bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proximity-Based Labeling Identifies MHC Class II and CD37 as B Cell Receptor–Proximal Proteins with Immunological Functions
Authors: Hoeger Sean , Drake Lisa A , Drake James R 
Published: April 2024

Abstract
The BCR allows for Ag-driven B cell activation and subsequent Ag endocytosis, processing, and presentation to recruit T cell help. Core drivers of BCR signaling and endocytosis are motifs within the receptor’s cytoplasmic tail (primarily CD79). However, BCR function can be tuned by other proximal cellular elements, such as CD20 and membrane lipid microdomains. To identify additional proteins that could modulate BCR function, we used a proximity-based biotinylation technique paired with mass spectrometry to identify molecular neighbors of the murine IgM BCR. Those neighbors include MHC class II molecules, integrins, various transporters, and membrane microdomain proteins. Class II molecules, some of which are invariant chain–associated nascent class II, are a readily detected BCR neighbor. This finding is consistent with reports of BCR–class II association within intracellular compartments. The BCR is also in close proximity to multiple proteins involved in the formation of membrane microdomains, including CD37, raftlin, and Ig superfamily member 8. Known defects in T cell–dependent humoral immunity in CD37 knockout mice suggest a role for CD37 in BCR function. In line with this notion, CRISPR-based knockout of CD37 expression in a B cell line heightens BCR signaling, slows BCR endocytosis, and tempers formation of peptide–class II complexes. These results indicate that BCR molecular neighbors can impact membrane-mediated BCR functions. Overall, a proximity-based labeling technique allowed for identification of multiple previously unknown BCR molecular neighbors, including the tetraspanin protein CD37, which can modulate BCR function.
Mycobacterium genavense Mycobacteremia in a Host with Advanced AIDS
Authors: Kandikuppa Ravi Teja , Gopalakrishnan Ram , Sethuraman Nandini 
Published: April 2024

Abstract
Nontuberculous mycobacteria and Pneumocystis jirovecii pneumonia (PCP) are important opportunistic pathogens in patients with advanced immunodeficiency. We present a case of a 38-year-old male who presented with fever, cough, breathlessness, and constitutional symptoms and, on evaluation, was found to have advanced acquired immunodeficiency syndrome (AIDS), possible PCP, and mycobacteremia caused by Mycobacterium genavense. We report what seems to be the first case report of M. genavense mycobacteremia in a host with AIDS from India.
Clinical Outcomes of Patients Treated with Intravenous Fosfomycin in a Tertiary Care Hospital: An Observational Study
Authors: Premachandran Krishna Prabha , Gopalakrishnan Ram , Ramasubramanian Venkatasubramanian , Krishnamurthy Arun Chander , Nambi P. Senthur 
Published: April 2024

Abstract

Introduction:
Fosfomycin has a unique structure and mechanism of action among antimicrobials. It has reemerged as a potential tool against multidrug-resistant organisms in intensive care units. In this study, we looked into the clinical outcomes of patients treated with intravenous fosfomycin in our center for the past 5 years.

Materials and Methods:
A retrospective observational study on the characteristics and clinical outcomes of patients who received fosfomycin as definitive therapy from 2016 to 2021 was done.

Results:
The indications for use of fosfomycin were urosepsis (34%), intra-abdominal infections (22%), and primary bacteremia. The overall cure rate on treatment with fosfomycin was 69%. The highest cure rate was seen with meningitis, urosepsis, and skin and soft-tissue infections (SSTIs). Patients with infections caused by Escherichia coli had better survival than others. Adverse events were seen only in 6%.

Conclusions:
Fosfomycin is a very effective drug for urinary tract infections, SSTIs, and meningitis caused by carbapenem-resistant E. coli.
Cytomegalovirus Reactivation in Severe Coronavirus Disease 2019: Case Series from a Tertiary Care Center in the Western State of India
Authors: Patel Tushar , Pandya Pankti , Patel Ketan K. , Patel Kamlesh , Patel Atul K. 
Published: April 2024

Abstract

Introduction:
Cytomegalovirus (CMV) reactivation in patients who have been admitted to the intensive care unit (ICU) is linked to higher mortality and health-care costs. There is a dearth of published research on CMV reactivation in patients with severe SARS-CoV-2.

Materials and Methods:
Objectives: The objective of this study was to describe clinical and laboratory profiles and outcomes of CMV reactivation in patients with severe SARS-CoV-2 illness. In this retrospective study carried out at a tertiary care hospital ICU in the Western state of India, patients with severe SARS-CoV-2 who were admitted from January 1, 2021, to May 31, 2021, and who got CMV viral load testing by reverse transcriptase polymerase chain reaction were analyzed.

Results:
During the study period, 27 out of 277 admitted patients were subjected to plasma CMV viral load testing, of which 13 patients had detectable viral load giving a prevalence of 4.7%. Patients who tested positive for CMV had significantly higher mortality (P = 0.020) and ventilator support needs (P = 0.004). Both fungal and bacterial bloodstream infections were frequent in CMV-positive patients, but neither was statistically significant (P = 0.065 and P = 0.571, respectively). In this case series, there was no difference in CMV reactivations according to the degree of lymphopenia (P = 0.149), usage of steroids (P = 0.766), or immunomodulatory medications (tocilizumab/bevacizumab, P = 0.926).

Conclusions:
In SARS-CoV-2 patients with severe illness, CMV reactivation was associated with an increased need for ventilator support, a higher incidence of nosocomial infection (bacterial and fungal), and overall mortality.
Activated Partial Thromboplastin Time (aPTT) as a Screening Test for Predicting Bleeding Manifestations in Adult Patients with Dengue Infection – A Diagnostic Accuracy Study
Authors: Thomas Riya Sarah , Lenin Audrin , Sathyendra Sowmya , Hansdak Samuel George , George Tina , Zachariah Anand , Iyadurai Ramya , Belavendra Antonisamy , Geevar Tulasi , Abraham Asha Mary , Abraham Anuja , Beck Manisha Madhai , Rathore Swati 
Published: April 2024

Abstract

Background:
Thrombocytopenia has been well established in dengue infections; however, coagulopathy is yet to be explored. Objective: The primary outcome was to assess derangement of activated partial thromboplastin time (aPTT) as a predictor of bleeding manifestations and severity of disease in dengue.

Methods:
This prospective cohort study included adults with dengue fever confirmed by serology, presenting to a single tertiary care center in South India. A structured questionnaire was used to extract clinical features and laboratory parameters at presentation, including aPTT. The patients were clinically observed during their course of illness for the outcomes of major and minor bleeding manifestations along with features of severe dengue.

Results:
Between May 2020 and September 2021, 140 patients were screened and 122 were recruited. Among these, 72 patients had normal aPTT and 50 had deranged aPTT. There were 41 bleeding events noted and 35 patients had severe dengue. There was a statistically significant correlation for aPTT derangement with major bleeding events (relative risk [RR] =4.03 [95% confidence interval (CI): 1.6–10.5]; P = 0.002), with minor bleeding events (RR = 2.52 [95% CI: 1.1–5.6]; P = 0.017) and with severity of dengue (RR = 3.14 [95% CI: 1.7–5.8); P < 0.001]. aPTT had a good negative predictive value of 93.1% (95% CI: 84.5–97.7) for major bleeding. There was no statistically significant correlation between thrombocytopenia and bleeding manifestations.

Conclusion:
aPTT can be used as an indicator for predicting bleeding events and severity in dengue fever, with a good negative predictive value.
Characteristics & outcomes of cancer patients with COVID-19: A multicentre retrospective study from India
Authors: Kumar Akash , Baghmar Saphalta , Mehta Prashant , Tiwari Priya , Kumar Lalit , Bakhshi Sameer , Agarwal Amit , Gupta Ishaan , Trikha Anjan , Bhatnagar Sushma , Gogia Ajay , Malik Prabhat Singh , Sahoo Ranjit Kumar , Rastogi Sameer , Pramanik Raja , Batra Atul , Pushpam Deepam , Sharma Chitresh K , Sharma Vinod , Kataria Babita , Goyal Kapil , Samaga Shreyas , Bothra Sneha J , Sharma Atul 
Published: April 2024

Background & objectives:
High mortality has been observed in the cancer population affected with COVID-19 during this pandemic. We undertook this study to determine the characteristics and outcomes of cancer patients with COVID-19 and assessed the factors predicting outcome.

Methods:
Patients of all age groups with a proven history of malignancy and a recent diagnosis of SARS-CoV-2 infection based on nasal/nasopharyngeal reverse transcriptase (RT)-PCR tests were included. Demographic, clinical and laboratory variables were compared between survivors and non-survivors groups, with respect to observed mortality.

Results:
Between May 11 and August 10, 2020, 134 patients were included from the three centres and observed mortality was 17.1 per cent. The median age was 53 yr (interquartile range 39-61 yr) and thirty four patients (25%) were asymptomatic. Solid tumours accounted for 69.1 per cent and breast cancer was the most common tumour type (20%). One hundred and five patients (70.5%) had received chemotherapy within the past four weeks and 25 patients (19.3%) had neutropenia at presentation. On multivariate analysis, age [odds ratio (OR) 7.99 (95% confidence interval [CI] 1.18-54.00); P=0.033], haemoglobin [OR 6.28 (95% CI 1.07-37.04); P=0.042] neutrophil–lymphocyte ratio [OR 12.02 (95% CI 2.08-69.51); P=0.005] and baseline serum albumin [OR 18.52 (95% CI 2.80-122.27); P=0.002], were associated with higher mortality. Recent chemotherapy, haematological tumours type and baseline neutropenia did not affect the outcome.

Interpretation & conclusions:
Higher mortality in moderate and severe infections was associated with baseline organ dysfunction and elderly age. Significant proportion of patients were asymptomatic and might remain undetected.
Polyalanine polymorphism in the signal peptide of Glutathione peroxidase 1 (GPX1) gene & its association with osteoporosis
Authors: Ahuja Soni Ghumnani , Shahu Arjun , Rath Subrata , Adkar Neeraj , Shouche Yogesh , Ghaskadbi Saroj , Ashma Richa 
Published: April 2024

Background & objectives:
Osteoporosis is a systemic skeletal disease, characterized by a low bone mass leading to increased bone fragility and hence, a greater susceptibility to the risk of fracture. Since age-related oxidative stress is one of the factors that has been implicated in developing low bone mineral density (BMD), leading to osteoporosis, this study wanted to explore the expression of antioxidant enzymes in individuals with osteoporosis. The present study focused on mapping polymorphism in an important antioxidant enzyme glutathione peroxidase 1 (GPx1) among osteoporosis and healthy Asian Indians.

Methods:
Dual-energy X-ray absorptiometry was used to assess BMD of individuals and was classified into normal (n=96) and osteoporotic (n=88) groups. Biochemical parameters such as vitamin D, total oxidant status (TOS), and GPx1 enzyme activity were estimated from plasma samples of recruited individuals. Quantitative real-time qRT-PCR was carried out using GAPDH as an endogenous control. Genomic DNA was isolated from whole blood, and polymorphisms were evaluated by sequencing.

Results:
The BMD was lower in osteoporotic individuals, and further analysis of biochemical parameters indicated significantly low 25-hydroxy vitamin D and GPx1 with higher TOS levels in osteoporotic as compared to healthy individuals. Furthermore, qRT-PCR revealed low expression of GPX1 in osteoporotic individuals. GPX1 sequence analysis of the promoter and two exons revealed the lower frequency of five alanine repeats in the osteoporotic individuals.

Interpretation & conclusions:
In this study, the in silico analysis revealed the lower frequency of five alanine repeats in exon 1 of GPX1 and high TOS to be associated with osteoporosis. However, no polymorphism was found in exon 2 of GPX1 among the two study groups.
COTPA implementation status: An observational study in South Indian city
Authors: Tripathi Surbhi , Chinnakali Palanivel , Naik Bijaya Nanda , Kar Sitanshu Sekhar 
Published: April 2024

Background & objectives:
The World Health Organization (WHO) document released on the World No Tobacco Day, 2020, mentions that tobacco kills over 22,000 people worldwide every day either from its use or second-hand smoke exposure, which is one person every 4 sec. In 2003, the Cigarettes and Other Tobacco Products Act (COTPA) was enacted by the Indian government to control/regulate use of tobacco and tobacco products. Despite various amendments to this law, there has not been any appreciable decrease in tobacco use. The objective of this study was to assess the compliance level with sections 4-10 of COTPA in urban Puducherry in South India.

Methods:
Random sample survey of 13 wards was carried out in selected parts of the city of Puducherry. The estimated sample size was minimum 160 public places and point of sales (PoS) each. A pre-tested checklist was used to obtain information on compliance with COTPA. Statistical and spatial analysis was performed using STATA v12.0 and QGIS v2.14.21, respectively.

Results:
Eight per cent of public places, 0 per cent of PoS, 1.7 per cent of educational institutions and 48 per cent of tobacco packages were found compliant with COTPA specifications. The compliance in public places varied from 0 (bus stops) to 55 per cent (religious places).

Interpretation & conclusions:
The overall compliance with COTPA was found to be very low in urban Puducherry. In order to ensure proper implementation of the laws, effective enforcement with periodic monitoring of various sections of COTPA are needed.
Cost of implementing the QualityRights programme in public hospitals in Gujarat providing mental healthcare
Authors: Chatterjee Susmita , Pathare Soumitra , Funk Michelle , Drew-Bold Natalie , Das Palash , Chauhan Ajay , Kalha Jasmine , Krishnamoorthy Sadhvi , Sapag Jaime C. , Bobbili Sireesha J. , Shah Sandip , Mehta Ritambhara , Patel Animesh , Gandhi Upendra , Tilwani Mahesh , Shah Rakesh , Sheth Hitesh , Vankar Ganpat , Parikh Minakshi , Parikh Indravadan , Rangaswamy Thara , Bakshy Amritkumar , Khenti Akwatu 
Published: April 2024

Background & objectives:
Investment in mental health is quite meagre worldwide, including in India. The costs of new interventions must be clarified to ensure the appropriate utilization of available resources. The government of Gujarat implemented QualityRights intervention at six public mental health hospitals. This study was aimed to project the costs of scaling up of the Gujarat QualityRights intervention to understand the additional resources needed for a broader implementation.

Methods:
Economic costs of the QualityRights intervention were calculated using an ingredients-based approach from the health systems’ perspective. Major activities within the QualityRights intervention included assessment visits, meetings, training of trainers, provision of peer support and onsite training.

Results:
Total costs of implementing the QualityRights intervention varied from Indian Rupees (

JOURNAL/ijmer/04.03/02223309-202306000-00006/524FF01/v/2023-09-02T030054Z/r/image-tiff

) 0.59 million to

JOURNAL/ijmer/04.03/02223309-202306000-00006/524FF01/v/2023-09-02T030054Z/r/image-tiff

2.59 million [1United States Dollars (US $) =

JOURNAL/ijmer/04.03/02223309-202306000-00006/524FF01/v/2023-09-02T030054Z/r/image-tiff

74.132] across six intervention sites at 2020 prices with 69-79 per cent of the cost being time cost. Scaling up the intervention to the entire State of Gujarat would require about two per cent increase in financial investment, or about 7.5 per cent increase in total cost including time costs over and above the costs of usual care for people with mental health conditions in public health facilities across the State.

Interpretation & conclusions:
The findings of this study suggest that human resources were the major cost contributor of the programme. Given the shortage of trained human resources in the mental health sector, appropriate planning during the scale-up phase of the QualityRights intervention is required to ensure all staff members receive the required training, and the treatment is not compromised during this training phase. As only about two per cent increase in financial cost can improve the quality of mental healthcare significantly, the State government can plan for its scale-up across the State.
Cingulum bundle integrity in schizophrenia with auditory verbal hallucinations: A diffusion tensor imaging tractographic study
Authors: Chawla Nishtha , Deep Raman , Khandelwal Sudhir Kumar , Garg Ajay 
Published: April 2024

Background & objectives:
Cingulum bundle (CB) is frequently implicated in schizophrenia; however, its role in specific symptoms of schizophrenia such as auditory verbal hallucinations (AVHs) is less explored. Few studies have reported association between reduced integrity of CB and severity of AVH. Using a symptom-based approach, this diffusion tensor imaging (DTI) tractographic study was aimed to assess and compare the integrity of CB in schizophrenia with AVH, schizophrenia without AVH and healthy controls.

Methods:
A total of 92 right-handed adult individuals (aged 18-50 yr) were recruited across three study groups. Those with Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) diagnosis of schizophrenia with AVH (group I; n=30) were compared to those with DSM-5 schizophrenia without lifetime AVH (group II; n=32) and healthy controls (group III; n=30; screened using Mini International Neuropsychiatric Interview version-7.0.0. and negative family history). Clinical assessments (groups I and II) included scale for assessment of positive symptoms, scale for assessment of negative symptoms, clinical global impression-schizophrenia and psychotic symptom rating scale. All participants underwent DTI, and quantitative tract-based measurements of fractional anisotropy (FA) were obtained for images using DTI studio version-3.0.

Results:
All groups were comparable for age, gender, education and severity of illness. Group I had significantly lower FA values in the cingulate gyrus (CG) part of the left CB compared to groups II and III. No significant difference was found between groups II and III.

Interpretation & conclusions:
The findings of this study suggest that the disruption in the left CB appears to be specific for AVH-positive schizophrenia. The finding is, however, preliminary subject to replication in future studies. Further investigations are needed to understand its relevance in the context of AVH-positive schizophrenia.
A retrospective analysis of serological & molecular testing data on dengue fever in Kolkata & adjacent districts during 2016-2019
Authors: Majumdar Agniva , Gupta Rajarshi , Chatterjee Ananya , Banu Hasina , Biswas Madhumonti , Gupta Rudrak , Mukherjee Soumen , Sadhukhan Provash , Dutta Shanta 
Published: April 2024

Background & objectives:
Regional Virus Research and Diagnostic Laboratory established at ICMR-National Institute of Cholera and Enteric Diseases (NICED) regularly receives samples for dengue screening and serotyping from patients of acute febrile illness (AFI) from Kolkata and adjacent districts. In this study, data over a three year period (August 2016-July 2019) was retrospectively analyzed to provide insight into the epidemiological trends of dengue fever in this region.

Methods:
Serological screening of dengue was performed by detection of NS1 antigen and/or immunoglobulin M (IgM) antibody. Dengue serotyping was done by conventional or real-time reverse transcriptase–PCR. The data were analyzed to describe the distribution of dengue with respect to age of patient, duration of fever on the day of blood collection and month of the year. Zip codes were used for spatial plotting.

Results:
Out of the 24,474 samples received from Kolkata and its adjacent districts (Hooghly, Howrah, North and South 24 Parganas), 38.3 per cent (95% confidence interval: 37.7-38.9%) samples were screened positive for dengue. The correlation between age and dengue positivity was found to be weak. A combination of dengue NS1 antigen and dengue IgM antibody detection may be a better option for detecting dengue positivity compared to a single test. Most AFI cases were tested from August to November during the study period, with maximum dengue positivity noted during September (45.9%). The predominant serotype of 2016, dengue virus serotype 1 (DENV-1), was almost entirely replaced by DENV-2 in 2017 and 2018.

Interpretation & conclusions:
Dengue continues to be an important cause of AFI in the region and round-the-year preventive measures are required for its control. Serotype switching is alarming and should be monitored routinely.
Aflibercept vs. dexamethasone implant for recalcitrant diabetic macular edema in pseudophakic eyes – 1-year outcomes from a quazi-randomized study in India
Authors: Chakraborty Debdulal , Mondal Soumen , Sengupta Sabyasachi , Maiti Aniruddha , Boral Subhendu , Das Arnab , Sinha Tushar K , Nandi Krishnendu 
Published: April 2024

Purpose:
To assess the safety and efficacy of intravitreal Aflibercept (IVA) versus dexamethasone (DEX) implant for treating recalcitrant diabetic macular edema (DME) in pseudophakic eyes at 1-year follow-up.

Design:
Retrospective comparative case series.

Participants:
Data of all patients diagnosed with DME between January 2019 and December 2021, who underwent 4-monthly doses of intravitreal ranibizumab but had persistent DME [central macular thickness (CMT) within 10% of baseline value] were extracted from a computerized database. Of these, only pseudophakic eyes that underwent either IVA or DEX implant and had at least 1-year follow-up were included for analysis.

Methods:
DEX implant was preferred before December 2020 and IVA after this time point. In the IVA group, patients were followed up every month while DEX were followed at least every 3 months. Reinjections were considered when vision dropped by at least 1 Snellen’s line or CMT increased by at least 10% from the previous visit in both groups.

Main Outcome Measures:
Comparison of change in vision and CMT at 1-year follow-up in DEX versus IVA groups.

Results:
Eighty-four eyes of 84 patients aged 54.4 + 4.4 years were included, 39 (46%) received DEX and 45 (54%) received IVA. Groups were comparable for baseline vision and CMT. Vision improved equally in both groups from 0.83 + 0.15 logMAR to 0.52 + 0.10 logMAR at 3 months (P < 0.01) and then stabilized till 1 year. However, eyes in the IVA group were 6.5 times more likely (Odds ratio = 6.45, 95% CI = 1.3 – 31.9) to achieve >3-line improvement in vision. The CMT reduction was also comparable between groups (-169 + 51 in DEX vs. -174 + 49 in IVA, P = 0.67). More eyes in the IVA group required >3 injections (91% vs. 69% in DEX, P = 0.01). The IOP was significantly higher at 6 and 9 months in the DEX group and 5 eyes (13%) required IOP lowering medications.

Conclusion:
In pseudophakic eyes with recalcitrant DME not responding to ranibizumab, switching to IVA or DEX implant results in equal visual improvement and CMT reduction. Though >3-line improvement occurs more frequently with IVA, this comes at the expense of a greater number of injections and follow-up visits.