Background: Healthcare-associated infections (HAIs) are a major global threat to patient safety. Systematic surveillance is crucial for understanding HAI rates and antimicrobial resistance trends and to guide infection prevention and control (IPC) activities based on local epidemiology. In India, no standardized national HAI surveillance system was in place before 2017. Methods: Public and private hospitals from across 21 states in India were recruited to participate in an HAI surveillance network. Baseline assessments followed by trainings ensured that basic microbiology and IPC implementation capacity existed at all sites. Standardized surveillance protocols for central-line–associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) were modified from the NHSN for the Indian context. IPC nurses were trained to implement surveillance protocols. Data were reported through a locally developed web portal. Standardized external data quality checks were performed to assure data quality. Results: Between May 2017 and April 2019, 109 ICUs from 37 hospitals (29 public and 8 private) enrolled in the network, of which 33 were teaching hospitals with >500 beds. The network recorded 679,109 patient days, 212,081 central-line days, and 387,092 urinary catheter days. Overall, 4,301 bloodstream infection (BSI) events and 1,402 urinary tract infection (UTI) events were reported. The network CLABSI rate was 9.4 per 1,000 central-line days and the CAUTI rate was 3.4 per 1,000 catheter days. The central-line utilization ratio was 0.31 and the urinary catheter utilization ratio was 0.57. Moreover, 3,542 (73%) of 4,742 pathogens reported from BSIs and 868 (53%) of 1,644 pathogens reported from UTIs were gram negative. Also, 1,680 (26.3%) of all 6,386 pathogens reported were Enterobacteriaceae. Of 1,486 Enterobacteriaceae with complete antibiotic susceptibility testing data reported, 832 (57%) were carbapenem resistant. Of 951 Enterobacteriaceae subjected to colistin broth microdilution testing, 62 (7%) were colistin resistant. The surveillance platform identified 2 separate hospital-level HAI outbreaks; one caused by colistin-resistant K. pneumoniae and another due to Burkholderia cepacia. Phased expansion of surveillance to additional hospitals continues. Conclusions: HAI surveillance was successfully implemented across a national network of diverse hospitals using modified NHSN protocols. Surveillance data are being used to understand HAI burden and trends at the facility and national levels, to inform public policy, and to direct efforts to implement effective hospital IPC activities. This network approach to HAI surveillance may provide lessons to other countries or contexts with limited surveillance capacity.

Funding: None

Disclosures: None

A new facility for radiocarbon dating by accelerator mass spectrometry (AMS) was established in early 2015 at the Inter-University Accelerator Centre in New Delhi, India. The facility uses a 500 kV National Electrostatic Corporation (NEC) Pelletron accelerator for AMS measurements on graphite produced using the automated graphitization equipment (AGE) interfaced with an elemental analyzer and the carbonate handling system (CHS). A precision of better than 1‰ in the ratio of 14C/12C for the modern carbon sample and the background level of 1 × 10–15 from dead carbon sample has been achieved. This is the first dedicated accelerator of India only for AMS activities. This AMS system has the capabilities to perform 10Be and 26Al measurements as well.

Experiments were carried out with air as the test gas to obtain the surface convective heating rate and surface pressure distribution on blunt and sharp cone models flying at hypersonic speeds. Tests were performed in a hypersonic shock tunnel at two different angles of attack: ${0}^\circ$ and ${5}^\circ$ with angles of rotation $\phi = {0}^\circ, {90}^\circ$ , and ${180}^\circ$ . The experiments were conducted at a stagnation enthalpy of 1.4MJ/kg, flow Mach number of 6.56 and free stream Reynolds number based on the model length of $9.1 \times {10}^{5}$ . The effective test time of the shock tunnel is 3ms. The results obtained for cone model with a bluntness ratio of 0.2 were compared with sharp cone models for $\alpha ={0}^\circ$ . The measured stagnation heat transfer value matched well with the theoretical value predicted by the Fay and Riddell correlation and with the CFD results.

Cerebral malaria (CM) is the severe neurological complication causing acute non-traumatic encephalopathy in tropical countries. The mechanisms underlying the fatal cerebral complications are still not fully understood. Glutamate, a major excitatory neurotransmitter in the central nervous system of the mammalian brain, plays a key role in the development of neuronal cells, motor function, synaptic plasticity, learning and memory processes under normal physiological conditions. The subtypes of ionotropic glutamate receptor are N-methyl-D-aspartate receptors (NMDARs) which are involved in cellular mechanisms of learning and memory, synaptic plasticity and also mediate excitotoxic neuronal injury. In the present study, we found that glutamate level in synaptosomes, as well as expression of NMDAR, was elevated during the extreme condition of CM in C57BL6 mice. Arteether at 50 mg kg−1 × 1, 25 mg kg−1 × 2, days decreased the NMDAR expression and increased the overall survival of the experimental CM mice.

This study was undertaken with an aim of exploring community knowledge and treatment practices related to malaria and their determinants in high- and low-transmission areas of central India. A community-based cross-sectional study was carried out between August 2015 and January 2016 in two high- and two low-malaria-endemic districts of central India. A total of 1470 respondents were interviewed using a pre-tested structured interview schedule. Respondents residing in high-transmission areas with higher literacy levels, and of higher socioeconomic status, were found to practise more modern preventive measures than those living in low-transmission areas with low literacy levels and who were economically poor. Level of literacy, socioeconomic status and area (district) of residence were found to be the main factors affecting people’s knowledge of malaria aetiology and clinical features, and prevention and treatment practices, in this community in central India.

Invasive populations of Dalmation toadflax [Linaria dalmatica (L.) Mill.] and yellow toadflax (Linaria vulgaris Mill.) are widespread throughout the Intermountain West, where gene flow between these nonnative species is producing vigorous and fertile hybrids. These hybrid toadflax populations are less responsive to herbicides than either parent species, and biocontrol agents routinely released on L. dalmatica and L. vulgaris often fail to establish on hybrid hosts. Early detection of hybrid Linaria populations is therefore essential for effective management, but resources are limited for scouting large expanses of range and wildland. We used species distribution modeling to identify environmentally suitable areas for these invasive Linaria taxa in Montana, Wyoming, and Colorado. Areas suitable for hybrid Linaria establishment were estimated using two different modeling approaches: first, based on known hybrid occurrence and associated environmental conditions, and second, based on zones environmentally suitable for co-occurrence of the parent species. This also allowed comparison of different model outputs, especially relevant when modeling emerging invasives, such as novel hybrids, with minimal occurrence data. Combining the two model outputs identified areas at greatest risk of hybrid Linaria invasion, including parts of north-central Montana, where model estimates indicate the hybrid may spread without prior co-invasion of the parents. Potential hybrid hot spots were also identified in western Montana; northwestern, northeastern, and southeastern Wyoming; and the Western Slope and Front Range of Colorado. Despite relatively few confirmed occurrences of hybrid populations to date, our results indicate that extensive spread of hybrid populations is possible within the studied area. Model-based maps of potential Linaria distributions will allow area weed managers to direct limited resources more effectively for locating and controlling these invaders.

An important step towards developing a successful integrated pest management (IPM) programme for the control of banana pseudostem weevil, Odoiporus longicollis (Olivier), a serious pest of banana in India, is the study of the population structure of the pest. In the present study, the genetic variation among 30 individual weevils of O.longicollis collected from six different locations was assessed by analysing the primary nucleotide sequences of the rDNA ITS1 and ITS2 regions. AMOVA, Mantel test, and the maximum likelihood trees of the haplotypes failed to reveal any phylogeographic structuring, which was confirmed by haplotype analysis and genetic differentiation estimates. The results indicate that the locations are not differentiated, i.e. there is gene flow between the locations. The star-shaped networks revealed a signature of demographic expansion that was confirmed by the different demographic tests. These results provide important information, which is essential for the development of suitable strategies for the control of this banana pest, as well as management of its resistance to insecticides.

Interrupted aortic arch is a rare congenital anomaly in newborns and infants and is commonly associated with other cardiovascular anomalies. Here, we report an unusual case of type A interrupted cervical aortic arch associated with long segment coarctation of the descending thoracic aorta. Patent ductus arteriosus reconstituted the descending thoracic aorta. Proximal segments of the left common carotid and left subclavian arteries were atretic. Echocardiography-gated multidetector CT angiography not only identified the type of aortic arch interruption in the neonate but also delineated the exact anatomical details.

We could find a new 5 year periodicity in the occurrences of peaks in sunspot activity and inferred deviations of annual Indian monsoon rainfall variations from the normal during the Maunder minimum (MM) period. This result is explained in terms of solar dynamo functioning in a different mode from normal during the MM where quadrupole field (first harmonic, 5-5.5 years) dominate over dipole field (fundamental, 11 years) causing extreme north south asymmetry in sunspot activity.

The Murshidabad District of West Bengal, India has practised traditional mulberry sericulture since time immemorial. One of the most important aspects for sustainable development of the sericulture industry is the control and prevention of silkworm diseases. The main objective of this study was to determine silkworm disease incidence over the period 1992–2011 in Murshidabad District and how environmental factors have contributed towards their occurrence. Data were collected from a crop-wise survey of silkworm diseases from 25 farmers (five farmers from five villages), who each had a separate rearing house, were progressive and had a capacity of rearing at least 100 disease free layings (dfls) in each crop. Disease incidence was expressed in percentage and calculated taking into consideration 40,000 larvae per 100 dfls. Crop-wise silkworm disease mortality data were correlated with meteorological data. Data collected from the continuous survey conducted in the district during 1992–2011 revealed that there was no set pattern of occurrence of silkworm diseases. However, maximum mortality (up to 30%) of silkworm due to diseases in all the seasons occurred mainly due to grasserie, as relative humidity remains high for most part of the year in this area. However, other than grasserie, for most of the period, disease incidence was below 10%. This observation of the dominance of grasserie over other diseases in causing silkworm mortality calls for renewed emphasis on the preventive measures and development of disease forecasting models, for disease control. Another observation was that since 1993, pebrine, the deadliest disease of the silkworm, has not been reported from the farmers’ fields.

Cosmopolites sordidus (Germar), commonly known as banana corm weevil, is an important economic pest in Asia that can cause severe yield loss depending upon the stage at which infestation occurs. In spite of its economic importance, little is known about the population structure of this pest in India. Random amplified polymorphic DNA (RAPD) and amplified fragment length polymorphism (AFLP) were used to characterize the population genetic structure of C. sordidus collected from five hot spot locations in India. Nineteen RAPD primers and five selective AFLP primer combinations generated 147 and 304 amplification products, respectively. UPGMA dendrograms generated with both marker systems failed to reveal populations clustered based on geographic distance, which was confirmed by the Mantel test, which did not show a strong correlation between genetic distance and geographic distance. Values of indices of genetic identity showed that the populations were closely related. Though the gene flow estimate (Nm) between the populations was 0.469, suggesting restricted gene flow, the populations are not genetically distinct. These observations suggest that the range expansion of this banana pest in India has taken place through transport of infested corms and plant material, resulting in genetically close populations that are geographically distinct. These results provide important information on the population structure of this pest in India, which will aid in designing suitable strategies for its control and management, especially with respect to insecticide resistance.

The present experiment was undertaken to validate a probiotic of canine origin for its potential use in dogs. A total of fifteen adult female Labrador dogs were allocated to three equal groups and fed a basal diet without probiotic (control) or with probiotic of either canine (Lactobacillus johnsonii CPN23; cPRO) or dairy (L. acidophilus NCDC 15; dPRO) origin for 9 weeks. The digestibility of most macronutrients remained similar among the groups; however, fibre digestibility was improved (P = 0·034) in dogs receiving cPRO. The faecal fermentative metabolites ammonia (P < 0·05) and lactate (P = 0·094) were altered favourably, indicating a positive influence of both probiotics. Faecal concentrations of acetate, propionate and butyrate were increased (P < 0·01) in both probiotic groups. However, improvements were higher in cPRO v. dPRO. The delayed-type hypersensitivity reaction to intradermal inoculation of phytohaemagglutinin-P was higher (P = 0·053) in cPRO as compared with control. The antibody response to sheep erythrocytes was, however, similar across the three groups. Overall, in dogs, the canine-origin probiotic was superior when compared with the dairy-origin probiotic.

Objectives: Zika virus (ZikaV) is currently one of the most important emerging viruses in the world which has caused outbreaks and epidemics and has also been associated with severe clinical manifestations and congenital malformations. Traditional approaches to combat the ZikaV outbreak are not effective for detection and control. The aim of this study is to propose a cloud-based system to prevent and control the spread of Zika virus disease using integration of mobile phones and Internet of Things (IoT).

Methods: A Naive Bayesian Network (NBN) is used to diagnose the possibly infected users, and Google Maps Web service is used to provide the geographic positioning system (GPS)-based risk assessment to prevent the outbreak. It is used to represent each ZikaV infected user, mosquito-dense sites, and breeding sites on the Google map that helps the government healthcare authorities to control such risk-prone areas effectively and efficiently.

Results: The performance and accuracy of the proposed system are evaluated using dataset for 2 million users. Our system provides high accuracy for initial diagnosis of different users according to their symptoms and appropriate GPS-based risk assessment.

Conclusions: The cloud-based proposed system contributed to the accurate NBN-based classification of infected users and accurate identification of risk-prone areas using Google Maps.

In the open Southern Ocean (SO), both modern and past size changes of the diatom Fragilariopsis kerguelensis appear to be strongly controlled by iron availability. Conversely, sea surface temperatures (SST) and sea ice seasonal dynamics take over in the seasonal sea-ice zone where iron is not limiting. No information exists on F. kerguelensis biometry from the subtropical SO, on the other extreme of the thermal and nutrient gradients. We present here new data on mean valve area of F. kerguelensis (FkergArea) from a sediment core covering the last ~42 cal kyrs from the southern Subtropical Front (SSTF) of the Indian sector of the SO, where iron and silica stocks are thought to have been consistently low over this period. Our results suggest that larger F. kerguelensis valves occurred during the Last Glacial period, and declined during the Holocene period. These findings indicate that more favourable SST, within the F. kerguelensis ecological range, during the Last Glacial period may have enabled F. kerguelensis to make better use of the low silica stocks prevailing in the subtropical zone leading to larger valves. Conversely, declining FkergArea during the deglacial and the Holocene periods may have been a result of higher SST which hampered the utilization of silica.

Cerebral malaria (CM) shows lethality rate of 15–25% despite effective antimalarial chemotherapy. The effective adjunct treatment to counteract the CM pathogenesis is urgently required. In murine CM model, most interventions studied till date are administered before the onset of CM symptoms, which belittle its translational value to human. We studied intramuscular arteether–vitamin D (ART–VD) combination treatment for CM outcome improvement after the onset of neurological symptoms. The intramuscular dose of 50 µg kg−1 VD for 3 days combined with a loading dose of 25 mg kg−1 α/β arteether followed by 12·5 mg kg−1 dose for two consecutive days led to significant improvement in survival (73% in combination group vs 29 and 0% in arteether and VD monotherapy, respectively) and clinical recovery. The treatment in all the groups partially restored the blood–brain barrier integrity and reduced the level of serum proinflammatory cytokines tumour necrosis factor-α and interferon-γ. The brain transcripts of inflammatory chemokines viz. CXCL10, CXCL9, CCL4 and CCL5 and T cell migration in the brain microvasculature were significantly diminished in all the treatment groups. ART–VD treatment significantly reduced intercellular cell adhesion molecule-1 expression. Taken together, our findings show that coordinated actions of ART–VD improve the outcome of experimental CM.