolymer Coatings for Edible Fruits to Enhance Shelf Life.

In recent years, biopolymer coatings have emerged as an effective approach for extending the shelf life of edible fruits. The invention of biopolymer coverings has emerged as an innovation for extending fruit shelf life. Natural polymers, like chitosan, alginate, and pectin, are used to create these surfaces, which have several uses, including creating a barrier that prevents water evaporation, the spread of living microbes, and respiratory movement. These biopolymer coatings' primary benefits are their environmental friendliness and lack of damage. This study highlights the advancements made in the creation and usage of biopolymer coatings, highlighting how well they preserve fruit quality, reduce post-harvest losses, and satisfy consumer demand for natural preservation methods. This study discusses the usefulness of the biopolymer coating in terms of preserving fruit quality, reducing waste, and extending the product's shelf life. Biopolymer coatings' potential as a sustainable solution for synthetic preservatives in the fruit sector is highlighted as are formulation process advances that combine natural ingredients and environmental implications. This essay focuses on the essential methods, such as new natural additives, as well as the environmental effect of biopolymer coatings, which are safe and healthy commercial alternatives.

Fabrication of highly fluorescent graphene quantum dots for quantification of As3+ ion using modified cellulose paper.

Easy, economical, and swift detecting tools are very demanded for assaying various chemical species. The introduction of label-free paper-based read-out devices has significantly reached the demand of analytical science for target analytes assays. Herein, a facile, and disposable inexpensive paper-based sensing tool was fabricated for sensing As3+ ion using graphene quantum dots (GQDs) as a fluorescent reader. The CA-GQDs were synthesized using citric acid (CA) as a precursor via the pyrolysis method, further physisorbed on the cellulose substrate for sensing of As3+ via aggregation-based fluorescence "turn-off" mechanism. The linear range for quantitating As3+ ion is in the range of 0.05-50 µM with a detection limit of 10 nM. The practical application of the CA-GQDs-based analytical platform was verified by assaying As3+ ion in water samples. The CA-GQDs-embedded paper strip can be easily extended for assaying of As3+ ion, which meets the demand for monitoring of As3+ ion in real samples.

Therapeutic Leukapheresis in a Pediatric Acute Myeloid Leukemia (AML) Crisis as a Critical Life-Saving Adjunctive Therapy: A Case Report.

Hematological malignancies can present with severe complications, including hyperleukocytosis, which demands immediate intervention due to elevated leukocyte counts that increase blood viscosity and cause microcirculatory abnormalities. This case report highlights the critical role of therapeutic leukapheresis in managing a pediatric patient with acute myeloid leukemia (AML) in crisis. A six-year-old male child presented with symptoms of severe hyperleukocytosis, including high-grade fever, respiratory distress, and a significant leukocyte count (555,820/µL). Immediate interventions included intravenous hydration, antibiotics, steroids, and non-invasive ventilation, followed by therapeutic leukapheresis. The leukapheresis procedure successfully reduced the leukocyte count by 81% without any adverse events. Post-procedure treatment with etoposide further decreased the leukocyte count, leading to symptomatic improvement and stabilization of the patient. The patient was later discharged in stable condition and continued receiving induction-phase chemotherapy. This case underscores the efficacy and necessity of leukapheresis as a life-saving adjunctive therapy in pediatric AML crises, demonstrating its role in rapidly reducing leukocyte counts and preventing life-threatening complications.

Facile synthesis of Eu3+-doped niobium carbide MXene quantum dots for parallel detection of hypoxanthine and fluoxetine via fluorescence quenching and enhancement mechanisms.

A hydrothermal synthetic method is established to produce blue fluorescent Eu3+-doped niobium carbide MXene quantum dots (Eu3+-Nb2C MQDs). The synthesized Eu3+-Nb2C MQDs demonstrated a quantum yield of 20.61% and a maximum emission intensity at 405 nm. The as-prepared Eu3+-Nb2C MQDs acted as a sensor for the rapid and sensitive detection of hypoxanthine through fluorescence quenching, and of fluoxetine through fluorescence enhancement mechanisms. The emission peak of Eu3+-Nb2C MQDs at 405 nm exhibited a linear response for hypoxanthine and fluoxetine in the ranges of 0.5-25 µM and 0.125-2.5 µM, with detection limits of 15.0 and 3.7 nM, respectively. The newly developed probe was effectively used for the selective detection of hypoxanthine and fluoxetine in biofluids and pharmaceutical samples. Remarkably, the Eu3+-Nb2C MQDs exhibited minimal cytotoxicity towards A549 lung cancer cells and showed great potential as imaging agent for imaging of Saccharomyces cerevisiae cells.

Analysis of Blood Donor Deferral Pattern at a Tertiary Care Hospital in Chennai: A Cross-Sectional Retrospective Study.

Background Blood is essential for saving lives, particularly in emergencies. However, many patients, especially in developing countries face delays in accessing safe blood due to inadequate infrastructure, insufficient blood banks, poorly equipped laboratories, unreliable transportation systems, low donation rates driven by cultural beliefs, fear, and misconceptions, poor blood donor recruitment and retention, economic constraints, and a general lack of awareness and education about blood donation. Ensuring safe transfusions requires advanced technology and promoting healthy, voluntary donations. Donor selection is crucial for safety, preventing adverse reactions through proper criteria and infection screenings. Donor deferrals can discourage donors and hinder recruitment, so identifying and addressing deferral causes is vital. Blood centers must balance quality and quantity by using thorough donor assessments. Efforts should focus on both recruiting new donors and retaining deferred ones to ensure a stable blood supply. Aim The aim of the study is to evaluate and analyze the patterns and causes of blood donor deferrals in a tertiary care hospital. The objectives are to determine the incidence and reasons for blood donor deferrals. Materials and methods A cross-sectional retrospective study was conducted for 36 months from May 2021 to May 2024. A simple random sampling method was used to select the blood donors who reported for donation. Data was obtained from records maintained by the blood center. Descriptive statistics were utilized to summarize the demographics of the blood donors, including deferral rates among males and females, and the frequency of temporary and permanent deferrals. A Chi-square test was done to find the association between gender and deferral rates in blood donation. This analysis aimed to explore gender variations and underlying health status differences between male and female donors, as these can influence deferral rates. Results From May 2021 to May 2024, 17,082 people registered to donate blood at the Blood Centre, Department of Transfusion Medicine. Out of these, 1,000 donors, or 5.85%, were deferred. The majority of donors were males 16,638, with only 444 females. Most deferrals (76.4%) were temporary, often due to low hemoglobin levels or recent alcohol intake. Permanent deferrals (23.6%) were usually due to uncontrolled hypertension and diabetes. A significant association was found between gender and type of deferral among participants (p < 0.05). Conclusion This cross-sectional retrospective study on blood donor deferral patterns in a tertiary care hospital highlights key reasons such as low hemoglobin, recent alcohol intake, hypertension, and diabetes. To improve donor eligibility and retention, targeted strategies including enhanced education and community engagement are essential. These efforts will strengthen blood transfusion services and support critical healthcare needs effectively.

Response Patterns and Behavior of Seropositive Blood Donors: A Comprehensive Analysis.

Background Blood transfusion services are vital in healthcare, ensuring a steady and safe supply of blood for patients in need. Identifying seropositive blood donors and understanding their response patterns and behaviors are critical for improving the safety and efficacy of blood transfusion practices. Aim Our study aims to determine the response rate and pattern of blood donors who test reactive for transfusion-transmitted infections (TTIs) and to understand the attitudes of reactive blood donors toward post-donation notification, follow-up, and counseling. Materials and methods Our study is retrospective audit analyzing the data record for a period of 24 months from October 2021 to October 2023 in the transfusion medicine department of a tertiary care hospital in southern India. All donations were screened for hepatitis B, hepatitis C, HIV, malaria, and syphilis. Results Of the total 8,276 donations during the study period, 117 (1.41%) were reactive for various TTIs. The highest prevalence was hepatitis B (0.61%), followed by hepatitis C (0.38%), then HIV (0.22%) and syphilis (0.14%). Of all the TTI reactive donors, 82 donors (70%) responded after communication, and the remaining 30% could not be contacted by any mode of communication. The most common reason for non-communication was the fabricated postal address given by the donors. Of the donors approached, 57 (48.7%) reinstated to our blood bank for further counseling and specific treatment. The donor's busy schedule and out-of-city residence were the main reasons for non-compliance with the follow-up protocol. Conclusion Informing donors of their serological status and providing post-donation counseling are crucial elements of blood transfusion protocol. Necessary knowledge about TTIs are to be instilled to the donors during the blood collection procedure. Moreover, its crucial for the donor to provide accurate demographic details aiding follow up and easy access during times of managing blood inventory.

Assessment of Cognitive Functions Among Remitted Patients of Schizophrenia and Bipolar Disorder: A Comparative Study.

Introduction Bipolar disorder and schizophrenia exhibit different patterns of cognitive impairment, with schizophrenia demonstrating more profound deficiencies in verbal memory and bipolar disorder in social cognition. Understanding these patterns may guide the development of interventions to enhance cognition in these disorders. Aim This study aims to assess and compare the cognitive abilities of persons diagnosed with bipolar illness and schizophrenia. Methodology A facility-based cross-sectional study was done from December 2016 to June 2017 among 30 schizophrenia and 30 bipolar disorder patients aged 18-45 years, in remission selected after screening through Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS), or Positive and Negative Syndrome Scale (PANSS). Exclusions included schizoaffective disorder, systemic illness, brain/neurological conditions, and substance abuse. After collecting the baseline demographic and clinical profile of the selected patients, the cognitive domains were assessed such as attention (digit span), verbal memory (Rey's Auditory Verbal Learning Test (RAVLT)), visual memory (Rey Complex Figure), verbal fluency (Animal Naming), and executive functions (Stroop and Trail Making). The data was analyzed using the IBM SPSS Statistics for Windows, Version 16 (Released 2007; IBM Corp., Armonk, New York, United States) using standard descriptive and inferential statistics. Results Sociodemographic and clinical characteristics were largely similar between groups. Schizophrenia patients showed poorer attention, working memory, and visual attention/task-switching compared to bipolar patients. Bipolar patients demonstrated relatively preserved abilities in these domains but exhibited more impairments in visual and verbal memory. Distinct patterns highlight unique neurobiological underpinnings, showing association of more generalized cognitive deficits in schizophrenia and more localized impairments in memory functions in bipolar disorder. Conclusion The study findings explain these disorders' unique neurobiological mechanisms and may help develop targeted cognitive remediation and pharmacological interventions to improve functional outcomes and quality of life.

Exosomes Isolation, Purification, and Characterization.

Exosomes are double-layered lipid membranous nanovesicles that are endosomal in origin and secreted by almost all cells. They are 30-130 nm in size and contain various molecular signatures such as miRNAs, mRNAs, DNA, lipids, and proteins. Due to their highly heterogeneous content, exosomes have a major role in influencing cellular physiology and pathology. Although exosome research has been in progress for a long time, its biomedical applications have recently been expanding due to its bio-friendly nature. However, the most challenging part is its isolation to obtain quality exosomes with good yield. Therefore, in this chapter, we have described appropriate protocols for exosome isolation and characterization along with alternative purification methods.

Severe Pneumonia in PICU Admissions: The Pediatric Acute and Critical Care Medicine Asian Network (PACCMAN) Observational Cohort Study, 2020-2022.

OBJECTIVES: Mortality from pneumonia is three times higher in Asia compared with industrialized countries. We aimed to determine the epidemiology, microbiology, and outcome of severe pneumonia in PICUs across the Pediatric Acute and Critical Care Medicine Asian Network (PACCMAN). DESIGN: Prospective multicenter observational study from June 2020 to September 2022. SETTING: Fifteen PICUs in PACCMAN. PATIENTS: All children younger than 18 years old diagnosed with pneumonia and admitted to the PICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Clinical, microbiologic, and outcome data were recorded. The primary outcome was PICU mortality. Univariate and multivariable logistic regression was performed to investigate associations between PICU mortality and explanatory risk factors on presentation to the PICU. Among patients screened, 846 of 11,778 PICU patients (7.2%) with a median age of 1.2 years (interquartile range, 0.4-3.7 yr) had pneumonia. Respiratory syncytial virus was detected in 111 of 846 cases (13.1%). The most common bacteria were Staphylococcus species (71/846 [8.4%]) followed by Pseudomonas species (60/846 [7.1%]). Second-generation cephalosporins (322/846 [38.1%]) were the most common broad-spectrum antibiotics prescribed, followed by carbapenems (174/846 [20.6%]). Invasive mechanical ventilation and noninvasive respiratory support was provided in 438 of 846 (51.8%) and 500 of 846 (59.1%) patients, respectively. PICU mortality was 65 of 846 (7.7%). In the multivariable logistic regression model, age (adjusted odds ratio [aOR], 1.08; 95% CI, 1.00-1.16), Pediatric Index of Mortality 3 score (aOR, 1.03; 95% CI, 1.02-1.05), and drowsiness (aOR, 2.73; 95% CI, 1.24-6.00) were associated with greater odds of mortality. CONCLUSIONS: In the PACCMAN contributing PICUs, pneumonia is a frequent cause for admission (7%) and is associated with a greater odds of mortality.

Synchrotron induced X-ray fluorescence spectroscopy reveals heavy metal translocation in sludge amended soil-plant systems: assessment of ecological and health risks.

The use of composted sludge from sewage treatment plants as a soil amendment is a common practice of recycling nutrients like organic carbon, nitrogen, and phosphorus. The sewage generated in larger cities of developing countries is often contaminated with various heavy metals (HMs) that ultimately end up in composted sludge. Thus, using such composted sludge is likely to pose ecological and human health risks. Hence, the knowledge of HM translocation in sludge-soil-plant systems is of vital importance. The present study was aimed at investigating the HM translocation in sludge-soil-plant system. The HM translocation was measured using synchrotron radiation-induced x-ray fluorescence spectrometry and atomic absorption spectroscopic techniques. The results indicated high HM mobility (up to 2628.5 mg kg-1) from sludge to spinach plant. The metal accumulation (mg kg-1) ranged in the order-Fe (950.55-2628.5) > Zn (20.11-172.13) > Cu (13.86-136.17) > Mn (2.13-34.67) > Cd (0.11-31.17) > Pb (1.50-30.16) > Co (0.18-9.85) As (0.02-7.80) > Cr (0.01-5.69). This observed accumulation depended on the volume of sewage being treated in the sewage treatment plant (STP) and varied in the order control < (8 MLD Bhagwanpur, STP 1) < (80 MLD Dinapur, STP2) < (140 MLD Dinapur, STP3) hence the HM load coming into STPs. The metal transfer factor, bioconcentration factor, and translocation factor values also correlated with the abundance of Fe, Cu, Pb, Cd, and Zn in spinach root and shoot compartments. The carcinogenic risk for heavy metal carcinogens like As, Cd, Cr, and Pb revealed children being more prone to cancer upon spinach consumption. Hence, it is necessary to assess the heavy metals present in the sludge prior to its application in agricultural fields.